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PACIENTES PRESTACIONES MONTO FARMACIA MONTO TOTAL

LEON PUMACAHUA ANDRES E001 - 306 237.00 E001 - 307 51.92 288.92
ARVILDO LOJA ADRIEL JACOB E001 - 304 139.00 E001 - 305 5.10 144.10
VILCA HUAMAN MOISES E001 - 302 421.00 E001 - 303 51.54 472.54
RAMIREZ HUAMAN ISAIAS ESTEBAN E001 - 300 74.00 E001 - 301 0.83 74.83
LANAZCA TAYPE BRYAN PIERO E001 - 298 117.00 0.00 117.00
SANCHEZ LEON CARLOS EDUARDO E001 - 292 366.00 E001 - 293 35.67 401.67
TIBURCIO FLORES LEONARDO E001 - 294 6,059.00 E001 - 297 554.44 6,613.44
TOTAL: 7,413.00 699.50 8,112.50

PACIENTES PRESTACIONES MONTO FARMACIA MONTO TOTAL


PACHECO TORRES JUAN RANULFO E001 - 334 87.00 E001 - 311 5.26 92.26
GARCIA MONTALVAN RICHARD ALEXANDER E001 - 308 161.00 E001 - 309 1.50 162.50
PLASENCIA GARCIA ROSA ELENA E001 - 312 70.00 E001 - 315 38.48 108.48
ZAMBRANO RAMIREZ JONATHAN E001 - 316 57.38 57.38
ZELAYA SOLIS EMERSON ALEXANDRO E001 - 317 966.00 E001 - 318 84.24 1,050.24
MACHAY SOLANO SANTA CELESTINA E001 - 332 161.00 E001 - 333 2.49 163.49
SANCHEZ RIVERA RICHARD E001 - 330 155.00 E001 - 331 34.85 189.85
SALAZAR CHIPANA MAXIMILIANO E001 - 326 53.00 E001 - 327 3.18 56.18
VALLE MEJIA AMALIA FRANCISCA E001 - 324 98.00 E001 - 325 1.28 99.28
ATOCHE DIAZ NYDIA BERENICE E001 - 322 148.00 E001 - 323 3.51 151.51
SALAZAR CHIPANA MAXIMILIANO E001 - 319 86.00 E001 - 320 32.18 118.18
TOTAL: 2,042.38 206.97 2,249.35

10,361.85

AFOCAT LIMA METROPOLITANA

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 MUJICA DE LA CRUZ ROCIO KARINA E001 - 379 272.81 E001 - 378 2,171.00 2,443.81 2635 - 9F 20515915185
02 REQUEJO VASQUEZ MARIA LEONILDA E001 - 380 99.00 99.00 9458 - 3C 20515915185
03 QUIROZ HUAPAYA GERZON VLADIMIR E001 - 382 33.00 33.00 4790 - 5C 20515915185
04 CORONADO DELGADO CLEOFE E001 - 384 104.00 104.00 F7L - 870 20515915185
05 CASTILLO SUAREZ JUDITH COROMOTO E001 - 387 0.63 E001 - 386 110.00 110.63 B5 - 6809 20515915185
06 PALPA CARDENAS MARIA ELENA E001 - 389 2.71 E001 - 388 89.00 91.71 D4J - 695 20515915185
07 ALVARADO ALIAGA PRISCILA BRENDA E001 - 392 3.68 E001 - 391 148.00 151.68 C1 - 7267 20515915185
08 ESPINOZA SALON ANGELY STEFANY E001 - 395 0.27 E001 - 393 38.00 38.27 4766 - NA 20515915185
09 REATEGUI LA TORRE JERRY E001 - 398 0.80 E001 - 396 45.00 45.80 2944 - 9F 20515915185
10 CRUZ SOTO ALCIDES VETRIMINIO E001 - 403 72.39 E001 - 405 516.00 588.39 0310 - 3A 20515915185
11 VASQUEZ JIMENEZ MILAGROS JESUS E001 - 409 3.53 E001 - 408 153.00 156.53 B9 - 8460 20515915185
12 CAMAN SALON CINDY RUBI E001 - 412 0.27 E001 - 410 38.00 38.27 4766 - NA 20515915185
13 LIMACHI HUAYCANI ROCIO E001 - 414 85.00 85.00 NG - 56406 20515915185
14 OLIVARES FERNANDEZ ROXANA E001 - 416 33.00 33.00 1759 - 2D 20515915185
15 QUIROZ SANDONAZ BELIZARIO FIDENCIO E001 - 417 33.00 33.00 1921 - 8C 20515915185
16 QUIROZ SANDONAZ BELIZARIO FIDENCIO E001 - 420 66.00 66.00 1921 - 8C 20515915185
17 MORE SANDOVAL VALERIA E001 - 423 0.62 E001 - 422 131.00 131.62 398 - 3D 20515915185
18 TIBURCIO RAMIREZ JUAN JESUS JUNIOR E001 - 426 1.31 E001 - 425 75.00 76.31 F7N - 544 20515915185
19 MANTARI TARAZONA NIDIT YERALDINE E001 - 428 1.41 E001 - 427 75.00 76.41 F7N - 544 20515915185
20 CURO GAMARRA ROSARIO SOLEDAD E001 - 430 1.21 E001 - 429 45.00 46.21 F7L - 870 20515915185
21 ECO FLORES YOVANA E001 - 434 1.32 E001 - 435 131.00 132.32 F7L - 870 20515915185
22 TAIPE CRISPIN BLASIDA E001 - 440 25.10 E001 - 439 392.00 417.10 1335 - 0A 20515915185
23 ESPINOZA SALON CAMILA DESIRHE E001 - 442 0.25 E001 - 441 38.00 38.25 4766 - NA 20515915185
24 SALON ROJAS KEILA E001 - 444 1.50 E001 - 443 38.00 39.50 4766 - NA 20515915185
25 QUIROZ SANDONAZ BELIZARIO FIDENCIO E001 - 446 19.10 E001 - 445 33.00 52.10 1921 - 8C 20515915185
26 PINEDO LANZA GLORIA ELIZABETH E001 - 449 2.14 E001 - 447 93.00 95.14 B3A - 671 20515915185
27 QUIROZ SANDONAZ BELIZARIO FIDENCIO E001 - 451 11.10 E001 - 450 66.00 77.10 1921 - 8C 20515915185
28 PASION NORABUENA JYOMIRA SURYKO E001 - 437 0.62 E001 - 436 75.00 75.62 B7C - 642 20515915185
29 PASTRANA VILCHEZ LUANA AYELEN E001 - 432 0.62 E001 - 431 45.00 45.62 1461 - 5F 20515915185
30 QUIROZ SANDONAZ BELIZARIO FIDENCIO E001 - 453 2.40 E001 - 452 33.00 35.40 1921 - 8C 20515915185
31 CABELLO FERNANDEZ LEONOR DEMETRIO E001 - 459 0.41 E001 - 458 45.00 45.41 0622 - 4A 20515915185
32 CABELLO MESARAY BRYAN ISAIAS E001 - 457 0.18 E001 - 456 38.00 38.18 0622 - 4A 20515915185
33 CASTAÑEDA GARAY KENYI FABIAN E001 - 461 0.41 E001 - 460 45.00 45.41 3615 - IA 20515915185
34 CABELLO FERNANDEZ HAYDEE EDITH E001 - 455 0.41 E001 - 454 45.00 45.41 0622 - 4A 20515915185
35 RODRIGUEZ HUAMAN MANUEL E001 - 463 6.14 E001 - 462 104.00 110.14 4769 - 9A 20515915185
36 CORREA MENDOZA JULIO ALEJANDRO E001 - 465 1.58 E001 - 646 74.00 75.58 7262 - 7A 20515915185
37 ZELADA ABANTO DIONICIO E001 - 467 8.78 E001 - 466 93.00 101.78 7262 - 7A 20515915185
38 CAPUÑAY CHAVEZ JUAN ANTONIO E001 - 470 5.86 E001 - 469 222.00 227.86 B8 - 8579 20515915185
39 TERAN RAMIREZ ROGER ELVIS E001 - 472 1.21 E001 - 471 45.00 46.21 2944 - 9F 20515915185
40 ROBLES VASQUEZ JHOJAN E001 - 475 2.40 E001 - 473 38.00 40.40 AO - 6810 20515915185
41 TIMOTEO MEZA PAMELA YISELA E001 - 477 43.31 E001 - 476 94.00 137.31 AO - 6810 20515915185
42 TORRES LOPEZ THIAGO E001 - 480 36.87 E001 - 479 71.00 107.87 9010 - 8A 20515915185
43 DELELMA MEDINA GUEVARA E001 - 483 14.11 E001 - 482 397.00 411.11 1449 - FA 20515915185
44 VASQUEZ PEREZ YUSSEL E001 - 485 11.64 E001 - 484 74.00 85.64 AO - 6810 20515915185
45 VASQUEZ ZORRILLA MAYA EMA E001 - 505 1.28 E001 - 504 213.00 214.28 1335 - OA 20515915185
46 VARILLAS CASTELLARES GUISELLY JHOYSI E001 - 507 0.88 E001 - 506 45.00 45.88 3022 - 9B 20515915185
47 RODRIGUEZ CASTELLARES DYLAN ANDREW E001 - 509 3.20 E001 - 508 38.00 41.20 3022 - 9B 20515915185
48 PACHERRES LUJAN VIVIANA CARMEN E001 - 511 14.36 E001 - 510 94.00 108.36 F7L - 870 20515915185
49 VALENCIA ACUACHE ESPERANZA JANET E001 - 513 2.71 E001 - 512 149.00 151.71 1389 - 6F 20515915185
50 ESPINOZA GUZMAN JABES ISAC E001 - 515 85.00 85.00 7280 - 9C 20515915185
51 CRUZ SOTO VETRIMINIO E001 - 517 4.94 E001 - 516 423.00 427.94 0310 - 3A 20515915185
TOTAL: 586.47 7,463.00 8,049.47

RIMAC SEGUROS Y REASEGUROS

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 FLORIAN VALLE KAROL BENYRAND E001 - 553 16.63 E001 - 552 65.00 81.63 F3M - 814 20100041953
02 ÑAHUILLA ARIAS HILARA SALUSTIANA E001 - 555 97.00 97.00 A8Y - 782 20100041953
03 SOLIS QUISPE AURORA DE GUADALUPE E001 - 557 2.55 E001 - 556 100.00 102.55 APT - 929 20100041953
04 ROSALES RODRIGUEZ JOSE LUIS E001 - 559 17.30 E001 - 558 95.00 112.30 D5A - 927 20100041953
05 GUILLEN BRITO LUIS DANIEL E001 - 560 86.00 86.00 A3E - 736 20100041953
06 CUYA PEÑA JANETH LIZETH E001 - 563 0.70 E001 - 562 62.00 62.70 C8W - 780 20100041953
07 HAVEZ GRANADOS MARIA CRISTINA E001 - 565 10.70 E001 - 564 33.00 43.70 AHR - 582 20100041953
08 MATIENZO ROBLES ANTUANET SARITA E001 - 567 2.58 E001 - 566 157.00 159.58 APV - 861 20100041953
09 TUMBAY PALACIOS JOSUE ALEXANDER E001 - 569 14.16 E001 - 568 186.00 200.16 3333 - 1D 20100041953
10 GUAMAN OROSCO OLGA E001 - 571 0.48 E001 - 570 45.00 45.48 AMB - 925 20100041953
11 BENDEZU OROSCO VICTORIA E001 - 573 1.21 E001 - 572 154.00 155.21 AMB - 925 20100041953
12 LOPEZ CARRILLO LOURDES PAULINA E001 - 576 2.00 E001 - 574 68.00 70.00 A3E - 736 20100041953
13 LOAYZA BRAVO KATHERINE FALENI E001- 578 1.32 E001 - 577 45.00 46.32 B4R - 354 20100041953
14 CORDOVA RIVERA JUAN CARLOS E001 - 580 11.41 E001 - 579 86.00 97.41 ABL - 189 20100041953
15 ORELLANA BOULLOZA ANGELA ISABEL E001 - 582 1.21 E001 - 581 167.00 168.21 A0U - 793 20100041953
16 JAMANCA SUAREZ EDITH LAGOS E001 - 585 7.70 E001 - 584 200.00 207.70 AYP - 587 20100041953
17 NICOLLE DE LOS SANTOS REIMI FERRARI E001 - 586 38.00 38.00 A3E - 736 20100041953
18 SANTISTEBAN QUISPE NILTON E001 - 587 38.00 38.00 340 - 9F 20100041953
19 ALVA BAUTISTA MIGUEL ANGELO E001 - 588 63.00 63.00 B3X - 752 20100041953
20 HUANCAS CUEVA JILTON E001 - 590 1.69 E001 - 589 88.00 89.69 AVQ - 354 20100041953
21 LUYA MELGAREJO BRUCE ABRAHAM FRANCISCO E001 - 592 25.90 E001 - 591 257.00 282.90 ANF - 827 20100041953
22 SANCHEZ SEMINO WILLIAM GUSTAVO E001 - 594 58.32 E001 - 593 502.00 560.32 AWF - 141 20100041953
23 CHAVEZ LLALLICO JUAN CESAR E001 - 596 207.92 E001 - 595 1,844.00 2,051.92 B3I - 766 20100041953
TOTAL: 383.78 4,476.00 4,859.78

MAPFRE PERÚ COMPAÑÍA DE SEGUROS

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 CAMA GARCIA ROSA MARIA E001 - 603 2.50 E001 - 602 171.00 173.50 ALO - 792 20202380621
02 PAPUICO NORIEGA LESSLI NICOL E001 - 605 2.77 E001 - 604 127.00 129.77 AJP - 112 20202380621
03 LEON JARA MARIO EMILIANO E001 - 607 6.62 E001 - 606 85.00 91.62 AHZ - 462 20202380621
TOTAL: 11.89 383.00 394.89

BNP PARIBAS CARDIF S.A

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 ESPINOZA JAIME LIZBETH E001 - 599 116.00 116.00 APR - 598 20513328819
02 HEREDIA MANRIQUE JESUS ALBERTO E001 - 600 160.00 160.00 AC - 8047 20513328819
TOTAL: 0.00 276.00 276.00

PROTECTA S.A COMPAÑÍA DE SEGUROS

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 LIVIAC GUARDIA MARIBEL JULIA E001 - 608 38.00 38.00 Z2E - 270 20517207331
02 CASTILLO ALCANTARA CARLOS JESUS E001 - 610 56.00 56.00 2756 - 1C 20517207331
03 MENACHO FERRUA YEYSON E001 - 611 45.00 45.00 A5 - 1111 20517207331
04 CAMPOS MEJIA WILMAN EDINSON E001 - 614 29.57 E001 - 612 148.00 177.57 0843 - BA 20517207331
05 ANAYA CUBA VIANIT ESTRELLA E001 - 616 30.89 E001 - 615 267.00 297.89 4355 - 6D 20517207331
TOTAL: 60.46 554.00 614.46

LA POSITIVA SEGUROS Y REASEGUROS

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 MORI VASQUEZ THALIA ELIZABETH E001 - 503 33.00 33.00 D8D - 341 20100210909
02 GARCIA ALEJOS SHIRLEY MIREYA E001 - 597 79.00 79.00 D10 - 163 20100210909
03 GUILLEN LOPEZ ABRIL ALIZZE E001 - 502 38.00 38.00 3097 - 7D 20100210909
04 ARRIOLA ISIDRO AARON FABRIZIO E001 - 501 38.00 38.00 B6Z - 751 20100210909
05 BERNUY RAMIREZ LISHET NOEMI E001 - 498 38.00 38.00 1621 - 2V 20100210909
06 CASTILLO HUAYNAPATA CESAR WILMER E001 - 514 6.31 E001 - 500 94.00 100.31 A2X - 768 20100210909
07 MARTINEZ CALLA ROXANA GABRIELA E001 - 519 1.91 E001 - 497 45.00 46.91 B6V - 758 20100210909
08 SOTO DE AYALA ALEJANDRINA FELICITA E001 - 496 45.00 45.00 D6M - 143 20100210909
09 FERNANDEZ RAMIREZ SAMUEL DAVID E001 - 520 1.32 E001 - 495 75.00 76.32 APC - 178 20100210909
10 MEDINA QUISPE LEWTONG ANDRE E001 - 494 33.00 33.00 C2A - 790 20100210909
11 GARCIA ALEJOS SHIRLEY MIREYA E001 - 493 33.00 33.00 D10 - 163 20100210909
12 GARCIA ALEJOS SHIRLEY MIREYA E001 - 492 33.00 33.00 D10 - 163 20100210909
13 GARCIA ALEJOS SHIRLEY MIREYA E001 - 490 56.00 56.00 D10 - 163 20100210909
14 GARCIA ALEJOS SHIRLEY MIREYA E001 - 521 2.32 E001 - 491 113.00 115.32 D10 - 163 20100210909
15 TREJO NORABUENA DOLORES E001 - 522 5.74 E001 - 489 33.00 38.74 D3Q - 153 20100210909
16 TICRA DURAN ALBERTO EMER E001 - 488 33.00 33.00 ASM - 761 20100210909
17 RODRIGUEZ LAÑAS MATHIAS DOMINICK E001 - 487 33.00 33.00 B5H - 862 20100210909
18 MAYO RAMIREZ JUAN RENATO E001 - 486 33.00 33.00 5447 - 2F 20100210909
19 GUTIERREZ FLORES MOISES E001 - 481 33.00 33.00 D5D - 499 20100210909
20 SUSAYA CABALLERO LUIS E001 - 474 53.00 53.00 D9S - 382 20100210909
21 RAMIREZ TADEO JESUS E001 - 424 99.00 99.00 F7K - 189 20100210909
22 PACHECO TELLO ENZO DAVID E001 - 419 82.00 82.00 AMD - 524 20100210909
23 TOLEDO AYALA JAIR ALEJANDRO E001 - 411 58.00 58.00 2038 - 2F 20100210909
24 SUSAYA CABALLERO LUIS E001 - 404 55.00 55.00 D9S - 382 20100210909
25 KOVACH ALVARADO JORGE LUIS E001 - 397 38.00 38.00 ASL - 686 20100210909
26 MUNDACA TARRILLO ROBERTO JOSE E001 - 399 66.00 66.00 2694 - 5A 20100210909
27 HUERTA AGUIRRE RUDY BILL E001 - 402 78.00 78.00 9279 - 6B 20100210909
28 CANO CONDOR SANDRA E001 - 383 38.00 38.00 C6N - 005 20100210909
29 DAKOTA CORTEZ SHERLYN VAYOLETH E001 - 377 38.00 38.00 C6N - 005 20100210909
30 DEL VALLE SICUS CLAUDIA E001 - 376 45.00 45.00 A8F - 936 20100210909
31 ACOSTA ALIAGA NANCY MANUELA E001 - 523 2.22 E001 - 361 108.00 110.22 AT - 479 20100210909
32 RAMIREZ CHEPE HENRY MIGUEL E001 - 525 2.22 E001 - 478 93.00 95.22 B7G - 010 20100210909
33 FERNANDEZ ARELLAN FLAVIO E001 - 295 1.20 E001 - 296 82.00 83.20 ALW - 368 20100210909
34 LOPEZ RUIZ JENNY CARETH E001 - 526 1.55 E001 - 363 68.00 69.55 AZT - 479 20100210909
35 ACOSTA COBEÑAS MARILYN E001 - 527 1.59 E001 - 364 131.00 132.59 AZT - 479 20100210909
36 MELANIE DAYANA DIEGO ENEQUE E001 - 528 23.40 E001 - 365 93.00 116.40 M1E - 735 20100210909
37 LIMA MEZA ROSA DE LOS ANGELES E001 - 299 2.23 E001 - 313 134.00 136.23 ATK - 848 20100210909
38 RODRIGUEZ GONZALES JAIRO JHAIR E001 - 353 14.02 E001 - 314 161.00 175.02 0481 - 5F 20100210909
39 HUAMANTICO DE ESPINAL IDALIA E001 - 347 1.32 E001 - 321 45.00 46.32 F5R - 405 20100210909
40 MARCELO POMIANO DANIEL E001 - 341 1.50 E001 - 329 146.00 147.50 0463 - 4D 20100210909
41 MARCELO POMIANO LIZET E001 - 337 10.68 E001 - 328 65.00 75.68 0463 - 4D 20100210909
42 ALARCON RAMIREZ JOSE CALIN E001 - 358 1.28 E001 . 354 135.00 136.28 A1 - 0212 20100210909
43 ERNANDES CUEVA DILASB E001 - 360 6.00 E001 - 352 45.00 51.00 APC - 178 20100210909
44 DAVILA VILLAVICENCIO YESENIA ANAELI E001 - 351 45.00 45.00 1621 - 2V 20100210909
45 NUÑEZ TORRES KATHERINE GRACE E001 - 367 0.45 E001 - 348 45.00 45.45 D6M - 143 20100210909
46 MONTENEGRO PEDRAZA HERMEL E001 - 370 10.52 E001 - 346 65.00 75.52 F9E - 781 20100210909
47 AMADOR ESPINOZA ENCISO E001 - 345 38.00 38.00 ASL - 686 20100210909
48 HIDALGO ROSALES EDITH REYNA E001 - 342 38.00 38.00 ASW - 003 20100210909
49 CACERES SHUAN MARICIELO PAMELA E001 - 385 0.61 E001 - 340 88.00 88.61 B3P - 756 20100210909
50 CASTILLO FARFAN JHAIR KHAR E001 - 394 2.01 E001 - 335 153.00 155.01 7624 - 7C 20100210909
51 UNTOL LAGUNA ELEN CLEMENCIA E001 - 418 0.57 E001 - 359 93.00 93.57 T5O - 679 20100210909
52 TARAZONA SAUCEDO CRISTOPHER ANTHONNY E001 - 438 51.53 E001 - 357 203.00 254.53 9501 - 8F 20100210909
53 ROJAS ROJAS EVER JESUS E001 - 448 10.96 E001 - 356 86.00 96.96 M1E - 871 20100210909
54 SILVA CUBAS REGULO WILMER E001 - 530 17.09 E001 - 349 182.00 199.09 1540 - LM 20100210909
55 SUSAYA CABALLERO LUIS E001 - 468 33.00 33.00 D9S - 382 20100210909
56 CORDOVA LOPEZ ANASILVIA E001 - 529 1.21 E001 - 350 45.00 46.21 M1I - 509 20100210909
57 ESCALANTE MEDRANO DIOCORIDES ELEUTERIO E001 - 531 1.78 E001 - 421 179.00 180.78 5547 - 7D 20100210909
58 OTAROLA RAMOS DAVID CRISTIAN E001 - 532 4.38 E001 - 339 148.00 152.38 AWL - 743 20100210909
59 CARHUAYO LUPACA FERNANDO FIDEL E001 - 533 1.21 E001 - 355 170.00 171.21 B9A - 201 20100210909
60 PARADA PEREZ JUAN CARLOS E001 - 534 1.48 E001 - 343 68.00 69.48 ASU - 753 20100210909
61 ZENOBIA VALVERDE POLINARIO E001 - 535 4.80 E001 - 415 33.00 37.80 B6U - 965 20100210909
62 QUIÑONES LLALLAHUE GERALDINE MARIA E001 - 536 6.68 E001 - 413 100.00 106.68 2038 - 2F 20100210909
63 MONGE VASQUEZ DAVID ADRIAN E001 - 539 3.41 E001 - 537 101.00 104.41 0297 - AF 20100210909
64 SALAZAR ACUÑA MANUEL MARINO E001 - 541 33.00 33.00 C3M - 464 20100210909
65 CARRASCO GARCIA RENZO E001 - 543 93.00 93.00 H2F - 119 20100210909
66 MORI VASQUEZ THALIA ELIZABETH E001 - 544 0.70 E001 - 546 56.00 56.70 D8D - 341 20100210909
67 QUILLA ORCCON ANA ISABEL E001 - 538 1.22 E001 - 407 177.00 178.22 ACW - 535 20100210909
68 FALCON RMERO RANDALL STEVENS E001 - 540 2.78 E001 - 406 104.00 106.78 ARI - 200 20100210909
69 ENEQUE QUICIO YOVANA E001 - 542 18.30 E001 - 372 122.00 140.30 A1E - 735 20100210909
70 BASAURI REA KAREN ROCIO E001 - 547 3.05 E001 - 374 170.00 173.05 ARX - 120 20100210909
71 RETUERTO VERGARA ERNESTO E001 - 545 10.00 E001 - 375 157.00 167.00 1210 - 4F 20100210909
72 VEGA NAVARRO JORGE LUIS E001 - 548 2.39 E001 - 373 75.00 77.39 ARX - 120 20100210909
73 ORTIZ CARRASCO JEAN FRANCO E001 - 549 2.82 E001 - 371 133.00 135.82 3125 - 8D 20100210909
74 NUÑEZ ZAMORA MARIA GLADYS E001 - 550 3.91 E001 - 369 168.00 171.91 F6B - 833 20100210909
75 CAZORLA GUZMAN JEAN PIERRE E001 - 551 11.54 E001 - 368 133.00 144.54 3444 - 3C 20100210909
76 MUNDACA TARRILLO ROBERTO JOSE E001 - 561 2.88 E001 - 400 66.00 68.88 2694 - 5A 20100210909
77 MORALES NUÑEZ ORGE E001 - 554 4.37 E001 - 381 100.00 104.37 ARI - 200 20100210909
78 MORI VASQUEZ THALIA ELIZABETH E001 - 583 112.00 112.00 D8D - 341 20100210909
79 RUBIO REATEGUI HARRY PETTER E001 - 641 21.54 E001 - 638 222.00 243.54 3003 - 5D 20100210909
80 ZENOBIA VALVERDE POLINARIO E001 - 642 442.61 E001 - 637 6,548.32 6,990.93 B6U - 965 20100210909
81 RAIVIS PANAIFO SANGAMA E001 - 643 2.11 E001 - 629 173.00 175.11 0166 - AA 20100210909
82 ROCARDO GERMAN VERA CASTAÑEDA E001 - 644 445.33 E001 - 630 1,160.08 1,605.41 5668 - AA 20100210909
83 SALAZAR ROJAS LYAN YHASIR E001 - 645 3.86 E001 - 631 124.00 127.86 F7Q - 128 20100210909
84 TINOCO LEON YOKO NAOKI LUHANA E001 - 646 8.04 E001 -632 58.00 66.04 AYI - 908 20100210909
85 TITO LUIS ENECE UCEDA E001 - 647 15.25 E001 - 633 138.00 153.25 L4 - 7391 20100210909
86 RONALD MARIO CHOQUE QUIROZ E001 - 640 28.53 E001 - 639 389.00 417.53 NI - 24927 20100210909
87 VILLAFANA VEGA LUIS DAVID E001 - 648 4.20 E001 - 635 172.00 176.20 3785 - DA 20100210909 176.2
88 WILDER CABELLO MALPARTIDA E001 - 650 0.62 E001 - 636 89.00 89.62 C1R - 944 20100210909 89.62
89 RAMIREZ RUEDA MARIA ANTONIETA E001 - 652 1.13 E001 - 628 133.00 134.13 C6R - 604 20100210909
90 AVGERINOS VEGA YANNYS ARTURO E001 - 653 2.76 E001 - 622 89.00 91.76 BO - 1642 20100210909
91 BALDERA VIDAURRE OMAR E001 - 655 2.16 E001 - 623 119.00 121.16 2180 - MA 20100210909
92 CESPEDES BETETA MARCELINA E001 - 656 2.71 E001 - 624 149.00 151.71 AUP - 798 20100210909
93 VICTOR MANUEL PEÑA BARRAZUELA E001 - 609 6.00 E001 - 598 116.00 122.00 A61 - 645 20100210909 134.13
94 VELASQUEZ VALDIVIA JAMIR ALONSO E001 - 620 6.22 E001 - 338 118.00 124.22 C1A - 891 20100210909 91.76
95 CHAVARRIA CARHUAPOMA LISETH YANIRET E001 - 618 1.32 E001 - 621 105.00 106.32 ASO - 117 20100210909 121.16
96 ANGELES DIAZ ROSA MARIA E001 - 390 0.73 E001 - 336 100.00 100.73 AEK - 926 20100210909 612.87
97 CAMPOS MORA SOLE RICARDO E001 - 651 1.21 E001 - 625 198.00 199.21 6366 - 7D 20100210909
98 CARLOS SANTIAGO RIVERA SULLCARAY E001 - 654 37.80 E001 - 626 1,303.00 1,340.80 0700 - LA 20100210909
99 CALERO PACHECO MARIA ELENA E001 - 657 32.49 E001 - 627 166.00 198.49 3728 - SA 20100210909
100 AYALA GALVEZ DAYRON JARETN E001 - 658 13.00 E001 - 499 93.00 106.00 A7Z - 753 20100210909
101 UTIA AQUITUARI FRANG LENER E001 - 649 143.20 E001 - 634 508.00 651.20 DOW - 931 20100210909
102 MONTERO RODRIGUEZ ALFREDO ALEX E001 - 676 1.60 E001 - 675 105.00 106.60 AKN - 362 20100210909
103 MOSCOL CULQUE JHON HENRRY E001 - 674 25.66 E001 - 673 123.00 148.66 4343 - 4W 20100210909
104 MAYO RAMIREZ JUAN RENATO E001 - 672 20.44 E001 - 671 206.00 226.44 5447 - 2F 20100210909
105 OCAÑA JUAREZ LIDIA E001 - 668 11.71 E001 - 667 239.00 250.71 F5W - 810 20100210909
106 VERA CASTAÑEDA RICARDO GERMAN E001 - 663 26.03 E001 - 666 1,097.00 1,123.03 5668 - AA 20100210909
107 MINAYA NUÑEZ CINTHIA JUDITH E001 - 665 1.91 E001 - 662 121.00 122.91 M1I - 509 20100210909
108 SOLIS CORTEZ LIZ VANESSA E001 - 659 58.00 58.00 A7Z - 753 20100210909
109 SOLIS CORTEZ LIZ VANESSA E001 - 660 33.00 33.00 A7Z - 753 20100210909
110 PRINCIPE OLORTEGUI BALVES E001 - 575 5.20 E001 - 679 63.00 68.20 A8G - 730 20100210909
111 MEDINA VEGA CARLOS ALFREDO E001 - 678 29.63 E001 - 677 178.00 207.63 7545 - 8F 20100210909
112 TORDOYA MICHAEL RONALD E001 - 670 23.16 E001 - 669 217.00 240.16 2678 - 1F 20100210909
113 MACEDO SALAZAR LEONOR ESTELA E001 - 681 1.05 E001 - 680 128.00 129.05 AST - 790 20100210909
TOTAL: 1,638.67 21,324.40 22,963.07

LA POSITIVA SEGUROS Y REASEGUROS

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 MALCA SLIS ALCIBIADES E001 - 718 117.00 117.00 AJM - 937 20100210909
02 CAMPOS VELA BLANCA MARIBEL E001 - 719 1.21 E001 - 715 139.00 140.21 CSZ - 649 20100210909
03 MARIN SOLER DAVID E001 - 714 97.87 E001 - 713 1,540.00 1,637.87 2675 - 1F 20100210909
04 DEL VALLE SICUS LAURA ANGELICA E001 - 720 12.57 E001 - 682 144.00 156.57 A8F - 936 20100210909
05 HUILCA PAITAN ESTRELLA E001 - 708 38.48 E001 - 707 690.00 728.48 6738 - 1A 20100210909
06 ESPINOZA DANGGELO CLARA ANALIA E001 - 710 23.56 E001 - 709 389.00 412.56 5842 - EA 20100210909
07 GUERRERO RONCAL EMER E001 - 712 1.28 E001 - 711 167.00 168.28 9421 - 1F 20100210909
08 RIOS PORTOCARRERO ERLING WILLIAM E001 - 706 1.50 E001 - 705 164.00 165.50 AVR - 381 20100210909
09 FLORES GEMZA GABRIELA LIZETH E001 - 704 3.59 E001 - 703 163.00 166.59 0297 - 4F 20100210909
10 GARCIA ALEJOS SHIRLEY MIREYA E001 - 702 95.12 E001 - 701 426.00 521.12 D10 - 163 20100210909
11 CADILLO HUILLCA GENESIS NICOL E001 - 700 149.14 E001 - 699 1,567.00 1,716.14 5341 - OF 20100210909
12 HERLINDA INKA ESTUVILCA E001 - 692 15.81 E001 - 691 122.00 137.81 ACW - 535 20100210909
13 HUANCA GIRON ALFREDO E001 - 696 18.51 E001 - 695 109.00 127.51 9329 - 5D 20100210909
14 BETANCCURI CARDONA JHON STIVEN E001 - 694 23.92 E001 - 693 404.00 427.92 9897 - 7D 20100210909
15 CCANTO PINEDO KIARA MASIEL E001 - 690 121.00 121.00 D20 - 255 20100210909
16 SOLIS CORTEZ LIZ VENESA E001 - 717 25.72 E001 - 716 157.00 182.72 A7Z - 753 20100210909
17 UNRIA ESPINOZA LEIDA ROSARIO E001 - 689 93.00 93.00 ATD - 847 20100210909
18 LAZO ARTEAGA LEONARDO AMERICO E001 - 688 27.35 E001 - 687 328.00 355.35 B1L - 787 20100210909
19 LEON ARAMBULO OLIVIA JANETH DEL SOCORRO E001 - 685 1.32 E001 - 684 271.00 272.32 B8Z - 242 20100210909
20 CADILLO HUILLCA GENESIS NICOL E001 - 698 37.19 E001 - 697 976.00 1,013.19 5341 - OF 20100210909
21 QUISPE TASAYCO FRANCISCO LEANDRO E001 - 686 14.80 E001 - 683 129.00 143.80 COI - 716 20100210909
TOTAL: 588.94 8,216.00 8,804.94

AUTOSEGURO AFOCAT

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 RAMIREZ RUIZ DE PEREZ GINA E001 - 765 74.00 74.00 0126 - DA 20516314398
02 CCUNO PARARI ANTOLIN E001 - 764 21.12 E001 - 763 180.00 201.12 A5D - 756 20516314398
03 VARGAS TUESTA BREMILDA MERCEDES E001 - 759 16.28 E001 - 758 108.00 124.28 X3M - 572 20516314398
04 PORTILLA UCHUPE GERARDO E001 - 754 26.82 E001 - 753 122.00 148.82 TOO - 181 20516314398
05 RAMOS PARIONA MARITZA VIOLETA E001 - 762 2.17 E001 - 761 324.00 326.17 A5R - 629 20516314398
06 CHAPOÑAN SIESQUEN JOSE RICARDO E001 - 742 2.55 E001 - 741 38.00 40.55 AEB - 250 20516314398
07 TRUJILLO BENDITO MICHELSON E001 - 751 17.10 E001 - 750 248.00 265.10 F2N - 689 20516314398
08 FIGUEROA CHAPOÑAN SURAY E001 - 748 0.78 E001 - 745 45.00 45.78 AEB - 250 20516314398
09 CHAPOÑAN ALONSO DAMIAN E001 - 744 E001 - 743 45.00 45.00 AEB - 250 20516314398
10 ALDAY LEON VALERIA NORMA E001 - 740 45.00 45.00 ALY - 586 20516314398
11 FIGUEROA CHAPOÑAN JOSUE E001 - 731 0.65 E001 - 732 45.00 45.65 AEB - 250 20516314398
12 DAMIAN CHAPOÑAN MATIAS E001 - 729 1.00 E001 - 727 38.00 39.00 AEB - 250 20516314398
13 CHAPOÑAN SUAREZ PAOLA IGNACIA E001 - 725 1.52 E001 - 724 45.00 46.52 AEB - 250 20516314398
14 CHAVEZ SILVA KHALESSY GAELA E001 - 723 67.00 67.00 ACX - 698 20516314398
15 PONCE BRENER JENIFER PAOLA E001 - 722 5.77 E001 - 721 48.00 53.77 AFX - 610 20516314398
TOTAL: 95.76 1,472.00 1,567.76

AFOCAT REGIÓN LIMA

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 CASTRO OBREGON KIARA SOLET E001 - 797 3.20 E001 - 796 45.00 48.20 8321 - 4F 20515127403
02 ZORRILLA YANA AMALIA E001 - 768 1.00 E001 - 770 45.00 46.00 1731 - 5F 20515127403
03 QUISPE CACHIQUE YADIEL MATHIAS E001 - 780 1.20 E001 - 775 38.00 39.20 AZR - 782 20515127403
04 MARGARITA REYNA VALVERDE FABIAN E001 - 746 66.00 66.00 B6 - 9916 20515127403
05 CACERES DE SALAZAR CELIA PALOMINO E001 - 749 33.00 33.00 0573 - 9A 20515127403
06 ORTEGA ESCALANTE CLAUDIA EUGENIA E001 - 733 6.22 E001 - 735 53.00 59.22 0330 - 5C 20515127403
07 LUNA NUÑEZ ARON JOSEP E001 - 737 33.00 33.00 F4U - 222 20515127403
08 CONDORI QUISPE ANTONIO E001 - 739 33.00 33.00 AO - 7919 20515127403
09 CHUYA CALDERON SUSY E001 - 790 4.08 E001 - 789 33.00 37.08 A3 - 7464 20515127403
10 CHINCHAY OTERO JUSTO E001 - 788 6.82 E001 - 787 93.00 99.82 A70 - 735 20515127403
11 ROMERO VALVERDE DAYANA MAYTE E001 - 786 13.15 E001 - 785 262.00 275.15 C17 - 330 20515127403
12 PUELLES PADILLA FILIMON E001 - 784 6.47 E001 - 783 93.00 99.47 A4 - 8515 20515127403
13 FLORES BEJAR RENAN PELAYO E001 - 782 2.71 E001 - 781 75.00 77.71 B6 - 1685 20515127403
14 CACHIQUE MUÑOZ SILVANA CELESTE E001 - 779 0.63 E001 - 778 45.00 45.63 A2R - 782 20515127403
15 CASAS CAMACHO GIANELLA ARACELY E001 - 776 67.00 67.00 5677 - 6F 20515127403
16 ANGULO ROJAS SAID EYAL E001 - 774 16.51 E001 - 773 86.00 102.51 0057 - JA 20515127403
17 MATOS CALDAS GUSTAVO EDER E001 - 772 1.91 E001 - 771 90.00 91.91 ASI - 574 20515127403
18 POLINO ALCEDO CARLOS E001 - 769 1.53 E001 - 766 70.00 71.53 6196 - 7A 20515127403
19 SILVERA AGAMA GIANELA MILAGROS E001 - 760 1.85 E001 - 757 67.00 68.85 NI - 24735 20515127403
20 SOTO HERRERA MONICA E001 - 756 0.70 E001 - 755 165.00 165.70 3503 - 1A 20515127403
21 PEÑA UTRILLA BRITTANY ASHLEY E001 - 752 117.00 117.00 BO - 3161 20515127403
22 ARCANGEL TRUJILLO CABRERA E001 - 747 68.00 68.00 4117 - 1D 20515127403
23 OBREGON MEJIA ANTONY ALEX E001 - 738 94.00 94.00 AS - 7020 20515127403
24 NAYELI IVONE FABIAN MAUTINO E001 - 736 33.00 33.00 D4G - 537 20515127403
25 CHINCHAY OTERO JUSTO E001 - 734 33.00 33.00 A70 - 735 20515127403
26 GUTIERREZ CARDENAS CLAUDIA E001 - 728 33.00 33.00 6825 - 7F 20515127403
27 TOLENTINO CHAVARRIA JUANA E001 - 726 33.00 33.00 7781 - G1 20515127403
28 FERNANDEZ VALVERDE EDEN E001 - 808 9.82 E001 - 807 93.00 102.82 C7P - 292 20515127403
29 MENDEZ SOTOMAYOR MYRIAM ISABEL E001 - 805 36.52 E001 - 804 469.00 505.52 4449 - 3C 20515127403
30 OLAZABAL SANCHEZ LISETTE JAZMIN E001 - 803 2.96 E001 - 802 153.00 155.96 A3 - 7524 20515127403
31 NELIA MIGUEL BRAVO E001 - 801 18.05 E001 - 800 270.00 288.05 A5 - 7020 20515127403
32 OBREGON CORREA DALILA MAURIS E001 - 798 0.80 E001 - 795 45.00 45.80 8321 - 4F 20515127403
33 POLIN REYES AURELIO ABRAHAM E001 - 794 20.40 E001 - 793 101.00 121.40 8321 - 4F 20515127403
34 CASTRO OBREGON SASCHA BRITANY E001 - 792 1.75 E001 - 791 101.00 102.75 8321 - 4F 20515127403
35 SANCHEZ LULO KENIA LUZ E001 - 810 920.54 E001 - 809 4,479.76 5,400.30 W10 - 764 20515127403
36 JIMENEZ MENDOZA DANIELA LUCERO E001 - 812 2.27 E001 - 811 174.00 176.27 C7P - 292 20515127403
37 ALTAMIRANO JIMENEZ SEGUNDO OMAR E001 - 814 1.42 E001 - 813 45.00 46.42 1281 - RA 20515127403
TOTAL: 1,082.51 7,833.76 8,916.27

Mar-19

ASOCIACIÓN FONDO CONTRA ACCIDENTES DE TRÁNSITO LÍDER PERÚ

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 PEÑA ONOFRE JULY ESTELA E001 - 1057 33.00 33.00 0995 - 2C 20508523344 3/12/2019
02 CAPCHA RAMOS DE ARELLANO MARTHA MARISELA E001 - 1058 33.00 33.00 A9 - 6719 20508523344 3/12/2019
03 NAJARRO GOMEZ DAVID MOISES E001 - 1062 16.20 E001 - 1060 33.00 49.20 A71 - 778 20508523344 3/12/2019
04 NAJARRO GOMEZ DAVID MOISES E001 - 1063 60.00 60.00 A71 - 778 20508523344 3/12/2019
05 NAJARRO GOMEZ DAVID MOISES E001 - 1065 33.00 33.00 A71 - 778 20508523344 3/12/2019
06 PEÑA ONOFRE JULY ESTELA E001 - 1067 33.00 33.00 0995 - 2C 20508523344 3/12/2019
07 PEÑA ONOFRE JULY ESTELA E001 - 1069 33.00 33.00 0995 - 2C 20508523344 3/12/2019
08 REYES MENDO JUANA E001 - 1073 3.20 E001 - 1072 93.00 96.20 A9 - 6719 20508523344 3/12/2019
09 CONTRERAS OROSCO MILAGROS SARITA E001 - 1075 2.63 E001 - 1074 74.00 76.63 F3S - 082 20508523344 3/12/2019
10 TORRES CHUJUTALLIALFONSO E001 - 1078 1.32 E001 - 1076 75.00 76.32 A41 - 1076 20508523344 3/12/2019
11 PULIDO HUAMAN WILLIAN HITLER E001 - 1080 116.89 E001 - 1079 227.00 343.89 13L - 218 20508523344 3/12/2019
12 ASENCIO AGURTO NORVI YOEL E001 - 1083 33.00 33.00 A3W - 735 20508523344 3/12/2019
13 SLANO GOMEZ ELIZABETH E001 - 1084 45.00 45.00 F3S - 082 20508523344 3/12/2019
14 SOLANO OTOYA DAVID NOLBERTO E001 - 1094 16.61 E001 - 1090 423.00 439.61 C6 - 1653 20508523344 3/12/2019
15 FLORES ILLAN JHON ROSBEL E001 - 1127 6.93 E001 - 1086 115.00 121.93 F3S - 082 20508523344 3/12/2019
16 DAZA FACHIN DARWIN E001 - 1118 63.00 63.00 B9 - 2864 20508523344 3/12/2019
17 QUISPE CUCCHE JAIME ROSALIO E001 - 1120 23.45 E001 - 1119 115.00 138.45 C2B - 410 20508523344 3/13/2019
18 GUEVARA FERNANDEZ MARIA ROSA E001 - 1122 65.00 65.00 Z3S - 150 20508523344 3/13/2019
19 GUEVARA FERNANDEZ MARIA ROSA E001 - 1125 1.31 E001 - 1124 98.00 99.31 Z3S - 150 20508523344 3/13/2019
20 MAMANI MAMANI MARIA ROSA E001 - 1117 21.07 E001 - 1116 479.00 500.07 4895 - OB 20508523344 3/13/2019
TOTAL: 209.61 2,163.00 2,372.61

INTERSEGURO COMPAÑÍA DE SEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 VALLADOLID CALDERON CLORINDA NATIVIDAD E001 - 1029 0.70 E001 - 1028 56.00 56.70 F2H - 250 20382748566 3/11/2019
02 VERASTEGUI VERA DAVID TOMAS E001 - 1027 1.94 E001 - 1026 75.00 76.94 BAR - 354 20382748566 3/11/2019
03 ALVITES DELGADO JESUS E001 - 993 1.50 E001 - 992 171.00 172.50 B2K - 467 20382748566 3/11/2019
04 VALLADOLID CALDERON CLORINDA NATIVIDAD E001 - 987 33.00 33.00 F2H - 250 20382748566 3/11/2019
05 ROMAN MOTTA SELENE ROSARIO E001 - 1023 2.75 E001 -1021 280.00 282.75 D7W - 265 20382748566 3/11/2019
06 VALLADOLID CALDERON CLORINDA NATIVIDAD E001 - 1016 33.00 33.00 F2H - 250 20382748566 3/11/2019
07 SALCEDO REVOREDO STEFANO NICOLAS E001 - 1013 1.60 E001 - 1012 60.00 61.60 C1P - 236 20382748566 3/11/2019
08 SUMARAN POLINAR JULIO E001 - 1009 1.50 E001 - 1006 127.00 128.50 B2K - 467 20382748566 3/11/2019
09 PRINCIPE ANGELES FRANCISCO LUIS E001 - 1019 1,258.00 E001 - 1018 8,292.68 9,550.68 W4Z - 859 20382748566 3/11/2019
TOTAL: 1,267.99 9,127.68 10,395.67

LA POSITIVA SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 CADILLO HUILLCA GENESIS NICOL E001 - 972 33.00 33.00 5341 - OF 20100210909 3/8/2019
02 MORI VASQUEZ THALIA ELIZABETH E001 - 970 99.00 99.00 D8D - 341 20100210909 3/8/2019
03 MUÑOZ CHUSDEN ARSENIO E001 - 966 5.52 E001 - 964 178.00 183.52 C4H - 816 20100210909 3/8/2019
04 DARRIGO ALVARADO PIERRE PHILIPS E001 - 962 6.46 E001 - 960 75.00 81.46 4652 - 1D 20100210909 3/8/2019
05 HUERTA LOPEZ DE JIMENE JUANA E001 - 959 2.63 E001 - 958 141.00 143.63 AXR - 112 20100210909 3/8/2019
06 SIFUENTES HUAYANAY WININGER E001 - 957 66.00 66.00 RIA - 038 20100210909 3/8/2019
07 ESPINOZA AYALA FRANCISCA E001 - 956 7.34 E001 - 955 93.00 100.34 DSW - 727 20100210909 3/8/2019
08 LUNA PEREZ JOSE LUIS E001 - 952 33.00 33.00 9019 - 7A 20100210909 3/8/2019
09 LUNA PEREZ JOSE LUIS E001 - 950 33.00 33.00 9019 - 7A 20100210909 3/8/2019
10 GARCIA ALEJOS SHIRLEY MIREYA E001 - 948 33.00 33.00 DIO - 163 20100210909 3/8/2019
11 CALDERON PATIÑO MARLON JESUS E001 - 945 1.05 E001 - 944 33.00 34.05 A6M - 951 20100210909 3/8/2019
12 MAYLLE CIRIACO ESTEBAN E001 - 941 126.00 126.00 W5 - 4425 20100210909 3/8/2019
13 SARASI HUMANI DE LARA IRENE E001 - 937 0.73 E001 - 935 133.00 133.73 AWW - 709 20100210909 3/8/2019
14 MARUJO DOMINGUEZ JULIAN ELADIO E001 - 929 4.86 E001 - 927 68.00 72.86 8703 - AW 20100210909 3/8/2019
15 CASTILLO GONZALES WALTER E001 - 923 15.50 E001 - 922 45.00 60.50 1649 - 9F 20100210909 3/7/2019
16 SANCHEZ LEON RAUL ORLANDO E001 - 921 55.00 55.00 B3 - 2637 20100210909 3/7/2019
17 POLO PEÑA JOSE MANUEL E001 - 919 86.00 86.00 5059 - 1C 20100210909 3/7/2019
18 VASQUEZ MEJIA FRANCISCA E001 - 917 219.00 219.00 ACR - 839 20100210909 3/7/2019
19 MONTALVO ONTON JULIANA VANESSA E001 - 914 1.28 E001 - 911 171.00 172.28 AXR - 112 20100210909 3/7/2019
TOTAL: 45.37 1,720.00 1,765.37

MAPFRE PERÚ COMPAÑÍA DE SEGUROS Y REASEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 CASTILLO JANAMPA NIXON EDDINSON E001 - 1104 22.03 E001 - 1102 172.00 194.03 F1V - 215 20202380621 3/13/2019
02 GUEVARA ACEVEDO JOSE MIGUEL E001 - 1101 79.83 E001 - 1077 301.00 380.83 2614 - AC 20202380621 3/13/2019
03 MINBELA VELASQUEZ ALEJANDRO E001 - 1052 7.93 E001 - 1048 86.00 93.93 274 - AF 20202380621 3/12/2019
04 SANDOVAL RAMOS ROSO E001 - 1044 1.34 E001 - 1042 60.00 61.34 7771 - 2F 20202380621 3/12/2019
05 SANDOVAL RAMOS ROSO E001 - 1033 33.00 33.00 7771 - 2F 20202380621 3/12/2019
06 COLAN DE LA SOTA GUSTAVO JONATHAN E001 - 1032 38.00 38.00 ASS - 212 20202380621 3/12/2019
07 TAZA SAMANIEGO JEAN CARLOS E001 - 1031 38.00 38.00 3306 - FA 20202380621 3/12/2019
08 SANDOVAL RAMOS ROSO E001 - 1030 33.00 33.00 7771 - 2F 20202380621 3/12/2019
09 ESPINOZA MOLINA LUIS ANTONIO E001 - 1133 29.31 E001 - 1121 563.00 592.31 ABL - 942 20202380621 3/14/2019
TOTAL: 140.44 1,324.00 1,464.44

RIMAC SEGUROS Y REASGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 JARA ATERO JOSEP LUIS E001 - 994 1.80 E001 - 996 66.00 67.80 DOB - 891 20100041953 3/11/2019
02 JARA ATERO JOSEP LUIS E001 - 995 2.10 E001 - 988 66.00 68.10 DOB - 891 20100041953 3/11/2019
03 PABLO ROBERTO CSARMEN CHIROQUE E001 - 1025 37.57 E001 - 1024 239.00 276.57 ACP - 572 20100041953 3/11/2019
04 DULANTO AGUIRRE JUAN CARLOS E001 - 1022 68.17 E001 - 1020 1,199.00 1,267.17 F1S - 852 20100041953 3/11/2019
05 LOPEZ BENITO ALEX GUILLERMO E001 - 1017 82.00 82.00 AWA - 545 20100041953 3/11/2019
06 MENDOZA MORE ROSITA AMELIA E001 - 1015 1.58 E001 - 1014 107.00 108.58 A2W - 751 20100041953 3/11/2019
07 LARA GRADOS DANNY DANIEL E001 - 1011 144.65 E001 - 1010 471.00 615.65 C5 - 1105 20100041953 3/11/2019
08 PAJUELO LIJARZA MARIA PILAR E001 - 1008 2.08 E001 - 1007 75.00 77.08 AYV - 909 20100041953 3/11/2019
09 SEGUNDO CHAVEZ BRICEÑO E001 - 1005 85.18 E001 - 1004 1,583.00 1,668.18 A9L - 827 20100041953 3/11/2019
10 CASTILLO LEON NELSON E001 - 1003 0.70 E001 - 1002 148.00 148.70 A3Y - 884 20100041953 3/11/2019
11 MORENO MIRANDA DORILA E001 - 1001 44.51 E001 - 1000 474.00 518.51 A2D - 962 20100041953 3/11/2019
12 JARA ATERO JOSEP LUIS E001 - 999 8.10 E001 - 998 66.00 74.10 DOB - 891 20100041953 3/11/2019
13 OTINIANO APARICIO YASELI YUSBELI E001 - 990 55.00 55.00 A6N - 597 20100041953 3/11/2019
14 JARA ATERO JOSEP LUIS E001 - 989 36.00 E001 - 988 66.00 102.00 DOB - 891 20100041953 3/11/2019
15 SILVA LLANCUL DIONILA E001 - 986 0.22 E001 - 985 60.00 60.22 AUY - 939 20100041953 3/11/2019
16 GUZMAN HUAMAN ANGIE JOSELYN E001 - 984 0.45 E001 - 983 33.00 33.45 A2P - 728 20100041953 3/11/2019
17 VALDIVIA RMIREZ ERICK JESUS E001 - 982 3.00 E001 - 981 33.00 36.00 8256 - 4B 20100041953 3/11/2019
18 TINTAYA BENITES GERARDO HENRY E001 - 980 1.42 E001 - 979 45.00 46.42 F2I - 846 20100041953 3/11/2019
19 CHAVEZ ABANTO RICHARD GABRIEL SEGUNDO E001 - 978 1.42 E001 - 977 45.00 46.42 F2I - 846 20100041953 3/11/2019
20 QUINTANA TELLO DANIEL JESUS E001 - 973 1.50 E001 - 974 45.00 46.50 F2I - 846 20100041953 3/11/2019
21 AEDO PATIÑO CARLOS ALFREDO E001 - 976 1.42 E001 - 975 45.00 46.42 F2I - 846 20100041953 3/11/2019
22 ROJAS RAMIREZ MAGNO VICENTE E001 - 971 2.78 E001 - 969 154.00 156.78 ATD - 063 20100041953 3/11/2019
23 TARIFE CASTILLO LUIS ALBERTO E001 - 968 38.00 38.00 A2P - 728 20100041953 3/11/2019
24 FUERTES TRUJILLO HENRY ERLINDO E001 - 967 1.75 E001 - 965 179.00 180.75 C5 - 1105 20100041953 3/11/2019
TOTAL: 446.40 5,374.00 5,820.40

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 CARRILLO GOMEZ ANGELICA JUANA E001 - 907 5.62 E001 - 906 65.00 70.62 7334 - 5W 20515127403 3/7/2019
02 VILCA LEANDRO MESIA LICED E001 - 954 13.83 E001 - 963 145.00 158.83 B5T - 267 20515127403 3/8/2019
03 NUÑEZ LLEREN ADRIANA NADIE E001 - 918 8.75 E001 - 916 94.00 102.75 9879 - 0B 20515127403 3/7/2019
04 CASTRO TORRES FERNANDO RUBEN E001 - 915 99.00 99.00 W1G - 721 20515127403 3/7/2019
05 DE LA CRUZ MEDRANO DIONICIO YGNACIO E001 - 913 33.00 33.00 D5L - 611 20515127403 3/7/2019
06 VILCAS RASHTA GEORGE MARLON E001 - 912 33.00 33.00 B8 - 6342 20515127403 3/7/2019
07 CACHIQUE TAMANI ADRIANO MOISES E001 - 910 38.00 38.00 B3 - 6504 20515127403 3/7/2019
08 GALINDO CHAVEZ ASHLEY VIVIANA E001 - 909 89.00 89.00 2653 - 4B 20515127403 3/7/2019
09 HONOFRE TORRES ISABEL E001 - 908 38.00 38.00 F8F - 038 20515127403 3/7/2019
10 HUAMAN BALVIN LESLY LUZ E001 - 905 11.22 E001 - 904 58.00 69.22 4211 - NA 20515127403 3/7/2019
11 VILLAVICENCIO DULANTO NAHUIN ISAI E001 - 961 0.22 E001 - 953 60.00 60.22 C4 - 8145 20515127403 3/8/2019
12 MARQUEZ HERNANDEZ HAYDEE E001 - 951 9.90 E001 - 949 132.00 141.90 W1B - 770 20515127403 3/8/2019
13 ALARCON GARCIA JOSUE AARON E001 - 947 0.70 E001 - 946 66.00 66.70 HCG - 0815 20515127403 3/8/2019
14 PALACIOS GARCIA MOISES ALEX E001 - 943 11.20 E001 - 942 33.00 44.20 3812 - 6A 20515127403 3/8/2019
15 AYMARA CCACHUCO SEGUNDO FORTUNATO E001 - 940 5.11 E001 - 939 58.00 63.11 8567 - 7B 20515127403 3/8/2019
16 SOTO HERRERA MONICA E001 - 938 1.50 E001 - 936 142.00 143.50 3503 - 1A 20515127403 3/8/2019
17 SALVATIERRA ALBERTO NAIRA ANGELICA E001 - 934 1.20 E001 - 933 117.00 118.20 B8 - 6327 20515127403 3/8/2019
18 ALVAREZ DURAND CINDY ALEXANDRA E001 - 932 2.23 E001 - 931 75.00 77.23 AZR - 782 20515127403 3/8/2019
19 AGUILAR VILLAFANE NELLY MARIA E001 - 930 1.58 E001 - 928 101.00 102.58 AZR - 782 20515127403 3/8/2019
20 VENTURA GAONIA KEILOR MATHIAS E001 - 926 30.80 E001 - 925 241.00 271.80 4873 - FA 20515127403 3/8/2019
21 CARRASCO SERNAQUE CARLOS E001 - 924 0.48 E001 - 920 75.00 75.48 A3 - 7708 20515127403 3/8/2019
22 SEMINARIO CARRILLO HECTOR FELIPE E001 - 901 9.15 E001 - 899 102.00 111.15 7334 - 5W 20515127403 3/7/2019
23 MINCHAN MORALES JUAN NICOLAS E001 - 898 22.48 E001 - 903 267.00 289.48 B4 - 8855 20515127403 3/7/2019
24 PALACIOS SILVA MIRIAM E001 - 892 2.02 E001 - 891 74.00 76.02 2003 - 6A 20515127403 3/7/2019
25 MATOS CHAUPIS SILVIA E001 - 896 31.69 E001 - 895 225.00 256.69 7607 - 4F 20515127403 3/7/2019
26 VILLAVICENCIO DULANTO NAHUN ISAI E001 - 902 8.01 E001 - 897 136.00 144.01 C4 - 8145 20515127403 3/7/2019
27 ESPINOZA ROJAS ERIK DANIEL E001 - 894 0.41 E001 - 893 67.00 67.41 2095 - 7C 20515127403 3/7/2019
28 MEDINA CALAGUA PIERO FERNANDO E001 - 890 8.89 E001 - 889 93.00 101.89 B5 - 9170 20515127403 3/7/2019
29 FLORES LEON KIMBERLY NICOL E001 - 888 1.60 E001 - 887 67.00 68.60 2663 - 6B 20515127403 3/7/2019
30 GOMEZ HUAMANI LIA PRINCESA E001 - 900 1.00 E001 - 886 71.00 72.00 3737 - EA 20515127403 3/7/2019
31 LEON CRUZ SAIDA E001 - 885 2.01 E001 - 884 123.00 125.01 2663 - 6B 20515127403 3/6/2019
32 CABELLO HUERTA RONALD ROLANDO E001 - 883 20.71 E001 - 882 86.00 106.71 A5 - 7020 20515127403 3/6/2019
33 MAURICIO MANRIQUE PEDRO ABEL E001 - 881 94.00 94.00 A5 - 7020 20515127403 3/6/2019
34 HUAMANI ROSSELL MONICA CECILIA E001 - 880 61.00 61.00 3737 - EA 20515127403 3/6/2019
35 QUICHE CARRILLO RAQUEL VERONICA E001 - 879 37.15 E001 - 878 122.00 159.15 B9J - 498 20515127403 3/6/2019
36 CASTRO VALDERRAMA NESTOR LUIS E001 - 877 45.00 45.00 B6 - 8245 20515127403 3/6/2019
37 CONDORI QUISPE ANTONIO E001 - 876 0.95 E001 - 875 157.00 157.95 A0 - 7919 20515127403 3/6/2019
38 RAMIREZ HERRERA GERMAN E001 - 874 43.03 E001 - 873 984.00 1,027.03 1448 - 1C 20515127403 3/6/2019
39 NAVARRO CHINCHANO JIMENA MARIANA E001 - 872 0.77 E001 - 871 74.00 74.77 B8 - 9241 20515127403 3/6/2019
40 TORRES GARAY DIANA CAROLINA E001 - 870 24.81 E001 - 869 156.00 180.81 0652 - HA 20515127403 3/6/2019
41 MARROQUIN GARCIA MATEO CALEB E001 - 868 0.12 E001 - 867 155.00 155.12 C4 - 7330 20515127403 3/6/2019
42 CHINCHANO ALARCON ROSI JULIANA E001 - 866 0.59 E001 - 865 130.00 130.59 B8 - 9241 20515127403 3/6/2019
43 OBREGON ARCE YEFERSON LEONEL E001 - 864 97.00 97.00 MYG - 25428 20515127403 3/6/2019
44 CARRERA TOLENTINO ALEJANDRINA E001 - 863 19.31 E001 - 862 148.00 167.31 C1 - 4971 20515127403 3/6/2019
45 IGNACIO CORDOVA DAVID JEFERSON E001 - 861 2.92 E001 - 860 2.92 5.84 0047 - 2C 20515127403 3/6/2019
46 SANDOVAL CUEVA ANA ROSA E001 - 859 24.51 E001 - 858 101.00 125.51 0795 - 0D 20515127403 3/6/2019
47 ALVA HIGINIO RICHARD ANTONIO E001 - 857 1.28 E001 - 856 175.00 176.28 C2E - 654 20515127403 3/6/2019
48 VALDERRAMA GUERRA VALENTIN ANGEL E001 - 855 42.52 E001 - 854 229.00 271.52 8605 - 0C 20515127403 3/6/2019
49 RIVAS CAMPOS FRANK JESUS E001 - 853 9.36 E001 - 852 281.00 290.36 B4 - 9856 20515127403 3/6/2019
50 ALBERCA ADRIANEN NATALIA E001 - 851 1.31 E001 - 850 75.00 76.31 2003 - 6A 20515127403 3/6/2019
51 TENORIO MEDINA EMILIANO LUIS ALFREDO E001 - 847 636.87 636.87 9034 - 5F 20515127403 3/5/2019
52 TENORIO MEDINA EMILIANO LUIS ALFREDO E001 - 846 532.98 532.98 9034 - 5F 20515127403 3/5/2019
53 PEREZ DURAND MARIA DEL CARMEN E001 - 845 50.34 E001 - 844 826.00 876.34 2838 - 0B 20515127403 3/5/2019
54 HUALLPA HUAMAYALLI ALVINO E001 - 843 31.66 E001 - 842 302.00 333.66 A8 - 9096 20515127403 3/5/2019
55 RIVERA MANRIQUE REIMUNDO AGUSTIN E001- 841 0.32 E001 - 840 45.00 45.32 3396 - GA 20515127403 3/5/2019
56 CABELLO DE MORALES VICTORIA E001 - 839 0.48 E001 - 838 74.00 74.48 7037 - 4B 20515127403 3/5/2019
57 VERASTEGUI CHOLAN LUZ MARIBEL E001 - 816 1.21 E001 - 815 45.00 46.21 1684 - 5F 20515127403 3/4/2019
58 FELIX VERASTEGUI DULCE ARMING ESPERANZA E001 - 818 1.21 E001 - 817 65.00 66.21 1684 - 5F 20515127403 3/4/2019
59 MEJIA ROBLES ELLERYCK BREDI E001 - 820 0.68 E001 - 819 45.00 45.68 0350 - 9C 20515127403 3/4/2019
60 LEYVA VALERIO EDISON JORGE SMITH E001 - 822 9.38 E001 - 821 100.00 109.38 0350 - 9C 20515127403 3/4/2019
61 AZAÑERO PORRAS GERALDINE RUBI E001 - 824 1.04 E001 - 823 45.00 46.04 9141 - 1C 20515127403 3/4/2019
62 SANTOS LEON DE ARCENIO GLORIA E001 - 826 74.09 E001- 825 1,464.00 1,538.09 5840 - BA 20515127403 3/4/2019
63 CARMEN GARRO MARIA ELIZABETH E001 - 828 50.19 E001 - 827 312.00 362.19 C7 - 6993 20515127403 3/4/2019
64 ANASTACIO YNGA WILMER E001 - 830 1.28 E001 - 829 205.00 206.28 3396 - GS 20515127403 3/4/2019
65 PIO HEREDIA VERONICA E01 - 831 87.00 87.00 3123 - 9C 20515127403 3/4/2019
66 BENITES ZARSOZA SEBASTIAN ALBERTO E001 - 833 0.42 E001 - 832 81.00 81.42 B2 - 7331 20515127403 3/4/2019
67 HUANCHO LAZTRA ELIAS ALEXANDER E001 - 835 13.70 E001 - 834 125.00 138.70 2823 - JA 20515127403 3/4/2019
68 UCEDA PEREDA MILAGROS YSABEL E001 - 837 1.75 E001 - 836 97.00 98.75 A49 - 822 20515127403 3/4/2019
TOTAL: 658.69 11,277.77 11,936.46

PACÍFICO COMPAÑÍA DE SEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 NAVARRO PAREDES ROBERTO E001 - 1156 4.90 E001 - 1155 65.00 69.90 7906 - 5F 20332970411 3/14/2019
02 UGARTE MALQUICHAHUA JENNY E001 - 1159 6.08 E001 - 1158 190.00 196.08 B1 - 3086 20332970411 3/14/2019
03 ARREDONDO MACHACUAY ELSA EUSEBIA E001 - 1164 2.05 E001 - 1163 98.00 100.05 4508 - 2F 20332970411 3/14/2019
04 ZELAYA SOLIS EMERSON ALEXANDRO E001 - 1162 66.00 66.00 D4X - 394 20332970411 3/14/2019
05 GUARNIZ MELGAREJO VICTOR POOLD E001 - 1161 3.58 E001 - 1160 156.00 159.58 0216 - NA 20332970411 3/14/2019
06 SALAMAN BONIFACIO FELIX E001 - 1174 15.65 E001 - 1173 33.00 48.65 BAA - 039 20332970411 3/14/2019
07 RUIZ HUASANGA POL MAYER E001 - 1170 1.12 E001 - 1169 60.00 61.12 ASS - 824 20332970411 3/14/2019
08 SALAMAN BONIFACIO FELIX E001 - 1172 3.60 E001 - 1171 132.00 135.60 BAA - 039 20332970411 3/14/2019
09 SALAMAN BONIFACIO FELIX E001 - 1168 12.60 E001 - 1167 33.00 45.60 BAA - 039 20332970411 3/14/2019
10 AYALA TRUJILLO MAURA E001 - 1166 5.37 E001 - 1165 135.00 140.37 A3S - 797 20332970411 3/14/2019
TOTAL: 54.95 968.00 1,022.95

BNP PARIBAS CARDIF S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 JARA MORENO XIANA GABRIELA E001 - 1175 84.00 84.00 A8W - 405 20513328819 3/15/2019
TOTAL: 0.00 84.00 84.00

MINISTERIO DE TRANSPORTE Y COMUNICACIONES

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 GAMARRA QUISPE JONATHAN PIERO 0.00 20131379944 3/15/2019
TOTAL: 0.00 0.00 0.00

AFOCAT PREMIUM

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 RODRIGUEZ GONZALES PEDRO E001 - 1128 124.00 124.00 1025 - FA 20514583201 3/14/2019
02 ASENCIO DEUNICIO CARLOS PABLO E001 - 1130 30.88 E001 - 1129 95.00 125.88 3589 - 6C 20514583201 3/14/2019
03 MERCEDES ROLDAN DORIS E001 - 1132 1.21 E001 - 1131 45.00 46.21 P2S - 821 20514583201 3/14/2019
04 VILLAVICENCIO SALDAÑA ANTUAND ALEXIS E001 - 1136 147.00 147.00 7280 - 4C 20514583201 3/14/2019
05 GUTIERREZ JARA LIDIA E001 - 1138 31.84 E001 - 1137 100.00 131.84 NG - 98932 20514583201 3/14/2019
06 PASCUAL ESPINOZA CARMEN ROSA E001 - 1140 3.74 E001 - 1139 131.00 134.74 AET - 736 20514583201 3/14/2019
07 CANTORIN CANTORIN JORGE LUIS E001 - 1142 16.23 E001 - 1141 151.00 167.23 4856 - 1D 20514583201 3/14/2019
08 CRUZ ROJAS RAUL E001 - 1144 10.40 E001 - 1143 86.00 96.40 B4 - 4937 20514583201 3/14/2019
09 ORTIZ AVILA PEDRO AMERICO E001 - 1145 33.00 33.00 A1T - 725 20514583201 3/14/2019
10 ESPINOZA FALCON DAVID BENJAMIN E001 - 1147 15.28 E001 - 1146 201.00 216.28 1708 - 1D 20514583201 3/14/2019
11 SANTOS PEREZ OFELIA E001 - 1149 2.12 E001 - 1148 78.00 80.12 A0 - 7569 20514583201 3/14/2019
12 VELASQUEZ SANTOS LOAN EDINTONG E001 - 1151 1.60 E001 - 1150 67.00 68.60 A0 - 7569 20514583201 3/14/2019
13 SUDARIO ASCENCIOS BRRITH CECILIA E001 - 1153 1.21 E001 - 1152 101.00 102.21 P2S - 821 20514583201 3/14/2019
14 SANCHEZ CARANCA AQUILES ALFREDO E001 - 1157 1.21 E001 - 1154 45.00 46.21 P2S - 821 20514583201 3/14/2019
TOTAL: 115.72 1,404.00 1,519.72

ASOCIACIÓN FONDO CONTRA ACCIDENTES DE TRÁNSITO AUTOSEGURO

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 VILLA CARMEN JOVANNA CARMEN E001 - 1188 45.00 45.00 677 - 1A 20516314398 3/18/2019
02 LEANDRO PONCE NIVIA E001 - 1189 38.00 38.00 V1R - 741 20516314398 3/18/2019
03 LEON TANANTA JESSICA PATRICIA E001 - 1191 2.77 E001 - 1190 88.00 90.77 ALY - 586 20516314398 3/18/2019
TOTAL: 2.77 171.00 173.77

AFOCAT SOCAT PERÚ

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 VENTURA PORTILLA DIANA E001 - 1179 1.50 E001 - 1178 195.00 196.50 0668 - 8C 20543657132 3/15/2019
02 RIVERA HUERTA LUNA VALERIA E001 - 1177 15.05 E001 - 1176 122.00 137.05 F7U - 483 20543657132 3/15/2019
03 CHAVEZ SIFUENTES DELMICIO E001 -1183 14.30 E001 - 1180 144.00 158.30 F7U - 483 20543657132 3/15/2019
04 GARRIDO NEYRA ELI E001 - 1185 1.28 E001 - 1184 75.00 76.28 D3A - 690 20543657132 3/15/2019
05 ROMERO MORENO JUAN CARLOS E001 - 1187 0.95 E001 - 1186 124.00 124.95 W2I - 798 20543657132 3/15/2019
TOTAL: 33.08 660.00 693.08

ASOCIACIÓN FONDO CONTRA ACCIDENTES DE TRÁNSITO LIMA METROPOLITANA - AFOCAT LIMA METROPOLITANA

FECHA DE FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA Nº CAT ATENCION RUC EMISIÓN
01 MANZANO POLANCO JOSUED DE JESUS E001 - 1135 14.88 E001 - 1134 266.00 280.88 8716 - 2F 024434 - 2018 1/23/2019 2.0515E+10 3/14/2019
02 VILLA AREVALO BRUNO JOEL E001 - 1113 16.22 E001 - 1112 65.00 81.22 3537 - 6F 039978 - 2018 1/21/2019 2.0515E+10 3/13/2019
03 MAMANI CHUMBES CIELO E001 - 1111 0.18 E001 - 1110 38.00 38.18 2111 - 3C 042993 - 2018 1/7/2019 2.0515E+10 3/13/2019
04 TARAZONA CUNZA NANCY E001 - 1115 3.90 E001 - 1114 78.00 81.90 F7L - 870 60888 - 2018 10/10/2018 2.0515E+10 3/13/2019
05 LUCANO CULLCUSH CIRILO GAVINO E001 - 1109 17.63 E001 - 1108 93.00 110.63 0328 - 8A 060510 - 2018 10/15/2018 2.0515E+10 3/13/2019
06 CHAVEZ BRAÑEZ PAUL ALEXANDRO E001 - 1107 13.55 E001 - 1126 127.00 140.55 3513 - 2C 063039 - 2017 2/3/2018 2.0515E+10 3/13/2019
07 MORALES PALOMINO CARLOS MANUEL E001 - 1106 1.32 E001 - 1105 218.00 219.32 A8 - 9353 059376 - 2017 5/10/2018 2.0515E+10 3/13/2019
08 CHUQUIMANGO LIMAY ROSA MARIA E001 - 1103 64.35 E001 - 1100 513.00 577.35 6838 - 3C 2726 - 2018 1/9/2019 2.0515E+10 3/13/2019
09 MAMANI URURI SALOME E001 - 1098 238.00 238.00 9300 - 1F 6860 - 2018 6/14/2018 2.0515E+10 3/13/2019
10 LOPEZ GUTIERREZ YESENIA NAOMI E001 - 1097 1.50 E001 - 1096 164.00 165.50 A8 - 9353 059376 - 2017 3/2/2018 2.0515E+10 3/13/2019
11 LOPEZ SALINAS GRACIELA JHOVANA E001 - 1095 1.50 E001 - 1093 134.00 135.50 5285 - 7A 053776 - 2017 4/28/2018 2.0515E+10 3/12/2019
12 CASIMIRO MAMANI IVAN NEYMAR E001 -1092 1.78 E001 - 1091 97.00 98.78 5285 - 7A 0006860 - 2018 6/15/2018 2.0515E+10 3/12/2019
13 LOPEZ VELIZ ALLISON KARINA E001 - 1089 0.33 E001 - 1088 64.00 64.33 3864 - GA 019357 - 2018 6/8/2018 2.0515E+10 3/12/2019
14 VASQUEZ CAMPOS ROBER LUIS E001 - 1087 2.05 E001 - 1085 222.00 224.05 3558 - 6A 51184 - 2017 3/10/2018 2.0515E+10 3/12/2019
15 NEIRA IMAN JOSE JULIO E001 - 1082 15.80 E001 - 1081 241.00 256.80 0695 - 7C 44842 - 2018 1/7/2018 2.0515E+10 3/12/2019
16 SUTTA BEDON GENESIS YEN E001 - 1071 13.10 E001 - 1070 115.00 128.10 1334 - 1F 007785 - 2018 1/23/2018 2.0515E+10 3/12/2019
17 COBA HUAMAN JESUS E001 - 1068 87.00 87.00 2958 - OF 55177 - 2017 3/16/2018 2.0515E+10 3/12/2019
18 ESPINOZA AGUILAR MAGALY E001 - 1066 15.24 E001 - 1064 216.00 231.24 B5 - 9430 056088 - 2017 5/15/2018 2.0515E+10 3/12/2019
19 LOPEZ DE LA TORRE ELIZABETH MARGOT E001 - 1061 20.71 E001 - 1059 163.00 183.71 1837 - JA 026914 - 2018 6/12/2018 2.0515E+10 3/12/2019
20 BARRIOS MASACHE CARLOS ENRIQUE E001 - 1056 20.46 E001 - 1055 638.00 658.46 0969 - 0A 022733 - 2018 6/20/2018 2.0515E+10 3/12/2019
21 ESPINOZA SANTOS PEDRO FLORENCIO E001 - 1054 4.83 E001 - 1053 83.00 87.83 A4 - 9522 013124 - 2018 6/21/2018 2.0515E+10 3/12/2019
22 BASURTO RAMIREZ KATHERINE ROSARIO E001 - 1051 16.27 E001 - 1050 227.00 243.27 F3H - 091 003032 - 2018 4/9/2018 2.0515E+10 3/12/2019
23 PINEDO LANZA GLORIA ELIZABETH E001 - 1049 63.00 63.00 B3A - 671 078298 - 2015 11/24/2016 2.0515E+10 3/12/2019
24 CHAVEZ CHUMACERO GRACIELA E001 - 1047 4.80 E001 . 1046 33.00 37.80 ABT - 759 003026 - 2018 6/14/2018 2.0515E+10 3/12/2019
25 MENDOZA EVCHEVARRIA MERY DEL PILAR E001 - 1045 4.40 E001 - 1043 66.00 70.40 ABT - 759 003026 - 2018 3/19/2018 2.0515E+10 3/12/2019
26 ONOFRE RAMIREZ NOEMI E001 - 1041 3.00 E001 - 1040 33.00 36.00 A9 - 8985 039728 - 2017 8/14/2018 2.0515E+10 3/12/2019
27 ONOFRE RAMIREZ NOEMI E001 - 1039 4.00 E001 - 1038 66.00 70.00 A9 - 8985 039728 - 2017 8/27/2018 2.0515E+10 3/12/2019
28 ONOFRE RAMIREZ NOEMI E001 - 1037 33.00 33.00 A9 - 8985 039728 - 2017 4/10/2018 2.0515E+10 3/12/2019
29 ONOFRE RAMIREZ NOEMI E001 - 1036 0.70 E001 - 1035 66.00 66.70 A9 - 8985 039728 - 2017 4/25/2018 2.0515E+10 3/12/2019
30 MORILLO REYES HERLINDA AMANDA E001 - 1034 269.00 269.00 9966 - 3F 020456 - 2017 3/2/2018 2.0515E+10 3/12/2019
TOTAL: 262.50 4,716.00 4,978.50

ABRIL DEL 2019

ASOCIACIÓN FONDO CONTRA ACCIDENTES DE TRÁNSITO LÍDER PERÚ

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC


01 SOLANO OTOYA DAVID NOLVERTO E001 - 1197 16.61 E001 - 1198 423.00 439.61 C6 - 1653 20508523344 4/10/2019
02 PULIDO HUAMAN WILLIAN HITLER E001 - 1200 116.89 E001 - 1199 227.00 343.89 A3L - 218 20508523344
03 FLORES ILLAN JHON ROSBEL E001 - 1201 6.93 E001 - 1202 115.00 121.93 F3S - 082 20508523344
TOTAL: 140.43 765.00 905.43

MAYO DEL 2019

AUTOSEGURO AFOCAT

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 YOVERA MARTINEZ CARMEL E001 - 1288 16.68 E001 - 1289 194.00 210.68 A7R - 727 20516314398 5/7/2019
02 MORALES FIGUERO MARUJA DIANA E001 - 1286 35.04 E001 - 1285 167.00 202.04 A7R - 727 20516314398 5/7/2019
03 DALEN IZAGUIRRE MEDINA E001 - 1282 18.47 E001 - 1281 164.00 182.47 B2V - 663 20516314398 5/7/2019
04 DILIA MARGOT MORALES ARROYO E001 - 1279 6.43 E001 - 1277 130.00 136.43 AJZ - 395 20516314398 5/7/2019
05 AMPARO SOLEDAD BRAÑEZ ESTRELLA E001 - 1292 18.53 E001 - 1291 519.00 537.53 A7R - 727 20516314398 5/7/2019
06 QUESÑAY CUYATE ROSA ESTHER E001 - 1302 4.98 E001 - 1300 127.00 131.98 F2N - 689 20516314398 5/7/2019
07 AYALA MACHADO ANATOLIA E001 - 1299 1.32 E001 - 1297 103.00 104.32 MG - 54067 20516314398 5/7/2019
08 MEJIA ADAN HIUMBERTO SILVANO E001 - 296 2.22 E001 - 1294 171.00 173.22 ALD - 477 20516314398 5/7/2019
TOTAL: 103.67 1,575.00 1,678.67

INTERSEGURO COMPAÑÍA DE SEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 ANTAURCO CARMEN LUISA E001 - 1330 5.75 E001 - 1329 208.00 213.75 B4C - 232 20382748566 5/8/2019
02 PRINCIPE ANGELES FRANCISCO LUIS E001 - 1332 5.04 E001 - 1331 63.00 68.04 W4Z - 859 20382748566 5/8/2019
03 CARO MUÑOZ DAVID OMAR E001 - 1334 184.93 E001 - 1333 1,683.00 1,867.93 W21 - 932 20382748566 5/8/2019
04 HAVEZ CRUZ DEYSI E001 - 1336 0.33 E001 - 1335 183.00 183.33 B4C - 232 20382748566 5/8/2019
05 PRINCIPE ANGELES FRANCISCO LUIS E001 - 1337 33.00 33.00 W4Z - 859 20382748566 5/8/2019
06 PRINCIPE ANGELES FRANCISCO LUIS E001 - 1339 63.00 63.00 W4Z - 859 20382748566 5/9/2019
07 PRINCIPE ANGELES FRANCISCO LUIS E001 - 1341 1.79 E001 - 1340 63.00 64.79 W4Z - 859 20382748566 5/9/2019
TOTAL: 197.84 2,296.00 2,493.84

AFOCAT LÍDER PERÚ

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 CHAVEZ OYARCE PERLITA NAYELI E001 - 1320 8.36 E001 - 1318 65.00 73.36 F6E - 650 20508523344 5/8/2019
02 BASILIO LOPEZ ABELARDO E001 - 1322 8.88 E001 - 1321 134.00 142.88 8138 - 4A 20508523344 5/8/2019
03 JUAREZ ALVINO JOSUE PETER E001 - 1324 8.95 E001 - 1323 237.00 245.95 ANR - 202 20508523344 5/8/2019
04 BRANDON HARO BRAYAN SMITH E001 - 1326 1.14 E001 - 1325 45.00 46.14 8633 - 9B 20508523344 5/8/2019
05 BRANDON HARO KIARA SADITH E001 - 1328 2.07 E001 - 1327 45.00 47.07 8633 - 9B 20508523344 5/8/2019
TOTAL: 29.40 526.00 555.40

BNP PARIBAS CARDIF S.A COMPAÑÍA DE SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 PUELLES MACHADO VDA DE RAMIREZ VICTORIA E001 - 1316 7.91 E001 - 1315 196.00 203.91 B2Q - 703 20513328819 5/8/2019
02 MENDOZA ROJAS MARGARITA SUSANA E001 - 1314 113.02 E001 - 1313 980.00 1,093.02 AXT - 462 20513328819 5/8/2019
TOTAL: 120.93 1,176.00 1,296.93

RIMAC SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 LEON TENORIO KEILITA E001 - 1304 33.00 33.00 B4L - 966 20100041953 5/7/2019
02 APARICIO CANCHIS MARGARITA ADRIANA E001 - 1287 1.50 E001 - 1290 192.00 193.50 A6N - 597 20100041953 5/7/2019
03 CHACALIAZA VIERA MARIO JEANPEER E001 - 1284 77.58 E001 - 1283 316.00 393.58 C14 - 155 20100041953 5/7/2019
04 MAMANI LIÑAN KRISTEL ORIANA E001 - 1280 19.08 E001 - 1278 468.00 487.08 V4Z - 395 20100041953 5/7/2019
05 CHAVEZ ATALATA DE HERNANDEZ MARIA BERTHA E001 - 1276 2.00 E001 - 1275 94.00 96.00 A2D - 962 20100041953 5/6/2019
06 VASQUEZ GOMEZ ANGELO WILDER E001 - 1271 1.28 E001 - 1270 130.00 131.28 AEP - 545 20100041953 5/6/2019
07 TORERO OYANGUREN PAOLO E001 - 1268 38.00 38.00 ACV - 285 20100041953 5/6/2019
08 OYANGUREN SILVA MONICA ARLENE E001 - 1266 45.00 45.00 ACV - 285 20100041953 5/6/2019
09 OCHOA ROQUE MELITON E001 - 1264 91.00 91.00 A1T - 777 20100041953 5/6/2019
10 DOMINGUEZ CORDOVA VICENTA ILDA E001 - 1262 0.66 E001 - 1260 129.00 129.66 A3F - 713 20100041953 5/6/2019
11 LIVISI MAMANI AGUSTIN HERMES E001 - 1259 2.92 E001 - 1258 181.00 183.92 A3F - 713 20100041953 5/6/2019
12 MAGUIÑA CAMONES MIDORI AGRIPINA E001 - 1257 2.82 E001 - 1256 118.00 120.82 CQD - 171 20100041953 5/6/2019
13 GONZALES GOMEZ JOAO FRANK E001 - 1255 2.32 E001 - 1254 103.00 105.32 CQD - 171 20100041953 5/6/2019
14 BIANCA ZARARAY SILVA FERNANDEZ E001 - 1253 0.68 E001 - 1252 167.00 167.68 COL - 965 20100041953 5/6/2019
15 GONZALES RUIZ OLGA E001 - 1251 3.57 E001 - 1250 68.00 71.57 F3N - 769 20100041953 5/6/2019
16 MACHUCA GARDINI ROXANA ENITH E001 - 1249 0.98 E001 - 1248 131.00 131.98 AUX - 746 20100041953 5/6/2019
TOTAL: 115.39 2,304.00 2,419.39

PROTECTA S.A COMPAÑÍA DE SEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 LOZADA LUNA JOSE MARTIN E001 - 1247 33.00 33.00 0057 - 6B 20517207331 5/6/2019
02 SEGURA PAREDES JUAN JOSE E001 - 1246 45.00 45.00 A5 - 1111 20517207331 5/6/2019
TOTAL: 0.00 78.00 78.00

MAPFRE PERÚ COMPAÑÍA DE SEGUROS REASEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 RODRIGUEZ CASAS CARMEN ROSA E001 - 1238 1.21 E001 - 1236 75.00 76.21 F7T - 059 20202380621 5/3/2019
02 ACUÑA AGUIRRE JORGE LUIS E001 - 1243 92.30 E001 - 1242 430.00 522.30 A53 - 312 20202380621 5/3/2019
03 JAIME MARTINEZ JONNY JOEL E001 - 1223 2.07 E001 - 1222 57.00 59.07 A5U - 795 20202380621 5/3/2019
04 RAMOS JACINTO CARLOS ENRIQUE E001 - 1227 37.86 E001 - 1226 216.00 253.86 BEF - 629 20202380621 5/3/2019
05 HERNANDEZ TRONCOSO CARMEN ROSA E001 - 1210 52.72 E001 - 1213 341.00 393.72 D3L - 108 20202380621 5/3/2019
06 FLORIAN MORALES EDITA NOEMI E001 - 1234 13.17 E001 - 1231 271.00 284.17 A1D - 706 20202380621 5/3/2019
TOTAL: 199.33 1,390.00 1,589.33

AFOCAT SOCAT PERÚ

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 VILLEGAS CHAVEZ LEOVILDA E001 - 1273 12.01 E001 - 1272 93.00 105.01 C21 - 626 20543657132 5/6/2019
02 RIVERA HUERTA UNA VALERIA E001 - 1274 1.12 E001 - 1269 60.00 61.12 F7U - 483 20543657132 5/6/2019
TOTAL: 13.13 153.00 166.13

AFOFAT PREMIUM

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 BERMUDEZ VERGARAY EDWIN WILDER E001 - 1267 1.05 E001 - 1265 99.00 100.05 C4 - 7565 20514583201 5/6/2019
02 ESPINOZA FALCON DAVID BENJAMIN E001 - 1426 15.28 E001 - 1261 201.00 216.28 1708 - 1D 20514583201 5/14/2019
03 OLIVERA ESPINOZA YACKELINE MELIZZA E001 - 1245 3.11 E001 - 1244 173.00 176.11 8203 - 3A 20514583201 5/3/2019
04 VALENZUELA CHIPANA YORDAN ENMANUEL E001 - 1228 37.83 E001 - 1224 238.00 275.83 2926 - CA 20514583201 5/3/2019
05 VILLANUEVA SANCHEZ ELVIA E001 - 1207 16.09 E001 - 1206 186.00 202.09 F3L - 704 20514583201 5/3/2019
06 TERRONEZ BAZAN NELLY E001 - 1209 1.06 E001 - 1208 114.00 115.06 ABK - 204 20514583201 5/3/2019
07 VILLAGRA VILLAGRA MIGUEL ANGEL E001 - 1211 23.50 E001 - 1212 225.00 248.50 2930 - 9A 20514583201 5/3/2019
08 MORALES MELGAREJO FLOR MARIANELA E001 - 1215 2.15 E001 - 1214 108.00 110.15 A2 - 8952 20514583201 5/3/2019
09 OLIVERA ESPINOZA NICOLAS E001 - 1219 4.61 E001 - 1218 120.00 124.61 8203 - 3A 20514583201 5/3/2019
10 YBAÑEZ ESPINOZA ANGELA MILAGROS E001 - 1221 1.20 E001 - 1220 38.00 39.20 W4 - 7483 20514583201 5/3/2019
11 JIMENEZ QUISPE CARLOS ENRIQUE E001 - 1229 86.00 86.00 0438 - 5B 20514583201 5/3/2019
12 VENTOCILLA ROBLEDO JAIR E001 - 1235 1.45 E001 - 1233 38.00 39.45 2462 - 8F 20514583201 5/3/2019
13 CORDOVA CARRION HEYDI SHANELL E001 - 1239 0.62 E001 - 1237 184.00 184.62 9936 - 8C 20514583201 5/3/2019
14 CARRION CUIVIN SOBEIDA E001 - 1241 1.35 E001 - 1240 234.00 235.35 9936 - 8C 20514583201 5/3/2019
15 RAMOS TOLEDO NAHIARA E001 - 1232 1.20 E001 - 1230 38.00 39.20 2462 - 8F 20514583201 5/3/2019
TOTAL: 110.50 2,082.00 2,192.50

AFOCAT LIMA METROPOLITANA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 HUAMAN SOMOZA CAYETANA DONATA E001 - 1423 1.27 E001 - 1422 176.00 177.27 A0 - 8014 20515915185 5/14/2019
02 HUERTAS GARCIA DIEGO FERNANDO E001 - 1421 16.52 E001 - 1420 408.00 424.52 7272 - 1C 20515915185 5/14/2019
03 NINGLE MARQUINA EDWIN JOSUE E001 - 1419 0.55 E001 - 1418 131.00 131.55 3884 - 9C 20515915185 5/14/2019
04 AGURTO HERRERA MONICA E001 - 1417 39.17 E001 - 1416 410.00 449.17 A2X - 041 20515915185 5/13/2019
05 REYES LA ROSA ELIZABETH VICTORIA E001 - 1415 1.39 E001 - 1414 227.00 228.39 6448 - 4B 20515915185 5/13/2019
06 PIÑIN AGUILAR NARCISO E001 - 1413 1.50 E001 - 1412 123.00 124.50 A2X - 041 20515915185 5/13/2019
07 JULCA FERNANDEZ FAUSTINO FLORENCIO E001 - 1411 1.50 E001 - 1410 71.00 72.50 A2X - 041 20515915185 5/13/2019
08 FUENTES TIPO SANDRA VERONICA E001 - 1409 4.16 E001 - 1408 165.00 169.16 B7 - 7005 20515915185 5/13/2019
09 LANDEO BALBUENA KARENT ROSSANA E001 - 1407 31.50 E001 - 1406 690.00 721.50 C6 - 8238 20515915185 5/13/2019
10 MEZARAY PARIONA MELIA YANET E001 - 1405 0.18 E001 - 1404 123.00 123.18 0622 - 4A 20515915185 5/13/2019
11 ESPINOZA BAEZOLA JORGE LUIS E001 - 1403 2.91 E001 - 1402 131.00 133.91 9252 - 0D 20515915185 5/13/2019
12 AYALA VERDE FERNANDA LUANA E001 - 1401 1.20 E001 - 1400 113.00 114.20 9252 - 0D 20515915185 5/13/2019
13 VERDE ESPINOZA MIRSA YANET E001 - 1399 7.93 E001 - 1398 45.00 52.93 9252 - 0D 20515915185 5/13/2019
14 CAMANCHI IZQUIERDO LIZBETH SUSAN E001 - 1397 5.77 E001 - 1396 147.00 152.77 9044 - AA 20515915185 5/13/2019
15 SANCHEZ MINETTO LUIS E001 - 1395 2.58 E001 - 1394 95.00 97.58 A5 - 7892 20515915185 5/13/2019
16 HUAMAN LABAN ORESTILA E001 - 1393 69.39 E001 - 1392 513.00 582.39 7262 - 7A 20515915185 5/13/2019
17 MUJICA BLANCO AMANDA VICTORIA E001 - 1391 22.11 E001 - 1390 219.00 241.11 4636 - DA 20515915185 5/13/2019
18 LEON TANTAJULCA NICOLAS ANDRES E001 - 1389 1.86 E001 - 1388 45.00 46.86 6448 - 4B 20515915185 5/13/2019
19 ALBINO PRADO JENNY E001 - 1387 4.48 E001 - 1386 58.00 62.48 4419 - GA 20515915185 5/13/2019
20 NINAHUAMAN CHOQUEHUANCA DE ÑAHUI PRUDENCIA E001 - 1385 108.82 E001 - 1384 965.00 1,073.82 7649 - 4D 20515915185 5/13/2019
21 LIMAYMANTA ALBINO JENKER E001 - 1383 7.40 E001 - 1382 38.00 45.40 4419 - GA 20515915185 5/13/2019
22 TINEO HUAMAN ALICIA E001 - 1381 0.66 E001 - 1380 74.00 74.66 3613 - 2A 20515915185 5/13/2019
23 TINEO HUAMAN ADILSON E001 - 1379 1.06 E001 -1378 74.00 75.06 3613 - 2A 20515915185 5/13/2019
24 RODRIGUEZ ALBINO ESTRELLA DEL CIELO E001 - 1376 0.30 E001 - 1375 45.00 45.30 4419 - GA 20515915185 5/13/2019
25 NINAHUAMAN CHOQUEHUANCAI PRUDENCIA E001 - 1374 187.00 187.00 7649 - 4D 20515915185 5/10/2019
26 SOLISBANGO VILLACREZ KIARA SAMIRA E001 - 1373 99.00 99.00 M2X - 496 20515915185 5/10/2019
27 SOLISBANGO VILLACREZ KIARA SAMIRA E001 - 1372 33.00 33.00 M2X - 496 20515915185 5/10/2019
CUBA DOMINGUEZ JHON BRIAN E001 - 1371 33.00 33.00 2376 - 2F 20515915185 5/10/2019
28 LOPEZ MUJICA YAMILEY SAYURI E001 - 1370 30.50 E001 - 1369 148.00 178.50 2635 - 9F 20515915185 5/10/2019
29 CORREA SUXE HONNATAN ELVIS E001 - 1368 1.06 E001 - 1367 61.00 62.06 C3 - 8593 20515915185 5/10/2019
30 SOMMO CORDOVA AUSTRY VANESSA E001 - 1366 14.85 E001 - 1365 192.00 206.85 C1 - 7267 20515915185 5/10/2019
TOTAL: 380.62 5,839.00 6,219.62

PACÍFICO COMPAÑÍA DE SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 CALDERON TRINIDAD JESENIA GLENI E001 - 1436 1,173.47 E001 - 1460 3,996.50 5,169.97 BFI - 380 20332970411 5/20/2019 6523.5
CALDERON TRINIDAD JESENIA GLENI E001 - 1461 2,527.00 2,527.00 BFI - 380 20332970411 5/20/2019
02 SALAZAR CHIPANA MAXIMILIANO E001 - 1348 11.30 E001 - 1347 83.00 94.30 F1T - 852 20332970411 5/9/2019
03 SALAZAR MEZA JOSE LUIS E001 - 1364 15.62 E001 - 1363 554.00 569.62 9904 - 7B 20332970411 5/10/2019
04 HUAMANTOMA CALLATA LUIS ANGEL E001 - 1362 11.88 E001 - 1361 81.00 92.88 4595 - TA 20332970411 5/10/2019
05 NUÑEZ ACERO CARMEN E001 - 1360 21.12 E001 - 1359 240.00 261.12 ACI - 530 20332970411 5/10/2019
06 VILCHEZ DE LA CRUZ GREGORIA E001 - 1358 5.60 E001 - 1357 283.00 288.60 5340 - 5B 20332970411 5/10/2019
07 HUACHO MEDINA CLETO MARCELINO E001 - 1356 133.09 E001 - 1355 1,117.00 1,250.09 A3X - 749 20332970411 5/10/2019
08 ALBUJAR ACUÑA FERNANDO E001 - 1354 44.67 E001 - 1353 495.00 539.67 4814 - 9F 20332970411 5/10/2019
09 VEGA POMA MARCELO E001 - 1352 2.66 E001 - 1351 108.00 110.66 W4C - 745 20332970411 5/9/2019
10 KUSHIDA GOYZETA FABRIZIO KUSHIDA E001 - 1350 1.13 E001 - 1349 104.00 105.13 ALE - 264 20332970411 5/9/2019
11 LOZANO CRUZ SEGUNDO AURELIANO E001 - 1344 33.81 E001 - 1343 216.00 249.81 0314 - 5B 20332970411 5/9/2019
12 SALAZAR MEZA JOSE LUIS E001 - 1293 33.00 33.00 9904 - 7B 20332970411 5/7/2019
13 CARBAJAL TORRES DORIS DEY E001 - 1295 75.00 75.00 F3Z - 657 20332970411 5/7/2019
14 RAMIREZ BRICEÑO YENDERVER E001 - 1298 60.00 60.00 AYC - 489 20332970411 5/7/2019
15 ESCOBAR TRUJILLO EDWIN ALBEIRO E001 - 1303 93.00 93.00 1495 - 7F 20332970411 5/7/2019
16 LOAYZA PALACIOS ABRIL E001 - 1301 97.00 97.00 AYC - 489 20332970411 5/7/2019
17 YENQUE GOYZUETA NICOLAS SHOUNE E001 - 1306 0.27 E001 - 1305 38.00 38.27 ALE - 264 20332970411 5/7/2019
18 MUÑOZ LEON ERICK LEANDRO E001 - 1308 1.06 E001 - 1307 75.00 76.06 ALE - 264 20332970411 5/8/2019
19 RIBBECK MENDOZA AGUIDA ENRIQUETA E001 - 1310 11.60 E001 - 1309 86.00 97.60 A4K - 701 20332970411 5/8/2019
20 VILCHEZ BARBOZA EDUARD E001 - 1312 0.71 E001 - 1311 143.00 143.71 0564 - RA 20332970411 5/8/2019
21 GOMEZ HUACSO ALEXANDER SAUL E001 - 1319 1.50 E001 - 1317 38.00 39.50 F1U - 827 20332970411 5/8/2019
22 MAYHUA BERROCAL ANTHONY MIGUEL E001 - 1342 33.91 E001 - 1338 145.00 178.91 P1X -742 20332970411 5/9/2019
23 HERNANDEZ OSOREZ IVAN ADOLFO E001 - 1346 2.50 E001 - 1345 45.00 47.50 MNI - 3039 20332970411 5/9/2019
TOTAL: 1,505.90 10,732.50 12,238.40

ASOCIACIÓN FONDO CONTRA ACCIDENTES DE TRÁNSITO REGIÓN LIMA - AFOCAT REGIÓN LIMA

FECHA DE
ATENCIO FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA Nº CAT N RUC EMISIÓN
01 REQUEJO ALTAMIRANO LILA FLOR E001 - 1512 10.60 E001 - 1510 312.00 322.60 1065 - KA 005349 - 2 11/2/2018 2.0515E+10 5/20/2019
02 VASQUEZ ZORRILLA MAYA EMA E001 - 1509 14.22 E001 - 1507 112.00 126.22 A1 - 9378 007527 - 2 3/2/2019
03 FOLCO OBLITAS CRISS YENNIFER E001 - 1504 9.65 E001 - 1503 98.00 107.65 8034 - 8D 053334 - 2 1/16/2018
04 MEJIA REATEGUI GUISELLA MARITZA E001 - 1501 2.81 E001 - 1500 68.00 70.81 32211 - EA 026239 - 2 ###
05 CHUVIABANTI DIAZ YEFERSON YOFAN E001 - 1497 14.93 E001 - 1496 430.00 444.93 1460 - EA 018073 - 2 ###
06 CONDOR VASQUEZ JESUS E001 - 1494 39.91 E001 - 1493 204.00 243.91 1065 - KA 005349 - 2 11/2/2018
07 VILLAVICENCIO DULANTO NAHUN ISAI E001 - 1492 8.01 E001 - 1491 175.00 183.01 C4 - 8145 055059 - 2 6/16/2018
08 ROJAS RAMIREZ MARIO E001 - 1488 22.29 E001 - 1487 116.00 138.29 1065 - KA 005349 - 2 11/2/2018
09 MANZANEDA SALAZAR EMERZON E001 - 1485 10.47 E001 - 1483 105.00 115.47 2840 - 8C 017943 - 2 4/24/2018
10 VENTURA RAMOS DARIA E001 - 1479 1.60 E001 - 1477 96.00 97.60 6691 - OB 067635 - 2 2/23/2019
11 BAZAN GUEVARA IRVIN DARWIN E001 - 1475 1.74 E001 - 1473 123.00 124.74 1421 - BA 002428 - 2 6/9/2018
12 SILVA DIAZ JUAN FERNANDO E001 - 1470 19.79 E001 - 1469 134.00 153.79 1065 - KA 005349 - 2 11/2/2018
13 CHALCO CHAMPAC MICAELA EMMA E001 - 1468 82.00 82.00 B7 - 1053 052631 - 2 2/11/2019
14 OSORIO GAYTAN EDITH LARITZA E001 - 1467 0.93 E001 - 1466 127.00 127.93 2435 - 4D 032016 - 2 3/2/2019
15 MILLAN SALAS ULVER E001 - 1465 4.83 E001 - 1463 86.00 90.83 A3 - 7708 036471 - 2 6/30/2018
16 GUTIERREZ CARDENAS CLAUDIA E001 - 1462 229.00 229.00 6825 - 7F 028045 - 2 6/8/2018
17 CHIROQUE RODRIGUEZ FABRIZZIO E001 - 1459 8.78 E001 - 1458 93.00 101.78 B8 - 7354 045910 - 2 ###
18 TORRES SANTAMARIA GREGORIA E001 - 1457 7.55 E001 - 1456 74.00 81.55 2196 - 4A 008068 - 2 4/13/2019
19 LOLO ZACARIAS ANTONY JUAN E001 - 1455 1.98 E001 - 1454 60.00 61.98 B8 - 7354 045910 - 2 ###
20 RODRIGUEZ OURAO ROCIO GIULIANA E001 - 1453 2.48 E001 - 1452 71.00 73.48 B8 - 7354 045910 - 2 ###
21 ROMERO AUMA CRISTOBAL E001 - 1451 3.03 E001 - 1450 153.00 156.03 3445 - 8M
22 ZELADA CERDAN MOISES WILDER E001 - 1449 36.41 E001 - 1448 262.00 298.41 0025 - 3A
23 QUIÑONEZ ESPINOZA NEYMAR ESTEBAN E001 - 1447 3.02 E001 - 1446 74.00 77.02 0336 - 8A
24 TENORIO MEDINA EMILIANO LUIS ALFREDO E001 - 1445 10.56 E001 - 1444 217.00 227.56 9034 - 5F
25 VEGA PASCUAL NAYADE LIZ E001 - 1443 2.08 E001 - 1442 33.00 35.08 C61 - 143
26 CUADROS VELARDE EDISON JOELL E001 - 1441 8.76 E001 - 1440 123.00 131.76 B8 - 6342
27 VILLANUEVA JARAMILLO DIGNA E001 - 1439 23.74 E001 - 1438 624.00 647.74 NI - 29990
28 SINARAHUA PASHANASE ROBESPIERRE E001 - 1437 5.75 E001 - 1433 86.00 91.75 B0 - 8147
29 VEGA PASCUAL NAYADE LIZ E001 - 1432 33.00 33.00 C61 - 143
30 VEGA PASCUAL NAYADE LIZ E001 - 1431 66.00 66.00 C61 - 143
31 MEJIA REATEGUI GUISELLA MARITZA E001 - 1430 33.00 33.00 3211 - EA
32 MEJIA REATEGUI GUISELLA MARITZA E001 - 1429 33.00 33.00 3211 - EA
33 TANTALEAN ZELADA JEANPIERRE E001 - 1428 21.62 E001 - 1427 86.00 107.62 B7 - 8197
34 DIAZ CASTRO LIONEL THIAGO E001 - 1425 5.84 E001 - 1424 158.00 163.84 B3D - 738
TOTAL: 303.38 4,776.00 5,079.38

LA POSITIVA SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 ZUMARAN SILVA CESAR AUGUSTO E001 - 1471 8.92 E001 - 1464 86.00 94.92 B7N - 051 20100210909 5/20/2019
02 LOPEZ PRADO MEDALID DEL ROSARIO E001 - 1474 2.05 E001 - 1472 68.00 70.05 ACP - 844 20100210909 5/20/2019
03 NUÑEZ TORRES SOLEDAD ESPERANZA E001 - 1476 33.00 33.00 A3Z - 791 20100210909 5/20/2019
04 NUÑEZ TORRES SOLEDAD ESPERANZA E001 - 1478 99.00 99.00 A3Z - 791 20100210909 5/20/2019
05 VEGA PASCUAL NAYADE LIZ E001 - 1481 4.80 E001 - 1480 66.00 70.80 ABA - 837 20100210909 5/20/2019
06 NUÑEZ TORRES SOLEDAD ESPERANZA E001 - 1482 33.00 33.00 A3Z - 791 20100210909 5/20/2019
07 GARCIA ALEJOS SHIRLEY MIREYA E001 - 1484 56.00 56.00 D10 - 163 20100210909 5/20/2019
08 ZAMBRANO BLANCO ANAYIS E001 - 1489 30.35 E001 - 1486 101.00 131.35 ACP - 844 20100210909 5/20/2019
09 PRADO MENDOZA YESSENIA DEL PILAR E001 - 1495 0.41 E001 - 1490 75.00 75.41 ACP - 844 20100210909 5/20/2019
10 BUENO CONDORI MARCO ANTONIO E001 - 1499 1.06 E001 - 1498 45.00 46.06 9748 - 8F 20100210909 5/20/2019
11 RIOS VICOS NICOLE STEPHANIE E001 - 1505 1.06 E001 - 1502 68.00 69.06 9748 - 8F 20100210909 5/20/2019
12 TREJO ALBERTCA VICTOR EDUARDO E001 - 1508 0.25 E001 - 1506 98.00 98.25 4515 - 5C 20100210909 5/20/2019
13 MEDINA IMAN JULISA YANIRA E001 - 1513 1.27 E001 - 1511 178.00 179.27 ABA - 303 20100210909 5/20/2019
14 ZAVALA CALDAS DANIEL ABEL E001 - 1515 7.36 E001 - 1514 105.00 112.36 AOD - 819 20100210909 5/20/2019
15 URIOL SOLANO ANTONY CARLO E001 - 1517 0.30 E001 - 1516 88.00 88.30 1880 - VA 20100210909 5/21/2019
16 HUAMAN SIFUENTES LOUIS PAUL E001 - 1519 21.99 E001 - 1518 207.00 228.99 A7Z - 753 20100210909 5/21/2019
17 VILLANUEVA CESPEDES YULI BLANCA E001 - 1523 32.31 E001 - 1520 97.00 129.31 8703 - AW 20100210909 5/21/2019
18 VEGA GALINDO YOSHELIN JANETH E001 - 1528 85.00 85.00 A8O - 588 20100210909 5/21/2019
19 SERRANO GUTIERREZ ROSA E001 - 1535 1.91 E001 - 1534 67.00 68.91 B7N - 060 20100210909 5/21/2019
20 FERNANDO FARID REGALADO ROMAN E001 - 1537 2.71 E001 - 1536 160.00 162.71 1854 - DA 20100210909 5/21/2019
21 NAMICHE ALANYA ISABEL JESUS E001 - 1539 1.21 E001 - 1538 45.00 46.21 7761 - OB 20100210909 5/21/2019
22 MORALES OBREGON UBER ESTEFANO E001 - 1530 12.24 E001 - 1524 122.00 134.24 A3U - 889 20100210909 5/21/2019
23 ALVAREZ RICO LUIS DANIEL E001 - 1522 41.49 E001 - 1521 86.00 127.49 AQH - 549 20100210909 5/21/2019
24 RAMOS ESPINOZA LOLA EUGENIA E001 - 1541 1.43 E001 - 1540 163.00 164.43 F5S - 803 20100210909 5/21/2019
25 ESPIRITU VASQUEZ JOSE LUIS E001 - 1543 25.85 E001 - 1542 157.00 182.85 7617 - 4F 20100210909 5/21/2019
26 GALLARDO ROJAS MARIA ALEJANDRINA E001 - 1526 9.15 E001 - 1525 226.00 235.15 F2Q - 425 20100210909 5/21/2019
27 DOMINGUEZ LA ROSA HUMBERTO E001 - 1532 1.42 E001 - 1531 191.00 192.42 6042 - 8B 20100210909 5/21/2019
28 HERNANDO CAMILO JIMENEZ OLIVERA E001 - 1529 1.28 E001 - 1527 230.00 231.28 AXR - 112 20100210909 5/21/2019
29 AZABACHE YSLA JUAN CHRISTIAN E001 - 1549 8.98 E001 - 1548 307.00 315.98 2012 - 5F 20100210909 5/21/2019
30 PORTILLA KAQUI IZAQUELA E001 - 1547 145.00 145.00 C9U - 407 20100210909 5/21/2019
31 RODRIGUEZ GUZMAN DEDICACIONA E001 - 1545 662.00 662.00 B7Z - 806 20100210909 5/21/2019
33 PEÑA GARCIA NORMA E001 - 1546 65.00 65.00 5059 - 1C 20100210909 5/21/2019
30 CHIARA ALVAREZ ELENA MARCIANA E001 - 1544 1.21 E001 - 1533 196.00 197.21 A8C - 750 20100210909 5/22/2019
TOTAL: 221.01 4,410.00 4,631.01

JUNIO

SOCAT PERÚ

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 PACHECO HUN GINA LIZETH E001 - 1598 1.50 E001 - 1597 107.00 108.50 A3T - 776 20543657132 6/5/2019
TOTAL: 1.50 107.00 108.50

AFOCAT LIMA METROPOLITANA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 ARISTA MUÑOZ NANCY ELIANA E001 - 1582 1.50 E001 - 1581 81.00 82.50 9044 - AA 20515915185 6/4/2019
02 FERNANDEZ CHUNGA SEBASTIAN JOSHUA E001 - 1584 3.40 E001 - 1583 78.00 81.40 3261 - 9A 20515915185 6/4/2019
03 SALAS AGUILAR PEDRO JORGE E001 - 1586 35.97 E001 - 1585 96.00 131.97 2533 - 3C 20515915185 6/4/2019
04 RAMIREZ SALAS RONEL LIZANDRO E001 - 1588 36.93 E001 - 1587 374.00 410.93 4040 - 7C 20515915185 6/4/2019
05 REYES BERROCAL MARCO ANTONIO E001 - 1591 5,697.81 E001 - 1590 5,941.00 11,638.81 3933 - 3B 20515915185 6/4/2019
06 REYES BERROCAL MARCO ANTONIO E001 - 1589 8,342.19 8,342.19 20515915185
07 CUBAS HOYOS CESAR ANTONIO E001 - 1592 38.00 38.00 8201 - AC 20515915185 6/5/2019
08 VASQUEZ ALCANTARA KEVIN E001 - 1594 1.21 E001 - 1593 75.00 76.21 6348 - 7A 20515915185 6/5/2019
09 DIAZ QUINTANA ANGEALLA BRIGITT E001 - 1596 2.34 E001 - 1595 105.00 20,802.01 A7 - 8939 6/5/2019
5,779.16 15,130.19 41,604.02

AFOCAT PREMIUM

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 RUEDA ORTIZ ANGEL AUGUSTO E001 - 1600 24.49 E001 - 1599 288.00 312.49 W3F - 797 20514583201 6/5/2019
02 CASIMIRO APOLINARIO CESAR WALTER E001 - 1602 26.83 E001 - 1601 454.00 480.83 3064 - RA 20514583201 6/5/2019
03 TOLEDO SANCHEZ SANDRA ALEJANDR E001 - 1605 4.50 E001 - 1604 104.00 108.50 2642 - 8F 20514583201 6/5/2019
04 CHUMPITAZ RAMIREZ JOSEPH ADALBERTH E001 - 1610 2.26 E001 - 1608 45.00 47.26 A2M - 791 20514583201 6/5/2019
05 AYALA PALMADERA OLGA KARINA E001 - 1611 38.00 38.00 2013 - 3D 20514583201 6/5/2019
06 LLASACCE HERHUAY OSCAR E001 - 1614 10.16 E001 - 1613 123.00 133.16 A2M - 791 20514583201 6/5/2019
TOTAL: 68.24 1,052.00 1,120.24

MAPFRE PERÚ COMPAÑÍA DE SEGUROS Y REASEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 AGUIRRE VILLANUEVA MARIA YSABEL E001 - 1570 2.56 E001 - 1569 91.00 93.56 1226 - 1F 20202380621 6/4/2019
02 ZUÑIGA CRISTOBAL GONZALO APARICIO E001 - 1572 2.66 E001 - 1571 90.00 92.66 ATV - 377 20202380621 6/4/2019
03 LOPEZ DE LA TORRE AYDEE URANIA E001 - 1574 5.19 E001 - 1573 128.00 133.19 A5U - 795 20202380621 6/4/2019
04 CAYETANO CHUMPITAZ YRMA DALILA E001 - 1576 9.38 E001 - 1575 45.00 54.38 A3Y - 748 20202380621 6/4/2019
05 REY ESPINOZA MIRTHA MARIA E001 - 1578 5.41 E001 - 1577 143.00 148.41 ABY - 712 20202380621 6/4/2019
06 RAYMUNDEZ RIVERA SUSY E001 - 1580 6.87 E001 - 1579 309.00 315.87 Z5D - 592 20202380621 6/4/2019
TOTAL: 32.07 806.00 838.07

AUTOSEGURO AFOCAT

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 AIRA AGUIRRE FELICITA E001 - 1557 0.53 E001 - 1556 70.00 70.53 1528 - 1A 20516314398 6/3/2019
02 SANTIAGO ORBEZO WILMER SAUL E001 - 1555 67.10 E001 - 1554 1,533.00 1,600.10 0849 - GA 20516314398 6/3/2019
03 VASQUEZ TAPIA DEYSI E001 - 1553 21.36 E001 - 1552 144.00 165.36 C6W - 255 20516314398 6/3/2019
04 BERNUY SALCEDO CLAUDIA ROSALIA E001 - 1559 5.99 E001 - 1558 240.00 245.99 B1S - 640 20516314398 6/4/2019
05 VILLEGAS BERNUY FRIDA ALEJANDRA E001 - 1561 2.92 E001 - 1560 68.00 70.92 B1S - 640 20516314398 6/4/2019
06 DE LA CRUZ HIDALGO ALEXANDER AUGUSTO E001 - 1563 7.86 E001 - 1562 134.00 141.86 3647 - KA 20516314398 6/4/2019
07 CORTEZ PFLUCKER ANGELA CLARET E001 - 1565 111.00 111.00 AHT - 585 20516314398 6/4/2019
08 RODAS CAMPOS ANGELA YOLANDA E001 - 1564 123.00 123.00 AHT - 585 20516314398 6/4/2019
09 GOMEZ CORTEZ TAREK ALEXANDER E001 - 1566 81.00 81.00 AHT - 585 20516314398 6/4/2019
10 VERANO RODAS ARIANA NICOLE E001 - 1568 0.27 E001 - 1567 68.00 68.27 AHT - 585 20516314398 6/4/2019
TOTAL: 106.03 2,572.00 2,678.03

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 DUEÑAS MARENGO EDITH RANCISCA E001 - 1617 17.11 E001 - 1616 122.00 139.11 NG - 37558 20515127403 6/6/2019
02 ROSALES HUATA FIBIANO ARMANDO E001 - 1621 14.84 E001 - 1619 86.00 100.84 C5 - 9630 20515127403 6/6/2019
03 CABRERA GUTIERREZ CHRISTIAN ANDRE E001 - 1624 1.06 E001 - 1623 75.00 76.06 C2 - 5686 20515127403 6/6/2019
04 CASTAÑEDA LUGO DIONICIO EMILIO E001 - 1635 1.21 E001 - 1632 81.00 82.21 1898 - 7F 20515127403 6/6/2019
05 NUÑEZ ZEVALLOS MARIA LUZ E001 - 1641 17.13 E001 - 1640 243.00 260.13 B7R - 769 20515127403 6/10/2019
06 VELIZ NEYRA ANGEL ISMAEL E001 - 1643 3.71 E001 - 1642 45.00 48.71 4274 - 6C 20515127403 6/10/2019
07 GUEVARA ENRIQUE PAOLO ALEXANDER E001 - 1645 0.45 E001 - 1644 117.00 117.45 0545 - 6A 20515127403 6/10/2019
08 ROSALES LAGUA GERALDINE ROSMERY E001 - 1647 3.48 E001 - 1646 113.00 116.48 9360 - 1C 20515127403 6/10/2019
09 ROQUE LINO WILDER CIPRIANO E001 - 1649 9.90 E001 - 1648 115.00 124.90 8554 - 8D 20515127403 6/10/2019
10 MAYO MARTIN DELIX E001 - 1651 3.99 E001 - 1650 159.00 162.99 3298 - IA 20515127403 6/10/2019
11 DIAZ LLAMO ARACELI E001 - 1653 4.93 E001 - 1652 109.00 113.93 C1 - 5393 20515127403 6/10/2019
12 PEREZ CONTRERAS EDGAR FABIAN E001 - 1655 0.42 E001 - 1654 91.00 91.42 C5 - 6330 20515127403 6/11/2019
13 CANTARO TRIBEÑOS EMILY ABIGAIL E001 - 1657 8.97 E001 - 1656 186.00 194.97 2899 - CA 20515127403 6/11/2019
14 SOTO SANTOS ARIAN JHAIR E001 - 1659 24.65 E001 - 1658 129.00 153.65 A6 - 7095 20515127403 6/11/2019
15 CORREA RUESTA ROCIO DEL PILAR E001 - 1661 13.49 E001 - 1660 93.00 106.49 9420 - AD 20515127403 6/11/2019
16 CHAVEZ CHUMACERO GRACIELA E001 - 1662 20.26 E001 - 1663 445.00 465.26 6768 - 1D 20515127403 6/11/2019
17 VILLENA REYES JAQUELINE YOJANE E001 - 1665 20.51 E001 - 1664 107.00 127.51 1573 -EA 20515127403 6/11/2019
18 SAPALLANAY VASQUEZ ANGEL JASEF E001 - 1667 3.00 E001 - 1666 127.00 130.00 0724 - NA 20515127403 6/11/2019
19 GUZMAN ESPINPOZA YENI YANET E001 - 1669 21.01 E001 - 1668 67.00 88.01 5341 - 6A 20515127403 6/11/2019
20 JULCA FIGUEROA EVERT JOSE E001 - 1671 2.05 E001 - 1670 137.00 139.05 5911 - 9C 20515127403 6/11/2019
21 GOMEZ BADARACO ANGELO JUAN E001 - 1673 2.56 E001 - 1672 75.00 77.56 5297 - ZA 20515127403 6/11/2019
22 DIAZ VASQUEZ OSCAR HUMBERTO E001 - 1675 16.16 E001 - 1674 163.00 179.16 4899 - 4F 20515127403 6/11/2019
TOTAL: 210.89 2,885.00 3,095.89

RIMAC SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 MORALES CHERO ANDI ANDRES E001 - 1679 193.94 E001 - 1678 977.00 1,170.94 C9W - 015 20100041953 6/11/2019
02 ESPEJO CIRIACO FRANK JEAR E001 - 1677 2.95 E001 - 1676 132.00 134.95 ANL - 573 20100041953 6/11/2019
03 RIVERA LINO LEONIDAS E001 - 1606 43.35 E001 - 1603 679.00 722.35 V2P - 350 20100041953 6/5/2019
04 RIQUEROS VILLEGAS TORIBIA ANA E001 - 1609 1.41 E001 - 1607 67.00 68.41 A1K - 701 20100041953 6/5/2019
05 RICO ACEVEDO YANEIVI NAZARETH E001 - 1615 8.11 E001 - 1612 105.00 113.11 F8R - 819 20100041953 5/6/2019
06 JERI GUTIERREZ FRANCISCO E001 - 1620 0.90 E001 - 1618 75.00 75.90 AJL - 558 20100041953 5/6/2019
07 AIRA AGUIRRE FELICITA E001 - 1625 0.53 E001 - 1622 70.00 70.53 D6B - 708 20100041953 5/6/2019
08 MIRANDA GIRALDO HERMELINDA NANCY E001 - 1627 28.17 E001 - 1626 123.00 151.17 APJ - 467 20100041953 5/6/2019
09 QUISPE PALOMINO YUDI LAURA E001 - 1629 10.21 E001 - 1628 93.00 103.21 F8R - 819 20100041953 5/6/2019
10 ALQUIZAR VARGAS ERICK JORGE E001 - 1631 28.13 E001 - 1630 203.00 231.13 APJ - 467 20100041953 5/6/2019
11 RAMIREZ SOTO MAYCON PEDRO E001 - 1634 2.51 E001 - 1633 180.00 182.51 ALT - 411 20100041953 5/6/2019
12 CALDERON OCAMPO ANA CAROLINA E001 - 1636 38.00 38.00 ANR - 680 20100041953 5/6/2019
13 PANTALEON PURIZACA MARIA JUANA E001 - 1638 20.76 E001 - 1639 554.00 574.76 AJL - 558 20100041953 6/7/2019
TOTAL: 340.97 3,296.00 3,636.97

AFOCAT LÍDER PERÚ

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 PAZ CARRANZA MIRIAM DE ROCIO E001 - 1735 4,252.79 E001 - 1734 8,230.00 12,482.79 8138 - 4A 20508523344 6/17/2019
02 PAZ CARRANZA MIRIAM DE ROCIO E001 - 1733 7,774.60 7,774.60 8138 - 4A 20508523344 6/17/2019
03 ROSALES POLO TEOFILO E001 - 1712 4.72 E001 - 1711 130.00 134.72 DON - 268 20508523344 6/14/2019
04 RODRIGUEZ YANAC ARSENIO BALVER E001 - 1710 22.18 E001 - 1680 436.00 458.18 2579 - RA 20508523344 6/14/2019
TOTAL: 4,279.69 16,570.60 20,850.29

PACÍFICO COMPAÑÍA DE SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 AYAMBO GONZALES NADIUSKA GRETHEL E001 - 1732 945.21 E001 - 1731 2,927.00 3,872.21 F8D - 892 20332970411 6/17/2019
02 AYAMBO GONZALES NADIUSKA GRETHEL E001 - 1730 4,366.76 4,366.76 F8D - 892 20332970411 6/17/2019
03 ROJAS SANDOVAL ALFONSO E001 - 1729 15.20 E001 - 1728 301.00 316.20 A0T - 1728 20332970411 6/17/2019
04 QUISPE PAHUACHO SARA BEATRIZ E001 - 1727 5.41 E001 - 1726 123.00 128.41 AYA - 212 20332970411 6/17/2019
05 AMASIFUEN SABOYA EDUARDA E001 - 1725 75.00 75.00 AQT - 753 20332970411 6/17/2019
06 QUISPE MORALES MILAGROS AZUCENA E001 - 1724 0.27 E001 - 1723 38.00 38.27 W2I - 115 20332970411 6/17/2019
07 NUÑEZ ACERO JACK HAMILTON E001 - 1722 1.80 E001 - 1721 105.00 106.80 ACI - 530 20332970411 6/17/2019
08 CANO CERRON CATALINA E001 - 1720 3.10 E001 - 1719 153.00 156.10 A3X - 749 20332970411 6/17/2019
09 ARANDA HUERTA JUNDADORA PERUANITA E001 - 1718 3.68 E001 - 1717 68.00 71.68 A0E - 726 20332970411 6/17/2019
10 ACERO VASQUEZ DE NUÑEZ JUANA ISIDORA E001 - 1716 2.56 E001 - 1715 52.00 54.56 ACI - 530 20332970411 6/17/2019
11 JIMENEZ HERBOZO RUFINA ALICIA E001 - 1714 1.28 E001 - 1713 117.00 118.28 A0Y - 252 20332970411 6/17/2019
12 SAGASTEGUI VALIENTE SANTOS GUILLERMO E001 - 1709 1.88 E001 - 1708 75.00 76.88 BFZ - 240 20332970411 6/13/2019
13 SAGASTEGUI BLAS VANIA ANTONELLA E001 - 1707 1.20 E001 - 1706 67.00 68.20 BFZ - 240 20332970411 6/13/2019
14 NUÑEZ ACERO JESUS E001 - 1705 1.90 E001 - 1704 91.00 92.90 ACI - 530 20332970411 6/13/2019
15 BUSTAMANTE ATOCHE REGINA BERENICE E001 - 1703 14.10 E001 - 1702 307.00 321.10 C0O - 094 20332970411 6/13/2019
16 VARGAS MALCA TEOFILO EUGENIO E001 - 1701 8.78 E001 - 1700 167.00 175.78 D6Q - 486 20332970411 6/13/2019
17 PIZARRO RIZ KEVIN ALEXANDER E001 - 1699 46.35 E001 - 1698 178.00 224.35 2224 - 7D 20332970411 6/13/2019
18 HUACHO MEDINA CLETO MARCELINO E001 - 1697 0.70 E001 - 1696 33.00 33.70 A3X - 749 20332970411 6/13/2019
19 HUACHO MEDINA CLETO MARCELINO E001 - 1695 3.00 E001 - 1694 33.00 36.00 A3X - 749 20332970411 6/13/2019
20 HUACHO MEDINA CLETO MARCELINO E001 - 1693 66.00 66.00 A3X - 749 20332970411 6/13/2019
21 HUACHO MEDINA CLETO MARCELINO E001 - 1692 33.00 33.00 A3X - 749 20332970411 6/13/2019
22 MELGAR IRIGOIN GABRIELA ALEXANDRA E001 - 1691 1.60 E001 - 1690 74.00 75.60 B2T - 735 20332970411 6/13/2019
23 HUACHO MEDINA CLETO MARCELINO E001 - 1689 33.00 33.00 A3X - 749 20332970411 6/13/2019
24 HUACHO MEDINA CLETO MARCELINO E001 - 1688 66.00 66.00 A3X - 749 20332970411 6/13/2019
25 QUIROZ HERNANDEZ JUAN DIEGO E001 - 1687 14.14 E001 - 1686 86.00 100.14 0461 - AT 20332970411 6/13/2019
26 NOEL OROZCO RUTH NOEMI E001 - 1685 199.00 199.00 B4 - 4399 20332970411 6/13/2019
27 MELGAR IRIGOIN SERGIO ANDRES E001 - 1684 1.20 E001 - 1683 74.00 75.20 B2T - 735 20332970411 6/13/2019
28 URETA SANTIAGO JOEL E001 - 1682 14.44 E001 - 1681 77.00 91.44 8089 - 7F 20332970411 6/13/2019
TOTAL: 1,087.80 9,984.76 11,072.56

INTERSEGURO COMPAÑÍA DE SEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 SAMALIA SALAZAR KATTY SILVIA E001 - 1750 1.60 E001 - 1748 75.00 76.60 AHC - 855 20382748566 6/18/2019
02 FLORES ASENCIOS BERNARDO FELIX E001 - 1747 11.46 E001 - 1746 45.00 56.46 AUP - 080 20382748566 6/18/2019
03 CIERTO SAMALIA PEDRO DYLAN E001 - 1745 2.40 E001 - 1744 98.00 100.40 AHC - 855 20382748566 6/18/2019
04 SORIA ZUÑIGA GLORIA FAUSTA E001 - 1742 53.86 E001 - 1741 496.00 549.86 B9H - 425 20382748566 6/18/2019
05 REQUEJO ABAD CARLOS ALBERTO E001 - 1740 1.60 E001 - 1739 75.00 76.60 A9S - 410 20382748566 6/18/2019
06 MARTINEZ MALPARTIDA DEBORAH SEKINA E001 - 1738 33.71 E001 - 1737 146.00 179.71 A9S - 410 20382748566 6/18/2019
TOTAL: 104.63 935.00 1,039.63

MINISTERIO DE TRANSPORTE Y COMUNICACIONES

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL RUC EMISIÓN
01 SANCHEZ NAVARRO MIGUEL ANGEL E001 - 1755 42.28 E001 - 1756 603.00 645.28 20131379944 6/18/2019
02 RAMIREZ GONZALES ENMA E001 - 1751 5,438.00 5,438.00 20131379944 6/18/2019
03 RAMIREZ GONZALES ENMA E001 - 1753 6,663.53 E001- 1749 4,408.80 11,072.33 20131379944 6/18/2019
TOTAL: 6,705.81 10,449.80 17,155.61

LA POSITIVA SEGUROS Y REASEGUROS S.A.

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 ZUÑIGA ESCUDERO DENNIS JESUS E001 - 1834 6.17 E001 - 1832 108.00 114.17 5403 - IA 20100210909 6/20/2019
02 CONTRERAS GRANADOS DIEGO SERGIO E001 - 1827 2.41 E001 - 1826 93.00 95.41 BDE - 151 20100210909 6/20/2019
03 YSUIZA VASQUEZ MIRIAM ANITA E001 - 1835 1.35 E001 - 1833 147.00 148.35 7529 - 3A 20100210909 6/20/2019
04 HERRERA PEÑA GABRIEL E001 - 1838 3,698.03 E001 - 1836 6,568.92 10,266.95 9501 - 8F 20100210909 6/20/2019
05 HERRERA PEÑA GABRIEL E001 - 1837 3,133.00 3,133.00 9501 - 8F 20100210909 6/20/2019
06 MARRUFO IDROGO HUGO E001 - 1840 96.37 E001 - 1839 636.00 732.37 BJB - 540 20100210909 6/20/2019
07 TRUJILLO CARRERA ADEMIR E001 - 1841 45.00 45.00 F6E - 518 20100210909 6/20/2019
08 CASTILLO CUEVA JUAN ROBERTO E001 - 1758 1.17 E001 - 1757 38.00 39.17 3728 - SA 20100210909 6/18/2019
09 QUISPE QUISPE ELIZABETH SAMANTA E001 - 1829 2.41 E001 - 1828 97.00 99.41 BDE - 151 20100210909 6/20/2019
10 DELGADO AGUILAR ELIANITA E001 - 1831 1.13 E001 - 1830 207.00 208.13 A5Y - 1830 20100210909 6/20/2019
11 CERCADO SANCHEZ NIMER E001 - 1762 15.25 E001 - 1761 167.00 182.25 4147 - EA 20100210909 6/19/2019
12 GONZALES TANTA JAIRO JAVIER E001 - 1760 0.41 E001 - 1759 67.00 67.41 B8N - 659 20100210909 6/19/2019
13 PURIHUAMAN MANAYAY EVARISTO E001 - 1764 2.81 E001 - 1763 45.00 47.81 3728 - SA 20100210909 6/19/2019
14 CUSIQUISIBAN ESQUERRE LEANDRO AGAPITO E001 - 1766 10.01 E001 - 1765 130.00 140.01 7761 - 0B 20100210909 6/19/2019
15 PRUDENCIO LEON MARIO ANIBAR E001 - 1768 2.11 E001 - 1767 194.00 196.11 C3Y - 870 20100210909 6/19/2019
16 MAGUIÑA CARRILLO ROCIO FRANCISCO E001 - 1770 4.91 E001 - 1769 45.00 49.91 0422 - FA 20100210909 6/19/2019
17 COTRINA TORRES THIAGO MATIAS E001 - 1771 67.00 67.00 BDE - 151 20100210909 6/19/2019
18 CALCERDE DEL CASTILLO YOHANNA E001 - 1772 124.00 124.00 9385 - 4D 20100210909 6/19/2019
19 FABIAN RAMOS MIGUEL ANGEL E001 - 1773 38.00 38.00 APT - 814 20100210909 6/20/2019
20 CALERO PAJUELO KATHERINE TANIA E001 - 1774 94.00 94.00 AJF - 361 20100210909 6/20/2019
21 WININGER SIFUENTES HUAYANAY E001 - 1801 233.70 E001 - 1798 489.00 722.70 RIA - 038 20100210909 6/20/2019
22 GALVEZ ANGULO ARMANDO ENRIQUE E001 - 1797 11.31 E001 - 1796 293.00 304.31 ARD - 096 20100210909 6/20/2019
23 GUERRERO CASTAÑEDA AARON NOATH E001 - 1795 0.84 E001 - 1794 94.00 94.84 AJF - 361 20100210909 6/20/2019
24 ARANGUREN TEJEDO VDA DE RIOJA ÑIGIA AIME E001 - 1793 2.12 E001 - 1792 163.00 165.12 APT - 929 20100210909 6/20/2019
25 GONZALES HUARANAGA PEDRO RONNY E001 - 1791 4.98 E001 - 1790 148.00 152.98 0422 - FA 20100210909 6/20/2019
26 RAMIREZ SONO ALEXIS E001 - 1789 3.42 E001 - 1788 111.00 114.42 APT - 814 20100210909 6/20/2019
27 CAYCHO VILLAR MANUEL ALFREDO E001 - 1787 16.74 E001 - 1786 468.00 484.74 ADK - 909 20100210909 6/20/2019
28 CABRERA LEYTON LESLIEN MARAYA E001 - 1785 0.52 E001 - 1784 94.00 94.52 AJF - 361 20100210909 6/20/2019
29 MORENO BARROSO MILAGROS DEYSI E001 - 1783 46.39 E001 - 1782 652.00 698.39 APG - 598 20100210909 6/20/2019
30 CALLUPE LEON NESTOR ROLANDO E001 - 1781 193.53 E001 - 1780 1,046.00 1,239.53 B9G - 188 20100210909 6/20/2019
31 MORI VASQUEZ THALIA ELIZABETH E001 - 1779 30.20 E001 - 1778 472.00 502.20 D8D - 341 20100210909 6/20/2019
32 GOMEZ CUBAS YOLANDA E001 - 1777 172.30 E001 - 1776 2,437.00 2,609.30 D9G - 954 20100210909 6/20/2019
33 HERRERA MARTINEZ ANDDY YOSMEH E001 - 1775 58.00 58.00 D8A - 584 20100210909 6/20/2019
34 INGA GUZMAN HILARIO E001 - 1820 402.33 E001 - 1818 2,330.00 2,732.33 BDT - 200 20100210909 6/20/2019
35 CASAS PAYHUA RUTH ISABEL E001 - 1814 45.00 45.00 ARD - 096 20100210909 6/20/2019
36 ANAYA FLORES OSCAR JHON E001 - 1812 3.82 E001 - 1811 417.00 420.82 4124 - DA 20100210909 6/20/2019
37 NAJARRO ZELAYA GLORIA KEIDA E001 - 1800 0.98 E001 - 1799 101.00 101.98 1880 - VA 20100210909 6/20/2019
38 ALOMSO VILLAORDUÑA WILDER E001 - 1803 7.54 E001 - 1802 375.00 382.54 F6L - 368 20100210909 6/20/2019
39 AGUALIMPIA TUBERQUIA JOSE ERNESTO E001 - 1804 144.00 144.00 1135 - IA 20100210909 6/20/2019
40 DOMINGUEZ SAAVEDRA FREY ALEXANDER E001 - 1806 169.07 E001 - 1805 624.00 793.07 4147 - EA 20100210909 6/20/2019
41 ALIAGA TACUCHE PAULA REINA E001 - 1808 107.02 E001 - 1807 1,209.00 1,316.02 ACW - 535 20100210909 6/20/2019
42 VERA CORDOVA ROCIO CONNIE E001 - 1810 19.18 E001 - 1809 263.00 282.18 ASG - 743 20100210909 6/20/2019
43 ORTIZ CERNA NEYDER DIOFANTO E001 - 1813 2.01 E001 - 1815 124.00 126.01 7529 - 3A 20100210909 6/20/2019
44 SILVA SILVA AMIVALIA E001 - 1817 18.11 E001 - 1816 93.00 111.11 C9V - 329 20100210909 6/20/2019
45 ROMERO CHOCA JUANA AMBROSIA E001 - 1821 0.32 E001 - 1819 108.00 108.32 F2S - 051 20100210909 6/20/2019
46 RAFAEL TERRONES XIOMARA JULIETH E001 - 1823 31.20 E001 - 1822 139.00 170.20 8985 - 6M 20100210909 6/20/2019
47 REYNA VASQUEZ JUAN CARLOS E001 - 1825 1.35 E001 - 1824 128.00 129.35 BDE - 151 20100210909 6/20/2019
TOTAL: 5,323.52 24,668.92 29,992.44

MES DE JULIO 2019

AUTOSEGURO AFOCAT

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 QUISPE VEGA RODRIGO E001 - 1947 18.84 E001 - 1948 294.00 312.84 C5B - 284 20516314398 7/7/2019
02 VILLEGAS BERNUY ALVA NICOL E001 - 1949 1.44 E001 - 1950 91.00 92.44 B1S - 640 20516314398 7/7/2019
TOTAL: 20.28 385.00 405.28

PACÍFICO COMPAÑÍA DE SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 CHANGA LASTRA ALBERTO E001 - 1974 1.46 E001 - 1973 75.00 76.46 COE - 196 20332970411 7/8/2019
02 CARHUAYANO INCHICAQUE JOSE LUIS E001 - 1972 97.00 97.00 F4X - 508 20332970411 7/8/2019
03 GUTIERREZ NEIRA JANETH DE MARIA E001 - 1970 14.23 E001 - 1971 45.00 59.23 8089 - 7F 20332970411 7/8/2019
04 CORCINO MORALES NILA ROXANA E001 - 1968 3.19 E001 - 1969 162.00 165.19 A0E - 726 20332970411 7/8/2019
05 SANDOVAL RIOS MARCIAL MANUEL E001 - 1966 10.21 E001 - 1967 45.00 55.21 B1 - I777 20332970411 7/8/2019
06 URETA GUTIERREZ LEVI DARIO JOEL E001 - 1964 15.15 E001 - 1965 45.00 60.15 8089 - 7F 20332970411 7/8/2019
07 AYAMBO GONZALES NADIUSKA GRETHEL E001 - 1963 33.00 33.00 F8D - 892 20332970411 7/8/2019
08 AYAMBO GONZALES NADIUSKA GRETHEL E001 - 1961 1.70 E001 - 1962 103.00 104.70 F8D - 892 20332970411 7/8/2019
09 AYAMBO GONZALES NADIUSKA GRETHEL E001 - 1960 47.99 E001 - 1959 80.00 127.99 F8D - 892 20332970411 7/8/2019
10 SALAMAN BONIFACIO FELIX E001 - 1958 33.00 33.00 BAA - 039 20332970411 7/8/2019
11 SALAMAN BONIFACIO FELIX E001 - 1956 4.80 E001 - 1957 33.00 37.80 BAA - 039 20332970411 7/8/2019
12 SALAZAR CHIPANA MAXIMILIANO E001 - 1954 0.70 E001 - 1955 63.00 63.70 F1T - 852 20332970411 7/8/2019
13 QUISPE PUMA EVELYN LIDIA E001 - 1953 33.00 33.00 AYZ - 620 20332970411 7/8/2019
14 QUISPE PUMA EVELYN LIDIA E001 - 1951 3.50 E001 - 1952 33.00 36.50 AYZ - 620 20332970411 7/8/2019
TOTAL: 102.93 880.00 982.93

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 ROSAS FRANCO DE VALVERDE CHARO ELENA E001 - 1907 142.00 142.00 4340 - 3F 20515127403 7/6/2019

02 GIL ROSARIO LUIS ALEJANDRO E001 - 1908 92.00 92.00 4340 - 3F 20515127403 7/6/2019

03 PANTOJO LOPEZ MARIA ROGELIA E001 - 1909 3.04 E001 - 1910 118.00 121.04 A5 - 6114 20515127403 7/6/2019

04 BERNARDO RAMIREZ LUIS ERICK E001 - 1911 36.05 E001 - 1912 162.00 198.05 B3J - 619 20515127403 7/6/2019

05 TINCO CCOLQUE LUCAS E001 - 1913 2.57 E001 - 1914 68.00 70.57 3568 - NA 20515127403 7/6/2019

06 PONTA AHUANARI ALEXIS DANIEL E001 - 1915 3.32 E001 - 1916 115.00 118.32 W27 - 596 20515127403 7/6/2019

07 MARCELO CASTILLO JOSE LUIS E001 - 1917 0.50 E001 - 1918 60.00 60.50 8267 - BA 20515127403 7/6/2019

08 RODRIGUEZ CASTRO APRIL KAORY E001 - 1919 1.60 E001 - 1920 132.00 133.60 B0W - 678 20515127403 7/6/2019

09 MASHUCURI MANCI LEYLIS E001 - 1921 0.72 E001 - 1922 101.00 101.72 0185 - 9B 20515127403 7/6/2019

10 LEON CARDENAS MIGUEL ANGEL E001 - 1923 11.54 E001 - 1924 155.00 166.54 0122 - 7D 20515127403 7/6/2019

11 CAMPOS BRIGIDO SARITA COLONIA E001 - 1925 111.00 111.00 ARN - 245 20515127403 7/7/2019

12 GUIZADO SANDOVAL ANTONI JESUS E001 - 1926 12.48 E001 - 1927 86.00 98.48 A7Z - 756 20515127403 7/7/2019

13 RODRIGUEZ VILLENA HARVEY JAMES E001 - 1928 1.20 E001 - 1929 38.00 39.20 1573 - EA 20515127403 7/7/2019

14 SANDOVAL DE AQUINO OFELIA AURELIA E001 - 1930 0.90 E001 - 1931 200.00 200.90 ARN - 245 20515127403 7/7/2019

15 TORRES SANTAMARIA RUMALDA E001 - 1932 11.97 E001 - 1933 290.00 301.97 2196 - 4A 20515127403 7/7/2019

16 AIRA PEÑA LUIS ALAN E001 - 1934 2.31 E001 - 1935 45.00 47.31 9313 - 5F 20515127403 7/7/2019

17 CARLOS ELIAS ANTONIO RAMIREZ E001 - 1936 655.37 E001 - 1937 2,459.72 3,115.09 MG - 45006 20515127403 7/7/2019

18 CARLOS ELIAS ANTONIO RAMIREZ E001 - 1938 1,453.00 1,453.00 MG - 45006 20515127403 7/7/2019

19 VALLADOLID HOSTIA LILIANA MIRTHA E001 - 1941 5.44 E001 - 1942 153.00 158.44 A8 - 9096 20515127403 7/7/2019

20 CHUGNAS ORTIZ WALTER E001 - 1939 38.91 E001 - 1940 259.00 297.91 F8F - 038 20515127403 7/7/2019

21 GARCIA SAYAGO ANDERSON LLAIR E001 - 1896 38.00 38.00 B7 - 8197 20515127403 7/6/2019

22 AQUINO IPANAQUE JULIO JUAN E001 - 1898 25.62 E001 - 1897 239.00 264.62 ARN - 245 20515127403 7/6/2019

23 ABANTO VILLEGAS OSCAR FERNANDO E001 - 1899 0.18 E001 - 1900 107.00 107.18 4217 - 7B 20515127403 7/6/2019

24 ROQUE APOLINARIO MEY SUANNY E001 - 1901 38.00 38.00 8554 - 8D 20515127403 7/6/2019

25 ROQUE APOLINARIO YUREM SANTIAGO E001 - 1902 38.00 38.00 8554 - 8D 20515127403 7/6/2019

26 RODRIGUEZ RAMOS EDSON E001 - 1903 16.86 E001 - 1904 45.00 61.86 1573 -EA 20515127403 7/6/2019

27 CONDE DAMASCO JERAL NICOLAS E001 - 1905 5.45 E001 - 1906 58.00 63.45 5725 - 0M 20515127403 7/6/2019

28 SALAZAR PARIASCA MATILDE ARACELI E001 - 1943 8.10 E001 - 1944 219.00 227.10 0234 - 7F 20515127403 7/7/2019

29 VICTOR TANUCHI RODRIGUEZ ASHIYAMA E001 - 1945 16.12 E001 - 1946 659.00 675.12 6942-8A 20515127403 7/7/2019

TOTAL: 860.25 7,680.72 8,540.97

AFOCAT PREMIUM

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 AQUISE MARTINEZ ANA CRISTINA E001 - 1879 2.81 E001 - 1878 120.00 122.81 2209 - JA 20514583201 7/4/2019
02 MARTINEZ HUACRE CIPRIANA E001 - 1881 6.96 E001 - 1880 120.00 126.96 2209 - JA 20514583201 7/4/2019
03 AQUISE SICHA RODOLFO E001 - 1883 11.59 E001 - 1882 86.00 97.59 2209 - JA 20514583201 7/4/2019
04 CARPIO VASQUEZ VIVIANA E001 - 1885 3.19 E001 - 1884 156.00 159.19 W1Y - 709 20514583201 7/4/2019
05 ZUÑIGA LEONARDO SANTOS ESTEBAN E001 - 1895 22.71 E001 - 1894 287.00 309.71 B9 - 3251 20514583201 7/5/2019
06 ESPINOZA ROMERO MARILU EUGENIA E001 - 1893 3.41 E001 - 1892 121.00 124.41 W1Y - 709 20514583201 7/5/2019
07 AGUILAR ZUMAETA GLORIA E001 - 1891 3.26 E001 - 1890 145.00 148.26 W1Y - 709 20514583201 7/5/2019
08 VALDEZ VASQUEZ ROSAS VIDAL E001 - 1889 7.65 E001 - 1888 107.00 114.65 A4N - 781 20514583201 7/5/2019
09 CORONADO SANTAMARIA JOSE WILMER E001 - 1887 0.98 E001 - 1886 91.00 91.98 A2M - 791 20514583201 7/4/2019
TOTAL: 62.56 1,233.00 1,295.56

AFOCAT LIMA METROPOLITANA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 DE LOS SANTOS GUERRERO ELIZABETH E001 - 1854 16.29 E001 - 1853 86.00 102.29 MG7 - 3561 20515915185 7/3/2019
02 MORILLO MATOS PAULA MARIA E001 - 1856 2.71 E001 - 1855 255.00 257.71 5675 - 6F 20515915185 7/4/2019
03 ALBERTO IRUPAILLA JHUSSEIN SAMUEL E001 - 1858 2.67 E001 - 1857 52.00 54.67 2636 - GA 20515915185 7/4/2019
04 BACA VARGAS MARIA HILDA E001 - 1860 24.47 E001 - 1859 141.00 165.47 7962 - 1D 20515915185 7/4/2019
05 RODRIGUEZ FLORES MARIA OLODIA E001 - 1862 2.30 E001 - 1861 74.00 76.30 A67 - 500 20515915185 7/4/2019
06 MEZA TRILLO REABEL E001 - 1864 1.41 E001 - 1863 118.00 119.41 0403 - 1D 20515915185 7/4/2019
07 RIVERA AGUILAR FRANCESCA ELIZABETH E001 - 1866 7.36 E001 - 1865 282.00 289.36 0831 - 5C 20515915185 7/4/2019
08 VERDE ALARCON MOISES E001 - 1868 7.39 E001 - 1867 109.00 116.39 3613 - 2A 20515915185 7/4/2019
09 CARRION VERDE JANELA JUNGZU E001 - 1870 14.75 E001 - 1869 123.00 137.75 9252 - 0D 20515915185 7/4/2019
10 VALLADARES GUZMAN MARCELINA ANGELINA E001 - 1872 1.60 E001 - 1871 67.00 68.60 8782 - 6D 20515915185 7/4/2019
11 ARTEAGA ALFARO MAYLI E001 - 1874 2.56 E001 - 1873 104.00 106.56 C4 - 2293 20515915185 7/4/2019
12 ZULUETA RIGOIN CAROLINA E001 - 1876 12.39 E001 - 1875 138.00 150.39 2968 - 4B 20515915185 7/4/2019
13 PEREZ JARA NOEMI NORMA E001 - 1877 38.00 38.00 7896 - 6A 20515915185 7/4/2019
TOTAL: 95.90 1,587.00 1,682.90

AFOCAT LÍDER PERÚ

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 HERNADEZ CASTAÑEDA LIAN ALONSO E001 - 1849 34.16 E001 - 1848 978.00 1,012.16 Z3A - 707 20508523344 7/3/2019
02 SANTOS YARIN ROSARIO ANABELA E001 - 1850 45.00 45.00 2343 - 9C 20508523344 7/3/2019
TOTAL: 34.16 1,023.00 1,057.16

BNP PARIBAS CARDIF S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 TORRES DOMINGUEZ MARIA LUZBEIDA E001 - 1978 1.21 E001 - 1979 198.00 199.21 BGS - 188 20513328819 7/9/2019
TOTAL: 1.21 198.00 199.21

PROTECTA S.A COMPAÑÍA DE SEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 BAUTISTA CHOMBA MELIANO E001 - 1983 522.09 522.09 B1J - 937 20517207331 7/10/2019
02 SANTOS YARIN ROSARIO ANABELA E001 - 1984 86.00 86.00 7772 - 0B 20508523344 7/10/2019
TOTAL: 0.00 608.09 608.09

MAPFRE PERÚ COMPAÑÍA DE SEGUROS Y REASEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 AGUIRRE VILLANERA MARIA YSABEL E001 - 1986 3.18 E001 - 1987 33.00 36.18 1226 - 1F 20202380621 7/10/2019
02 AGUIRRE VILLANERA MARIA YSABEL E001 - 1958 4.14 E001 - 1989 33.00 37.14 1226 - 1F 20202380621 7/10/2019
03 ARELLAN DOMINGUEZ FIORELLA GIORGINA E001 - 1990 13.81 E001 - 1991 247.00 260.81 A1D - 706 20202380621 7/10/2019
04 TORIBIO VALLEJOS GADIER E001 - 1992 25.72 E001 - 1993 123.00 148.72 8164 - 3F 20202380621 7/10/2019
TOTAL: 46.85 436.00 482.85

RIMAC SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 ROMERO VASQUEZ PORFIRIO E001 - 2004 60.00 60.00 B7M - 716 20100041953 7/10/2019
02 CHAVEZ GRANADOS MARIA CRISTINA E001 - 2003 63.00 63.00 AHR - 582 20100041953 7/10/2019
03 ORIHUELA GASPAR CESAR ALBERTO E001 - 2001 48.60 E001 - 2002 250.00 298.60 5022 - CA 20100041953 7/10/2019
04 MORENO MIRANDA CIRILO SEGUNDO E001 - 1999 1.05 E001 - 2000 135.00 136.05 A2D - 962 20100041953 7/10/2019
05 PISCOYA REYES OSCAR ALFREDO E001 - 1997 1.06 E001 - 1998 45.00 46.06 FBR - 819 20100041953 7/10/2019
06 SANCHEZ CHAVEZ MAXIMINA E001 - 1995 0.41 E001 - 1996 151.00 151.41 B3C - 720 20100041953 7/10/2019
07 LECANO CASTRO MARISSA E001 - 1994 45.00 45.00 F8R - 819 20100041953 7/10/2019
TOTAL: 51.12 749.00 800.12

INTERSEGURO COMPAÑÍA DE SEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 VALLADOLID CALDERON CLORINDA NATIVIDAD E001 - 2012 56.00 56.00 F2H - 250 20382748566 7/10/2019
02 LOPEZ TICONA RENZO ANDREE E001 - 2010 31.74 E001 - 2011 402.00 433.74 D4H - 026 20382748566 7/10/2019
03 AGUILAR MENDO NATALY E001 - 2008 1.28 E001 - 2009 118.00 119.28 BAK - 682 20382748566 7/10/2019
04 ARRIETA ACCINELLI JOAQUIN E001 - 2006 1.28 E001 - 2007 111.00 112.28 BAK - 682 20382748566 7/10/2019
05 PRINCIPE ANGELES FRANCISCO LUIS E001 - 2005 33.00 33.00 W4Z - 859 20382748566 7/10/2019
TOTAL: 34.30 720.00 754.30

LA POSITIVA SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 LANDA VELASQUEZ ERINSO MIGUEL E001 - 2042 789.79 E001 - 2043 2,912.28 3,702.07 C5Q - 623 20100210909 7/15/2019
02 LANDA VELASQUEZ ERINSO MIGUEL E001 - 2044 2,379.00 2,379.00 C5Q - 623 20100210909 7/15/2019
03 AMANTE RASHTA MARCELA ADRIANA E001 - 2041 102.00 102.00 8654 - 3F 20100210909 7/15/2019
04 ESCALANTE MEDRANO DIOCORIDES ELEUTERIO E001 - 2039 0.70 E001 - 2040 96.00 96.70 5547 - 7D 20100210909 7/15/2019
05 LANDA VELASQUEZ ERINSO MIGUEL E001 - 2037 9.90 E001 - 2038 93.00 102.90 C5Q - 623 20100210909 7/15/2019
06 JULCA BERRU YESSICA PAOLA E001 - 2036 66.00 66.00 8985 - 6M 20100210909 7/15/2019
07 VEGA PASCUAL NAYADE LIZ E001 - 2034 13.09 E001 - 2035 163.00 176.09 ABA - 837 20100210909 7/15/2019
08 SILVA SILVA AMIVALIA E001 - 2033 33.00 33.00 C9V - 329 20100210909 7/15/2019
09 SILVA SILVA AMIVALIA E001 - 2032 33.00 33.00 C9V - 329 20100210909 7/15/2019
10 BECERRA CHIMBOR GAVY GRACIELA E001 - 2030 5.76 E001 - 2031 75.00 80.76 AYH - 767 20100210909 7/15/2019
11 CAPUÑAY CHACON FREDERICK ROGELIO E001 - 2028 2.56 E001 - 2029 45.00 47.56 0775 - MA 20100210909 7/15/2019
12 VELARDE LLERENA RODOLFO E001 - 2026 9.54 E001 - 2027 52.00 61.54 B71 - 464 20100210909 7/15/2019
13 TORRES PALOMINO GUISELLA MADELEYNE E001 - 2024 23.00 E001 - 2025 203.00 226.00 BDE - 151 20100210909 7/15/2019
14 MATOS RAMIREZ MARITZA CECILIA E001 - 2022 13.80 E001 - 2023 323.00 336.80 M2P - 662 20100210909 7/15/2019
15 GIORDANO SAAVEDRA DANIELA CLAUDIA E001 - 2020 2.55 E001 - 2021 113.00 115.55 3976 - AA 20100210909 7/15/2019
16 CALLUPE RAMOS APOLONIA E001 - 2018 35.99 E001 - 2019 595.00 630.99 B9G - 188 20100210909 7/11/2019
17 LA ROSA NICHO UBERTINA E001 - 2015 144.12 E001 - 2016 1,670.00 1,814.12 AST - 849 20100210909 7/11/2019
18 LA ROSA NICHO UBERTINA E001 - 2017 588.00 588.00 AST - 849 20100210909 7/11/2019
19 MIÑANO ORUNA ANA BERTHA E001 - 2013 41.14 E001 - 2014 739.00 780.14 B9A - 201 20100210909 7/11/2019
TOTAL: 1,091.94 10,280.28 11,372.22

AGOSTO

PACÍFICO COMPAÑÍA DE SEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 GASTELO FERNANDEZ RONALDO JESUS E001 - 2047 1.25 E001 - 2048 154.00 155.25 HA-3518 20332970411 8/1/2019
02 NADIUSKA GRETHEL AYAMBO GONZALES E001 - 2049 33.00 33.00 F8D-892 20332970411 8/1/2019
03 EVELYN LIDIA QUISPE PUMA E001 - 2050 1.50 E001 - 2051 83.00 84.50 AYZ-620 20332970411 8/1/2019
04 SANTOS ORTIZ CARLOS AURELIO E001 - 2052 1.37 E001 - 2053 407.00 408.37 6A-1337 20332970411 8/1/2019
05 YUPANQUI QUISPE FLORENCIO E001 - 2054 2.40 E001 - 2055 45.00 47.40 A0E-726 20332970411 8/1/2019
06 RAMOS GAMBOA MICHAEL OWEN E001 - 2056 1.20 E001 - 2057 67.00 68.20 BHM - 475 20332970411 8/3/2019
07 CESPEDES HERNANDEZ ELMER JHON E001 - 2058 75.92 E001 - 2059 837.00 912.92 A93 - 139 20332970411 8/3/2019
08 CONDOR MOGOLLON BLAS EFRAIN E001 - 2060 16.80 E001 - 2061 370.00 386.80 PL - 18208 20332970411 8/3/2019
09 ROMERO ENRIQUEZ YHADIRA LILIBETH E001 - 2062 7.30 E001 - 2063 71.00 78.30 B2S - 799 20332970411 8/3/2019
10 MALLQUI ANTIALON ISABEL E001 - 2064 1.13 E001 - 2065 45.00 46.13 A3X - 749 20332970411 8/3/2019
11 PRUDENCIO TRUJILLO ALEX NICANOR E001 - 2066 38.00 38.00 ACI - 530 20332970411 8/3/2019
12 HANCCO VALLE MERI CLARED E001 - 2067 7.56 E001 - 2068 86.00 93.56 D7C - 631 20332970411 8/3/2019
13 QUINECHE VENTURA JUAN CARLOS E001 - 2069 22.99 E001 - 2070 162.00 184.99 AAD - 471 20332970411 8/3/2019
TOTAL: 139.42 2,398.00 2,537.42

AUTOSEGURO AFOAT

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 MARTINEZ QUISPE JHEISON OSCAR E001 - 2071 18.64 E001 - 2072 208.00 226.64 A7R - 727 20516314398 8/4/2019
02 ÑAUPARI INGA JHONY ALEJANDRO E001 - 2082 1.35 E001 - 2083 86.00 87.35 MCG - 15859 20516314398 8/4/2019
03 PAREDES BAZAN KIMILSUNG E001 - 2081 1.32 E001 - 2080 204.00 205.32 A7R - 727 20516314398 8/4/2019
04 SANTANDER MALAGA ROMMI LINA E001 - 2078 0.27 E001 - 2079 38.00 38.27 7774 - 4F 20516314398 8/4/2019
05 HERNANDEZ SATANDER LEONIAS ALESSANDRO E001 - 2077 38.00 38.00 7774 - 4F 20516314398 8/4/2019
06 RAMOS SAENZ LUIS ANGEL E001 - 2075 8.96 E001 - 2076 446.00 454.96 D5F - 135 20516314398 8/4/2019
07 ROMERO ORTEGA BLANCA FLORA E001 - 2073 0.55 E001 - 2074 227.00 227.55 A7R - 727 20516314398 8/4/2019
TOTAL: 31.09 1,247.00 1,278.09

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 RETAMOZO ANDIA MARIANO E001 - 2153 8.45 E001 - 2154 93.00 101.45 3171 - 6F 20515127403 8/6/2019
02 GUTIERREZ CARDENAS CLAUDIA E001 - 2151 631.26 631.26 6825 - 7F 20515127403 8/6/2019
03 MUÑOZ PAREDES MARCO ANTONIO E001 - 2148 1.50 E001 - 2149 57.00 58.50 A7 - 8860 20515127403 8/6/2019
04 RUIZ GASTELO EDGAR JAVIER E001 - 2150 17.08 E001 - 2152 86.00 103.08 0862 - LA 20515127403 8/6/2019
05 CHIROQUE MOCARRO NELLY E001 - 2146 1.50 E001 - 2147 38.00 39.50 8668 - 7A 20515127403 8/6/2019
06 RETA CRUZ YANET E001 - 2144 1.91 E001 - 2145 45.00 46.91 3572 - LA 20515127403 8/6/2019
07 AIRA PEÑA LUIS ALAN E001 - 2142 5.25 E001 - 2143 143.00 148.25 9313 - 5F 20515127403 8/6/2019
08 AQUINO IPANAQUE JULIO JUAN E001 - 2140 2.10 E001 - 2141 66.00 68.10 ARN - 249 20515127403 8/6/2019
09 AQUINO IPANAQUE JULIO JUAN E001 - 2138 1.13 E001 - 2139 33.00 34.13 ARN - 249 20515127403 8/6/2019
10 AQUINO IPANAQUE JULIO JUAN E001 - 2136 42.65 E001 - 2137 106.00 148.65 ARN - 249 20515127403 8/6/2019
11 SILVA RAMOS VICTORIO E001 - 2135 93.00 93.00 A7 - 8857 20515127403 8/6/2019
12 GUZMAN ESPINOZA YENI YANET E001 - 2133 6.38 E001 - 2134 99.00 105.38 5341 - 6A 20515127403 8/6/2019
13 PALACIOS GARCIA MOISES ALEX E001 - 2131 23.16 E001 - 2132 66.00 89.16 3812 - 6A 20515127403 8/6/2019
14 AGUILAR TACURI MARILU E001 - 2130 66.00 66.00 B8 - 4724 20515127403 8/6/2019
15 AGUILAR TACURI MARILU E001 - 2129 66.00 66.00 B8 - 4724 20515127403 8/6/2019
16 SANDOVAL DE AQUINO OFELIA AURELIA E001 - 2127 1.40 E001 - 2128 66.00 67.40 ARN - 245 20515127403 8/6/2019
17 SANDOVAL DE AQUINO OFELIA AURELIA E001 - 2125 1.80 E001 - 2126 66.00 67.80 ARN - 245 20515127403 8/6/2019
18 UTRILLA ROMANI ANI SOLANGE E001 - 2123 4.33 E001 - 2124 214.00 218.33 C1 -1343 20515127403 8/6/2019
19 HUAMAN VARGAS ROBERTO ANDRES E001 - 2121 23.02 E001 - 2122 438.00 461.02 0669 - HA 20515127403 8/6/2019
20 MONTOYA CORDOVA JULIA DE JESUS E001 - 2119 15.57 E001 - 2120 81.00 96.57 4559 - AD 20515127403 8/6/2019
21 ARENAS TORRES ALADINO E001 - 2117 17.08 E001 - 2118 86.00 103.08 0862 - LA 20515127403 8/6/2019
22 CORDOVA MONTOYA ROXANA VANESSA E001 - 2115 1.57 E001 - 2116 45.00 46.57 4559 - AD 20515127403 8/6/2019
23 BETALLELUZ AGUIRRE ANA CRISTINA E001 - 2113 0.62 E001 - 2114 111.00 111.62 9899 - 6A 20515127403 8/6/2019
24 HUAMAN YUPANQUI SHUSSAN VANESSA E001 - 2111 0.80 E001 - 2112 130.00 130.80 4559 - 4D 20515127403 8/6/2019
25 AGUILAR TACURI MARILU E001 - 2109 13.47 E001 - 2110 239.00 252.47 B8 - 4724 20515127403 8/6/2019
26 CARDENAS LLANOS TEODOLINDA E001 - 2107 0.66 E001 - 2108 225.00 225.66 1394 - IA 20515127403 8/6/2019
27 ORTEGA VILCATANTA MARYANN E001 - 2105 0.66 E001 - 2106 74.00 74.66 1394 - IA 20515127403 8/6/2019
28 LOAIZA LEON ZOE DEISY E001 - 2104 45.00 45.00 NG60 - 470 20515127403 8/6/2019
29 SALDAÑA ALANYA CARLOS ALBERTO E001 - 2102 1.33 E001 - 2103 45.00 46.33 0862 - LA 20515127403 8/6/2019
30 HUARANGA ESCOBEDO DAVID DANIEL E001 - 2100 29.60 E001 - 2101 1,210.00 1,239.60 D40 - 223 20515127403 8/6/2019
31 RODRIGUEZ NAVEROS MOISES ABEL E001 - 2098 27.38 E001 - 2099 148.00 175.38 0052 - 6A 20515127403 8/6/2019
32 OCAÑA DIONISIO AQUILA REODOSIA E001 - 2097 161.00 161.00 B19 - 081 20515127403 8/6/2019
33 AYALA VARGAS DE TOCAS NARCISA E001 - 2095 13.72 E001 - 2096 175.00 188.72 C5 - 7485 20515127403 8/6/2019
34 RODRIGUEZ CABRERA NICOLAS DIONICIO E001 - 2093 21.23 E001 - 2094 123.00 144.23 8914 - 1F 20515127403 8/6/2019
35 VILCHEZ RODRIGUEZ SANTIAGO EITHAN E001 - 2092 38.00 38.00 B8 - 7354 20515127403 8/6/2019
36 RABANAL ALIAGA JONATHAN CALEB E001 - 2090 0.62 E001 - 2091 124.00 124.62 MG - 89397 20515127403 8/6/2019
37 SALINAS DE JERI ROCIO DEL CARMEN E001 - 2089 95.00 95.00 4242 - IA 20515127403 8/6/2019
38 NEIRA GARCIA MARIA VILMA E001 - 2088 93.00 93.00 1382 - 6B 20515127403 8/6/2019
39 WINNER WINERGER AGURTO RAFAEL E001 - 2086 983.00 E001 - 2087 99.00 1,082.00 1169 - PA 20515127403 8/6/2019
40 RODRIGUEZ VILLENA JEAN PAUL E001 - 2084 0.42 E001 - 2085 38.00 38.42 1573 - EA 20515127403 8/6/2019
TOTAL: 1,269.39 5,857.26 7,126.65

AFOCAT LIDER PERU

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 MARIA SOLEDAD MUSAYON REYES E001-2177 94.59 E001-2178 575.00 669.59 FA-4332 20508523344 8/10/2019
02 QUISPE CHOCCA ABEL E001-2179 1.05 E001-2180 61.00 62.05 9F-4300 20508523344 8/10/2019
03 JOEL EFUS SANCHEZ E001-2181 37.04 E001-2182 244.00 281.04 2F-4730 20508523344 8/10/2019
04 MAURO PEREZ LOPEZ E001-2183 33.00 33.00 TIK-618 20508523344 8/10/2019
05 VASQUEZ PAREDES ANGEL E001-2184 1.40 E001-2185 66.00 67.40 2F-4730 20508523344 8/10/2019
06 YULY ESTELA PEÑA ONOFRE E001-2186 33.00 33.00 2C-0995 20508523344 8/10/2019
07 ARISTA VISALOT HANDELL YONE E001-2187 3.59 E001-2188 91.00 94.59 C4 - 8071 20508523344 8/10/2019

TOTAL: 137.67 1,103.00 1,240.67

RIMAC SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 CASTILLO ALVAREZ DE RUEDA MARIA E001-2189 1.69 E001-2190 104.00 105.69 A717 - 96 20100041953 8/10/2019

02 FRANK JEAR ESPEJO CIRIACO E001-2191 3.84 E001-2192 133.00 136.84 ANL -573 20100041953 8/10/2019

03 ROMER YPUSHIMA CABUDIVO E001-2193 18.22 E001-2194 368.00 386.22 F3U - 747 20100041953 8/10/2019

04 SALAZAR BOCANGEL AUGUSTO SEBASTIAN E001-2195 11.78 E001-2196 93.00 104.78 A6 - 1323 20100041953 8/10/2019

05 CORPUS TREJO FLORIANO CALICIO E001-2197 6.00 E001-2198 45.00 51.00 A9F - 704 20100041953 8/10/2019

06 FLORES MEDRANO FERNANDA E001-2199 1.00 E001-2200 38.00 39.00 A9F - 704 20100041953 8/10/2019

07 SANCHEZ BRICEÑO RUSSEL WALTER E001-2201 13.06 E001-2202 339.00 352.06 1C- 4875 20100041953 8/10/2019

08 MARY STEFANY SANTIN ESPINOZA E001-2203 43.61 E001-2204 646.00 689.61 F8R-819 20100041953 8/10/2019

09 FERNANDA TORRES MARIA VIDALINA E001-2205 14.32 E001-2206 93.00 107.32 B9J-728 20100041953 8/10/2019

10 GALLARDO REYES SANDRA DANIELA E001-2207 24.05 E001-2208 133.00 157.05 1C- 4875 20100041953 8/10/2019

11 ESCARLET MARINA TRUJILLO HERNANDEZ E001-2209 23.42 E001-2210 377.00 400.42 A8L-039 20100041953 8/10/2019

12 MARILIYN OCAMPO PEREZ E001-2211 38.00 38.00 ANR-680 20100041953 8/10/2019

13 CESAR RUBEN ZUÑUGA VASQUEZ E001-2212 1.20 E001-2213 67.00 68.20 A50-286 20100041953 8/10/2019

14 MIRANDA ROMERO PERCY ANGEL E001-2214 23.87 E001-2215 261.00 284.87 A3R-659 20100041953 8/10/2019

15 YASELI YUSVELI OTINIANO APARICIO E001-2216 30.20 E001-2217 195.00 225.20 A6H-597 20100041953 8/10/2019

16 LEONOR ANGELICA GOMERO ZORRILLA E001-2218 1.76 E001-2219 96.00 97.76 AUW-838 20100041953 8/10/2019

17 GUERRERO CORDOVA VERONICA E001-2220 29.30 E001-2221 113.00 142.30 B8Q-637 20100041953 8/10/2019

18 LASTRA ALGUNA LILA E001-2222 1.31 E001-2223 64.00 65.31 A9F - 704 20100041953 8/10/2019

19 SOTO CERNA MAGNA E001-2224 2.68 E001-2225 191.00 193.68 ALT-411 20100041953 8/10/2019

TOTAL: 251.31 3,394.00 3,645.31

LA POSITIVA SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 TADEO VALENTIN CANDELA PEÑA E001-2156 43.38 E001-2157 518.00 561.38 1772-7A 20514583201 8/8/2019

02 JAMBO MARIN CLEBER FELIPE E001-2158 17.41 E001-2159 119.00 136.41 B7-4472 20514583201 8/8/2019

03 CABRERA UTRILLA JOEL ANGEL E001-2160 29.59 E001-2161 122.00 151.59 ABU-774 20514583201 8/8/2019

04 ESPIRILLA USCAMAYTA VERONICA E001-2162 6.02 E001-2163 151.00 157.02 2732-8D 20514583201 8/8/2019

05 ASCA PADILLA VICTOR HENRY E001-2164 0.48 E001-2165 248.00 248.48 A2X-710 20514583201 8/9/2019

06 BRUNO GOMEZ CARHUAJULCA E001-2166 38.00 38.00 0457-2C 20514583201 8/9/2019

07 JUSTO MORY LIZ E001-2167 0.27 E001-2168 38.00 38.27 C56-045 20514583201 8/9/2019

08 NARRO AVALOS ELIZABETH MERCEDES E001-2169 1.12 E001-2170 45.00 46.12 2030-AA 20514583201 8/9/2019

09 CASTILLO NARRO INGRID FATIMA E001-2171 0.48 E001-2172 45.00 45.48 2030-AA 20514583201 8/9/2019

10 PALOMINO LIZONDO MAYRA DEYSI E001-2173 4.83 E001-2174 93.00 97.83 NI-16615 20514583201 8/9/2019

11 CLARET MARITZA OLORTEGUI E001-2175 10.35 E001-2176 149.00 159.35 A2M-791 20514583201 8/9/2019

TOTAL: 113.93 1,566.00 1,679.93

AFOCAT LIMA METROPOLITANA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 GARAY HUAYHUA EMERITA E001-2226 2.66 E001-2227 67.00 69.66 7567-AA 20515915185 8/11/2019

02 QUIROZ GARAY AMILCAR JOSUE E001-2228 67.00 67.00 7567-AA 20515915185 8/11/2019

03 HUAMAN CANO MARIA LEONOR E001-2229 2.52 E001-2230 118.00 120.52 9255-4C 20515915185 8/11/2019

04 KATHIA ARACELI MORI INUMA E001-2231 6.35 E001-2232 155.00 161.35 5653-7B 20515915185 8/11/2019

05 IVANA KRISTEL PALOMINO RAMOS E001-2233 1.05 E001-2234 89.00 90.05 1465-AA 20515915185 8/11/2019

06 DAMIANA DE LA CRUZ ESTELA E001-2237 1.20 E001-2238 264.00 265.20 NG-94829 20515915185 8/13/2019

07 GINO ORLANDO AGURTO DURAN E001-2239 316.00 316.00 0880-6D 20515915185 8/13/2019

08 RODRIGUEZ HEREDIA VIVIANA ISABEL E001-2240 1.31 E001-2241 68.00 69.31 6083-9B 20515915185 8/13/2019

09 PAPINIANO GALARZA CHIRRE E001-2242 86.00 86.00 6083-9B 20515915185 8/13/2019

10 YANDEL AGUSTIN RIOS CAPA E001-2243 38.00 38.00 C3-4354 20515915185 8/13/2019

11 CHAVEZ FLORES CHRISTIAN JONATHAN E001-2244 1.17 E001-2245 61.00 62.17 1115-SA 20515915185 8/13/2019

12 RAMOS VEGA RENZO GIL E001-2246 75.00 75.00 0125-NA 20515915185 8/13/2019

13 DORA BECERRA TORRES E001-2247 8.53 E001-2248 1,149.00 1,157.53 4793.-8A 20515915185 8/14/2019

14 DORA BECERRA TORRES E001-2249 100.89 E001-2250 277.00 377.89 4793-8A 20515915185 8/14/2019

15 CHANCHARI ZAMBRANO YOLANDA E001-2251 45.41 E001-2252 157.00 202.41 F7L-870 20515915185 8/14/2019

16 TACILIA SANCHEZ FELIX E001-2253 1.84 E001-2254 174.00 175.84 F7L-870 20515915185 8/14/2019

17 CASTILLO RAMIREZ FRANK E001-2255 2.20 E001-2256 67.00 69.20 1666-7F 20515915185 8/14/2019

18 PURIHUAMAN RODRIGUEZ NELSON E001-2257 21.86 E001-2258 93.00 114.86 7715-3C 20515915185 8/14/2019

19 ALBITES VIGIL DE BERNALES TERESA E001-2259 2.86 E001-2260 103.00 105.86 A49-298 20515915185 8/14/2019

20 ALBITES VIGIL DE BERNALES TERESA E001-2261 4.05 E001-2262 66.00 70.05 A49-298 20515915185 8/14/2019

21 CORINA GAMARRA OSORIO E001-2263 3.00 E001-2264 33.00 36.00 1727-7A 20515915185 8/14/2019

22 RODRIGUEZ LIMA DE MAYANGA JUANA E001-2265 14.40 E001-2266 33.00 47.40 3553-GA 20515915185 8/14/2019

23 VELASQUEZ LOPEZ JOSE ANTONIO E001-2267 7.50 E001-2268 86.00 93.50 5852-3D 20515915185 8/14/2019

24 GARCIA PANTA BENITA MERCEDES E001-2269 18.06 E001-2270 101.00 119.06 8495-6F 20515915185 8/14/2019

25 GOMEZ CHIROQUE DARIEL SALVADOR E001-2271 1.20 E001-2272 38.00 39.20 1455-VA 20515915185 8/14/2019

26 VELASQUEZ PASTOR FLORA MICAELA E001-2273 1.86 E001-2274 45.00 46.86 1455-VA 20515915185 8/14/2019

27 GONZALES ABAN VIKY MARUJA E001-2275 105.00 105.00 2546-QA 20515915185 8/14/2019

28 HUAMAN CANO MIGUEL ANGEL E001-2276 4.21 E001-2277 45.00 49.21 9255-AC 20515915185 8/14/2019

TOTAL: 254.13 3,976.00 4,230.13

AFOCAT REGION LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 BENIGNO CHINGA MELENDEZ E001-2235 57.15 E001-2236 338.00 395.15 C3-3155 20515127403 8/13/2019

TOTAL: 57.15 338.00 395.15

PACIFICO COMPAÑÍA SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
01 BONIFACIO EVANGELISTA JHONEL LINDER E001-2280 10.76 E001-2281 146.00 156.76 0196 -BA 20332970411 8/14/2019

02 GOÑE RISCO JOSE E001-2282 26.61 E001-2283 92.00 118.61 8024-5C 20332970411 8/14/2019

03 AMASIFUEN GONZALES HERLINDA GEORGINA E001-2284 1.91 E001-2285 90.00 91.91 ABG-897 20332970411 8/14/2019

04 FERNANDO VESLASQUEZ VILLEGAS E001-2286 24.73 E001-2287 237.00 261.73 ALY-627 20332970411 8/14/2019

05 ANDRADE COCHAN VDA DE MENDOZA E001-2288 96.15 E001-2289 986.00 1,082.15 F8W-170 20332970411 8/14/2019

06 RUTBEL ELKIN SALDAÑA LOPEZ E001-2290 3.87 E001-2291 141.00 144.87 3612-KA 20332970411 8/14/2019

07 ERNERTO SEBASTIAN VASQUEZ E001-2292 38.00 38.00 C9A-757 20332970411 8/14/2019

08 FERNANDEZ BAUTISTA ALEJANDRO E001-2293 1.20 E001-2294 38.00 39.20 AQY-700 20332970411 8/14/2019

TOTAL: 165.23 1,768.00 1,933.23

INTERSEGURO COMPAÑÍA SEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 ESWIN AZAEL ALEXANDER CRUZ FARFAN E001-2327 1.00 E001-2328 38.00 39.00 DAU-478 20382748566 8/18/2019

02 CARRASCO SOTO OLGER E001-2330 17.17 E001-2331 145.00 162.17 A5Z-827 20382748566 8/18/2019

03 CHOQUE QUELCA VDA DE JARA ELIZABETH E001-2332 2.56 E001-2333 233.00 235.56 AU-3884 20382748566 8/18/2019

TOTAL: 20.73 416.00 436.73

LA POSITIVA SEGUROS Y REASEGUROS S.A.

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 YACHACHIN LUIS EMMA LUZ E001-2334 22.01 E001-2335 104.00 126.01 D6T-146 20382748566 8/18/2019

02 YACHACHIN LUIS GLADYS DORIS E001-2336 1.91 E001-2337 97.00 98.91 D6T-146 20382748566 8/18/2019

03 VILCHEZ MIRANDA PATRICK E001-2338 1.45 E001-2339 38.00 39.45 A8O-659 20382748566 8/18/2019

04 JACINTO CHACON THEDGE AXEL E001-2341 1.86 E001-2340 145.00 146.86 1159-3B 20382748566 8/18/2019

05 ANTICONA QUISPE DANIEL ENGELBERT E001-2342 1.17 E001-2343 52.00 53.17 6160-HA 20382748566 8/18/2019

06 ANTICONA QUISPE CLARELIS RUBY E001-2344 1.17 E001-2345 45.00 46.17 6160-HA 20382748566 8/18/2019

07 VILCHEZ CHUNGA JOSE ALEJANDRO E001-2346 1.06 E001-2347 75.00 76.06 A8O-659 20382748566 8/18/2019

08 CERRON TORRES BRYANNA SAYURI E001-2348 0.55 E001-2349 115.00 115.55 A2F-635 20382748566 8/18/2019

09 VILCHEZ MIRANDA JOSE ANGEL E001-2350 1.20 E001-2351 38.00 39.20 A8O-659 20382748566 8/18/2019

10 ARMANDO ALEJANDRO VILLANUEVA Z. E001-2352 9.41 E001-2353 149.00 158.41 OO78-OD 20382748566 8/18/2019

11 AGUILAR API LUIS MIGUEL E001-2354 0.41 E001-2355 45.00 45.41 AYN-850 20382748566 8/18/2019

12 AYLLON YACHACHIN BRAYAN STEVE E001-2356 0.27 E001-2357 38.00 38.27 D6T-146 20382748566 8/18/2019

13 LIPA YACHICHIN GAEL E001-2358 1.45 E001-2359 38.00 39.45 D6T-146 20382748566 8/18/2019

14 YACHACHIN LUIS DINA MARTHA E001-2360 29.66 E001-2361 199.00 228.66 D6T-146 20382748566 8/18/2019

15 YACHACHIN CRISTOBAL MARITZA ROXANA E001-2362 27.00 E001-2363 38.00 65.00 D6T-146 20382748566 8/18/2019

16 GALLEGOS BERNUY JONATHAN JOHN E001-2364 2.25 E001-2365 96.00 98.25 ACR-144 20382748566 8/18/2019

17 ERINSO MIGUEL LANDA VELASQUEZ E001-2366 66.00 66.00 C5Q-623 20382748566 8/18/2019

18 PAUL JUNIOR APUMAYTA HURTADO E001-2367 1.51 E001-2368 174.00 175.51 2269-KA 20382748566 8/18/2019

19 WILBER YUPE PANDURO E001-2369 38.00 38.00 A8O-588 20382748566 8/18/2019

20 TAFUR TACILLA IVAN LUIS E001-2370 17.34 E001-2371 145.00 162.34 FOZ-504 20382748566 8/18/2019

21 GERARDO RAMOS PANCORDO E001-2372 60.00 60.00 EUE-345 20382748566 8/18/2019

22 CLEISER GUEVARA PAZ E001-2373 131.63 E001-2374 884.00 1,015.63 4655-2F 20382748566 8/19/2019

23 CLEISER GUEVARA PAZ E001-2385 434.00 434.00 4655-2F 20382748566 8/19/2019

24 CLEMENTE ACEVEDO BERNARDINA M. E001-2375 6.33 E001-2376 101.00 107.33 FOV-186 20382748566 8/19/2019

25 HUAPAYA PEVEZ ESTELA LEONOR E001-2377 1.91 E001-2378 45.00 46.91 AVX-240 20382748566 8/19/2019

26 PALOMARES BACILIO JHON MILLER E001-2379 4.18 E001-2380 136.00 140.18 1246-LA 20382748566 8/19/2019

27 THALIA ELIZABETH MORI VASQUEZ E001-2381 311.04 E001-2382 590.00 901.04 D8D-341 20382748566 8/19/2019

28 AYALA CONDORI JOAQUINA HERLINDA E001-2383 5.37 E001-2384 74.00 79.37 C9B-714 20382748566 8/19/2019

TOTAL: 582.14 4,059.00 4,641.14

MAPFRE PERU COMPAÑÍA SEGUROS Y REASEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 SOTO RAMIREZ LUCILA E001-2295 0.66 E001-2296 127.00 127.66 C7W-230 20202380621 8/14/2019

02 JIMENEZ ZAPATA EVER ARMANADO E001-2297 60.00 60.00 0983-5P 20202380621 8/14/2019

03 CABEZAS SANTILLAN POOL MARIANO E001-2298 1.90 E001-2299 105.00 106.90 ABS-749 20202380621 8/14/2019

04 ESPINOZA PINTO DIANA EVELYN E001-2300 4.72 E001-2301 147.00 151.72 AWI-918 20202380621 8/14/2019

05 ALEGRIA GARCIA BERNARDINA E001-2302 3.76 E001-2303 64.00 67.76 AWI-922 20202380621 8/14/2019

06 MARIA YSABEL AGUIRRE VILLANERA E001-2304 33.00 33.00 1226-1F 20202380621 8/14/2019

07 HONORES LUCANO OLGA LIDIA E001-2305 60.97 E001-2306 707.00 767.97 D71-298 20202380621 8/14/2019

08 LLIULIA GAMARRA TEOFILIA E001-2307 4.60 E001-2308 104.00 108.60 A5U-795 20202380621 8/18/2019

09 HERRERA MORALES TRINIDAD E001-2309 1.15 E001-2310 97.00 98.15 A5U-795 20202380621 8/18/2019

10 GALINDO MONTEBLANCO DEYVISS I. E001-2311 1.15 E001-2312 97.00 98.15 A5U-795 20202380621 8/18/2019

11 TRINIDAD RINCON CESAR MARINO E001-2313 1.28 E001-2314 45.00 46.28 D3L-108 20202380621 8/18/2019

12 RIVAS CAMPOS ELVIRA E001-2315 23.46 E001-2316 378.00 401.46 F5G-390 20202380621 8/18/2019

13 VALDIVIA LAZARO DOMINIC JOEL E001-2317 1.20 E001-2318 38.00 39.20 F5U-882 20202380621 8/18/2019

14 AHUITE TAPUY EULALIA E001-2319 1.32 E001-2320 45.00 46.32 D5P-281 20202380621 8/18/2019

15 DELGADO DELGADO EDITH ELIZABETH E001-2321 29.88 E001-2322 122.00 151.88 47V-718 20202380621 8/18/2019

16 PABLO EUGENIO LOPEZ FLORES E001-2323 6,023.10 E001-2324 5,420.00 11,443.10 ASU-425 20202380621 8/18/2019

17 PABLO EUGENIO LOPEZ FLORES E001-2325 6,034.00 6,034.00 ASU-425 20202380621 8/18/2019

18 PABLO EUGENIO LOPEZ FLORES E001-2326 1,057.00 1,057.00 ASU-425 20202380621 8/18/2019

TOTAL: 6,159.15 14,680.00 20,839.15

AFOCAT LIDER PERU

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 VASQUEZ PAREDES ANGEL E001-2387 5.79 E001-2388 229.00 234.79 4730-2F 20508523344 8/22/2019

02 SANCHEZ ESCOBAR ESTEBAN E001-2389 3.13 E001-2390 206.00 209.13 F4A-082 20508523344 8/22/2019

03 AGÜERO MONTERO ESTRELLA GLADYS E001-2391 1.06 E001-2392 75.00 76.06 C4A-658 20508523344 8/22/2019

TOTAL: 9.98 510.00 519.98

AUTOSEGURO AFOCAT

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 CABRERA POVEZ YANET ROSARIO E001-2393 7.73 E001-2394 93.00 100.73 1813-9B 20516314398 02/09/2019

2 CABRERA POVEZ YANET ROSARIO E001-2395 137.45 E001-2396 3,094.00 3,231.45 1813-9B 20516314398 02/09/2019

3 COPIA DAVILA ROXANA E001-2397 28.50 E001-2398 139.00 167.50 MCG-15859 20516314398 02/09/2019

4 SANDEE GISSELL GUIZADO LUDEÑA E001-2420 13.91 E001-2421 75.00 88.91 F1Y-722 20516314398 9/3/2019

5 SAMUEL ANDRE RIVERA VENEGAS E001-2422 67.00 67.00 AJX-555 20516314398 9/3/2019

TOTAL: 187.59 3,468.00 3,655.59

AFOCAT LIDER PERU

FECHA D E
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 HUINGO DIAZ ANDREA ROSARIO E001-2399 12.05 E001-2400 93.00 105.05 BFX-349 20508523344 02/09/2019

2 DELINA SATALAYA NAVARRO E001-2402 5.68 E001-2401 286.00 291.68 4730-2F 20508523344 02/09/2019

3 INGA INGA MARIA MARGARITA E001-2403 47.57 E001-2404 429.00 476.57 D0J-812 20508523344 02/09/2019

4 GABRIELA GOMEZ VELASQUEZ E001-2556 0.25 E001-2557 64.00 64.25 2579-RA 20508523344 10/09/2019
TOTAL: 65.55 872.00 937.55

AFOCAT LIMA METROPOLITANA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 MORILLO REYES HERLINDA AMANDA E001-2405 91.01 91.01 9966-3F 20515915185 9/3/2019

02 MEDIANA CAJO ANDERSON ANTHONY E001-2406 1.50 E001-2407 90.00 91.50 6316-9B 20515915185 9/3/2019

03 CHURANO VEGA ADELA ESTHER E001-2408 0.32 E001-2409 93.00 93.32 B7-2118 20515915185 9/3/2019

04 RUIZ COCHACHES PEDRO YOEL E001-2410 67.00 67.00 0880-6D 20515915185 9/3/2019

05 SICCHA VERA CARLOS ANTONIO E001-2411 1.06 E001-2412 125.00 126.06 5271-SA 20515915185 9/3/2019

06 CORINA GAMARRA OSORIO E001-2413 33.53 E001-2414 182.00 215.53 1727-7A 20515915185 9/3/2019

07 CHUMIOQUE MICHUE GUILLERMO E001-2415 29.25 E001-2416 68.00 97.25 A0-8990 20515915185 9/3/2019

08 SALCEDO HUAYHUA ALEX ALDAIR E001-2417 0.63 E001-2418 71.00 71.63 1863-2D 20515915185 9/3/2019

09 MORI INUMA KATHIA ARACELI E001-2419 201.00 201.00 5653-7B 20515915185 9/3/2019

10 NEYRA MORENO JOSUE ANDRES E001-2423 7.10 E001-2424 68.00 75.10 0880-6D 20515915185 9/3/2019

11 GALINDO LOPEZ YANISSE LUCERO E001-2425 1.06 E001-2426 229.00 230.06 0880-6D 20515915185 9/3/2019

12 CAPA RAMOS YESSICA MODESTA E001-2427 33.36 E001-2428 124.00 157.36 C3-4354 20515915185 9/3/2019

13 CIEZA TORRES ANGIE NICOLE E001-2429 1.50 E001-2430 103.00 104.50 2111-3C 20515915185 9/3/2019

14 MARICRUZ ROJAS AYALA E001-2431 1.06 E001-2432 126.00 127.06 0752-5F 20515915185 9/3/2019

15 MARICARMEN JUANA ANCHIRAICO A. E001-2433 3.07 E001-2434 100.00 103.07 AO-8014 20515915185 9/3/2019

16 RIOS RIOS MARCOS ANTONIO E001-2435 17.43 E001-2436 136.00 153.43 5018-2B 20515915185 9/3/2019

17 JORDAN CUBA JARA E001-2437 9.40 E001-2438 86.00 95.40 790-26 20515915185 9/3/2019

18 OCAÑA CISNEROS JUAN PABLO E001-2439 49.86 E001-2440 612.00 661.86 1491-7F 20515915185 9/4/2019

19 BENJAMIN JESUS ROJAS JIRON E001-2441 2.28 E001-2442 204.00 206.28 5598-2F 20515915185 9/4/2019

20 BECERRA CHUZON YOBANA DEL MILAGRO E001-2443 12.40 E001-2444 112.00 124.40 5770-KA 20515915185 9/4/2019

21 CHAVEZ ESPINOZA DORA SANTA E001-2445 2.56 E001-2446 147.00 149.56 8364-1A 20515915185 9/4/2019

22 PIÑAN GARCIA LUIS FERNANDO E001-2447 35.00 E001-2448 101.00 136.00 6182-8F 20515915185 9/4/2019

23 PERFECTO URBANO JESSICA LISSET E001-2449 2.66 E001-2450 103.00 105.66 8364-1A 20515915185 9/4/2019

24 MARTHA CASTILLO INGA E001-2451 28.60 E001-2452 200.00 228.60 2546-QA 20515915185 9/4/2019

25 MIGUEL RICARDO TUME JACINTO E001-2453 35.52 E001-2454 224.00 259.52 5066-2F 20515915185 9/4/2019

26 LYAN JESUS RIOS CAPA E001-2455 38.00 38.00 C3-4354 20515915185 9/4/2019

27 CRIOLLO GUERRERO HILDA CLEOFE E001-2456 2.56 E001-2457 75.00 77.56 A4-6703 20515915185 9/4/2019

28 MAMANI CHUMES ESTRELLA E001-2458 1.50 E001-2459 38.00 39.50 2111-3C 20515915185 9/4/2019

29 RINCONES RIVERO GETULIO RAFAEL E001-2460 1.50 E001-2461 38.00 39.50 2695-9B 20515915185 9/4/2019

30 HILARIO PRADO ROMINA ANGELY E001-2462 0.56 E001-2463 63.00 63.56 0165-5F 20515915185 9/4/2019

TOTAL: 315.27 3,915.01 4,230.28

AFOCAT PREMIUM

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 ARACELI SANDY GABRIELA SOTELO GRADOS E001-2464 17.86 E001-2465 245.00 262.86 0204-7F 20514583201 9/4/2019

02 BERMUDEZ VERGARAY EDWIN WILDER E001-2466 84.14 84.14 C4-7865 20514583201 9/4/2019

03 ALEJO PIÑANO ANA BRIGINIA E001-2467 7.30 E001-2468 104.00 111.30 9157-FA 20514583201 9/4/2019

04 CARHUAJULCA GUEVARA GIOVANA E001-2469 2.56 E001-2470 156.00 158.56 0457-2C 20514583201 9/4/2019

05 QUILICHE MANTILLA ISABEL E001-2471 104.00 104.00 D65-740 20514583201 9/4/2019

06 JHONATAN COBA ASHCALLA E001-2472 101.00 101.00 A2-8733 20514583201 9/4/2019

07 LIA GAELA MARTINEZ SURCO E001-2473 0.40 E001-2474 89.00 89.40 7032-1F 20514583201 9/4/2019

TOTAL: 28.12 883.14 911.26

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 ASTRID SAHIT VELVEDER VIDAL E001-2491 6.88 E001-2492 45.00 51.88 3714-9D 20515127403 9/8/2019

02 ALIAGA MAÑEZ MAXIMILIANO GAMALIEL E001-2493 1.20 E001-2494 67.00 68.20 H2T-966 20515127403 9/8/2019

03 SOLANO OTOYA DAVID NOLBERTO E001-2495 86.00 86.00 7149-8F 20515127403 9/8/2019

04 PABLO ANTONIO MONTOYA HERRERA E001-2496 342.20 E001-2497 1,196.00 1,538.20 ARN-059 20515127403 9/8/2019

05 PABLO ANTONIO MONTOYA HERRERA E001-2498 569.00 569.00 ARN-059 20515127403 9/8/2019

06 SERGIO ANTONIO DASILVA LANDAETA E001-2499 17.00 E001-2500 295.00 312.00 C3-5709 20515127403 9/8/2019

07 ELIAS CORONADO FERNANDEZ E001-2501 38.00 38.00 1467-9D 20515127403 9/8/2019

08 LUCELY IBET PAREDES ARDILES E001-2502 1.20 E001-2503 61.00 62.20 7527-8D 20515127403 9/8/2019

09 SERNA MEDINA AXEL SAIR E001-2504 7.89 E001-2505 144.00 151.89 3547-9A 20515127403 9/8/2019

10 CUEVA PINEDA ANGEL EDUARDO E001-2506 25.05 E001-2507 63.00 88.05 8446-AB 20515127403 9/8/2019

11 JOSE DAVID HUAMAN SAUCEDO E001-2508 0.15 E001-2509 90.00 90.15 5721-KA 20515127403 9/8/2019

12 VERONICA YARUSKA HUAMAN GIRALDO E001-2510 88.70 E001-2511 335.00 423.70 B0-8147 20515127403 9/8/2019

13 TADEO MELLIZO VICTORIA MARGARITA E001-2512 6.95 E001-2513 81.00 87.95 5547-4C 20515127403 9/8/2019

14 HUGO LUIS TELLO RAMIREZ E001-2514 4.11 E001-2515 173.00 177.11 C4-8616 20515127403 9/8/2019

15 OSCATE CARPIO LUIS E001-2517 35.07 E001-2516 116.00 151.07 8668-7A 20515127403 9/8/2019

16 HUAMAN MENDOZA NESTOR ALBERTO E001-2518 48.21 E001-2519 487.00 535.21 C7-7123 20515127403 9/8/2019

17 ROMERO GAMARRA LEYLA ROSA E001-2520 23.17 E001-2521 171.00 194.17 9632-7A 20515127403 9/8/2019

18 MAMANI HUAHUASONCO GRACILEA E001-2522 13.94 E001-2523 428.00 441.94 B0-6843 20515127403 9/8/2019

19 SANTA ALEJANDRINA CACHAY MUÑOZ E001-2524 25.05 E001-2525 94.00 119.05 0353-EA 20515127403 9/8/2019

20 VASQUEZ PEREZ MARIA LUISA E001-2526 1.06 E001-2527 101.00 102.06 9240-AB 20515127403 9/8/2019

21 SHIRLEY GABRIELA SANTA CRUZ SUSANIBAR E001-2528 142.19 E001-2530 501.00 643.19 9083-9D 20515127403 9/8/2019

22 LOPEZ VIDAL ADRIANO MIGUEL E001-2531 0.30 E001-2532 101.00 101.30 0706-4A 20515127403 9/9/2019

23 MOYA RIVERA JHAIR ALEXANDER E001-2533 3.20 E001-2534 218.00 221.20 4951-6B 20515127403 9/9/2019

24 ZAMUDIO CABRERA CRISPIN E001-2535 6.15 E001-2536 58.00 64.15 5547-4C 20515127403 9/9/2019

25 SALAS CHINCHAY LIA KORINA E001-2537 1.45 E001-2538 38.00 39.45 B1-6850 20515127403 9/9/2019

26 CHINCHAY MAYTA LEYLA JASMIN E001-2539 1.50 E001-2540 60.00 61.50 B1-6850 20515127403 9/9/2019

27 MISHTI LLECLLISH GLORIA LILIANA E001-2541 1.50 E001-2542 67.00 68.50 8668-7A 20515127403 9/9/2019

TOTAL: 804.12 5,683.00 6,487.12

RIMAC SEGUROS Y REASEGUROS

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE


EMISIÓN

01 MARIO QUEVEDO MORAN E001-2475 33.00 33.00 1461-KA 20100041953 9/6/2019

02 ROMER YPUSHIMA CABUDIVO E001-2476 13.50 E001-2477 76.00 89.50 F3U-747 20100041953 9/6/2019

03 JANETH LIZETH CUYA PEÑA E001-2478 2.83 E001-2479 210.00 212.83 C8W-780 20100041953 9/6/2019

04 FARFAN AGUILAR FLORENCIA ANA E001-2480 2.47 E001-2481 74.00 76.47 A3F-777 20100041953 9/6/2019

05 RAMIREZ AGURTO FRANCISCO E001-2482 110.19 E001-2483 1,253.00 1,363.19 F1Z-206 20100041953 9/6/2019

06 RAMIREZ AGURTO FRANCISCO E001-2484 773.00 773.00 F1Z-206 20100041953 9/6/2019

07 ORTEGA CHIROQUE ALVARO JEAN E001-2485 2.40 E001-2486 38.00 40.40 P1N-287 20100041953 9/6/2019

08 MILLAN TOLENTINO JENNY ARACELLI E001-2487 0.41 E001-2488 97.00 97.41 ASU-707 20100041953 9/6/2019

09 ROMERO EGOABIL ANGEL GABRIEL E001-2489 8.25 E001-2490 356.00 364.25 0647-2D 20100041953 9/6/2019

10 NILSON OMAR CHAVEZ ZAMORA E001-2550 1.82 E001-2551 225.00 226.82 B7C-561 20100041953 9/9/2019

11 NECIOSUP SILVA JOSE FREDY E001-2552 27.81 E001-2553 90.00 117.81 D1A-756 20100041953 9/9/2019

12 ERICK FRANCK ROMERO VILLALOBOS E001-2554 25.83 E001-2555 164.00 189.83 AXQ-076 20100041953 9/9/2019

TOTAL: 195.51 3,389.00 3,584.51

AFOCAT AUTOSEGURO

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 RAFAEL ALEX GAMARRA MENDEZ E001-2548 75.61 E001-2549 183.00 258.61 BDV-285 2051631498 9/9/2019

TOTAL: 75.61 183.00 258.61

AFOCAT PREMIUM

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE


EMISIÓN

01 VALLADOLID CARDENAS SARITA G. E001-2543 1.97 E001-2544 197.00 198.97 3273-GA 20514583201 9/9/2019

02 RODRIGUEZ ESPINOZA EUGENIO E001-2545 23.40 E001-2546 346.00 369.40 1497-5C 20514583201 9/9/2019

03 ALLISON PAMELA VEGA HERRERA E001-2547 121.00 121.00 A4H-743 20514583201 9/9/2019

TOTAL: 25.37 664.00 689.37

PACIFICO COMPAÑÍA SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 SANTAMARIA LLANCACHAHUA LEE E001-2558 16.98 E001-2559 330.00 346.98 3192-OA 20332970411 9/10/2019

02 PALOMINO ALARCON PRUDENCIO ALARCON E001-2560 28.25 E001-2561 364.00 392.25 0257-CA 20332970411 9/10/2019

03 QUISPE GUTIERREZ ALEXIS JHONNY E001-2562 2.53 E001-2563 300.00 302.53 2661-HA 20332970411 9/10/2019

0 04 ALEXIS JHONNY QUISPE GUTIERREZ E001-2564 0.70 E001-2565 33.00 33.70 2661-HA 20332970411 9/10/2019

05 ALEXIS JHONNY QUISPE GUTIERREZ E001-2566 33.00 33.00 2661-HA 20332970411 9/10/2019

06 ALEXIS JHONNY QUISPE GUTIERREZ E001-2567 3.00 E001-2568 33.00 36.00 2661-HA 20332970411 9/10/2019

07 DALIA DELFINA JARAMILLO DIESTRA E001-2569 1.50 E001-2570 66.00 67.50 B2U-720 20332970411 9/10/2019

08 DERECK JOSHMAR LUJAN PEREZ E001-2571 38.00 38.00 F1V- 778 20332970411 9/10/2019

09 DALIA DELFINA JARAMILLO DIESTRA E001-2571 3.85 E001-2573 66.00 69.85 B2U-720 20332970411 9/10/2019

10 DALIA DELFINA JARAMILLO DIESTRA E001-2574 31.28 E001-2575 122.00 153.28 BSU-720 20332970411 9/10/2019

11 VICTOR JOEL ZEÑA FALLA E001-2576 265.94 E001-2577 1,030.00 1,295.94 4346-3A 20332970411 9/10/2019

12 VICTOR JOEL ZEÑA FALLA E001-2578 518.00 518.00 4346-3A 20332970411 9/10/2019

13 JUAN CARLOS YPARRAGUIRRE CHAVEZ E001-2579 20.40 E001-2580 324.00 344.40 F1V-741 20332970411 9/10/2019

14 RUMALDO CANTARO MAXIMO VICENTE E001-2581 2.67 E001-2582 68.00 70.67 4687-2F 20332970411 9/10/2019

TOTAL: 377.10 3,325.00 3,702.10

AFOCAT LIMA METROPOLITANA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 MICHUE ESPINOZA JESUS GUILLERMO E001-2585 4.44 E001-2586 152.00 156.44 AO-8990 20515915185 9/11/2019

02 HILARIO PRADO ANGIE LISSET E001-2587 1.17 E001-2588 130.00 131.17 0165-5F 20515915185 9/12/2019

03 JULIA DOMINGUEZ HARO E001-2589 2.10 E001-2590 124.00 126.10 2191-VA 20515915185 9/12/2019

04 LEON SOSA CONSUELO GUILLERMINA E001-2591 11.22 E001-2592 496.00 507.22 8571-7B 20515915185 9/12/2019

05 BLANCO TAMAYO JUAN RAFAEL E001-2593 10.87 E001-2594 306.00 316.87 0813-RA 20515915185 9/12/2019

06 GOMEZ EGUSQUIZA LUISA E001-2595 130.00 130.00 D1W-642 20515915185 9/12/2019

07 ERRIBARES ALAMO MILAGROS DE L. E001-2596 2.21 E001-2597 104.00 106.21 D1W-642 20515915185 9/12/2019

TOTAL: 32.01 1,442.00 1,474.01

MAPFRE PERU COMPAÑÍA SEGUROS Y REASEGUROS S.A


N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE
EMISIÓN

01 MARIA ANITA SALAZAR SANCHEZ E001-2612 154.00 154.00 D7I-298 20202380621 9/15/2019

02 MISAICO GONZALES DAVID MENLY E001-2613 1.69 E001-2614 38.00 39.69 ABS-749 20202380621 9/15/2019

03 COLAN RIVERA CARLOS ANTONIO E001-2615 25.25 E001-2616 186.00 211.25 0522-BA 20202380621 9/15/2019

04 RUBIO FERNANDEZ VICTOR ANTERO E001-2617 37.43 E001-2618 186.00 223.43 A2L-795 20202380621 9/15/2019

05 ZAMBRANO TORRES KETY MARGARITA E001-2619 29.30 E001-2620 374.00 403.30 A5U-795 20202380621 9/15/2019

06 LILIANA AURORA UBILLUS BAYANA E001-2621 38.00 38.00 B5X-962 20202380621 9/15/2019

07 SEGUNDO JOAQUIN VELASQUEZ OJEDA E001-2622 58.05 E001-2623 123.00 181.05 ABS-735 20202380621 9/15/2019

08 KNOLL GIANINA ROSSMERY E001-2624 3.31 E001-2625 178.00 181.31 BHP-577 20202380621 9/15/2019

09 DARWIN ESTEMIR FIGUEROA DIAZ E001-2626 2.33 E001-2627 45.00 47.33 AHK-713 20202380621 9/15/2019

10 LILIANA JOAN OCAS UBILLUS E001-2628 38.00 38.00 B5X-962 20202380621 9/15/2019

11 LUIS HENRY CHANGANAQUI SOSA E001-2629 38.00 38.00 B5X-962 20202380621 9/15/2019

12 ORLANDO RAFAEL CALDERON BEST E001-2630 75.00 75.00 B5X-962 20202380621 9/15/2019

13 QUISPE BORDA JOSSELYN VANESSA E001-2631 16.77 E001-2632 256.00 272.77 9595-2V 20202380621 9/15/2019

14 PERCI FRANCISCO PALOMINO RIVERA E001-2633 270.74 E001-2634 481.00 751.74 AFL-856 20202380621 9/15/2019

15 PERCI FRANCISCO PALOMINO RIVERA E001-2635 229.00 229.00 AFL-856 20202380621 9/15/2019

TOTAL: 444.87 2,439.00 2,883.87

AFOCAT REGIÓN LIMA

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE


EMISIÓN

01 JERI RIVAS FRANK EMERSSON E001-2600 21.61 E001-2601 86.00 107.61 7262-BA 20515127403 9/12/2019

02 ENEDINA HILDA BALBIN RAMOS E001-2602 38.89 E001-2603 536.00 574.89 4211-NA 20515127403 9/12/2019

03 CAMPOS MAYTA ANA CRISTINA E001-2608 37.03 E001-2609 125.00 162.03 0336-BA 20515127403 9/15/2019

04 MARLENY MAZA YESQUEN E001-2610 17.17 E001-2611 399.00 416.17 3474-EA 20515127403 9/15/2019

TOTAL: 114.70 1,146.00 1,260.70

LA POSITIVA SEGUROS Y REASEGUROS S.A.

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 OJEDA VILCHEZ CARLOS ALBERTO E001-2648 2.22 E001-2649 153.00 155.22 2516-1C 20382748566 9/16/2019

02 KELLY PRADO GUTIERREZ E001-2650 57.00 57.00 AFG-557 20382748566 9/16/2019

03 JORGE LUIS CHAMBERGO ZEÑA E001-2651 14.55 E001-2652 86.00 100.55 BAS-668 20382748566 9/16/2019

04 UBERTINA LA ROSA NICHO E001-2653 33.00 33.00 AST-849 20382748566 9/16/2019

05 SANTIAGO VILLANUEVA JULIA NATALIA E001-2654 40.79 E001-2655 381.38 422.17 B1E-766 20382748566 9/17/2019

06 GLADYS ZUNILDA PUCURIMAY FUENTES E001-2656 4.54 E001-2657 147.00 151.54 AFQ-529 20382748566 9/17/2019

07 WALTER RAMON QUISPE FIGUEROA E001-2658 10.04 E001-2659 190.00 200.04 BBQ-063 20382748566 9/17/2019

08 CASTILLO DAS NEVES JOSE ANTONIO E001-2661 113.89 E001-2660 640.00 753.89 1854-4S 20382748566 9/17/2019

09 GRABIEL ROMERO BERNARDO E001-2662 0.55 E001-2663 173.00 173.55 D9K-697 20382748566 9/17/2019

TOTAL: 186.58 1,860.38 2,046.96

INTERSEGURO COMPAÑÍA SEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 BAZAN OCAÑA VICTOR CALIXTO E001-2641 148.00 148.00 B5W-839 20382748566 9/16/2019

02 PEZO FLORES ALDE VALENTINO E001-2642 1.06 E001-2643 45.00 46.06 F7F-107 20382748566 9/16/2019

03 TINEO RIOS KATTYA MABEL E001-2644 1.55 E001-2645 79.00 80.55 C6P-073 20382748566 9/16/2019

04 PEZO PINEDO ANGELA VALENTINA E001-2646 0.45 E001-2647 38.00 38.45 F7F-107 20382748566 9/16/2019

TOTAL: 3.06 310.00 313.06

PROTECTA S.A COMPAÑÍA SEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
20517207331
01 LOZADAN LUNA JOSE MARTIN E001-2636 277.00 E001-2637 54.13 331.13 0057-6B 9/16/2019
20517207331
02 EVARISTO PAUCAR OCAÑA E001-2638 523.88 E001-2639 3,824.76 4,348.64 AYA-072 9/16/2019

TOTAL: 800.88 3,878.89 4,679.77

MINISTERIO DE TRANSPORTE Y COMUNICACIONES

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN
20131379944
01 GABRIEL SOTOMAYOR HUAMAN E001-2664 126.00 126.00 29952 9/17/2019

20131379944
02 DAVID PEDRO QUISPE AMPUDIA E001-2666 1,096.00 1,096.00 20569 9/17/2019

20131379944
02 DAVID PEDRO QUISPE AMPUDIA E001-2668 849.07 E001-2667 646.00 1,495.07 20569 9/17/2019

TOTAL: 849.07 1,868.00 2,717.07

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 ALFREDO OSWALDO RAMIREZ SOLORZANO E001-2687 13.22 E001-2688 179.42 192.64 2871-5A 20515127403 10/3/2019

02 HORTENCIA MAYNARDA PINEDO TRUJILLO E001-2689 33.00 33.00 B7-1053 20515127403 10/3/2019

03 ABARCA LARA KATHERINNE EDITH E001-2690 85.00 85.00 6231-1A 20515127403 10/3/2019

04 HORTENCIA MAYNARDA PINEDO TRUJILLO E001-2691 2.98 E001-2692 151.00 153.98 B7-1053 20515127403 10/3/2019

05 PORRAS ROBLES FLAVIO FRANCO E001-2693 7.52 E001-2694 74.00 81.52 5373-6A 20515127403 10/3/2019

06 PERALTA HUAYNATES JOSE MATIAS E001-2695 1.45 E001-2696 67.00 68.45 ASY-762 20515127403 10/3/2019

07 ROCIO DEL CARMEN SALINAS DE JERI E001-2697 6.72 E001-2698 153.00 159.72 4242-IA 20515127403 10/3/2019

08 ZUÑIGA ALCA GREISSI AZUCENA E001-2699 1.60 E001-2700 67.00 68.60 0704-OA 20515127403 10/3/2019

09 MARITZA MYRIAN SUSANIBAR MATTOS E001-2701 1.20 E001-2702 33.00 34.20 9083-9D 20515127403 10/3/2019

10 EMILIANO FERNANDEZ CABEZAS E001-2703 1.13 E001-2704 45.00 46.13 2435-AD 20515127403 10/3/2019

TOTAL: 35.82 887.42 923.24

AFOCAT AUTOSEGURO

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

1 WILMER SAUL SANTIAGO ORBEZO E001-2680 1.12 E001-2681 60.00 61.12 0849-6A 2051631498 10/2/2019

2 CARLOS AGUSTIN ORTIZ ALVAREZ E001-2682 99.00 99.00 WIM-772 2051631498 10/2/2019

3 RAFAEL ALEX GAMARRA MENDEZ E001-2684 1.92 E001-2683 33.00 34.92 BDV-285 2051631498 10/2/2019

TOTAL: 3.04 192.00 195.04

AFOCAT - SOCAT PERU

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 MARTINEZ QUISPE JOSE LUIS E001-2685 1.21 E001-2686 163.00 164.21 0859-CA 20543657132 10/3/2019

TOTAL: 1.21 163.00 164.21

AFOCAT LIDER PERU

FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 JIMENEZ VILCHEZ BETZABE CORAL E001-2705 17.31 E001-2706 91.00 108.31 ANZ-788 20508523344 10/3/2019

02 DENNIS CHAVEZ ORTIZ E001-2707 6.81 E001-2709 220.00 226.81 8366-KA 20508523344 10/7/2019

03 GRANADOS HUILLCA MARIA GUADALUPE E001-2710 1.14 E001-2711 126.00 127.14 A5-7365 20508523344 10/7/2019

04 ALAMO GOMEZ BRAYAN JESUS E001-2712 10.56 E001-2713 383.00 393.56 8646-GA 20508523344 10/8/2019

05 JANETH SANDY MERMAU DE REJANO E001-2714 9.47 E001-2715 253.00 262.47 A57-365 20508523344 10/8/2019

06 ANA ROSA VASQUEZ HUILLCA E001-2716 0.87 E001-2717 179.00 179.87 A57-365 20508523344 10/8/2019

07 WILLIAM DAMIAN FLORES INGA E001-2718 1.20 E001-2719 67.00 68.20 AEJ-474 20508523344 10/8/2019

08 INGA CHUINGA MARIA CARMEN E001-2720 0.36 E001-2721 81.00 81.36 AEJ-474 20508523344 10/9/2019

09 SEGOVIA MONTALVO DAYANNA E001-2722 61.00 61.00 7347-8D 20508523344 10/9/2019

10 FLORES INGA CAMILA NAOMY E001-2723 1.00 E001-2724 81.00 82.00 AEJ-474 20508523344 10/9/2019

11 TIBURCIA MARGARITA MATOS MIRANDA E001-2725 0.98 E001-2726 117.00 117.98 9737-1D 20508523344 10/9/2019

12 PARDAVE VERDE LEVI E001-2727 11.81 E001-2728 93.00 104.81 7347-8D 20508523344 10/9/2019

13 RAYME UCHIDA FRANCHESCOLI SALVATTORE E001-2729 6.30 E001-2730 90.00 96.30 5170-9F 20508523344 10/9/2019

TOTAL: 67.81 1,842.00 1,909.81

RIMAC SEGUROS Y REASEGUROS

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 ESCARLET MARINA TRUJILLO HERNANDEZ E001-2731 13.50 E001-2732 66.00 79.50 A8L-039 20100041953 10/9/2019

02 FERNANDEZ TORRES ELBIRA LILY E001-2733 1.06 E001-2734 130.00 131.06 AWP-896 20100041953 10/9/2019

03 NAHOMI ELENA DEZA ALIAGA E001-2735 5.02 E001-2736 118.00 123.02 ACI-187 20100041953 10/9/2019

04 MARIO ARGIMIRO QUEVEDO MORAN E001-2737 39.79 E001-2738 216.00 255.79 1461-KA 20100041953 10/9/2019

05 EMMANUEL SEBASTIAN GAMBOA TORRES E001-2739 38.00 38.00 ABO-286 20100041953 10/9/2019

06 BRANDON DEIDID VILLAFUERTE CHAPE E001-2740 79.46 E001-2741 1,417.00 1,496.46 4089-OA 20100041953 10/9/2019

07 EDITN ROBLES CONCO E001-2742 36.80 E001-2743 466.00 502.80 ADI-772 20100041953 10/9/2019

TOTAL: 175.63 2,451.00 2,626.63

AFOCAT PREMIUM
FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 ABRAHAM DAVID SULCA CARDENAS E001-2746 1.17 E001-2747 75.00 76.17 5659-6F 20514583201 10/10/2019

02 ANTONIO TARAZONA MORENO E001-2748 5.85 E001-2749 230.00 235.85 D65-740 20514583201 12/10/2019

03 DAVID SAMIR ROJAS GUERRA E001-2750 6.00 E001-2751 67.00 73.00 B6-9066 20514583201 12/10/2019

04 RIANA MILAGROS LLIUYA IZQUIERDO E001-2752 1.20 E001-2752 81.00 82.20 0712-68 20514583201 12/10/2019

05 LEE SMITH ROJAS SIRLUPU E001-2754 1.50 E001-2755 60.00 61.50 0804-QA 20514583201 12/10/2019

06 CARLOS MOLLINEDO ESPINO E001-2756 0.66 E001-2757 45.00 45.66 7014-8F 20514583201 12/10/2019

07 KARLA MOLLINERO YUHIMACHI E001-2758 0.97 E001-2759 45.00 45.97 7014-8F 20514583201 12/10/2019

08 FERNANDO PONGO GAONA E001-2760 1.91 E001-2761 147.00 148.91 567-1HA 20514583201 12/10/2019

09 STEVEN RED CHINCHAY QUINTEROS E001-2762 7.29 E001-2763 134.00 141.29 BEU-046 20514583201 12/10/2019

10 VICENTA GONZALES VALVERDE DE FALLA E001-2764 1.50 E001-2765 82.00 83.50 AVI-028 20514583201 12/10/2019

TOTAL: 28.05 966.00 994.05

AFOCAT AUTOSEGURO

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 ANGELI VARGAS FIRMA E001-2766 38.00 38.00 9395-EA 2051631498 10/12/2019

2 OBDULIA FIRMA JUIPA E001-2767 0.84 E001-2768 38.00 38.84 9395-EA 2051631498 10/12/2019

3 YASHIRA LEA GUERRERO GONZA E001-2769 2.86 E001-2770 93.00 95.86 F8Z-287 2051631498 10/12/2019

TOTAL: 3.70 169.00 172.70

PACIFICO COMPAÑÍA SEGUROS Y REASEGUROS


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 KEIKO ROCIO RAMIREZ FABIAN E001-2771 0.41 E001-2772 155.00 155.41 AJK-277 20332970411 10/12/2019

02 JUAN CARLOS YPARRAGUIRRE CHAVEZ E001-2773 0.90 E001-2774 33.00 33.90 FIV-741 20332970411 10/12/2019

03 JUAN CARLOS YPARRAGUIRRE CHAVEZ E001-2775 33.00 33.00 FIV-741 20332970411 10/12/2019

04 EMITH ORTIZ SAAVEDRA E001-2776 1.06 E001-2777 75.00 76.06 F1V-778 20332970411 10/12/2019

05 MARLENI CARRANZA VARGAS E001-2778 85.01 E001-2779 904.00 989.01 B2T-701 20332970411 10/12/2019

06 MARLENE CARRANZA VARGAS E001-2780 108.38 E001-2796 1,336.00 1,444.38 B2T-701 20332970411 10/13/2019

07 MONTEJO ROMAN MARGOT VERENISE E001-2781 1.12 E001-2782 162.00 163.12 A30-749 20332970411 10/13/2019

08 DALIA DELFINA JARAMILLO DIESTRA E001-2783 33.00 33.00 B2U-720 20332970411 10/13/2019

09 DALIA DELFINA JARAMILLO DIESTRA E001-2784 21.08 E001-2785 66.00 87.08 B2U-720 20332970411 10/13/2019

10 LUIS ALBERTO LAZO SOLIS E001-2786 25.94 E001-2787 53.00 78.94 B2M-709 20332970411 10/13/2019

11 BRISSA DE FATIMA POMAJULCA LAGOS E001-2788 1.60 E001-2789 67.00 68.60 D9P-938 20332970411 10/13/2019

12 MURRIETA ORTIZ THIAGO JAHERN E001-2790 38.00 38.00 F1V-778 20332970411 10/13/2019

13 MORENO MEJIA CRISTHIAN PAUL E001-2791 1.46 E001-2792 68.00 69.46 4012-6F 20332970411 10/13/2019

14 CROSBI ADRIAN DE LA CRUZ TORRES E001-2793 1,098.51 E001-2794 2,641.62 3,740.13 B9K-508 20332970411 10/14/2019

CROSBI ADRIAN DE LA CRUZ TORRES E001-2795 1,259.00 1,259.00 B9K-508 20332970411 10/14/2019

TOTAL: 1,345.47 6,923.62 8,269.09

AFOCAT LIMA METROPOLITANA

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE


EMISIÓN

01 EDUARDO ERIK GONZALES ABAN E001-2814 1.06 E001-2815 45.00 46.06 2546-QA 20515915185 10/16/2019

02 JOSE MIGUEL MARCELO BALLADARES E001-2816 2.41 E001-2817 154.00 156.41 1990-LA 20515915185 10/16/2019

03 JORGE ARMANDO SAMPEM ALQUIZAR E001-2818 45.00 45.00 A4-6703 20515915185 10/16/2019

04 SOTELO ROCA FROILAN MARTIN E001-2819 2.01 E001-2820 91.00 93.01 B7-7476 20515915185 10/16/2019

05 RENATO SAMUEL AGUILAR CHUPAN E001-2821 1.20 E001-2822 111.00 112.20 7314-BC 20515915185 10/16/2019

06 ANGELICA QUIÑONEZ YSOLIS E001-2823 45.00 45.00 7123-JA 20515915185 10/16/2019

07 NOEMI ONOFRE RAMIREZ E001-2824 673.82 673.82 A9-8985 20515915185 10/16/2019

08 INGRID JOHANA GUTIERREZ MALDONADO E001-2825 64.26 E001-2826 702.00 766.26 0813-RA 20515915185 10/16/2019

09 DENISSE ESPINO AGUILAR E001-2827 3.31 E001-2828 133.00 136.31 8364-1A 20515915185 10/16/2019

10 BEATRIZ GUTIERREZ VILLARREAL E001-2829 28.34 E001-2830 183.00 211.34 A0-7771 20515915185 10/16/2019

11 JUANA ,MARINA RODRIGUEZ LIMA MAYANGA E001-2831 2.41 E001-2832 146.00 148.41 3553-GA 20515915185 10/16/2019

12 MIKAELA ALEJANDRA PAREDES ACEVEDO E001-2833 33.00 33.00 6298-CA 20515915185 10/16/2019

13 GUZMAN BRAVO FRANCISCO PABLO E001-2834 0.52 E001-2835 45.00 45.52 2695-9B 20515915185 10/16/2019

14 JESUS GUILLERMO MICHUE ESPINOZA E001-2836 72.69 E001-2837 615.00 687.69 A0-8990 20515915185 10/16/2019

15 MIKAELA ALEJANDRA PAREDES ACEVEDO E001-2838 70.70 E001-2839 798.00 868.70 6298-CA 20515915185 10/16/2019

16 JORGE ALBERTO LEON MONTALVO E001-2840 44.18 E001-2841 566.00 610.18 NG-93663 20515915185 10/16/2019

17 ATALAYA CABRERA LUZ CHARITO E001-2842 29.98 E001-2843 86.00 115.98 8654-7F 20515915185 10/16/2019

18 CAPILLO SANCHEZ JOSE SAMIR E001-2844 48.00 48.00 C3-9844 20515915185 10/16/2019

TOTAL: 323.07 4,519.82 4,842.89

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 JOSE ALFONSO ZACARIAS CAMPOS E001-2944 1.00 E001-2945 38.00 39.00 ARN-245 20515127403 11/5/2019

02 YOSA LIVIA BRAVO ALVARADO E001-2946 5.63 E001-2947 82.00 87.63 1362-SA 20515127403 11/5/2019

03 ARMY MARTIN REYES GROSSO E001-2948 1.23 E001-2949 84.00 85.23 C7-4501 20515127403 11/5/2019
MARIA F LOR A PALOMINO ÑAÑA CCHUA RI DE
04 BRAVO E001-2950 8.34 E001-2951 122.00 130.34 1407-QA 20515127403 11/5/2019

05 DELFIN EDWIN ESCUBAR VALEJO E001-2952 2.25 E001-2953 333.00 335.25 B4-3419 20515127403 11/5/2019

06 DAFNE JHENY SUAREZ HUAMAN E001-2955 0.51 E001-2954 173.00 173.51 C5 -9004 20515127403 11/5/2019

07 HERMENEGILDO FRITAS ROSALES E001-2956 15.96 E001-2957 86.00 101.96 4062-3B 20515127403 11/5/2019

08 ROBIN FREDY FERNANDEZ HEREDIA E001-2958 77.89 E001-2959 708.58 786.47 1087-QA 20515127403 11/5/2019

09 HUAGI VALLES YULIANA LINDA E001-2960 5.54 E001-2961 153.00 158.54 F8F-038 20515127403 11/5/2019

10 JULIO CESAR CRISTOBAL NAUPARI E001-2962 8.16 E001-2963 52.00 60.16 A37-240 20515127403 11/5/2019

11 PABLO BONIFACIO HUERTAS BAZAN E001-2964 6.17 E001-2965 85.00 91.17 1362-SA 20515127403 11/5/2019

12 MARYORI MILAGROS PORRAS BRAVO E001-2966 1.20 E001-2967 81.00 82.20 1362-SA 20515127403 11/5/2019

13 ISIDORA INDALACIA SAENZ BULA E001-2968 0.63 E001-2969 38.00 38.63 4062-3B 20515127403 11/5/2019

14 DUNIECHIKA ZUBEYDA GARCIA HUISACAYNA E001-2970 2.56 E001-2971 103.00 105.56 7903-CA 20515127403 11/5/2019

15 MOISES CHERO TUNGA E001-2972 4.97 E001-2973 153.00 157.97 0502-KA 20515127403 11/5/2019

16 ABARCA LARA KATHERINNE EDIYH E001-2974 1.74 E001-2975 74.00 75.74 623-11A 20515127403 11/5/2019

17 JULIO CESAR MARQUEZ TOVAR E001-2976 1.06 E001-2977 68.00 69.06 7889-BA 20515127403 11/5/2019

TOTAL: 144.84 2,433.58 2,578.42

INTERSEGURO COMPAÑÍA SEGUROS S.A

FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 HENRY GREGORIO GASTELU ALEJO E001-2854 33.00 33.00 A6L-626 20382748566 10/19/2019

02 HENRY GREGORIO GASTELU ALEJO E001-2855 66.00 66.00 A6L-626 20382748566 10/19/2019

03 HENRY GREGORIO GASTELU ALEJO E001-2856 2.72 E001-2857 33.00 35.72 A6L-626 20382748566 10/19/2019

04 HENRY GREGORIO GASTELU ALEJO E001-2903 27.00 27.00 A6L-626 20382748566 10/21/2019

05 FRANCISCA CRISTOBAL HEREDIA DE LORENZO E001-2861 2.48 E001-2862 235.00 237.48 F6G-938 20382748566 10/20/2019

06 MANUEL JESUS GALLARDO DE LA CRUZ E001-2863 53.10 E001-2864 407.00 460.10 D3F-869 20382748566 10/20/2019

07 KID BREYSON CESPEDES QUEVEDO E001-2865 68.00 68.00 BCE-517 20382748566 10/20/2019

08 HENRY GREGORIO GASTELU ALEJO E001-2904 30.59 E001-2859 1,230.24 1,260.83 A6L-626 20382748566 10/19/2019

HENRY GREGORIO GASTELU ALEJO E001-2858 548.50 E001-2860 548.00 1,096.50 A6L-626 20382748566 10/19/2019

TOTAL: 637.39 2,647.24 3,284.63

MAPFRE PERU COMPAÑÍA SEGUROS Y REASEGUROS S.A

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 ADONIA CHAUPIZ BUSTAMANTE E001-2846 2.72 E001-2847 105.00 107.72 F2J-963 20202380621 10/18/2019

02 ROY GERMAN MENDIZABAL MELCHOR E001-2848 12.21 E001-2849 112.00 124.21 F2J-963 20202380621 10/18/2019

03 CARMEN MOEMI CONDOR CONDOR E001-2850 30.15 E001-2851 280.00 310.15 B5X-962 20202380621 10/19/2019

04 LOPEZ CACHIQUE MARIELA E001-2852 13.05 E001-2853 122.00 135.05 ARU-473 20202380621 10/19/2019

TOTAL: 58.13 619.00 677.13

LA POSITIVA SEGUROS Y REASEGUROS S.A.

FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 CARDENAS VILCHEZ FRANCISCO JOSE E001-2866 63.00 63.00 7617-4F 20100210909 10/20/2019

02 AMIVALIA SILVA SIVA E001-2868 1.12 E001-2867 120.00 121.12 C9V-329 20100210909 10/20/2019

03 TERESA ELISA FLORES VELARDE E001-2869 1.06 E001-2870 151.00 152.06 2928-8C 20100210909 10/20/2019

04 GLADYS ZUMILDA PUCURIMAY FUENTES E001-2871 3.00 E001-2872 33.00 36.00 AFQ-529 20100210909 10/20/2019

05 GLADYS ZUMILDA PUCURIMAY FUENTES E001-2873 33.00 33.00 AFQ-529 20100210909 10/20/2019

06 DOMINGUEZ PECHE JOSE VICTOR E001-2874 2.25 E001-2875 33.00 35.25 5629-AP 20100210909 10/20/2019

07 ADRIANA MILAGRO RIVERA NUÑEZ E001-2876 9.97 E001-2877 151.00 160.97 AFG-557 20100210909 10/20/2019

08 LUIS ANGEL GUTIERREZ VALLES E001-2878 8.22 E001-2879 38.00 46.22 4691-RA 20100210909 10/20/2019

09 JHOVER YOEL MEJIA ROJAS E001-2880 45.00 45.00 2794-JA 20100210909 10/20/2019

10 LUIS ALBERTO JAYA MIÑAN E001-2881 367.71 E001-2882 1,030.00 1,397.71 3908-4C 20100210909 10/20/2019

LUIS ALBERTO JAYA MIÑAN E001-2883 1,067.00 1,067.00 3908-4C 20100210909 10/20/2019

11 ROBINSON STIVEN MARIN OSORIO E001-2884 577.52 E001-2885 1,818.40 2,395.92 4979-8D 20100210909 10/20/2019

ROBINSON STIVEN MARIN OSORIO E001-2886 1,082.00 1,082.00 4979-8D 20100210909 10/20/2019

12 JEREMY JAVIER FEIJOO MESIA E001-2887 947.67 E001-2889 2,203.32 3,150.99 T5N-846 20100210909 10/20/2019

JEREMY JAVIER FEIJOO MESIA E001-2890 1,976.00 1,976.00 T5N-846 20382748566 10/20/2019

13 FRANCISCO JOSE CARDENAS VILCHEZ E001-2888 1,330.86 E001-2891 2,818.20 4,149.06 7617-4F 20382748566 10/20/2019

FRANCISCO JOSE CARDENAS VILCHEZ E001-2892 2,473.00 2,473.00 7617-4F 20382748566 10/20/2019

14 EDWIN MICHEL VASQUEZ DIAZ E001-2893 46.99 E001-2894 638.00 684.99 EU-0293 20382748566 10/20/2019

15 UBERTINA LA ROSA NICHO E001-2895 0.33 E001-2896 551.00 551.33 AST-849 20382748566 10/20/2019

16 SINTIA DEBORAH CHOQUEHUANCA REYES E001-2897 90.03 E001-2898 1,412.00 1,502.03 B3G-768 20382748566 10/20/2019

17 CERNA RODRIGUEZ MOISES E001-2899 24.38 E001-2900 461.00 485.38 T9B-858 20382748566 10/20/2019

18 MARIA ARCEÑA OLIVERA URIARTE E001-2901 294.70 E001-2902 1,300.00 1,594.70 2693-1F 20382748566 10/20/2019

19 SOSIMO CASAS ALCARRAZ E001-2905 820.58 E001-2906 3,159.76 3,980.34 A4J-819 20382748566 10/21/2019

SOSIMO CASAS ALCARRAZ E001-2907 440.00 440.00 A4J-819 20382748566 10/21/2019

20 SANDOVAL SANTILLAN ELVIS ROY E001-2908 24.80 E001-2909 187.00 211.80 5533-2D 20382748566 10/21/2019

21 BARRAZA BERNINZON ARABELLA E001-2910 13.17 E001-2911 215.00 228.17 A0H-119 20382748566 10/21/2019

22 SOTELO CASIMIRO TEODOMIRO E001-2912 100.00 100.00 7321-5D 20382748566 10/21/2019

23 LUCIA LILIANA VENTURO SUAREZ E001-2913 1.06 E001-2914 178.00 179.06 6822-8D 20382748566 10/21/2019

24 CESAR ANTHONY FLORES PALACIOS E001-2915 38.75 E001-2916 103.00 141.75 1159-7U 20382748566 10/21/2019

25 IDA DINA RAMIREZ QUISPE E001-2917 2.10 E001-2918 230.00 232.10 A0Z-702 20382748566 10/21/2019

26 ABILGAIL MARILYN CHAVEZ OSORIO E001-2919 0.45 E001-2920 103.00 103.45 AFG-557 20382748566 10/21/2019

27 REZABAL TORIBIO ERIKA VANESSA E001-2921 2.25 E001-2923 97.00 99.25 A6M-759 20382748566 10/21/2019

28 MARTINEZ RINCON EDWIN ALEJANDRO E001-2924 8.38 E001-2925 209.00 217.38 8157-9C 20382748566 10/21/2019

29 MOLDA ROMERO DIEGO FERNANDO E001-2926 169.00 169.00 ABC-946 20382748566 10/21/2019

30 DOMINGUEZ PECHE JOSE VICTOR E001-2927 11.68 E001-2928 133.00 144.68 5629-AP 20382748566 10/21/2019

31 EDWIN CESAR TOCTO CHOQUEHUANGA E001-2931 490.32 E001-2929 1,306.00 1,796.32 9244-DA 20382748566 10/21/2019

EDWIN CESAR TOCTO CHOQUEHUANGA E001-2930 1,232.00 1,232.00 9244-DA 20382748566 10/21/2019

TOTAL: 5,119.35 27,358.68 32,478.03

AFOCAT AUTOSEGURO
FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 NEWMAN MUSSOLINE GUZMAN CORONEL E001-2933 3.86 E001-2934 85.00 88.86 3572-LA 20516314398 11/4/2019

2 AQUILES JOSE MARTINEZ MORGADO E001-2935 1.04 E001-2936 52.00 53.04 9395-EA 20516314398 11/4/2019

3 MARGARITA PAOLA CERVANTES JAULIS E001-2937 38.00 38.00 BDE-345 20516314398 11/4/2019

4 SALAZAR CONDOR MAYCOM JACKSON E001-2938 14.52 E001-2939 307.00 321.52 D7M-349 20516314398 11/4/2019

5 ZOE VARGAS FIRMA E001-2940 7.16 E001-2941 86.00 93.16 9395-EA 20516314398 11/4/2019

6 IVETT AMELIA ASCENCIOS FLORES E001-2942 2.66 E001-2943 45.00 47.66 BDE-345 20516314398 11/4/2019

TOTAL: 29.24 613.00 642.24

AFOCAT LIMA METROPOLITANA

FEC HA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 CHUIMES CERVANTES GRACIELA MERCEDES E001-2978 26.65 E001-2979 103.00 129.65 2111-3C 20515915185 11/6/2019

02 GUTIERREZ RIVAS BRIANNA VALESKA E001-2980 0.70 E001-2981 68.00 68.70 1420-0B 20515915185 11/6/2019

03 JUANA CLOTILDE BAZAN CASTAÑEDA E001-2982 1.31 E001-2983 64.00 65.31 2715-5B 20515915185 11/6/2019

04 MARTINEZ CONDORI REYNALDO SEBASTIAN E001-2984 1.60 E001-2985 129.00 130.60 9611-1D 20515915185 11/6/2019

05 LEO ROMERO SAMANIEGO E001-2986 6.45 E001-2987 124.00 130.45 0669-DA 20515915185 11/6/2019

06 LAURA LORENA VELARDE PEÑA E001-2988 4.01 E001-2989 97.00 101.01 1655-3D 20515915185 11/6/2019

07 NATHALY AGUILAR LOAYZA E001-2991 2.36 E001-2992 117.00 119.36 4095-3A 20515915185 11/6/2019

08 MAGALLANES CASTRO JAZMIN ROXANA YSABEL E001-2993 110.05 E001-2994 248.00 358.05 C6Z-397 20515915185 11/6/2019

09 MARLON KENNE AGURRE QUIROZ E001-2996 2.59 E001-2997 64.00 66.59 1555-OA 20515915185 11/6/2019

10 AMAO POMA LUZ MARIANA E001-2998 96.00 96.00 7522-OC 20515915185 11/6/2019

TOTAL: 155.72 1,110.00 1,265.72

RIMAC SEGUROS Y REASEGUROS

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE


EMISIÓN

01 GALLARDO FLORES ALFREDO GABRIEL E001-3000 74.00 74.00 B3C-736 20100041953 11/7/2019

02 ELEUTERIO CASTRO ALVIA E001-3001 0.48 E001-3002 38.00 38.48 W1L-031 20100041953 11/7/2019

03 ABEL ALBERTO MATEO NIETO E001-3003 0.66 E001-3004 45.00 45.66 B70-955 20100041953 11/7/2019

04 CHRISTIAN ABRHAM FLORES MATIRE E001-3005 68.00 68.00 D1A-756 20100041953 11/7/2019

05 OLIVARES TENA JANINNA EDELMIRA E001-3006 115.41 E001-3007 119.00 234.41 BFI-437 20100041953 11/7/2019

06 DANA ALMUDENA PAYAJO ZEVALLOS E001-3008 19.02 E001-3009 190.00 209.02 AOM-875 20100041953 11/7/2019

07 PABLO ROBERTO CARMEN CHIROQUE E001-3059 925.60 925.60 ACP-572 20100041953 11/11/2019

08 MANUELA MARGARITA VERGARA MARRUFO E001-3060 38.00 38.00 A7A-966 20100041953 11/11/2019

09 MARIA LUISA TUPACYUPANQUI DE AGUILAR E001-3061 13.13 E001-3062 122.00 135.13 F0N-478 20100041953 11/11/2019

10 NADIA EDITH FUENTES NEIRA E001-3063 45.00 45.00 B70-955 20100041953 11/11/2019

11 SONIA LIZ RODRIGUEZ LUCIANO E001-3064 74.00 74.00 B70-955 20100041953 11/11/2019

12 DANISSA MILAGROS GUTIERREZ PEZO E001-3065 4.50 E001-3066 38.00 42.50 B70-955 20100041953 11/11/2019

13 ROSARIO PAOLA REYES SANCHEZ E001-3067 93.00 93.00 B70-955 20100041953 11/11/2019

14 JOSE LUIS CASO RICALDI E001-3068 4.01 E001-3069 178.00 182.01 B70-955 20100041953 11/11/2019

TOTAL: 157.21 2,047.60 2,204.81

AFOCAT AUTOSEGURO

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

1 SERGIO REYNALDO TORIBIO ABARCA E001-3051 29.41 E001-3052 170.00 199.41 NG5-0494 20516314398 11/11/2019

2 ROGELIA MALLQUI RODRIGUEZ E001-3053 63.66 E001-3054 734.00 797.66 ANK-694 20516314398 11/11/2019

ROGELIA MALLQUI RODRIGUEZ E001-3055 254.00 254.00 ANK-694 20516314398 11/11/2019

3 DEYVIS RAFAEL MARIN MALAVER E001-3056 241.00 241.00 AZM-676 20516314398 11/11/2019

4 AMILCAR JUSKCA YAURI E001-3057 18.12 E001-3058 152.00 170.12 9338-AA 20516314398 11/11/2019

TOTAL: 111.19 1,551.00 1,662.19

PACIFICO COMPAÑÍA SEGUROS Y REASEGUROS


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN
ANA JULIA CAROL INA AL VARDO
01 TORRELLAS E001-3016 0.41 E001-3017 114.00 114.41 F0S-545 20332970411 11/11/2019

02 JAIME CESAR RAMOS ESPINOZA E001-3018 44.21 E001-3019 187.00 231.21 AZJ-215 20332970411 11/11/2019

03 REUZ YAURIEL CLAROS CALDERON E001-3020 29.40 E001-3021 246.00 275.40 BFI-380 20332970411 11/11/2019

04 SONIA OCTAVIA MENDOZA FIGUEROA E001-3047 4.26 E001-3048 75.00 79.26 D3M-805 20332970411 11/11/2019

05 MICHAEL OWEN RAMON GAMBOA E001-3049 24.24 E001-3050 354.00 378.24 BHM-475 20332970411 11/11/2019
TOTAL: 102.52 976.00 1,078.52

AFOCAT PREMIUM

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE


EMISIÓN

01 WENDY MARIA MENDOZA ALEJOS E001-3010 0.29 E001-3037 337.00 337.29 D6S-740 20514583201 07/11/2019

02 LID VICTORIA ZAVALETA FRANCIA E001-3012 2.02 E001-3011 148.00 150.02 7525-JA 20514583201 07/11/2019

03 JHAMPIERO DULANTO ROJAS E001-3013 10.51 E001-3038 522.85 533.36 5841-5S 20514583201 11/11/2019

04 LEYLA JAZMIN GARCIA QUISPE E001-3014 2.91 E001-3015 150.00 152.91 9775-EA 20514583201 07/11/2019

05 ANDERSON GERAL ROMERO QUISPE E001-3039 7.04 E001-3040 112.00 119.04 3988-HA 20514583201 11/11/2019

06 CELIO ALFREDO SUCA HUACARPUMA E001-3041 2.16 E001-3042 205.00 207.16 0204-7F 20514583201 11/11/2019

07 JULIO CESAR RIOS CORTEZ E001-3043 18.65 E001-3044 84.00 102.65 0457-2C 20514583201 11/11/2019

08 JULIA CESPEDES CCONISLLA E001-3045 4.97 E001-3046 179.00 183.97 2802-5D 20514583201 11/11/2019

TOTAL: 48.55 1,737.85 1,786.40

INTERSEGURO COMPAÑÍA SEGUROS S.A


FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 IRENE STEPHANY CRUZATT SORIA E001-3022 2.67 E001-3023 45.00 47.67 AFH-284 20382748566 11/9/2019

02 ELENA CASTILLO PACHECO E001-3024 3.11 E001-3025 243.00 246.11 AFH-284 20382748566 11/9/2019

03 RONAL ALMEDO HUAMAN MENDOZA E001-3026 93.00 93.00 F7X-283 20382748566 11/9/2019

04 LEON PUMACAHUA ANDRES E001-3027 74.00 74.00 ACA-208 20382748566 11/9/2019

05 VIVAR MATIENZO YOLANDA MARGARITA E001-3028 12.32 E001-3029 251.00 263.32 D6F-124 20382748566 11/9/2019

06 GARCIA CORDOVA AURELIA SOLEDAD E001-3030 4.06 E001-3031 240.00 244.06 D6F-124 20382748566 11/9/2019

07 JOSHUA EZIO SAMIR TORRES CRUZATT E001-3032 2.40 E001-3033 67.00 69.40 AFH-284 20382748566 11/9/2019

08 DANI CUSTODIO GUZMAN E001-3034 16.67 E001-3035 543.00 559.67 A2D-670 20382748566 11/9/2019

09 HURTADO VALDIVIA ANGEL JOSUE E001-3036 58.00 58.00 F4P-021 20382748566 11/12/2019

10 PRINCIPE ANGELES FRANCISCO LUIS E001-3070 724.89 724.89 W4Z-859 20382748566 11/12/2019

11 PRINCIPE ANGELES FRANCISCO LUIS E001-3071 603.73 603.73 W4Z-859 20382748566 11/12/2019

12 LUIS ALBERTO VALERA MERLO E001-3072 15.57 E001-3073 45.00 60.57 A2H-882 20382748566 11/12/2019

13 DANIEL SANTIAGO CCANTO TOVAR E001-3074 19.17 E001-3075 75.00 94.17 A2H-882 20382748566 11/12/2019

TOTAL: 75.97 3,062.62 3,138.59

AFOCAT LIMA METROPOLITANA


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 OSCAR GERMAN ALARCON HUERTA E001-3076 13.32 E001-3077 86.00 99.32 5290-1A 20515915185 11/12/2019

02 MELIZA AZUCENA OLIVAS TREJO E001-3078 0.41 E001-3079 179.00 179.41 1465-AA 20515915185 11/12/2019

03 JANET YISELA GUERRA GARCIA E001-3080 2.20 E001-3081 159.00 161.20 5386-6A 20515915185 11/12/2019

04 MARIA ANGELICA CHAVEZ CAMPOS E001-3082 2.28 E001-3083 103.00 105.28 2715-5B 20515915185 11/12/2019

05 LIZETH ROSMERY HUAROC CHANCO E001-3085 0.80 E001-3084 165.00 165.80 2063-2F 20515915185 11/12/2019

06 NATHALIE SARITA CAVERO GALINDO E001-3086 1.50 E001-3087 94.00 95.50 A8F-739 20515915185 11/12/2019

07 JHONEL ANTHONY LUNA PORTAL E001-3088 2.65 E001-3089 129.00 131.65 0203-8B 20515915185 11/12/2019

08 LUIS ALBERTO ARIBE HUAPAYA E001-3090 27.00 E001-3091 103.00 130.00 3261-9A 20515915185 11/12/2019

TOTAL: 50.16 1,018.00 1,068.16

AFOCAT LIDER PERU

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 SONIA NOEMI BRICEÑO MALDONADO E001-3092 72.92 E001-3093 1,088.00 1,160.92 8366-KA 20508523344 12/11/2019

2 FLOR ARACELI DAMIAN CARMIN E001-3094 2.71 E001-3095 45.00 47.71 D5Y-029 20508523344 12/11/2019

3 CANDELARIA QUIROZ NEIRA E001-3096 1.23 E001-3097 255.00 256.23 2579-RA 20508523344 12/11/2019

TOTAL: 76.86 1,388.00 1,464.86

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 MILAGROS CELESTE TADEO TELLO E001-3098 0.63 E001-3099 104.00 104.63 4010-NA 20515127403 11/14/2019

02 REYNA ISABEL RAMON SANCHEZ E001-3100 25.02 E001-3101 97.00 122.02 ASY-762 20515127403 11/14/2019

03 OLINDA GAVILAN LUNA E001-3102 1.91 E001-3103 70.00 71.91 ASY-762 20515127403 11/14/2019

04 MARIA NELY GUERRERO VILLOSLADA E001-3104 5.01 E001-3105 182.00 187.01 ALU-332 20515127403 11/14/2019

05 MATILDE BARTOLO DE LA CHIRA E001-3106 45.00 45.00 7251-6B 20515127403 11/14/2019

06 SUSY ELIZABETH ACOSTA DAVILA E001-3107 1.75 E001-3108 61.00 62.75 ALU-332 20515127403 11/14/2019

07 ROBERT AGRAMONTE GONZALES E001-3109 1.76 E001-3110 74.00 75.76 0378-OA 20515127403 11/14/2019

TOTAL: 36.08 633.00 669.08

CRECER SEGUROS S.A


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 NICOLAS LLANOS SOTOMAYOR E001-3111 38.00 38.00 AWG-326 20600098633 14/11/2019

2 JANNET ELENA SOTOMAYOR VIDAL E001-3112 38.00 38.00 AWG-326 20600098633 14/11/2019

TOTAL: 0.00 76.00 76.00

PROTECTA S.A COMPAÑÍA DE SEGUROS


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

1 FRANKLIN WILFREDO SALAS PABLO E001-3113 94.83 E001-3114 1,037.00 1,131.83 F1T-093 20517207331 14/11/2019

2 ZORRILLA ESPINOZA JIM E001-3115 3.20 E001-3116 159.00 162.20 A7A-397 20517207331 14/11/2019

3 MELIANO BAUTISTA CHOMBA E001-3117 898.90 898.90 B1J-937 20517207331 14/11/2019

TOTAL: 98.03 2,094.90 2,192.93

LA POSITIVA SEGUROS Y REASEGUROS S.A.

FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 PACIENTE OMAR DAVID PARIHUAMAN CESPEDE E001-3118 28.17 E001-3119 151.00 179.17 D7W-692 20100210909 11/16/2019

02 RUBEN MENDOZA ESTRADA E001-3120 27.33 E001-3121 146.00 173.33 3358-9C 20100210909 11/16/2019

03 JACINTA ADRIANZEN MENDEZ E001-3122 1.68 E001-3123 96.00 97.68 D4X-392 20100210909 11/16/2019

04 ESTHEFANI FABIOLA VASQUEZ BUJAICO E001-3124 1.50 E001-3125 116.00 117.50 6657-1A 20100210909 11/16/2019

05 ZAPATA SANCHEZ AZAID FARID E001-3126 2.91 E001-3127 140.00 142.91 0266-SA 20100210909 11/16/2019

06 JHOANS GUTIERREZ TAQUIO E001-3128 6.06 E001-3129 248.75 254.81 9631-9U 20100210909 11/16/2019

07 LUCINDA CARBAJAL JERONIMO E001-3130 40.23 E001-3131 339.00 379.23 ATO-708 20100210909 11/16/2019

08 OLGA BETTY MILLA SOLIZOR E001-3132 4.10 E001-3133 57.00 61.10 A9G-795 20100210909 11/16/2019

09 MIGUEL ANGEL FLORES CORONADO E001-3134 11.86 E001-3135 101.00 112.86 6351-EA 20100210909 11/16/2019

10 DELIA MARCA ALMIDON VDA GUTIERREZ E001-3136 34.30 E001-3137 70.00 104.30 A5M-241 20100210909 11/16/2019

11 JHONY JUNIOR ARBIZA CASTILLO E001-3140 8.56 E001-3141 86.00 94.56 6767-6F 20100210909 11/16/2019

12 PEDRO HUGO BEGAZO ARROSPIDE E001-3142 211.00 211.00 3034-6B 20100210909 11/16/2019

13 EVERT AMILCAR AREVALO TRUJILLO E001-3142 15.43 E001-3144 96.00 111.43 0152-OA 20100210909 11/16/2019

14 BRAYAN DANILO PACHAS MACURI E001-3145 16.80 E001-3146 416.00 432.80 5569-IA 20382748566 11/16/2019

15 CARLOS MANUEL AGUIRRE CONTRERAS E001-3147 44.21 E001-3148 651.00 695.21 6878-7B 20382748566 11/16/2019

16 YESLY JANET CASO LAIME E001-3149 0.41 E001-3150 88.00 88.41 B1Q-639 20382748566 11/16/2019

17 FRANKLIN CHAVARRIA FLORES E001-3151 25.08 E001-3152 115.00 140.08 A5P-773 20382748566 11/16/2019

18 IMELDA CESAREA MIRANDA TRUJILLO E001-3153 117.00 117.00 D01-419 20382748566 11/16/2019

19 VILCA DEONICIO JOSE LUIS E001-3154 1.50 E001-3155 60.00 61.50 0266-SA 20382748566 11/16/2019

20 ALFREDO HUANCA GIRON E001-3156 55.89 E001-3157 221.00 276.89 9329-5D 20382748566 11/16/2019

21 JHOSSEF ELIAS PALOMINO SANCHEZ E001-3158 31.18 E001-3159 144.00 175.18 4280-SA 20382748566 11/16/2019

22 FLORIAN PADILLA LIZ ORFELINDA E001-3160 1.50 E001-3161 45.00 46.50 AUL-796 20382748566 11/17/2019

23 CARMEN AMALIA ZEGARRA CASTILLO E001-3162 641.38 E001-3163 2,121.96 2,763.34 0343-7C 20382748566 11/17/2019

23 E001-3164 928.00 928.00 0343-7C 20382748566 11/17/2019

24 MARIBEL SANDOVAL HUAMAN E001-3165 16.72 E001-3166 206.00 222.72 F6R-228 20382748566 11/18/2019

25 LUIS ALBERTO PIEDRA MENDOZA E001-3203 1.05 E001-3204 61.00 62.05 EU-1929 20382748566 11/19/2019

TOTAL: 1,017.85 7,031.71 8,049.56

MAPFRE PERU COMPAÑÍA SEGUROS Y REASEGUROS S.A


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 MAGNOLIA MAYBE MISHTI REGALADO E001-3167 2.56 E001-3168 132.00 134.56 B1T-767 20202380621 11/18/2019

02 SIXTO VILLANUEVA OLORTEGUI E001-3169 34.82 E001-3170 114.00 148.82 AWJ-705 20202380621 11/18/2019

03 LUIS GUEVARA SANCHEZ E001-3171 4.88 E001-3172 153.00 157.88 AHK-713 20202380621 11/18/2019

04 EDWIN DIAZ ORTIZ E001-3173 14.92 E001-3174 198.00 212.92 5529.-2F 20202380621 11/18/2019

05 GUSTAVO JOSE JUNIOR SILVA ALVAREZ E001-3175 105.00 105.00 1743-1D 20202380621 11/18/2019

06 DAVID PELAEZ ALZATE E001-3176 288.00 288.00 1743-1D 20202380621 11/18/2019

07 JORGE EDUARDO TADEO FLORES E001-3177 28.73 E001-3178 474.00 502.73 D71-298 20202380621 11/18/2019

08 BEATRIZ MIRANDA PEDROZO DE ALTAMIRANO E001-3179 19.57 E001-3180 112.00 131.57 ABS-749 20202380621 11/18/2019

09 SERGIO ALFONSO PAIRAZAMAN SERAFIN E001-3181 20.30 E001-3182 122.00 142.30 6039-DA 20202380621 11/18/2019

10 MIRSA ABREGU LONDOÑE E001-3183 8.10 E001-3184 138.00 146.10 AKY-567 20202380621 11/18/2019

11 EFRAIN CESAR SILVANO LIGARDA E001-3185 42.48 E001-3186 358.00 400.48 T4-0321 20202380621 11/18/2019

12 VALERIANO LEONARDO BRITO DIAZ E001-3187 60.11 E001-3188 573.00 633.11 B8Z-592 20202380621 11/18/2019

13 JOHAN SALCEDO TAMARA E001-3189 61.32 E001-3190 700.00 761.32 6854-KA 20202380621 11/19/2019

14 DORIS KAORI PALOMINO CHILINGANO E001-3191 0.25 E001-3192 74.00 74.25 T4-0321 20202380621 11/19/2019

15 CARMEN ELENA AGUIRRE ANTON E001-3193 1.61 E001-3194 137.00 138.61 ABK-753 20202380621 11/19/2019

16 CARMEN ELENA AGUIRRE ANTON E001-3195 38.00 38.00 ABK-753 20202380621 11/19/2019

17 VICTOR ANTONIO PAZCE CASAS E001-3196 36.40 E001-3197 100.00 136.40 A5V-779 20202380621 11/19/2019

18 MICHAEL JEHAN CRUCES LLAMOCA E001-3198 23.01 E001-3199 155.00 178.01 2025-8D 20202380621 11/19/2019

19 JOSE SANTOS SOLANO COTRINA E001-3201 3.49 E001-3202 93.00 96.49 ABS-749 20202380621 11/19/2019

TOTAL: 362.55 4,064.00 4,426.55

MINISTERIO DE TRANSPORTES Y COMUNICACIONES

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE


EMISIÓN

1 MAYCOL FRAN VASQUEZ FABIAN E001-3200 526.00 526.00 20131379944 19/11/2019

TOTAL: 0.00 526.00 526.00

AFOCAT LIMA METROPOLITANA


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 TEODORA VALENCIA RAMIREZ E001-3205 86.00 86.00 4092-8D 20515915185 12/2/2019

02 SANDRA ARIANA CHUMPITAZ ATALAYA E001-3206 1.20 E001-3207 114.00 115.20 1655-3D 20515915185 12/2/2019

03 CERCEDA BACA HERMINIA E001-3208 23.86 E001-3209 244.00 267.86 7367-EA 20515915185 12/2/2019

04 PEDRO EMILIANO AVILA CARBAJAL E001-3210 21.91 E001-3211 96.00 117.91 A1-6383 20515915185 12/2/2019

05 TOLENTINO CHAVARRIA ANTONINO E001-3212 2.01 E001-3213 45.00 47.01 A0-7711 20515915185 12/2/2019

06 CESAR AUGUSTO QUIROZ MATILDO E001-3214 22.01 E001-3215 115.00 137.01 A8-8945 20515915185 12/2/2019

07 MICAEL ABDIEL ANDERSON TORRES SILVA E001-3216 4.60 E001-3217 38.00 42.60 6022-CA 20515915185 12/2/2019

08 CARRASCO TRUJILLO ROSA NELLY E001-3218 8.33 E001-3219 199.00 207.33 A9-6719 20515915185 12/2/2019

09 DIAZ CASTILLO ARIANA ESTELA E001-3220 18.70 E001-3221 61.00 79.70 5959-OA 20515915185 12/2/2019

10 YACHA DOMINGUEZ EMIL SILBESTRE E001-3222 18.70 E001-3223 287.00 305.70 0976-IA 20515915185 12/2/2019

11 YACHA DOMINGUEZ EMIL SILBESTRE E001-3224 46.53 E001-3232 150.00 196.53 0976-IA 20515915185 12/2/2019

12 CASTILLO ATAHUAMAN EDITH E001-3225 81.00 81.00 5959-OA 20515915185 12/2/2019

13 KARINA ALEXI GARCIA ALVARADO E001-3226 23.86 E001-3227 115.00 138.86 A8-8945 20515915185 12/2/2019

14 CARMEN JULIA ESPINOZA RISCO E001-3228 31.91 E001-3229 149.00 180.91 1482-6D 20515915185 12/2/2019

15 SANDRA LEONOR CASTAÑEDA NOMBERTO E001-3230 1.20 E001-3231 94.00 95.20 5940-1C 20515915185 12/2/2019

16 BLANCA LUZMILA ASENCIOS VALENCIA E001-3233 10.67 E001-3234 148.00 158.67 4092-8D 20515915185 12/2/2019

17 CAMILA ADRIANA FLORES VELASCO E001-3235 143.00 143.00 6943-IA 20515915185 12/2/2019

18 ESTHER JANET CASTRO GALARZA E001-3236 38.00 38.00 7096-3D 20515915185 12/2/2019

19 MERCEDES MILAGROS CONTRERAS SANTARIA E001-3237 38.00 38.00 7096-3D 20515915185 12/2/2019

20 TEOFILO JUSTINIANO AMAYA CALDERON E001-3238 6.62 E001-3239 93.00 99.62 3744-LA 20515915185 12/2/2019

21 BLANCA CONSUELO VIGO PULIDO E001-3240 101.00 101.00 7096-3D 20515915185 12/2/2019

TOTAL: 242.11 2,435.00 2,677.11

AFOCAT AUTOSEGURO
FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

1 SALAZAR CONDOR MAYCON JACKSON E001-3241 14.52 E001-3242 307.00 321.52 D7M-349 20516314398 12/2/2019

2 SERGIO REYNALDO TORIBIO ABARCA E001-3243 29.41 E001-3244 170.00 199.41 NG5-0494 20516314398 12/2/2019

3 ROGELIA MALLQUI RODRIGUEZ E001-3245 63.66 E001-3246 734.00 797.66 ANK-694 20516314398 12/2/2019

ROGELIA MALLQUI RODRIGUEZ E001-3247 254.00 254.00 ANK-694 20516314398 12/2/2019

5 DEYVIS RAFAEL MARIN MALAVER E001-3248 241.00 241.00 AZM-676 20516314398 12/2/2019

6 AMILCAR JUSKCA YAURI E001-3249 18.12 E001-3250 152.00 170.12 9338-AA 20516314398 12/2/2019

TOTAL: 125.71 1,858.00 1,983.71

AFOCAT LIDER PERU

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 GUADALUPE JOHANA MALPARTIDA GARAY E001-3251 2.16 E001-3252 244.00 246.16 0162-MM 20508523344 03/12/2019

2 JOSE MATIAS PERALTA HUAYNATES E001-3253 38.00 38.00 5127-LA 20508523344 03/12/2019

3 BRICEÑO MALDONADO EVA BEATRIZ E001-3254 27.41 E001-3255 159.00 186.41 8366-KA 20508523344 03/12/2019

4 OBISPO MILAGROS MELSI SARMIENTO E001-3256 125.64 E001-3257 347.00 472.64 DOW-599 20508523344 03/12/2019

TOTAL: 155.21 788.00 943.21

AFOCAT PREMIUM
FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 JOSE MAURY GUILLERMO E001-3258 1.82 E001-3259 174.00 175.82 S3-7313 20514583201 03/12/2019

02 PROSPERA MORENO MARTEL DE BERAMENDI E001-3260 17.17 E001-3261 115.00 132.17 A5-8885 20514583201 03/12/2019

03 HILDEBRANT CHAULIREY PEREZ ORE E001-3262 1.21 E001-3263 78.00 79.21 9964-EA 20514583201 03/12/2019

04 KATALEYA CARY JIMENEZ E001-3264 38.00 38.00 4267-1A 20514583201 03/12/2019

05 LUZ AIDA ESPINOZA BOCANEGRA E001-3265 1.00 E001-3266 243.00 244.00 2198-IA 20514583201 03/12/2019

06 JULO CESAR AYORA GASPAR E001-3267 38.00 38.00 ABI-794 20514583201 03/12/2019

TOTAL: 21.20 686.00 707.20

RIMAC SEGUROS Y REASEGUROS


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 ANTONIA MODESTO CACHAY E001-3292 4.26 E001-3293 74.00 78.26 F0N-478 20100041953 12/7/2019

02 MARISOL CARRIZALES NINACONDO E001-3294 38.00 38.00 Z2D-709 20100041953 12/7/2019

03 JOSE CARRIZALES NINACONDOR E001-3295 38.00 38.00 Z2D-709 20100041953 12/7/2019

04 ANGIE ESTRELLA TORRES CARRION E001-3296 7.90 E001-3297 93.00 100.90 B4L-108 20100041953 12/7/2019

05 MEZA VILLADEZA DELIA VICTORIA E001-3298 89.00 89.00 B2M-044 20100041953 12/7/2019

06 CAÑARI SILVERA RUANO NORBERT E001-3299 13.85 E001-3300 104.00 117.85 BEF-535 20100041953 12/7/2019

07 MYA VALENTINA CARRIZALES PANTOJA E001-3301 38.00 38.00 A2D-709 20100041953 12/7/2019

08 ANGELA KALESSI DANNAE HINOJOSA CARRIZALES E001-3302 38.00 38.00 Z2D-709 20100041953 12/7/2019
GREGORIA HERMENESIA ROSAS ROBLES DE
09 COR PU S E001-3303 9.00 E001-3304 75.00 84.00 B9J-728 20100041953 12/7/2019

10 JAIME PEPE AYRA IGLESIAS E001-3305 1.35 E001-3306 67.00 68.35 ADE -739 20100041953 12/7/2019

11 LUZ MARITA DIAZ TARRILLO E001-3307 9.04 E001-3308 38.00 47.04 ADE -739 20100041953 12/7/2019

12 XUSAN ÑIQUE CANCHARI E001-3309 1.91 E001-3310 61.00 62.91 ADE -739 20100041953 12/7/2019

13 MARIA TTITO ACCOSTUPA E001-3311 1.50 E001-3312 61.00 62.50 ADE -739 20100041953 12/7/2019

14 EDUARDO GONZALO CONTRERAS CAPCHA E001-3313 1.35 E001-3314 38.00 39.35 ADE -739 20100041953 12/7/2019

15 VICTORIA JULIA VALVERDE ISIDRO E001-3315 1.51 E001-3316 74.00 75.51 ADE -739 20100041953 12/7/2019

16 ROXANA ISABEL MARREROS RODRIGUEZ E001-3317 16.83 E001-3318 67.00 83.83 ADE -739 20100041953 12/7/2019

TOTAL: 68.50 993.00 1,061.50

BNP PARIBAS CARDIF S.A


FECH A DE
PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
N° EMISIÓN

01 NATALY JENNIFER SILVA CHINCHAY E001 - 3291 443.04 443.04 AVP-017 20513328819 05/012/2019

TOTAL: 0.00 443.04 443.04

PACIFICO COMPAÑÍA SEGUROS Y REASEGUROS


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 NADINE EYZAGUIRRE TARAZONA E001-3278 0.41 E001-3279 155.00 155.41 AIK-277 20332970411 12/5/2019

02 BUENAVENTURA SOLIS BARDALES E001-3280 6.12 E001-3281 212.00 218.12 A1D-641 20332970411 12/5/2019

03 KATIA ELIZABETH LARA YNCIO E001-3282 40.54 E001-3283 234.00 274.54 B9Y-551 20332970411 12/5/2019

04 ALEXIS JHONNY QUISPE GUTIERREZ E001-3284 70.14 70.14 2661-HA 20332970411 12/5/2019

05 CHIPAO CHOQUE ABEL E001-3285 18.86 E001-3286 366.00 384.86 H1T-794 20332970411 12/5/2019

06 TAFUR CASTILLEJO ELVIS GUADALUPE E001-3287 97.00 E001-3288 239.00 336.00 H1T-794 20332970411 12/5/2019

07 JOSE PORFIRIO CHUQUIRUNA CULQUI E001-3289 1.50 E001-3290 60.00 61.50 D10-859 20332970411 12/5/2019

TOTAL: 164.43 1,336.14 1,500.57

INTERSEGURO COMPAÑÍA SEGUROS S.A


FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 NORMA ELIZABETH PINEDA VELASQUEZ E001-3268 1.56 E001-3269 181.00 182.56 BL0-578 20382748566 12/5/2019

02 JESSICA KARLA MORALES PÁDILLA E001-3270 32.66 E001-3271 253.00 285.66 BFL-062 20382748566 12/5/2019

03 FORTUNATA MARQUESA PADILLA APOLINARIO E001-3272 0.27 E001-3273 105.00 105.27 BFL-062 20382748566 12/5/2019

04 NAYDI YESEBEL ARAUJO ZEA E001-3274 0.90 E001-3275 223.00 223.90 V4W-155 20382748566 12/5/2019

05 FRANCIS ROSA MORALES PADILLA E001-3276 1.80 E001-3277 103.00 104.80 BFL-062 20382748566 12/5/2019

TOTAL: 37.19 865.00 902.19

AFOCAT REGIÓN LIMA

FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

1 GIOVANNA PAOLA GONZALES RISCO E001-3319 23.20 E001-3320 84.00 107.20 0194-5C 20515127403 12/8/2019

2 DELIA YULISA ROJAS URETA E001-3321 2.16 E001-3322 97.00 99.16 5789-BA 20515127403 12/8/2019

3 YOSELYN CYNTHIA MONTES DURAN E001-3323 1.50 E001-3324 60.00 61.50 3342-TA 20515127403 12/8/2019

4 JESUSA MARIA VERAMENDI ORTEGA E001-3325 1.55 E001-3326 98.00 99.55 5762-MA 20515127403 12/8/2019

5 MARIZA MERLO VASQUEZ E001-3327 0.91 E001-3328 118.00 118.91 1280-5B 20515127403 12/8/2019

6 VICTOR IVAN PERALTA LAPA E001-3329 2.73 E001-3330 113.00 115.73 ALU-332 20515127403 12/8/2019

7 MANSUELTO CUADRA SIFUENTES E001-3331 33.20 E001-3332 139.00 172.20 6128-FA 20515127403 12/8/2019

8 URIEL BLAS ORTIZ E001-3333 9.86 E001-3334 172.00 181.86 3457.0F 20515127403 12/8/2019

9 ORTENCIO ROLANDO RAMOS SANCHEZ E001-3335 17.10 E001-3336 116.00 133.10 3421-7F 20515127403 12/8/2019

10 GUIZADO PESANTES HUGO WILFREDO E001-3337 5.18 E001-3338 99.00 104.18 5412-DA 20515127403 12/8/2019

11 CONDORI ROQUE BLANCA MARELYNN E001-3339 1.91 E001-3340 68.00 69.91 5412-DA 20515127403 12/8/2019

12 MAÑEZ TAPULLIMA ELISA E001-3341 33.55 E001-3342 157.00 190.55 H2T-966 20515127403 12/8/2019

13 PINEDO MAS MARIA DINA E001-3343 13.46 E001-3344 396.00 409.46 6367-OD 20515127403 12/8/2019

14 JUAN DE DIOS VALDIZAN JUAN JAIRO E001-3345 4.28 E001-3346 311.00 315.28 A1-9559 20515127403 12/8/2019

15 FELIX JAIME GAMARRA PERALTA E001-3347 8.25 E001-3348 45.00 53.25 A0-7318 20515127403 12/8/2019

16 EVA ZELADA MELGAR E001-3349 0.27 E001-3350 123.00 123.27 A7-6595 20515127403 12/8/2019

17 AURELIO QUINTANA CHAPPA E001-3351 1.78 E001-3352 100.00 101.78 A7-6595 20515127403 12/8/2019

18 SHEYLA NOEMI SILVA LINGAN E001-3353 29.28 E001-3354 67.00 96.28 1574-KA 20515127403 12/8/2019

19 ANJALY GABRIELA PAULET BARTRA E001-3355 12.90 E001-3356 67.00 79.90 6179-8F 20515127403 12/8/2019

20 DOMINIC RONALD BUSTAMENTE BLAS E001-3357 38.00 38.00 5814-3B 20515127403 12/8/2019

21 EMANUEL JULCAHUAMAN NAVARRO E001-3358 0.54 E001-3359 67.00 67.54 6196-7A 20515127403 12/8/2019

22 JANIER DEYVIS MELCHOR FLORES E001-3360 2.03 E001-3361 105.00 107.03 5611-LA 20515127403 12/8/2019

23 LIZBETH FIORELA CAPCHA UGARTE E001-3362 34.43 E001-3363 63.00 97.43 9854-1S 20515127403 12/8/2019

24 MATEO NEEMIAS SALAZAR LOARTE E001-3364 82.00 82.00 5911-1D 20515127403 12/8/2019

25 ERIKA YADIRA ROJAS LEYVA E001-3365 13.81 E001-3366 123.00 136.81 B4-8856 20515127403 12/8/2019

26 MARINA MERCEDES RIVAS QUISPE E001-3367 2.10 E001-3368 86.00 88.10 5347-3A 20515127403 12/8/2019

27 BRAYAN JOSUE SERNAQUE MAZA E001-3369 1.45 E001-3370 139.00 140.45 3474-EA 20515127403 12/8/2019

28 FILADELFO HUAMAN NUÑEZ E001-3371 11.96 E001-3372 86.00 97.96 9236-7A 20515127403 12/8/2019

29 DAVID QUEVEDO FRETICHER E001-3373 5.67 E001-3374 122.00 127.67 9236-7A 20515127403 12/8/2019

30 ALESSANDRO FAUSTO ROCA ROJAS E001-3375 1.45 E001-3376 38.00 39.45 B4-8856 20515127403 12/8/2019

31 JUANA MARGARITA CHAMBI ESQUIVEL E001-3377 6.88 E001-3378 196.00 202.88 A7R-720 20515127403 12/8/2019

32 JUAN OSCAR LOPEZ CHAVEZ E001-3379 1.97 E001-3380 108.00 109.97 5762-MA 20515127403 12/8/2019

33 BEATRIZ JUANA PEÑA MORALES DE CANGANA E001-3381 1.37 E001-3382 97.00 98.37 5762-MA 20515127403 12/8/2019

34 MARYCIELO MASCCO BAUTISTA E001-3383 4.17 E001-3384 68.00 72.17 0807-2A 20515127403 12/8/2019

35 LUZ MARINA ARIAS ARMUTO E001-3385 5.52 E001-3386 122.00 127.52 0807-2A 20515127403 12/8/2019

TOTAL: 296.42 3,970.00 4,266.42

AFOCAT AUTOSEGURO

N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC FECHA DE


EMISIÓN

1 ROGER CHUNQUE LINARES E00-3419 0.18 E00-3420 38.00 38.18 AUB-515 20516314398 12/2/2019

TOTAL: 0.18 38.00 38.18

AFOCAT REGIÓN LIMA


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

1 GIOVANNA PAOLA GONZALES RISCO E001-3319 23.20 E001-3320 84.00 107.20 0194-5C 20515127403 12/8/2019

2 DELIA YULISA ROJAS URETA E001-3321 2.16 E001-3322 97.00 99.16 5789-BA 20515127403 12/8/2019

3 YOSELYN CYNTHIA MONTES DURAN E001-3323 1.50 E001-3324 60.00 61.50 3342-TA 20515127403 12/8/2019

4 JESUSA MARIA VERAMENDI ORTEGA E001-3325 1.55 E001-3326 98.00 99.55 5762-MA 20515127403 12/8/2019

5 MARIZA MERLO VASQUEZ E001-3327 0.91 E001-3328 118.00 118.91 1280-5B 20515127403 12/8/2019

6 VICTOR IVAN PERALTA LAPA E001-3329 2.73 E001-3330 113.00 115.73 ALU-332 20515127403 12/8/2019

7 MANSUELTO CUADRA SIFUENTES E001-3331 33.20 E001-3332 139.00 172.20 6128-FA 20515127403 12/8/2019

8 URIEL BLAS ORTIZ E001-3333 9.86 E001-3334 172.00 181.86 3457.0F 20515127403 12/8/2019

9 ORTENCIO ROLANDO RAMOS SANCHEZ E001-3335 17.10 E001-3336 116.00 133.10 3421-7F 20515127403 12/8/2019

10 GUIZADO PESANTES HUGO WILFREDO E001-3337 5.18 E001-3338 99.00 104.18 5412-DA 20515127403 12/8/2019

11 CONDORI ROQUE BLANCA MARELYNN E001-3339 1.91 E001-3340 68.00 69.91 5412-DA 20515127403 12/8/2019

12 MAÑEZ TAPULLIMA ELISA E001-3341 33.55 E001-3342 157.00 190.55 H2T-966 20515127403 12/8/2019

13 PINEDO MAS MARIA DINA E001-3343 13.46 E001-3344 396.00 409.46 6367-OD 20515127403 12/8/2019

14 JUAN DE DIOS VALDIZAN JUAN JAIRO E001-3345 4.28 E001-3346 311.00 315.28 A1-9559 20515127403 12/8/2019

15 FELIX JAIME GAMARRA PERALTA E001-3347 8.25 E001-3348 45.00 53.25 A0-7318 20515127403 12/8/2019

16 EVA ZELADA MELGAR E001-3349 0.27 E001-3350 123.00 123.27 A7-6595 20515127403 12/8/2019

17 AURELIO QUINTANA CHAPPA E001-3351 1.78 E001-3352 100.00 101.78 A7-6595 20515127403 12/8/2019

18 SHEYLA NOEMI SILVA LINGAN E001-3353 29.28 E001-3354 67.00 96.28 1574-KA 20515127403 12/8/2019

19 ANJALY GABRIELA PAULET BARTRA E001-3355 12.90 E001-3356 67.00 79.90 6179-8F 20515127403 12/8/2019

20 DOMINIC RONALD BUSTAMENTE BLAS E001-3357 38.00 38.00 5814-3B 20515127403 12/8/2019

21 EMANUEL JULCAHUAMAN NAVARRO E001-3358 0.54 E001-3359 67.00 67.54 6196-7A 20515127403 12/8/2019

22 JANIER DEYVIS MELCHOR FLORES E001-3360 2.03 E001-3361 105.00 107.03 5611-LA 20515127403 12/8/2019

23 LIZBETH FIORELA CAPCHA UGARTE E001-3362 34.43 E001-3363 63.00 97.43 9854-1S 20515127403 12/8/2019

24 MATEO NEEMIAS SALAZAR LOARTE E001-3364 82.00 82.00 5911-1D 20515127403 12/8/2019

25 ERIKA YADIRA ROJAS LEYVA E001-3365 13.81 E001-3366 123.00 136.81 B4-8856 20515127403 12/8/2019

26 MARINA MERCEDES RIVAS QUISPE E001-3367 2.10 E001-3368 86.00 88.10 5347-3A 20515127403 12/8/2019

27 BRAYAN JOSUE SERNAQUE MAZA E001-3369 1.45 E001-3370 139.00 140.45 3474-EA 20515127403 12/8/2019

28 FILADELFO HUAMAN NUÑEZ E001-3371 11.96 E001-3372 86.00 97.96 9236-7A 20515127403 12/8/2019

29 DAVID QUEVEDO FRETICHER E001-3373 5.67 E001-3374 122.00 127.67 9236-7A 20515127403 12/8/2019

30 ALESSANDRO FAUSTO ROCA ROJAS E001-3375 1.45 E001-3376 38.00 39.45 B4-8856 20515127403 12/8/2019

31 JUANA MARGARITA CHAMBI ESQUIVEL E001-3377 6.88 E001-3378 196.00 202.88 A7R-720 20515127403 12/8/2019

32 JUAN OSCAR LOPEZ CHAVEZ E001-3379 1.97 E001-3380 108.00 109.97 5762-MA 20515127403 12/8/2019

33 BEATRIZ JUANA PEÑA MORALES DE CANGANA E001-3381 1.37 E001-3382 97.00 98.37 5762-MA 20515127403 12/8/2019

34 MARYCIELO MASCCO BAUTISTA E001-3383 4.17 E001-3384 68.00 72.17 0807-2A 20515127403 12/8/2019

35 LUZ MARINA ARIAS ARMUTO E001-3385 5.52 E001-3386 122.00 127.52 0807-2A 20515127403 12/8/2019

36 MORA DOMINGUEZ SATURNINO E001-3422 1.80 E001-3421 67.00 68.80 6179-8F 20515127403 12/10/2019

37 ESPINOZA TAYA XIOMAR EDDU E001-3424 24.55 E001-3423 142.00 166.55 6681-3F 20515127403 12/10/2019
38 HIDALGO TRUJILLO CESAR E001-3426 0.63 E001-3425 86.00 86.63 AO-9277 20515127403 12/10/2019

39 RIMARACHIN RODRIGUEZ NATALI YVONNE E001-3428 6.22 E001-3427 181.00 187.22 MG-39861 20515127403 12/10/2019

TOTAL: 329.62 4,446.00 4,775.62

PACIFICO COMPAÑÍA SEGUROS Y REASEGUROS


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 NADINE EYZAGUIRRE TARAZONA E001-3278 0.41 E001-3279 155.00 155.41 AIK-277 20332970411 12/5/2019

02 BUENAVENTURA SOLIS BARDALES E001-3280 6.12 E001-3281 212.00 218.12 A1D-641 20332970411 12/5/2019

03 KATIA ELIZABETH LARA YNCIO E001-3282 40.54 E001-3283 234.00 274.54 B9Y-551 20332970411 12/5/2019

04 ALEXIS JHONNY QUISPE GUTIERREZ E001-3284 70.14 70.14 2661-HA 20332970411 12/5/2019

05 CHIPAO CHOQUE ABEL E001-3285 18.86 E001-3286 366.00 384.86 H1T-794 20332970411 12/5/2019

06 TAFUR CASTILLEJO ELVIS GUADALUPE E001-3287 97.00 E001-3288 239.00 336.00 H1T-794 20332970411 12/5/2019

07 JOSE PORFIRIO CHUQUIRUNA CULQUI E001-3289 1.50 E001-3290 60.00 61.50 D10-859 20332970411 12/5/2019

08 CUEVA BAZAN LUCY E001-3429 110.00 110.00 D2R-722 20332970411 12/10/2019

09 ACEVEDO FLORES JOSE VICTOR E001-3430 22.12 E001-3431 75.00 97.12 EGQ-193 20332970411 12/10/2019

TOTAL: 186.55 1,521.14 1,707.69

MAPFRE PERU COMPAÑÍA SEGUROS Y REASEGUROS S.A


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 OSCAR RIVAS JAIMES E001-3390 8.72 E001-3389 93.00 101.72 D1V-677 20202380621 12/10/2019

02 DIEGO ALFONSO VALLE COVA E001-3391 8.10 E001-3392 45.00 53.10 5801-PA 20202380621 12/10/2019

03 ARLINSON FABIAN CALDERON ORTIZ E001-3393 8.00 E001-3394 60.00 68.00 5801-PA 20202380621 12/10/2019

04 JUANA ELSA ROJAS RAMIREZ DE VALIENTE E001-3395 1.86 E001-3396 118.00 119.86 B2R-777 20202380621 12/10/2019

05 OCAS UBILLUS ADRIAN JESUS E001-3397 97.00 97.00 B5X-962 20202380621 12/10/2019

06 ROMERO GARCIA JESUS DANIEL E001-3398 16.37 E001-3399 249.00 265.37 0355-TA 20202380621 12/10/2019

07 MACA MERMAO NELVA MARIANA E001-3400 0.47 E001-3401 151.00 151.47 BAC-570 20202380621 12/10/2019

08 RIVERA SARMIENTO MARISOL BLANCA E001-3402 0.52 E001-3403 75.00 75.52 85X-962 20202380621 12/10/2019

09 JULIA DELFINA ALBARRAN CARRETEROS E001-3404 0.47 E001-3405 88.00 88.47 B5X-962 20202380621 12/10/2019

10 MIXI TAMARA RENGIFO PANDURO E001-3406 1.37 E001-3407 128.00 129.37 85X-962 20202380621 12/10/2019

11 ZENAYDA PAULINO HUAMAN DE LICAS E001-3408 67.22 E001-3409 1,164.00 1,231.22 0355-TA 20202380621 12/10/2019

12 RAUL STEPHAN ZUBIETTA CASTILLO E001-3410 189.00 189.00 85X-962 20202380621 12/10/2019

13 ROBERT JOSE HERNANDEZ LIMPIO E001-3411 30.59 E001-3412 461.00 491.59 0355-TA 20202380621 12/10/2019

14 EDINSON PIÑA YAHUARCANI E001-3413 16.18 E001-3414 78.00 94.18 7980-RA 20202380621 12/10/2019

15 JULIO CESAR OLIVERA TAMAYO E001-3415 7.33 E001-3416 219.00 226.33 C2K-803 20202380621 12/10/2019

16 ANDRES CONSTANTINO REYES FERNANDEZ E001-3417 40.84 E001-3418 236.00 276.84 AWI-928 20202380621 12/10/2019

TOTAL: 208.04 3,451.00 3,659.04

MINISTERIO DE TRANSPORTES Y COMUNICACIONES


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 MONICA JULIA PACHAS MARTIN E001-3690 804.96 E001-3691 1,537.00 2,341.96 5125-8A 20515915185 12/11/2019

02 E001-3692 1,667.00 1,667.00 NI-31353 20515915185 12/11/2019

03 0.00 AS-7342 20515915185 12/11/2019

04 0.00 4095-3A 20515915185 12/11/2019

TOTAL: 804.96 3,204.00 4,008.96

AFOCAT PREMIUM
FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 DIAZ ALDAVE LUCIANA ALEXANDRA E001-3432 67.00 67.00 B3-8479 20514583201 11/12/2019

02 GARCIA ARMAS ARTURO ENRIQUE E001-3434 4.67 E001-3433 145.00 149.67 A8-9592 20514583201 11/12/2019

03 MORQUENCHO HERRERA JERFFERSON E001-3436 11.34 E001-3435 123.00 134.34 5313-3F 20514583201 11/12/2019

04 SILVA VASQUEZ JENNY FRANAS E001-3438 4.09 E001-3437 131.00 135.09 B3-8479 20514583201 11/12/2019

05 ALDAVE VASQUEZ ROSA ELENA E001-3440 4.09 E001-3439 131.00 135.09 B3-8479 20514583201 11/12/2019

06 YUHIMACHI TAPULLIMA JOISY SIGRID E001-3442 0.66 E001-3441 45.00 45.66 7014-BF 20514583201 11/12/2019

07 DAZA BRONCANO RUTH E001-3444 4.14 E001-3443 209.00 213.14 3668-QA 20514583201 11/12/2019

08 MOLLINEDO YUHIMACHI HILDA E. E001-3446 2.91 E001-3445 45.00 47.91 7014-BF 20514583201 11/12/2019

09 ROQUE LUGO IAN ESTEFANO E001-3448 20.72 E001-3447 289.00 309.72 B8-0616 20514583201 11/12/2019

TOTAL: 52.62 1,185.00 1,237.62

RIMAC SEGUROS Y REASEGUROS


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 DIGMA PAMELA PASTOR SALAZAR E001-3457 35.33 E001-3458 332.00 367.33 870-955 20100041953 12/11/2019

02 DELGADO YACSAHUANCA FRANCO O. E001-3459 1.71 E001-3460 105.00 106.71 A9J-790 20100041953 12/11/2019

03 ISRAEL ROMERO MENDOZA E001-3461 5,169.30 E001-3469 7,450.48 12,619.78 F5Y -907 20100041953 12/11/2019

E001-3470 6,869.93 6,869.93 F5Y -907 20100041953 12/11/2019

E001-3471 642.00 642.00 F5Y -907 20100041953 12/11/2019

04 GLEYDI CLEMENTINA CALLE CORDOVA E001-3462 22.20 E001-3463 711.00 733.20 T5W-955 20100041953 12/11/2019

05 KELLY YASMIRA CABALLERO SOLIS E001-3464 59.92 E001-3465 644.75 704.67 B70-955 20100041953 12/11/2019

E001-3466 251.00 251.00 B70-955 20100041953 12/11/2019

06 CARLOS ALFONFO MALLMA LUYO E001-3467 35.63 E001-3468 745.00 780.63 ARE-472 20100041953 12/11/2019

07 YOLANDA NORABUENA RAMIREZ E001-3472 14.46 E001-3473 302.00 316.46 F1W-917 20100041953 12/11/2019

08 FIDEL MAXIMO LOPEZ PIÑAN E001-3474 1,813.98 E001-3475 4,321.40 6,135.38 BVK-275 20100041953 11/11/2019

E001-3476 3,473.59 3,473.59 BVK-275 20100041953 11/11/2019

E001-3477 187.00 187.00 BVK-275 20100041953 11/11/2019

TOTAL: 7,152.53 26,035.15 33,187.68

INTERSEGURO COMPAÑÍA SEGUROS S.A


FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 DEREK ALBERTO SULLON LOZANO E001-3478 38.00 38.00 BER-548 20382748566 12/12/2019

02 YONEEL DANIEL PINEDA VELASQUEZ E001-3479 2.01 E001-3480 118.00 120.01 BLO-578 20382748566 12/12/2019

03 YARELI ALISSIA SULLON LOZANO E001-3481 38.00 38.00 BER-548 20382748566 12/12/2019

04 XIOMARA MIRELLA ALFARO LUIS E001-3482 1.31 E001-3483 45.00 46.31 W3P-555 20382748566 12/12/2019

05 ALESIA ALTAMIRANO PAZ E001-3484 38.00 38.00 BER-548 20382748566 12/12/2019

06 OLGA QUIROZ FLORES DE FARFAN E001-3485 0.70 E001-3486 60.00 60.70 AHP-207 20382748566 12/12/2019

07 SAMUEL ALFARO CUBAS E001-3487 3.58 E001-3488 64.00 67.58 W3P-555 20382748566 12/12/2019

08 SONIA Y YANINA LUIS SACHUN E001-3489 1.90 E001-3490 45.00 46.90 W3P-555 20382748566 12/12/2019

0.00 20382748566 12/12/2019

TOTAL: 9.50 446.00 455.50

INTERSEGURO COMPAÑÍA SEGUROS S.A

FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 THANIA AGUIRRE REATIGUI E001-4038 2.72 E001-4039 181.00 183.72 EO-6325 20382748566 2/18/2020

02 MANUEL SANTIAGO TORRES VALLADARES E001-4040 0.41 E001-4041 45.00 45.41 BHQ-628 20382748566 2/18/2020

03 LIDIA ETELVINA CALDERON HUANAMBAL DE A. E001-4042 10.80 E001-4043 357.00 367.80 BFV-152 20382748566 2/18/2020

04 MARIA ESTHER BONIFACIO MATIAS E001-4044 11.22 E001-4045 133.83 145.05 EO-6325 20382748566 2/18/2020

05 RONALD CASTAÑEDA CANALES E001-4046 0.90 E001-4047 156.00 156.90 W2K-694 20382748566 2/18/2020

06 RONALD HENRY SANDOVAL HUAMAN E001-4048 0.30 E001-4049 94.00 94.30 AEU-241 20382748566 2/18/2020

07 AINHOA ANDREA GARCIA ESPINOZA E001-4050 45.00 45.00 AEU-241 20382748566 2/18/2020

08 ANDREA DEL ROSARIO ESPINOZA MANTILLA E001-4051 22.84 E001-4052 93.00 115.84 AEU-241 20382748566 2/18/2020

09 PEDRO FRANCISCO MIRANDA ROJAS E001-4053 35.86 E001-4054 101.00 136.86 F4Q-385 20382748566 2/18/2020

10 MARIA GUISSELA COBEÑAS SERNAQUE E001-4055 14.61 E001-4056 122.00 136.61 B7W-681 20382748566 2/18/2020

11 JESSICA ZUMAETA TAMANI E001-4057 3.26 E001-4058 118.00 121.26 BER-548 20382748566 2/18/2020

12 LOZANO RAMOS NATALY E001-4059 2.08 E001-4060 125.00 127.08 BER-548 20382748566 2/18/2020

13 IKER SAHID ZUÑIGA FHILIP E001-4061 719.13 E001-4062 1,824.76 2,543.89 ANE-750 20382748566 2/18/2020

IKER SAHID ZUÑIGA FHILIP E001-4063 930.00 930.00 ANE-750 20382748566 2/18/2020

TOTAL: 824.13 4,325.59 5,149.72

LA POSITIVA SEGUROS Y REASEGUROS S.A.


FECH A DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC
EMISIÓN

01 LESLIE CABRERA LEYTON, E001-4226 33.00 33.00 AJF-361 20100210909 3/9/2020

02 HUAMAN VEGA ROGER ALEJANDRO E001-4227 14.64 E001-4228 45.00 59.64 6124-0B 20100210909 3/9/2020

03 KEVIN JOAO ESQUIVEL BALBUENA E001-4229 2.66 E001-4230 45.00 47.66 290-4D 20100210909 3/9/2020

04 CHALAN RUIZ SANTA VICENTA E001-4231 31.86 E001-4232 337.00 368.86 6124-0B 20100210909 3/9/2020

05 FABIO MILAN CARO RONDINEL E001-4233 1.45 E001-4234 67.00 68.45 A4A-705 20100210909 3/9/2020

06 MARIA BARRAZA MARTEL E001-4235 114.00 114.00 A2P-748 20100210909 3/9/2020

07 LUIS MANUEL ESPINOZA BONIFACIO E001-4236 32.78 32.78 X2M-622 20100210909 3/9/2020

08 KELLY MARIBEL CHAVARRIA VASQUEZ E001-4256 1.50 E001-4237 63.00 64.50 A4A-705 20100210909 3/9/2020

09 JHON FABER CARDONA HENAO E001-4238 35.26 E001-4239 179.00 214.26 7939-AF 20100210909 3/9/2020

10 ALBERTO IVAN VIRU MATURRANO E001-4240 26.40 E001-4241 62.62 89.02 A4A-705 20100210909 3/9/2020

11 JULIO CESAR TERRONES AGUILAR E001-4242 25.25 E001-4243 327.19 352.44 B2-2296 20100210909 3/9/2020

12 NOE RUBEN CAMARENA GARCIA E001-4244 45.13 45.13 B8-8511 20100210909 3/9/2020

13 MARIA MERCEDES COLLANTES GARCIA E001-4245 3.56 E001-4246 182.00 185.56 D7U-717 20100210909 3/9/2020

14 INGRID MARISELLA CAPILLO GARCIA E001-4247 0.88 E001-4248 104.00 104.88 0531-AS 20382748566 3/9/2020

15 KEVIN SAMIR RODAS GRANADOS E001-4249 1.38 E001-4250 74.00 75.38 AXJ-288 20382748566 3/9/2020

16 HUAHUALUQUE FLORES WILSON E001-4251 18.21 E001-4252 118.00 136.21 2657-KA 20382748566 3/9/2020

17 ROBINSON STIVEN MARIN OSORIO E001-4253 33.00 33.00 4979-8D 20382748566 3/9/2020

18 CARLOS ALBERTO SORIA DELGADILLO E001-4254 0.55 E001-4255 67.00 67.55 6703-FA 20382748566 3/9/2020

TOTAL: 163.60 1,928.72 2,092.32

MAPFRE PERU COMPAÑÍA SEGUROS Y REASEGUROS S.A


FECHA DE
N° PACIENTES FARMACIA MONTO PRESTACIONES MONTO TOTAL N° DE PLACA RUC EMISIÓN

01 GONZALES PEREIRA JOSE LEONARDO E001-4093 24.46 E001-4094 122.00 146.46 BEL-043 20202380621 3/2/2020

02 JOSE ANTONIO BARDALES CULQUICONDOR E001-4095 33.00 33.00 A7L-796 20202380621 3/2/2020

03 JOSE ANTONIO BARDALES CULQUICONDOR E001-4096 33.00 33.00 A7L-796 20202380621 3/2/2020

04 JOSE ANTONIO BARDALES CULQUICONDOR E001-4097 33.00 33.00 A7L-796 20202380621 3/2/2020

05 CARMEN ELENA AGUIRRE ANTON E001-4098 0.48 E001-4099 33.00 33.48 ABK-753 20202380621 3/2/2020

06 OLGA HONORES LUCANO E001-4100 33.00 33.00 D71-298 20202380621 3/2/2020

07 YOSELIN ADRIANA NAVARRO PAEZ E001-4101 52.00 52.00 F3G-683 20202380621 3/2/2020

08 ROLANDO SANTISTEBAN FARROÑAN E001-4102 17.20 E001-4103 122.73 139.93 BDC-430 20202380621 3/2/2020

09 RUDEL EDINSON VEGA OBREGON E001-4104 6.46 E001-4105 177.64 184.10 D0Q-739 20202380621 3/2/2020

10 MARVIN SMITH MIGUEL RAMOS E001-4106 18.00 E001-4107 165.99 183.99 4006-OF 20202380621 3/2/2020

11 LEONIDAS TREBEJOS VILLADEZA E001-4108 2.23 E001-4109 254.76 256.99 A2A-645 20202380621 3/2/2020

TOTAL: 68.83 1,060.12 1,128.95

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