Rekap BPJS Ri 2015 Update

Rekapitulasi INA CBGs Bulan Januari (LAPORAN MEDREK)
KODE KODE ICD

DIAGNOSA KODE
NO NAMA PASIEN NO. MR DIAGNOSA PRIMER TINDAKAN ICD KELAS HARGA RS HARGA INA CBGS
SEKUNDER SECUNDER TINDAKAN
UTAMA
1 DANIEL ARIF H 350591 MEATAL STENOSIS MEATOTOMY + AFF STENT N35.9 56.1 + 97.65II 17,059,481.00 12,108,700.00
2 MAEMUNAH 380065 CYSTA OVARY DM + HT N83.2 E11.7+I10 III 1,508,586.00 2,131,000.00
3 NINIK SURATI BT 307374 PARTUS SC PEB SCTP O82.9 O14.1 74.99 II 8,676,066.00 4,826,600.00
4 HARIYANTO 392777 STT FEMUR BE D48.1 83.39 I 9,751,933.00 6,819,800.00
5 RATIH SETIANINGS 350504 SOL R90.0 III 1,756,808.00 1,551,700.00
6 MUHAMAD REYHAH335371 MORBILI B05.9 II 1,687,989.00 2,331,600.00
7 H.APIH 392616 STROKE EMBOLI dd/ MENINGITIS I66.9 + G03.9 III 22,946,793.00 3,652,800.00
8 IDA ROSITA BT OYI 392897 PARTUS SC CPD SCTP O82.9 O33.8 74.99 II 8,869,788.00 4,826,600.00
9 MEGI YANTI 393055 TYPHOID FEVER A01.0 II 2,570,533.00 3,329,400.00
10 MUHAMAD RIZKI F 393055 TYPHOID FEVER ANEMIA+SUSP KP A01.0 D64.9+A16.9 II 2,266,690.00 4,282,400.00
11 ENIMULYANI 321160 PARTUS SPONTAN O80.9 II 4,068,853.00 2,416,400.00
12 aho wijaya 392924 HT I10 I 3,891,400.00 4,509,100.00
13 MEITA JAYANTI 393007 GASTRITIS AKUT ASMA K29.1 J45.9 I 2,173,300.00 2,171,800.00
14 MOENDIROEN 389054 BPH MEATAL STENOSIS TURP + MEATOTOMY N40 60.29 + 50.6I 14,126,800.00 14,126,800.00
15 DARSA 391776 BPH ANEMIA TURP N40 D64.9 60.29 III 13,599,681.00 7,524,800.00
16 WILYATI 388327 CA MAMAE B C50.9 I 2,934,626.00 3,088,100.00
17 ATA 391765 BPH TURP N40 60.29 II 18,716,406.00 7,427,400.00
18 YEYET DURIAT 393067 STROKE INFARK I63.9 II 4,845,558.00 3,515,900.00
19 DARUS SAMSUDIN 392947 ISK N39.0 II 3,986,955.00 1,860,600.00
20 WARNI 391335 DYSPEPSIA HYPERTENSI K30 I10 III 2,579,371.00 2,779,600.00
21 cucu 392949 GASTRITIS AKUT K29.1 III 2,366,673.00 1,551,300.00
22 MUHAMAD FADLI 392955 BRONCHOPNEUMONIA J18.0 III 1,813,135.00 3,475,100.00
23 FADILLA ADINDA P 392758 BRONCHOPNEUMONIA ANEMIA J18.0 D64.9 II 3,979,049.00 5,860,100.00
24 SYARIP HIDAYAT 392694 HIL HERNIORRHAPHY K40.9 53.29 I 10,574,870.00 4,997,900.00
25 HODIJAH 344663 ASMA J45.9 III 4,607,989.00 1,552,400.00
26 NENG YUYU 382625 PPOK TB V + TRIGGER FINGER J44.9 A15.0 + M65.3 II 4,372,754.00 2,878,100.00
27 WILI WILIYANA 393262 STT EAR EKSTIRPASI D21.0 83.39 III 4,988,292.00 4,871,300.00
28 JOHANSYAH 390918 CHEST PAIN R07.4 I 3,607,550.00 4,509,100.00
29 TAMSIL ISWANDI 360522 DIARE ESRD ON HD A09 N18.0 III 7,443,341.00 3,326,100.00
30 INNE DESIYA 383610 DIARE A09 II 1,931,957.00 2,423,100.00
31 EPIYUSPIANTI 393162 DHF TYPHOID FEVER A91 A01.0 II 2,615,208.00 3,398,900.00
32 wiwi tarwida 390678 BURSITIS GENU M71.9 III 1,434,990.00 1,547,500.00
33 ACIP SUHERMAN 371400 SPONDILOPATHY LUMBAR M48.96 I 2,171,179.00 2,712,300.00
34 MUHAMMAD LATIF393225 PHYMOSIS SIRKUMSISI N47 64 III 6,298,952.00 1,212,700.00
35 ASEP SUTISNA 393179 SYNDROM DYSPEPSIA K30 III 1,394,296.00 2,779,600.00
36 sunart 392588 MYOMA UTERI LAPARATOMY D25.9 54.19 III 9,685,395.00 5,677,000.00
37 WIWI YUNINGSIH 392867 DCM BP + DC + AF I42.0 J18.0 + I51.9 + I48 II 6,131,824.00 5,086,800.00
38 ASEP JUHARTA 378578 SIROSIS HATI ESRD ON HD + PANSITOPENIA ec MDS ? K74.6 N18.0 + D61.9 I 9,200,156.00 6,147,800.00
39 SOPIAH 317976 KOLIK ABD DMT2 + HT R10.4 E11.7 + I10 II 4,075,872.00 3,421,100.00
40 MUHAMMADSYAH 393048 TYPHOID FEVER BRONCHOPNEUMONIA A01.0 J18.0 II 2,477,003.00 4,906,600.00
41 SENA DWI SAKINA 392959 BRONCHOPNEUMONIA ANEMIA + TYPHOID FEVER J18.0 D64.9 + A01.0 II 4,510,127.00 9,699,100.00
42 NAYLA FADLA AZA 379351 EPILEPSI TONSILOFARINGITIS + TB PARU G40.9 J06.9 + A15.0 II 2,314,117.00 2,334,700.00
43 NOPRIZAL CATUR 392775 VARICELA BP + ANEMIA B05.9 J18.0 + D64.9 III 4,630,110.00 2,832,400.00
44 PUSPITA NINGTYAS 384563 DIARE ANEMIA A09 D64.9 II 2,333,318.00 3,421,100.00
45 WISANG MULQI FI 305184 HYDROCELE INSISI N43.3 61 II 9,220,346.00 6,684,700.00
46 AZRIEL ESA SUHE 393166 BRONCHOPNEUMONIA MORBILI J18.0 B05.9 II 2,988,063.00 4,170,100.00
47 renaldy 392909 LYMPHADENITIS EKSISI I88.9 40.29 II 9,869,898.00 4,242,600.00
48 ENTIN SUMARTINI 386370 MAMAE ABBERANT EKSISI Q83.8 85.24 I 13,390,443.00 7,137,800.00
49 al nata chandra au 392513 DEHIDRASI DIARE + ANEMIA E86 A09+D64.9 II 2,708,865.00 3,107,400.00
50 RAJAL 100.00 100.00
51 TUMI 392934 HYPOGLIKEMIA CAD + ANEMIA + LBP E16.2 I25.1 + D64.9 + M54.5 I 8,243,759.00 4,743,400.00
52 almira delysta kahi 392728 DHF EFUSI PLEURA A91 J90 I 8,593,666.00 3,965,400.00
53 YETI NAHDIYATI M 393333 AB. INKOMPLIT KURET O05.4 69.02 III 3,958,965.00 2,732,600.00
54 SANTY NOFIANTY 326490 STT MAMAE BE D24 85.24 I 9,288,339.00 7,137,800.00
55 rahmawat 393028 LAHIR SC P03.4 II 1,771,912.00 1,995,800.00
56 halimah tusyadian 393240 KISTA ATHEROMA EKSTIRPASI L72.8 83.39 II 7,015,066.00 5,845,600.00
57 SITI CHOTIMAH 393253 TUMOR MAMAE BIOPSI D24 85.12 I 8,905,561.00 7,137,800.00
58 ISMARLINA 387996 NEFROLITHIASIS ESWL N20.0 98.51 II 9,702,482.00 12,108,700.00
59 IKA 388270 NEFROLITHIASIS ESWL N20.0 98.51 III 7,622,168.00 10,090,500.00
60 ANI PURI HANDAYA 393216 TYPHOID FEVER GASTRITIS AKUT A01.0 K29.1 III 2,588,858.00 3,568,700.00
61 DEFI ALFI ZAHRAH 341422 ISPA HEG J06.9 O21.0 II 2,448,482.00 1,829,000.00
62 ACIM 392865 STT EKSISI D48.1 83.39 III 6,066,528.00 4,871,300.00
63 JOHANSYAH 390918 DYSPEPSIA K30 I 4,457,100.00 3,891,400.00
64 FAUZAN HAFIZ 334461 TYPHOID FEVER ASMA A01.0 J45.9 III 3,187,391.00 2,774,500.00
65 YURI TIVANI 393318 PARTUS SPONTAN O80.9 II 5,426,638.00 2,416,400.00
66 MUHAMAD ARDIA 310987 TONSILADENOID HYPERTROPFARINGITIS KRONISTONSILOADENOIDEKTOMI + PH J35.2 J02.9 28.3 + 29.33II 7,641,531.00 5,713,700.00
67 WILDA SARI 392703 TONSILITIS HYPERTROPI FARINGITIS TONSILEKTOMI + PHARINGECTO J35.1 J02.9 28.2 + 29.33II 7,547,310.00 5,713,700.00
68 ENEN 393290 LIPOMA EKSISI D17.9 83.39 III 7,044,905.00 4,871,300.00
69 DEVA ANGGARA 393149 HIL KP HERNIORRHAPHY K40.9 A16.2 53.29 II 9,021,848.00 5,947,200.00
70 hendrik 392961 PTERYGIUM IMPLANT PTERYGIUM H11.0 11.39 II 1,139,066.00 4,973,900.00
71 HJ IIS MULYATI 328260 SPONDILOPATHY LUMBAR M48.96 I 2,195,306.00 2,712,300.00
72 RUSNADI SOMADIS 392916 LBP FRAKTUR LUMBAR VERTEBRA M54.5 S32.0 I 2,712,300.00 3,814,500.00
73 KADIRUN TEJO SU 393074 VL PATELLA RUPTUR TENDON PDEBRIDEMENT + RUPTUR TEND S81.0 S96.8 86.22 + 83.8II 2,455,903.00 2,455,903.00
74 TITIK KUMALASARI 300542 AB. INKOMPLIT CURET O05.4 69.02 I 6,970,089.00 3,825,600.00
75 ALDI PUTRA PRAT 392771 TONSILADENOID HYPERTROPFARINGITIS KRONISTONSILOADENOIDEKTOMI + PH J35.2 J02.9 28.3 + 29.33II 7,829,086.00 5,713,700.00
76 MICKE KADIR 383358 CKD ON HD DYSPNEU + ANEMIHEMODIALISA N18.9 R06.0+D64.9 39.95 II 2,328,600.00 3,883,500.00
77 DEDI KUSNADI 391756 GERD K21.9 II 3,641,015.00 1,862,400.00
78 DJUNAEDI 391353 KISTA ATHEROMA LIPOMA EKSTIRPASI L72.9 D17.9 83.39 I 9,163,455.00 6,819,800.00
79 MAEMUNAH 380065 CYSTA OVARY KISTECTOMY N83.2 65.29 III 9,609,244.00 5,272,800.00
80 ARYA BIMA FIRMA 323842 DADRS A09 III 1,312,191.00 2,355,800.00
81 ENDU WISNU 393146 TB PARU SEQ. STROKE A15.0 I69.3 I 4,436,039.00 5,839,000.00
82 NY. DEDE HAYATI 384242 TUMOR MAMAE EKSISI D24 85.12 II 6,816,253.00 6,118,200.00
83 CITRA PERMATA SA 393247 FAM EKSISI D24 85.12 III 6,372,164.00 5,098,500.00
84 ASSYIFA NUR KHOL 362707 TOF BRONKIOLITIS + KP J06.8 J21.9 + A15.0 III 1,367,225.00 1,778,800.00
85 EEN HARYATI 393196 OA GENU M19.99 I 5,236,263.00 2,905,500.00
86 ATIK REUSMIATI N 393135 LYMPHADENOPATHY COLLI LYMPHADECTOMY I88.9 40.29 II 6,586,826.00 4,242,600.00
87 athar safaraz anwa 392784 HIL B ANEMIA HERNIOTOMY K40.9 D64.9 53.1 I 10,563,489.00 6,938,400.00
88 karolina 380643 TENDINITIS SHOULDER SEQ. STROKE M75.9 I69.3 I 2,069,985.00 2,166,600.00
89 EDWAR SOFYAN 392868 LBP M54.5 I 1,761,689.00 2,712,300.00
90 RINI SETIAWATI 365864 FASCITIS M72.9 II 1,336,123.00 1,857,000.00
91 IHAT SOLIHAT 393515 CAD SYOK CARDIOGENIC + CKD + HYPERKALEMIA + DMTI25.1 R57.0 + N18.9 + E87.5 + EII 1,986,565.00 4,645,500.00
92 H. TOHA 393239 DC HHD + AF + PPOK + DM + KP I51.9 I11.9 + I48 + J44.9 + E11. III 4,716,953.00 6,292,900.00
93 DESY RUSLINAH 393393 TTH DYSPEPSIA G44.2 K30 II 3,333,068.00 1,865,900.00
94 VALLEYSHA AZ ZAH 393180 SYNDROM DYSPEPSIA K30 I 4,401,448.00 3,891,400.00
95 moh adhar rival m 349147 TONSILADENOID HYPERTROPFARINGITIS KRONISTONSILOADENOIDEKTOMI + PH J35.2 J31.2 28.3 + 29.33III 6,562,249.00 4,761,400.00
96 SANNIYA ZAHRA M 326781 TONSILADENOID HYPERTROPFARINGITIS KRONISTONSILOADENOIDEKTOMI + PH J35.2 J31.2 28.3 + 29.33I 9,316,702.00 6,666,000.00
97 NADIA SANDRA RO 347659 DADRS ANEMIA A09 D64.9 I 2,607,076.00 3,991,400.00
98 DESSY SUDIARTI 390866 CYST OVARY LAPARATOMY + SOD N83.2 54.19 + 65.6II 12,006,284.00 6,812,300.00
99 AGUSBINKARIM 387328 OBS FEBRIS R50.9 III 1,415,706.00 1,556,900.00
100 RIFKIANI FAUZIAH 380409 LYMPHADENOPATHY COLLI BIOPSI EKSTIRPASI I88.9 40.11 + 40.2I 8,664,309.00 4,949,700.00
101 deni surya 393489 ABSES SEPSIS L02.9 A41.9 86.04 III 5,898,768.00 5,747,000.00
102 ETI ROHAYATI 393176 HEMIBALISSMUS STROKE G25.5 I64 I 3,296,100.00 9,130,700.00
103 faisal ahmad hafid 381356 MORBILI BRONCHOPNEUMONIA + TB PARU B05.9 J18.0 + A15.0 II 6,764,813.00 3,398,900.00
104 KASIM 391840 HIL HERNIORRHAPHY K40.9 53 II 10,339,155.00 4,283,900.00
105 AISYAH NURUL R 393102 PERITONITIS ec PERFORATIO SEPSIS K35.0 A41.9 54.11 + 54.5I 12,981,251.00 15,128,700.00
106 RESKALSALIMULAL393506 BRONCHOPNEUMONIA TYPHOID FEVER J18.0 A01.0 II 1,824,193.00 9,699,100.00
107 didin solehudin, sa 393471 TYPHOID FEVER A01.0 II 3,928,100.00 3,329,400.00
108 MUHAMAD RIZAL 377777 DADRS BRONCHOPNEUMONIA A09 J18.0 II 2,966,484.00 3,540,100.00
109 LISNA MARSELA 392627 KISTA THYROID KISTECTOMY E04.1 6.31 III 13,276,078.00 4,789,900.00
110 YANI HENDRAYANI 393371 PTERYGIUM EKSISI PTERYGIUM H11.0 11.32 I 3,652,634.00 5,802,900.00
111 IIN SUNARDI 393665 OBS FEBRIS DYSPEPSIA R50.9 K30 II 1,361,721.00 1,868,300.00
112 SRI KANTI MULYAN 310054 CYSTA OVARY LAPARATOMY + SOD N83.2 54.19 + 65.6II 12,013,724.00 6,812,300.00
113 SUPRAPTAMA 393292 HIL HERNIORRHAPHY K40.9 53 I 10,603,280.00 4,997,900.00
114 HJ. ADE ROHAETI 385078 LYMPHADENOPATHY EKSISI I88.9 40.29 I 11,731,892.00 4,949,700.00
115 BASUKI LISTIYO 388981 MEATAL STENOSIS MEATOTOMY + AFF STENT N35.9 56.1 + 97.65III 15,409,704.00 10,090,500.00
116 ERI NURWATI 379282 PARTUS SC PLASENTA PREVIA SCTP O82.9 O44.0 74.1 I 11,551,773.00 5,631,000.00
117 raisya nur azmi sup 393577 LAHIR SC P03.4 I 2,404,352.00 2,328,400.00
118 ANDI 391354 NEFROLITHIASIS UERETROLITHIASISESWL N20.0 N20.9 + N13. 98.51 III 8,353,005.00 11,421,000.00
119 EUIS ROSDIANA 357387 HYPOGLIKEMIA CKD + DM E16.2 N18.9 + E11.7 III 1,942,900.00 3,388,200.00
120 MEITA JAYANTI 393007 GASTRITIS AKUT ASMA K29.1 J45.9 I 2,827,110.00 2,171,800.00
121 DEDI SUPRIADI 388471 MEATAL STENOSIS MEATOTOMY + AFF STENT N35.9 56.1 + 97.65I 20,850,611.00 14,126,800.00
122 suhaeni 393531 NEFROLITHIASIS ESWL N20.0 98.51 III 8,390,482.00 10,090,500.00
123 SUKWANA 380682 VIRAL INFECTION ASMA + HT B34.9 J45.9 + I10 I 3,916,263.00 2,720,200.00
124 aida 391732 GRAVIDUM FASE LATEN O32.0 II 717,193.00 2,502,400.00
125 POPI SUNTARI 337590 GASTRITIS AKUT K29.1 II 684,861.00 1,861,600.00
126 TIDAK ADA KARTU 100.00 100.00
127 gynastar nugroho 392901 OSTEOCHONDROMA FIBULA EKSISI D16.2 77.67 II 11,382,315.00 3,548,000.00
128 MOCHAMMAD FAD367625 KDS FARINGITIS R56.8 J02.9 II 1,723,965.00 1,859,300.00
129 IHSAN KAFFAH AL- 319039 BRONCHOPNEUMONIA J18.0 I 4,211,783.00 4,865,100.00
130 AGITA RATNA KUM 393129 TUMOR MAMAE EKSISI D24 85.24 III 7,749,705.00 5,098,500.00
131 DEDE 385088 BRONCHIECTASIS J47 I 8,484,068.00 3,357,800.00
132 evan aditya prana 385129 ISPA ANEMIA + RETINOBLASTOMA J06.9 D64.9 + C69.2 II 2,110,793.00 2,134,600.00
133 FERA NURHAYATI 315885 PREMATUR KONTRAKSI O60.0 I 3,149,044.00 2,819,100.00
134 ADE BINTI SUBRI 379230 STENOSIS URETER URETROLITHIASIS LYSIS INTRALUMINAL + LITOTRIPSN35.9 N20.9 56.81 + 57.0III 14,095,534.00 10,090,500.00
135 juju juaeni 379264 STENOSIS URETER LYSIS INTRALUMINAL + INSERSI N35.9 56.81 + 59.8II 19,117,196.00 12,108,700.00
136 moch el zhibran 393576 DIARE AKUT ANEMIA A09 D64.9 II 2,590,577.00 3,421,100.00
137 SURTINAH 386922 HHD DYSPEPSIA + CAD + DM + ISK I11.9 K30 + I25.1 + E11.7 + N39II 3,257,643.00 5,179,100.00
138 AMINAH 393132 STENOSIS URETER LYSIS INTRALUMINAL + INSERSI N35.9 56.81 III 16,247,138.00 10,090,500.00
139 YENI FITRINAINGSI 335562 OBS FEBRIS R50.9 II 558,432.00 1,868,300.00
140 GANDA 393671 SNAKE BITE T63.0 III 1,392,663.00 1,165,900.00
141 CAHYATIEFARINA 393706 CKR S09.9 II 1,527,550.00 3,336,600.00
142 SYARIF HIDAYAT B 393774 OBS FEBRIS R50.9 II 698,807.00 1,868,300.00
143 EMAN SULAEMAN 378838 DEHIDRASI DC + EFUSI PLEURA E86 I25.1 + J90 II 989,285.00 6,861,900.00
144 DAYI BT ATMA 393460 DC HHD + UTI I51.9 I11.9 + N39.0 I 8,812,560.00 8,810,000.00
145 SATORI 392613 KOLELITIASIS PPOK + TB PARU K80.8 J44.9 + A15.0 III 4,990,407.00 2,709,000.00
146 WAFIQ SHANI FAU 393659 DADRS ANEMIA + TB PARU + ISPA A09 D64.9 + A15.0 + J06.9 II 3,345,459.00 3,421,100.00
147 raihana faiha 389699 DEHIDRASI RINGAN-SEDANG TONSILOFARINGITIS + TB PARU + DRUG INDUCED HEE86 J06.8 + A15.0 + T88.7 III 3,882,791.00 2,589,500.00
148 SOLIAH 331173 TYPHOID FEVER DENGUE FEVER A01.0 A90 II 2,792,146.00 4,282,400.00
149 SYAIFUL ANWAR 373051 PERITONITIS DIFUSE ec PER SEPSIS LE + APP + DHESI K35.2 A41.9 54.11 + 47.0II 17,332,481.00 12,967,400.00
150 ANDRIAN MAULAN 346428 DRUG ERUPTION L27.0 III 2,608,629.00 1,551,700.00
151 ANAS IKHSANUDIN 393007 DC HHD + ANEMIA + GNA I51.9 I11.9 + D64.9 + N00.8 II 3,049,213.00 7,788,300.00
152 IIS MAYA HANA N 387600 PARTUS SC EKLAMSIA + ANEMSCTP O82.9 O15.9 + D64. 74.1 II 25,066,302.00 5,326,100.00
153 RIRIN SITI FATIMA 392021 TONSILADENOID HYPERTROPIFARINGITIS KRONISTONSILOADENOIDEKTOMI + PH J35.2 J31.2 28.3 + 29.33I 10,395,460.00 6,666,000.00
154 YANI SURYANI 392907 TUMOR MAMAE HYPERTENSI BIOPSI D24 I10 85.12 III 1,386,499.00 1,551,700.00
155 NANI 392763 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 III 7,658,492.00 11,421,000.00
156 HETI NURHAYATI 391475 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 I 10,089,584.00 15,989,400.00
157 HJ. SRI MULYATI 392835 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 I 10,231,935.00 14,126,800.00
158 MISNAWATI 393804 CLAVUS EKSISI L84 83.39 II 7,015,952.00 5,845,600.00
159 HJ. EET 388589 NEFROLITHIASIS CYST GINJAL ESWL N20.0 N28.1 98.51 II 9,692,482.00 13,705,200.00
160 NURMALASARI 393917 PARTUS SPONTAN O80.9 I 7,252,378.00 2,819,100.00
161 UJU JULAEHA 393822 PAPILOMA CHEST EKSISI D36.7 83.39 I 8,683,918.00 6,819,800.00
162 PUJI YANTI 385790 TYPHOID FEVER A01.0 II 2,335,931.00 3,329,400.00
163 DIAN RINALDI 393934 CLOSED FRAKTUR DIGITI I MANUS DX S62.6 II 729,977.00 1,860,400.00
164 MELLY AGUSTINA 379833 GANGLION EKSISI M67.4 83.39 III 5,958,665.00 4,871,300.00
165 IDJAH HODIJAH 393916 DC HHD +CKD + ANEMIA I51.9 I11.9 + N18.9 + D64.9 III 6,292,900.00 6,292,900.00
166 DARMO SULARTO 393398 CLOSE FRAKTUR TIBIA ORIF S82.20 79.36 III 20,964,492.00 9,119,300.00
167 HALID SODIKIN 377515 NEFROLITHIASIS ESWL N20.0 98.51 II 9,532,010.00 12,108,700.00
168 FAISAL RIZKAN SU 370950 ASMA J45.9 III 2,737,033.00 1,552,400.00
169 RESI RIZKYANI 392022 TONSILITIS HYPERTROPI FARINGITIS TONSILEKTOMI + PHARINGECTO J35.1 J02.9 28.2 + 29.33III 6,935,547.00 4,761,400.00
170 EEN HALIMAH 393705 HEMMOROID INTERNA HEMMOROIDECTOMY I84.2 49.46 II 8,617,661.00 5,225,100.00
171 rahmat 393788 LBP M54.5 II 3,521,332.00 2,324,900.00
172 Muhammad iqbal 393799 BRONCHOPNEUMONIA J18.0 II 3,167,922.00 4,170,100.00
173 dayu 392761 TONSILOFARINGITIS KRONIS TONSILEKTOMI + PHARINGECTO J06.8 28.2 + 29.33I 9,980,653.00 6,666,000.00
174 EEM HAMIDAH 391817 PERDARAHAN PERVAGINA KURET N93.9 69.09 I 6,335,693.00 3,825,600.00
175 subhan 393516 HIL HERNIORRHAPHY K40.9 53.29 II 9,243,194.00 4,283,900.00
176 ASMANTO 393328 BPH HYDRONEFROSIS TURP + SISTOSCOPY N40 N13.3 60.29 + 57.3I 11,722,998.00 10,534,700.00
177 RISMA R 387536 MENORHAGIA N92.0 II 4,363,904.00 1,863,500.00
178 LASMAWATI BT OC 390590 NEGLECTED FRAKTUR FEMUR ORIF + BONE GRAFT M70.27 S72.9 79.35 + 78.0III 18,923,365.00 13,059,600.00
179 WARDI 389628 NEFROLITHIASIS ESWL N20.0 98.51 III 8,194,760.00 10,090,500.00
180 SAEFUL BAHRI 389814 NEFROLITHIASIS ESWL N20.0 98.51 II 9,921,010.00 12,108,700.00
181 ZARQAMEIYLAASSA302769 HEPATITIS LIVER TB PARU K75.9 A15.0 II 3,162,784.00 4,238,500.00
182 MIA KURNIAWATI 393854 LETSU PARTUS SC SCTP O32.1 O82.9 74.1 I 11,388,644.00 5,631,000.00
183 SALMAN ALFARISI 392817 KONTRAKTUR DIGITI V MD RELEASE KONTRAKTUR DG Z PLAM20.0 83.19 I 9,630,347.00 6,819,800.00
184 MADSODIN 391369 URETROLITHIASIS HYDRONEFROSIS ESWL N20.9 N13.3 98.51 III 8,252,070.00 11,421,000.00
185 SARKUM 390964 NEFROLITHIASIS ESWL N20.0 98.51 II 10,016,151.00 12,108,700.00
186 DETIASYAIDINA 323888 DADRS A09 II 2,081,032.00 2,423,100.00
187 ENGKOS KOSASIH, 325275 CAD DM + HT I25.1 E11.7 + I10 I 3,820,400.00 4,170,900.00
188 NABILA KIRANA D 311235 SYNDROM DYSPEPSIA ISPA +TB PARU K30 J06.9 +A15.0 II 2,414,213.00 5,003,200.00
189 EKAPUTRAANDRIA 338718 BRONCHOPNEUMONIA TB PARU J18.0 A15.0 II 3,053,243.00 4,170,100.00
190 MUHAMAD ARYAN 393895 TONSILITIS HYPERTROPI TONSILEKTOMI + PHARINGECTO J35.1 28.2 + 29.33II 7,674,334.00 5,713,700.00
191 FAUZAN RIZQI FAD 393927 VOMITUS R11 I 4,034,545.00 2,827,100.00
192 SA'DIYAH NURLIA 393326 APP KRONIS EKSASERBASI AKUT APPENDECTOMY K35.9 47.09 III 7,528,769.00 2,846,700.00
193 M FAHRUDIN 380004 KISTA ATHEROMA EKSISI L72.9 83.39 III 6,372,299.00 4,871,300.00
194 RINI SUWARNI 393856 BPPV DM + HT H81.1 E11.7 + I10 I 1,236,342.00 3,255,900.00
195 SUGIARTI 392797 LYMPHADENOPATHY COLLI BIOPSI I88.8 40.11 II 6,919,134.00 4,242,600.00
196 TSABITAFATHIYYAH 326333 POST ORIF # HUMERUS REMOVE IMPLANT Z47.0 78.62 II 11,045,468.00 3,548,000.00
197 TITIM SOPIAH 394051 DMT2 HHD + HT +CAD + ISK E11.7 I11.9 + I10 + I25.1 + N39. II 3,646,952.00 5,179,100.00
198 NANI 394008 PARTUS SPONTAN O80.9 II 4,945,831.00 2,416,400.00
199 ESIH SULASTRI 393929 KET AB. IMMINENS + TYPHOID FEVER O00.1 A01.0 II 15,859,253.00 12,967,400.00
200 imas rosyani 394015 HHD HT + TTH I11.9 I10 + G44.2 II 2,679,045.00 3,820,400.00
201 HENDRIK FEBRIAN 388882 LIPOMA EKSTIRPASI D17.9 83.39 II 9,180,467.00 5,845,600.00
202 iyah wariah 384653 MELENA ESRD K92.1 N18.0 II 4,629,169.00 5,003,200.00
203 MAURICE ANASTAS 394016 ISPA J06.9 II 1,957,290.00 1,829,000.00
204 H.RISYANA SUKAN 374230 DC COPD + HHD + PNEUMONIA DG SEPSIS I51.9 J44.9 + I11.9 + J18.9 + A4 I 13,133,029.00 9,086,800.00
205 AGUSSURYANA 394003 GEA A09 II 2,591,687.00 2,423,100.00
206 HJ. ADE ROHAETI 385078 OPEN WOUND COLLI DEBRIDEMENT + SUTURE PRIME T81.4 86.22 + 86.5I 3,735,366.00 6,132,300.00
207 didin hasanundin 393823 HEMATOCHEZIA ANEMIA + HT K92.1 D64.9 + I10 I 8,258,837.00 5,837,000.00
208 SUKIRMAN ARIES R 324651 NEFROLITHIASIS CYST GINJAL ESWL N20.0 N28.1 98.51 II 9,849,030.00 13,705,200.00
209 suminih 393571 MOLA HIDATIDOSA ANEMIA O01.9 D64.9 III 6,485,645.00 4,804,200.00
210 ROBIAH 379848 NEFROLITHIASIS DM ESWL N20.0 E11.6 98.51 III 8,228,949.00 11,421,000.00
211 SITI AMINAH 392342 CYSTA OVARY KISTECTOMY N83.2 65.29 I 14,339,414.00 7,381,900.00
212 TOLHAS B BANJAR 392464 DISLOKASI ANKLE JOINT DEBRIDEMENT S93.0 86.22 II 19,949,908.00 1,860,400.00
213 ENGKOY RUKOYAH 394252 DIARE AKUT A09 I 2,171,800.00 2,827,100.00
214 KANIH BINTI SARE 391651 NEFROLITHIASIS ESWL N20.0 98.51 I 10,483,625.00 14,126,800.00
215 OKTAVIANI LATIPA 341251 EPILEPSI G40.9 I 905,364.00 2,169,200.00
216 HJ aisah 368520 HHD DC + CKD +HYPERKALEMIA I11.9 I51.9 + N18.9 + E87.6 III 1,383,317.00 4,315,900.00
217 ENDANG JAMALUD 389371 DC HHD + MELENA + ANEMIA I51.9 I11.9 + K92.1 + D64.9 II 5,308,142.00 7,551,400.00
218 MOCH SUGENG RIY392062 POST ORIF # TIBIA REMOVE IMPLANT Z47.9 78.67 II 17,806,629.00 3,548,000.00
219 retha rusbit awat 391608 PARTUS SPONTAN O80.9 II 2,522,400.00 2,416,400.00
220 SOMA SOMANTRI, 380651 DC HHD + ESRD I25.1 I11.9 + N18.0 I 2,601,436.00 4,170,900.00
221 WIWIN NURHASA 303358 CHOLELITHIASIS CHOLECYSTECTOMY K80.8 51.22 II 15,662,944.00 6,481,200.00
222 TASLIM 392832 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 II 9,561,636.00 13,705,200.00
223 WIWI NURYANI 320120 CHEST PAIN R07.4 II 5,039,000.00 3,865,000.00
224 OPID 337899 STENOSIS URETER NEFROLITHIASIS LYSIS INTRALUMINAL + INSERSI DN35.9 N20.0 56.81 + 59.8I 22,834,044.00 15,989,400.00
225 RADEN MOCHAMAD388338 DMT2 TB PARU E11.6 A15.0 I 4,743,400.00 4,743,400.00
226 NAJAAR 393256 VESICOLITHIASIS LITOTRIPSI + URETROSCOPY N21.0 57.0 +58.22 III 15,836,065.00 6,172,400.00
227 RADHWA SHIDQI Y 393741 DHF TF + ANEMIA A91 A01.0 + D64.9 I 9,312,926.00 3,965,400.00
228 DENDI KURNIA IB 394247 KDS ISPA R56 J06.9 II 2,033,666.00 2,134,600.00
229 NABIA MAYSA ARA 394019 BRONCHOPNEUMONIA J18.0 II 4,010,079.00 4,170,100.00
230 TATIK UTAMI 345442 HERNIA INCISIONAL HERNIORRHAPHY K43.9 53.59 II 13,059,274.00 3,149,200.00
231 muhammad raziq a 378450 ASMA J45.9 III 3,758,420.00 1,552,400.00
232 RIZKA NURMAULID 394236 TYPHOID FEVER A01.0 II 2,824,637.00 3,329,400.00
233 SOPANDI 392821 LBP M54.5 II 1,323,352.00 2,324,900.00
234 IRENA JUNIAR S 332851 GRANULOMA UMBILICUS EKSISI L92.8 54.3 II 9,352,922.00 6,812,300.00
235 NOVA NOVIANAH 374936 HEMMOROID INTERNA HEMOROIDECTOMY I84.2 49.46 I 10,492,631.00 6,095,900.00
236 SAHRONI 393905 PNEUMOTHORAX WSD A16.2 34.04 III 8,251,034.00 4,170,700.00
237 h agus mulyana 393987 LBP M54.8 I 2,232,455.00 2,712,300.00
238 PUSPITA NINGTYAS 384563 DHF ANEMIA A91 D64.9 II 5,483,503.00 2,791,900.00
239 NENENG YULIANIN 393891 HT EFUSI PLEURA + ESRD I10 J90 + N18.0 I 9,577,081.00 7,333,300.00
240 NANI LESTARI WA 394348 PARTUS SPONTAN KPD O80.9 O42.9 II 4,626,462.00 2,416,400.00
241 HJ . HASANAH , S . 394094 CEPHALGIA R51 I 4,294,560.00 2,176,900.00
242 PATMAWATI 392017 PLACENTA PREVIA PARTUS SC SCTP O44.9 O82.9 74.1 III 7,260,193.00 4,022,100.00
243 kevin raditya prat 376435 BRONCHOPNEUMONIA J18.0 III 3,329,642.00 3,475,100.00
244 PIPIN SUPINAH 377658 CAD I25.1 II 3,941,597.00 3,575,100.00
245 SYARIF HERYANTO 394149 HT HHD I10 I11.9 III 3,285,927.00 3,183,700.00
246 NURIHASANAH 394326 BRONCHITIS AKUT FEBRILE CONVULSION J20.9 R56.0 II 2,330,490.00 3,761,300.00
247 AHMAD HAMBALI 389073 POST PYEOLITROTIPSI URETROSISTOSCOPY N99.1 58.22 + 97.6I 20,746,675.00 3,632,200.00
248 EDI KUSNADI 392514 STT EKSISI D48.1 83.39 I 9,193,900.00 6,819,800.00
249 SARAH MUTIARA 385311 HE O21.0 II 1,923,112.00 2,502,400.00
250 UUS KUSMIYATI 394316 TYPHOID FEVER A01.0 II 2,763,393.00 3,329,400.00
251 KATI 381150 DC CAD +PPOK + HT I51.9 I25.1 + J44.9 + I10 II 7,553,100.00 7,551,400.00
252 E. SRI JUBAEDAH 379637 CERVICOGENIC HEADACHE G44.8 I 4,798,231.00 2,176,900.00
253 A. MAKSUM 393474 BPH TURP + SISTOSKOPI N40 60.29 + 57.3III 16,050,530.00 6,189,500.00
254 muhammad habibi 376745 BRONCHOPNEUMONIA J18.0 III 1,604,802.00 3,475,100.00
255 ADE SETIAWAN 386938 NEFROLITHIASIS URETROSISTOSCOPY + AFF STENTN20.0 58.22 + 97.6II 18,217,412.00 2,464,300.00
256 SITI SUMIATI 394352 FAM EKSISI D24 85.24 II 6,947,230.00 6,118,200.00
257 MOCH. FIKRAM 394302 ABSES EKSISI L02.9 83.39 II 7,241,309.00 5,845,600.00
258 JUNAEDI 393487 BPH TURP + SISTOSKOPI N40 60.29 + 57.3I 23,431,086.00 8,665,300.00
259 dede fatmawat 393505 CYST MAMAE EKSISI N60.0 85.24 II 8,247,752.00 6,118,200.00
260 WAHIDIN 393753 DC EFUSI PLEURA I51.9 J90 I 13,409,270.00 9,086,800.00
261 shidqiyya suci ram 394117 BRONCHOPNEUMONIA ANEMIA J18.0 D64.9 III 1,752,084.00 4,883,400.00
262 ROFIK 301891 NEFROLITHIASIS ESWL N20.0 98.51 III 7,578,949.00 10,090,500.00
263 AGUS SUTISNA 394406 VERUCA EKSISI B07 83.39 II 4,462,960.00 5,845,600.00
264 dora clara 381901 LYMPHADENOPATHY COLLI BIOPSI I88.8 40.11 II 7,043,724.00 4,242,600.00
265 DEWI NOVIANTI 394311 HEMMOROID INTERNA HEMOROIDECTOMY I84.2 49.46 II 8,910,092.00 5,225,100.00
266 H EEP SAEFUL AFF 371362 CKD DCM + ANEMIA N18.9 I42.0 + D64.9 II 3,259,300.00 3,883,500.00
267 MITA ASRI LESTARI 394555 FAM EKSISI D24 85.24 III 6,093,266.00 5,098,500.00
268 RENI RIVA 319177 BRONCHITIS DERMATITIS J40 L30.9 II 2,948,279.00 1,858,600.00
269 RUMIYATI 394476 STT EKSISI D48.1 83.39 III 6,066,019.00 4,871,300.00
270 Nani Mintarsih 394137 CYST OVARY LAPARATOMY N83.2 54.19 II 11,874,490.00 6,812,300.00
271 TIARASISKAPRATIW371791 TYPHOID FEVER A01.0 II 2,727,410.00 3,329,400.00
272 TIKA KARTIKA SAN 394478 AB. IMMINENS HEG O20.0 O21.0 II 1,998,957.00 1,677,400.00
273 H ABDUL LATIF 394339 HERPES Z DG INFEKSI DYSPEPSIA B00.9 K30 III 3,500,700.00 4,169,300.00
274 SITI SUHARTINI 383955 SYNDROM GERIATRI ISK R54 N39.0 I 7,506,700.00 7,506,700.00
275 MULYADI SOSRO, B 308885 GEA HHD A09 I11.9 I 3,189,600.00 2,827,100.00
276 DEWI SRI ANDRIAN 353470 PARTUS SPONTAN O80.9 II 4,715,278.00 2,416,400.00
277 ADE BINTI SUBRI 379230 TYPHOID FEVER A01.0 III 5,700,042.00 2,774,500.00
278 NOVRITA 393900 TUMOR MAMAE SIMPLE MASTECTOMY D24 85.41 I 10,178,183.00 7,137,800.00
279 RAFLY S.F.D 326405 ISPA J06.9 II 1,911,560.00 1,829,000.00
280 ATI 394385 CYST OVARY LAPARATOMY N83.2 54.19 III 10,615,729.00 5,677,000.00
281 HILMANNAWAWI 361328 DADRS FARINGITIS + ISPA A09 J02.9 + J06.9 II 2,981,629.00 2,423,100.00
282 AHMID MUHAMID 383318 DENGUE FEVER A90 II 2,409,016.00 2,331,600.00
283 ADE MUHIDIN 394682 ABSES DEBRIDEMENT L02.9 86.22 II 6,922,065.00 2,800,400.00
284 SAHLAN SOLIHIN 388042 KP ESRD + ANEMIA A16.2 N18.0 + D64.9 III 5,266,059.00 4,982,800.00
285 WARSIH 394286 EFUSI PLEURA DMT2 + CRF + HT J90 E11.7 + N18.9 + I10 II 8,205,093.00 5,388,000.00
286 FAUZIAH HANUM 376886 DMT2 HT E11.7 I10 III 2,964,128.00 1,942,900.00
287 RANI UTARI BINTI 394048 GASTRITIS AKUT K29.1 II 2,318,351.00 1,861,600.00
288 muhamad farhan a 355601 BRONCHOPNEUMONIA ANEMIA J18.0 D64.9 III 3,773,732.00 4,883,400.00
289 USEN 383345 HT CKD I10 N18.9 III 5,537,434.00 4,315,900.00
290 NENGSIH 394513 HEMMOROID INTERNA HEMOROIDECTOMY I84.2 49.46 II 7,949,406.00 5,225,100.00
291 TAZQIROH HASAN, 372592 BRONCHOPNEUMONIA DHF J18.0 A91 II 4,952,809.00 9,699,100.00
292 NURMILASARI 386740 DKP PARTUS SC SCTP O33.8 O82.9 74.1 II 9,083,510.00 4,826,600.00
293 ETISUHAETI 394520 CPD PARTUS SC SCTP O33.8 O82.9 74.1 II 9,484,831.00 4,826,600.00
294 AI SOPIAH 390897 TUMOR THYROID THYROIDECTOMY E04.1 6.31 III 8,364,357.00 4,789,900.00
295 leni marlina 392754 HEMMOROID INTERNA HEMOROIDECTOMY I84.2 49.46 II 8,871,071.00 5,225,100.00
296 N. IKOH 394209 MYOMA UTERI ANEMIA BSO D25.9 D64.9 65.61 II 11,523,116.00 8,933,600.00
297 M JUAN AGUSTIAN 394491 STT EKSISI D48.1 83.39 II 8,927,559.00 5,845,600.00
298 JUFRI, TN 334740 KP AKTIF ANEMIA A15.0 D64.9 I 9,507,218.00 6,976,000.00
299 H ONONG SUPAR 394438 ILEUS PARALITIK KP K56.0 A15.0 II 16,120,373.00 3,447,800.00
300 MARDI 394543 VARICELA B01.9 III 2,745,652.00 1,943,000.00
301 TINA AGUSTINA 378249 PARTUS SC PRESENTASI BOKO SCTP O82.9 O32.9 74.1 II 9,282,072.00 4,826,600.00
302 JONI HERIYAN 389850 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 I 10,375,030.00 15,989,400.00
303 NENG TJITJIH 393810 NEFROLITHIASIS ESWL N20.0 98.51 I 10,363,538.00 14,126,800.00
304 engkay k viatn 388976 MASSA INTRABULI TURBT + AFF STENT C67.9 57.0 + 97.62III 15,093,407.00 6,172,400.00
305 NANANG SULAEM 394427 DC HHD + DM ULKUS + ANEMIA I51.9 I11.9 + E14.5 + D64.9 I 8,070,000.00 8,810,000.00
306 DURRE ADAN 375602 HEMMOROID INTERNA HEMOROIDECTOMY I84.2 49.46 II 8,689,177.00 5,225,100.00
307 YUYUN DWIYUNIAS394448 HHD ANEMIA I11.9 D64.9 I 4,605,528.00 6,042,200.00
308 DEDEH 392707 STENOSIS URETER LYSIS INTRALUMINAL N35.9 56.81 + 59.8III 16,719,889.00 10,090,500.00
309 FATURROHMAN NU394493 TYPHOID FEVER ANEMIA A01.0 D64.9 II 4,073,568.00 4,282,400.00
310 ALBI ADITYA AHM 374655 BRONCHOPNEUMONIA ANEMIA J18.0 D64.9 II 3,772,489.00 5,860,100.00
311 YATI SURYATI 311855 CPD SC SCTP O33.8 O82.9 II 9,157,097.00 4,826,600.00
312 RAKA NOVIAR RAM 394400 APPENDICITIS AKUT APPENDECTOMY K35.9 47.09 II 8,504,127.00 3,416,000.00
313 ACIM 394859 LIPOMA EKSISI D17.9 83.39 III 5,686,030.00 4,871,300.00
314 AGUS ISNAWAN 370856 GANGLION M67.4 II 6,706,078.00 5,845,600.00
315 IIM ROHIMAH 390982 SNNT THYROIDECTOMY E04.1 6.39 II 10,705,478.00 5,747,900.00
316 tyan prabowo 394612 DADRS BP + ANEMIA A09 J18.0 + D64.9 I 5,204,562.00 4,130,300.00
317 aulia hanafi 362060 CHOLECYSTITIS HT K81.9 I10 I 12,396,136.00 3,266,900.00
318 CIPTO ALIANSYAH 394303 TB PARU TB ABDOMEN + HEP B + TF A15.0 A18.3 + B16 + A01.0 II 11,866,860.00 7,945,500.00
319 DINA KRISTIANA 394746 PID N73.9 II 3,413,129.00 2,180,700.00
320 FAUZI SUNGKARNA 393651 DMT2 KP + CAD + HT E11.7 A15.0 + I25.1 + I10 I 2,209,848.00 4,743,400.00
321 HARUN 394722 BPH TURP + SISTOSKOPI N40.9 60.29 + 57.3II 14,204,636.00 7,427,400.00
322 KHALISHA DWIPUT 394661 TONSILOFARINGITIS MUMPS J06.8 B26.8 II 3,313,027.00 2,134,600.00
323 FATMAWATI 100.00 100.00
324 SANUSI 386280 POST URETROLITHOTOMY URETROSISTOSCOPY + AFF STENTN99.1 58.22 + 97.6III 12,838,019.00 2,594,400.00
325 ABDUL KARNEN 324987 GANGLION EKSISI M67.4 83.39 II 5,008,269.00 5,845,600.00
326 HERLANGGA SEPTI 378723 CLAVUS EKSISI L84 83.39 II 4,488,508.00 5,845,600.00
327 ADE SETIAWAN 386938 NEFROLITHIASIS HYDRONEFROSIS N20.0 N13.3 II 8,205,030.00 13,705,200.00
328 NENENG SULASTRI 373913 NEFROLITHIASIS ESWL N20.0 98.51 III 7,339,090.00 10,090,500.00
329 SODIK DJUJARTIN 369536 URETROLITHIASIS HYDRONEFROSIS ESWL N20.9 N13.3 98.51 II 7,481,103.00 13,705,200.00
330 UDIN TARUDIN 394502 HYDRONEFROSIS URETROLITHIASIS ESWL N13.3 N20.9 I 7,691,103.00 14,126,800.00
331 AMAR FAUZI 394740 NEFROLITHIASIS N20.0 II 4,726,293.00 2,464,300.00
332 FACHRYDENISFADI 374960 TYPHOID FEVER ANEMIA A01.0 D64.9 II 3,531,667.00 4,282,400.00
333 nazla aulia kirani 343021 ISPA CEREBRAL PALSY J06.9 G80.9 II 1,674,220.00 1,829,000.00
334 ADANG 394721 STT EKSISI D48.1 83.39 III 5,721,979.00 4,871,300.00
335 MAMAT RUHIMAT 394752 HEMMOROID INTERNA HEMOROIDECTOMY I84.2 49.46 I 10,999,341.00 6,095,900.00
336 HERY JUHAERI 393444 KP AKTIF ASMA A15.0 J45.9 II 3,431,962.00 5,004,900.00
337 RAHMAN 321759 PPOK DYSPEPSIA J44.9 K30 II 3,324,100.00 2,878,100.00
338 OMAN 382207 NEFROLITHIASIS URETROSISTOSCOPY + INSERSI S N20.0 58.22 + 59.8II 17,258,321.00 2,464,300.00
339 nining asmara ning 385163 TENDINITIS SHOULDER M75.8 II 1,912,688.00 1,857,000.00
340 OMA PARTINI 380280 NEFROLITHIASIS URETROSISTOSCOPY + INSERSI S N20.0 58.22 + 59.8III 14,722,580.00 2,053,600.00
341 SILVIA KHOERUNNI 394839 STT EKSISI D48.1 83.39 II 6,926,371.00 5,845,600.00
342 WARTIKA 301487 HEG O21.0 II 2,435,927.00 2,502,400.00
343 DIANA WATI 360009 DYSPEPSIA K30 II 4,324,786.00 3,335,500.00
344 ICIH 394789 DIARE KRONIS ANEMIA A09 D64.9 III 4,515,768.00 3,326,100.00
345 NANI RUKANIDAH 383795 HEG O21.0 I 3,057,805.00 2,919,500.00
346 MUJI ASTUTI 394468 HEP A B15.9 II 5,723,926.00 2,799,100.00
347 SITI JULAEHA 389768 SYNDROM PIRIFORMIS M62.88 II 2,205,677.00 1,857,000.00
348 ROSADAH 394798 HEG O21.0 III 2,017,188.00 2,085,300.00
349 HJ.EPI 387926 GEA DM + HT +SEQ. STROKE A09 E11.7 + I10 + I69.3 II 5,500,932.00 3,421,100.00
350 abdul rozak 394006 STROKE INFARK COXITIS + CAD I63.9 M13.1 + I25.1 II 12,827,358.00 3,515,900.00
351 RIKA NURBAYANTI 394967 GASTRITIS AKUT K29.1 I 750,209.00 2,171,800.00
352 RATNANENGSIH 368186 LYMPHADENOPATHY COLLI EKSISI I88.9 40.29 II 7,039,873.00 4,242,600.00
353 yudramarni 394802 DIARE DM + HYPOGLIKEMIA + CAD A09 E11.7 + E16.2 + I25.1 III 5,370,100.00 3,326,100.00
354 EUIS ROHAETI, NY. 394836 MELENA E.C CH dg HYPOALBUMINEMIA K92.1 K73.8 + E88.0 I 5,837,000.00 5,837,000.00
355 ROHAYATI 307789 FEBRIS HT + DM R50.9 I10 + E11.7 II 3,324,983.00 2,386,500.00
356 IDA KOMALASARI 395075 AB. INKOMPLIT KURET O05.4 69.02 II 5,524,702.00 3,279,100.00
357 ADE SARIFUDIN 394709 DENGUE FEVER A90 II 4,146,000.00 2,331,600.00
358 selly septani 394367 APP KRONIS EKSASERBASI AKUT APPENDECTOMY K35.9 47.09 II 8,489,955.00 3,416,800.00
359 sunart 392588 PERDARAHAN POST OPERATIANEMIA T81.0 D64.9 III 3,089,611.00 2,751,400.00
360 ALYA HAFIZHAH 385685 DHF TB PARU A91 A15.0 II 6,968,327.00 2,791,900.00
361 H. ANWARI 393330 BPH TURP + SISTOSKOPI N40 60.29 + 58.2I 25,416,245.00 8,665,300.00
362 NAYLA DWI PUTRI 356697 DHF ISPA A91 J06.9 II 4,333,413.00 2,331,600.00
363 NURAENI 303261 GRAVIDUM DHF + TF O98.5 A91 + A01.0 II 5,352,571.00 4,535,500.00
364 YANI SURYANI 392907 TUMOR MAMAE BIOPSI D24 85.12 III 6,001,261.00 5,098,500.00
365 IIN SUHARTINI 307588 HYDRONEFROSIS URETROLITHIASIS ESWL N13.3 N20.9 98.51 II 7,602,205.00 12,108,700.00
366 RUKMINI 386415 GEA GASTRITIS EROSIVE A09 K29.0 I 2,171,800.00 4,130,300.00
367 ZIA FAUZIAH 395303 CLAVUS EKSISI L84 83.39 I 3,250,230.00 6,819,800.00
368 FAJAR RAMADHAN 395061 KP A15.0 I 4,724,283.00 5,839,000.00
369 MICKHAYLA ZAHRA 374364 DADRS A09 II 2,910,797.00 2,423,100.00
370 moch. fadhil muhya382830 DHF A91 II 2,824,955.00 2,331,600.00
371 RINA SRI MARYANI 394757 DSS TYPHOID FEVER A91 + R57A01.0 II 10,742,257.00 4,906,600.00
372 eljuna bisyari ram 395071 FEBRIS R50.9 III 2,350,254.00 1,556,900.00
373 KHANSA KHOERUN 365782 DADRS A09 II 2,213,284.00 2,423,100.00
374 ANDRIANSYAH 395126 DYSPEPSIA K30 II 2,765,145.00 3,335,500.00
375 ASTI APRILIAN 346051 ISPA SYNDROM DYSPEPSIA J06.9 K30 II 1,650,096.00 1,829,000.00
376 nasyiah putri ardel 394812 DHF A91 III 3,876,288.00 1,943,000.00
377 AFSYARINI ZAHRA 363522 ISPA J06.9 III 1,710,332.00 1,524,100.00
378 H.SAIDIN 395246 BPPV HT + DM T2 H81.1 I10 + E11.7 III 1,474,060.00 2,325,600.00
379 BAYU DHIKA PRAT 394569 UNDENCED TESTIS ORCHIDECTOMY Q53.9 62.3 II 8,797,658.00 6,684,700.00
380 NIASULISTIANI 394843 APPENDICITIS AKUT APPENDECTOMY + ADHESIOLYSISK35.0 47.09 + 54.5II 12,082,390.00 5,841,200.00
381 engkos kosasih 370298 PNC URETROSISTOSCOPY N11.1 58.22 I 24,944,000.00 3,252,500.00
382 SITI MUNAWAROH 393850 PARTUS SPONTAN KPD O80.9 O42.9 III 4,346,404.00 2,013,600.00
383 AMIH 394475 STT EKSISI D48.1 83.39 II 8,597,924.00 5,845,600.00
384 YETI SUHAETI 392179 CYST OVARY LAPARATOMY N83.2 54.19 II 12,884,354.00 6,812,300.00
385 DEDE SYARIF HIDA 375789 NEFROLITHIASIS ESWL N20.0 98.51 I 7,710,949.00 14,126,800.00
386 ASTRI WIDIASTUTI 305590 NEFROLITHIASIS ESWL N20.0 98.51 I 7,818,782.00 14,126,800.00
387 ENIS 394860 MYOMA UTERI ANEMIA D25.9 D64.9 III 2,358,379.00 2,131,000.00
388 ELI NURHASANAH 395063 VIRAL INFECTION B34.9 II 2,199,744.00 2,331,600.00
389 LUSYANA FITRIA 395129 KET KURET O00.1 69.02 II 5,986,257.00 3,279,100.00
390 MUHAMMAD DAFI 394874 HYDROCELE HYDROCELECTOMY N43.3 63.1 I 10,508,893.00 5,361,600.00
391 CICAH KUSMIAWAT 394540 LYMPHADENOPATHY COLLI BIOPSI I88.9 40.11 II 6,225,715.00 4,242,600.00
392 YEYEN PK 395013 TONSILITIS HYPERTROPI FARINGITIS KRONISTONSILEKTOMI + PHARINGECTO J35.1 J31.2 28.2 + 29.33II 8,146,399.00 5,713,700.00
393 LASMIATI 301037 NEFROLITHIASIS ESWL N20.0 98.51 I 7,652,155.00 14,126,800.00
394 SLAMET KASWADI 393852 VESICOLITHIASIS CYSTITIS + DM N21.0 N30.9 + E11. 98.51 I 7,650,949.00 15,989,400.00
395 ADELIA PELITA FEB 386331 TYPHOID FEVER TB PARU A01.0 A15.0 III 1,757,822.00 3,568,700.00
396 SINTIA DEWI RATN 390762 SNNT THYROIDECTOMY E04.9 6.31 I 19,019,073.00 6,705,900.00
397 K. DAPIN BIN SUR 392663 FRAKTUR HUMERUS KP ORIF + BONE GRAFT S42.3 A16.2 79.31 + 78.0II 20,278,105.00 8,194,900.00
398 IYAY YULIANTI 395367 GASTRITIS AKUT K29.1 II 457,868.00 1,861,600.00
399 JUFRI, TN 334740 DC HHD + TB PARU + ESRD I51.9 I11.9 + A15.0 + N18.0 I 5,638,418.00 8,810,000.00
400 FAHREZA NAULI SI 395326 KDK SUSP BP R56 J18.0 II 1,011,563.00 2,674,000.00
401 IPAH SARIPAH, NY. 369693 SINDROM GERIATRI R54 I 10,259,862.00 6,458,700.00
TOTAL 398 2,673,691,998.00 2,046,441,903.00
NAMA DOKTER
dr. YUDI, Sp.U

dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. DIK ADI, Sp.B
dr. ADE, Sp.S
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S
dr. SARJUNAS, Sp.OG
dr. ACHMAD B, Sp.PD
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.PD
dr. ACHMAD B, Sp.PD
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. DIK ADI, Sp.B
dr. YUDI, Sp.U
dr. ADE, Sp.S
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MR. KURNIA, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. HENDRI, Sp.B
dr. ACHMAD B, Sp.PD
dr. ACHMAD B, Sp.PD
dr. RICHARD, Sp.THT
dr. ACHMAD B, Sp.PD
dr. ACHMAD B, Sp.PD
dr. ACHMAD B, Sp.PD
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. SARJUNAS, Sp.OG
dr. ACHMAD B, Sp.PD
dr. ACHMAD B, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. DIK ADI, Sp.B
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DIK ADI, Sp.B
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD

dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. DIK ADI, Sp.B
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. RICHARD, Sp.THT
dr. RICHARD, Sp.THT
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. M. SOEDARMANTO, Sp.M
dr. MEDIA, Sp.S
dr. GHUNA, Sp.OT
dr. GHUNA, Sp.OT
dr. MAULIA, Sp.OG
dr. RICHARD, Sp.THT
dr. ACHMAD B, Sp.PD
dr. ACHMAD B, Sp.PD
dr. PITRAJAYA, Sp.B
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. ADE, Sp.S
dr. ADE, Sp.S
dr. ADE, Sp.S
dr. ACHMAD B, Sp.PD
dr. ADE, Sp.S
dr. WIWIN, Sp.A
dr. RICHARD, Sp.THT
dr. RICHARD, Sp.THT
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. ADE, Sp.S
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. YAYAN, Sp.M
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. YUDI, Sp.U
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. ACHMAD B, Sp.PD
dr. YUDI, Sp.U
dr. RENNY, Sp.U
dr. ARIF
dr. TOTO
dr. GHUNA, Sp.OT

dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. WIWIN, Sp.A
dr. ACHMAD B, Sp.PD
dr. YUDI, Sp.U
dr. TOTO
dr. SAPTANINGTYAS
dr. SAPTANINGTYAS
dr. FITRIYATI
dr. ARIF
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. WIWIN, Sp.A
dr. MAULIA, Sp.OG
dr. RICHARD, Sp.THT
dr. DJOKO, Sp.B
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. MAULIA, Sp.OG
dr. PITRAJAYA, Sp.B
dr. TOTO
dr. DJOKO, Sp.B
dr. GHUNA, Sp.OT
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. RICHARD, Sp.THT
dr. PITRAJAYA, Sp.B
dr. ADE, Sp.S
dr. PARAMITA, Sp.A
dr. RICHARD, Sp.THT
dr. SARJUNAS, Sp.OG
dr. DJOKO, Sp.B
dr. YUDI, Sp.U
dr. MAULIA, Sp.OG
dr. GHUNA, Sp.OT
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. DJOKO, Sp.B
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. RICHARD, Sp.THT
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. GHUNA, Sp.OT
dr. ACHMAD B, Sp.PD
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. ACHMAD B, Sp.PD
dr. PITRAJAYA, Sp.B
dr. ACHMAD B, Sp.PD
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. RENNY, Sp.U
dr. SARJUNAS, Sp.OG
dr. RENNY, Sp.U
dr. SARJUNAS, Sp.OG
dr. GHUNA, Sp.OT
dr. ACHMAD B, Sp.PD
dr. RENNY, Sp.U
dr. SAPTANINGTYAS
dr. ACHMAD B, Sp.PD
dr. GHUNA, Sp.OT
dr. MAULIA, Sp.OG
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U
dr. ACHMAD B, Sp.PD
dr. YUDI, Sp.U
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. ADE, Sp.S
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. DEASY, Sp.P
dr. ADE, Sp.S
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. ADE, Sp.S
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. WIWIN, Sp.A
dr. RENNY, Sp.U
dr. DJOKO, Sp.B
dr. SARJUNAS, Sp.OG
dr. ACHMAD B, Sp.PD
dr. ACHMAD B, Sp.PD
dr. ADE, Sp.S
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. YUDI, Sp.U
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. ACHMAD B, Sp.PD
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. ACHMAD B, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. SARJUNAS, Sp.OG
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. MAULIA, Sp.OG
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. MAULIA, Sp.OG
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. YUDI, Sp.U
dr. PITRAJAYA, Sp.B
dr. ACHMAD B, Sp.PD
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. ACHMAD B, Sp.PD
dr. ACHMAD B, Sp.PD
dr. ACHMAD B, Sp.PD
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U
dr. WIWIN, Sp.A
dr. RENNY, Sp.U

dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. RENNY, Sp.U
dr. MEDIA, Sp.S
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. MAULIA, Sp.OG
dr. MIFTAH, Sp.PD
dr. ACHMAD B, Sp.PD
dr. SARJUNAS, Sp.OG
dr. ACHMAD B, Sp.PD
dr. MEDIA, Sp.S
dr. MAULIA, Sp.OG
dr. ACHMAD B, Sp.PD
dr. MEDIA, Sp.S
dr. FITRIYATI
dr. DJOKO, Sp.B
dr. ACHMAD B, Sp.PD
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. DJOKO, Sp.B
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. ADE, Sp.S
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. RENNY, Sp.U
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. SARJUNAS, Sp.OG
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. RICHARD, Sp.THT
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. GHUNA, Sp.OT
dr. DWIANA
dr. TOTO
dr. MIFTAH, Sp.PD
Rekapitulasi INA CBGs Bulan Februari (LAPORAN MEDREK)
KODE KODE ICD KODE

DIAGNOSA DIAGNOSA
NO NAMA PASIEN NO. MR TINDAKAN ICD SECUNDE TINDAKA KELAS HARGA RS HARGA INA CBGS
PRIMER SEKUNDER UTAMA R N
1 HADIJAH 1 395077 UNSTEABLE ANGIN HT + DYSPEPSIA I20.0 I10 + K30 I 4,509,100.00 4,509,100.00
2 HODIJAH 2 378799 PARTUS SC KPD SCTP O82.9 O42.9 74.1 II 9,984,089.00 4,826,600.00
3 ibrahim al jabar suryana 3 395240 LAHIR SC P03.4 II 1,443,672.00 1,995,800.00
4 RESNIANADA 4 395187 TB PARU A16.2 II 2,481,002.00 5,004,900.00
5 SITI MAEMUNAH 5 393425 CYST OVARI N83.2 II 2,041,587.00 1,863,500.00
6 m rois 6 395128 CA HEPAR SIROSIS + NEFROLITHIASIS + AKI C22.9 N20.0 + N17.9 II 9,163,287.00 5,742,300.00
8 galang darianta saputra 7 331544 VIRAL INFECTION TB PARU B34.9 A15.0 II 3,083,424.00 2,791,900.00
64 BERNARDI UTOMO 63 390519 NEFROLITHIASIS ESWL N20.0 98.51 I 8,590,750.00 14,126,800.00
70 DEDEH 69 392707 NEFROLITHIASIS ESWL N20.0 98.51 III 8,005,750.00 10,090,500.00
72 A. MAKSUM 71 393474 NEFROLITHIASIS ESWL N20.0 98.51 III 7,896,760.00 10,090,500.00
73 H. BADRUDIN 72 393639 NEFROLITHIASIS ESWL N20.0 98.51 III 7,893,750.00 10,090,500.00
174 saini 173 395883 STENOSIS URETER BATU URETER URETERAL MEATOT
N35.9 N20.9 56.1 + 57.0III 9,078,825.00 10,090,500.00
207 BERNARDI UTOMO 206 395019 NEFROLITHIASIS URETERAL MEATON20.0 56.1 + 97. I 20,973,748.00 14,126,800.00
208 HALID SODIKIN 207 377515 MEATAL STENOSIS MEATOTOMY + AFN35.9 56.1 + 97. II 17,578,099.00 12,108,700.00
221 ECIH SUKAESIH 220 323485 STENOSIS URETER URETERAL MEATOT
N35.9 56.1 + 59.8I 22,442,800.00 14,126,800.00
226 nadia almira 224 395882 BRONCHOPNEUMON TB PARU + ANEMIA J18.0 A16.2 + D64.9 III 3,851,994.00 4,883,400.00
227 NENI TRIANA 225 390238 DYSPEPSIA HT K30 I10 II 2,611,863.00 3,335,500.00
228 TRIAN YUDANTARA 226 396271 TYPHOID FEVER DHF A01.0 A91 II 4,318,165.00 4,906,600.00
229 SYIFA WULANDARI 227 358964 TYPHOID FEVER TB PARU A01.0 A16.2 II 3,300,277.00 4,282,400.00
230 ASSYIFAZIKRAAPRILLIA 228 345036 TYPHOID FEVER TB PARU A01.0 A16.2 II 2,320,807.00 4,282,400.00
231 SITI HOTIMAH 229 396363 BRONCHOPNEUMONIA J18.0 II 4,469,487.00 4,170,100.00
232 YENI HERYANI 230 373376 CYSTA OVARI LAPARATOMY + S N83.2 54.19 + 65I 14,117,952.00 7,947,700.00
233 ATANG 231 392910 VESICOLITHIASIS URETROSCOPY+ N21.0 58.22 + 55III 19,283,091.00 10,090,500.00
234 MUHAMMAD FACHRI AZI 232 361683 TYPHOID FEVER ISPA + ANEMIA A01.0 J06.9 + D64.9 III 1,733,602.00 3,568,700.00
235 YAYAD MULYADI 233 395887 BACTERIAL INFECTION A49.9 III 2,774,500.00 2,774,500.00
236 TITIN HARTINAH 234 396297 DC-HHD ANEMIA + DYSPEPSIA + HYPOKA I50.9 I11.9 + D64.9 + K30 +I 8,810,000.00 8,810,000.00
237 rustam 235 391723 STENOSIS URETERNEFROLITHIASURETERAL MEATN35.9 N20.0 56.1 + 59.II 18,681,680.00 13,705,200.00
238 IVA NOOR CHOLIFAH 236 396518 FAM EKSISI D24 85.24 I 8,676,178.00 7,137,800.00
239 SATORI 237 392613 CHOLELITHIASIS TB + PPOK + SE CHOLECYSTECTO K80.8 A16.2 + J4 51.22 III 44,546,688.00 13,688,400.00
240 KAYLA AFIFAH 238 396547 MORBILI BRONCHOPNEUMONIA B05.9 J18.0 II 2,627,522.00 3,398,900.00
241 NENDEN SULISTIAWATI, AMK 239 327050 RIW. SC PARTUS SC SCTP O33.4 O82.9 74.1 I 13,009,711.00 5,631,000.00
242 Wiwin Listani 240 396229 MUCOCELE EKSISI D10.3 24.31 II 2,400,008.00 2,323,100.00
243 E. KOSASIH 241 371442 SPONDILOPATHY L CERVICL SYND M48.96 M53.19 III 4,692,656.00 1,937,400.00
244 santka 242 396369 CYST OVARI ANEMIA N83.2 D64.9 II 7,810,205.00 2,557,200.00
245 IROH 243 385756 SELULITIS DMT2 + HT L03.1 E11.7 + I10 III 4,193,616.00 4,172,800.00
246 ELIS TRISNAWATI 244 396403 TUMOR MAMAE EKSISI D24 85.24 II 7,079,753.00 6,118,200.00
247 ERNA S 245 396350 ITP D69.3 III 2,429,150.00 1,938,100.00
248 DJUDJUN DJUANDA, SH 246 387164 NEFROLITHIASIS ESWL N20.0 98.51 II 7,455,602.00 12,108,700.00
249 IRNA RIZKI AMALIA 247 396170 TYPHOID FEVER DHF + TB PARU A01.0 A91 + A16.2 II 5,357,238.00 4,906,600.00
250 ASEP NUGRAHA 248 377741 CKD N18.9 III 954,360.00 1,940,500.00
251 REVI PRATAMA 249 385650 DSS ENCEPHALOPATHY + DRUG INDUCA91 + R56G93.4 + T88.7+ D64.9II 9,627,851.00 3,398,900.00
252 YENNI NOVAYANTI 250 308028 HAMIL TRAUMA TUMPUL O98.5 T14.9 I 2,044,963.00 2,919,500.00
253 RATMINI 251 396741 DYSPEPSIA K30 II 2,857,435.00 3,335,500.00
254 Aditya Rizki Fahrezi 252 396724 VIRAL INFECTION TB PARU B34.9 A16.2 II 2,184,904.00 2,791,900.00
255 NADYA SITI HAERUNIDA 253 396509 TYPHOID FEVER TB PARU A01.0 A16.2 II 3,334,773.00 4,282,400.00
256 muhammad ali akbar 254 396580 BRONCHOPNEUMONIA J18.0 III 1,802,041.00 3,475,100.00
257 ACENG KURNIA 255 395871 SPONDILOPATHY LUMBAR M48.96 III 1,323,605.00 1,937,400.00
258 aulia nurul anisa 256 367231 HAMIL O36.8 III 1,043,268.00 2,085,300.00
259 dede sit nuraeni 257 396015 CYSTA OVARI LAPARATOMY + S N83.2 54.19 + 65II 12,002,271.00 6,812,300.00
260 YAI ROHANAH 258 396506 TYPHOID FEVER SEQ. STROKE + OA A01.0 I69.3 + M19.9 II 6,520,840.00 3,329,400.00
261 TITIN ROSMIATI 259 373547 spoNDILOPATHY FRAKTUR LUMBAR M48.96 S32.0 I 1,931,781.00 3,814,500.00
262 jejen jaenudin 260 396521 HHD. DC DMT2 + CKD + EFUSI PLEURA I11.9, I51 E11.7 + N18.9 + J90 III 5,031,600.00 5,238,100.00
263 ROCHIM HADIDI 261 396890 FRAKTUR DISTAL RADIUS CASTING + BONE S52.5 93.53 + 78I 13,829,709.00 7,272,500.00
264 bety nurbaety 262 314946 NEFROLITHIASIS ESWL N20.0 98.51 II 7,120,710.00 12,108,700.00
265 vielga r rofa 263 383341 NEFROLITHIASIS ESWL N20.0 98.51 III 7,441,765.00 10,090,500.00
266 MAMAH 264 389623 URETROLITHIASIS ESWL N20.9 98.51 III 7,031,206.00 10,090,500.00
267 SULYATI 265 386040 NEFROLITHIASIS PYELONEFRITIS ESWL N20.0 N13.9 98.51 I 7,833,897.00 14,126,800.00
268 h. saan 266 365977 ILEUS OBSTRUKTIF K56.6 II 5,824,535.00 2,325,300.00
269 FIRLI FIRMANSYAH 267 387333 VIRAL INFECTION HYPOCALCEMIA B34.9 E83.5 II 1,568,475.00 2,326,600.00
270 LASMINAH 268 396061 CYST PAROTIS EKSISI K11.6 83.39 I 11,178,434.00 6,819,800.00
271 anisa chika dania 269 387174 APP AKUT APPENDECTOMY K35.9 47.09 I 11,540,328.00 3,985,400.00
272 DONI TRITENSA ALFAREZE 270 344028 ISPA J06.9 I 1,851,407.00 2,133,800.00
273 IDANINGSIH BAKRI 271 303752 STT EKSISI D48.1 83.39 II 9,002,526.00 5,845,600.00
274 YUNIA GUSTINI 272 396425 ABSES DEBRIDEMENT L02.9 86.22 II 6,100,587.00 2,800,400.00
275 UCI SANUSI ACHDIAT.SS 273 396609 HEMIPARESE SUSP STROKE G81.9 I63.9 I 5,546,743.00 5,566,600.00
276 HARUN MAULANA 274 335297 NEURALGIA PARSTHSEQ. STROKE B02.2 + GI69.3 II 769,774.00 3,117,600.00
277 ai 275 396889 CAD HT I25.1 I10 III 3,508,292.00 2,331,600.00
278 inggit nursafitri 276 396405 DENGUE FEVER TYPHOID FEVER A90 A01.0 I 3,965,400.00 3,965,400.00
279 M. UHEN RUKHIYAT 277 396582 MELENA CH + HYPOALBUMIN + ANEMIA K92.1 K74.6 + E88.0 + D64. I 5,837,000.00 5,837,000.00
280 ELIN NOPHIA KARSANA 278 379523 CHOLECYSTITIS CHOLELITHIASISCHOLECYSTECTOMYK81.8 K80.8 + K651.22 + 54II 6,481,200.00 6,481,200.00
281 SITI AISYAH RAHMAWATI 279 397080 AB. INKOMPLIT KURET O05.4 69.02 II 4,645,552.00 3,279,100.00
282 FITRIANNA BR MANULUNG 280 396891 DHF A91 II 3,341,020.00 2,331,600.00
283 OMAN 281 382207 NEFROLITHIASIS HYDRONEFROSIESWL N20.0 N13.3 98.51 II 8,093,029.00 13,705,200.00
284 ENENG HALIMAH SITI nurfala 282 396251 KISTA TYROID KISTECTOMY E05.1 6.31 II 10,150,495.00 5,747,900.00
285 naila saidah putri 283 368457 BRONCHOPNEUMONIA J18.0 II 3,943,911.00 4,170,100.00
286 ALvIANI eka MARTA 284 394233 GRANULOMA SKIN GRAFT L92.9 86.69 III 12,389,089.00 6,888,200.00
287 SOBANDI 285 396700 HIL HERNIORHAPY K40.9 53.29 I 11,036,635.00 4,997,900.00
288 MIA KURNIAWATI 286 368982 HIL HERNIORHAPY K40.9 53.29 I 10,228,961.00 4,997,900.00
289 SAPRI HIDAYAT 287 396927 VIRAL INFECTION B34.9 I 2,497,765.00 2,720,200.00
290 CEPIHANAPISAPUTRA 288 315137 TYPHOID FEVER TB PARU A01.0 A16.2 II 3,534,817.00 4,282,400.00
291 AFIFAH WAFIYATUN NISA 289 396779 TYPHOID FEVER TB PARU A01.0 A16.2 II 3,209,681.00 4,282,400.00
292 SALMA NOVIC 290 365142 DADRS A09 II 2,331,826.00 2,423,100.00
293 FERIR 291 397067 ABSES DEBRIDEMENT L02.9 86.22 II 5,443,020.00 2,800,400.00
294 isah 292 396727 DC COPD I51.9 J44.9 I 3,775,323.00 8,810,000.00
295 YUNENGSIH 293 373261 NEFROLITHIASIS ESWL N20.0 98.51 II 8,066,515.00 12,108,700.00
296 OPID 294 337899 NEFROLITHIASIS ESWL N20.0 98.51 I 8,256,515.00 14,126,800.00
297 SURIPTO 295 382549 NEFROLITHIASIS ESWL N20.0 98.51 II 8,479,030.00 12,108,700.00
298 HENI SUHARTINI 296 348186 PRESENTASI BOKONPARTUS SC SCTP O32.9 O82.9 74.1 II 9,525,809.00 4,022,100.00
299 RAFLI INDRAZAKTI 297 324792 TYPHOID FEVER TB PARU A01.0 A16.2 II 3,234,095.00 4,282,400.00
300 ANDINI N MAULIDA 298 396586 BRONCHOPNEUMON TB PARU J18.0 A16.2 II 2,689,946.00 4,170,100.00
301 EUIS ROJAETIN 299 395097 MYOM UTERI ANEMIA LAPARATOMY + T D25.9 D64.9 54.19 + 68III 10,537,520.00 6,516,000.00
302 ACUN SUWITARASA, TN 300 380486 TENDINOSIS SHOULSEQ. STROKE M75.8 I69.3 I 1,725,978.00 2,166,600.00
303 ENDANG SUMARNA 301 395444 STROKE HT I64 I10 I 2,974,997.00 3,296,100.00
304 glassinea nurul utami 302 362137 RIW. SC PARTUS SC SCTP O34.2 O82.9 74.1 II 9,008,573.00 4,826,600.00
305 ENGKOS KOSASIH, H 303 325075 neuraLGIA DM M79.28 E11.7 I 4,813,300.00 4,813,300.00
306 MILA EKARIA YULIANA 304 392039 PARTUS SPONTAN KPD + ANEMIA + GEMELLY O80.9 O42.1 + O30.0 + D64.III 9,768,943.00 2,383,300.00
307 NASYWA CAMILA EL-NISSA 305 396213 TYPHOID FEVER ISPA + DHF A01.0 J06.9 + A91 I 5,724,400.00 5,724,400.00
308 ARSYSHALAFIYNUGRAHA 306 375921 BRONCHOPNEUMON WHEEZING J18.0 R06.2 II 3,420,849.00 4,170,100.00
309 AMBAR NURFITRIA 307 394562 PAIN LUMBAR M54.5 II 1,664,108.00 2,324,900.00
310 UDIN TARUDIN 308 394502 NEFROLITHIASIS HYDRONEFROSIESWL N20.0 N13.3 98.51 I 7,643,743.00 15,989,400.00
311 ADE SUGIARTI 309 396279 HIL HERNIORHAPY K40.9 53.29 II 9,633,909.00 4,283,900.00
312 SUNIRAH 310 396087 TUMOR THYROID TYROIDECTOMY E04.1 6.39 III 10,455,331.00 4,789,900.00
313 afriza saputra 311 396948 HYDROCELE HYDROCELECTOMN43.3 63.1 III 5,365,778.00 3,829,700.00
314 NENENG SULASTRI 312 373913 NEFROLITHIASIS ESWL N20.0 98.51 III 7,280,463.00 10,090,500.00
315 SLAMET KASWADI 313 393852 NEFROLITHIASIS HYDRONEFROSIESWL N20.0 N13.3 98.51 I 7,666,897.00 15,989,400.00
316 DEDEH JUBAEDAH 314 396649 LYMPHADENOPATI COLLI EKSISI I88.9 40.29 II 6,920,804.00 4,242,600.00
317 shidqiyya suci ramadhani 315 394117 DIARE TB PARU A09 A16.2 III 4,700,272.00 3,326,100.00
318 YOGA MAULANA 316 355860 OSA EC TONSILITIS FARINGITIS KROTONSILADENOIDEG47.3 J35.2 + J3128.3 + 29. II 7,754,097.00 5,713,700.00
319 lilis nurhayat 317 390418 CYST OVARI LAPARATOMY N83.2 54.19 II 11,923,654.00 6,812,300.00
320 EVA SISDWI ASTUTI, NY 318 375762 DYSPEPSIA K30 II 4,352,396.00 3,335,500.00
321 karman 319 395948 NEFROLITHIASIS ESWL N20.0 98.51 II 8,523,029.00 12,108,700.00
322 SUKIRMAN ARIES ROZIE 320 324651 NEFROLITHIASIS CYST GINJAL ESWL N20.0 N28.0 98.51 II 7,456,897.00 13,705,200.00
323 ricky ardiansyah gumilar 321 395631 FAM TTNA D14.3 33.93 I 4,812,121.00 4,052,300.00
324 SANTI AMIATI 322 396611 DENGUE FEVER A90 II 4,771,558.00 2,331,600.00
325 MUSLIM 323 397090 OF R50.9 II 1,868,300.00 1,868,300.00
326 USEP SAPTUMI 324 392930 CHF SUSP PPOK + SUSP CAD I51.9 J44.9 + I25.1 II 536,398.00 7,142,500.00
327 RAHMA DIAN LESTARI 325 396723 TENDINOSIS SHOULDER M75.8 I 2,320,235.00 2,166,600.00
328 yoyoh 326 396735 NEFROLITHIASIS FATTY LIVER N20.0 K76.0 I 3,366,194.00 3,450,900.00
329 ELVRINA M SITORUS 327 358789 DHF TYPHOID FEVER A91 A01.0 III 3,388,546.00 2,832,400.00
330 WARDI 328 389628 STENOSIS URETER VESICOLITHIASIMEATOTOMY + LITN35.9 N21.0 56.1 + 57.0III 16,059,524.00 10,090,500.00
331 AMIN SURIADINATA 329 396272 MEATAL STENOSIS VESICOLITHIASIMEATOTOMY + LITN35.9 N21.0 56.1 + 57.0I 21,339,915.00 15,989,400.00
332 INA LISNAWATI 330 380497 PARTUS SPONTAN KPD O80.9 O42.9 II 5,360,022.00 2,416,400.00
333 M. DAFFA JULIAN 331 396881 TYPHOID FEVER DADRS A01.0 A09 II 4,413,687.00 3,329,400.00
334 ATIM 332 360726 LBP NEPHRITIS M54.5 N05.9 II 3,890,894.00 2,324,900.00
335 RAVI AUFHAR IBRAHIM 333 396893 DENGUE FEVER ISPA A90 J06.9 II 5,065,859.00 2,331,600.00
336 NURYANTI 334 339214 LIPOMA EKSISI D17.9 83.39 II 7,842,774.00 5,845,600.00
337 HENY CAHYATI 335 387229 FAM EKSISI D24 85.24 II 6,880,351.00 6,118,200.00
338 ABDULLOH THOHIR 336 396838 STT EKSISI D48.1 83.39 III 6,769,779.00 4,871,300.00
339 HERMAN ZAENUDIN 337 319380 CHOLELITHIASIS NEFROLITHIASIS K80.8 N20.0 II 4,142,906.00 3,250,900.00
340 LINTANG NURIL ISLAMI 338 357286 MUCOCELE EKSISI D10.3 83.39 III 6,184,769.00 4,871,300.00
341 DINA PURNAMASARI 339 319944 KISTA ENDOMETRIOSIS LE + ADHESIOLYSIN85.8 54.11+54. II 18,481,876.00 5,841,000.00
342 HANI NURHANIFAH 340 388724 TYPHOID FEVER DHF + TB PARU A01.0 A91 + A16.2 III 3,263,351.00 4,088,900.00
343 FATMAWATI 341 396665 TENDINOSIS SHOULDER M75.8 I 2,267,071.00 2,166,600.00
344 BILLAL NAZRIEL HAMDY 342 374872 TYPHOID FEVER ANEMIA A01.0 D64.9 II 2,364,113.00 4,282,400.00
345 NONO WARTONO 343 397134 STT EKSISI D48.1 83.39 I 8,276,794.00 6,819,800.00
346 IJAH 344 396688 NEFROLITHIASIS HYDRONEFROSIURETROSISTOSCOP N20.0 N13.3 58.22 + 59II 18,044,583.00 2,957,900.00
347 WISNU DWIKI S 345 397116 VIRAL INFECTION B34.9 I 2,735,616.00 2,720,200.00
348 DIDI SUPANDI 346 396945 OTITIS MEDIA H66.9 II 4,326,656.00 1,829,000.00
349 NURI KADNURI 347 396935 NEFROLITHIASIS N20.0 II 4,141,900.00 2,464,300.00
350 SITI SUHARTINI 348 383955 DMT2 ISK + SYND GERIATRI E11.7 N39.0 + R54 I 12,154,355.00 4,743,400.00
351 assyifatu haifa schalan 349 389693 BRONCHOPNEUMON TB PARU J18.0 A16.2 II 6,383,500.00 4,170,100.00
352 SUSIYATI 350 396993 DM DG SELULITIS UTI E11.6 N39.0 I 4,624,478.00 4,743,400.00
353 JUBAEDAH 351 352635 CYST OVARI LAPARATOMY N83.2 54.19 II 12,036,178.00 6,812,300.00
354 manisi 352 396285 APP AKUT KISTA OVARIUM + TUBOOVARIAL K35.0 N83.2 + N70.9 + A01.III 8,258,635.00 5,332,400.00
355 IIN SUHARTINI, NY 353 307588 URETROLITHIASIS HYDRONEFROSIESWL N20.9 N13.3 98.51 II 8,224,601.00 13,705,200.00
356 H. SUGENG, SH. 354 361911 NEFROLITHIASIS ESWL N20.0 98.51 I 8,417,190.00 14,126,800.00
357 YAYAH ROBIYAH 355 397166 TUMOR MAMAE BIOPSI D24 85.12 III 6,612,572.00 5,098,500.00
358 ENOK JENAB 356 382937 DENGUE FEVER A90 II 4,403,789.00 2,331,600.00
359 ROKAYAH 357 386767 SPONDYLOSIS M48.96 III 1,496,908.00 1,937,400.00
360 TATI NY JD UDIN 358 395681 SPONDILOPATHY LUMBAR M48.96 II 1,955,198.00 2,324,900.00
361 DINI SUHARTINI 359 385390 TYPHOID FEVER A01.0 II 2,363,183.00 3,329,400.00
362 HOLIL MUTIARA 360 331556 NEFROLITHIASIS CYST GINJAL N20.0 N28.1 II 3,351,803.00 2,957,900.00
363 N. NANI SURYANI 361 397032 GEA ANEMIA A09 D64.9 II 3,109,962.00 3,421,100.00
364 AMAT ROSKANDI 362 396822 BPH TURP N40 60.29 I 22,665,436.00 8,665,300.00
365 HERTI 363 347670 BATU STAGHON PYELONEFROLIT N21.0 55.01 III 19,202,589.00 10,090,500.00
366 RAMIS BT WALAD 364 338731 HYDRONEFROSIS URESTROSCOPY N13.3 58.22 I 21,539,292.00 2,875,000.00
367 IDA ROSIDA 365 348250 DYSPEPSIA K30 II 3,550,126.00 3,335,500.00
368 ACHMAD 366 397070 KP A16.2 I 3,219,720.00 5,839,000.00
369 RATMINI 367 396741 TB PARU A16.2 II 7,248,134.00 5,004,900.00
370 IYES,hj 368 372584 TTH HT G44.2 I10 I 2,176,900.00 2,176,900.00
371 nanang nugraha 369 378753 NEFROLITHIASIS ESWL N20.0 98.51 III 7,895,155.00 10,090,500.00
372 ECIH SUKAESIH 370 323485 NEFROLITHIASIS ESWL N20.0 98.51 I 8,267,155.00 14,126,800.00
373 rustam 371 391723 NEFROLITHIASIS ESWL N20.0 98.51 II 8,066,515.00 12,108,700.00
374 UAS SOBANDI 372 377772 NEFROLITHIASIS ESWL N20.0 98.51 III 7,895,155.00 10,090,500.00
375 sit mariyam 373 320389 BURSITIS GENU M70.18 I 1,967,629.00 2,166,600.00
376 NURCE NURYATI 374 395719 TENOSYNOVITIS M65.84 I 2,050,128.00 2,166,600.00
377 ATANG SUPARMAN 375 448671 STROKE HAEMORHAENCEPHALOPATHY HYPERTENSIV I64 I67.4 III 898,635.00 3,652,800.00
378 akmal kian aditya 376 396794 BRONCHOPNEUMON ANEMIA J18.0 D64.9 II 6,941,667.00 5,860,100.00
379 agung nugroho 377 397066 LIPOMA EKSISI D17.9 83.39 II 8,848,888.00 5,845,600.00
380 GIO ALVIN VITARA ARAFAH 378 396531 STT EKSISI D48.1 83.39 II 6,910,908.00 5,845,600.00
381 SITI YULIANTI 379 391330 PARTUS SPONTAN KPD O80.9 O42.9 II 3,845,284.00 2,416,400.00
382 GILANG ABIZAR RAMADHAN 380 396949 HIL HERNIORHAPY K40.9 53.29 II 9,944,143.00 4,283,900.00
383 MIMI USMANIAH 381 381023 HNP M51.2 I 2,712,300.00 2,712,300.00
384 NAFISA FAWZIYA 382 396749 TONSILADENOIDITISFARINGITIS KROTONSILADENOIDEJ35.2 J31.2 28.3 + 29. II 8,897,016.00 5,713,700.00
385 muhmmad altaf jaeni 383 394490 BRONCHOPNEUMON TB PARU J18.0 A16.2 II 2,357,275.00 4,170,100.00
386 SRI MULYANI 384 317128 BO KURET O02.0 69.02 II 5,217,816.00 3,279,100.00
387 IYAN SOPYAN 385 396094 DC VI + HHD + HYPOCALCEMIA I51.9 B34.9 + I11.9 + E83.5III 2,443,541.00 6,292,900.00
388 RAMDHAN PUTRA RAMA 386 396904 BRONCHOPNEUMONIA J18.0 II 2,959,954.00 4,170,100.00
389 Fitri Verolina Hartawat 387 396972 TUMOR AXILLA EKSISI D36.7 83.39 II 9,139,240.00 5,845,600.00
390 SAEFUL BAHRI 388 389814 NEFROLITHIASIS ESWL N20.0 98.51 II 8,002,723.00 12,108,700.00
391 BASUKI RAHMAT 389 376926 GERAKAN INVOLUNTER R25.8 I 4,014,994.00 3,267,200.00
392 MINTARSIH 390 393277 HYDRONEFROSIS URETROLITHIASESWL N13.3 N20.9 98.51 III 7,358,282.00 10,090,500.00
393 RUKMAN 391 395005 NEFROLITHIASIS CYST GINJAL + ESWL N20.0 N28.1 + K7 98.51 II 7,287,395.00 13,705,200.00
394 USEN 392 383345 ESRD DM HD N18.0 E11.6 39.95 III 2,965,488.00 3,236,300.00
395 YATI 393 397477 IUFD O36.4 I 5,189,941.00 2,919,500.00
396 NENENG HADIATI, NY 394 390865 EFUSI PLEURA CKD + BP PUNGSI PLEURA J90 N18.0 + J1 34.91 I 1,761,260.00 8,563,600.00
397 muhammad raziq arsyad aziz 395 396895 RESPIRATORY DISEAHBR + TTN P22.9 P59.9 + P21.1 III 14,380,768.00 3,492,300.00
398 Nadira Putri Salsabila 396 351891 TYPHOID FEVER A01.0 I 5,500,885.00 3,884,300.00
399 PUTRA MUHAMAD AD DZIKR 397 397376 BRONCHOPNEUMON TB PARU + ANEMIA J18.0 A16.2 + D64.9 III 1,862,273.00 4,883,400.00
400 emin 398 397605 BPH Z53.0 II 2,179,235.00 1,399,400.00
401 SARAH RIZKY ERLANGGA 399 397429 LAHIR SC P03.4 II 1,699,307.00 1,995,800.00
402 TRI MARYANI 400 397351 LETSU SC SCTP O32.9 O82.9 74.1 II 9,747,278.00 4,826,600.00
403 YATI 401 397475 CYST OVARI DM N83.2 E11.6 II 2,103,165.00 2,557,200.00
404 MUHAMMAD ISKANDAR YUS 402 396671 POLIP SINUSITIS POLIPEKTOMY + J33.9 J32.9 21.31 + 22I 11,869,861.00 5,381,100.00
405 IYAN DIANATIKA 403 397043 FRAKTUR FEMUR REMOVE IMPLANS72.9 78.65 III 10,670,865.00 2,956,700.00
406 GARNIS AZIZ JAMIL 404 329499 TYPHOID FEVER BRONCHOPNEUMONIA A01.0 J18.0 II 3,456,108.00 4,906,600.00
407 ADE SETIAWAN 405 386938 URETROLITHIASISHYDRONEFROS ESWL N20.9 98.51 II 7,475,466.00 13,705,200.00
408 farisatul haqbillah 406 397382 TUMOR BIOPSI D48.9 83.21 II 8,790,112.00 2,820,300.00
409 M ASMAWI 407 303755 NEFROLITHIASIS DM + HYPERTENESWL N20.0 E11.7 + I1 98.51 II 7,593,055.00 13,705,200.00
410 SAIMAN 408 397613 CYST DAUN TELINGA EKSISI Q18.1 18.29 II 4,593,248.00 1,867,700.00
411 SAID ABDUL GHANI 409 396110 DC HHD + STROKE INFARK + SYNDR GI51.9 I11.9 + I63.9 + R54 I 9,086,800.00 9,086,800.00
412 anna octaviana 410 322830 ISK GRAVIDA N39.0 O36.8 I 3,084,500.00 2,170,700.00
413 ASRI 411 396075 BURSITIS GENU M71.58 I 2,499,896.00 2,166,600.00
2,653,275,535.00 2,152,521,000.00
BPJS 411
COB 8 .
TOTAL 419
COB INHEALTH
KODE KODE ICD KODE
DIAGNOSA DIAGNOSA
NO NAMA PASIEN NO. MR PRIMER SEKUNDER TINDAKAN ICD SECUNDE TINDAKA KELAS HARGA RS HARGA INA CBGS
UTAMA R N
1 ETI SULASTRI 397340 ISK DM N39.0 E11.6 I 5,491,963.00 3,252,500.00

2 ADE SOPWAN 321186 STROKE INFARK I63.9 II 1,829,961.00 3,515,900.00
3 SAEPUL RAMDHANI 395605 DIARE A09 II 1,076,540.00 2,423,100.00
4 HENDI 396607 MHI S09.9 II 4,668,656.00 3,336,600.00
5 PEVI SETYAWATI 396160 TYPHOID FEVER DHF A01.0 A91 II 6,022,586.00 4,906,600.00
6 BUDI PERMANA 395956 RUPTUR DIGITI II DAN III REPAIR TENDON S56.8 83.88 II 15,581,537.00 5,845,600.00
7 TONY SUSANTO 395997 TYPHOID FEVER ISK A01.0 N39.0 II 3,078,820.00 4,282,400.00
8 REYSHA PUTRI KHAIRUNISA 396579 DADRS ANEMIA A09 D64.9 II 5,717,076.00 3,421,100.00
43,467,139.00 30,983,800.00
7 ELIN NOPHIA KARSANA 379523 GASTRITIS EROSIVE CHOLELITHIASIS + CHOLECYSTITISK21.9 K80.8 + K81.8 II 6,481,200.00 2,172,800.00
225 yuyun yunanengsih 396230 PERDARAHAN POST OP T81.0 II 2,093,345.00 1,862,900.00
414 WANIS PULAILAH 325412 TENDINOSIS SHOULDER M75.8 II 1,638,652.00 1,857,000.00
NAMA DOKTER

dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A

dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A

dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S
dr. YUDI, Sp.U
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. SARJUNAS, Sp.OG
drg. FRANKY, Sp.BM
dr. MEDIA, Sp.S
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. HISKIA
dr. WIWIN, Sp.A
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. ACHMAD, Sp.PD
dr. MEDIA, Sp.S
dr. ACHMAD, Sp.PD
dr. ANDRI, Sp. OT
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. NUNUNG, Sp.OG
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. GHUNA, Sp.OT
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. MEDIA, Sp.S
dr. ADE, Sp.S
dr. MAULIA, Sp.OG
dr. MEDIA, Sp.S
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. MEDIA, Sp.S
dr. RENNY, Sp.U
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. RICHARD, Sp.THT
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.PD
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. DEASY, Sp.P
dr. MIFTAH, Sp.PD
dr. ACHMAD, Sp.PD
dr. TOTO
dr. MEDIA, Sp.S
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. ACHMAD, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG + dr. PITRAJAYA, Sp. B
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. YUDI, Sp.U
dr. ACHMAD, Sp.PD
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. RENNY, Sp.U
dr. ACHMAD, Sp.PD
dr. ACHMAD, Sp.PD
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. FITRI YANTI
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. MAULIA, Sp.OG
dr. PITRAJAYA, Sp.B
dr. MEDIA, Sp.S
dr. RICHARD, Sp.THT
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. YUDI, Sp.U
dr. MIFTAH, Sp.PD
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. DEASY, Sp.P
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. RICHARD, Sp.THT
dr. GHUNA, Sp.OT
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. RICHARD, Sp.THT
dr. ADE, Sp.S
dr. ACHMAD, Sp. PD
dr. MEDIA, Sp.S
NAMA DOKTER
dr. MIFTAH, Sp.PD

dr. ZUHAIRA, Sp.S
dr. WIWIN, Sp.S
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. GHUNA, Sp.OT
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD PENDING
dr. PITRAJAYA, Sp.B 1 EPISODE
dr. MEDIA, Sp.S TUNGGU PENANGGUHAN
Rekapitulasi INA CBGs Bulan Maret (LAPORAN MEDREK)
DIAGNOSA DIAGNOSA KODE ICD KODE ICD KODE
NO NAMA PASIEN NO. MR TINDAKAN KELAS HARGA RS HARGA INA CBGS
PRIMER SEKUNDER UTAMA SECUNDER TINDAKAN
1 NURHAYATI KOMALASA 397228 CYSTA OVARI MYOM UTERI SOD + MYOMECTO N83.2 D25.9 65.61 + 68.29 I 15,570,309.00 7,381,900.00
2 NENG TJITJIH 393810 NEFROLITHIASIS ESWL N20.0 98.51 I 8,046,856.00 14,126,800.00
3 UMROTUN SADIAH 348236 KP HT A16.2 I10 II 4,285,436.00 5,004,900.00
4 TUTI 397430 SUSP. CA COLON HT + HHD + CAD C18.9 I10 + I11.9 + I25.1 I 6,004,894.00 4,457,100.00
5 USEP SAPTUMI 392930 EFFUSI PLEURA DC + HHD + DM + KP J90 I25.1 + I11.9 + E11.7 + A16.2 II 4,127,932.00 5,388,000.00
6 IJAH 396688 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 II 4,280,400.00 13,705,200.00
7 RACI ROSMAWATI 396680 NEFROLITHIASIS UTI ESWL N20.0 N39.0 98.51 III 8,227,029.00 11,421,000.00
8 CICIH 393829 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 II 7,972,791.00 13,705,200.00
9 NINING BT UCI 397531 ILEUS OBSTRUKTI ANEMIA K56.6 D64.9 III 7,293,654.00 2,873,100.00
10 NUNUNG SITI FATIMAH 333240 AB. INKOMPLIT KURET O05.4 69.02 II 4,610,924.00 3,279,100.00
11 yeni marthia dewi 312492 BLIGHTED OVUM KURET O02.0 69.02 II 5,336,985.00 3,279,100.00
12 MUMUN 387753 EFFUSI PLEURA ANEMIA + CKD J90 D64.9 + N18.0 II 8,390,540.00 5,388,000.00
13 YAYAH RODIAH 397589 CTS OA + TRIGGER FINGERINJ BLOK SARAF PERG56.0 M19.9 + M65.3 4.8 I 2,454,400.00 3,619,200.00
14 haniya qonita salsabila 384068 BRONCHOPNEUMONIA J18.0 I 6,404,383.00 4,865,100.00
15 tet lisdiawat 383636 PRESENTASI BOKOPARTUS SC + HEP.A SCTP O32.9 B15.9 74.1 I 10,887,831.00 6,213,800.00
16 Elvira Al Zena 397341 BRONCHOPNEUMWHEEZING + ANEMIA J18.0 R06.2 + D64.9 II 5,557,421.00 4,170,100.00
17 syifana fadilah zulva 397366 BRONCHOPNEUMONIA J18.0 II 3,612,769.00 4,170,100.00
18 KASTO M 397355 HHD DYSPEPSIA + HYPOKALSEMIA I11.9 K30 + E83.5 I 5,193,590.00 6,042,200.00
19 KUSMIATI 397652 ASMA J45.9 I 3,099,680.00 2,173,300.00
20 khein azhar maulana 396134 BRONCHOPNEUMANEMIA J18.0 D64.9 II 2,535,796.00 5,860,100.00
21 nurhalimah 396951 CHOLELITHIASIS CHOLECYSTECTOMYK80.8 51.22 II 12,246,513.00 6,481,200.00
22 omay 397174 HIL HERNIORAPHY+OMK40.9 53.29+54.41 III 8,143,922.00 5,677,000.00
23 MUMUN 397450 LYMPHADENEITIS EC SUSP TB FNAB A18.2 33.26 II 877,776.00 2,248,300.00
24 IMAS SITI MAESAROH 397731 AB. INKOMPLIT KURET O05.4 69.02 II 4,120,623.00 3,279,100.00
25 UNUN NURIYAH 386153 RIW. SC PARTUS SC SCTP O34.2 O82.9 74.1 I 12,529,710.00 5,631,000.00
27 AYU AMBARWATI 308352 PARTUS SPONTANKPSW O80.9 O42.9 II 4,211,324.00 2,416,400.00
28 i putu oka 301289 PENURUNAN KES SUSP. STROKE ULANG + METABOLIK ENCE G47. I69.3 + G63.4 I 5,891,470.00 2,209,500.00
29 REZKY PUTRA IRHAMI 387557 BRONCHOPNEUMTB PARU J18.0 A16.2 II 3,792,741.00 4,170,100.00
30 NADIYA NISRINA RAHM 397598 TB PARU A16.2 III 2,085,623.00 4,170,700.00
31 hanisah putri septa 397628 BRONCHOPNEUMTB PARU J18.0 A16.2 II 3,107,342.00 4,170,100.00
32 ENUNG TUTI 397237 TYPHOID FEVER LBP + NEFROLIYHIASIS + INSOMNIA + HT A01.0 M54.5 + N20.0 + G47.0 + I10 III 6,972,530.00 3,568,700.00
33 subhan akhmad 386211 POST ORIF SPONDYLOSIS REMOVE IMPLANT Z47.9 M47.99 78.6 I 13,428,386.00 4,139,400.00
34 anisa kasandra 387468 BRONCHOPNEUMWHEEZING J18.0 R06.2 III 4,592,416.00 3,475,100.00
35 rina herlina 397649 GOUT ARTHRITIS M19.9 II 3,990,253.00 2,490,400.00
36 LINA MARLINA 392175 RIW. SC PARTUS SC + KPSW SCTP O34.2 O82.9 + O42.9 74.1 III 8,116,986.00 4,022,100.00
37 ASEP SAEPUDIN 397224 VIRAL INFECTION DENGUE FEVER B34.9 A90 II 2,791,900.00 2,791,900.00
38 ZAIDUL KISMAN 372727 DYSPEPSIA HYPOKALEMIA K30 E87.6 I 5,218,302.00 5,837,000.00
39 CUCUNCUNAYAH 395577 LBP M54.56 II 1,371,379.00 2,324,900.00
40 DEDI 392876 SPONDILOPATHY LUMBAR INJ SARAF PERIFER M48.96 4.8 III 1,477,894.00 1,937,400.00
41 KARMINA 395850 SPONDILOPATHY LUMBAR INJ FACET BLOK LU M48.96 3.92 II 1,911,644.00 2,324,900.00
42 SURATMAN 382531 TUMOR ANTEBRACHII EKSISI D36.7 83.39 I 9,381,260.00 6,819,800.00
43 Redza Aditya 391024 BRONCHOPNEUMONIA J18.0 II 3,890,660.00 4,170,100.00
44 euis suhyat 389101 BURSITIS INJ BURSA M70.18 83.96 II 1,588,469.00 1,857,000.00
45 RAFI IRWANTO 379061 BRONCHOPNEUMANEMIA J18.0 D64.9 I 2,770,448.00 4,865,100.00
46 Asep Hasan Muhidin 353779 STT EKSISI D48.1 83.39 II 8,486,095.00 5,845,600.00
47 DEWI RATNAWATI 347363 PARTUS NORMAL O80.9 II 2,416,400.00 2,416,400.00
48 AKIFA NAILA ANSOR 397768 DIARE A09 III 2,277,068.00 2,355,800.00
49 NUNUNG NURHAYATI 319777 STT EKSISI D48.1 83.39 I 9,293,876.00 6,819,800.00
50 ENDANG SUHANA 397327 DM T2 E11.5 I 5,086,280.00 4,345,900.00
51 RAISHA D.R 321446 TYPHOID FEVER DHF A01.0 A91 II 3,845,960.00 4,906,600.00
52 EHA JULAEHA 397794 SUSP BASAL CELL EKSISI + RECONTRU D23.9 86.3 + 86.69 II 7,562,796.00 8,265,800.00
53 imas nuraeni 397811 CYSTA ATHEROMA EKSISI L72.9 83.39 I 8,391,208.00 6,819,800.00
54 SALMA NOVIC, AN 365142 BRONCHOPNEUMONIA J18.0 II 3,856,216.00 4,170,100.00
55 SURTINAH 386922 TB PARU PLEURAPNEMONIA PUNSI PLEURA A16.2 J18.8 34.91 II 1,695,923.00 5,004,900.00
56 ETI NURBAETI 397623 TUMOR MAMAE EKSISI D24 85.24 II 8,136,669.00 6,118,200.00
57 DASEM 397160 TUMOR MAMAE BIOPSI D24 85.12 III 5,704,818.00 5,098,500.00
58 NAILA AZKADINA PUTRI 335783 TB PARU BRONCHOPNEUMONIA + TYPHOID FEVER A16.2 J18.0 + A01.0 II 2,908,302.00 7,945,500.00
59 DEDIH 397627 LIPOMA EKSISI D17.9 83.39 III 7,295,562.00 4,871,300.00
60 yoyoh 396735 NEFROLITHIASIS ESWL N20.0 98.51 I 8,416,850.00 14,126,800.00
61 SUNERI BT KIWANG 397587 PARTUS SC KPSW + GAGAL INDUKSCTP O82.9 O42.9 + O61.0 74.1 III 8,893,630.00 4,022,100.00
62 HERMINA LESTARI 397561 TYPHOID FEVER DF A01.0 A90 II 4,935,969.00 4,282,400.00
63 ELI KOSMIWATI 397033 EFFUSI PLEURA PPOK + DCM + DC + SYOK + SEPSIS +AKI J90 J44.9 + I42.0 + R57.8 + A41.9 +I 31,011,116.00 8,563,600.00
64 AYUNINGSIH 397829 STT UTERI KURET D39.0 69.09 II 4,813,711.00 3,279,100.00
65 YUSTINI 334134 STRUMA HT E04.9 I10 I 2,927,500.00 2,927,500.00
66 NY. WANTIH JD. SUKARI 397654 DKD DCM + FATTY LIVER E13.2 I42.0 + K76.0 II 6,520,066.00 4,123,300.00
67 SITIMASITOH 323889 AB. INKOMPLIT KURET O05.4 69.02 II 4,577,331.00 3,279,100.00
68 Sit Sopiah 314598 AB. INKOMPLIT KURET O05.4 69.02 II 4,378,098.00 3,279,100.00
69 NURAENI 311043 AB. INKOMPLIT KURET O05.4 69.02 II 4,311,942.00 3,279,100.00
70 SITI SUHARTINI 383955 GERIATRI R54 I 3,346,579.00 6,042,200.00
71 ENIH SUHAENIH 397642 GASRTIRIS EROSI CYSTITIS AKUT K21.9 N30.9 III 5,172,734.00 3,141,300.00
72 AZHAR SEPTIANLILAH 397651 TB PARU A16.2 II 5,004,900.00 5,004,900.00
73 AYYASH MUHAMMAD AL397820 TB PARU ISPA A16.2 J06.9 I 2,409,627.00 5,839,000.00
74 DEPIOKTAPIANIIBRAHI 397849 FAM EKSISI D24 85.24 II 7,117,074.00 6,118,200.00
75 YUNIKEU DIANA SARI 397800 PARONIKIA ROZER PLASTY L03.0 86.27 I 8,794,418.00 3,267,100.00
76 alexandru 397626 BRONCHOPNEUMTB PARU + ANEMIA J18.0 A16.2 + D64.9 II 4,877,150.00 5,860,100.00
77 IIN ROHIDIN 384102 TB PARU PPOK + DCM + DC + ISK A16.2 J44.9 + I42.0 + I51.9 + N39.0 I 5,715,845.00 6,976,000.00
78 NENG DEDEH KURNIAS 360204 TUMOR INTRA A ANEMIA RESECTION TUMORD36.7 D64.9 83.49 II 19,219,901.00 11,727,100.00
79 ENDANG KURNIAWAN 397655 FRAKTUR WRIST JOINT CRIF S62.8 79.12 II 10,584,569.00 6,233,600.00
80 ANENGSIH 391101 TTH HT G44.2 I10 III 2,122,661.00 1,554,900.00
81 IKIN SODIKIN 333591 EPILEPSI SIMPTOMATIK EC ARACHNOID CYST G93.0 G40.8 I 7,886,958.00 3,791,000.00
82 SARTIKA DEWI 334481 TYPHOID FEVER ANEMIA A01.0 D64.9 II 5,085,706.00 4,282,400.00
83 ade heryat 397456 PERIAPPENDICULAR LE + APPENDECTOMK37 54.11 + 47.09 I 11,600,942.00 7,947,700.00
84 h. saepulloh bin h. syar 397695 TUMOR KULIT EKSISI D23.9 83.39 II 7,822,221.00 5,845,600.00
85 DEDE AHMAD YANI 397807 STT FEMUR EKSISI D48.0 83.39 II 7,310,683.00 5,845,600.00
86 elis herawat 397812 LIPOMA EKSISI D17.9 83.39 III 6,007,397.00 4,871,300.00
87 ISMALIA AGUSTIN 309347 HEMMOROID HEMMOROIDECTOMI84.9 49.46 II 8,525,745.00 5,225,100.00
88 YUDA ADITYA PERMAN 397787 TYPHOID FEVER TB PARU A01.0 A16.2 II 2,269,873.00 4,282,400.00
89 ENA RAHMAWATI 331717 DMT2 VIRAL INFECTION E11.7 B34.9 I 1,130,863.00 3,257,200.00
90 TITIN K 354536 ASMA GASTRITIS J45.9 K29.1 II 888,769.00 2,812,500.00
91 ADE BINTI SUBRI 379230 URETROLITHIASIS ESWL N20.9 98.51 III 8,083,155.00 10,090,500.00
92 hj neneh suhartni 396984 NEFROLITHIASIS ESWL N20.0 98.51 II 8,367,380.00 12,108,700.00
93 YUNENGSIH 373261 NEFROLITHIASIS ESWL N20.0 98.51 II 8,367,380.00 12,108,700.00
94 DWIANIPERMATASARI 397712 ABSES MANDIBULLA INSISI L02.4 40 II 6,825,454.00 4,242,600.00
95 diana nurul latfah 347918 MUCOCELE LABIA EKSISI D10.0 27.43 III 2,517,590.00 4,051,400.00
96 WARSAD 397644 TB PARU ANEMIA + CKD A16.2 D64.9 + N18.9 I 10,413,201.00 6,976,000.00
97 lilis mulyani 397200 NEFROLITHIASIS ESWL N20.0 98.51 III 8,030,896.00 10,090,500.00
98Muhammad Rafka Irawan338318 TYPHOID FEVER TB PARU A01.0 A16.2 II 2,245,124.00 4,282,400.00
99 ESIH sulastri 393929 OBSTRUKTIF JAUNDICE K83.1 II 2,540,477.00 2,800,200.00
100 Surya Asfi Syahputra 319007 TYPHOID FEVER ISPA A01.0 J06.9 I 1,653,224.00 3,884,300.00
101 SRI KOMALASARI 397699 CYSTA OVARI LAPARATOMY N83.2 54.19 II 11,731,800.00 6,812,300.00
102 WESIH 397641 TYPHOID FEVER HT A01.0 I10 I 7,949,315.00 3,884,300.00
103 SAROHA HASIBUAN 378696 LBP INJ FACET JOINT M54.5 II 2,164,277.00 2,324,900.00
104 ENI ROHAYANI, NY. HJ. 335563 SPONDILOPATHY LUMBAR INJ bursa M48.96 83.96 I 2,801,204.00 2,712,300.00
105 MAESAROH 390412 SPONDILOPATHY LUMBAR INJ BLOK FACET JOI M48.96 81.92 I 3,397,933.00 2,712,300.00
106 ANDI 391354 NEFROLITHIASIS ESWL N20.0 98.51 III 8,082,213.00 10,090,500.00
107 AME ROHANI 336625 CAP SEPSIS + SIROSIS + HEPATOMEGALI J18.9 A41.9 + K74.6 + R16.0 I 26,287,291.00 11,315,600.00
108 MICHEL LAIPENY 357209 FRAKTUR FEMUR REMOVE IMPLANT S72.8 78.65 III 12,427,382.00 2,956,700.00
109 GINANJAR INDRA LAKS 361295 DENGUE FEVER A90 I 2,720,200.00 2,720,200.00
110 ENCEP SUGANDA 379564 CAD CAP +HT + HHD I25.1 J18.9 + I11.0 I 5,419,700.00 5,419,700.00
111 TATI RUBIATI 376354 SPONDILOPATHY LUMBAR INJ BLOK FACET JOI M48.96 81.92 III 1,663,758.00 1,937,400.00
112 DEDE SUMNI 397364 MYOMA TIDAK JAD ANEMIA Z53.0 D64.9 II 2,947,637.00 2,942,600.00
113 YATI 397475 CYSTA OVARI DMT2 LAPARATOMY N83.2 E11.6 II 11,785,396.00 7,819,200.00
114 SULTAN NOVIANA 396987 FRAKTUR FEMUR REFRAKTURASI + ORS72.9 78.70 + 79.35 III 16,752,748.00 9,309,600.00
115 Sari Nurheni 397943 GEA A09 II 2,466,416.00 2,423,100.00
116 TITIN K 354536 UNSTEABLE ANGI URTI I20.0 J06.9 II 3,304,093.00 3,865,000.00
117 jojo sudarjo NEFROLITHIASIS N20.0 III 2,960,647.00 2,053,600.00
118 ANDRIANI UNLARU 333571 CA THYROID TOTAL THYROIDECT C73 6.4 II 10,226,550.00 5,747,900.00
119 bunga ayu salsabila 390783 HEP A KOMA HEP TB PARU + ISPA B15.0 A16.2 + J06.9 II 8,950,785.00 4,238,500.00
120 SURAHMAN, DRS 397895 DYSPEPSIA FATTY LIVER K30 K76.0 I 5,245,830.00 5,837,000.00
121 LUSY KOMALA JULINAN 397925 DHF A91 II 2,651,507.00 2,331,600.00
122 juju juaeni 379264 NEFROLITHIASIS ESWL N20.0 98.51 II 7,971,375.00 12,108,700.00
123 WARDI 389628 URETROLITHIASIS ESWL N20.9 98.51 III 7,809,375.00 10,090,500.00
124 ENDAH ROSILAWATI 394961 CTS TENOSYNOVITIS INJ G56.0 M77.98 II 2,009,418.00 3,102,100.00
125 OPID 337899 MEATAL STENOSIS MEATOTOMY + AFF N35.9 56.1 + 97.65 I 20,469,159.00 14,126,800.00
126 FATIMATU JAHRO 397153 KISTA EKSISI K09.8 83.39 III 8,154,141.00 4,871,300.00
127 tjah 396878 STENOSIS URETER MEATOTOMY + LITOT N35.9 56.1 + 56.0 I 21,711,639.00 14,126,800.00
128 ATIM 360726 MEATAL STENOSIS MEATOTOMY + UREN35.9 56.1 + 58.22 II 16,956,811.00 12,108,700.00
129 H. BADRUDIN 393639 NEFROLITHIASIS ESWL N20.0 98.51 III 7,809,375.00 10,090,500.00
130 AZZAHRA NAIPAS 333263 TYPHOID FEVER TB PARU A01.0 A16.2 II 3,164,357.00 4,282,400.00
131 AHMAD HAMDAN 397933 NEFROLITHIASIS ESWL N20.0 98.51 III 10,020,484.00 10,090,500.00
132 AZWAR 398131 DC HT + SUSP PPOK + AMI I51.9 I10 + J44.9 + I21.9 II 1,478,790.00 6,285,700.00
133 DARPI 382215 DC PPOK +PNEUMONIA I51.9 J44.9 + J18.9 III 2,899,492.00 7,572,000.00
134 aprilia putri 398056 BRONCHOPNEUMTB PARU J18.0 A16.2 II 3,503,071.00 4,170,100.00
135 ELY SULAEMAN 397737 DC HHD + CH dg ASCITES, HYPOALBUMINEMIA I51.9 I11.9 + K73.8 + R18 + E88.0 + NII 5,903,295.00 8,696,500.00
136 JAJANG RIDWAN 396482 HIL HERNIORAPHY K40.9 53.29 III 8,325,573.00 3,569,900.00
137 KARTA 396994 ABSES EKSISI L02.9 83.39 II 9,657,036.00 5,845,600.00
138 rahmawat 393028 BRONCHOPNEUMDADRS + CMPA + PERIANAL RASH J18.0 A09 + T88.7 + L22 II 5,970,830.00 5,860,100.00
139 windi gustani 397010 FAM EKSISI D24 85.24 II 10,026,192.00 6,118,200.00
140 WINARNO 379331 STEMI DMT2 + SYNCOPE I21.3 E11.6 + R55 II 12,800,653.00 7,594,300.00
141 cahaya ratu arum 370895 BRONCHOPNEUMONIA J18.0 I 5,843,482.00 4,865,100.00
142 SRI HERAWATI 397139 CTS INJ BLOK SARAF PERG56.0 4.8 II 1,998,239.00 3,102,100.00
143 AMAH NURHASANAH 389495 TENDINOSIS SHOULDER INJ TENDON SHEAT M75.8 83.97 II 1,848,929.00 1,857,000.00
144 RUMINAH 395078 NEURITIS INJ FASCIA M79.21 83.98 III 1,276,894.00 2,585,100.00
145 SITI PATIMAH 356941 TENDINOSIS SHOULDER INJ TENDON SHEAT M75.8 83.97 + 83.98 III 1,482,023.00 1,547,500.00
146 Indah Firiani 398031 BRONCHOPNEUMTB PARU + TYPHOID FEVER J18.0 A16.2 + A01.0 II 2,348,827.00 9,699,100.00
147 DIAH SUKAEsih 391595 LYMPHADENOPATH NEFROLITHISIS + PID A18.2 N20.0 + N73.9 I 7,147,459.00 5,012,300.00
148 ENAR 397990 HHD PPOK + HT I11.0 J44.9 II 3,581,336.00 5,179,100.00
149 Ellya Rakhmandari 370207 TYPHOID FEVER A01.0 II 2,420,886.00 3,329,400.00
150 FAZRIN MAULANA FIRD 397927 BRONCHITIS TYPHOID FEVER J20.9 A01.0 III 3,199,197.00 4,447,200.00
151 RAKA HERMAWAN 398030 BRONCHOPNEUMONIA J18.0 II 2,755,904.00 4,170,100.00
152 AVI NOOR AVIFAH 361810 TYPHOID FEVER A01.0 II 2,833,735.00 3,329,400.00
153 HERMAN SUPANDI 347039 PNC CYST GINJAL + NEFROLESWL N11.1 N28.1 + N20.0 + 98.51 II 7,564,102.00 13,705,200.00
154 M. ARYA RIZKI SETYA P 378643 TYPHOID FEVER FARIGITIS A01.0 J02.9 II 2,496,216.00 3,329,400.00
155 H. ATMA 397441 TB PARU SD A16.2 K30 I 5,839,000.00 5,839,000.00
156 LUSE ADNAN SAMSUL 398191 STT EKSISI D48.1 83.39 I 6,172,949.00 6,819,800.00
157 RESHA FEBRIAN MAUL 398087 TYPHOID FEVER TB PARU A01.0 A16.2 II 1,793,706.00 4,282,400.00
158 abbad fathurokhman 374708 BRONCHOPNEUMONIA J18.0 II 6,877,197.00 4,170,100.00
159 sutsna saputra 337992 FRAKTUR FEMUR ANEMIA ORIF S72.9 D64.9 79.35 II 19,243,642.00 15,671,500.00
160 rasya fauzy 396376 BRONCHOPNEUMONIA J18.0 II 2,925,153.00 4,170,100.00
161 EGA NURAzIzAH 397796 FAM EKSISI N60.9 85.24 III 6,297,484.00 5,098,500.00
162 Ryan Fujiana 376699 STT EKSISI D48.1 83.39 II 6,985,722.00 5,845,600.00
163 MUHYI 388766 HT I10 II 10,809,057.00 5,004,900.00
164 NOVIHIDAYAT 319043 TYPHOID FEVER UTI A01.0 N39.0 II 2,604,610.00 4,282,400.00
165 ROHIMAH 397251 HYDRONEFROSIS URETROLITHISIS ESWL N13.3 N20.9 98.51 I 7,700,966.00 14,126,800.00
166 NINING YUNINGSIH 382556 HYDRONEFROSIS URETROLITHISIS ESWL N13.3 N20.9 98.51 II 7,497,614.00 12,108,700.00
167 LISMANITA 398204 AB. INKOMPLIT KURET O05.4 69.02 III 4,249,198.00 2,732,600.00
168 DINI LISNAWATI 398083 VIRAL INFECTION B34.9 II 2,780,021.00 2,331,600.00
169 TRI BUDIYANTO 388488 HT DYSPEPSIA + ANEMIA I10 K30 + D64.9 II 4,125,413.00 5,179,100.00
170 MUSTARI 397181 FRAKTUR FEMUR ORIF S72.9 79.35 III 12,370,013.00 9,309,600.00
171 ELON DACHLAN 397685 NEFROLITHIASIS BPH + UTI + HT ESWL N20.0 N40 + N39.0 + I 98.51 II 7,218,821.00 13,705,200.00
172 elis herawat 397812 HT I10 III 3,064,402.00 3,183,700.00
173 NITA NOVITA 381846 EMPIEMA ASPIRATION PLEUR J86.9 34.91 III 998,519.00 4,170,700.00
174 JEJEN JAENAL MUTTAQ 388003 VESICOLITHISIS HYDRONEFROSIS ESWL N21.0 N13.3 98.51 I 7,655,444.00 15,989,400.00
175 SITI NUR AZIZAH 397966 TONSIL HYPERTROPI TONSILEKTOMI + C J35.1 28.2 + 29.99 II 8,341,433.00 5,713,700.00
176 MAMAN HAMDANI 396316 BATU PYELUM HYDRONEFROSIS ESWL N21.0 N13.3 98.51 II 7,237,029.00 13,705,200.00
177 H. DIDI MARZUKI 397998 ISKEMIK CAD + AMI I24.9 I25.1 + I21.9 II 5,902,200.00 5,902,200.00
178 RENI INTANSARI 398107 DENGUE FEVER A90 III 2,438,074.00 1,943,000.00
179 DEDEN NURJAMAL 397936 TONSIL HYPERTROGRANUL PHARYNGITISTONSILEKTOMI + C J35.1 J31.2 28.2 + 29.99 III 7,234,215.00 4,761,400.00
180 ajeng oktaviani 397851 BRONCHOPNEUMTB PARU + TYPHOID FEVER J18.0 A16.2 + A01.0 III 8,888,729.00 8,082,600.00
181 YATI SURYATI 369631 LYMPHADENOPATHY BIOPSI I88.9 40.11 I 8,314,641.00 4,949,700.00
182 hiskia vano 398163 TYPHOID FEVER ANEMIA A01.0 D64.9 II 2,146,020.00 4,282,400.00
183 MASNA 398092 DYSPEPSIA DMT2 + AKI + DEHIDRASI K30 E74.8 + E86 II 4,605,408.00 5,003,200.00
184 SUYATMI 369694 NEFROLITHIASIS CKD PYELONEFROTOMY N20.0 N18.0 55.11 II 25,477,021.00 13,705,200.00
185 RIZKI RAHMAT ILAHI 398125 TYPHOID FEVER DENGUE FEVER A01.0 A90 I 2,720,200.00 4,996,100.00
186 TITA ROSITA 398161 TUMOR SUBMANDIBULLA EKSISI D11.7 83.39 III 7,688,205.00 4,871,300.00
187 mimbar hakim drajat 398167 ABSES EXPLORASIL02.9 83.09 III 5,680,556.00 4,871,300.00
188 BANGKIT SYABARUDIN 398266 TYPHOID FEVER DENGUE FEVER A01.0 A90 II 2,368,003.00 3,329,400.00
189 Ervina Sirait 398219 VIRAL INFECTION HYPOKALCEMIA B34.9 E83.5 II 2,791,900.00 2,791,900.00
190 HUSEN IRAWAN 398110 TB PARU A16.2 II 3,914,258.00 5,004,900.00
191 DIANA PUTRI ANGGRAE 398222 BRONCHOPNEUMONIA J18.0 II 2,907,024.00 4,170,100.00
192 LISTINA BELLA SAFITRI 321951 KISTA MUCOCELE LIDAH EKSISI D10.3 25.2 II 2,827,190.00 4,861,600.00
193 EUISSUGIHARTI 375742 FASCIITIS INJ FASCIA M72.9 83.98 II 1,615,807.00 1,857,000.00
194 dilla allisya putri 398156 STT TELINGA EKSISI D48.5 83.39 I 8,529,367.00 6,819,800.00
195 WINDY RISMAWANTI 396773 TONSIL HYPERTROPI TONSILEKTOMI + C J35.1 28.2 + 29.99 II 7,997,105.00 5,713,700.00
196 ILHAM FAUZI AZHARI 397704 HIL HERNIORRHAPY K40.9 53.29 II 9,693,413.00 4,283,900.00
197 MAPTUH 398361 HT AMI ANTERO SEPTAL I10 I21.2 II 4,582,047.00 6,285,700.00
198 OYOK AENU MARDIYAH 385607 CKR JATUH KAMAR MANDI S09.9 W18 I 2,569,178.00 3,892,700.00
199 ICA ROHYANI 397453 TUMOR MANDIBULA EKSISI D10.3 83.39 II 8,873,872.00 5,845,600.00
200 Eko Nugraha, A.Md.Kep 451559 KOLIK ABDOMEN R10.4 II 715,455.00 2,423,100.00
201 kevin raditya pratama 376435 PERDARAHAN INTSTATUS EPILEPTIKUS + BP + DADRS + ANE P10.9 G41.9 + P23.9 + A09 + P61.4 III 22,468,854.00 3,220,600.00
202 JASMINE ZAHRA QONIT 379529 BRONCHOPNEUMTB PARU + ANEMIA J18.0 A16.2 + D64.9 II 3,806,942.00 5,860,100.00
203 ABDULLOH 369500 POST ORIF FRAKTUR HUMERUS REMOVE IMPLANT Z41.7 S42.3 78.62 II 12,493,485.00 3,548,000.00
204 Nani Mintarsih 394137 CHOLELITHIASIS CHOLECYSTECTOMYK80.8 51.22 II 12,062,022.00 6,481,200.00
205 JANWARIYADI 398230 MUCOCELE LABIA MUCOCELECTOMY D10.0 27.43 II 7,891,600.00 4,861,600.00
206 nurhasanah 396857 GANGLION EKSISI M67.4 83.39 II 7,109,369.00 5,845,600.00
207 SURATMIN 391473 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 II 7,650,275.00 13,705,200.00
208 H. HASANUDIN BIN RA 397940 HIL HERNIORHAPHY K40.9 53.29 I 11,728,117.00 4,997,900.00
209 SARWAN 397947 HIL HERNIORHAPHY K40.9 53.29 III 8,328,919.00 3,569,900.00
210 HERA GUNAWAN 398343 TYPHOID FEVER BRONCHOPNEUMONIA A01.0 J18.0 II 2,386,340.00 4,906,600.00
211 DESI PUTRIANA 319469 FAM BE D24 85.24 II 7,192,184.00 6,118,200.00
212 JUL DEARNI SINA GA 362443 LETSU PARTUS SC SCTP O32.9 O82.9 74.1 II 8,724,605.00 4,826,600.00
213 OMA PARTINI 380280 NEFROLITHIASIS ESWL N20.0 98.51 III 7,280,896.00 10,090,500.00
214 NUNUNG HASANAH 398057 STROKE INFARK HT + DMT2 I63.9 I10 + E11.7 III 7,965,410.00 5,330,900.00
215 DIMIN 393567 DYSPEPSIA HT + DMT2 K30 I10 + E11.7 I 4,621,730.00 5,837,000.00
216 VENEZYA BEIBYNA AZRA 325592 TB PARU TYPHOID FEVER A16.2 A01.0 I 8,815,412.00 9,269,700.00
217 RAFA AL KHAFIDI FAUZI 385618 BRONCHOPNEUMTB PARU J18.0 A16.2 II 4,170,100.00 4,170,100.00
218 HARUN MAULANA 335297 NEURALGIA PARSTHETICA INJ B02.2 + G53.0 II 2,439,522.00 3,117,600.00
219 RAHMAT 396852 TENDINOSIS SHO SEQ. STROKE INJ M75.8 I69.3 II 2,236,340.00 1,857,000.00
220 ROKAYAH 386767 BURSITIS INJ M71.99 III 1,798,781.00 1,547,500.00
221 hj kanah 395189 CTS INJ BLOK SARAF PERG56.0 4.8 II 1,619,287.00 3,102,100.00
222 ADE WARSINI SULISTIA 398296 NEUROPATHY DM E14.4 I 3,619,200.00 3,619,200.00
223 DEDEH 392707 NEFROLITHIASIS ESWL N20.0 98.51 III 7,920,070.00 10,090,500.00
224 SOMA SOMANTRI, DRS 380651 NEFROLITHISIS ESWL N20.0 98.51 I 8,347,900.00 14,126,800.00
225 A. MAKSUM 393474 NEFROLITHIASIS ESWL N20.0 98.51 III 7,920,070.00 10,090,500.00
226 ROSIDAH 329508 NEFROLITHIASIS ESWL N20.0 98.51 II 8,117,057.00 12,108,700.00
227 UDIN TARUDIN 394502 NEFROLITHIASIS ESWL N20.0 98.51 I 8,440,398.00 14,126,800.00
228 YANA 397137 NEFROLITHIASIS ESWL N20.0 98.51 II 8,341,494.00 12,108,700.00
229 Akmal Adzikri Kusmaya 359180 BRONCHOPNEUMONIA J18.0 II 4,032,991.00 4,170,100.00
230 bayi ny. juldaerni sinag 398299 LAHIR SC P03.4 II 1,546,394.00 1,995,800.00
231 muhamad ramdan 391935 BRONCHOPNEUMTB PARU J18.0 A16.2 II 4,179,326.00 4,170,100.00
232 SUGIARTI 392797 TTH HT + TB PARU G44.2 I10 + A16.2 II 2,252,370.00 2,327,700.00
233 NYAI ROHANAH 364193 EVANS SYNDR CYST OVRIUM D69.3 N83.2 II 5,483,057.00 2,325,700.00
234 H SUKRIA 375599 VERTIGO PERIFERTB PARU H81.3 A16.2 III 4,244,320.00 2,325,600.00
235 alzena shafa dano 398336 BRONCHOPNEUMANEMIA J18.0 D64.9 I 5,237,405.00 6,836,700.00
236 HJ CICIH NURJANAH 383517 CRF DMT2 + TB PARU + EFUSI PLEURA N18.9 E13.2+ A16.2 + J90 I 7,718,058.00 7,415,200.00
237 enes bt lubar 395010 CA COLON RECTALTB PARU C19 A16.2 II 5,243,981.00 5,116,400.00
238 MIRA TANIA NURBAETI 398035 BO KURET O02.0 69.09 II 4,591,066.00 3,279,100.00
239 NITA RENITA MULYAWAT391658 MYOM UTERI ANEMIA LAPARATOMY D25.9 D64.9 54.19 I 14,758,882.00 9,122,400.00
240 RINA HANDAYANI 384952 DC PPOK + FARINGITIS I51.9 J44.9 + J02.9 I 3,642,376.00 8,810,000.00
241 mirawat sunardi 398534 AB. INKOMPLIT ANEMIA KURET O05.4 D64.9 69.02 III 5,060,209.00 4,804,200.00
242 ABDUR ROUF 386687 THALASEMIA TB PARU D56.9 A16.2 III 1,248,056.00 2,325,800.00
243 ENDANG SUHENDAR, T 380770 CKR JATUH DARI MOTOR CT SCAN S09.9 V28.9 87.03 I 6,647,771.00 3,892,700.00
244 RASJA 398327 DHF A91 II 2,919,303.00 2,331,600.00
245 UTJUP HIDAYAT 382614 HT UNSTEABLE ANGINA+ HYPOALKALCEMIA I10 I20.0 + E83.5 II 5,287,884.00 5,179,100.00
246 ADE BINTI SUBRI, NY 379230 STENOSIS URETER URETERAL MEATOTON35.9 56.1 + 97.65 III 15,025,025.00 10,090,500.00
247 H MA'MUN MULYANA 392562 STROKE PIS HT I61.9 I10 I 19,131,361.00 3,029,700.00
248 ENNAY RUCHIYATI 397972 NEFROLITHIASIS ESWL N20.0 98.51 I 8,604,270.00 15,989,400.00
249 DEVIA ASLA BILLA 398267 PERIAPPENDICULAR LE + APPENDECTOMK37 54.11 + 47.09 II 12,406,700.00 6,812,300.00
250 CUCU NURHASANAH 357296 TYPHOID FEVER A01.0 I 3,884,300.00 3,884,300.00
251 IKEU BAHTIAR 398583 BRONCHITIS ALERGI J45.9 I 2,173,300.00 2,173,300.00
252 AGUNG NUGRAHA 396063 DHF A91 III 1,040,780.00 1,943,000.00
253 EMMA SARIFA 383225 PYRIFORMIS SYNDARTROPHATY INJ BLOK SARAF ISC M62.88 M13.9 4.8 II 1,878,537.00 1,857,000.00
254 TATANG 397009 SPONDILOPATHY LUMBAR INJ FACET BLOK LU M48.96 3.92 II 2,404,669.00 2,324,900.00
255 Besar Hidayat Atmojo 344397 HIL HERNIORHAPHY K40.9 53.29 I 13,135,091.00 4,997,900.00
256 WATI SUSILAWATI 398181 HT UNSTEABLE ANGINA+ HYPOALKALCEMIA +I10 I20.0 + E83.5 + M81.98 I 4,710,858.00 6,042,200.00
257 JENAL ABIDIN 319228 HIL HERNIORHAPHY K40.9 53.29 III 9,782,008.00 3,569,900.00
258 U N I 398272 TB PARU CAP + ANEMIA A16.2 J18.9 + D64.9 II 4,857,512.00 5,979,400.00
259 SARAHNAFISAHROSADI 398538 TYPHOID FEVER TB PARU A01.0 A16.2 II 2,420,851.00 4,282,400.00
260 USNAP 398363 VESICOLITHISIS LITOTRIPSI N21.0 57 III 14,763,358.00 6,172,400.00
261 DEDE SUMNI 397364 CYST CHOCOLATE ANEMIA LAPARATOMY N80.1 D64.9 54.19 II 13,600,544.00 7,819,200.00
262 TUTI 383172 GAMELLY PARTUS SC SCTP O30.0 O82.9 74.1 I 6,902,648.00 5,631,000.00
263 MANIH 396961 CYST OVARI LAPARATOMY N83.2 54.19 III 9,116,774.00 5,677,000.00
264 SUMARNI 390956 PARTUS SPONTAN O80.9 II 2,416,400.00 2,416,400.00
265 meyshiana syahila naw 398283 DRUG ERUPTION ISPA + ANEMIA L27.0 + Y40J06.9 + D64.9 II 5,440,861.00 2,794,700.00
266 NIna Herlina 310614 GERD K21.9 I 2,717,800.00 2,172,800.00
267 DADAN RAMDANI 393612 CYSTA EYE EKSISI H57.8 I69.3 III 5,720,330.00 4,144,900.00
268 tama 397985 CAUDA EQUINA PAIN LUMBAR INJ BLOK SARAF PERG83.4 M54.5 4.8 III 1,425,820.00 2,585,100.00
269 SURTINAH 386922 EFFUSI PLEURA PUNGSI PLEURA J90 34.91 II 1,462,730.00 3,264,000.00
270 FARHANKHAFABI 324358 BRONKIOLITIS J21.9 II 2,359,506.00 1,862,800.00
271 WIDADRAIHANA 398465 DHF A91 II 4,089,561.00 2,331,600.00
272 solihat 398477 MELENA ANEMIA K92.1 D64.9 I 6,695,164.00 5,837,000.00
273 TIGA HARA SIREGAR BT 330128 SISA KEHAMILAN KURET O94 69.09 II 4,612,781.00 3,279,100.00
274 M. YUSUP 398276 PPOK J44.9 II 3,701,865.00 2,878,100.00
275 ANENDAR 398579 STT FEMUR EKSISI D48.0 83.39 II 9,132,113.00 5,845,600.00
276 ayi mamun 398115 STT EKSISI D48.1 83.39 III 7,422,905.00 4,871,300.00
277 R WAHYUNINGSIH 390346 CA MAMAE ANEMIA C50.0 D63.0 I 3,147,319.00 4,225,500.00
278 FITRI RIA DEPI 398576 TYPHOID FEVER A01.0 I 4,095,703.00 3,884,300.00
279 SUKADIS GANDHI. S, B 302074 HIL HERNIORHAPHY K40.9 53.29 I 11,931,936.00 4,997,900.00
280 Nazwa Khoerunnisa Ku 341511 TYPHOID FEVER KP A01.0 A16.2 II 2,835,898.00 3,329,400.00
281 merisa wilma ks 398685 UAP I20.0 I 2,229,303.00 4,509,100.00
282 APONG JUNIAWATI 398588 VIRAL INFECTION B34.9 I 3,568,849.00 2,720,200.00
283 KARWATI 338161 RETENSIO PLASENTA KURET O72.0 69.09 II 5,638,487.00 2,458,000.00
284 muhammad andrea nug 398623 BRONCHOPNEUMONIA J18.0 II 2,180,413.00 4,170,100.00
285 EUIS ROSDIANA 357387 ULKUS DM EKSISI E14.5 86.3 III 8,928,386.00 3,274,200.00
286 SRI ASTUTI 394570 DC HHD + BRONCHITIS KRONIS I11.9 J31.2 + I50.9 II 4,216,655.00 5,179,100.00
287 SHIFASOLIHAT 398721 EKLAMPSIA PARTUS SPONTAN O14.0 O80.9 II 3,859,574.00 3,346,400.00
288 KARYONO BIN WASLIM 397939 NEFROLITHIASIS ESWL N20.0 98.51 I 8,418,287.00 14,126,800.00
289 karman 395948 NEFROLITHIASIS ESWL N20.0 98.51 II 8,207,057.00 12,108,700.00
290 DASIM PRAMULYANA,D 395662 SPONDILOPATHY LBP INJ FACET JOINT M48.96 M54.5 3.92 I 2,688,537.00 2,712,300.00
291 NANO MULYA SASMITA 398384 STENOSIS URETER URETERAL MEATOTON35.9 56.1 + 59.8 I 14,126,800.00 14,126,800.00
292 Nurlaela, A.Md.Kep 350186 HEG O21.0 II 1,901,115.00 2,502,400.00
294 rizki oktafiyani 398419 TONSIL HYPERTROFARINGITIS KRONIS TONSILEKTOMI + C J35.1 J31.2 28.2 + 29.99 II 7,788,427.00 5,713,700.00
295 miftahul fadli 398731 FISTULA ANI FISTULECTOMY K60.3 49.12 III 5,818,023.00 4,354,200.00
296 NINA HELTINA 398736 FAM EKSISI D24 85.24 II 7,644,183.00 6,118,200.00
297 TAHMID 398747 FAM FEMUR EKSISI D48.0 83.39 III 5,879,477.00 4,871,300.00
298 D.SUDRAZAT 396873 OA GENU BURSITIS INJ M19.97 M71.57 I 2,431,056.00 2,905,500.00
299 SARKUM 390964 NEFROLITHIASIS ESWL N20.0 98.51 II 7,458,420.00 12,108,700.00
300 ISO 398546 HT SUSP KP I10 A16.9 II 676,683.00 3,820,400.00
301 NURAENI 398321 APP AKUT APPENDECTOMY K35.9 47.09 II 9,365,946.00 3,416,000.00
302 DEWI SRI RAHAYU 398245 LBP INJ FACET JOINT M54.59 3.92 II 1,845,666.00 2,324,900.00
303 USEP SAPTUMI 392930 TB PARU DC-HHD + DYSPEPSIA + DM A16.2 I11.9 + K30 + E11.7 + I51.9 II 3,950,507.00 5,979,400.00
304 SARTIM 397700 BPH TURP N40 60.29 I 17,220,378.00 8,665,300.00
305 emin 397605 BPH TURP N40 60.29 II 19,984,755.00 7,427,400.00
306 dede kusmiyat 398617 GAGAL INDUKSI CPD + ANEMIA + PARTUS SPONTAN O61.0 O33.8 + D64.9 + O80.9 I 13,038,290.00 6,213,800.00
307 neni samiaji 363311 APP AKUT APPENDECTOMY K35.9 47.09 II 10,809,425.00 3,416,000.00
308 OYONG SUWARTI 398828 ABSES MAMAE EKSISI N61 85.24 II 7,047,381.00 6,118,200.00
309 MUHAMMADSYAHRUL 393048 TYPHOID FEVER ANEMIA A01.0 D64.9 II 2,414,228.00 4,282,400.00
310 MUMUN 387753 HT ESRD I10 N18.9 II 5,604,357.00 5,179,900.00
311 DIAN DIANA 398724 TYPHOID FEVER A01.0 II 2,272,996.00 3,329,400.00
312 Rega Haerunnisa 398260 GRANULOMA PHATONSILITIS HYPERTYROEKSISI GRANULOMAJ39.2 J35.1 29.99 + 28.2 II 7,942,787.00 5,713,700.00
313 muhammad rasyad a 398427 BRONCHOPNEUMTB PARU + DIARE J18.0 A16.2 + A09 I 4,865,100.00 4,865,100.00
314 ADE SETIAWAN 386938 NEFROLITHIASIS URETROLITHISIS + HY ESWL N20.0 N20.9 + N13.3 98.51 II 7,968,505.00 13,705,200.00
315 euis suhyat 389101 NEFROLITHIASIS ESWL N20.0 98.51 II 7,653,797.00 12,108,700.00
316 KARSIMAH 353354 NEFROLITHIASIS ESWL N20.0 98.51 III 7,280,896.00 10,090,500.00
317 asep saepudin 398271 URETROLITHIASISHYDRONEFROSIS ESWL N20.9 N13.3 98.51 II 7,480,105.00 13,705,200.00
318 NONI SUSANTI 398890 BO KURET O02.0 69.09 II 4,661,612.00 3,279,100.00
319 ERIC SUKARNO H, TN 380371 UAP DMT2 I20.0 E11.6 I 7,055,576.00 5,182,000.00
320 NAIREM 398699 GRAVIS DISEASE E05.1 III 1,598,477.00 2,091,100.00
321 ENJANG SURYANA 398657 TB PARU A16.2 I 7,950,622.00 5,839,000.00
322 SOMA SOMANTRI, DRS 380651 NEFROLITHIASIS ESWL N20.0 98.51 I 8,493,160.00 14,126,800.00
323 HASANUDIN 398771 FARINGITIS KRONITONSILITIS HYPERTROPCOUTER PHARYNG +J31.2 + J35.2 29.99 + 28.2 II 7,369,273.00 5,713,700.00
324 muhamad zaky munand 398543 BRONCHOPNEUMTB PARU J18.0 A16.2 II 6,953,270.00 5,860,100.00
325 tjah yuliant pertwi 398621 TYPHOID FEVER BRONCHITIS KRONIS A01.0 J41.0 II 2,088,986.00 3,329,400.00
326 IIM 398478 CYST OVARI LAPARATOMY N83.2 54.19 II 10,570,662.00 6,812,300.00
327 raisha aqila 398720 DIARE A09 II 2,827,669.00 2,423,100.00
328 NERLIS NURHAYATIN 398368 NEFROLITHIASIS ESWL N20.0 98.51 II 8,139,130.00 12,108,700.00
329 Edi Purwanto 305455 PPOK J44.9 II 2,814,620.00 2,878,100.00
330 NIMAH NOPIANTI 380473 TUMOR TYROID ISHMULOBECTOMY D34 6.39 III 12,332,496.00 4,789,900.00
331 ASIAH HINDAYAH 398282 LEUKEMIA AKUT TYPHOID FEVER C95.9 A01.0 I 11,436,172.00 9,998,800.00
332 yUDI PRAHARA 398889 TYPHOID FEVER A01.0 III 2,270,628.00 2,774,500.00
333 Wendi Rahayu 377134 TYPHOID FEVER A01.0 II 3,368,366.00 3,329,400.00
334 Piyan Sopyan 398791 DYSPEPSIA K30 II 3,691,502.00 3,335,500.00
335 haniya qonita salsabila 384068 TB PARU A16.2 I 2,196,280.00 5,839,000.00
336 khairunisa salsabila ku 385605 DIARE BP A09 J18.0 II 4,015,865.00 3,540,100.00
337 REZKY PUTRA IRHAMI 387557 DIARE KDS + TB PARU A09 R56.8 + A16.2 II 5,932,050.00 3,421,100.00
338 YAYAH HARYATI 378877 HEMMOROID INTERNA HEMMOROIDECTOMI84.2 49.46 III 6,893,760.00 4,354,200.00
339 ISMI PUJI ASTUTI 312107 ABSES FLANK INSISI L02.9 54 II 8,454,419.00 7,225,400.00
340 aisyah handayani 369149 OILIGOHIDRAMNIPARTUS SPONTAN O80.9 I 5,503,196.00 3,336,600.00
341 ANENGSIH 391101 HT VERTIGO I10 R42 III 1,504,161.00 3,183,700.00
342 MUTMAINAH 398925 STT OCCIPITA EKSISI D43.0 83.39 I 9,227,973.00 6,819,800.00
343 DELISHA QAIREEN RA 398564 EPILEPSI IDIOPHACC + ANEMIA G40.9 J00 + D64.9 II 2,087,243.00 2,334,700.00
344 ENCEP SUGANDA 379564 UNSTEABLE ANGI HT I20.0 I10 I 5,182,000.00 5,182,000.00
345 SOLIHIN LESMANA 363621 TYPHOID FEVER A01.0 I 3,884,300.00 3,884,300.00
346 PANDADINATA 398852 UAP DYSPEPSIA I20.0 K30 I 4,509,100.00 4,509,100.00
347 INA DIANA 398713 DHF A91 III 3,189,715.00 1,943,000.00
348 nadysa najla azzahra 398985 DHF ISPA A91 J06.9 II 2,472,656.00 2,331,600.00
349 NENENG YULIANINGSIH 393891 DC- HHD PNEUMONIA + ESRD + ANEMIA + HYPOKAI13.2 J18.9 + D64.9 + E83.5 + E87.5 I 15,092,809.00 6,061,200.00
350 NADA INDAH DIANA 398998 BRONCHOPNEUMONIA J18.0 II 2,160,741.00 4,170,100.00
351 AULIYA SEPTIARA, AN 308011 TYPHOID FEVER BRONCHITIS A01.0 J20.9 II 3,351,316.00 3,329,400.00
352 ETI NURBAETI 397623 CA MAMAE BRONCHITIS RADICAL MASTECT C50.9 85.45 II 15,434,636.00 6,118,200.00
353 Aura Nourida Allya W 362026 KEJANG DEMAM VIRAL INFECTION R56.8 B34.9 I 2,791,332.00 3,257,200.00
354 LIA MARYATUL QIFTIYA 396603 CYST OVARI LAPARATOMY N83.2 54.19 II 12,049,053.00 6,812,300.00
355 TOTO HARYANTO 399058 MULTIPLE VE + FRAKTUR RADIUS + FRAKTUR CLAVICLE T14.9 S52.8 + S42.0 I 2,530,501.00 2,717,700.00
356 Rifdah Zhafirah Arghobi 371294 BACTERIAL INFECTION A49.9 II 3,908,100.00 3,329,400.00
357 JUANA 344394 PARONIKIA ROZERPLASTY L03.0 86.27 II 5,020,184.00 2,800,400.00
358 hj yayah hasanah 361551 PNEUMONIA SEPSIS J18.0 A41.9 I 14,018,676.00 11,315,600.00
359 SALMIN 398902 LIPOMA EKSISI D17.9 83.39 II 6,842,988.00 5,845,600.00
360 RONY SUJAYANA 399035 TETANUS A35 III 3,520,039.00 2,774,500.00
361 SUPARMI 380631 GEA DMT2 A09 E11.6 I 3,443,871.00 3,991,400.00
362 DRA. ETI TARYATI 399041 DENGUE FEVER DMT2 A90 E11.6 I 2,951,352.00 3,257,200.00
363 RISMAYANi 396172 CALCANEUS SPUR INJ CALCANEUS M77.39 81.92 I 2,397,576.00 2,166,600.00
364 MEYDIA ANASYA 399057 BRONCHOPNEUMKP J18.0 A16.2 II 1,936,855.00 4,170,100.00
365 DEDEH NONIH 398835 NEUROPATI TTH + HT + SUSP STROKE INFARK G58.9 G44.2 + I10 + I63.9 II 5,615,610.00 6,914,700.00
366 ZEVANYAAPRILIO 399047 TYPHOID FEVER A01.0 II 1,689,758.00 3,329,400.00
367 SITI ZAHRA NURAENI 312412 TYPHOID FEVER A01.0 I 4,417,238.00 3,884,300.00
368 IYES,hj 372584 OA GENU INJ INTRAARTICULAM19.97 81.92 I 2,172,003.00 2,905,500.00
369 rohimat 399022 ASMA TB PARU J45.9 A16.2 III 3,861,140.00 2,343,800.00
370 CECEP TOLHAH 399021 DYSPEPSIA HT K30 I10 I 3,770,378.00 3,891,400.00
371 SRI YUSMININA WATI 332453 VIRAL INFECTION B34.9 III 2,393,193.00 1,943,000.00
372 SITI SUMINAH 399049 TYPHOID FEVER A01.0 II 2,554,676.00 3,329,400.00
373 ERNA S 396350 EVANS SYNDR D69.4 III 4,360,930.00 1,938,100.00
374 Widianto, A. Md. Kep 342790 TYPHOID FEVER A01.0 II 2,108,782.00 3,329,400.00
375 ICAH AYISAH JD ENO 398990 DIARE A09 II 2,423,100.00 2,423,100.00
376 LILIS ROHAYATI 397705 TENDINOSIS SHOULDER INJ TENDON SHEAT M75.8 83.97 II 1,712,618.00 1,857,000.00
377 DWI CITRA 344899 TENDINOSIS SHO CDH INJ TENDON SHEAT M75.8 G44.0 83.97 II 1,717,269.00 1,857,000.00
378 EKA KURNIA MALIK 392958 OA GENU INJ INTRAARTICULAM19.99 81.92 I 2,181,272.00 2,905,500.00
379 DEWI 321782 DIARE A09 II 2,374,305.00 2,423,100.00
380 SUBUR ARIPIN 399082 HIL HERNIORHAPY K40.9 53.29 II 8,594,313.00 4,283,900.00
381 bety nurbaety 314946 NEFROLITHIASIS ESWL N20.0 98.51 II 8,192,891.00 12,108,700.00
382 SITI SUHARTINI 383955 MASSA INTRA VESDM + HT D30.3 E11.7 + I10 I 8,756,916.00 4,342,500.00
383 SAEFUDIN. A. 398516 BPH TURP N40 60.29 I 23,480,208.00 8,665,300.00
384 NANO MULYA SASMITA 398384 STENOSIS URETERCKD + ISK HD N35.9 N18.9 + N39.0 39.95 I 11,025,402.00 4,342,500.00
385 HM SODIK 381471 LYMPHADENITIS TPPOK FNAB A18.2 J44.9 I 2,227,919.00 2,623,000.00
386 EMI TRIAS YUNIWATI 323279 AB. IMMINENS O20.0 II 2,728,998.00 1,677,400.00
387 WARYA AYUT 398373 DIVERTIKEL BULI DIVERTIKULECTOMYN32.3 57.59 III 17,477,805.00 5,912,900.00
388 gautama thufail tsabit 392869 BRONCHOPNEUMLARYNGOMALACIA J18.0 Q31.5 II 4,980,936.00 5,860,100.00
389 SEPTI EMIANI 399069 KOLIK ABDOMEN R10.4 I 2,827,100.00 2,827,100.00
390 NENENG HADIATI, NY 390865 EFFUSI PLEURA PUNGSI PLEURA J90 34.91 I 1,785,910.00 3,808,000.00
391 ENTJEP SUDRAJAT 398760 HIL HERNIORHAPY K40.9 53.29 I 12,753,524.00 4,997,900.00
392 SALI 399092 ABSES DEBRIDEMENT L02.9 86.3 III 5,718,138.00 3,274,200.00
393 MULYATI 397703 NEFROLITHIASIS URS + INSERSI STENN20.0 58.22 + 59.8 III 15,530,068.00 2,053,600.00
394 salman rizky fauzan 355579 BRONCHOPNEUMANEMIA J18.0 D64.9 III 2,577,794.00 4,883,400.00
395 sit khodizah 397989 BRONCHOPNEUMANEMIA J18.0 D64.9 III 3,101,347.00 4,883,400.00
396 ARDAN JAENARI 398970 TYPHOID FEVER A01.0 III 3,137,145.00 2,774,500.00
397 arya hidayat 359622 TYPHOID FEVER TB PARU A01.0 A16.2 III 1,576,267.00 3,568,700.00
398 muhamad fazri akbar 399076 TYPHOID FEVER A01.0 II 2,605,793.00 3,329,400.00
399 aisyah handayani 369149 SISA PLASENTA ANEMIA KURET O94 D64.9 69.09 I 8,900,953.00 6,725,900.00
400 enes bt lubar 395010 TUMOR RECTUM BIOPSI D12.8 48.25 II 9,064,915.00 5,225,100.00
401 NANANG SOPIAN 398922 NEFROLITHIASIS URS + INSERSI STENN20.0 58.22 + 59.8 II 17,631,149.00 2,464,300.00
402 RISMA ADHANI NINGSI 399129 DHF A91 I 3,487,827.00 2,720,200.00
403 AFaNDI AGUSTIAN 387215 BRONCHOPNEUMTB PARU J18.0 A16.2 II 3,377,681.00 4,170,100.00
404 KARSIN 325111 STROKE INFARK DM I63.9 E11.6 II 29,589,181.00 6397000
405 DARMAWAN 399050 TRAUMA LUMBAL S39.9 III 939,135.00 1,551,700.00
406 bintang maulana salam 399365 DIARE HYPERKLORIDA A09 E87.8 III 1,972,710.00 3,326,100.00
407 shakila afiqa sukmana 377174 BRONCHOPNEUMONIA J18.0 I 5,133,721.00 4,865,100.00
408 noer vina sit h 399411 ASMA J45.9 I 2,168,400.00 2,173,300.00
409 RONI MARDI 377717 NEFROLITHIASIS ESWL N20.0 98.51 II 8,117,208.00 12,108,700.00
410 RANI SILPIA EVARISTI 314482 RIW. SC PARTUS SC SCTP O33.4 O82.9 74.1 II 9,097,856.00 4,826,600.00
411 shafa aliyah sudrajat 399232 THALASEMIA ANEMIA D56.9 D64.9 I 2,854,630.00 2,172,900.00
412 Tri Qomaryatun 350848 GRAVIDUM KPD O99.8 O42.9 II 2,909,902.00 2,502,400.00
413 SUSANTI 307731 PARTUS SPONTANKPD KURET O80.9 O42.9 69.02 II 8,051,228.00 2,458,000.00
414 MUHAMAD NABIL AL S 399370 TYPHOID FEVER DF A01.0 A90 II 2,437,657.00 4,282,400.00
415 MAMAN HAMDANI 396316 NEFROLITHIASIS HYDRONEFROSIS ESWL N20.0 N13.3 98.51 II 8,305,527.00 13,705,200.00
416 MULYATI 397703 BATU STAGHON ESWL N21.0 98.51 III 8,079,802.00 10,090,500.00
417 CICI 398026 DC- HHD DM I11.0 E11.6 I 4,801,357.00 6,042,200.00
418 MAMAT MUDIA PERM 398228 DYSPEPSIA K30 I 4,917,715.00 3,891,400.00
419 epa nur pujiant 399317 CPD PARTUS SC + KPD SCTP O33.8 O82.9 + O33.8 III 7,849,985.00 4,022,100.00
420 DEWI SRI RAHAYU 398245 LBP M54.5 II 2,252,200.00 2,324,900.00
421 YATI SURYATI 369631 TUMOR COLLI BIOPSI D36.0 40.11 I 10,241,823.00 4,949,700.00
422 MARDI 387524 HERNIA HERNIORHAPI K40.9 53.29 I 14,105,201.00 4,997,900.00
423 DEDI SUPRIADI 388593 CHEST PAIN R07.4 I 4,509,100.00 4,509,100.00
424 ZUNETI 399266 HE O21.0 II 2,064,279.00 2,502,400.00
425 SUKIM ANDREAS B D 370850 SPONDYLITIS TB LAMINECTOMY DECO A18.0 + M49.06 03.09 + 81.08 III 17,260,270.00 22,036,300.00
426 ISMARLINA 387996 NEFROLITHIASIS ESWL N20.0 98.51 II 8,515,967.00 12,108,700.00
427 engkos kosasih 370298 NEFROLITHIASIS ESWL N20.0 98.51 I 8,454,475.00 14,126,800.00
428 ILHAM REZA S, TN 318323 OA FRAKTUR FEMUR ORIF M19.9 S72.9 79.35 II 18,029,982.00 15,671,500.00
429 MASHUDI 376693 NEFROLITHIASIS ESWL N20.0 98.51 I 8,766,428.00 14,126,800.00
430 HJ EPIH SHOPIAH 396009 VARICES VAGINA PARTUS SC SCTP O22.1 O82.9 74.1 I 14,375,044.00 5,631,000.00
431 TIRAH 399286 IUFD PARTUS SPONTAN PSP + KURET O36.4 O80.9 69.02 + 73.59 III 5,007,686.00 2,383,300.00
432 NUKEU ARYANTI SAGIT 399262 TYPHOID FEVER A01.0 II 2,733,717.00 3,329,400.00
433 WARSAD 397644 TB PARU DC-HHD + ESRD A16.2 I51.9 + I11.9 + N18.0 I 10,103,934.00 5,839,000.00
434 AGUS YUDI.SH 399233 VIRAL INFECTION B34.9 II 2,611,172.00 2,331,600.00
435 YATI NOVITA 399073 TYPHOID FEVER DHF A01.0 A90 II 4,924,865.00 4,906,600.00
436 SURATMAN ARIES SOFJ 399124 ABSES PERIANAL INSISI K61.0 49.01 I 11,815,787.00 6,095,900.00
437 SHEILLA ALYA SAFIRA R. 399333 TUMOR PAYUDARA EKSISI D24 85.24 II 8,844,019.00 6,118,200.00
438 NANANG SOPIAN 398922 NEFROLITHIASIS ESWL N20.0 98.51 II 8,256,260.00 12,108,700.00
439 nining asmara ningsih 385163 DYSPEPSIA HYPERTENSI + HYPERKALCEMIA K30 I10 + E83.5 II 2,240,606.00 3,335,500.00
440 RULLIADY, DRS. 388349 FATTY LIVER K74.6 I 1,012,048.00 3,265,600.00
441 Nana Sumarna 318722 DIARE AKUT A09 II 2,087,249.00 2,423,100.00
442 QUEENZHA ADZKADINA 399364 BRONCHOPNEUMONIA J18.0 II 3,934,290.00 4,170,100.00
443 NURAENI BT HENDI 399486 PARTUS SPONTAN O80.9 III 3,623,613.00 2,013,600.00
444 fadil alvaro nugraha 399424 BRONCHOPNEUMTYPHOID FEVER J18.0 A01.0 II 2,962,115.00 9,699,100.00
445 TITIN SUHARTINI 398318 RENCANA OP Z53.0 I 866,792.00 1,632,600.00
446 lerien nathaniea azzahr 399419 lahir sc P03.4 II 1,497,935.00 1,995,800.00
447 melfa 399376 TYPHOID FEVER DYSPEPSIA A01.0 K30 II 2,997,559.00 3,329,400.00
448 ATANG 392910 WOUND DEHISCENSE REPAIR WOUND DEHT81.3 54.61 III 9,814,843.00 5,677,000.00
449 MUHTAR KUSUMA ATM 399426 TYPHOID FEVER A01.0 II 3,169,622.00 3,329,400.00
450 gilang badhrika arifin 376543 BRONCHOPNEUMONIA J18.0 III 3,162,430.00 3,475,100.00
451 AINI ZAZKIA, AN 371739 OF R50.9 III 1,498,537.00 1,556,900.00
452 IKA ARYANTI 315008 TYPHOID FEVER A01.0 III 2,158,925.00 2,774,500.00
453 NGADIYONO 399371 SIROSIS HATI K74.6 I 3,265,600.00 3,265,600.00
454 FINDRIGUNARYANTI 341628 OLIGOHIDRAMNIOPARTUS SC SCTP O41.0 O82.9 74.1 II 8,963,314.00 4,826,600.00
455 Mega Purwantni 342534 VIRAL INFECTION B34.9 I 3,925,545.00 2,720,200.00
456 tni suhartni 379412 HHD +HT CAD + BP I11.9 I25.1 + J18.0 III 4,152,238.00 5,238,100.00
457 LILI MARULOH 398938 DC- HHD DM + PPOK I11.0 E11.7 + J44.9 III 9,461,670.00 4,315,900.00
458 eka aulia nurfitriyani 381626 BRONCHOPNEUMONIA J18.0 II 8,148,055.00 4,170,100.00
459 IJAH 396688 NEFROLITHIASIS URS + AFF STENT N20.0 58.22 + 97.65 II 15,868,338.00 2,464,300.00
460 MESSYA LIENARDI VALE 321712 STT EKSISI D48.1 83.39 II 6,771,998.00 5,845,600.00
461 h kaka komarudin 396876 LBP INJ FACET JOINT M54.5 3.92 III 996,076.00 1,937,400.00
462 SUGENG WIDODO 399379 STROKE INFARK LBP I63.9 M54.5 I 6,153,645.00 4,101,800.00
463 abdurrahman zhafran 399435 BRONCHOPNEUMONIA J18.0 I 4,865,100.00 4,865,100.00
464 DEDI IRAWAN 366098 TB PARU HT A16.0 I10 II 5,345,646.00 5,004,900.00
465 IWAN SETIAWAN 394147 HT UNSTEABLE ANGINA + DM I10 I20.0 + E11.7 I 13,863,376.00 6,042,200.00
466 YUSI ARISTA 321621 DYSPEPSIA K30 II 2,754,060.00 3,335,500.00
467 widaningsih 389471 HEG O21.0 III 1,305,244.00 2,085,300.00
468 SILVIA MAYESTISSA SIT 396257 KISTA GUSI EKSISI D10.3 24.31 II 2,904,916.00 2,323,100.00
469 H. MOHAMAD AZIS 397902 LBP INJ FACET JOINT L M54.5 3.92 II 1,503,414.00 2,324,900.00
470 sit maemunah 398002 NEFROLITHIASIS URS + INSERSI STENN20.0 58.22 + 59.8 II 17,410,053.00 2,957,900.00
471 DARNI 399446 CPD PARTUS SC + ANEMIA SCTP O33.8 O82.9 + D64.9 III 9,027,812.00 4,438,400.00
472 R WAHYU APANDI, TN 379168 HIL HERNIORHAPI K40.9 53.29 I 4,997,900.00 4,997,900.00
473 NINA NURAENI 399476 DYSPEPSIA K30 I 921,243.00 3,891,400.00
2,936,517,557.00 2,513,978,600.00
DIAGNOSA DIAGNOSA KODE ICD KODE ICD KODE

NO NAMA PASIEN NO. MR TINDAKAN KELAS HARGA RS HARGA INA CBGS
PRIMER SEKUNDER UTAMA SECUNDER TINDAKAN
1 RAFLI INDRAZAKTI 324792 BRONCHOPNEUMASD + TB PARU J18.0 Q21.1 + A16.2 II 5,786,649.00 5,860,100.00
2 FUZY LESTARI 389869 BRONCHITIS J41.0 I 2,635,091.00 2,173,300.00
4 ROILAH 321560 APPENDECITIS LE + APPENDECTOMK37 54.11 + 47.09 II 10,388,885.00 6,812,300.00
5 AAS SUMARSIH 317858 ASM J45.9 II 4,372,850.00 1,862,800.00
6 DEWI ARDANA. R 398376 MUCOCELE LABII EKSISI D10.0 II 2,351,528.00 4,861,600.00
7 YULIAWATI 398360 CA PARU CKD +SEPSIS + STRES ULCEER C34.1 N18.9 + A41.9 + K27.9 II 15,288,574.00 6,798,100.00
8 MUTIA ZAHIROH SUPEN 398313 TYPHOID FEVER DHF A01.0 A91 II 5,734,764.00 4,906,600.00
9 SALSABILA ZAHSY AL 398802 GEA DEHIDRASI INJ TENDON SHEAT A09 E86 83.97 II 1,601,026.00 2,423,100.00
10 ASIAH SETYAWATI 339778 TENDINOSIS SHO NEURITIS M75.8 M79.2 83.97 I 1,754,291.00 2,166,600.00
11 HENNY HENDIRANI 331343 TENDINOSIS SHOULDER INJ TENDON SHEAT M75.8 83.97 II 1,703,788.00 1,857,000.00
12 RR SHAFA SEKAR FADHI 398967 MUCOCELE LABII EKSISI D10.0 27.43 I 8,296,869.00 5,671,900.00
13 GWEN STEFANY ADAM 328607 DYSPEPSIA K30 II 2,541,969.00 3,335,500.00
62,456,284.00 48,728,900.00
414 WANIS PULAILAH 325412 TENDINOSIS SHOULDER M75.8 II 1,638,652.00 1,857,000.00

0.856108827
NAMA DOKTER
dr. SARJUNAS, Sp.OG

dr. RENNY, Sp.U
dr. ACHMAD, Sp.PD
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. DJOKO. Sp.B
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. ACHMAD, Sp.PD
dr. MEDIA, Sp.S
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. DEASY, Sp.P
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG
dr. IS, Sp.An
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. GHUNA, Sp.OT
dr. WIWIN, Sp.A
dr. ACHMAD, Sp.PD
dr. MAULIA, Sp.OG
dr. ACHMAD, Sp.PD
dr. MIFTAH, Sp.PD
dr. ADE, Sp.S
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. DJOKO. Sp.B
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S
dr. PARAMITA, Sp.A
dr. DJOKO. Sp.B
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A 2,355,800.00
dr. DJOKO. Sp.B
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. DEASY, Sp.P
dr. PITRAJAYA, Sp.B
dr. DJOKO. Sp.B
dr. WIWIN, Sp.A
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. SARJUNAS, Sp.OG
dr. ACHMAD, Sp.PD
dr. ACHMAD, Sp.PD
dr. MAULIA, Sp.OG
dr. ACHMAD, Sp.PD 2,927,500.00
dr. ACHMAD, Sp.PD
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.PD
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. DJOKO. Sp.B
dr. GHUNA, Sp.OT
dr. MIFTAH, Sp.PD
dr. MEDIA, Sp.S
dr. MIFTAH, Sp.PD
dr. DJOKO. Sp.B 11,250,942.00
dr. DJOKO. Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. DJOKO. Sp.B
dr. PARAMITA, Sp.A
dr. FITRIYATI
dr. TOTO
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. DJOKO. Sp.B
drg. FRANKY, Sp.BM
dr. ACHMAD, Sp.PD
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. WIWIN, Sp.A
dr. SARJUNAS, Sp.OG
dr. ACHMAD, Sp.PD
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. GHUNA, Sp.OT
dr. MIFTAH, Sp.PD 2,720,200.00
dr. MEDIA, Sp.S
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. ANDI, Sp.OT
dr. ACHMAD, Sp.PD
dr. ACHMAD, Sp.PD
dr. DJOKO. Sp.B
dr. WIWIN, Sp.A
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. MEDIA, Sp.S
dr. YUDI, Sp.U
dr. PITRAJAYA, Sp.B
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. TOTO
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. ZUHAIRA, Sp.S
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. WIWIN, Sp.A
dr. ACHMAD, Sp.PD
dr. ACHMAD, Sp.PD
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. MIFTAH, Sp.PD
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. DEASY, Sp.P
dr. DJOKO. Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. GHUNA, Sp.OT
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. ACHMAD, Sp.PD
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. NUNUNG, Sp.OG
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. ANDI, Sp.OT
dr. RENNY, Sp.U
dr. ACHMAD, Sp.PD
dr. DEASY, Sp.P
dr. RENNY, Sp.U
dr. RICHARD, Sp.THT
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD 4,655,500.00
dr. ACHMAD, Sp.PD
dr. RICHARD, Sp.THT
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. YUDI, Sp.U
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A
drg. FRANKY, Sp.BM
dr. ZUHAIRA, Sp.S
dr. RICHARD, Sp.THT
dr. RICHARD, Sp.THT
dr. DJOKO. Sp.B
dr. UJANG
dr. DJOKO. Sp.B
dr. TOTO
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. GHUNA, Sp.OT
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. DIK ADI, Sp.B
dr. SARJUNAS, Sp.OG
dr. RENNY, Sp.U
dr. MEDIA, Sp.S
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. ZUHAIRA, Sp.S
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. MIFTAH, Sp.PD
dr. ADE, Sp.S
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. ACHMAD, Sp.PD
dr. MAULIA, Sp.OG 4,381,066.00
dr. SARJUNAS, Sp.OG
dr. ACHMAD, Sp.PD
dr. SARJUNAS, Sp.OG
dr. WIWIN, Sp.A
dr. DJOKO. Sp.B
dr. ACHMAD, Sp.PD
dr. YUDI, Sp.U
dr. ACHMAD, Sp.PD
dr. RENNY, Sp.U
dr. DJOKO. Sp.B
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. WIWIN, Sp.A
dr. ACHMAD, Sp.PD
dr. YAYAN, Sp.M
dr. MEDIA, Sp.S
dr. DEASY, Sp.P
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. MIFTAH, Sp.PD
dr. NUNUNG, Sp.OG
dr. MIFTAH, Sp.PD
dr. DIK ADI, Sp.B
dr. DIK ADI, Sp.B
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. SARJUNAS, Sp.OG
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. MEDIA, Sp.S
dr. YUDI, Sp.U
dr. MAULIA, Sp.OG
dr. RICHARD, Sp.THT
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. MEDIA, Sp.S
dr. RENNY, Sp.U
dr. TOTO
dr. PITRAJAYA, Sp.B
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. RICHARD, Sp.THT
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. MAULIA, Sp.OG
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. ACHMAD, Sp.PD
dr. YUDI, Sp.U
dr. RICHARD, Sp.THT
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. MIFTAH, Sp.PD
dr. DIK ADI, Sp.B
dr. MIFTAH, Sp.PD
dr. ACHMAD, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. HENDRI, Sp.B
dr. MAULIA, Sp.OG
dr. ZUHAIRA, Sp.S
dr. DIK ADI, Sp.B
dr. WIWIN, Sp.A
dr. MR. KURNIA, Sp.PD 4,170,900.00
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. SARJUNAS, Sp.OG
dr. TOTO
dr. PARAMITA, Sp.A
dr. DIK ADI, Sp.B
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. ACHMAD, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. ADE, Sp.S
dr. WIWIN, Sp.A
dr. MEDIA, Sp.S
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. ZUHAIRA, Sp.S
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. DEASY, Sp.P
dr. MAULIA, Sp.OG
dr. YUDI, Sp.U
dr. WIWIN, Sp.A
dr. HENDRI, Sp.B
dr. DEASY, Sp.P
dr. DIK ADI, Sp.B
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. DIK ADI, Sp.B
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. SAPTANINGTYAS
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. SARJUNAS, Sp.OG
dr. WIWIN, Sp.A
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. ACHMAD, Sp.PD
dr. ACHMAD, Sp.PD
dr. SARJUNAS, Sp.OG
dr. ADE, Sp.S
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. ACHMAD, Sp.PD
dr. SARJUNAS, Sp.OG
dr. GHUNA, Sp.OT
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. GHUNA, Sp.OT
dr. YUDI, Sp.U
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. HENDRI, Sp.B
dr. DJOKO. Sp.B
dr. RENNY, Sp.U
dr. FITRI YANTI
dr. ACHMAD, Sp.PD
dr. WIWIN, Sp.A
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. ACHMAD, Sp.PD
dr. MAULIA, Sp.OG
dr. ACHMAD, Sp.PD
dr. ACHMAD, Sp.PD
dr. ACHMAD, Sp.PD
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. MEDIA, Sp.S
dr. ZUHAIRA, Sp.S
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. ACHMAD, Sp.PD
dr. MAULIA, Sp.OG
drg. FRANKY, Sp.BM
dr. ADE, Sp.S
dr. RENNY, Sp.U
dr. SARJUNAS, Sp.OG
dr. DJOKO. Sp.B
dr. FITRIYATI
NAMA DOKTER
dr. WIWIN, Sp.A

dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. ACHMAD, Sp.PD
drg. FRANKY, Sp. BM
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. MEDIA, Sp.S
dr. MEDIA, Sp.S
dr. HENRY, Sp.B
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S TUNGGU PENANGGUHAN

Rekapitulasi INA CBGs Bulan April (LAPORAN MEDREK)
KODE ICD KODE ICD
NO NAMA PASIEN NO. MR DIAGNOSA PRIMER DIAGNOSA SEKUNDER TINDAKAN KODE TINDAKAN KELAS HARGA RS HARGA INA CBGS
UTAMA SECUNDER
1 ENGKUS KUSNADI 399505 BRONCHIECTASIS J47 II 2,878,100.00 2,878,100.00
2 RAHMAH RINI SAPA 399685 KOLIK ABDOMEN R10.4 I 1,837,788.00 2,827,100.00
3 ESMINA SIANIPAR 399644 KISTA ATHEROMA EKSISI L72.1 86.3 I 8,090,278.00 4,583,900.00
4 KHUSNUL KHOTIM 335759 GANGLION EKSISI M67.4 83.49 II 7,020,715.00 5,845,600.00
5 YEYEH HOLIAH 399175 GRANULOMA PHARYN TONSILITISADENOID EKSISI GRANULOMA + TO J39.2 J35.2 29.99 + 28.3 III 6,719,138.00 4,761,400.00
6 SYAIFUL BAHRI, TN 373545 LIPOMA EKSISI D17.9 83.39 I 10,364,111.00 6,819,800.00
7 mila nurmilah 399511 PERDARAHAN PERVAGANEMIA KURET O72.1 D62 69.09 I 9,730,530.00 3,809,800.00
8 IMAS SAMSIAH 323837 GRANULOMA PHARYN TONSILITIS HYPERTROPI EKSISI GRANULOMA + TO J39.2 J35.1 29.99 + 28.2 II 7,857,427.00 5,713,700.00
9 RUKMAN 395005 NEPHROLITHIASIS PNC ESWL N20.0 N20.9 98.51 II 8,132,160.00 12,108,700.00
10 DEDE SUPRIYADI S 399654 URETEROLITHIASIS HYDRONEFFROSIS ESWL N13.2 98.51 I 9,016,958.00 14,126,800.00
11 DEDE SYARIF HIDA 375789 NEFROLITHIASIS BPH + HYPERURICEMIA +ESWL N20.0 N13.3 98.51 I 8,467,355.00 14,126,800.00
12 SODIK DJUJARTIN 369536 URETEROLITHIASIS HYDRONEFFROSIS ESWL N13.2 98.51 II 8,278,078.00 12,108,700.00
13 IWAN TRISNADI 399043 HHD-DC I11.9 II 4,575,900.00 3,820,400.00
14 DIAN SURYANI 399494 DYSPEPSIA DENGUE FEVER K30 A90 II 3,595,861.00 5,003,200.00
15 SITI MARYAM 339644 ABSES MAMAE DEBRIDEMENT N61 86.28 III 6,919,210.00 1,551,700.00
16 Ida Farida, A.Md.K 300161 NEURITIS TENDINOSIS SHOULDER INJ TENDON SHEAT M.7921 M75.8 + M60.9 83.97 I
17 ENDANG MULYANI 397752 TENDINOSIS SHOULDER INJ TENDON SHEAT M75.8 83.97 III
18 MAMAN SUHERM 394395 CTS SEQ. STROKE G56.0 I69.3 I
19 Yusup Supriatna 305462 TB PARU TYPHOID FEVER A15.0 A01.0 II 5,321,534.00 4,282,400.00
20 CICIH 393829 NEFROLITHIASIS ESWL N20.0 98.551 II 8,352,588.00 12,108,700.00
21 sit maemunah 398002 NEFROLITHIASIS ESWL N20.0 98.51 II 8,315,568.00 12,108,700.00
22 AHYAN 398014 VESICOLITHIASIS LITOTRIPSI + MEATOTOMYN21.0 57.0 + 56.1 III 15,571,010.00 10,090,500.00
23 NINA NURAENI 399476 DENGUE FEVER A90 I
24 SYAHRIL RIZAL, S.P 399585 DHF A91 I 4,746,272.00 2,720,200.00
25 HERTI 347670 URETEROLITHIASIS LITOTRIPSI + AFF STENT N20.1 56.0 + 97.65 III 14,968,604.00 6,172,400.00
26 juju juaeni 379264 URETEROLITHIASIS LITOTRIPSI + AFF STENT N20.1 56.0 + 97.65 II 17,235,922.00 7,406,900.00
27 saini 395883 STENOSIS URETER LITOTRIPSI + AFF STENT N35.9 56.0 + 97.65 III 13,541,488.00 6,172,400.00
28 AMAN 393341 BPH UROLITHIASIS + HYDRONURS + TURP N40 N20.9 + N13.3 56.31 + 60.29 III 18,192,507.00 7,524,800.00
29 ANIDA RIZKIA 398910 GRANULOMA PHARYN TONSILITIS HYPERTROPI EKSISI GRANULOMA + TO J39.2 J35.1 29.99 + 28.2 II 8,140,983.00 5,713,700.00
30 siau ling 399651 CPD RIW. SC + PARTUS SC SCTP O33.8 O34.2 + O82.8 74.99 I 12,704,354.00 5,631,000.00
31 ECIH SUKAESIH 323485 BATU URETER LITOTRIPSI + AFF STENT N20.1 56.0 + 97.65 I 21,446,390.00 8,641,400.00
32 DANU ARIS BIN A 396944 BPH URS + TURP N40 56.31 + 60.29 II 18,858,935.00 7,427,400.00
33 E. KARMILA 380889 HNP INJ PERIFER M51.2 4.8 II
34 Annisa Putri Seta 344657 INFEKSI VIRAL AKUT STOMATITIS B34.9 K12.2 II 3,291,572.00 2,791,900.00
35 nurman didil 397210 CAP CAD + DC + CKD J18.9 I25.1 + I51.9 + N18.9 I 4,252,717.00 6,836,700.00
36 OMAN 382207 NEFROLITHIASIS ESWL N20.0 98.51 II 8,344,035.00 12,108,700.00
37 IJAH 396688 NEFROLITHIASIS ESWL N20.0 98.51 II 8,238,829.00 12,108,700.00
38 JAENI 399523 DYSPEPSIA URTI K30 J06.9 III 2,676,595.00 2,779,600.00
39 MUMUN 399499 GEA DEHIDRASI + CYST GINJAL KANAN A09 E86 + N28.1 III 4,740,496.00 3,326,100.00
40 NY.CUCU HARTINI 382553 KP ESRD A15.0 N18.0 I 4,297,110.00 6,976,000.00
41 AIRLANGGAPUTRA 368486 ISK TB PARU + STOMATITIS N39.0 A15.0 + K12.2 II 2,485,678.00 2,787,800.00
42 Zetta Pratsena Ar 372746 TYPHOID FEVER A01.0 II 3,514,798.00 3,329,400.00
43 randhika febrian h 383626 BRONCHOPNEUMONIA J18.0 II 4,211,305.00 4,170,100.00
44 KAYYISA ELMA MA 399044 BRONCHOPNEUMONIALEUKOSITOSIS J18.0 D72.8 II 15,683,513.00 4,170,100.00
45 muhammad fadlan 399547 BRONCHOPNEUMONIASEPSIS J18.0 A41.9 II 3,082,629.00 9,699,100.00
46 SAMUEL ARCHELAU 399682 BRONCHOPNEUMONIA J18.0 II 1,878,528.00 4,170,100.00
47 mochamad septan 399529 BRONCHOPNEUMONIATYPHOID FEVER J18.0 A01.0 II 3,933,112.00 9,699,100.00
48 tahfiz ilman hendr 385057 BRONCHOPNEUMONIA J18.0 III 2,671,316.00 3,475,100.00
49 FADILLAH ARDIAN 399323 GRANULOMA PHARYN TONSILITISADENOID EKSISI GRANULOMA + TO J39.2 J35.2 29.99 + 28.3 II 7,674,859.00 5,713,700.00
50 LEA AGASTYA 399803 HORDEOLUM INSISI H00.0 8.09 II
51 RENALDI LOEKITO 302176 TYPHOID FEVER DHF A01.0 A91 I 5,724,400.00 5,724,400.00
52 HJ.SITI ROHMAH 386876 VARICOCELE COLPORRHAPY ANTEROR I+86.2 70.51 + 70.52 III 9,789,993.00 2,730,600.00
53 WIDYA CHOERUNI 383845 DYSPEPSIA K30 I 3,315,896.00 3,891,400.00
54 RIRIN JULIASTUTI 399601 TYPHOID FEVER A01.0 I 3,884,300.00 3,884,300.00
55 cahaya ratu arum 370895 BRONCHOPNEUMONIA J18.0 I 9,943,810.00 4,865,100.00
56 VIAN EVALUDIN 363732 Vertebro-basilar artery syndrome G45.0 II 4,559,085.00 2,329,200.00
57 RUSYATTY 383866 FEBRIS R50.9 I 3,676,496.00 2,179,700.00
58 SRI KUNARSIH 399590 VIRAL INFECTION DM + HT B34.9 E14.8 + I10 I 5,150,199.00 3,257,200.00
59 NENENG SRI WINE 399545 DYSPEPSIA GEA K30 A09 II 5,755,334.00 3,335,500.00
60 riska resmiat 399513 DYSPEPSIA K30 II 5,073,697.00 3,335,500.00
61 ELA LAELASARI 386961 TB PARU KONVULSI A15.0 R56.8 II 3,424,334.00 5,979,400.00
62 SARTIM 397700 RETENSIO URINE R33 I 3,390,958.00 2,698,900.00
63 NENENG YULIANIN 393891 DC-HHD ESRD I11.9 N18.0 I 11,340,300.00 2,716,700.00
64 AHMAD RESKI SAP 354481 UNGUIS INCARNATUS ROZER PLASTY L60.0 86.27 II
65 tni kustni 348002 AB. INKOMPLIT KURET O05.4 69.02 II 5,269,138.00 3,279,100.00
66 ASEP SUPRIADI 399694 TYPHOID FEVER DENGUE FEVER + ISK A01.0 A90 + N39.0 I 3,477,447.00 4,996,100.00
67 NIK NIK MARYATI 357290 BRONCHOPNEUMONIA J18.0 I 4,649,400.00 5,839,000.00
68 POPON SATIASIH 377907 DYSPEPSIA K30 I 3,891,400.00 3,891,400.00
69 SUGENG WIDODO 463153 SH I61.9 I
70 EVA MARDIANA 399478 VARICOCELE VARICOCELECTOMY I86.1 61 II 8,049,924.00 6,684,700.00
71 REVAN ERLANGGA 399807 MUCOSITIS K12.3 III 1,767,133.00 1,935,900.00
72 rosanah 399752 BPPV H81.1 II 1,858,400.00 1,858,400.00
73 RATU SITI ROKAYA 399495 GASTRITIS KRONIS K29.5 I 2,171,800.00 2,171,800.00
74 HARDIANAH 399420 ILEUS OBSTRUKTIF ec ADHESI POST OP K91.3 I 7,754,943.00 3,891,400.00
75 YULI YULIAWATI 397001 ASMA BR BRONCHITIS AKUT + DYSPEPSIA J45.9 J20.9 + K30 II 6,064,418.00 1,862,800.00
76 ANDRIAN KLOSE 399521 TYPHOID FEVER DHF + ISPA A01.0 A91 + J06.9 II 8,191,688.00 4,906,600.00
77 A. MAKSUM 393474 DYSPEPSIA DMT2 K30 E11.9 III 7,030,873.00 2,779,600.00
78 Sartni 300798 FEBRIS R50.9 I 2,307,654.00 2,179,700.00
79 YENI MARDIANI 399833 ABSES LABIA MINOR N76.4 I 2,536,324.00 2,544,100.00
80 VERRAVIRGINIA 399819 TYPHOID FEVER A01.0 II 2,627,176.00 3,329,400.00
81 NENGSIH JUNAESI 349099 RHD CARDIOGENIC SHOCK I09.9 R57.0 II 2,007,539.00 4,814,100.00
82 ADELIA PELITA FEB 386331 ISPA J06.9 III 1,132,295.00 1,524,100.00
83 eddy waluyo 366522 CKD + PPOK + CAP VENTILATOR 48 JAM N18.9 J44.9 + J18.9 96.71 II 14,307,170.00 13,988,500.00
84 H ROYANI 378581 PLEURAPNEUMONIA ec TB PUNGSI PLEURA A15.0 34.91 II 1,563,538.00 5,004,900.00
85 JENAL ABIDIN 319228 HYDROCELE HYDROCELECTOMY N43.4 63.1 III 7,529,852.00 3,829,700.00
86 ENENG SUARTIMA 399779 DMT2 TYPHOID + HYPONATREMIA E11.8 A01.0 + E87.1 I 7,200,930.00 4,996,100.00
87 GIEZKA AMELIA 399841 BRONCHOPNEUMONIA J18.0 II 2,830,406.00 4,170,100.00
88 KARNO 394112 HEMAPTOE R04.2 II 1,858,600.00 1,861,600.00
89 FATMAWATI 384558 HERPES ESRD B02.9 N18.0 I 5,514,655.00 3,788,700.00
90 DJUNAEDI 399612 HIL HERNIORRHAPY K40.9 53.29 II 9,697,275.00 4,283,900.00
91 ADE SULAEMAN 399845 VIRAL INFECTION DYSPNEU B34.9 R06.0 III 741,782.00 1,943,000.00
92 MAFATICHUR ROH 400036 STT EKSISI D48.1 83.49 II 6,897,357.00 5,845,600.00
93 H. PUDROJI SANTO 344642 PPOK HT J44.9 I10 I 4,822,062.00 3,357,800.00
94 R YAYAN SOFYAN 399793 ESRD HT I13.1 I 2,030,921.00 2,716,700.00
95 HJ NINIK RAHAYU 399527 OA GENU RL INJ JOINT M19.97 M54.16 81.92 I
96 LUCIA DWI NURAN 384069 SPONDILOPATHY LUMBOA GENU INJ FACET JOINT M47.86 M19.98 81.92 I
97 ADZKIA THAFANA 383976 BRONCHOPNEUMONIA J18.0 III 2,418,662.00 3,475,100.00
98 MUHAMADROBBIF 366048 BACTERIAL INFECTION KDS A49.9 R56.8 II 1,491,775.00 4,282,400.00
99 hiskia vano 398163 VIRAL INFECTION B34.9 II 1,913,184.00 2,331,600.00
100 by. ny. aisyah 398989 NEC SEPSIS + HBR + ANEMIA + BBLR P77 + P36.9 + P59.9 + P61.4 + P07.1 I 8,305,763.00 5,837,000.00
101 NUNING HANDRAY 400021 CEPHALGIA R51 III 3,203,994.00 1,554,900.00
102 FEMI UBAYANI PU 350545 PERDARAHAN PERVAGINA N93.9 I 2,954,638.00 2,174,100.00
103 IPANG 398036 BATU STAGHORN BIVALVE NEPHROTOMY N21.0 55.01 II 21,350,856.00 12,108,700.00
104 NAWAWI HEPNI 399913 DYSPEPESIA K30 I 4,029,555.00 3,891,400.00
105 USNAP 398363 BPH TURP N40 60.29 III 16,064,738.00 6,189,500.00
106 RIZKY CAHYANI PU 328066 TYPHOID FEVER A01.0 I 3,884,300.00 3,884,300.00
107 DWIANIPERMATAS 397712 V. GRANULOMA DEBRIDEMENT + SUTURE K10.1 86.22 + 83.49 II 6,719,338.00 5,845,600.00
108 SOPIANSAH 399629 GRANULOMA PHARYN TONSILITISADENOID COUTER GRANULOMA + TJ39.2 J35.2 29.99 + 28.3 II 7,379,371.00 5,713,700.00
109 AWI ROSMIATI 399892 FAM B EKSISI D + BIOPSI S N60.2 85.24 + 85.12 II 9,274,021.00 6,118,200.00
110 betari dwi pratwi 399887 DENGUE FEVER A90 III 2,315,223.00 1,943,000.00
111 CASIM 400004 STOKE ec INFARK I63.9 II 4,473,983.00 3,515,900.00
112 RETNO KURNIASIH 399697 MELENA SHOCK HIPOVOLEMIK + ANOSCOPY + LIGASI HE K92.1 T81.1 + D62 49.21 + 49.45 I 25,513,464.00 8,209,900.00
113 Leni Marlina 399777 HEMMOROID INTERNA HEMMOROIDECTOMY I84.2 49.46 I 11,317,011.00 6,095,900.00
114 AGGI RAIKUSUMA 399989 ABSES ar COLLI INSISI DRAINAGE + DEBR L02.1 86.04 + 86.22 III 7,584,808.00 2,333,600.00
115 HENDRA PURNAM 400020 PERITONITS ec APP PERFORASI LE + APPENDECTOMY + ADK35.0 54.11 + 47.09 + 54.5II 10,103,320.00 6,812,300.00
116 SUCI DESIYANTI 319417 VIRAL INFECTION UTI B34.9 N39.0 II 3,753,305.00 2,791,900.00
117 DHIKA BAYANGKA 399728 FRAKTUR NASAL REPOSISI FRAKTUR S02.2 21.83 II 8,821,583.00 5,713,700.00
118 ferdy rizki moh. fa 312593 TYPHOID FEVER A01.0 I 2,825,368.00 3,884,300.00
119 KHALISHANUROKTA 303431 SYNDROM DYSPEPSIA VIRAL INFECTION K30 B34.9 II 2,515,645.00 3,335,500.00
120 bisma naufal budi 400058 DADRS A09 II 2,185,484.00 2,423,100.00
121 nining asmara ning 385163 SPONDILOPATHY LUMBAL INJ FACET JOINT M47.86 81.92 II
122 Tri Qomaryatun 350848 KPD PARTUS SPONTAN + LAHIR SINGLE O42.9 O80.9 + Z37.0 II 4,643,651.00 2,859,900.00
123 Rima Bayu Rahmaw 347018 FAM EKSISI N60.1 85.24 II 7,056,552.00 6,118,200.00
124 NANI 399957 GANGLION EKSISI M67.4 83.39 III 7,056,888.00 4,871,300.00
125 MUHAMMAD FAUZ 399934 ISPA DADRS J06.9 A09 I 3,304,481.00 2,133,800.00
126 annisa azahra mul 392957 ISPA KDS + DADRS J06.9 R56.8 + A09 II 2,866,555.00 2,134,600.00
127 WISHNU DANU KE 399577 CHOLELITHIASIS RUPTUR LIEN LE + CHOLECYSTECTOMY +K80.8 S36.0 54.11 + 51.22 + 41.5II 24,261,435.00 10,656,400.00
128 IRMA AGUSTINi 394052 THALASEMIA STRUMA D56.9 E04.9 II 2,774,955.00 1,862,500.00
129 HJ NYAI ICIH BT 399104 NEFROLITHIASIS ESWL N20.0 98.51 I 8,463,139.00 14,126,800.00
130 UJU JUARIAH 350464 NEFROLITHIASIS ISK ESWL N20.0 N39.0 98.51 III 8,079,519.00 11,421,000.00
131 MAYA 398009 PALNTAR FASCITIS INJ TENDON M72.27 83.97 III
132 RASINAH 399902 TUMOR MAMAE BIOPSI D24 85.12 II 7,978,985.00 6,118,200.00
133 IKHSAN RAMDANI 397178 HIL HERNIORRHAPY K40.9 53.29 III 7,699,066.00 3,569,900.00
134 ASHARI USMAN 388277 DYSPNEU ec DC HT I51.9 + R06.0 I10 I 3,198,500.00 3,198,500.00
135 HJ.MAEMUNAH 399714 CHOLELITHIASIS CHOLECYSTECTOMY K80.8 51.22 II 10,786,239.00 6,481,200.00
136 DASRIP
137 SARNADI 398897 LIPOMA EKSISI D17.9 83.39 III 5,830,014.00 4,871,300.00
138 ai sumarni 399996 FAM EKSISI N60.2 85.24 II 7,902,872.00 6,118,200.00
139 ZAHRA FAIRUZ 351067 DHF TYPHOID FEVER A91 A01.0 I 6,143,099.00 3,965,400.00
140 UNAH 399948 PPOK HT dg VERTIGO + DYSPEPSIA J44.9 I10 + K30 I 5,683,906.00 3,357,800.00
141 LIA SITI NURLAELA 400001 BRONCHOPNEUMONIA J18.0 II 4,386,618.00 4,170,100.00
142 Amelia Handayani 400051 PREMATUR KONTRAKSI o42.9 III 2,818,097.00 2,085,300.00
143 HENDI SUHENDI 392917 TENDINITIS SHOULDER INJ TENDON SHEAT M75.8 83.97 I
144 MAMAN 351472 TYPHOID FEVER A01.0 II 3,447,970.00 3,329,400.00
145 KIKI RISMAWATI 400012 RUPTUR PERIANAL REPAIR PERIANAL K60.2 49.79 III 7,609,654.00 4,354,200.00
146 yani haryani 391431 KPD PARTUS SC SCTP O42.1 O80.9 II 3,540,253.00 2,859,900.00
147 EDI SUHAEDI 400230 KISTA ATHEROMA EKSISI L72.8 86.3 I 8,817,852.00 4,583,900.00
148 ANNISA FITRIA APR 363409 DYSPEPESIA K30 II 2,143,484.00 2,331,600.00
149 BENY RAKHMAT B 386762 NEFROLITHIASIS ESWL N20.0 98.51 I 8,672,404.00 14,126,800.00
150 WANDA B SUWAND 379157 NEFROLITHIASIS dg HYDRONEFROSIS ESWL N13.2 98.51 II 8,278,650.00 12,108,700.00
151 HJ. TITIN KURAESI 326340 NEFROLITHIASIS ESWL N20.0 98.51 II 8,288,866.00 12,108,700.00
152 RIANA PERTIWI A 322633 BO KURET O02.0 69.02 I 4,163,557.00 3,825,600.00
153 Yulia Anggraeni Tr 332131 TYPHOID FEVER A01.0 I 3,884,300.00 3,884,300.00
154 Devi Desasmi, A.M 339339 PLACENTA PREVIA HAP + PARTUS SPONTANSCTP O44.1 O46.9+ O82.9 74.4 II 9,342,655.00 4,826,600.00
155 VANESSA ANINDYA 400149 BAYI LAHIR SC P03.4 II 1,703,932.00 2,351,500.00
156 HAYATUL FATA BIL 400295 MHI TERKENA PAGAR BDM + ISPA S09.9 E10.8 + J06.9 + W31 I 4,997,464.00 3,892,700.00
157 TIAH RAHMAWATI 400282 UTI RETENSIO URINE N39.0 R33 II 2,798,313.00 1,860,600.00
158 YATI SURYATI 369631 TYPHOID FEVER A01.0 I 7,483,889.00 3,884,300.00
159 FIRGO SIREGAR 400456 GASRTITIS AKUT K29.1 I 2,226,255.00 2,171,800.00
160 Ira Puspita Sari 400214 ISK N39.0 II 3,604,915.00 1,860,600.00
161 NIA HUSNIAWATI 400218 HUMAN BITE HEMATOMA AXIPITAL (KDRT) S69.8 S01.8 +W50 II 2,577,956.00 1,857,000.00
162 Neneng Sulastri 399566 HEMMOROID GRD IV PARTUS SC SCTP I84.9 O82.9 74.99 II 9,533,388.00 4,826,600.00
163 NADIRAKHOIRUNN 400221 ISPA J06.9 II 2,114,486.00 1,829,000.00
164 ANI MARYANI 400215 TYPHOID FEVER A01.0 III 2,431,105.00 2,774,500.00
165 NURHIDA 381143 TYPHOID FEVER DF A01.0 A90 I 4,366,048.00 4,996,100.00
166 TETI HERAWATI 319448 CALCANEUS SPUR INJ CALCANEUS M77.39 81.92 II
167 CUCU KOMALASAR 400132 NEFROLITHIASIS ESWL N20.0 98.51 II 8,238,292.00 12,108,700.00
168 E HERDIAWAN 394697 PPOK HT J44.9 I10 I 2,794,306.00 3,357,800.00
169 RUNAWATI 359994 VIRAL INFECTION B34.9 II 3,523,168.00 2,331,600.00
170 HJ. KOMARIAH 400306 TB ISK + CHRONIC LIVER DISEASE A15.0 N39.0 + K76.9 I 3,561,145.00 6,976,000.00
171 mimin mintarsih 399581 CKD TB PARU + EFUSI PLEURA N18.9 A16.5 III 10,668,300.00 3,236,300.00
172 WIDIA KRISNAWAT 313832 TYPHOID FEVER A01.0 II 3,884,300.00 3,329,400.00
173 gathifa aisha nirw 400243 LABIOSKIZIS LABIOPLASTY Q36.9 27.99 II 7,821,139.00 4,861,600.00
174 reza aditya ramad 400446 TYPHOID FEVER A01.0 II 2,838,070.00 3,329,400.00
175 oong saan 400213 HHD PNEUMONIA I11.9 J18.9 III 5,407,746.00 5,238,100.00
176 FARHAN ERFANGGA 400489 TYPHOID FEVER A01.0 II 2,882,265.00 3,329,400.00
177 ERNA YULIANI 400271 AB. INKOMPLIT KURET O05.4 69.02 II 4,748,570.00 3,279,100.00
178 nanang sukianto 400171 STT LUTUT EKSISI D36.7 83.39 I 8,722,440.00 6,819,800.00
179 DAVID ANGGARA 400425 TYPHOID FEVER A01.0 III 2,032,816.00 2,774,500.00
180 YULI AWALIAH 399933 PEB PARTUS PREMATUR + RIW SCTP O14.1 O60.1 + O34.2 74.4 II 27,141,810.00 5,326,100.00
181 MOUDI SITI HAJAR 354308 MYALGIA M79.1 II 2,493,620.00 1,860,700.00
182 Tita Rohita 358656 HEG O21.0 II 2,196,214.00 2,502,400.00
183 uniat 366915 GASTRITIS NSAID HHD-HT + OA GENU K29.7 I11.9 + M19.9 I 5,690,979.00 2,171,800.00
184 ANAH MAEMUNA 400563 IUFD KURET O36.4 69.02 III 4,418,922.00 2,732,600.00
185 mario wagio samu 341634 BRONCHOPNEUMONIA J18.0 III 3,690,836.00 3,475,100.00
186 AI NURHASANAH 400553 AB. IMMINENS O20.0 II 1,640,346.00 1,677,400.00
187 SUHALIB 370251 NEFROLITHIASIS ESWL N20.0 98.51 II 7,978,012.00 12,108,700.00
188 NURYADI BIN JUIN, 378183 NEFROLITJIASIS ESWL N20.0 98.51 III 8,081,255.00 10,090,500.00
189 ENDI SURYANA 400160 STT FEMUR EKSISI D48.1 83.39 II 6,885,235.00 5,845,600.00
190 NUR AZIS HADIYU 367304 STT SUBMANDIBULLA EKSISI D11.7 83.39 II 6,880,526.00 5,845,600.00
191 HJ CICIH NURJANA 383517 DKD E14.2 + N08.3 I 7,322,782.00 3,632,200.00
192 CUCU SULAEMAN, 323087 DYSPEPESIA K30 II 2,888,301.00 3,335,500.00
193 ilma faridah 397835 ABSES DEBRIDEMENT N61 86.28 I 8,393,824.00 2,172,400.00
194 Aura Nourida Ally 362026 TYPHOID FEVER KEJANG DEMAM A01.0 R56.0 I 5,366,905.00 4,996,100.00
195 encoh suhaedah 399869 KISTA OVARY ANEMIA N83,2 D64.9 III 11,585,642.00 6,516,000.00
196 satk widayat 396186 POST OP HALLUX VALGUS REMOVE K-WIRE Z47.9 M20.1 78.69 I 9,873,111.00 4,139,400.00
197 Satria Bima sakt 342435 TYPHOID FEVER A01.0 I 3,884,300.00 3,884,300.00
198 adiva ryanita putri 400595 BRONCHOPNEUMONIA J18.0 II 2,117,911.00 4,170,100.00
199 Lilis Suhartat 336377 TYPHOID FEVER ISK A01.0 N39.0 II 2,628,173.00 4,282,400.00
200 didi kartawijaya 468680 NEFROLITHIASIS ISK ESWL N20.0 N39.0 98.51 III 8,143,166.00 10,090,500.00
201 tuminem 374739 AB. INKOMPLIT KURET O05.4 69.02 II 4,848,363.00 3,279,100.00
202 NENENG YULIANIN 393891 HYPERTENSI ANEMIA + ESRD I12.9 D63.8 II 4,619,762.00 4,530,800.00
203 LAILA MONICA 370215 LYMPHADENOPATHY COLLI LYMPHADECTOMY L04.0 40.9 II 6,516,956.00 4,242,600.00
204 RANGGA MUHARR 396964 TYPHOID FEVER TB PARU A01.0 A15.0 I 3,255,202.00 4,996,100.00
205 SULYATI 386040 HYDRONEFROSIS URS N13.3 58.22 I 21,657,182.00 2,875,000.00
206 RESMIATI LAELASA 400710 STT AXILLA EKSISI D36.7 83.39 II 6,780,198.00 5,845,600.00
207 Randhika Febrian 383626 BRONCHOPNEUMONIADADRS J18.0 A09 II 5,714,665.00 4,170,100.00
208 DIAH AMELIA 363443 TYPHOID FEVER A01.0 II 2,952,810.00 3,329,400.00
209 HAMBALI 388364 PERIAPPENDICULAR INFILTRAT LE + APPENDECTOMY K35.2 54.11 + 47.09 III 7,557,961.00 5,677,000.00
210 DINDAAPRIANI 334286 TYPHOID FEVER ISPA A01.0 J06.9 II 2,885,966.00 3,329,400.00
211 DEVI PEBRIYANTI 396786 TONSILITIS HYPERTROPGRANULOMA PHARYNG COUTER GRANULOMA + TJ39.2 J06.8 29.99 + 28.2 III 6,522,000.00 4,761,400.00
212 ABDUR ROUF 386687 THALASEMIA TB PARU D56.9 A15.0 III 1,847,779.00 1,166,200.00
213 ENUR 400761 STT AXILLA EKSISI D36.7 83.39 III 6,015,848.00 4,871,300.00
214 neneng fathiyyah 407559 CLAVUS EKSISI L84 86.3 II
215 RIZKY ERLANGGA 382859 MORBILI TB PARU B05.9 A15.0 III 2,092,861.00 2,326,600.00
216 NANANG JUNAND 398643 FRAKTUR VERTEBRA PAIN LUMBOSACRAL INJ PERIPHERAL S22.0 M54.57 4.8 II
217 Lutfiyatul Munawa 386464 TUMOR SUBMANDIBULLA EKSISI D11.7 83.49 II 6,820,531.00 5,845,600.00
218 ARKAN YUSUF HAK 400542 HYDROCELE HYDROCELECTOMY N43.4 63.1 II 7,538,476.00 4,595,600.00
219 ADE SUPANDI 377279 TYPHOID FEVER TB PARU A01.0 A15.0 II 5,567,044.00 4,282,400.00
220 NURAINI, NY 354643 HYPERTENSI POLINEUROPATI DM + NEINJ TO FASCIA + INJ TEN I10 E11. 4+ G63.2 83.97 III 6,640,899.00 4,315,900.00
221 WANIS PULAILAH 325412 SPONDILOPATHY LUMBOA GENU INJ FACET JOINT M48.96 M19.97 3.92 II
222 SITI SUAEBAH 398109 PREMATUR KONTRAKSI O42.9 II 1,863,576.00 2,720,000.00
223 KARDODI 381897 KOLIK ABDOMEN R10.4 III 2,355,800.00 2,355,800.00
224 nida riana nur rah 400750 ISPA KDS J06.9 R56.8 I 2,640,295.00 2,490,300.00
225 ENGKOS 399652 VESICOLITHIASIS URS + INSERSI STENT N21.0 58.22 +B 57.0 II 18,045,236.00 7,406,900.00
226 TAJI MAHENDRA 387917 DHF ISPA A91 J06.9 III 2,437,264.00 1,943,000.00
227 diana khaerunnisa 399804 DADRS A09 II 2,340,660.00 2,423,100.00
228 DADAN SARIPAN 400472 HIL HRNIORHAPY OMENTECT K40.9 53.29 + 54.4 I 13,687,904.00 4,997,900.00
229 MUHAMMAD FADHI 400714 TYPHOID FEVER DADRS A01.0 A09 II 3,600,702.00 3,329,400.00
230 VANESSA ANINDYA 400149 HRB P59.9 II 2,104,496.00 2,351,500.00
231 KERTI GANDIANIN 356557 PARTUS SPONTAN O80.9 I 5,765,053.00 2,819,100.00
232 daffa rasya aprilia 400223 NH SAD P59.9 P36.8 II 11,616,264.00 5,188,900.00
233 Daffa Hanif Khatr 397821 OSTEOMYELITIS ABSES EC TB INSISI DRAINAGE + DEBR M86.97 A18.0 + M90.0 86.04 I 8,724,287.00 4,345,100.00
234 yeni santoso 326226 BPPV HT H81.1 I10 I 2,168,100.00 2,168,100.00
235 arjuna hamizan arg 400210 BRONCHOPNEUMONIAANEMIA J18.0 D63.8 II 4,843,815.00 5,860,100.00
236 USNAP 398363 NEFROLITHIASIS ESWL N20.0 98.51 III 7,926,680.00 10,090,500.00
237 rustam 391723 NEFROLITHIASIS ESWL N20.0 98.51 II 8,098,610.00 12,108,700.00
238 Farizal Lukman Hid 400224 STT EKSISI D48.1 83.39 II 7,008,281.00 5,845,600.00
239 DARMO 400611 HIL HERNIORRHAPY K40.9 53.29 III 5,677,000.00 5,677,000.00
240 ENUNG SOLIHATI, 373272 HEMOROID INTERNA grd I HEMMOROIDECTOMY I84.2 49.46 I 12,082,450.00 6,095,500.00
241 SUPINAH 384429 OA GENU INJ INTRAARTICULAR M19.97 81.92 III
242 ENEN 469895 DYSPEPSIA HT K30 I10 III 758,301.00 2,779,600.00
243 DEDI AMALUDIN 400094 URETHROLITHIASIS HYDRONEFROSIS ESWL N13.2 98.51 II 8,323,794.00 12,108,700.00
244 asep saepudin 398271 NEFROLITHIASIS ESWL N20.0 98.51 II 8,255,602.00 12,108,700.00
245 KOMAR 400087 NEFROLITHIASIS ESWL N20.0 98.51 I 8,487,785.00 14,126,800.00
246 UTIN 314765 NEFROLITHIASIS HYDRONEFROSIS N13.2 III 8,100,934.00 10,090,500.00
247 haryat 400735 HEMMOROID INTERNA HEMMOROIDECTOMY I84.2 49.46 II 8,889,441.00 5,225,100.00
248 ANNUR MAHESWAR 377995 LTB I84.2 I 6,324,596.00 2,168,400.00
249 R WAHYUNINGSIH 390346 CA MAMAE ANEMIA Z51.3 I 2,179,044.00 1,632,600.00
250 MUNA KUSNIA N 378309 CPD PARTUS SPONTAN O33.8 O80.9 III 2,613,959.00 2,788,700.00
251 RISKA PRIDIANTI 392863 TUMOR DINDING DAD TB TTNA D36.7 A16.2 33.93 II 5,370,935.00 3,473,400.00
252 TASYA DESTY PRA 400869 DADRS A09 II 2,293,966.00 2,423,100.00
253 tb supriyatna 348613 CAD STEMI + CKD + DM + HHD I25.1 I21.9 + I12.9 + E11.9 I 8,431,893.00 5,419,700.00
254 suci indriany 379791 BPPV DYSLIPIDEMIA H81.0 E78.5 II 4,659,586.00 1,858,400.00
255 ten kartni 358877 OA TOTAL KNEE REPLACEMENM19.9 81.54 II 38,829,600.00 38,829,600.00
256 Rifdah Zhafirah Ar 371294 TYPHOID FEVER TB PARU A01.0 A15.0 II 2,296,175.00 4,282,400.00
257 NURbAETI 341430 FRAKTUR TIBIA FIBULA ORIF S82.2 79.35 I 30,829,283.00 12,767,000.00
258 Fatmawat Dewi 400824 PLACENTA PREVIA SC SCTP O44.0 O82.9 74.4 I 11,925,847.00 5,631,000.00
259 ELSYE FUJI HAEUM 337051 AIHA D59.1 III 6,681,867.00 1,552,100.00
260 sit mariyam 320389 OA GENU BURSITIS GENU INJ ARTICULAR + BURSA M19.979 M70.17 81.92 + 83.96 I
261 handeriyani perat 380141 TYPHOID FEVER A01.0 I 3,373,137.00 3,884,300.00
262 ASEP JUANDI 374687 DF A90 II 3,528,531.00 2,331,600.00
263 NANI SUMARNI 400736 DHF A91 III 1,969,548.00 1,943,000.00
264 OCTAVIANA PUTRI 400943 DYSPEPESIA K30 III 2,448,901.00 2,779,600.00
265 TASLIMAH 400112 PTERYGIUM EKSISI GRAFT H11.0 11.39 I 7,403,965.00 5,802,900.00
266 IIP LATIPAH 390323 CA MAMAE RADICAL MASTECTOMY C50.9 85.45 III 11,623,432.00 5,098,500.00
267 CINDY ARUM LARA 390127 RIW. SC GEMELI + SC PARTUS SC O34.2 O30.0 + O82.9 74.4 I 12,267,098.00 5,631,000.00
268 LAILA NURAENI 386966 DYSPEPESIA K30 II 1,844,555.00 3,335,500.00
269 YANA 397137 NEFROLITHIASIS ESWL N20.0 98.51 II 8,279,939.00 12,108,700.00
270 Yusriant Wahyu Pu 341181 VIRAL INFECTION B34.9 II 2,248,623.00 2,331,600.00
271 HERNASIH 401270 HAP KURET O46.9 69.09 II 4,645,505.00 3,279,100.00
272 E KURAESIN 316203 DMT2 + DKD DYSPEPSIA + HT E14.2 + N08.3 K30 II 3,772,234.00 3,113,300.00
273 AA RIZAL ARIANA 334279 CEPHALGIA R51 I 6,482,755.00 2,176,900.00
274 WAWAN WAHYUDI 400619 HIL HERNIORRHAPY K40.9 53.29 III 7,785,346.00 3,569,900.00
275 h. zaenal arifin 384157 HHD, CAD, OMI DC, HT, DM I11.9 I25.1 + I25.2 + E11.8 III 3,207,472.00 3,183,700.00
276 WILDAN FIRDAUS 400742 malunion FRAKTUR RADIUS OSTEOTOMY + ORIF M84.39 S52.8 77.33 + 79.32 III 13,155,359.00 5,194,700.00
277 Dahlia 400963 ADNEXITIS VAGINISTIS N70.9 N76.0 II 2,257,597.00 2,180,700.00
278 DESTI MARYATI 358362 PARTUS SPONTAN O80.9 II 5,095,129.00 2,416,400.00
279 SITI KULSUM 401013 VIRAL INFECTION B34.9 II 2,873,138.00 2,331,600.00
280 DADANG HAMDAN 401050 STT EKSISI D48.1 83.39 I 8,489,500.00 6,819,800.00
281 MIMIN AMINAH 400893 FAM EKSISI N60.2 85.24 III 5,944,332.00 5,098,500.00
282 syahril aziz ely 386469 ASMA J45.9 I 2,173,300.00 2,173,300.00
283 FITRIYAH 401034 STT EKSISI D48.1 83.49 I 6,650,694.00 5,845,600.00
284 SUBHAN RIZKI RA 400815 TYPHOID FEVER ISPA A01.0 J06.9 II 2,746,328.00 3,329,400.00
285 gathifa aisha nirw 400243 DADRS ISPA A09 J06.9 II 2,814,937.00 2,423,100.00
286 azzam assad alfat 400564 MORBILI LTB + TB PARU B05.9 J40 + A16.2 II 10,049,111.00 2,791,900.00
287 INDRA BAHARI 400958 DEHIDRASI ec INTAKE MULTIPLE STOMATITIS E63.1 E86 + K12.2 II 2,053,195.00 2,794,000.00
288 fahri ahmad 400945 BRONCHOPNEUMONIA J18,0 I 4,585,518.00 4,865,100.00
289 nadhif radhika wa 401008 BRONCHOPNEUMONIA J18.0 II 2,522,425.00 4,170,100.00
290 nurul hajijah fauzi 398315 BRONCHOPNEUMONIA J18.0 III 2,624,103.00 3,475,100.00
291 SABRINA SAKHI AL 400937 DHF A91 II 3,695,854.00 2,331,600.00
292 IQBAL ABDURAHM 381144 MORBILI BRONCHOPNEUMONIA B05.9 J18.0 I 3,489,563.00 3,965,400.00
293 ALKHANSA NAILA 364118 BRONCHOPNEUMONIASEPSIS J18.0 A41.8 II 3,285,991.00 9,699,100.00
294 NURYADI BIN JUIN, 378183 NEFROLITHIASIS HT + UNSTEABLE ANGINA N20.0 I10 + I20.0 III 5,285,540.00 4,169,300.00
295 AJI MAULANA 400987 DENGUE FEVER A01.0 III 2,207,077.00 1,943,000.00
296 Ngadah 398005 NEFROLITHIASIS ESWL N20.0 98.51 I 8,310,810.00 14,126,800.00
297 nanang nugraha 378753 NEFROLITHIASIS ESWL N20.0 98.51 III 7,930,010.00 10,090,500.00
298 SURIPTO 382549 NEFROLITHIASIS ESWL N20.0 98.51 II 8,100,810.00 12,108,700.00
299 AGUS WAWAN 400979 STT EKSISI D48.1 83.49 III 7,453,497.00 4,871,300.00
300 heni heryani 395268 MENINGITIS TB PARU A17.0 G01 I 14,250,739.00 3,258,400.00
301 UNTUNG BASUKI 310493 DYSPEPESIA HHD K30 I11.9 II 3,235,123.00 3,335,500.00
302 UJANG SOFYAN 390894 PPOK HT J44.9 I10 I 9,173,566.00 3,357,800.00
303 DEDE SITI AMINAH 401148 PEB O14.1 III 1,369,908.00 2,085,300.00
304 WINDY ROSE 401093 AB. INKOMPLIT KURET O05.4 69.02 II 5,574,308.00 3,279,100.00
305 EDAH DJUBAEDAH 384719 KISTA EKSISI D10.3 24.23 II 2,554,297.00 2,323,100.00
306 UN UN SUNDAYATI 389844 AB. INKOMPLIT KURET O05.4 69.02 II 5,003,844.00 3,279,100.00
307 ENDANG SULASTRI 333984 STENOSIS URETER URETERAL MEATOTOMY +N35.9 56.1 + 97.65 II 18,714,113.00 12,108,700.00
308 ENUNG NUR AENI 324880 PPI O61.0 II 1,790,209.00 1,677,400.00
309 HANIFA DWI PUTR 400581 TYPHOID FEVER DENGUE FEVER A01.0 A90 II 6,371,994.00 4,282,400.00
310 RAISYA DWI SEPTI 400099 BRONCHOPNEUMONIA J18.0 II 2,342,525.00 4,170,100.00
311 Ir. Dede Irsad 401277 BRONCHITIS J20 I 2,168,400.00 2,168,400.00
312 HERTI 347670 BATU STAGHORN BIVALVE NEPHROTOMY N20.0 55.01 III 19,441,615.00 10,090,500.00
313 NURHAYATI 350444 CEPHALGIA R51 I 5,793,655.00 2,176,900.00
314 NAUFAL MAHBUB 400968 TONILADENOIDITIS GRANULOMA PHARYNG TONSILADENOIDECTOMY J35.2 J39.2 28.3 + 29.99 III 6,696,080.00 4,761,400.00
315 Jasmine Indah Prat 348489 GASTRITIS DEHIDRASI ec VOMITUS E86 R11 + K29.7 I 2,998,030.00 2,171,800.00
316 DENDEN HERU HA 401163 LIPOMA EKSISI D17.9 83.49 I 11,720,740.00 6,819,800.00
317 nanda cahyani sals 401012 BRONCHOPNEUMONIAANEMIA + CMPA J18.0 D63.8 + T78.1 II 6,134,518.00 5,860,100.00
318 SANDRA NOVIANTI 348997 GSTRITIS GRAVIDUM O99.8 K29.7 II 1,499,632.00 2,502,400.00
319 WARMAD ABDILLA 401198 GA M19.99 III 1,870,315.00 2,075,300.00
320 TIAS SAFITA 401107 TYPHOID FEVER A01.0 II 3,119,354.00 3,329,400.00
321 ENEN 400724 ESRD DC ec HHD + HYPOCALCEMIA I12.0 E83.5 III 4,010,204.00 3,236,300.00
322 FEBRI MARDIANA 399709 LYMPHADENOPATHY COLLI BIOPSY EKSISI I88.8 40.11 III 6,215,425.00 3,535,500.00
323 SITI NURJANAH 401205 AB. INKOMPLIT KURET O05.4 69.02 II 5,048,302.00 3,279,100.00
324 IIM KHODIMULLO 401080 EFUSI PLEURA PUNGSI PLEURA J90 34.91 I 1,594,387.00 3,808,000.00
325 DINI OKTAVIANI 328056 FAM EKSISI N60.2 85.24 II 6,803,057.00 6,118,200.00
326 NOVIANY WIJAYAN 328671 TYPHOID FEVER A01.0 II 2,622,925.00 3,329,400.00
327 rohman 401260 CML ANEMIA C92.1 D63.8 II 3,097,051.00 3,722,000.00
328 dadang munandar 401217 DYSPEPESIA K30 I 3,891,400.00 3,891,400.00
329 adila asma syahida 401074 DHF TB PARU A91 A16.7 III 9,202,421.00 2,326,600.00
330 SELVI OCKTAVIA M 401190 SUSP APP AKUT K35.9 II 2,729,101.00 3,335,500.00
331 SITI SUHARTINI 383955 MASSA BULI CARUNCULOE URETRHA URETERAL MEATOTOMY +C67.9 N36.2 56.1 + 58.22 I 23,631,583.00 14,126,800.00
332 WAWAN BIN JONO 397590 BATU STAGHORN BIVALVE NEPHROTOMY N20.0 55.01 III 19,767,420.00 10,090,500.00
333 ENDANG SULASTRi 400980 CHOLELITHIASIS CHOLECYSTECTOMY K80.8 51.22 III 11,380,015.00 5,401,000.00
334 QASTHALANI HAFIZ 333889 BRONCHOPNEUMONIATYPHOID FEVER J18.0 A01.0 II 3,616,748.00 9,699,100.00
335 DEDEH 392707 NEFROLITHIASIS ESWL N20.0 98.51 III 7,853,020.00 10,090,500.00
336 DEDE DANI 301524 NEFROLITHIASIS ESWL N20.0 98.51 II 8,315,275.00 12,108,700.00
337 juju juaeni 379264 NEFROLITHIASIS ESWL N20.0 98.51 II 8,021,070.00 12,108,700.00
338 H. BADRUDIN 393639 NEFROLITHIASIS ESWL N20.0 98.51 III 7,853,020.00 10,090,500.00
339 SUSI SUSANTI 401463 AB. INKOMPLIT KURET O05.4 69.02 III 4,039,164.00 2,732,600.00
340 NURLAELA 389137 GAGAL INDUKSI PARTUS SC SCTP O61.0 O82.9 74.4 II 10,314,154.00 4,826,600.00
341 ALFIN RAHYUNI 365390 APPENDECITIS CYSTA ENDOMETRIUM LE + APPENDECTOMY + K K37 N85.8 54.11 + 47.09 + 68.2II 13,531,153.00 6,812,300.00
342 H ABDUL ROSID 401246 DYSPEPESIA HT K30 I10 I 4,564,975.00 3,891,400.00
343 TSANIALATHIFATU 352855 BRONCHOPNEUMONIA J18.0 II 2,200,268.00 4,170,100.00
344 ZIHAN NUR fauziy 302217 BRONCHOPNEUMONIA J18.0 II 3,330,464.00 4,170,100.00
345 by ny eli nurhasan 401418 NCB SMK P03.4 II 1,129,301.00 1,995,800.00
346 ELI NURHASANAH 401004 GAGAL INDUKSI PARTUS SC SCTP O60.1 O82.9 74.4 II 9,531,947.00 4,826,600.00
347 DIMAS ADITIA M 332207 TYPHOID FEVER A01.0 II 4,300,219.00 3,329,400.00
348 NOORSY M 382243 LYMPHADENOPATHY COLLI BIOPSI I88.8 40.11 I 8,402,153.00 4,949,700.00
349 REZA ADITYA 350348 ABSES EKSISI L02.9 83.49 II 9,394,779.00 5,845,600.00
350 SAEPUDIN 401323 HEMMOROID INTERNA HEMMOROIDECTOMY I84.2 49.46 III 7,464,309.00 4,354,200.00
351 YEYET SURYATI 401484 VIRAL INFECTION B34.9 II 1,350,699.00 2,331,600.00
352 LINDA APRIANI 389956 PPI O60.1 II 2,380,974.00 1,677,400.00
353 MILA HERAWATI 401384 TYPHOID FEVER A01.0 III 2,385,030.00 2,774,500.00
354 Sit Aminah 338734 SISA PLACENTA KURET O94 69.02 II 7,606,405.00 3,279,100.00
355 delia nurasyifa 401342 BBL P03.4 II 1,554,559.00 1,995,800.00
356 SELASIH MARGI SU 401078 TYPHOID FEVER DHF A01.0 A91 II 4,909,905.00 4,906,600.00
357 DIANA DWI APRIL 374672 TYPHOID FEVER A01.0 I 3,891,400.00 3,884,300.00
358 LABUAN LUMBAN 401316 TYPHOID FEVER A01.0 I 3,884,300.00 3,884,300.00
359 ANDIKA PUTRA D 324745 TYPHOID FEVER A01.0 II 2,346,483.00 3,329,400.00
360 ALISKA RASELIYA 401054 DHF A91 I 6,670,572.00 2,720,200.00
361 MELIROSDIANA 334749 TYPHOID FEVER A01.0 II 3,163,946.00 3,329,400.00
362 SADIAH 315085 CLAVUS EKSISI L84 86.3 I 9,877,175.00 4,583,900.00
363 SONI PERMADI 401364 STT EKSISI D48.1 83.49 I 8,497,236.00 6,819,800.00
364 TUMINAH 400956 LYMPHADENOPATHY COLLI BIOPSI I88.8 40.11 II 6,800,314.00 4,242,600.00
365 SUNARSIH 350372 ABSES MAMAE SIMPLE MASTECTOMY N61 85.41 I 11,305,467.00 7,137,800.00
366 MUHAMADROBBIF 366048 BRONCHOPNEUMONIAMORBILI B05.2 J17.1 II 3,864,511.00 3,398,900.00
367 CECE SUTISNA 401204 LYMPHADENITIS SUSP TB KELENJAR LYMPHADECTOMY A18.2 40 III 7,492,975.00 3,535,500.00
368 IIM SUKARNA 401225 FISTULA CUTANEOUS ABSES THORAX EKSISI + FISTULECTOMY J86.0 34.4 + 86.3 II 9,119,012.00 6,913,100.00
369 RIKO SONJAYA PUT 401290 GRANULOMA PHARYN TONSILITIS HYPERTROPI TONSILITIS HYPERTROPIK J39.2 J35.1 29.99 + 28.2 II 7,950,796.00 5,713,700.00
370 iyah wariah 384653 GASTRITIS N18.0 K29.1 II 3,507,277.00 2,793,700.00
371 YUYUN DWIYUNIAS 394448 HHD + HT GERD I11.9 K29.1 I 5,117,221.00 4,457,100.00
372 IIS SUSILOWATI 400030 KISTA ENDOMETRIUM PERIAPPENDICULAR + SELE + APPENDECTOMY + K N85.8 K37 + A41.9 54.11 + 47.09 + 68.2II 14,588,737.00 12,967,400.00
373 IIS CHOLISOH 384388 HEG O21.0 II 2,241,745.00 2,502,400.00
374 SARI NURHAYATI 401297 CPD SC PARTUS SC O33.8 O82.9 74.4 II 10,814,769.00 4,826,600.00
375 NENG AI NURALIA 366479 HT SC SCTP O14.0 O82.9 74.4 II 9,196,846.00 4,826,600.00
376 ATEN SUHENDAR 371457 ESRD GASTRITIS EROSIVE HD N18.0 K29.1 39.95 I 8,096,542.00 3,259,300.00
377 muhamad habibi 401425 BBL P03.4 II 1,557,724.00 1,995,800.00
378 JUMAR 401249 TB PARU DM A15.0 E11.9 II 4,690,076.00 5,004,900.00
379 ANASTASIA SACHAR 401192 TYPHOID FEVER HYPOCALCEMIA A01.0 E83.5 I 9,364,049.00 4,996,100.00
380 SYARIF HIDAYAT 401462 EDEMA PARU ESRD J81 N18.0 II 3,883,500.00 3,761,300.00
381 SUSENO 381687 STT EKSISI D48.1 83.49 II 6,829,352.00 5,845,600.00
382 ZIAN MAHRY RIZKY 331709 MORBILI TYPHOID FEVER B05.9 A01.0 II 1,976,753.00 3,329,400.00
383 ujun junaedi 401365 STROKE INFARK I63.9 III 5,012,125.00 2,929,900.00
384 raihan herdiana 401349 BRONCHOPNEUMONIA J18.0 II 3,275,216.00 4,170,100.00
385 Ida Farida, A.Md.K 300161 TENDINITIS SHOULDERHYPOCALCEMIA M75.8 E83.5 I 2,381,502.00 2,846,800.00
386 SURACHMAN 382756 TUMOR THYROID THYROIDECTOMY D34 6.31 I 16,173,307.00 6,705,900.00
387 FAUZAN HAFIZ, AN 334461 TYPHOID FEVER ISPA A01.0 J06.9 III 1,947,565.00 2,774,500.00
388 NINDA ASMIDA, A 375226 TYPHOID FEVER A01.0 II 3,183,528.00 3,329,400.00
389 IDAR YUSNIDAR 401542 PPOK HT + TF J44.9 I10 + A01.0 I 5,443,951.00 4,771,700.00
390 Rini Kartni 397037 AB. IMMINENS O20.0 II 2,531,989.00 1,677,400.00
391 warsini 401620 AB. INKOMPLIT KURET O05.4 69.02 II 4,583,384.00 3,279,100.00
392 IIM FATIMAH 378855 CYST OVRIUM LETSU + SC SCTP N83.2 O32.9 + O82.9 74.4 I 12,389,150.00 7,381,900.00
393 ANA SUHANA 401077 TYPHOID FEVER A01.0 II 3,329,400.00 3,329,400.00
394 SITI SRI SAMROTUL 401790 RIW. SC SC SCTP O34.2 O82.9 74.4 II 4,826,600.00 4,826,600.00
395 HJ. IKAH ATIKAH 367543 FRAKTUR ANKLE REMOVE IMPLANT Z47.0 78.69 III 11,329,183.00 2,956,700.00
396 ISMI PUJI ASTUTI 312107 ABSES GLUTEAL INSISI DRAINAGE + DEBR L02.3 86.04 8,339,442.00 2,800,400.00
397 mizzaki sakha alkha 377729 DADRS DEHIDRASI A09 E86 II 1,694,881.00 2,423,100.00
398 NURHAYANI, SE 401606 CYSTA BUCCAL EKSISI K09.8 27.49 I
399 Dimas Ardiana 329442 TYPHOID FEVER MORBILI + ISPA A01.0 B05.9 + J06.9 II 1,972,814.00 3,329,400.00
400 Gifari Arkhan Fauji 366650 DADRS KDS A09 R56.0 II 2,360,161.00 3,421,100.00
401 LIOE GIOK KIAN 302972 TYPHOID FEVER A01.0 I 3,965,400.00 3,884,300.00
402 SULASTRI MAYASAR 401528 GANGLION EKSISI M67.4 83.49 II 6,742,693.00 5,845,600.00
403 Husnia Rani Azzah 380373 BRONCHOPNEUMONIA J18.0 II 4,170,100.00 4,170,100.00
404 nanang sukianto 400171 STT EKSISI D48.1 83.39 I 8,537,979.00 6,819,800.00
405 SYARIF HERYANTO 394149 HHD + HT HYPOCALCEMIA E11.9 E83.5 III 1,886,411.00 3,183,700.00
406 ZAHRA TUSSYITA 365460 DHF BRONCHOPNEUMONIA A91 J18.0 II 4,556,563.00 3,398,900.00
407 OYOH ROKAYAH 303052 TYPHOID FEVER DENGUE FEVER A01.0 A90 II 5,197,779.00 4,282,400.00
408 DESY PERMATA SAR 390840 APP AKUT APPENDECTOMY K35.9 47.09 II 10,949,737.00 3,416,000.00
409 RORO PUJIANTI 377759 TYPHOID FEVER DENGUE FEVER A01.0 A90 II 7,236,428.00 3,329,400.00
410 DEDI IRAWAN 366098 EFFUSI PLEURA ESRD WSD J90 N18.0 34.04 II 27,937,036.00 5,388,000.00
411 ANIH HANIPAH 401556 PER KPD + SC SCTP O14.0 O42.0 + O82.9 74.4 II 10,197,911.00 4,826,600.00
412 Widya Yuniar Savitr 401564 AB. INKOMPLIT KURET O05.4 69.02 II 7,324,378.00 3,279,100.00
413 FITRIA MARYANI 378459 APP AKUT APPENDECTOMY K35.9 47.09 III 6,789,170.00 2,846,700.00
414 M HAYKAL FARDHI 373713 BRONCHOPNEUMONIATYPHOID FEVER J18.0 A01.0 II 6,026,062.00 9,699,100.00
415 MUJIMAN 307762 LYMPHADENOPATY EKSISI I88.8 40.29 II 8,929,120.00 4,242,600.00
416 NURSANTY CHAN 391376 STT EKSISI D48.1 83.49 I 10,319,184.00 6,819,800.00
417 A. K. AMIRUDIN 373360 LBP INJ FACET JOINT M54.5 81.92 I
418 nisa fhatmah azah 401575 DIARE DEHIDRASI + ISPA + ANEMIA A09 E86 + J06.9 + D51 II 2,621,310.00 3,421,100.00
419 YUYU KOMARA 335720 TTH HT + SYNCOPE G44.2 I10 + R55 I 2,176,900.00 2,176,900.00
420 NENGSIH 305638 LETSU SC SCTP O32.9 O82.9 74.4 II 9,242,582.00 4,826,600.00
421 SITI ASIYAH 391065 POST DATE PARTUS SPONTAN O48 O80.9 II 4,991,004.00 2,859,900.00
422 RETNO KURNIASIH 399697 SKIBULA ar rectum anoscopy r15 T81.0 + I84.1 I 20,130,506.00 3,852,000.00
423 by. ny. nengsih 401657 BBL P03.4 II 1,799,450.00 1,995,800.00
424 IDA ROSNANI 309021 GANGLION EKSISI M67.4 83.49 I 8,190,961.00 6,819,800.00
425 KARTIKA, ST RIW. SC PARTUS SC SCTP O34.2 O82.9 74.4 I 11,167,086.00 5,631,000.00
426 muhammad azka 401728 BBL P03.4 I 1,707,643.00 2,328,400.00
427 SUHARTINI 369450 NEFROLITHIASIS ESWL N20.0 98.51 II 7,817,650.00 12,108,700.00
428 ahmad padilah 377606 DADRS A09 II 2,219,172.00 2,423,100.00
429 SUHALIB 370251 NEFROLITHIASIS ESWL N20.0 98.51 II 8,027,650.00 12,108,700.00
430 ENDANG SULASTRI 333984 NEFROLITHIASIS ESWL N20.0 98.51 II 8,009,070.00 12,108,700.00
431 euis kartni 310773 DF VERTIGO + POLYNEUROPATI A90 R42 + G62.9 II 4,448,094.00 2,791,900.00
432 AISY RAHMA LUTF 310341 GASTRITIS DEHIDRASI ec VOMITUS + ISPA K29.7 E86 + R11 + J06.9 I 3,271,698.00 2,171,800.00
433 SARIMANAH 401640 TYPHOID FEVER DF A01.0 A90 II 3,624,437.00 4,282,400.00
434 fabio seza saputra 348670 HIL PHYMOSIS HERNIORHAPY + CIRCUMSK40.9 N47 53.29 + 64.0 III 6,741,333.00 3,569,900.00
435 SAFIRA RAIDA 334674 TYPHOID FEVER GASTRITIS A01.0 K29.7 I 2,818,245.00 3,884,300.00
436 WARDI 389628 NEFROLITHIASIS ESWL N20.0 98.51 III 7,862,156.00 10,090,500.00
437 R. EVI VIRGIANTI, N 300145 BO KURET O02.0 69.09 II 4,941,077.00 3,279,100.00
438 LIS SURTINI 401347 LYMPHADENOPATI SEPSIS + SHOCK + HY RESUSITASI I88.8 A41.9 + E87.1 99.6 I 24,440,915.00 7,028,300.00
439 Elvira Indah, AMD 301108 DYSPEPSIA HYPOCALCEMIA K30 E87.5 II 3,008,904.00 5,003,200.00
440 EPIFANI DEVANCI 401704 FAM EKSISI N60.2 85.24 I 7,896,026.00 7,137,800.00
2,696,490,627.00 2,062,820,200.00
KODE ICD KODE ICD

NO NAMA PASIEN NO. MR DIAGNOSA PRIMER DIAGNOSA SEKUNDER TINDAKAN KODE TINDAKAN KELAS HARGA RS HARGA INA CBGS
UTAMA SECUNDER
1 ANNISA PUTRI AUL 334377 MYOCARDITIS ISPA I51.4 J06.9 II 1,496,839.00 2,741,500.00
2 MUAAMAR RIZKY 342524 TOF DIARE J06.8 A09 II 1,492,935.00 1,829,000.00
3 ADIBA KHANZA AZ 367852 DADRS ISOA + D. ATOPIC A09 J06.9 + L20.9 II 3,000,166.00 2,423,100.00
4 SITI RUBIAH 317326 DYSPEPSIA ABSES K30 L02.9 II 8,639,805.00 5,003,200.00
5 CITRA AULIA HIDA 400586 TYPHOID FEVER ISPA A01.0 J06.9 II 2,257,992.00 3,329,400.00
6 farin azkia rukm 395430 DADRS ec CMPA T78.1 A09 II 6,845,098.00 1,399,100.00
7 ANGGA DANU SAP 400850 STT EKSISI D48.1 83.49 II 4,590,917.00 5,845,600.00
8 WIWI LATIFAH 400671 DYSPEPSIA HT K30 I10 II 2,845,254.00 3,335,500.00
9 AVILIA KUSUMA A 385005 KOLIK ABDOMEN R10.4 II 6,394,377.00 2,423,100.00
10 EDIATMA WIJAYA 327759 SESAK OBSTRUKTIF HT + GERD J98.8 I10 + K21.9 II 3,983,751.00 1,858,600.00
11 WIDIYATI , NY
12 WIDIYATI 400708 NEFROLITHIASIS ESWL N20.0 98.51 III 8,015,939.00 14,126,800.00
13 TETI MARYATI 397121 SLE STATUS EPILEPTIKUS CT-SCAN M32.9 G41.9 87.03 II 17,159,388.00 7,341,900.00
14 RENI GUSTRIANI 383875
15 KOSASIH 355316 PERDARAHAN ARACHNOID VENTILATOR I60.9 96.71 II 14,863,444.00 6,913,100.00
16 SETYO ADHI W 401271 DHF ISPA A91 I 4,405,650.00 2,720,200.00
17 SITI MARIAM 396006 TYPHOID FEVER TB PARU A01.0 A15.0 II 2,112,216.00 3,329,400.00
18 NABILA CAHAYA 401471 LTB BP J40 J18.0 II 10,194,570.00 5,336,700.00
19 FEBRIANA NUR 401028 TYPHOID FEVER A01.0 II 1,663,733.00 3,329,400.00
20 DWI WAHYUNI 401717 AB. INKOMPLIT KURET O05.4 69.02 II 4,134,785.00 3,279,100.00
21 I MASKANAH 321374 AB. INKOMPLIT KURET O05.4 69.02 II 4,077,577.00 3,279,100.00
22 SETIO RAHADI 345748 FISTULA ANI FISTULECTOMY K60.3 49.12 I 9,108,322.00 6,095,900.00
117,282,758.00 85,939,700.00
NAMA DOKTER
dr. DEASY, Sp.P

dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. RICHARD, Sp.THT
dr. DJOKO, Sp.B
dr. NUNUNG, Sp.OG
dr. RICHARD, Sp.THT
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. ACHMAD BARUNA, Sp.PD
dr. PITRAJAYA, Sp.B
dr. MEDIA, Sp.S ### ###
dr. ZUHAIRA, Sp.S ### ###
dr. MIFTAH, Sp.PD
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. YUDI, Sp.U
dr. MIFTAH, Sp.PD INKONSIS ### ###
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. RENNY, Sp.U
dr. RICHARD, Sp.THT
dr. SARJUNAS, Sp.OG
dr. YUDI, Sp.U
dr. RENNY, Sp.U
dr. ADE, Sp.S ### ###
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. RICHARD, Sp.THT
dr. YAYAN, Sp.M rajal
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. ZUHAIRA, Sp.S
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U
dr. DJOKO, Sp.B rajal
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.PD
dr. HISKIA ### ###
dr. DJOKO, Sp.B
dr. WIWIN, Sp.A
dr. MEDIA, Sp.S
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. DWIANA
dr. WIWIN, Sp.A
dr. MIFTAH, Sp.PD
dr. DEASY, Sp.P
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. TOTO
dr. DJOKO, Sp.B
dr. MIFTAH, Sp.PD
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. ZUHAIRA, Sp.S
dr. SARJUNAS, Sp.OG
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. DJOKO, Sp.B
dr. RICHARD, Sp.THT
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. ZUHAIRA, Sp.S
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. RICHARD, Sp.THT
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. MAULIA, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. DJOKO, Sp.B
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
cancel operasi
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. MAULIA, Sp.OG
dr. ADE, Sp.S ### ###
dr. DJOKO, Sp.B
dr. NUNUNG, Sp.OG
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. MAULIA, Sp.OG
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. NUNUNG, Sp.OG
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. ADE, Sp.S ### ###
dr. RENNY, Sp.U
dr. DEASY, Sp.P
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. NUNUNG, Sp.OG
dr. MAULIA, Sp.OG
dr. NUNUNG, Sp.OG
dr. WIWIN, Sp.A
dr. NUNUNG, Sp.OG
dr. YUDI, Sp.U
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. SARJUNAS, Sp.OG
dr. ANDRI, Sp.OT
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. SARJUNAS, Sp.OG
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. RICHARD, Sp.THT
dr. WIWIN, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B rajal
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. MEDIA, Sp.S
dr. SARJUNAS, Sp.OG
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. WIWIN, Sp.A
dr. ANDRI, Sp.OT
dr. ADE, Sp.S
dr. WIWIN, Sp.A
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. FITRIYATI
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. NUNUNG, Sp.OG
dr. DEASY, Sp.P
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. GHUNA Sp.OT
dr. PARAMITA, Sp.A
dr. GHUNA Sp.OT
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.PD
dr. YAYAN, Sp.M
dr. DJOKO, Sp.B
dr. MAULIA, Sp.OG
dr. MIFTAH, Sp.PD
dr. RENNY, Sp.U
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. ZUHAIRA, Sp.S
dr. PITRAJAYA, Sp.B
dr. ANDRI, Sp.OT
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. DJOKO, Sp.B
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
drg. FRANKY, Sp.BM
dr. SARJUNAS, Sp.OG
dr. YUDI, Sp.U
dr. MAULIA, Sp.OG
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U
dr. ZUHAIRA, Sp.S
dr. RICHARD, Sp.THT
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. SARJUNAS, Sp.OG
dr. DEASY, Sp.P
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. RENNY, Sp.U
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG
dr. MAULIA, Sp.OG
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. WIWIN, Sp.A
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. MAULIA, Sp.OG
dr. NUNUNG, Sp.OG
dr. WIWIN, Sp.A
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. RICHARD, Sp.THT
dr. MAULIA, Sp.OG
dr. NUNUNG, Sp.OG
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. ZUHAIRA, Sp.S
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG
dr. MAULIA, Sp.OG
dr. GHUNA Sp.OT
dr. DJOKO, Sp.B
dr. WIWIN, Sp.A
drg. FRANKY, Sp.BM dirajal
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. DEDI
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. NUNUNG, Sp.OG
dr. NUNUNG, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. ADE, Sp.S ### ###
dr. WIWIN, Sp.A
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. MAULIA, Sp.OG
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. YUDI, Sp.U
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. MAULIA, Sp.OG
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
NAMA DOKTER
dr. WIWIN, Sp.A

dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. MIFTAH, Sp.PD
dr. WIWIN, Sp.A
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
1 episode
dr. RENNY, Sp.U
dr. MEDIA, Sp.S
inhealth
dr. IS, sp.An
dr. WIWIN, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
Rekapitulasi INA CBGs Bulan MEI (LAPORAN MEDREK)
DIAGNOSA
NO NAMA PASIEN NO. MR DIAGNOSA PRIMER TINDAKAN
SEKUNDER
1 OKTAVIANI LATIPA 341251 STATUS EPILEPTICUS BP
2 LINDA APRIANI 389956 PPI
3 BAYU PERMANA 323402 CEPHALGIA
4 FAHMI REZA 389963 STT PEDIS EKSISI
5 NIA KURNAESIH 401545 DSS CHOLESISTITIS + TF
6 tet herawat 345268 AB. INKOMPLIT KURET
7 h. almuyawan 401533 LBP INJ
8 CENDI NERLINA SIR 385092 HYPERTENSI PARTUS SC SCTP
9 hanup naufal 401563 RD ec MAS
10 WATONAH, NY 382214 TUMOR THYROID THYROIDECTOMY
11 SOLIHAH, HJ. 401412 NEGLECT FRAKTUR HUMERUS ORIF
12 EDEH 313095 UTI HT + HYDRONEFROSIS
13 deviant agustn 401630 TYPHOID FEVER DF
14 YATI SUMIATI 399967 NEFROLITHIASIS ESWL
15 AGGRA ADIWITYA 354010 BRONCHOPNEUMONIA
16 NURMA SUSANTI 401729 TYPHOID FEVER ISPA
17 HASAN AZHARI, AN 340654 TYPHOID FEVER DIARE
18 haniya qonita salsa 384068 DIARE DEHIDRASI + DRUG INDUCED HEPATIC ec OAT + TB peng
19 JUNAEDI 401804 ABSES DEBRIDEMENT
20 KARSIMAH 353354 NEFROLITHIASIS ESWL
21 MUHAMMAD RIZKY 401670 BRONCHOPNEUMONIA
22 ADE SETIAWAN 386938 NEFROLITHIASIS ESWL
23 MAMAN SULAEMA 401385 NEFROLITHIASIS ESWL
24 KARDODI 381897 NEFROLITHIASIS ESWL
25 yoyoh 396735 NEFROLITHIASIS ESWL
26 UJU JUARIAH 350464 NEFROLITHIASIS ESWL
27 AI KOMYATI 385286 DMT2 NEUROPATHY
28 LUSI MEILANI 399897 POST ORIF DEBRIDEMENT
29 SAMAD 401591 HIL HERNIORHAPY
30 HASANUDIN 382650 HIL HERNIORHAPY
31 Raden Herlina Marl 356051 CLAVUS EKSISI
32 RIZAL MAULANA H 401783 NEFROLITHIASIS ESWL
33 MUTOHAROH 399530 PERUT GANTUNG PARTUS SC SCTP
34 DIANA RATIKA A 386738 RIW. SC PARTUS SC SCTP
35 ASEP ABDUL JAB 401673
36 DIDIN ROSIDIN 401798 FIBROMA EKSISI
37 ENTIN SURYATI 391989 DYSPEPSIA HT
38 HJ. TUMIYEM 325409 DC ec ppok/HHD/IHD
39 HENI LESTARI 331699 STT EKSISI
40 DENHAS AJI PRAYO 401314 TUMOR THYROID THYROIDECTOMY
41 WIWIT WINENGSIH 395463 TUMOR THYROID THYROIDECTOMY
42 YATI ROHAYATI 373513 OA GENU BURSITIS GENU INJ BURSA
43 MUTOHAROH 401662 TYPHOID FEVER
44 OMA PARTINI 380280 NEFROLITHIASIS URS + AFF STENT
45 GAFIN PRAQIPTA 401637 DHF TF
46 ARI PATMAWATI 401874 DYSPEPSIA VIRAL INFECTION
47 DENI AHMAD RIVAL 401856 DHF SHOCK + ENSEFALOPATI
48 OMAN 382207 POST ESWL URS + AFF STENT
49 EUIS YULIANI 401918 STT PEDIS EKSISI
50 sit maemunah 398002 POST ESWL URS + AFF STENT
51 alifa safwatul fayza 401946 BBL
52 RODIAH 401908 GASTROPATI NEFROLITHIASIS
53 SITI JULAEHA 400508 PARONIKIA INFEKSI SEKUNDER ROZERPLASTY + EKSISI
54 ADHY LESMANA FI 395495 DADRS
55 FAWAZ RIDHO WAS 401583 TYPHOID FEVER BRONKHITIS + DF
56 ALMIRA ALYCIA SUJ 401967 BACTERIAL INFECTION
57 jehan saumi 401957 GEA
58 ROSENDI 334794 PSEUDOKISTA DAUN TELINGA KIRI EKSISI
59 muhamad audi meg 378910 DADRS
60 ABD RAHMAN 375818 DCM DC + HT + DM + DKD + DYSLIPIDEMIA
61 TRIA RAHMAWATI 399855 GLAUCOMA PARTUS SC SCTP
62 desi syafutry 401910 BRONCHOPNEUMONIA
63 NENI NURAENI 350808 KPD PARTUS SPONTAN
64 RANI NURBAYANI 343151 RIW. SC PARTUS SPONTAN KURET
65 ROKAYAH 356478 DC-HHD CKD St V ANAEMIA
66 HASYASYAFITRI 332071 TYPHOID FEVER
67 ETIN SETIATIN 384881 AB. INKOMPLIT KURET
68 SUBARDI 352118 HIL HERNORHAPY
69 AHMAD SUBARNA 401934 DEHIDRASI BERAT GEA
70 DEDI IRAWAN 366098 EFFUSI PLEURA CAP
71 CARISA KHUMAIRA 328992 TYPHOID FEVER
72 nandagia dwi liest 402068 GANGLION EKSISI
73 NaNI ROHAENI 401378 KISTA THYROID THYROIDECTOMY
74 YULISTIA HARDIYAN 401833 LYMPHADENOPATY LYMPHADECTOMY
75 syamsudin 392227 LBP INJ FACET JOINT
76 CUCU CUNAYAH 369989 KPD PARTUS SC SCTP
77 WASKIM 401358 ULCER PEDIS DEBRIDEMENT
78 heni rohaeni 401925 DYSPEPSIA VERTIGO
79 MIFTAHUL jANNAH 402084 HAP
80 LILIS SUMIATI 354377 HEG
81 AHMARUN 393344 SPONDYLOPATHI LUMBAL INJ FACET JOINT
82 wildan djaelani 402106 STT PEDIS EKSISI
83 CICIH 393829 NEFROLITHIASIS ESWL
84 IJAH 396688 NEFROLITHIASIS ESWL
85 mulyat 402112 CA CERVIX BIOPSI
86 Sit Choerunisa 402117 STT EKSISI
87 MUHAMAD DARIS 483893 HYPERPIREKSIA
88 LIA SUGIAROH 401875 TYPHOID FEVER
89 muhamad ramdan 391935 BP TB
90 RETNO KURNIASIH 399697 KONSTIPASI
91 MARIAH 401881 AIHA GASTRITIS EROSIVE
92 TITIN SUHARTINI 385442 LETSU SC SCTP
93 METTA AMALIA N 401980 OF FATELLA RUPTUR QUADICEPS REPAIR TENDON
94 DARMO 400611 TUMOR TESTIS ORCHIDECTOMY
95 NAWANGSIH 379910 CPD SC SCTP
96 HIKMAH WULAN FA 401936 LETSU PARTUS SC SCTP
97ASEP ABDUL JABAR 401673 FISTULA ANI HEMMORROID INTERNFISTULECTOMY + HEMORROIDHE
98 SONIA MANAH NAS 402138 TYPHOID FEVER
99 TERA PISKASARI 369956 ASMA
100 HENDRI LUKMAN A 398095 HIL HERNIORHAPY
101 MAJIDI 401953 ILEUS PARALYTIC HYDROPS VESICA FELLANEMIA
102 EDEH 313095 HYDRONEFROSIS NEFROLITHIASIS ESWL
103 SUTISNO, S.PD. 380508 NEFROLITHIASIS ESWL
104 HAPID 402040 HEMORRHOID HEMORROIDHECTOMY
105 AZKA SYAFFA MUTA 301801 TYPHOID FEVER
106 NIHA AULIA SARI 402215 DENGUE FEVER ISPA + VIRAL INFECTION
107 BAGAS ERLANGGA 401928 TYPHOID FEVER
108 IMAY ISMAIL 401849 TYPHOID FEVER ORCHITIS
109 tyan prabowo 394612 GEA
110 reyhan putra prat 401145 HEMANGIOMA FEMUR EKSISI
111 ASMID 401987 PPOK
112 OVI NOVITA 402214 PEB SC PARTUS SC
113 YEYET ROHAETI SE 400854 TENDINOSIS SHOULDER INJ SHOULDER
114 SAMSUDIN 316395 LBP INJ
115 MAMAN 381881 HHD GASTRITIS EROSIVE
116 PUSPITA SUCI MUT 402080 TYPHOID FEVER DHF
117 ABAS 401973 MYELOPATHY CERVICAL ec SP SPONDILOPATHY CERVICAL + AKI
118 Nazma Amalia Zaha 347394 TYPHOID FEVER
119 Alfin Andriansyah 402218 OF
120 DINA KRISTIANA 394746 RADICULITIS + BI
121 et tatn diani 3880221 ABSES DIGITI III MD INCISI
122 EKA RURY 379927 LUPUS NEPHRITIS
123 NAZRILILHAMNUG 402007 DHF
124 pazia ajwa nurhalu 402220 KDS
125 SODIK DJUJARTIN 369536 URETEROLITHIASIS HYDRONEFROSIS ESWL
126 HJ. TITIN KURAESIN 326340 NEFROLITHIASIS ESWL
127 MUHAMAD RIZKY A 402063 TYPHOID FEVER TOF
128 YUNI KARTIKA 402193 DYSPEPSIA UTI
129 MASRON 401982 HT HNP
130 SUMO WIYONO 402204 HIL HERNIORRHAPY
131 evi liana masmedi 396012 RIW. SC PARTUS SC SCTP
132 KENZO ALVARO HU 398093 TYPHOID FEVER
133 TITO SUPIATI 401754 TUMOR PARU NODUL SOLTARY + DYSPEPSIA + BEKAS TB
134 SARI DJURIAH, HJ 402330 GEA DMT2
135 KARSIN 325111 TENDINOSIS SHOULDER INJ TENDON SHEAT
136 YUL HIZBAINI 401871 PANCYTOPENIA PERIFER
137 ASEP RIMBAWAN 402277 VI
138 NANI 308870 BR AKUT DM
139 EUIS NURSAADAH 402339 DYSPEPSIA
140 ARWIN SUANDI 402219 TYPHOID FEVER TAK
141 WARJA BIN CAMU 402421 SUSP STROKE PIS
142 SITI MARDIANA 402508 PLR SPONTN KURET
143 SARNADI 398897 CHOLELITHIASIS CHOLECYSTECTOMY
144 UUS HIDAYAT 324129 STT EKSISI
145 ANJAR PIANDRA PU 365270 DADRS
146 SITI MASITOH 383207 DYSPEPSIA EPILEPSI
147 AULIANAZWAF 323855 VARICELLA
148 DEMAH BT SARDI 402318 SPONDILOPATHY LUMBAR HNP INJ FACET JOINT
149 SURIYAH 349014 MASTITIS
150 MAFGAN SUPRIYAD 380308 ASMA
151 SITI KAMILLIYA 402409 GEA
152 neng iim marlina 383831 NEFROLITHIASIS ESWL
153 OOM 393052 NEFROLITHIASIS
154 SUGENG BUDI TRI 372622 NEFROLITHIASIS ESWL
155 TRESNO PAMBUDI 400527 STT EKSISI
156 GINAN 352289 EFFUSI PLEURA PUNGSI PLEURA
157 azzahirapuji ramad 385293 DADRS
158 ADE KARTA 331617 VARICOCELE varicocelectomy
159 FANI YULIANTY, Am 389406 CANCEL CHOLECYSTECTOMY KRN PX HAID
160 SUTOMO 391026 TF KP + GEA
161 DEVI HARIANI 397868 CHOLELITHIASIS CAD
162 HENNIATI MANIK 402404 TYPHOID FEVER
163 RIZKY ZULFIKAR 402331 TYPHOID FEVER DF
164 PARTINI 393686 MYOM UTERI ANEMIA SOS
165 FENNY TRIANA SO 393365 G3P2A0 TIDAK ADA KEMAJUAN PERSalinan
166 IPANG 398036 NEFROLITHIASIS ESWL
167 UDIN MISBAHUDIN 369589 NEFROLITHIASIS ESWL
168 RODIAH 401908 NEFROLITHIASIS ESWL
169 KOMARIAH 402524 HHD CAD
170 nanang nugraha 378573 NEFROLITHIASIS ESWL
171 YETI YULIATI 401920 LYMPHADENOPATY BIOPSI
172 SAAT 402098 CKD BPH + HYPOKALEMI
173 RIPKI PUTRA HIDA 338505 HYPERTROPI TONSILADENOIDGRANULOMA PHARYNG COUTER PHRYNG + TONSILADENO
174 IDRIS ISMAIL 402060 HT STROKE INFARK
175 HETTY RAHMAWAT 358700 GAGAL INDUKSI SC SCTP
176 by ny hetty rahma 402426 BBL
177 ALFIRA NADHIFA B 389227 ASMA ISPA
178 AAH MARTINI 323924 GASTRITIS AKUT
179 akhsya adiba 395655 BP + TB PARU DADRS
180 RENALDY DWI PUT 402701 DHF
181 HERMANDA 402383 DF TF
182 LULU LATIVASARI 402708 BACTERIAL INFECTION
183 NENG SITI ZAHIRA 402431 TYPHOID FEVER DHF
184 m. alif rizia seto 402686 DADRS ISPA
185 MERVANPEBRIANA 337912 TYPHOID FEVER
186 nagita kaiyra putr 402668 MORBILI ISPA
187 H. BADRUDIN 393639 HT VERTIGO + BPH
188 mudakir 385252 CANCEL OPERASI HERNIA APS
189 ENENG KULSUM F 365014 FAM EKSISI
190 SAHRI SYARIPUDIN 402302 HIL HERNIORHAPY
191 Ch. Wilhelmina P. 348498 TRIGGER THUMB RELEASE PULLY
192 CASMID 372911 NEFROLITHIASIS HYDRONEFROSIS ESWL
193 BINTANGVALENTI 308492 TYPHOID FEVER ISPA
194 UTIN 314765 NEFROLITHIASIS ESWL
195 DINI PURWANTI 402437 FISTULA ANI FISTULECTOMY
196 ENUNG NURHAYATI 371988 LBP INJ
197 LINGGA DZAKI APR 349814 TYPHOID FEVER ISPA
198 KANIA SARI 389390 LL SC SCTP
199 Jadi setadi 402425 BACTERIAL INFECTION
200 TIARAPUTRIALWIA 321555 TYPHOID FEVER
201 FANI NURMAULIDI 402491 TYPHOID FEVER
202 SARINEM 397765 LBP INJ
203 R SYAFINA AZIZAh 399305 TOF TB PARU
204 RAICY MAYORA 402537 TYPHOID FEVER
205 ROKAYAH 356478 HT CKD + ANEMIA
206 YENI MARLINA 304339 RIW. SC SC SCTP
207 NENG YUYU 382625 CPC TB PENGOBATAN
208 MUTOHAROH 401662 TYPHOID FEVER
209 ATI'AH BT SAYIM 402538 MENINGIOMA
210 ABDUR ROUF 386687 TRANFUSI ai THALASEMIA
211 HENI MULYANI 402380 SNNT ISHMULOBECTOMY
212 SUDARSONO 401865 HYDRONEFROSIS NEFROLITHIASIS ESWL
213 TAYINAH 398069 HNP INJ
214 NINING SUHRIANIN 402321 AB. INKOMPLIT KURET
215 NANI MARYATI 389524 NEFROLITHIASIS ESWL
216 DEDE SUPRIYADI S 399654 HYDRONEFROSIS URETROLITHIASIS ESWL
217 YOGA MAULANA 355860 DEHIDRASI ISPA + DIARE
218 SINTIYA SUSI KARTI 402728 TYPHOID FEVER
219 rustam 391723 DJ STENT IN SITU URS + AFF STENT
220 DAHLAN H SANUSI, 331899 NEFROLITHIASIS ESWL
221 DINI RAHMAWATI 401171 RIW. SC PLASENTA PREVIA SCTP
222 KEN ARIA HILAL R 383659 DEHIDRASI ISPA
223 afiqa putri rahmaw 402726 BBL SC
224 ASORI 402752 ACS CHF
225 HUSEN IRAWAN 398110 OA CALCANEUS SPUR + TB + HHD
226 iyoh 402789 DYSENTRI
227 ABD RAHMAN 375818 DYSPEPSIA DM NEUROPATHY + DC + DCM
228 HJ.SITI HAFSAH 402631 DC-HHD HYPERGLIKEMIA
229 A NURJANAH 402542 LIPOMA EKSISI
230 MASTUROH 363967 STENOSIS URETER URETERAL MEATOTOMY + LITOTRIP
231 IMAM SUSANTO 325146 STENOSIS URETER BATU URETER URETERAL MEATOTOMY + LITOTRIP
232 wahid 402096 BPH PROSTATECTOMY
233 TATI SUHARYATI 402616 TUMOR PAYUDARA EKSISI
234 MUSLIHAH 402736 ABSES SCAPULA INSISI
235 NUNUNG KURNIA 315651 CYSTA UMBILICUS EKSISI
236 Meike Dewi Murt, 310176 TYPHOID FEVER DHF
237 NANA TARLINA 402946 HT PARTUS NORMAL
238 SITI JULAEHA 402808 DHF
239 MAZHARRIFA AMR 402779 ABSES SUBMANDIBULLA
240 cahaya ratu arum 370895 BP
241 SITI NUR ALHAH 334829 DIARE
242 TRINNY RACHMAYA 402576 TRIGGER FINGER
243 RIKY IRHAM MANS 402832 PHIMOSIS CIRCUMSISI
244 DJOKO BISONO 401599 STT EKSISI
245 CARMISUMARNI 402457 AB. IMMINENS HEG
246 HJ SAYIDAH 389483 SIROSIS HATI CAP + CHF
247 febriant nuraemi 402644 STT EKSISI
248 MOCHAMAD ICHS 402805 VI TOF
249 TUGIARTO 402753 SIROSIS HATI
250 MOGY ANTAMA DI 402803 DF TF
251 SUHENDI 402507 HT UNSTEABLE ANGINA + DC-HHD + DM
252 R WAHYUNINGSIH 390346 TANSFUSI CA MAMAE ANEMIA
253 MARSIN 402870 LIPOMA EKSISI
254 NINA SUMARYATIN B 335752 KISTA COLLI EKSISI
255 H MA'MUN MULYA 392562 HT TENDINISITS + SEQ. STROKE
256 eni nuraeni 402893 GALACTOCELE SIMPLE MASTECTOMY
257 EKLINA NAINGGOLA 355505 APPENDICULAR LE + APPENDECTOMY
258 ANGGARDA PRATA 389162 TYPHOID FEVER
259 BUBUN RUNADI 402798 STROKE INFARK
260 SALMA NURUL TAZ 326025 HYPOCALCEMIA HYPOKALEMIA
261 sri rahayu 402622 STT EKSISI
262 IDAR SUMPENA 399641 DM ULCER AMPUTASI
263 MEISYA AYU PRAT 402715 BRONCHOPNEUMONIA
264 muhamad ferdians 389332 BRONCHOPNEUMONIA
265 KOMAR 400087 NEFROLITHIASIS ESWL
266 RANI NURAENI 392654 NEFROLITHIASIS ESWL
267 MAMAN HAMDANI 396316 NEFROLITHIASIS ESWL
268 AMUDSETIAWAN 402884 URETROLITHIASIS URETEROLITHOTOMY
269 saminah 400808 BATU STAGHON PYELOLITHOTOMY + INSERSRI STE
270 Cucu Kurniasih 348598 AB. IMMINENS
271 MISWANTO 402458 TB BE
272 NINDA WAHDANIAT 300011 TYPHOID FEVER
273 DELLA FEBRIANI 363757 TYPHOID FEVER CERVICOGENIC HEADACHE
274 AMI FITRI YANTI 333990 TYPHOID FEVER TOF
275 H. SAUD SUGIARNA 402976 OF
276 HJ. ROHMAH 402775 CAD HT + DM
277 PAHRUDIN 402394 CML
278 INDRA HUSNI 354518
279 SUNYANI 403031 SUSP CA MAMAE BIOPSI
280 RAISI FANATA MUS 343080 TYPHOID FEVER
281 SUSI HERLINA 402664 HEMMOROID INTERNA 402266
282 tjah 396878 NONFUNCTIONAL GINJAL NEPHRECTOMY
283 WIWI MARLIYANI 353434 ABSES MAMAE EKSSISI
284 AAS MUNIROH BIN 402912 STT EKSISI
285 TALITHA KAMILIA 377851 HIL HERNIORHAPY
286 Shintania Hersavitr 335937 EFFUSI PLEURA PUNGSI PLEURA
287 MADIA KURNIAWAN 402405 METABOLIK ENCEPHALOPATHYDYSEQUILIBRIUM
288 didi kartawijaya 400269 NEFROLITHIASIS ESWL
289 TUMINAH 400956 DILI TB LIMPHADENOPATY
290 AYU KOMARIAH 402264 CYSTA CHOCLATE BSO
291 L HARAHAP 399858 STROKE HAEMORRHAGIC DC + AMI
292 ERLANGGA DHILDA 334923 TYPHOID FEVER DEHIDRASI
293 YUYUN YUNENGSI 402937 CPD RIW. SC + PARTUS SC SCTP
294 FANI YULIANTY, Am 389406 CHOLELITHIASIS + CHOLECYSTECTOMY CHOLECYSTECTOMY
295 JAKA 402266 TUMOR TRIGLOSAL TRIGLOSECTOMY
296 NANI ROHANI 403069 HT DM dg HYPOGLICEMIA + ANEMIA + CKD
297 DADAN PERMADI 402974 VIRAL INFECTION EPISTAXIS
298 DELLA TRISHIANA 310801 GBS PARAPARESE + BRONCHIOLITIS
299 SYIFAIRMAYANTI 333652 TYPHOID FEVER DHF
300 EKA ROSA LINA 402942 KP AKTIF SEPSIS + EFFUSI PLEURA
301 HJ. KOMARIAH 400306 SIRHEP ILEUS OBSTRUKTIF
302 NEULIS 373896 DIARE HHD
303 ANI SATRIANA 403088 PLACENTA LATERALIS PARTUS SC SCTP
304 MUHAMAD ALFARIZ 313514 TYPHOID FEVER
305 GALANG RIZKYAWA 402975 TYPHOID FEVER DHF
306 LUTFI EKA PRASETI 402817 TYPHOID FEVER
307 suhendar 401636 SPONDILOPATHY LUMAR HNP INJ FACET JOINT
308 SITI NURJANAH 402992 CPD PARTUS SPONTAN SCTP
309 aqillah saepudin 403161 BBL
310 MELIAN HARIANI S 303072 GAGAL INDUKSI PARTUS SC SCTP
311 ENDANG SULASTRI 333984 URETER STENT URS + AFF STENT
312 DAYAT SUPRIADY 402901 APP LE
313 IIN SUHARTINI 307588 NEFROLITHIASIS ESWL
314 ASLIHATI 304598 NEFROLITHIASIS ESWL
315 EVI SUSANTI 403179 DYSPEPSIA CEPHALGIA
316 novel shelvya 403164 AB. INKOMPLIT KURET
317 ANE NADIA AMNA. 342834 LETSU PARTUS SC SCTP
318 CUCU KOMALASARI 400132 NEFROLITHIASIS ESWL
319 NURHAYATI 395576 DCM AF
320 FARIZ AL FARIZI 370947 DADRS
321 RIZHAN PRAWIRA 402843 TYPHOID FEVER
322 ALINKA PUTRI ABD 387479 TYPHOID FEVER
323 M ALFATHIR H, AN 303424 PNEUMONIA
324 YUNI NURHASANA 402483 LYMPHADENOPATY TB INSISI
325 ASYIFA RINALTI 403183 TYPHOID FEVER
326 KUSMIATI 397652 SPONDILOPATHY LUMAR HNP INJ SACROEPIRODAROLYSISI
327 YUYUN DWIYUNIAS 394448 NEFROLITHIASIS ESWL
328 LUCINA H SIREGAR 307353 CAP + KP DECUBITUS + PARKINSON
329 CICIH SUKAESIH 402638 CYSTA OVARIUM BSO
330 SUGENG BUDI T 372622 NEFROLITHIASIS ESWL
331 DAHLAN SUMAN P 403022 ILEUS OBSTRUKTIF ec HIL HERNIORHAPY
332 SAODAH 385013 HHD DYSPEPSIA + CHOLELITHIASIS dg CHOLECYSTITIS + CAD
333 YUNITAANGGRAEN 403262 BRONCHOPNEUMONIA
334 YUDI KAMALSYAH 368747 LYMPHADENOPATY BIOPSI
335 SAMSINAR 402892 CHOLELITHIASIS + CHOLECYSTECTOMY LE + CHOLECYSTECTOMY
336 HAYATI 402554 GASTROPATI HEADACHE
337 MAYANG SARI 394988 APP APPENDECTOMY
338 WAHYUDIN 403255 STT EKSISI
339 NASWA DWI ANNGY 403228 TYPHOID FEVER DHF
340 KANANG 371098 STENOSIS URETER BATU URETER URETERAL MEATOTOMY + LITOTRIP
341 PERAWATI 389018 KPD PARTUS SPONTAN
342 ADI SUCIPTO 401703 PTERYGIUM PTERYGIOPLASTY
343 NANA HUSNA HS, 401672 PTERYGIUM PTERYGIOPLASTY
344 ANDHIKA DEWATA 403087 TYPHOID FEVER DHF
345 RITA LENI 399701 TUMOR THYROID THYROIDECTOMY
346 SURYANI 403118 KPD PARTUS SPONTAN
347 rika ratna puri 373371 TYPHOID FEVER FARINGITIS
348 DIAN DARMAWAN 399692 DMT2 ABSES INTRAABDOMEN
349 NURJAMILAH BY 403315 PNEUMONIA
350 YUSUF TANUWIK 391787 TIA
351 WIWI MARLIANI 353434
352 DEVI HARIANI 397868 CHOLELITHIASIS CHOLECYSTECTOMY
353 HILWA CHAERUL 325633 TYPHOID FEVER
354 muhammad sakt aj 386351 ISPA PHYMOSIS
355 Ginan Rinandi 352289 EFFUSI PLEURA PUNGSI PLEURA
356 YULI YULIANTI 403382 FAM EKSISI
357 NENENG HADIATI 390865 EFFUSI PLEURA PUNGSI PLEURA
358 AGUNG PRASETYA 339684 HT KOSNTIPASI
359 FENNY TRIANA S 393365 POST DATE PARTUS SPONTAN
360 XALSHA AZZURA 403150 TUMOR ABDOMEN EKSISI
361 SUKATMA 324759 MYELITIS DYSPEPSIA
362 hasan basri 403437 KISTA ATHEROMA EKSISI
363 HJ.SUGIARTINI 301953 LIPOMA EKSISI
364 ARMAN 403139 FARINGITIS KRONIS TONSILITIS HYPERTROPCOUTER PHRYNG + TONSILECTOM
365 NURJAMILAH NY 313809 RIW. SC PARTUS SC SCTP
366 IKA SARTKA 403514
367 PRAMONO 391175 NEFROLITHIASIS ESWL
368 ROPENDI 372162 NEFROLITHIASIS ESWL
369 RATNA NUR AISYAH 398574 FAM EKSISI
370 MEGAWATI 403299 DYSPEPSIA KONSTIPASI
371 WARIH 401635 HYDRONEFROSIS URS
372 EUIS MARIAH 378586 SUSP CA CERVIX STD III HYPOCALCEMIA
373 FANNYJULIANI 337885 ABBERANT MAMAE EKSISI
374 ASLI HATI 304598 ISK
375 DIVA A R 403401 TYPHOID FEVER
376 ZAIDUL KISMAN 372727 NEFROLITHIASIS ESWL
377 INDRAHUSNI M 354518 NEFROLITHIASIS ESWL
378 TIN AFFIANTINI 383684 HT STROKE ULANG + HYPERLIPIDEMIA
379 shidqiyya suci ram 394117 DADRS
380 WELLY NATHALIA 402910 DYSPEPSIA DMT2 + T. KRURIS
381 HANAPI 403332 DC-HHD DYSPEPSI
382 YETI 402908 CYSTA COKLAT SOS
383 MUHAMMAD GILA 403456 TYPHOID FEVER
384 ANI NURAENI 402379 LYMPHADENOPATHY BIOPSI
385 SITI MAESAROH 392858 OA INJ
386 HJ NAFISAH 403452 HT TTH
387 Cucu Kurniasih 348598 BO KURET
388 H. KARDI BIN JAHI 403500 STROKE INFARK DEHIDRASI
389 DEDI AMALUDIN 400094 HYDRONEFROSIS NEFROLITHIASIS ESWL
390 A RUSJAMAN K 403143 ABSES PERITONSILAR DM + EPIG;OTITIS
391 MASTUROH 363967 NEFROLITHIASIS ESWL
392 fitra setawan 403446 DHF
393 ZAHRA APRILIa WIJ 344491 TYPHOID FEVER ISPA + STOMATITIS + KONSTIPASI
394 silvia azkha syaqila 403537 ISPA
395 EGI SAPUTRA 403564 DIARE
396 JUNADIWATI 403344 ITP DM TIPE LAIN
397 TARYANA 403526 TOURETTE
398 TAKRIB BIN BAD 381151 OF TIBIA OSTEOMYELITIS ORIF
399 SUHERTI 403565 LYMPHADENOPATHY EKSISI
400 KUSNADI 315131 LIPOMA EKSISI
401 SRI MULYANI 403502 KISTA SUBLINGUAL EKSISI
402 IIS HERYANI 401223 OA INJ INTRAARTICULAR
403 SUDIBJO 403135 ULKUS DM EKSISI
404 ARMIAH 403199 ULKUS DM
405 newi 403372 ULKUS DM EKSISI
406 DEDE SITI AMINAH 401148 HT PARTUS SPONTAN
407 dasih 403345 STT EKSISI
408 INTAN JUWITA SARI 386041 CHOLEITHIASIS CHOLECYSTECTOMY
409 YANTI NURHAYATI 403415 TYPHOID FEVER ISPA
410 FAKHRIAKAMILAFE 351508 TYPHOID FEVER ISPA
411 ai nurhayat 403375 TUMOR MAMAE DX MASTECTOMY
412 UDIN BADRUDIN 403218 HIL HERNIORHAPY
413 YANNY 402454 DYSPEPSIA DMT2
414 muhammad irsyaad 403591 BBL ai SC
415 MEGA VIRGIANI, HJ 402069 DKP PARTUS SC SSTP
416 HOTIMAH 389297 CA MAMAE HT RADICAL MASTECTOMY
417 ATI HARYATI 382191 KISTA COKLAT SOB
418 IPAH LATIPAH 403544 LS PARTUS SC SSTP
419 NURAENI BT NA 403445 KISTA OVARIUM SOB
420 YATI SUMIATI 399967 HYDRONEFROSIS BATU PYELUM ESWL
421 NURHAYATI 403348 FARINGITIS KRONIS TONSILITIS HYPERTROPCOUTER PHARYNG + TONSILECTO

422 calon bayi ny nana 402947 PNEUMONIA ASHFIXIA
423 YENI SUPRIANI 403624 FAM EKSISI
424 YAYA 402008 HYDRONEFROSIS NEFROLITHIASIS URS + ESWL
425 Talitha Nashyr 339202 TYPHOID FEVER ISPA
426 MULYADI 402197 BATU STAGHON PYELONEPHROTOMY
427 EDWIN ISKANDAR 403316 DHF UTI
428 JAENUDIN ANHA 400241 DYSPEPSIA ISK
DIAGNOSA
NO NAMA PASIEN NO. MR DIAGNOSA PRIMER SEKUNDER TINDAKAN
1 WIDIYATI 400708 NEFROLITHIASIS HYDRONEFROSIS ESWL

2 ICIH SUTARSIH 401989 AB. INKOMPLIT KURET
3 KOSWARA 402010 PARONIKIA
4 IR. SAHILUN 402100 LIPOMA EKSISI
5 SRI NUROHAYATI 384963 TYPHOID FEVER ISPA
6 AINUN MARDIYAH 383304 VI
7 ERNI HERAWATI 338199 EFFUSI PLEURA SEPSIS
8 KAISA ZAHIRA NUR 402065 DF
9 TYARA NABILLA. S 384963 MYOSPASME
10 GALAM 402546 TYPHOID FEVER
11 KAISA ZAHIRA NUR 402065 TYPHOID FEVER
12 JOHAN ANWAR SY 320874 HT
13 ELFITRA 318004 HEP A BRONKITIS AKUT
14 ANWAR ADRIAN 320013 TYPHOID FEVER DHF
15 ETI SULASTRI 397340 DM ULCER EKSISI
16 AINUN MARDIYAH 383304 TYPHOID FEVER
17 RIDWAN MAULANA 481633 DYSPEPSIA DIARE
KODE ICD KODE ICD KODE TINDAKAN KELAS HARGA RS HARGA INA CBGS
UTAMA SECUNDER
G41.9 J18.0 I 13,853,745.00 3,119,700.00
O47.0 II 1,273,619.00 1,677,400.00
R51 II 6,981,539.00 1,865,900.00
D21.2 83.49 I 11,254,075.00 6,819,800.00
A91 + R57.8K81.8 + A01.0 II 14,706,863.00 3,398,900.00
O05.4 69.02 II 4,772,782.00 3,279,100.00
M54.59 II 1,891,942.00
O16 O82.9 74.4 II 10,322,577.00 4,826,600.00
P24.0 P22.9 II 6,547,163.00 2,523,100.00
D34 6.31 III 11,739,268.00 4,789,900.00
S42.40 T74.0 79.31 I 26,355,002.00 7,272,500.00
N39.0 I10 +N13.3 II 5,724,800.00 2,787,800.00
A01.0 A90 III 2,237,800.00 3,568,700.00
N20.0 98.51 III 8,336,454.00
J18.0 II 1,822,156.00 4,170,100.00
A01.0 J06.9 II 2,758,355.00 3,329,400.00
A01.0 A09 III 2,307,413.00 2,774,500.00
A09 E86 + T37.1 + Y41.1 + Z92.9 I 2,320,572.00 2,827,100.00
L02.9 86.22 I 5,602,017.00 3,267,100.00
N20.0 98.51 III 8,209,494.00
J18.0 II 2,187,394.00 4,170,100.00
N20 98.51 II 8,542,086.00
N20 98.51 II 8,504,872.00
N20.0 98.51 III 8,128,666.00
N20.0 98.51 I 8,912,086.00
N20.0 98.51 III 8,350,442.00
E11.4 G59.0 I 3,669,787.00 3,619,200.00
Z47.0 86.22 III 11,554,426.00 2,956,700.00
K40.9 53.29 III 6,805,824.00 3,569,900.00
K40.9 53.29 II 9,467,664.00 4,283,900.00
L84 86.3 II 8,223,547.00 3,929,100.00
N20.0 98.51 I 13,190,253.00
O34.8 O82.9 74.4 III 7,409,319.00 4,022,100.00
O34.2 O82.9 74.4 II 8,869,113.00 4,826,600.00
D48.1 83.49 I
K30 I10 II 2,885,527.00 3,335,500.00
I11.9 J44.9 + I24.9 III 3,543,760.00 4,315,900.00
D36.7 83.49 II 6,529,994.00 5,845,600.00
D34 6.31 III 11,435,175.00 4,789,900.00
D34 6.31 III 11,635,044.00 4,789,900.00
M19.97 M70.58 83.96 I 2,173,308.00
A01.0 II 4,522,839.00 3,329,400.00
N20.0 58.22 + 97.65 III 13,579,194.00 2,053,600.00
A91 A01.0 I 4,996,100.00 5,724,400.00
K30 B34.9 III 2,372,692.00 2,779,600.00
A91 R57.9 + G04.9 II 7,492,827.00 5,416,400.00
n20.0 58.22 + 97.65 II 15,691,310.00 3,113,300.00
D48.1 83.49 I 8,578,053.00 6,819,800.00
N99.1 58.22 + 97.65 II 15,841,558.00 2,464,300.00
P03.4 II 1,765,906.00 1,995,800.00
K31.4 N20.0 III 3,583,234.00 2,779,600.00
L03.0 T81.3 86.27 + 86.23 III 6,139,159.00 2,333,600.00
A09 II 1,820,351.00 2,423,100.00
A01.0 J20.9 + A90 II 8,914,933.00 4,282,400.00
B34.9 II 3,329,400.00 3,329,400.00
A09 I 2,827,100.00 2,827,100.00
D23.2 18.29 II 4,609,932.00 1,862,100.00
A09 II 2,982,844.00 2,423,100.00
I42.0 I11.9 + E14.2 + N08.3+ E78.5 I 6,589,947.00 4,063,100.00
H40.9 O82.9 74.4 II 8,269,038.00 4,826,600.00
J18.0 II 3,011,728.00 4,170,100.00
O42.9 O80.9 II 4,312,542.00 2,859,900.00
O34.2 O75.7 69.02 II 10,463,002.00 2,458,000.00
I13.1 D63.8 I 4,530,800.00 4,530,800.00
A01.0 II 2,723,892.00 3,329,400.00
O05.4 69.02 II 5,484,748.00 3,279,100.00
K40.9 53.29 II 7,511,389.00 4,283,900.00
E86 A09 I 2,167,359.00 1,652,700.00
J90 J18.9 II 10,286,701.00 7,340,300.00
A01.0 I 2,993,766.00 3,884,300.00
M67.4 83.49 I 9,146,968.00 6,819,800.00
E04.9 6.31 II 10,495,550.00 5,747,900.00
I88.8 40 II 6,652,820.00 4,242,600.00
M54.5 81.92 III 1,512,696.00
O42.9 O82.9 74.4 II 10,132,335.00 4,826,600.00
L98.4 86.22 II 7,889,503.00 2,786,300.00
K30 R42 III 3,719,891.00 2,779,600.00
O46.8 III 1,673,337.00 2,085,300.00
O21.0 I 3,679,152.00 2,919,500.00
M48.96 81.92 I 2,280,263.00
D48.1 83.49 II
N20.0 98.51 II 8,401,586.00
N20.0 98.51 II 8,708,158.00
C53.9 67.12 II 4,934,860.00 3,276,700.00
D48.1 83.49 II 5,629,442.00 3,929,100.00
R50.9 III 527,816.00 1,556,900.00
A01.0 I 5,884,476.00 3,884,300.00
A16.2 II 3,588,097.00 5,004,900.00
K59.0 I
D59.1 K29.1 III 1,464,315.00 2,325,800.00
O32.9 O82.9 74.4 II 8,953,212.00 4,826,600.00
S82.01 S76.1 83.88 II 21,445,755.00 5,845,600.00
D29.2 62.3 III 7,928,278.00 5,570,600.00
O33.8 O82.9 74.4 II 9,562,226.00 4,826,600.00
O32.9 O82.9 74.4 III 7,971,467.00 4,022,100.00
K60.3 I84.2 49.12 + 49.46 II 8,434,464.00 5,225,100.00
A01.0 II 5,288,754.00 3,329,400.00
J45.9 II 1,847,059.00 1,862,800.00
K40.9 53.29 II 9,791,659.00 4,283,900.00
K56.0 K82.1 + D63.8 I 10,854,768.00 4,022,400.00
N13.2 II 8,609,502.00
N20.0 98.51 I 8,884,166.00
I84.2 49.46 II 10,115,103.00 5,225,100.00
A01.0 I 3,135,448.00 3,884,300.00
A90 J06.9 + B34.9 II 1,790,135.00 2,331,600.00
A01.0 III 3,933,461.00 2,774,500.00
A01.0 N45.9 I 10,587,387.00 3,884,300.00
A09 II 3,124,041.00 2,423,100.00
D16.2 83.49 III 7,650,230.00 4,871,300.00
J44.9 III 4,425,770.00 2,398,400.00
O14.1 O82.9 74.4 II 9,753,887.00 4,826,600.00
M75.8 83.97 I 2,031,503.00
M54.56 81.92 II 3,945,340.00 2,324,900.00
I11.9 K29.0 II 6,285,700.00 2,793,700.00
A01.0 A91 I 5,724,400.00 5,724,400.00
T09.3 G95.9 + N17.9 I 7,430,932.00 7,771,800.00
A01.0 II 2,661,151.00 3,329,400.00
R50.9 II 1,682,235.00 1,829,000.00
M54.16 E83.5 + A49.9 II 6,951,764.00 2,324,900.00
L02.4 86.04 II
M32.1 N08.5 II 5,567,124.00 2,298,600.00
A91 II 3,776,000.00 2,331,600.00
R56.0 II 2,315,123.00 1,859,300.00
N13.4 98.51 II 8,733,429.00
N20.0 98.51 II 8,720,666.00
A01.0 J06.8 II 2,592,566.00 3,329,400.00
K30 N39.0 II 4,615,662.00 5,003,200.00
I10 M51.2 II 3,820,400.00 3,820,400.00
K40.9 53.29 I 12,204,587.00 4,997,900.00
O34.2 O82.9 74.4 III 9,189,529.00 4,022,100.00
A01.0 I 3,359,779.00 3,884,300.00
D14.3 J98.4 + K30 + Z92.8 I 6,976,000.00 3,502,000.00
A09 E14.9 I 2,827,100.00 2,827,100.00
M75.8 81.91 II 1,377,503.00
D61.9 II 9,201,724.00 1,862,500.00
B34.9 I 2,720,200.00 2,720,200.00
J20.9 E11.9 II 5,077,128.00 1,858,600.00
K30 I 3,178,888.00 3,891,400.00
A01.0 A90 II 3,776,676.00 4,282,400.00
I61.9 III 2,637,591.00 2,164,000.00
O44.0 O80.9 69.02 III 5,269,151.00 2,788,700.00
K80.8 51.22 III 10,160,847.00 5,401,000.00
D48.1 83.49 II 7,110,814.00 3,929,100.00
A90 II 2,865,872.00 2,423,100.00
K30 G40.9 II 2,474,305.00 5,003,200.00
B01.9 II 1,211,809.00 2,331,600.00
M48.96 NM51.2 81.92 III 1,483,959.00
N61 III 979,792.00 1,551,700.00
J45.9 II 3,874,961.00 1,862,800.00
A09 I 2,827,100.00 2,827,100.00
N20.0 98.51 I 7,973,090.00
N20.0 I 5,635,321.00 2,716,700.00
N20.0 98.51 II 8,319,090.00
D48.1 83.49 I 7,905,171.00 4,583,900.00
J90 34.91 II 3,669,554.00 3,264,000.00
A09 II 3,033,863.00 2,423,100.00
I86.1 86 I 12,732,224.00 7,798,800.00
Z53.0 I 865,343.00 1,632,600.00
A09 Z92.8 + A01.0 II 3,813,744.00 3,329,400.00
K80.8 I25.1 II 4,781,515.00 2,800,200.00
A01.0 II 4,416,729.00 3,329,400.00
A01.0 A90 III 4,260,970.00 3,568,700.00
D25.9 D63.8 65.49 II 11,080,380.00 8,933,600.00
O47.1 I 1,471,894.00 1,363,600.00
N20.0 98.51 II 8,319,090.00
N20.0 98.51 I 8,610,728.00
N20.0 98.51 III 8,353,192.00
I11.9 I25.1 II 3,426,477.00 3,820,400.00
N20.0 98.51 III 8,098,090.00
I88.8 40.11 II 6,252,994.00 4,242,600.00
N18.9 N40 + E83.5 II 8,322,133.00 3,883,500.00
J35.2 J39.2 + G47.3 29.99 + 28.3 II 7,919,078.00 2,121,400.00
I10 I63.9 II 6,844,483.00 3,515,900.00
O61.9 O82.9 74.4 II 9,527,791.00 4,826,600.00
P03.4 II 1,431,050.00 1,995,800.00
J45.9 J06.9 I 4,774,510.00 2,173,300.00
K29.1 II 1,800,864.00 1,861,600.00
A15.0 A09 II 5,025,221.00 5,004,900.00
A91 I 5,787,047.00 2,720,200.00
A90 A01.0 I 11,261,567.00 3,965,400.00
A49.9 III 2,493,141.00 2,774,500.00
A01.0 A91 I 7,201,160.00 5,724,400.00
A09 J06.9 II 3,248,797.00 2,423,100.00
A01.0 II 2,048,831.00 3,329,400.00
B05.9 J06.9 II 2,864,224.00 2,331,600.00
I10 R42+N40 III 1,665,836.00 3,183,700.00
Z53.2 I 3,404,254.00 1,632,600.00
D24 85.24 II 8,190,779.00 6,118,200.00
K40.9 53.29 II 10,267,867.00 4,283,900.00
M65.3 82.01 I 7,205,006.00 7,272,500.00
N13.2 98.51 I 8,596,665.00
A01.0 J06.9 III 2,473,087.00 2,774,500.00
N20.0 98.51 III 8,264,634.00
K60.3 49.12 II 8,884,907.00 5,225,100.00
M54.5 81.92 I 2,549,642.00
A01.0 J06.9 II 6,329,127.00 3,329,400.00
O32.9 O82.9 74.4 III 8,935,813.00 4,022,100.00
A49.9 II 4,676,571.00 3,329,400.00
A01.0 II 2,980,610.00 3,329,400.00
A01.0 I 4,871,580.00 3,884,300.00
M54.5 I 2,498,409.00
J06.8 Z92.8 II 2,173,829.00 1,829,000.00
A01.0 II 2,804,983.00 3,329,400.00
I12.0 D64.9 I 4,174,634.00 4,530,800.00
O34.2 O82.9 74.4 I 12,543,734.00 5,631,000.00
I27.9 Z92.9 II 6,383,505.00 2,741,500.00
A01.0 II 4,469,623.00 3,329,400.00
D32.9 II 4,954,586.00 2,800,400.00
Z51.3 III 1,373,047.00 1,166,200.00
E05.1 6.31 II 11,268,202.00 5,747,900.00
N13.2 98.51 I 8,840,041.00
M51.2 II 2,633,562.00 2,324,900.00
O05.4 69.02 II 4,629,197.00 3,279,100.00
N20.0 98.51 II 8,561,505.00
N13.2 98.51 I 8,835,219.00
E86 J06.9 + A09 II 1,507,650.00 1,983,200.00
A01.0 II 2,521,463.00 3,329,400.00
N20.0 58.22 + 97.65 II 17,843,372.00 2,464,300.00
N20.0 98.51 I 8,319,180.00
O34.2 O44.0 + O82.9 74.4 II 9,350,941.00 4,826,600.00
E86 J06.9 I 2,225,601.00 2,720,000.00
P03.4 II 1,583,838.00 1,995,800.00
I24.9 I50.9 I 5,361,644.00 5,182,000.00
M19.9 M77.3 + Z93.8 + I11.9 II 4,840,416.00 2,490,400.00
A09 II 3,980,310.00 2,423,100.00
K30 E14.4 + N08.3 I51.9 + I42.0 I 7,902,058.00 5,837,000.00
I11.9 R73.9 I 4,457,100.00 4,457,100.00
D17.9 83.49 II 7,847,310.00 3,929,100.00
N35.9 56.1 + 56.0 III 16,251,357.00 10,090,500.00
N35.9 N20.1 56.1 + 56.0 II 22,618,358.00 13,705,200.00
N40 60.69 III 16,746,194.00 5,570,600.00
D24 85.12 II 6,919,969.00 6,118,200.00
M86.88 86.04 III 5,775,077.00 3,103,700.00
Q64.4 83.49 II 6,195,802.00 3,929,100.00
A01.0 A91 I 5,580,594.00 5,724,400.00
I10 O80.9 III 2,672,093.00 2,788,700.00
A91 II 3,334,079.00 2,331,600.00
K12.2 II 3,430,349.00 2,323,100.00
J18.0 I 8,838,281.00 4,865,100.00
A09 II 3,776,029.00 2,423,100.00
M65.3 II 1,527,479.00
N47 64 III 5,685,196.00 1,212,700.00
D48.1 83.49 III 6,027,895.00 4,871,300.00
O20.0 O21.0 I 2,980,922.00 1,957,000.00
K74.6 J18.9 + I51.9 II 8,031,517.00 5,269,500.00
D48.1 83.49 III 5,420,721.00 3,274,200.00
B34.9 J03.8 I 2,720,200.00 2,720,200.00
K74.6 II 2,799,100.00 2,799,100.00
A90 A01.0 I 4,306,947.00 3,965,400.00
I10 I20.0 + I11.9 + E11.9 II 19,658,807.00 5,179,100.00
Z51.3 D63.8 I 2,035,015.00 1,632,600.00
D17.9 83.49 II 7,262,522.00 5,845,600.00
D48.7 83.49 II 6,301,826.00 5,845,600.00
I10 M77.94 + I69.3 I 5,436,017.00 4,457,100.00
N64.8 85.41 III 7,171,565.00 5,098,500.00
K36 54.11 + 49.06 II 10,004,709.00 6,812,300.00
A01.0 III 5,175,975.00 2,774,500.00
I63.9 III 10,231,397.00 2,929,900.00
E83.5 E87.6 II 3,104,000.00 3,107,400.00
D48.1 83.49 II 10,057,607.00 5,845,600.00
E14.5 84.01 I 17,078,228.00 7,272,500.00
J18.0 II 5,323,522.00 4,170,100.00
J18.0 II 2,969,472.00 4,170,100.00
N20.0 98.51 I 8,904,510.00
N20.0 98.51 I 9,138,320.00
N20.0 98.51 II 8,543,334.00
N21.1 58 II 9,131,909.00 7,406,900.00
N21.0 55.11 + 59.2 II 21,918,540.00 12,108,700.00
O20.0 I 2,257,996.00 1,957,000.00
A15.0 J47 II 3,924,852.00 5,979,400.00
A01.0 I 3,884,300.00 3,884,300.00
A01.0 R51 I 3,884,300.00 3,884,300.00
A01.0 J06.8 II 3,329,400.00 3,329,400.00
R50.9 I 2,179,700.00 2,179,700.00
I25.1 I10 + E119 I 3,264,000.00 3,264,200.00
C92.1 III 3,549,616.00 2,328,500.00
C50.9 85.12 I 7,822,341.00 7,137,800.00

A01.0 II 2,385,354.00 3,329,400.00
I84.2 49.46 III 7,216,107.00 4,354,200.00
N28.9 55.51 I 26,390,690.00 14,126,800.00
N61 83.49 III 6,921,509.00 4,871,300.00
D48.1 83.49 III 6,593,499.00 4,871,300.00
K40.9 53.29 III 7,548,722.00 3,569,900.00
J90 34.91 II 1,602,298.00 3,264,000.00
G93.4 E87.8 II 13,907,049.00 3,196,300.00
N20.0 98.51 III 8,152,040.00
K71.3 Z92.8 II 2,478,675.00 2,799,100.00
N80.1 65.49 II 12,906,404.00 6,327,300.00
I61.9 I51.9 + I21.9 I 3,817,407.00 4,508,800.00
A01.0 E86 II 3,169,158.00 3,329,400.00
O33.8 O34.2 + O82.9 74.4 II 10,808,757.00 4,826,600.00
K80.8 K81.8 51.22 I 19,355,613.00 7,561,400.00
D34 25.3 III 7,511,009.00 4,789,900.00
I10 E16.0 + N18.9 + D63.8 III 3,801,337.00 3,236,300.00
B34.9 R06.0 II 2,624,069.00 2,791,900.00
G61.0 G81.9 + J21.9 II 3,993,414.00 3,117,600.00
A01.0 A91 II 4,636,088.00 4,906,600.00
A15.0 A41.9 + J90 34.91 II 5,365,703.00 5,004,900.00
k74.6 K56.6 I 4,944,900.00 4,944,900.00
A09 I11.9 I 2,827,100.00 2,827,000.00
O44.1 O82.9 74.4 II 9,874,856.00 4,826,600.00
A01.0 II 2,953,963.00 3,329,400.00
A01.0 A91 I 5,651,662.00 5,724,400.00
A01.0 II 4,891,892.00 3,329,400.00
M47.8 M51.2 3.92 II 1,603,538.00
O33.8 O82.9 74.4 III 8,046,839.00 4,022,100.00
P03.4 II 1,786,184.00 1,995,800.00
O61.8 O82.9 74.4 III 8,431,740.00 4,022,100.00
N35.9 58.22 + 97.65 II 17,261,185.00 2,464,300.00
K36 54.11 II 12,090,832.00 6,812,300.00
N20.0 98.51 II 8,352,546.00
N20.0 98.51 II 8,626,112.00
K30 R51 II 3,129,024.00 3,335,500.00
O05.4 69.02 I 7,327,529.00 3,825,600.00
O32.9 O82.9 74.4 I 11,690,364.00 5,631,000.00
N20.0 98.51 II 8,421,578.00
I42.0 I48 I 3,305,761.00 4,063,100.00
A09 II 2,758,218.00 2,423,100.00
A01.0 I 5,717,003.00 3,884,300.00
A01.0 III 1,511,436.00 2,774,500.00
J18.9 II 2,755,166.00 4,170,100.00
A18.2 40 I 12,237,386.00 4,949,700.00
A01.0 II 1,625,023.00 3,329,400.00
M47.8 M51.2 3.92 I 2,136,487.00
N20.0 98.51 I 8,844,587.00
A15.0 L98 + G20 II 14,784,473.00 7,945,500.00
N83.2 64.49 II 13,380,405.00 6,327,300.00
N20.0 98.51 II 8,172,258.00
K40.3 53.29 I 14,436,747.00 4,997,900.00
I11.9 K30 + K80.8 + K81.8 + I25.1 I 4,765,078.00 4,457,100.00
J18.0 II 2,312,429.00 4,170,100.00
I88.8 40.11 II 7,087,566.00 4,242,600.00
K80.8 K81.9 54.11 III 9,329,041.00 5,401,000.00
K31.4 R51 II 5,609,161.00 1,861,600.00
K35.9 47.09 II 10,165,928.00 3,416,000.00
D48.1 83.49 I 9,046,163.00 4,583,900.00
A01.0 A91 II 3,912,017.00 4,906,600.00
N35.9 N20.9 56.1 + 56.0 III 16,807,434.00 10,090,500.00
O42.9 O80.9 II 4,497,476.00 2,859,900.00
H11.0 11.39 II
H11.0 11.39 II
A01.0 A91 III 4,120,032.00 4,088,900.00
D34 6.31 II 13,548,365.00 5,747,900.00
O42.9 O80.9 II 4,982,486.00 2,859,900.00
A01.0 J02.9 III 1,907,862.00 2,774,500.00
E11.9 K65.0 I 6,012,300.00 6,012,300.00
P23.9 II 8,061,008.00 4,190,800.00
G45.9 II 2,329,200.00 2,329,200.00
K80.8 51.22 II 12,410,922.00 6,481,200.00

A01.0 I 2,665,554.00 3,884,300.00
J06.9 N47 II 1,889,876.00 1,829,000.00
J90 34.91 II 2,074,503.00 3,264,000.00
D24 85.24 II 7,286,875.00 6,118,200.00
J90 34.91 I 1,610,853.00 3,808,000.00
I10 K59.0 II 1,852,335.00 3,183,700.00
O48 O80.9 I 5,093,516.00 3,336,600.00
D23.5 83.49 I 12,572,805.00 6,819,800.00
G04.9 K30 II 10,294,380.00 3,117,600.00
L72.1 83.49 III 6,040,734.00 3,274,200.00
D17.9 83.49 I 8,533,700.00 6,819,800.00
II J39.2 J35.1 II 8,373,061.00 2,121,400.00
O34.2 O82.9 74.4 II 9,182,807.00 4,826,600.00
N20.0 98.51 II 8,382,258.00

N20.0 98.51 II 8,426,146.00
D24 83.49 II 6,893,091.00 6,118,200.00
K30 K59.0 II 3,504,875.00 3,335,500.00
N13.2 58.22 II 21,082,620.00 2,464,300.00
D26.9 E83.5 9.43 I 23,553,140.00 5,802,900.00
Q83.8 85.11 II 7,823,949.00 6,118,200.00
N39.0 II 2,075,905.00 1,860,600.00
A01.0 II 3,055,997.00 3,329,400.00
N20.0 98.51 I 9,666,612.00
N20.0 98.51 II 10,806,386.00
I10 I69.3 + E87.5 I 9,806,554.00 4,457,100.00
A09 III 3,022,798.00 2,355,800.00
K30 E11.9 + B35.9 II 5,003,200.00 5,003,200.00
I11.9 K30 I 4,457,100.00 4,457,100.00
N80.1 65.49 III 10,391,260.00 5,272,800.00
A01.0 III 1,534,969.00 2,774,500.00
I88.8 40.11 II 6,996,606.00 4,242,600.00
M19.9 81.92 II 1,752,320.00
I10 G44.2 II 3,612,053.00 3,820,400.00
O02.0 69.02 I 6,604,241.00 3,825,600.00
I63.9 E86 II 4,485,802.00 3,515,900.00
N13.2 98.51 II 8,640,905.00
J36 E11.9 + J05.1 I 2,133,800.00 2,133,800.00
N20.0 98.51 III 8,426,146.00
A91 II 3,050,763.00 2,331,600.00
A01.0 J06.9 + K12.2 + K59.0 II 2,499,418.00 4,282,400.00
J06.9 II 1,682,758.00 1,829,000.00
A09 I 4,441,266.00 2,827,100.00
D69.3 E14.9 I 3,608,164.00 2,713,300.00
F45.9 II 2,272,180.00 2,800,400.00
S82.21 M86.97 79.36 II 19,560,802.00 13,724,000.00
I88.8 40.23 II 6,804,162.00 4,242,600.00
D17.9 83.49 II 6,798,283.00 5,845,600.00
K11.6 26.3 III 6,481,827.00 4,184,700.00
M19.9 81.92 I 2,432,341.00
E14.5 86.3 I 19,318,299.00 4,583,900.00
E14.5 III 5,159,032.00 3,104,200.00
E14.5 86.3 II 8,539,173.00 3,929,100.00
O14.9 O80.8 III 2,583,373.00 2,788,700.00
D48.1 83.49 II 8,571,178.00 5,845,600.00
K80.8 51.22 II 10,352,158.00 6,481,200.00
A01.0 J06.9 II 3,341,631.00 3,329,400.00
A01.0 J06.9 II 2,785,192.00 3,329,400.00
D24 85.41 I 12,222,796.00 7,137,800.00
K40.9 53.29 III 9,356,929.00 3,569,900.00
K30 E11.9 II 3,867,931.00 3,335,500.00
P03.4 I 2,146,935.00 2,328,400.00
O33.8 O82.9 74.4 I 10,961,496.00 5,631,000.00
C50.9 I10 85.45 III 10,715,132.00 5,098,500.00
N80.1 65.49 II 13,732,057.00 6,327,300.00
O32.9 O82.9 74.4 II 8,424,520.00 4,826,600.00
N83.2 65.49 II 12,393,852.00 6,327,300.00
N13.2 98.51 III 8,417,242.00
J31.2 J35.1 29.99 + 28.2 III 6,956,595.00 1,767,900.00

P24.9 P21.9 III 18,204,358.00 4,170,700.00
D24 85.24 II 6,953,346.00 6,118,200.00
N13.2 58.22 + 98.51 III 23,652,018.00
A01.0 J06.9 I 2,327,838.00 3,884,300.00
N20.0 55.03 I 26,632,192.00 14,126,800.00
A91 N39.0 I 3,257,200.00 3,257,200.00
K30 N39.0 I 4,726,029.00 5,837,000.00
2,790,914,608.00 1,456,133,300.00
KODE ICD KODE ICD

UTAMA SECUNDER KODE TINDAKAN KELAS HARGA RS HARGA INA CBGS
N13.2 98.51 I 8,995,000.00

O05.4 69.02 II 4,498,020.00 3,279,100.00
L03.0 II 6,573,676.00 2,800,400.00
D17.9 83.49 I 11,699,091.00 6,819,800.00
A01.0 J06.9 II 1,611,359.00 3,329,400.00
B34.9 I 3,117,461.00 2,720,200.00
J90 A41.9 II 8,238,970.00 7,340,300.00
A90 II
R25.2 II 2,853,081.00 2,800,400.00
A01.0 I 3,884,300.00 3,884,300.00
A01.0 II 3,994,815.00 3,329,400.00
I10 I 2,456,389.00 4,457,100.00
B15.9 J20.9 II 4,794,442.00 2,799,100.00
A01.0 A91 II 6,994,228.00 4,906,600.00
E14.5 86.3 I 12,520,368.00 4,583,900.00
A01.0 I 3,637,062.00 3,884,300.00
K30 A09 II 973,742.00 2,779,600.00
86,842,004.00 59,713,900.00
NAMA DOKTER
dr. PARAMITA, Sp.A

dr. MAULIA, Sp.OG
dr. ADE, Sp.S
dr. DJOKO, Sp.B
dr. SARJUNAS, Sp.OG
dr. ADE, Sp.S 2,324,900.00
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. GHUNA, Sp.OT
dr. WIWIIN. Sp.A
dr. RENNY, Sp.U 10,090,500.00
dr. WIWIIN. Sp.A
dr. WIWIIN. Sp.A
dr. PARAMITA, Sp.A
dr. WIWIIN. Sp.A
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U 10,090,500.00
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U 12,108,700.00
dr. RENNY, Sp.U 12,108,700.00
dr. RENNY, Sp.U 10,090,500.00
dr. RENNY, Sp.U 14,126,800.00
dr. RENNY, Sp.U 10,090,500.00
dr. MIFTAH. Sp.PD
dr. GHUNA, Sp.OT
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. ACHMAD BARUNA, Sp.PD 14,126,800.00
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG
INKONSIS
dr. PITRAJAYA, Sp.B RAJAL
dr. MIFTAH. Sp.PD
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. MEDIA, Sp.S 2,905,500.00
dr. ACHMAD BARUNA, Sp.PD 3,329,400.00
dr. RENNY, Sp.U
dr. WIWIIN. Sp.A
dr. RENNY, Sp.U
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. RICHARD, Sp.THT
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. NUNUNG, Sp.OG
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. DWIANA
dr. MIFTAH. Sp.PD
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. ADE, Sp.S 1,937,400.00
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. SARJUNAS, Sp.OG
dr. NUNUNG, Sp.OG
dr. MEDIA, Sp.S 2,712,300.00
dr. PITRAJAYA, Sp.B RAJAL
dr. RENNY, Sp.U 12,108,700.00
dr. RENNY, Sp.U 12,108,700.00
dr. SARJUNAS, Sp.OG
dr. DJOKO, Sp.B
dr. DWIANA
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B 1 EPISODE
dr. MAULIA, Sp.OG
dr. ANDRI, Sp.OT
dr. DJOKO, Sp.B
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. MIFTAH. Sp.PD
dr. MIFTAH. Sp.PD
dr. DJOKO, Sp.B
dr. RENNY, Sp.U 12,108,700.00
dr. RENNY, Sp.U 14,126,800.00
dr. PITRAJAYA, Sp.B
dr. CITRA, Sp.A
dr. CITRA, Sp.A
dr. PARAMITA, Sp.A
dr. CITRA, Sp.A
dr. DJOKO, Sp.B
dr. SARJUNAS, Sp.OG
dr. MEDIA, Sp.S 2,166,600.00
dr. ADE, Sp.S
dr. MEDIA, Sp.S
dr. WIWIIN. Sp.A
dr. CITRA, Sp.A
dr. MEDIA, Sp.S
dr. DJOKO, Sp.B RAJAL
dr. CITRA, Sp.A
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U 12,108,700.00
dr. RENNY, Sp.U 12,108,700.00
dr. WIWIIN. Sp.A
dr. DJOKO, Sp.B
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. DEASY, Sp.P
dr. MIFTAH, Sp.PD
dr. MEDIA, Sp.S 1,857,000.00
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. FITRIYATI
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S 1,937,400.00
dr. MAULIA, Sp.OG
dr. WIWIIN. Sp.A
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U 14,126,800.00
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U 12,108,700.00
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. MAULIA, Sp.OG
dr. YUDI, Sp.U 12,108,700.00
dr. RENNY, Sp.U 14,126,800.00
dr. RENNY, Sp.U 10,090,500.00
dr. MIFTAH, Sp.PD
dr. YUDI, Sp.U 10,090,500.00
dr. PITRAJAYA, Sp.B
dr. RICHARD, Sp.THT
dr. MEDIA, Sp.S
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. WIWIIN. Sp.A
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. ANDI, Sp.OT
dr. RENNY, Sp.U 14,126,800.00
dr. WIWIIN. Sp.A
dr. RENNY, Sp.U 10,090,500.00
dr. PITRAJAYA, Sp.B
dr. MEDIA, Sp.S 2,712,300.00
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.Pd
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. ZUHAIRA, Sp.S 2,712,300.00
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. MIFTAH, Sp.Pd
dr. MIFTAH, Sp.Pd
dr. ZUHAIRA, Sp.S
dr. WIWIN, Sp.A
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U 14,126,800.00
dr. MEDIA, Sp.S
dr. MAULIA, Sp.OG
dr. RENNY, Sp.U 12,108,700.00
dr. RENNY, Sp.U 14,126,800.00
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. YUDI, Sp.U 14,126,800.00
dr. NUNUNG, Sp.OG
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. DJOKO, Sp.B
dr. YUDI, Sp.U
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. UJANG
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. NUNUNG, Sp.OG
dr. MIFTAH, Sp.Pd
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.Pd
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. ADE, Sp.S
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U 14,126,800.00
dr. RENNY, Sp.U 14,126,800.00
dr. RENNY, Sp.U 12,108,700.00
dr. PITRAJAYA, Sp.B
dr. YUDI, Sp.U
dr. MAULIA, Sp.OG
dr. MIFTAH, Sp.Pd
dr. MIFTAH, Sp.Pd
I EPISODE
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. YUDI, Sp.U
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. DEASY, Sp.P
dr. RENNY, Sp.U 10,090,500.00
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. SARJUNAS, Sp.OG
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. ADE, Sp.S
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S 2,324,900.00
dr. NUNUNG, Sp.OG
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. YUDI, Sp.U
dr. PITRAJAYA, Sp.B
dr. RENNY, Sp.U 12,108,700.00
dr. RENNY, Sp.U 12,108,700.00
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. RENNY, Sp.U 12,108,700.00
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. DEDE LIA, Sp.A
dr. DJOKO, Sp.B
dr. WIWIN, Sp.A
dr. MEDIA, Sp.S 2,712,300.00
dr. YUDI, Sp.U 14,126,800.00
dr. SARJUNAS, Sp.OG
dr. YUDI, Sp.U 12,108,700.00
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. DJOKO, Sp.B
dr. ADE, Sp.S
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
dr. SARJUNAS, Sp.OG
dr. YAYAN, Sp.M RAJAL
dr. YAYAN, Sp.M RAJAL
dr. DJOKO, Sp.B
dr. NUNUNG, Sp.OG
dr. PARAMITA, Sp.A
dr. MEDIA, Sp.S
1 EPISODE
dr. DJOKO, Sp.B
dr. WIWIN, Sp.A
dr. WIWIN, Sp.A
dr. DEASY, Sp.P
dr. DJOKO, Sp.B
dr. DEASY, Sp.P
dr. UJANG
dr. MAULIA, Sp.OG
dr. DJOKO, Sp.B
dr. ZUHAIRA, Sp.S
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. RICHARD, Sp.THT
dr. SARJUNAS, Sp.OG
RAKAL
dr. YUDI, Sp.U 12,108,700.00
dr. YUDI, Sp.U 12,108,700.00
dr. DJOKO, Sp.B
dr. RENNY, Sp.U
dr. MAULIA, Sp.OG
dr. DJOKO, Sp.B
dr. PARAMITA, Sp.A
dr. RENNY, Sp.U 14,126,800.00
dr. RENNY, Sp.U 12,108,700.00
dr MEDIA, Sp.S
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. SARJUNAS, Sp.OG
dr. WIWIN, Sp.A
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. MAULIA, Sp.OG
dr. ZUHAIRA, Sp.S
dr. RENNY, Sp.U 12,108,700.00
dr. RICHARD, Sp.THT
dr. YUDI, Sp.U 10,090,500.00
dr. WIWIN, Sp.A
dr. DEDE LIA, Sp.A
dr. PARAMITA, Sp.A
dr. MIFTAH, Sp.PD
dr. MEDIA, Sp.S
dr. GHUNA, Sp.OT
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. PITRAJAYA, Sp.B
dr. MIFTAH, Sp.PD
dr. PITRAJAYA, Sp.B
dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. DJOKO, Sp.B
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. MAULIA, Sp.OG
dr. DJOKO, Sp.B
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. SARJUNAS, Sp.OG
dr. RENNY, Sp.U 10,090,500.00
dr. RICHARD, Sp.THT

dr. PARAMITA, Sp.A
dr. DJOKO, Sp.B
dr. RENNY, Sp.U 10,090,500.00
dr. PARAMITA, Sp.A
dr. YUDI, Sp.U
NAMA DOKTER
dr. RENNY, Sp.U 14,126,800.00

dr. SARJUNAS, Sp.OG
dr. PITRAJAYA, Sp.B
dr. PITRAJAYA, Sp.B
dr. WIWIN, Sp.A
dr. CITRA, Sp.A 1 EPISODE
dr. MIFTAH, Sp.PD
dr. PARAMITA, Sp.A
dr. PARAMITA, Sp.A
dr. PITRAJAYA, Sp.B
dr. SIWI
FPK2 = 4 TIDAK DI KLAIM = 2 ESWL = 29
Rekapitulasi INA CBGs Bulan JUNI
NO NAMA PASIEN NO. MR DIAGNOSA PRIMER DIAGNOSA SEKUNDER
1 AHYAR 401647 GASTRITIS KRONIS DC + CAD

2 ILIK SUDARMI 402765 HERNIA FEMORAL ILEUS OBSTUKRIF
3
4 lydia nuraini 382707 ISPA KDS
5 KHANSA NOVIA DWI PUTRI 403653 BRONCHOPNEUMONIA LARINGOTRACHEOBRONCHITIS
6 IMAS S 403387 KP TYPHOID FEVER
7 RUKMAN 395005 NEFROLITHIASIS
8 DEVIE ANGGRAENI 403573 HAEMMOROID INTERNATHROMBOSED
9 GYANINGRUM SP 403652 BRONCHOPNEUMONIA
10 cucun cunayah 388653 AB. INKOMPLIT
11 SRI ALAM 398071 HEP A HT + ANEMIA
12 UNEH 394061 HT TTH + SCOLIOSIS LUMBAL
13 EPON 403351 PERBAIKAN KU (KISTA OVARY )
14 H MUHATA SUDIA 403484 DENGUE FEVER
15 EMAY MARYATI 403208 DM ABSES
16 KHOERUL STEPIANI 380179 DENGUE FEVER
17 TB. DADANG ANDYWIDJAYA 403720 KP AKTIF HHD + CAD + HYPONATREIUM
18 EDI JUNAEDI 321483 DMT2 CRF
19 IMAS SETYAWATI 403693 SUSP MYOMA UTERI
20 H SARIPUDIN 403552 HIL
21 MOCH SHOLEH. NA 403555 PPOK BP + DCM
22 SUPARMI 380631 DC-HHD DM + ANEMIA
23 DELLACAMELIAR 320238 TYPHOID FEVER
24 WARIH 401635 ISK
25 CECE SUTISNA 401204 DENGUE FEVER LYMPHADENITIS TB + DIL
26 ARLITA NAURA FATYA 378706 TYPHOID FEVER DHF
27 SARIM MUHARIM 346339 NEFROLITHIASIS
28 ROFIK 301891 NEFROLITHIASIS
29 helen fitriyani 403759 POST DATE KPD + PARTUS SC
30 NANI 403820 AB. INKOMPLIT
31 eva maspupah 388142 KPD PARTUS SPONTAN
32 ENENG RAHMATIKA 327683 AB. IMIMINENS
33 SADIAH 327835 DYSPEPSIA
34 SUHANDA 395377 PPOK NEUROPATHY
35 RAPIN 403787 TYPHOID FEVER STOMTITIS
36 YATI APRIANTI 403580 CHOLECYSTITIS DMT2
37 DINI PURWANTI 329729 VERTIGO
38 HJ NINIK RAHAYU SPD 399527 GASTRITIS AKUT
39 Yuniart Safitri 320398 TYPHOID FEVER SLE
40 maria susant dewi 403844 HEG
41 AAS MUNIROH BINTI MUHY 402912 WOUND DEHISCENCI
42 TINTIN SUMARNIsumarni 403556 GGG FIBROLATIC HT
43 kanz af'hari mahesa putra 404020 NCB SMK LAHIR SC
44 FELICIANURWAHIDAH 403866 TYPHOID FEVER GASTRITIS
45 ALTHAF RAYI ATANNAVAH 404009 NCB SMK LAHIR SC
46 NINDIA NOVIA RAKHMAH 402501 RIW. SC PARTUS SC
47 NABILA KIRANA DEWI, AN 311235 TYPHOID FEVER ISPA
48 NANDANG SAEFULAMIN 362023 STT BUCCAL
49 melfa 399376 GASTRITIS AKUT
50 muhammad andrea nugraha 398623 TYPHOID FEVER
MUTIARA NURFAUZIYAH, AN380562 TYPHOID FEVER
51 ISPA
52 muhamMAD DIRTA RYLAN A 398218 BRONCHOPNEUMONIA DIARE
53 SRI NIDA ANKHOFIYAH 403338 ABSES MAMAE
54 OOM SITI ROMLAH 308894 DIARE DYSPEPSIA + DERMATITIS
55 Afrizal 338619 TYPHOID FEVER ISK
56 LILIS 403513 ANEMIA ec CA MAMAE
57 SITI MASITOH 383207 EPILEPSI CEPHALGIA
58 VIKA ELLYA SAFARI, SE 316754 TB MENINGITIS TB MILIARY
59 EDI SUHARNA 345999 GEA
60 NINU NURZIAH S 404099 MOLA HYDATIDOSA
61 HAFIDZ AKBAR 404015 MORBILI
62 HJ aisah 368520 HHD-DC CKD
63 AAT SUCIATI 403977 CAD HHD + HT + DM
64 HALIMATUSADIAH 395728 CYSTA COKLAT
65 WARMAD ABDILLAH 401198 TB PARU DILI
66 IMA ROHIMAH 349459 HEG
67 KOKOM KOMALASARI 372628 TYPHOID FEVER ISK
68 UMASIH 403036 STROKE INFARK HT
69 PUTRI NAYLA APRILIA 403877 TYPHOID FEVER
70 ELI HERAWATI 364727 TUMOR MAMAE
71 SYARIF HIDAYAT 401462 KP DC-HHD
72 mikaila mustka aty 403840 NCB SMK LAHIR SC
73 SOPIAH 332981 STT PIPI
74 CUNARMAH 398634 RIW. SC CPD + PARTUS SC
75 RINI kOMALAYANTI 301153 VSD PARTUS SC
76 RAFI IRWANTO 379061 DIARE
77 MARIAH JEDOH BT MICHAEL 367835 EPILEPSI
78 m. alif rizia seto 402686 DRUG INDUCED ec OAT DEHIDRASI
79 HENDRATIN 403046 APP
80 AULIA ROHMAH 403899 FAM
81 NINA MARLINA 303437 FAM
82 DEVI NUGRAENI 403506 NEFROLITHIASIS
83 HADIAN 378300 GEA CAD
84 NAZWA MAULIDA RIZKI 378403 DRUG INDUCED ec OAT DHF (>100 RIBU ) + DIARE
85 EPON 403351 MYOMA UTERI
86 INDARTI
87 ADISTY MAHARANI 404037 MORBILI
88 SANDIKADWITASRIYANA 349575 TYPHOID FEVER ISPA
89 BILQIS ALMASAH FAJAR 359554 DHF TYPHOID FEVER
90 AAAOMMUCHAROM 403958 TYPHOID FEVER ISPA
91 yazid al munawar 403942 HIL
92 RATNA PURWANENGSIH 357520 DYSPEPSIA FA
93 AMI FITRI YANTI 333990 TONSILITIS AKUT FA
94 H DADANG SOENARTO 403968 ABSES BUCCAL
95 SUKAMAD 374182 ESRD on HD DMT2 (INSULIN)
96 KASIDI 365672 LBP
97 NINA MARDIANANA 403797 STT COLLI
98 LASMINI 404085 AB. INKOMPLIT
99 WILA MUSTIKA 314484 POST DATE RIW. SC
100 HERTI 347670 DJ STENT INSITU
101 RODIAH 401908 NEFROLITHIASIS HYDRONEFROSIS
102 NURLIAH 404073 NEFROLITHIASIS
103 Ngadah 398005 NEFROLITHIASIS
104 UJANG TRISNO JUNAEDI 489707 BPPV
105 IWA KOSWARA 490318 DYSPNEU
106 CICI AMELIA 403965 HEMMOROID
107 EPONG 403790 MASSA INTRAVESICA
108 HUSEN IRAWAN 398110 HHD DC ASMA + TB + OA
109 IMAM SUSANTO 325146 NEFROLITHIASIS
110 muhammad irsyaad arasyd 403591 HBR
111 HJ NAFISAH 403452 NEFROLITHIASIS
112 PURWO HADI S 371027 DMT2 GOUT + CKD + ANEMIA + ULKUS
113 NY. TJASIH 403890 NEFROLITHIASIS
114 shakila afiqa sukmana 377174 ISPA KDS
115 sunaedah 403953 CYSTA OVARIUM
116 Sesi Anisah 404284 BO
117 SOLEH 327998 HYPERURICEMIA VERTIGO
118 muhamad haykal adnan 404230 DADRS
119 sevia densie tri putri 386704 TYPHOID FEVER STOMATITIS
120 WARYA AYUT 398373 BATU STAGHON
121 maulana Zakaria sastra dija 392237 BRONCHOPNEUMONIA LARINGOTRACHEOBRONCHITIS + CMPA
122 HJ. YAYAH NURJANAH 381968 AKI DC ec COPD + TB PENGOBATAN
123 YANNY 402454 COLITIS
124 TUTI SETIAWATI 403648 STROKE PIS dengan subaedema cerebri
125 sukeni bt salim 350632 MYOMA UTERI
126 ana suryana 301878 STT
127 MUHAMMAD RAKA FADILL 311361 TYPHOID FEVER
128 SARKUM 390964 NEFROLITHIASIS UTI
129 SITI ZAINAB HUSAENI 404120 DF TF
130 ANDY JIMI 388221 PPOK TB PENGOBATAN + CKD + KATARAK
131 SITI SUTINAH 304943 GRAVIDA ASMA LETSU
132 nadia almira 395882 LYMPHADENOPATY AXILLA
133 YOGI ARDIANSYAH POHAN 373691 FARINGITIS
134 ABIYOGA ANJAYA 405258 HYPOGLIKEMIA LYMPHADENOPATHY + AF
135 SHANDY NOVAIZI S.M 402124 HYPERTROPI TONSIL
136 R WAHYUNINGSIH 390346 ANEMIA ec CA MAMAE
137 Y SAEFUL HAYAT 491726 CAD
138 rania aila nurhasanah 404395 BBL
139 RISKA NURSOLEH 372609 PEB PARTUS SC
140 ELA NURLAELA 357585 UTI
141 PUTRA FAUZAN DARMAWA 404411 BRONCHIOLITIS
142 IRMA AGUSTINi 394052 TRANSFUSI ec THALASE STRUMA NON TOXIC + C
143 namaza cagri nigmatullin 404091 BRONCHOPNEUMONIA URTIKARIA
144 ASIH BT SUNANTA 404163 MYOMA UTERI
145 HERMAWATI 401907 PEB PARTUS SC
146 muhammad azka hafidz 400459 VOMITUS FARINGITIS
147 ombi 397717 PPOK TB PENGOBATAN
148 A FATHONI 404280 VERTIGO
149 MOHAMAD FAJAR RAHMAN 404131 TYPHOID FEVER
150 DELLA SRI WANTY 404197 DHF
151 TATI SULIAWATI , NY 373792 POLYARTRITIS DYSPEPSIA
152 ZAHIRA FATHIA LUNA 396443 GANGLION
153 EDEH 313095 NEFROLITHIASIS
154 ANDRIYAN KUSUMAH 404166 ABSES SCALP
155 SANTI HARYANTI 404390 HEG
156 HERNAWATI 404359 FAM
157 EUIS KOMALASARI 401755 RIW. SC OLIGOHYDRAMNIONS + P
158 SITI AISYAH 401517 HT DM + NP + HYPOCALCEMIA
159 ACEP FIRDAUS A 399970 CLAVUS
160 RIFKI MUHAMMAD ABDUL 404277 HERNIORHAPY UDT
161 SARBINI 404179 STT COLLI
162 RAHMI AL-HAQ SRI WANTY 404199 TYPHOID FEVER DHF
163 DAFA MAULANA ALAMSY 349476 TYPHOID FEVER ISPA
164 GUGUM GUMILAR 381839 LIPOMA
165 ASEP ABDULLAH 403714 FRAKTUR MANDIBLE
166 ELA NURLAELASARI 350095 GASTRITIS GRAVIDUM
167 ERNA 404101 STT
168 FEBRIYANTINURKHOLIFAH 404330 TUMOR MAMAE
169 INDARTI 339271 AB. IMMINENS HEG
170 INNE DESIYA 383610 APPENDICITIS AKUT
171 LINDA APRIANI 389956 GRAVIDA ASMA
172 shidqiyya suci ramadhani 394117 DRUG INDUCED ec OAT PROLONGED FEVER
173 SURYANA 348731 GEA
174 UNTUNG BASUKI, TN 310493 CAD CHF + AF
175 TRI ASTRIA 403245 CYSTA COKLAT
176 TJIPTAHADI 402472 HAEMMOROID INTERNATHROMBOSED
177 ENDI HANANTO 404029 DHF
178 peri santoso 403339 NEFROLITHIASIS HYDRONEFROSIS
179 muhammad faiz abdul mu i 404185 BRONCHOPNEUMONIA
180 KASWIYAH 330266 NEFROLITHIASIS
181 IPANG 398036 NEFROLITHIASIS
182 OOM SITI ROMLAH 308894 DYSPEPSIA DMT2 + HT + DIARE
183 KANANG, TN 371098 NEFROLITHIASIS
184 vini noviani aripin 404513 SD
185 PUTRIMANDALEADIS 341909 TYPHOID FEVER DHF
186 LASMIATI 301037 NEFROLITHIASIS HT
187 MAHPUDIN 403266 NEFROLITHIASIS HYDRONEFROSIS
188 HERY TRESNAYADI 404410 SUSP APP GEA (DX UTAMA)
189 H. SAUD SUGIARNA 402976 HIL
190 ADRIEL AURELIUS KAWENG 384530 DADRS
191 ADE SETIAWAN 386938 NEFROLITHIASIS HYDRONEFROSIS
192 muhamad rizky nur sultonm 404514 BBL
193 ERFAH 394750 RIW. SC PARTUS SC
194 NURAENI 303261 KPSW PRESENTASI BOKONG + P
195 KOKOM KOMALASARI 389691 NEFROLITHIASIS
196 ELI SUSANTI 384888 CTS
197 RANI MUSTIKA DEWI 403639 APP AKUT
198 PATIMAH 374558 HT ESRD + SUSP DHF
199 NURDIN NURHIDIN 400644 HIL
200 M MISBAH MUNIR 402680 TYPHOID FEVER
201 WAWAN HERMAWAN 404414 TYPHOID FEVER
202 EVA SISDWI ASTUTI, NY 375762 CHOLECYSTITIS
203 HUSEN IRAWAN 398110 OA BRONCHOSPASM + HHD + TB PENGOBATAN
204 jaenudin 403520 SUPRAVENTRICULAR TACAD + CHF + SEQ, STROKE
205 Yulia Suhartat 376722 FRAKTUR DIGITI
206 Puji yono 386014 BRONCHOPNEUMONIA ASMA
207 GILANG HERDIANSYAH, AN 345341 BRONCHOPNEUMONIA
208 RASIM BIN RUSTAM 402122 BATU STAGHORN HYDRONEFROSIS + NEFRO
209 NADIYYA NUR SYIFA 399886 BRONCHOPNEUMONIA
210 NENA NUR LAELA SARI 404368 ABSES MAMAE
211 ACHMAD HUSAIN 403916 UNSTEABLE ANGINA DM
212 ruminah 404247 ASMA BP
213 kayla nuraini 388237 DEHIDRASI ec VOMITUSISPA
214 IQBAL JAENUDIN 404507 HAEMMOROID INTERNATHROMBOSED
215 NENDEN ROSMALA SARI 404569 STT
216 SITI YUGIARTI 347997 DYSPESIA BR ALLERGI
217 DENI MULYANA 394416 TYPHOID FEVER
218 YANI MARYANI 404478 TYPHOID FEVER
219 bayi ny tenten mudrika 404597 BBL
220 TENTEN MUDRIKA 401736 RIW. SC PARTUS SC
221 RAHMA ZONI 404500 DENGUE FEVER
222 arya hidayat 359622 MORBILI
223 Qodratulloh 396036 STT
224 RIDWAN FIRMANSYAH 404424 STT
225 YETI SURYATI BT. ABUN SUR 404537 TYPHOID FEVER
226 nafiya nissa'ul jannah 404663 BBL
227 LINDA APRIANI 389956 ASMA TIDAK TERKONTRPARTUS SC
228 INDAPITRIALATIFAH 404644 POLIP NASAL SINUSITIS MAX
229 kanz af'hari mahesa putra 404020 NH
230 ENOB WAHYUDIN 405235 CAD
231 HJ. TITIN KURAESIN 326340 NEFROLITHIASIS
232 TITIN PRIHATIN,NY 404626 PROLAPSE UTERI DM LEVEMIR
233 MANAN ABDUL HAKIM 324432 NEFROLITHIASIS
234 NURAISYAH 404622 LYMPHADENOPATHY COLLI
235 KIKI RISMAWATI 400012 RUPTUR PERIANAL
236 RIFKI AWALUDIN 399639 EPILEPSI
237 NENI NURHAENI 404385 DYSPNEU SUSP SEQ. STROKE + SUSP. DC
238 hj. yoyoh bt kolay 403727 PNEUMOTORAX SUSP MASSA PARU
239 ABDUR ROUF 336836 TYPHOID FEVER
240 mutara nurfauziyah 380562 DADRS
241 NY. TJASIH 403890 KISTA DERMOID
242 WAHYU 404715 HIL
243 NADHIF MUHTAROMHTAR 404764 TYPHOID FEVER
244 NOPRIZAL CATUR PUTRA 392775 VIRAL INFECTION KDS
245 OCAH 395603 GEA
246 Maya Khoerunisa 342398 PARTUS SPONTAN
247 keisha anindita sukma 404792 BBL
248 WAWAN BIN JONO 397590 STENOSIS URETER BATU URETER
249 NURMA SUSANTI 328413 HEMMOROID RIW. SC + PARTUS SC
250 DEDI SAEPUDIN 404698 ASMA
251 JANWAR PERDINAN 325252 MUCOCELE LIDAH
252 KISWATI 403888 CYSTA OVARIUM
253 Enen 404737 VIRAL INFECTION
254 SURIPTO 382549 NEFROLITHIASIS
255 KARTI 404526 NEFROLITHIASIS
256 ENDAH NURASYAH 401578 HIL
257 SITI SUAEBAH 351343 DYSPEPSIA
258 ZAKY MUBAROK 404611 TYPHOID FEVER ISPA
259 TUTI ROHANI 404643 INSUFF VERTEBROBASILHT + DYSLIPIDEMIA
260 DACHLAN HUSEN SANUSI 331899 NEFROLITHIASIS
261 APTU SUBHIARSIH 404809 AB. INKOMPLIT
262 AMAH NURHASANAH 389495 DM NEUROPATHY DYSPEPSIA
263 ALIZA DEVITA 403786 PERFORASI APP
264 ABDUL KODIR 404768 STT
265 YAYA 402008 ISK HT
266 PUJI PRASETYO 404631 LBP
267 ITOH MASITOH 391345 GEA DEHIDRASI
268 CHESAR PADILAH 372725 TONSILADENOIDITIS
269 dyla humaira ramadaniar 383386 TYPHOID FEVER CANDIDAL STOMATITIS + ISPA
270 NIA YULIANA 367773 GAGAL INDUKSI PARTUS SC
271 YENI HERLINA 382898 AB. INKOMPLIT
272 MOCH SULIM 314095 GEA
273 SITI MADINAH 404853 VERTIGO PERIFER
274 KOKOM KOMALASARI 389691 GASTRITIS AKUT
275 LUSI MEILANI 399897 V. GRANULOMA
276 IWAN RIDWAN 347574 MYALGIA LBP
277 AHMAD NURHARDYAN 404304 KP AKTIF SUSP AMI + DYSPEPSIA
278 SYIFA NAZWA NUR MAUL 404760 TYPHOID FEVER DBD
279 H TAJUSOLIHIN 403071 NEFROLITHIASIS
280 fany kartkasari dewi 404496 CYSTA OVARY
281 ADIN 404351 NEFROLITHIASIS
282 UJA ZAENUDIN 404143 PENURUNAN KESADARAN
283 CAHYONO 404984 PENURUNAN KESADARANDM TNP OBT + SELULITIS
284 raffa hazri oktaviansyah 386110 DADRS
285 SITI SUHARTINI 383955 SYNDROM GERIATRI
286 NENI ROHAENI BT SAFEI 404776 MYOM UTERI
287 MUHAMMADFAISHALLUTHF 404601 PERIAPPENDICULAR ABSES
288 ROFIK 301891 TRIGGER FINGER
289 YANI MULYANI 335016 CLAVUS
290 FITRI HANDAYANI 362992 CA MAMAE
291 SOPIAN SUPRIADI 404263 ESRD CAP
292 ALIM 404885 HT DYSPEPSIA
293 INGGIT 386260 AVNRT PULMONARY HYPERTENSI
294 DEAN ARYA PATAH 373217 TYPHOID FEVER
295 devi nugroho adiningrat 403078 SN BI + GASTRITIS AKUT
296 h toha 396039 PPOK
297 ENUNG NUR AENI 324880 KPSW PARTUS SPONTAN
298 UDIN SAHUDIN 404173 ISCHEMIC CARDIOGENIKCHF
299 RIKA JATNIKA 404940 AB. INKOMPLIT
300 YENI ROHAENI 404983 OLIGOHYDRAMNION PARTUS SC
301 DALI 395088 ESRD ec GLOMERULOPATI
302 CASRITA 382092 GEA
303 YANI MARYANI 404696 GEA
304 NURAENI 404865 DIARE
305 SAIFUL MA`RIF 404915 ABSES COLLI
306 NANI 403213 BATU PYELUM
307 otong 402473 BATU PYELUM
308 ETI SUHAETI 404784 AB. INKOMPLIT
309 zhaafirah nida syahla 385195 STT AR SUBMANDIBULLA
310 LINDA PURWANTI 404914 FAM
311 ara 404955 DYSPEPSIA UTI
312 ecah 404880 CAD HT + CKD
313 DINA OLIVIA 329509 TYPHOID FEVER
314 muhammad justn haufanza 404968 DADRS HYPOKALEMIA
315 muhamad rizky nur sultonm 404514 HBR
316 H.IBIN MUHIDIN 388987 BURSITIS ar PATELLA
317 ANDRIAN BUDI HERMANTO 405088 HEMMOROID THROMBOSED
RIZAL MAULANA HASANUDIN
318 401783 NEFROLITHIASIS HYDRONEFROSIS
319 YANNY 402454 COLITIS PROCTITIS
320 sALMA NISA NURAINA 337473 BACTERIAL INFECTION ISPA + VOMITUS
321 Ellya Rakhmandari 370207 TYPHOID FEVER
322 DADE 319538 TB PARU
323 FITRIHIDAYANTI 335774 DADRS
324 M. RENDY APRILLEZA 404982 PERITONITIS ec PERFORASI APPENDICITIS
325 ANGGARDA PRATAMA 389162 MORBILI
326 VINNYNOVITASARI 352661 HEMMOROID INTERNA THROMBOSED
327 YENNI NOVAYANTI 308028 RIW. SC PARTUS SC
328 ASEP NUGRAHA 364425 VSD POLISITEMIA SEKUNDER
329 IDA FARIDA 396343 MYOM UTERI
330 TITIN PRIHATIN,NY 404626 PROLAPSE UTERI
331 LENi heumasse 336698 CHOLELITHIASIS CHOLECYSTITIS + ADHESI
332 muhamad fiki agustan 391702 BRONCHOPNEUMONIA
333 FIKRI ADIANSYAH 405041 DADRS
334 NIA YULIANA 367773 PERDARAHAN PERVAGINA
335 SUPARDI 404979 HIM
336 NANA SURYANA 404923 FRAKTUR TIBIA PENGENDARA MOTOR M
337 muhammad alghomidi guno 405098 BBL
338 RUSMINI 372945 GANGRENE DIABETIKU STT
339 INA HASANAH 405008 FAM
340 ABIYOGA ANJAYA 383187 CA PROSTAT METASTASE SPINE
341 shakila afiqa sukmana 377174 DADRS KDS
342 efa lathifah 384786 OLIGOHYDRAMNION PARTUS SPONTAN
343 YULI YULIWATI 329219 KET
344 muhamad rhaditya al fatha 383726 VIRAL INFECTION
345 KRISLIA HIDAYAT 405023 VIRAL INFECTION HYPOCALCEMIA
346 HJ ENAH HASANAH 404783 LYNEN DIABETIKUM ar PEDIS
347 MUJI ASTUTI 394468 VIRAL INFECTION
348 ujun junaesih 394908 DC HHD KP AKTIF + EFFUSI PLEURA
349 dedeh sulastri 405075 ASMA TB PENGOBATAN
350 Farhan Wahyu Febriawan 405168 DENGUE FEVER
351 MIMIN 405151 PERDARAHAN PERVAGINA
352 ASIH ANASIH 405261 AB. INKOMPLIT
353 IIS ARISKA 401898 LYMPHADENOPATI COLLI
354 PRISKA INNESA 391042 LYMPHADENOPATI COLLI
355 NIA RUSFIANTI INDAH 405123 IUFD
356 FITRI SITI FATIMAH 347284 gea
357 HASAN MUSTARIH 403789 VESICOLITHIASIS NEFROLITHIASIS
358
359 IRNA ANJANI OLIVE 366100 VOMITUS FEBRIS
360 Sabrina Ayu Cahyaningrum 354336 OF VOMITUS
361 RUSMALA DEWI 399459 CHEST PAIN EC SUSP GASTRITIS
362 DIMYATI 405166 HT - HHD NEFRITIS + CYSTITIS + BPPV
363 SOBARI 405161 TB PARU BTA (-) SD
364 ANA SUMARNA 404878 ABSES + DM
365 JUWITA 403961 CAD NSTEMI + TB + CKD + PPOK
366 yuyun yunengsih 405179 POST DATE PARTUS SC
367 ILHAM REZA S, TN 318323 FRAKTUR FEMUR
368 RYAN ANGGUN RADIANS 405056 TETANUS
369 NENENG MILA MARLIANA 404210 BO
370 NIVA RANA PIRNANDA 405142 TYPHOID FEVER
371 NIVA RANA PIRNANDA 384715 GEA
372 RISMA 387536 MENOMTRORHAGIA ITP
373 FACHRUROZI 404331 EFFUSI PLEURA
374 cahaya ratu arum 370895 BRONCHOPNEUMONIA
375 NADA NADIRA ZALFA 397665 TYPHOID FEVER
376 SITI AISAH BINTI AGUS 402618 DRUG ERUPTION TB PENGOBATAN
377 JAYA KRISHNA 405066 OF GASTRITIS
378 DEAVI AMBAR PERMATASAR 405065 PROLONG FEVER
379 DANI HAMDANI 389038 DF TYPHOID FEVER
380 GUNAWAN GINTING 392804 VIRAL INFECTION
381 AISYAH ALIF FATHUL HUSNA 403606 BRONCHOPNEUMONIA
1 TETI MARYATI 397121 NP SLE IULKUS DECUBITUS

2 ANDHIKA ANSHORI 396708 ISPA KDS
3 ANGGA DANU SAPUTRA 400850 TYPHOID FEVER ISPA + KDS
4 ASEP JUHANI 357961 TYPHOID FEVER UTI
5 ELI HALIMATUS SADIAH 402608 NEFROLITHIASIS HYDRONEFROSIS
6 ASDI SETIADI 404088 VERTIGO PERIFER TINNITUS + DYSLIPIDEMIA
7 LIA FITRI. M 403945 APP AKUT
8 DIMYATI FATURAHMAN 404062 ABSES DIGITI III
9 ELFITRA 318004 NEFROLITHIASIS HEP B
10 RISKA ANGGRAENI 330056 TYPHOID FEVER
11 GABRIELLE STEVEN GILBERT 402448 TYPHOID FEVER
12 SHELLA ANJELA 341080 UTI
13 YATI SRI NURHAYATI 334598 TTH
14 MUHAMMAD FADEL 404337 TYPHOID FEVER
15 YOGA ARDIANSYAH 347814 BRONCHOPNEUMONIA
16 AFIKA KHANSA AZZAHRA 404542 DADRS
17 ERNI HERAWATI 338199 CYSTA OVARY
18 SITI JUBAEDAH 335182 DHF
19 PATIMAH 369273 FRAKTUR TIBIA
INSULIN E10
LANTUS
NOVOMIX
NOVORAPID
AVIDRA
YUYUN YUNENGSIH,NY POST DATE

INJ = 3 obs 8 jam = 92x ranap = 5 revisi = 1
INA CBGs Bulan JUNI
KODE ICD KODE ICD KODE KEL
TINDAKAN UTAMA SECUNDER TINDAKAN AS
K29.5 I51.9 + I25.1 I
LE + RESEKSI ANASTOMOSIS + K56.6 K41.9 54.11 + 49.6 I
J06.9 R56.0 III

ACHEOBRONCHITIS J18.0 J40 II
A15.0 A01.0 II
ESWL N20.0 98.51 II
HEMMOROIDECTOMY + THROMBECTOMY I84.0 49.46 + 49.47 I
J18.0 II
KURET O05.4 69.02 III
TRANSFUSI B15.9 I10 + D63.8 99.03 II
OSIS LUMBAL I10 G44.2 + M41.8 III
Z51.5 III
A90 II
DEBRIDEMENT E11.5 86.22 II
A90 I
+ HYPONATREIUM A15.0 I11.9 + I25.1 + E87.1 I
E11.2 I
D25.9 I
HERNIORRHAPY K40.9 53 I
J44.9 J18.0 + I42.0 III
TRANSFUSI I11.9 E10.9 + D63.8 99.03 I
A01.0 II
N39.0 II
TRANSFUSI A90 A18.2 + K71.6 99.03 III
A01.0 A91 II
ESWL N20.0 98.51 II
ESWL N20.0 98.51 II
SCTP O48 O42.1 + O82.9 74.4 II
KURET O05.4 69.02 II
O42.0 O80.9 II
O20.0 II
K30 I
J44.9 G58.9 II
A01.0 K12.2 II
K81.0 E14.9 II
R42 III
K29.1 I
A01.0 M32.9 II
O21.0 I
DEBRIDEMENT T81.3 86.22 III
INJ M72.89 I10 83.98 I
P03.4 II
A01.0 K29.6 II
P03.4 II
SCTP O34.2 O82.9 74.4 II
A01.0 J06.9 II
EKSISI D48.1 83.49 I
K29.1 I
A01.0 I
A01.0 J06.9 III
J18.0 A09 III
EKSISI N61 85.24 II
+ DERMATITIS A09 K30 + L30.9 II
A01.0 N39.0 II
TRANSFUSI Z51.3 99.03 II
G40.9 R51 II
A17.0 G01 + A19.9 I
A09 I
B05.9 II
I13.1 III
I25.1 I11.9 + E14.9 I
SOD N80.1 65.49 I
A15.0 K71.8 III
O21.0 I
A01.0 N39.0 I
I63.9 I10 I
A01.0 III
BIOPSI D24 85.12 II
A15.0 I11.9 II
P03.4 II
EKSISI D48.1 83.49 II
SCTP O34.2 O33.2 + O82.9 74.4 II
SCTP Q21.0 O82.9 74.4 II
A09 I
G40.9 II
T37.1 + Y41.1 E86 II
APPENDECTOMY K37 53.29 I
EKSISI D24 85.24 III
EKSISI D24 85.24 II
ESWL N20.0 98.51 II
A09 I25.1 I
RIBU ) + DIARE T37.1 Y41.1 + A90 + A09 II
STAH D25.9 68.39 III
B05.9 II
A01.0 J06.9 I
A91 A01.0 I
A01.0 J06.9 II
HERNIORHAPY K40.9 53 III
K30 J02.9 I
J03.9 J02.9 II
EKSISI DEBRIDEMENT K12.2 27.49 I
E10.2 I
INJ FACET JOINT M54.5 81.92 I
KURET O05.4 69.02 I
SCTP O48 O34.2 + O82.9 74.4 I
URETERL MEATOTOMY + AFF STENT N20.0 56.1 + 97.65 III
ESWL N13.2 98.51 III
ESWL N20.0 98.51 I
H81.0 III
R06.0 III
HEMMOROIDECTOMY I84.2 49.46 II
URETHRAL MEATOTOMY D30.9 58.1 III
I11.9 J45.9 + Z92.8 + M19.9 II
ESWL N20.0 98.51 II
P59.9 I
ESWL N20.0 98,51 II
D + ANEMIA + ULKUS E11.2 M10.99 + D64.9 + L98.8 II
ESWL N20.0 98.51 I
J06.9 R56.0 I
SOD N83.2 65.49 III
KURET O02.0 69.02 I
E79.0 R42 II
A09 III
A01.0 K12.2 III
NEFROTOMY + INSERSSI STENT N20.0 55.01 + 59.8 III
ACHEOBRONCHITIS + CMPA J18.0 J40 + T78.1 III
+ TB PENGOBATAN N17.9 J44.9 + I51.9 + Z92.8 I
k52.9 II
i61.4 G93.6 II
STAH D25.9 68.39 II
EKSISI D48.1 83.49 III
A01.0 II
ESWL N20.0 N39.0 98.51 II
A90 A01.0 II
ATAN + CKD + KATARAK J44.9 Z92.8 + H25.9 II
J45.9 O99.5 II
BIOPSI EKSISI L04.2 40.23 III
J02.9 I
NOPATHY + AF E16.2 I88.1 + I48 III
TONSILECTOMY J35.1 28.2 II
Z51.3 I
I25.1 III
P03.4 II
SCTP O14.1 O82.9 74.4 III
N39.0 I
J21.9 II
TRANFUSI Z51.3 E04.9 + G44.0 99.03 II
J18.0 L50.9 I
TAH D25.9 68.4 II
SCTP O14.1 O82.9 74.4 I
J02.9 R11 II
J44.9 Z92.8 I
R42 I
A01.0 I
A91 II
M13.09 K30 I
EKSISI M67.4 83.49 II
ESWL N20.0 98.51 I
INSISI L02.8 86.04 III
O21.0 I
EKSISI D24 85.24 II
SCTP O34.2 O41.0 + O82.9 74.4 II
HYPOCALCEMIA I10 E11.4 + G59.0 + E83.5 III
EKSISI L84 86.3 I
HERNIOTOMY + ORCHIDOPEXY K40.9 Q53.1 62.5 I
A01.0 A91 II
A01.0 J06.9 II
ORIF S02.6 79.39 III
K29.7 O99.6 I
FLAP D48.1 83.49 III
BIOPSI D24 85.12 II
O20.0 O21.0 II
APPENDECTOMY K35.9 47.09 II
J45.9 II
T37.1 + Y41.1 R50.9 III
A09 II
I25.1 I50.9 + I48 II
SOD N80.1 65.61 II
HEMMOROIDECTOMY + THROMBECTOMY I84.0 49.46 + 49.47 I
A91 II
J18.0 II
ESWL N20.0 98.51 II
E11.9 K30+ I10 + A09 II
K30 II
A01.0 A91 II
ESWL N20.0 I10 98.51 I
URS + INSERSI STENT + ESWL N13.2 58.22 + 59.8 + III
A09 K36 I
HERNIORHAPY K40.9 53 I
A09 I
ESWL N13.2 98.51 II
P03.4 II
SCTP O34.2 O82.9 74.4 II
SCTP O42.9 O32.9 + O82.9 74.4 II
INJ G56.0 4.8 II
K35.9 I
I12.0 A90 I
A01.0 III
A01.0 II
CHOLECYSTECTOMY K81.9 51.22 II
PASM + HHD + TB PENGOBATAN M19.9 J93.8 + I11.9 + Z92.8 II
+ SEQ, STROKE I47.0 I25.1 + I50.0 + I69.3 II
REMOVE IMPLANT S92.51 78.69 II
J18.0 J45.9 III
J18.0 II
URS + PYELOLITHOTOMY + INSERSI DJ STENT N13.2 V I
J18.0 II
DEBRIDEMENT EKSISI N61 85.21 II
I20.0 E14.9 I
J45.9 J18.0 II
R11 I
HEMMOROIDECTOMY + THROMBECTOMY I84.0 49.46 + 49.47 II
K30 J40 II
A01.0 I
A01.0 II
P03.4 I
SCTP O34.2 O82.9 74.4 I
A90 III
B05.9 III
EKSISI D48.1 83.49 III
A01.0 I
P03.4 II
SCTP J45.9 O82.9 74.4 II
POLIPECTOMY + FESS J33.9 J01.0 21.31 + 22.19
P59.9 II
I25.1 III
ESWL N20.0 98.51 II
N81.4 E10.9 I
ESWL N20.0 98.51 I
BIOPSI EKSISI I88.9 40.29 II
REPAIR ANAL + STSG K60.2 49.79 + 86.69 III
G40.9 III
TROKE + SUSP. DC R06.0 I69.3 + I51.9 III
TTNA J93.9 D38.1 33.2 I
A01.0 III
A09 III
SOS D27 65.49 II
A01.0 II
B34.9 R56.0 III
A09 II
O80.9 II
P03.4 II
URETERAL MEATOTOMY + LITOTRIPSI BATU + INSERSI URETN35.9 N20.1 56.1 + 56.0 + 5 III
SCTP I84.9 O34.2 + O82.9 74.4 II
J45.9 II
EKSISI D10.1 25.1 I
SOS N83.2 65.49 III
B34.9 II
ESWL N20.0 98.51 II
HERNIORHAPY K40.9 53 II
K30 I
A01.0 J06.9 II
G45.0 I10 + E78.5 I
ESWL N20.0 98.51 I
E14.4 G59.0 + K30 II
LE + APPENDECTOMY K35.0 54.11 I
N39.0 I10 III
M54.5 II
A09 II
TONSILADENOIDECTOMY J35.3 28.3 II
STOMATITIS + ISPA A01.0 B37.0 + J06.9 II
SCTP O61.8 O82.9 74.4 I
A09 I
H81.3 I
K29.1 III
DEBRIDEMENT + STSG Z47.0 77.69 + 86.69 III
M79.1 M54.5 I
A15.0 I21.9 + K30 I
A01.0 A91 I
ESWL N20.0 98.51 I
SOD N83.2 65.49 I
ESWL N20.0 98.51 II
R55 III
T + SELULITIS G93.4 III
A09 I
R54 I
KURET D25.9 69.09 I
LE K35.1 54.11 II
RELEASE M65.3 82.01 II
EKSISI L84 83.49 II
SIMPLE MASTECTOMY C50.9 85.41 II
HD N18.0 J18.9 39.95 III
I10 K30 I
Y HYPERTENSI I47.1 I27.2 III
A01.0 II
N04.9 A49.9 + K29.1 II
J44.9 III
O42.9 O80.9 II
I25.9 I50.0 I
SCTP O41.0 O80.9 II
N05.9 N18.0 III
A09 III
A09 III
A09 III
DEBRIDEMENT EKSISI L02.4 86.22 I
PYELONEFROTOMY N20.0 55.11 III
PYELOTOMY N20.0 55.11 II
EKSISI D24 85.24 I
K30 N39.0 I
I25.1 I12.9 I
A01.0 II
A09 E87.6 III
P59.9 II
DEBRIDEMENT BURSA M71.98 83.5 I
ESWL N13.2 98.51 I
k52.9 K62.8 II
A49.9 J06.9 + R11 III
A01.0 II
A15.0 I
A09 I
LE + APPENDECTOMY K35.0 54.11 + 47.09 I
B05.9 III
SCTP O34.2 O82.9 74.4 I
A SEKUNDER Q21.0 D75.1 II
STAH + SOS D25.9 68.39 + 65.49 I
TAH N81.4 68.4 I
CHOLECYSTECTOMY + ADHESIOLYSIS BILIER K80.8 K81 51.22 + 54.59 II
J18.0 III
A09 II
N93.9 I
HERNIORHAPY K40.9 53 I
REMOVE IMPLANT Z47.0 V22.4 78.67 III
P03.4 I
EKSISI E11.5 83.49 I
EKSISI D24 85.21 II
PARAPARESE C61 C79.5 + G82.2 II
A09 R56.0 I
O41.0 O80.9 I
SOS O00.1 65.49 II
B34.9 II
B34.9 E83.5 I
AMPUTASI E11.5 84.12 I
B34.9 II
EFFUSI PLEURA I11.9 A15.0 + J90 II
J45.9 Z92.8 III
A90 I
BIOPSI CERVIX N93.9 67.12 III
BIOPSI I88.8 40.11
BIOPSI EKSISI I88.8 40.29 II
A09 I
VESICOLITHOTOMY N21.0 N20.0 57.19 II
R11 R50.9 III

R50.9 R11 III
K29.6 III
CYSTITIS + BPPV I13.9 N30.9 + H81.1 II
A16.2 K30 III
DEBRIDEMENT E10.5 86.22 I
B + CKD + PPOK I25.1 I21.4 + A15.0 + N18.0 + J44.9 I
SCTP O48 O82.9 74.4 III
DEBRIDEMNT Z47.0 77.65 II
A35 III
KURET O02.0 69.09 I
A01.0 II
A09 I
N92.1 D69.3 II
PUNGSI PLEURA J90 34.91 II
J18.0 I
A01.0 II
L27.0 Z92.8 I
K29.6 III
R50.9 III
A90 A01.0 I
B34.9 I
J18.0 I
KODE ICD KODE ICD KODE KEL
TINDAKAN UTAMA SECUNDER TINDAKAN AS
DEBRIDEMENT M32.1 + N08.L89 86.22 II
J06.9 R56.0 II
A01.0 J06.9 + R56.0 II
A01.0 N39.0 II
ESWL N13.2 98.51 II
DYSLIPIDEMIA H81.3 H93.1 + E78.5 II
APPENDECTOMY K35.9 47.09 II
NECROTOMY L02.8 86.28 II
N20.0 B16.9 II
A01.0 II
A01.0 II
N39.0 I
G44.2 II
A01.0 II
J18.0 II
A09 II
SOD N83.2 65.49 II
A91 II
REMOVE IMPLANT Z47.0 78.67 I
HARGA RS HARGA INA CBGS NAMA DOKTER
2,112,083.00 2,171,800.00 dr. TOTO

39,134,814.00 7,947,700.00 dr. DJOKO, Sp.B
2,225,425.00 1,778,800.00 dr. PARAMITA, Sp.A

3,742,322.00 4,170,100.00 dr. PARAMITA, Sp.A
5,870,314.00 7,945,500.00 dr. MR KURNIA, Sp.PD
8,311,120.00 12,108,700.00 dr. RENNY, Sp.U
11,828,988.00 6,095,900.00 dr. DJOKO, Sp.B
2,504,204.00 4,170,100.00 dr. PARAMITA, Sp.A
3,850,587.00 2,732,600.00 dr. SARJUNAS, Sp.OG
8,306,913.00 4,238,500.00 dr. A BARUNA, Sp.PD
2,534,301.00 3,183,700.00 dr. A BARUNA, Sp.PD
3,123,093.00 1,166,200.00 dr. A BARUNA, Sp.PD
4,937,942.00 2,331,600.00 dr. A BARUNA, Sp.PD
4,065,800.00 3,725,100.00 dr. PITRAJAYA, Sp.B
3,884,300.00 2,720,200.00 dr. MIFTAH, Sp.PD
6,042,200.00 4,457,100.00 dr. MR KURNIA, Sp.PD
4,342,500.00 2,716,700.00 dr. MIFTAH, Sp.PD
4,249,458.00 2,174,100.00 dr. MAULIA, Sp.OG
11,740,372.00 4,997,900.00 dr. DJOKO, Sp.B
5,489,931.00 3,081,700.00 dr. A BARUNA, Sp.PD
6,042,000.00 6,042,200.00 dr. MR KURNIA, Sp.PD
2,906,758.00 3,329,400.00 dr. WIWIN, Sp.A
3,840,782.00 1,860,600.00 dr. MIFTAH, Sp.PD
5,195,188.00 2,326,600.00 dr. A BARUNA, Sp.PD
4,697,893.00 4,906,600.00 dr. PARAMITA, Sp.A
8,566,058.00 12,108,700.00 dr. RENNY, Sp.U
8,903,820.00 12,108,700.00 dr. RENNY, Sp.U
8,721,044.00 5,326,100.00 dr. SARJUNAS, Sp.OG
5,450,038.00 3,279,100.00 dr. SARJUNAS, Sp.OG
3,811,789.00 2,859,900.00 dr. SARJUNAS, Sp.OG
1,752,811.00 1,677,400.00 dr. SARJUNAS, Sp.OG
6,118,166.00 3,891,400.00 dr. A BARUNA, Sp.PD
4,716,077.00 2,878,100.00 dr. A BARUNA, Sp.PD
4,733,440.00 4,282,400.00 dr. MR KURNIA, Sp.PD
9,334,448.00 2,800,200.00 dr. A BARUNA, Sp.PD
3,158,361.00 1,548,700.00 dr. A BARUNA, Sp.PD
2,191,609.00 2,171,800.00 dr. A BARUNA, Sp.PD
2,647,081.00 3,329,400.00 dr. A BARUNA, Sp.PD
2,836,014.00 2,919,500.00 dr. MAULIA, Sp.OG
6,620,354.00 1,552,400.00 dr. HENDRY, Sp.B
1,944,779.00 2,166,600.00 dr. ZUHAIRA, Sp.S
1,338,577.00 1,995,800.00 dr. PARAMITA, Sp.A
3,109,881.00 3,329,400.00 dr. PARAMITA, Sp.A
1,214,989.00 1,995,800.00 dr. WIWIN, Sp.A
9,632,943.00 4,826,600.00 dr. MAULIA, Sp.OG
2,807,472.00 3,329,400.00 dr. PARAMITA, Sp.A
10,249,955.00 6,819,800.00 dr. PITRAJAYA, Sp.B
2,442,409.00 2,171,800.00 dr. WIWIN, Sp.A
4,263,234.00 3,884,300.00 dr. PARAMITA, Sp.A
2,204,440.00 2,774,500.00 dr. PARAMITA, Sp.A
2,539,436.00 3,475,100.00 dr. PARAMITA, Sp.A
9,613,120.00 6,118,200.00 dr. PITRAJAYA, Sp.B
2,970,929.00 2,423,100.00 dr. MIFTAH, Sp.PD
2,475,117.00 3,329,400.00 dr. A BARUNA, Sp.PD
20,489,119.00 1,399,400.00 dr. A BARUNA, Sp.PD
4,314,411.00 1,859,300.00 dr. ZUHAIRA, Sp.S
6,717,100.00 6,717,100.00 dr. MIFTAH, Sp.PD
2,827,100.00 2,827,100.00 dr. A BARUNA, Sp.PD
5,361,940.00 3,279,100.00 dr. SARJUNAS, Sp.OG
2,530,900.00 2,331,600.00 dr. WIWIN, Sp.A
3,975,610.00 1,940,500.00 dr. A BARUNA, Sp.PD
4,654,352.00 3,264,200.00 dr. A BARUNA, Sp.PD
10,311,480.00 7,381,900.00 dr. SARJUNAS, Sp.OG
20,790,316.00 4,982,800.00 dr. MIFTAH, Sp.PD
2,132,964.00 2,919,500.00 dr. MAULIA, Sp.OG
4,077,316.00 4,996,100.00 dr. A BARUNA, Sp.PD
8,147,997.00 4,101,800.00 dr. ZUHAIRA, Sp.S
1,864,889.00 2,774,500.00 dr. PARAMITA, Sp.A
7,780,232.00 6,118,200.00 dr. PITRAJAYA, Sp.B
13,781,936.00 5,004,900.00 dr. MR KURNIA, Sp.PD
1,514,067.00 1,995,800.00 dr. WIWIN, Sp.A
7,802,075.00 5,845,600.00 dr. DIK ADI, Sp.B
8,960,366.00 4,826,600.00 dr. NUNUNG, Sp.OG
9,264,424.00 4,826,600.00 dr. MAULIA, Sp.OG
2,827,100.00 2,827,100.00 dr. DEDE LIA, Sp.A
3,898,844.00 1,859,300.00 dr. ADE, Sp.S
3,001,543.00 1,399,100.00 dr. PARAMITA, Sp.A
11,455,264.00 3,985,400.00 dr. PITRAJAYA, Sp.B
6,789,263.00 5,098,500.00 dr. PITRAJAYA, Sp.B
8,230,953.00 6,118,200.00 dr. PITRAJAYA, Sp.B
8,603,131.00 12,108,700.00 dr. RENNY, Sp.U
8,023,187.00 2,827,100.00 dr. MIFTAH, Sp.PD
5,562,986.00 1,867,300.00 dr. WIWIN, Sp.A
8,368,623.00 5,272,800.00 dr. SARJUNAS, Sp.OG
APS
2,649,223.00 2,331,600.00 dr. PARAMITA, Sp.A
5,023,019.00 3,884,300.00 dr. PARAMITA, Sp.A
4,990,137.00 3,965,400.00 dr. PARAMITA, Sp.A
3,335,742.00 3,329,400.00 dr. PARAMITA, Sp.A
6,200,620.00 3,569,900.00 dr. PITRAJAYA, Sp.B
5,443,533.00 3,891,400.00 dr. MR KURNIA, Sp.PD
1,829,000.00 1,829,000.00 dr. RICHARD, Sp.THT
9,852,943.00 5,671,900.00 dr. PITRAJAYA, Sp.B
3,925,564.00 3,632,200.00 dr. A BARUNA, Sp.PD
2,330,389.00 2,712,300.00 dr. ADE, Sp.S
8,149,396.00 5,845,600.00 dr. DIK ADI, Sp.B
7,367,959.00 3,825,600.00 dr. SARJUNAS, Sp.OG
9,846,025.00 5,631,000.00 dr. SARJUNAS, Sp.OG
12,213,302.00 10,090,500.00 dr. YUDI, Sp.U
8,288,309.00 10,090,500.00 dr. RENNY, Sp.U
8,153,850.00 10,090,500.00 dr. YUDI, Sp.U
8,761,777.00 14,126,800.00 dr. YUDI, Sp.U
1,028,983.00 1,548,700.00 dr. UJANG
1,281,977.00 1,548,800.00 dr. TOTO
8,282,517.00 5,225,100.00 dr. PITRAJAYA, Sp.B
12,617,792.00 6,172,400.00 dr. YUDI, Sp.U
8,188,441.00 3,820,400.00 dr. A BARUNA, Sp.PD
8,428,020.00 12,108,700.00 dr. YUDI, Sp.U
3,156,878.00 3,265,600.00 dr. PARAMITA, Sp.A
8,551,111.00 12,108,700.00 dr. YUDI, Sp.U
4,065,800.00 3,722,100.00 dr. A BARUNA, Sp.PD
8,764,648.00 14,126,800.00 dr. YUDI, Sp.U
5,563,547.00 2,490,300.00 dr. PARAMITA, Sp.A
8,872,191.00 5,272,800.00 dr. SARJUNAS, Sp.OG
6,389,459.00 3,825,600.00 dr. MAULIA, Sp.OG
5,107,348.00 3,075,500.00 dr. ZUHAIRA, Sp.S
1,381,021.00 2,355,800.00 dr. PARAMITA, Sp.A
1,087,663.00 3,568,700.00 dr. WIWIN, Sp.A
17,672,425.00 10,090,500.00 dr. YUDI, Sp.U
19,010,995.00 3,475,100.00 dr. PARAMITA, Sp.A
1,965,565.00 4,530,800.00 dr. MR KURNIA, Sp.PD
6,285,300.00 2,423,100.00 dr. MIFTAH, Sp.PD
8,127,395.00 3,251,300.00 dr. MEDIA, Sp.S
12,033,577.00 6,327,300.00 dr. SARJUNAS, Sp.OG
6,584,232.00 4,871,300.00 dr. PITRAJAYA, Sp.B
2,633,835.00 3,329,400.00 dr. PARAMITA, Sp.A
8,963,434.00 13,705,200.00 dr. RENNY, Sp.U
5,005,269.00 3,398,900.00 dr. A BARUNA, Sp.PD
4,013,186.00 2,878,100.00 dr. A BARUNA, Sp.PD
2,141,119.00 1,862,800.00 dr. MAULIA, Sp.OG
7,192,117.00 3,535,500.00 dr. HENDRY, Sp.B
2,312,747.00 2,133,800.00 dr. PARAMITA, Sp.A
1,223,141.00 3,388,200.00 dr. UJANG RAJAL
7,094,994.00 2,121,400.00 dr. RICHARD, Sp.THT
3,966,664.00 1,632,600.00 dr. PITRAJAYA, Sp.B
3,536,689.00 2,331,600.00 dr. FITRIYATI
1,661,388.00 1,995,800.00 dr. WIWIN, Sp.A
8,459,693.00 4,022,100.00 dr. SARJUNAS, Sp.OG
5,036,798.00 2,170,700.00 dr. MR KURNIA, Sp.PD
2,900,217.00 1,862,800.00 dr. WIWIN, Sp.A
2,908,148.00 1,399,400.00 dr. A BARUNA, Sp.PD
4,651,890.00 4,865,100.00 dr. PARAMITA, Sp.A
9,757,518.00 6,327,300.00 dr. SARJUNAS, Sp.OG
11,255,247.00 5,631,000.00 dr. SARJUNAS, Sp.OG
2,318,640.00 1,829,000.00 dr. PARAMITA, Sp.A
3,497,148.00 3,357,800.00 dr. A BARUNA, Sp.PD
2,168,100.00 2,168,100.00 dr. ADE, Sp.S
3,884,300.00 3,884,300.00 dr. A BARUNA, Sp.PD
2,331,600.00 2,331,600.00 dr. MR KURNIA, Sp.PD
2,905,500.00 2,905,500.00 dr. MEDIA, Sp.S
7,775,851.00 5,845,600.00 dr. PITRAJAYA, Sp.B
8,909,819.00 14,126,800.00 dr. RENNY, Sp.U
6,360,762.00 2,333,600.00 dr. DIK ADI, Sp.B
1,909,168.00 2,919,500.00 dr. MAULIA, Sp.OG
7,270,057.00 6,118,200.00 dr. PITRAJAYA, Sp.B
8,055,319.00 4,826,600.00 dr. MAULIA, Sp.OG
3,994,942.00 4,315,900.00 dr. MR KURNIA, Sp.PD
9,467,376.00 4,583,900.00 dr. HENDRY, Sp.B
10,828,914.00 5,361,600.00 dr. HENDRY, Sp.B
8,508,956.00 5,845,600.00 dr. PITRAJAYA, Sp.B
4,239,420.00 4,906,600.00 dr. PARAMITA, Sp.A
3,464,732.00 3,329,400.00 dr. PARAMITA, Sp.A
8,864,261.00 6,819,800.00 dr. PITRAJAYA, Sp.B
19,949,135.00 6,284,000.00 dr. PITRAJAYA, Sp.B
4,445,757.00 2,171,800.00 dr. A BARUNA, Sp.PD
6,991,187.00 4,871,300.00 dr. GHUNA, Sp.OT
3,817,786.00 6,118,200.00 dr. DJOKO, Sp.B
2,106,131.00 1,677,400.00 dr. SARJUNAS, Sp.OG
10,409,267.00 3,416,000.00 dr. HENDRY, Sp.B
2,480,621.00 1,862,800.00 dr. MAULIA, Sp.OG
3,097,161.00 1,165,900.00 dr. PARAMITA, Sp.A
2,452,665.00 2,423,100.00 dr. A BARUNA, Sp.PD
4,101,524.00 3,575,100.00 dr. R. BAYU, Sp.J
12,024,711.00 6,327,300.00 dr. SARJUNAS, Sp.OG
13,037,129.00 6,095,900.00 dr. DIK ADI, Sp.B
3,816,109.00 2,331,600.00 dr. A BARUNA, Sp.PD
8,371,771.00 10,090,500.00 dr. RENNY, Sp.U
5,219,195.00 4,170,100.00 dr. PARAMITA, Sp.A
8,061,557.00 10,090,500.00 dr. YUDI, Sp.U
8,388,050.00 12,108,700.00 dr. YUDI, Sp.U
4,023,042.00 2,331,500.00 dr. A BARUNA, Sp.PD
8,139,557.00 10,090,500.00 dr. YUDI, Sp.U
2,281,079.00 3,335,500.00 dr. PARAMITA, Sp.A
3,633,752.00 4,906,600.00 dr. PARAMITA, Sp.A
8,061,557.00 14,126,800.00 dr. RENNY, Sp.U
25,080,569.00 10,090,500.00 dr. RENNY, Sp.U
4,383,097.00 2,827,100.00 dr. DJOKO, Sp.B
4,997,900.00 4,997,900.00 dr. PITRAJAYA, Sp.B
3,638,173.00 2,827,100.00 dr. PARAMITA, Sp.A
9,077,669.00 12,108,700.00 dr. RENNY, Sp.U
1,205,184.00 1,995,800.00 dr. PARAMITA, Sp.A
8,810,321.00 4,826,600.00 dr. SARJUNAS, Sp.OG
9,517,980.00 4,826,600.00 dr. MAULIA, Sp.OG
8,604,083.00 10,090,500.00 dr. RENNY, Sp.U
1,950,323.00 3,102,100.00 dr. ZUHIRA, Sp.S
3,891,400.00 3,891,400.00 dr. PITRAJAYA, Sp.B
332,636.00 4,530,800.00 dr. MR KURNIA, Sp.PD
8,565,139.00 3,569,900.00 dr. PITRAJAYA, Sp.B
4,254,502.00 2,774,500.00 dr. MIFTAH, Sp.PD
4,548,225.00 3,329,400.00 dr. MIFTAH, Sp.PD
10,594,665.00 6,481,200.00 dr. PITRAJAYA, Sp.B
3,781,307.00 2,490,400.00 dr. A BARUNA, Sp.PD
10,191,658.00 4,600,800.00 dr. RIEN, Sp.JP
11,975,013.00 3,548,000.00 dr. GHUNA, Sp.OT
2,984,187.00 3,475,100.00 dr. A BARUNA, Sp.PD
3,204,546.00 4,170,100.00 dr. PARAMITA, Sp.A
30,454,575.00 14,126,800.00 dr. RENNY, Sp.U
3,082,943.00 4,170,100.00 dr. PARAMITA, Sp.A
9,478,397.00 6,118,200.00 dr. PITRAJAYA, Sp.B
7,699,596.00 4,509,100.00 dr. MR KURNIA, Sp.PD
8,581,375.00 2,706,900.00 dr. DEASY, Sp.P
3,126,346.00 2,827,100.00 dr. PARAMITA, Sp.A
8,854,961.00 5,225,100.00 dr. DJOKO, Sp.B
6,910,605.00 5,845,600.00 dr. DJOKO, Sp.B
3,902,316.00 3,335,500.00 dr. A BARUNA, Sp.PD
5,577,694.00 3,884,300.00 dr. MIFTAH, Sp.PD
3,969,188.00 3,329,400.00 dr. MIFTAH, Sp.PD
2,007,608.00 2,328,400.00 dr. WIWIN, Sp.A
10,878,365.00 5,631,000.00 dr. MAULIA, Sp.OG
1,943,000.00 1,943,000.00 dr. A BARUNA, Sp.PD
2,401,931.00 1,943,000.00 dr. WIWIN, Sp.A
9,949,254.00 6,819,800.00 dr. PITRAJAYA, Sp.B
6,915,321.00 4,871,300.00 dr. PITRAJAYA, Sp.B
2,686,631.00 3,884,300.00 dr. A BARUNA, Sp.PD
1,204,046.00 1,995,800.00 dr. WIWIN, Sp.A
9,430,774.00 4,826,600.00 dr. MAULIA, Sp.OG
8,534,924.00 1,867,700.00 dr. RICHARD, Sp.THT
2,425,188.00 2,799,100.00 dr. PARAMITA, Sp.A
3,604,449.00 2,331,600.00 dr. FITRI YATI RAJAL
8,926,126.00 12,108,700.00 dr. RENNY, Sp.U
1,881,243.00 1,632,600.00 dr. SARJUNAS, Sp.OG
8,696,024.00 14,126,800.00 dr. RENNY, Sp.U
7,503,723.00 4,242,600.00 dr. PITRAJAYA, Sp.B
7,553,474.00 6,888,200.00 dr. DJOKO, Sp.B
3,415,142.00 1,549,400.00 dr. ZUHAIRA, Sp.S
1,004,794.00 1,548,800.00 dr. FITHRI YANTI
4,073,744.00 3,808,000.00 dr. DEASY, Sp.P
1,678,696.00 2,774,500.00 dr. PARAMITA, Sp.A
1,260,140.00 2,355,800.00 dr. PARAMITA, Sp.A
12,081,706.00 6,327,300.00 dr. MAULIA, Sp.OG
9,583,444.00 3,569,900.00 dr. DJOKO, Sp.B
2,314,596.00 3,329,400.00 dr. PARAMITA, Sp.A
1,812,767.00 2,326,600.00 dr. WIWIN, Sp.A
2,713,174.00 2,423,100.00 dr. A BARUNA, Sp.PD
4,285,375.00 2,416,400.00 dr. MAULIA, Sp.OG
1,387,917.00 1,995,800.00 dr. PARAMITA, Sp.A
16,452,581.00 11,421,000.00 dr, YUDI, Sp.U
9,575,162.00 4,826,600.00 dr. SARJUNAS, Sp.OG
2,589,850.00 1,862,800.00 dr. MR KURNIA, Sp.PD
10,670,860.00 5,671,900.00 drg. FRANKY, Sp.BM
9,818,437.00 5,272,800.00 dr. SARJUNAS, Sp.OG
3,319,084.00 2,331,600.00 dr. MR KURNIA, Sp.PD
8,455,039.00 12,108,700.00 dr. YUDI, Sp.U
11,966,691.00 10,090,500.00 dr. YUDI, Sp.U
9,378,372.00 4,283,900.00 dr. DJOKO, Sp.B
3,275,355.00 3,891,400.00 dr. MIFTAH, Sp.PD
3,898,916.00 3,329,400.00 dr. PARAMITA, Sp.A
2,717,400.00 2,717,400.00 dr. ZUHAIRA, Sp.S
9,081,778.00 14,126,800.00 dr. YUDI, Sp.U
5,012,925.00 3,279,100.00 dr. SARJUNAS, Sp.OG
4,173,165.00 3,102,100.00 dr. MR KURNIA, Sp.PD
12,159,275.00 7,947,700.00 dr. DJOKO, Sp.B
7,279,664.00 5,845,600.00 dr. DJOKO, Sp.B
5,264,309.00 1,550,500.00 dr. A BARUNA, Sp.PD
2,926,836.00 2,324,900.00 dr. ZUHAIRA, Sp.S
2,705,014.00 2,423,100.00 dr. MIFTAH, Sp.PD
8,163,686.00 2,121,400.00 dr. RICHARD, Sp.THT
2,487,305.00 4,282,400.00 dr. WIWIN, Sp.A
15,251,887.00 5,631,000.00 dr. MAULIA, Sp.OG
4,765,526.00 3,279,100.00 dr. SARJUNAS, Sp.OG
3,629,754.00 2,827,100.00 dr. MR KURNIA, Sp.PD
3,110,746.00 2,168,100.00 dr. ZUHAIRA, Sp.S
4,354,676.00 1,551,300.00 dr. A BARUNA, Sp.PD
14,606,359.00 6,888,200.00 dr. GHUNA, Sp.OT
3,882,761.00 2,170,800.00 dr. MIFTAH, Sp.PD
12,801,653.00 8,860,000.00 dr. MR KURNIA, Sp.PD
5,271,630.00 5,724,400.00 dr. PARAMITA, Sp.A
9,937,956.00 14,126,800.00 dr. RENNY, Sp.U
19,218,742.00 7,381,900.00 dr. SARJUNAS, Sp.OG
8,777,138.00 12,108,700.00 dr. RENNY, Sp.U
1,653,789.00 4,282,900.00 dr. FITRI YATI
1,356,897.00 1,578,200.00 dr. FITRI YANTI
2,767,108.00 2,827,100.00 dr. PARAMITA, Sp.A
5,308,617.00 6,459,800.00 dr. MIFTAH, Sp.PD
6,300,390.00 3,825,600.00 dr. NUNUNG, Sp.OG
14,380,825.00 6,812,300.00 dr. PITRAJAYA, Sp.B
11,867,405.00 6,233,600.00 dr. GHUNA, Sp.OT
6,937,065.00 5,845,600.00 dr. PITRAJAYA, Sp.B
11,561,755.00 6,118,200.00 dr. PITRAJAYA, Sp.B
9,161,638.00 4,329,400.00 dr. A BARUNA, Sp.PD
4,015,379.00 4,457,100.00 dr. A BARUNA, Sp.PD
8,366,687.00 3,834,000.00 dr. RIEN, Sp.JP
3,187,857.00 3,329,400.00 dr. PARAMITA, Sp.A
2,715,543.00 3,490,700.00 dr. DEDE LIA, Sp.A
3,826,038.00 2,398,400.00 dr. A BARUNA, Sp.PD
4,183,160.00 2,859,900.00 dr. MAULIA, Sp.OG
3,984,333.00 4,170,900.00 dr. R. BAYU, Sp.JP
5,124,171.00 3,279,100.00 dr. SARJUNAS, Sp.OG
3,525,947.00 2,859,900.00 dr. MAULIA, Sp.OG
4,203,874.00 2,014,800.00 dr. MIFTAH, Sp.PD
3,137,331.00 2,355,800.00 dr. MIFTAH, Sp.PD
499,597.00 2,355,800.00 dr. DWIANA
786,306.00 2,355,800.00 dr. FITRI YATI
10,053,113.00 3,267,100.00 dr. PITRAJAYA, Sp.B
20,782,176.00 10,090,500.00 dr. YUDI, Sp.U
22,075,053.00 12,108,700.00 dr. YUDI, Sp.U
4,822,515.00 3,279,100.00 dr. MAULIA, Sp.OG
8,669,906.00 4,861,600.00 dr. DJOKO, Sp.B
9,844,612.00 7,137,800.00 dr. PITRAJAYA, Sp.B
4,383,942.00 5,837,000.00 dr. MR KURNIA, Sp.PD
6,754,573.00 3,264,200.00 dr. A BARUNA, Sp.PD
3,217,075.00 3,329,400.00 dr. PARAMITA, Sp.A
2,159,512.00 3,326,100.00 dr. PARAMITA, Sp.A
3,860,533.00 2,799,100.00 dr. PARAMITA, Sp.A
16,458,379.00 6,819,800.00 dr. GHUNA, Sp.OT
9,138,293.00 5,225,100.00 dr. DJOKO, Sp.B
12,901,650.00 14,126,800.00 dr. RENNY, Sp.U
2,423,100.00 2,423,100.00 dr. MIFTAH, Sp.PD
1,564,557.00 1,943,000.00 dr. DEDE LIA, Sp.A
2,429,108.00 3,329,400.00 dr. MIFTAH, Sp.PD
6,989,105.00 5,839,000.00 dr. MIFTAH, Sp.PD
2,564,244.00 2,827,100.00 dr. WIWIN, Sp.A
14,565,698.00 7,947,700.00 dr. DJOKO, Sp.B
3,592,325.00 1,943,000.00 dr. PARAMITA, Sp.A
10,826,145.00 5,225,100.00 dr. DJOKO, Sp.B
11,735,697.00 5,631,000.00 dr. MAULIA, Sp.OG
2,278,348.00 3,693,400.00 dr. MR KURNIA, Sp.PD
11,301,513.00 7,381,900.00 dr. SARJUNAS, Sp.OG
13,602,407.00 7,381,900.00 dr. SARJUNAS, Sp.OG
11,138,169.00 6,481,200.00 dr. DJOKO, Sp.B
2,421,418.00 3,475,100.00 dr. PARAMITA, Sp.A
2,411,380.00 2,423,100.00 dr. PARAMITA, Sp.A
3,884,328.00 2,174,100.00 dr. MAULIA, Sp.OG
11,650,070.00 4,997,900.00 dr. PITRAJAYA, Sp.B
12,603,598.00 2,956,700.00 dr. GHUNA, Sp.OT
1,784,032.00 2,328,400.00 dr. WIWIN, Sp.A
9,167,441.00 6,819,800.00 dr. DJOKO, Sp.B
7,514,402.00 6,118,200.00 dr. DJOKO, Sp.B
4,775,020.00 4,643,000.00 dr. MEDIA, Sp.S
2,652,842.00 3,991,400.00 dr. PARAMITA, Sp.A
5,854,685.00 3,336,600.00 dr. MAULIA, Sp.OG
12,549,931.00 6,327,300.00 dr. SARJUNAS, Sp.OG
2,323,155.00 2,331,600.00 dr. DEDE LIA, Sp.A
6,184,919.00 3,257,200.00 dr. MR KURNIA, Sp.PD
26,569,567.00 10,191,300.00 dr. DJOKO, Sp.B
2,294,411.00 2,331,600.00 dr. A BARUNA, Sp.PD
7,844,363.00 6,285,700.00 dr. MR KURNIA, Sp.PD
4,824,295.00 1,552,400.00 dr. DEASY, Sp.P
4,176,862.00 2,720,200.00 dr. MIFTAH, Sp.PD
5,852,731.00 2,730,600.00 dr. SARJUNAS, Sp.OG
4,878,110.00 3,279,100.00 dr. SARJUNAS, Sp.OG
8,374,567.00 4,242,600.00 dr. PITRAJAYA, Sp.B
8,437,805.00 4,242,600.00 dr. PITRAJAYA, Sp.B
7,534,919.00 3,279,100.00 dr. SARJUNAS, Sp.OG
5,173,627.00 2,827,100.00 dr. MR KURNIA, Sp.PD
10,069,190.00 7,095,400.00 dr. DJOKO, Sp.B
1 EPISODE.
2,355,800.00 dr. FITRI YATI
599,625.00 1,556,900.00 dr. UJANG
1,002,633.00 1,551,300.00 dr. FITRI YATI
5,179,100.00 3,722,100.00 dr. A BARUNA, Sp.PD
3,381,214.00 4,170,700.00 dr. DEASY, Sp.P
22,130,519.00 4,345,900.00 dr. A BARUNA, Sp.PD
23,286,411.00 5,419,700.00 dr. A BARUNA, Sp.PD
8,653,885.00 4,022,100.00 dr. SARJUNAS, Sp.OG
8,636,530.00 3,548,000.00 dr. GHUNA. Sp.OT
4,407,220.00 2,774,500.00 dr. MEDIA, Sp.S
5,860,493.00 3,825,600.00 dr. MAULIA, Sp.OG
3,561,575.00 3,329,400.00 dr. PARAMITA, Sp.A
2,112,902.00 2,827,100.00 dr. MR KURNIA, Sp.PD
4,832,182.00 2,557,200.00 dr. MAULIA, Sp.OG
2,058,716.00 3,264,000.00 dr. DEASY, Sp.P
8,062,504.00 4,865,100.00 dr. PARAMITA, Sp.A
2,170,099.00 3,329,400.00 dr. PARAMITA, Sp.A
6,512,200.00 2,172,400.00 dr. DEASY, Sp.P
779,301.00 1,551,300.00 dr. FITRI YANTI
785,885.00 1,556,900.00 dr. FITRI YANTI
12,906,514.00 3,965,400.00 dr. A BARUNA, Sp.PD
2,667,839.00 2,720,200.00 dr. A BARUNA, Sp.PD
4,865,100.00 4,865,100.00 dr. PARAMITA, Sp.A
2,428,196,798.00 1,700,879,300.00
68,967,305.00 7,341,900.00 dr. MIFTAH, Sp.PD

2,513,293.00 2,134,600.00 dr. PARAMITA, Sp.A
3,221,626.00 4,282,400.00 dr. DEDE LIA, Sp.A
5,104,952.00 4,282,400.00 dr. MR KURNIA, Sp.PD
8,310,108.00 12,108,700.00 dr. RENNY, Sp.U
4,086,998.00 1,858,400.00 dr. ZUHAIRA, Sp.S
6,720,562.00 3,416,000.00 dr. PITRAJAYA, Sp.B
7,005,880.00 2,800,400.00 dr. DIK ADI, Sp.B
4,434,526.00 2,957,900.00 dr. A BARUNA, Sp.PD
3,630,763.00 3,329,400.00 dr. MR KURNIA, Sp.PD
1,658,954.00 3,329,400.00 dr. PARAMITA, Sp.A
3,154,078.00 2,170,700.00 dr. MR KURNIA, Sp.PD
2,526,435.00 1,865,900.00 dr. A BARUNA, Sp.PD
3,329,400.00 3,329,400.00 dr. PARAMITA, Sp.A
2,361,912.00 4,170,100.00 dr. PARAMITA, Sp.A
2,049,320.00 2,423,100.00 dr. PARAMITA, Sp.A
11,068,250.00 6,327,300.00 dr. SARJUNAS, Sp.OG
2,899,455.00 2,331,600.00 dr. A BARUNA, Sp.PD
15,652,859.00 4,139,400.00 dr. GHUNA, Sp.OT
158,696,676.00 74,599,000.00
APS
NO NAMA PASIEN NO. MR DIAGNOSA PRIMER
1 SUMARNI JD MASNA MUHAT 405282 SUSP EPIDERMOID CA DIGITI

2 mala damayant 319185 FAM
3 AYU ANGGITA DAMAYANTI 391636 DENGUE FEVER
4 HJ ELIH 405184 TB PARU
5 DIAN ARIANTI 358069 ASMA BR
6 BAYU KRISPRYANTO 405119 DHF
7 kayla nuraini 388237 MORBILI
8 MULYATI 405202 STT AXILLA
9 MUHAMADZHAFRAN 321655 DHF
10 SUSI 392569 SNNT
11 MAHPUDIN 403266 TYPHOID FEVER
12 DUDUNG JUNAEDI 405304 VIRAL INFECTION
13 elmira syavira zahra 404477 RESPIRATORY FAILURE
14 ELZA 405203 STT SUBMANDIBULLA
15 UMIYATI 405255 GASTRITIS EROSIVA
16 HJ.HERMI 405115 SIROSIS HEPAR
17 AZRIEL ALHIDAYAT 373346 DHF
18 dyandra theona gladys r 405365 BACTERIAL INFECTION
19 Erika Alawiyah, A. Md. Kep 328247 AB. IMMINENS
20 RUSMALA DEWI 399459 FATTY LIVER
21 GHAISAN AVRILLIO AMINUDI 405407 SKIN LOSS
22 CHRISTINA MANUPUTTY 337075 PLASENTA PREVIA
23 HERU ANUGRA 405068 DENGUE FEVER
24 HIDAYAT 404570 BPH
25 KUSNADI 353598 PPOK
26 SITI SUAEBAH 391809 CPD
27 FAZRiL FIRLAN SUHERLI 339886 TYPHOID FEVER
28 EMMA SARIFA 383225 FIBROMA
29 MOCH ARIFIN, S.HUT. 405234 UAP
30 IPANG 398036 DJ STENT IN SITU
31 MASTUROH 363967 DJ STENT IN SITU
32 FITRIANI 405373 DENGUE FEVER
33 KOMARUDIN 405376 ILEUS OBSTRUKTIF
34 ONENG LAHIRIAH 405363 ANEMIA ec SUSP MYOM UTERI
35 JELITANURMA'ATUSS 306586 DHF
36 HJ ENI HASANAH 396222 CHOLESISTITIS
37 IRA PUSPITA 405371 DENGUE FEVER
38 ENEN SITI JUBAEDAH 405149 ABSES PERIAPPENDICULAR
39 NIEKHATA MEILANI NURFADIL 405225 DHF
40 MUSLIMAH 405381 HYPERTENSI
41 ust 405216 ANEURYSMA INTRA AB
42 praditya arya bimo widodo 404822 ILEUS PARALYTIC ec EN
43 WAWAT S 374058 AB. INKOMPLIT
44 Salma Risa Risnayant 302404 TYPHOID FEVER
45 WAHIDAH 405319 ANEMIA ec MASSA CERVIX
46 asih kurniasih 405436 OBS INPARTUS
47 ALDELIAPUTRI F 405462 DHF
48 Ii Suhaibah 405538 DYSPEPSIA
49FAHMI MUKHTAR RAMDANI 382046 ISPA
50 KURNIASIH 403919 STENOSIS URETER
51 LIA RAHMAWATI 405454 KPSW
52 LILIN NIKAWATI 365919 HEG
53 MULYADI 403511 DIARE AKUT
54 nagata al habsy 405499 BBL ai SC
55 NENG WIDI 405311 LETSU
56 NUR PARIDA 405422 CPD
57 SYAHRAL SAPUTRA 405321 TYPHOID FEVER
58 HJ yuhani 402156 PERDARAHAN PERVAGINA
59 WARIH 401635 CKD ec URETEROLITHIASIS
60 Yuniart Safitri 320398 GASTRITIS AKUT
61 yulia rizki ramadhani 405431 BBL ai SC
62 Atk Yusniar 402781 GASTRITIS AKUT
63 ILHAM SAPUTRA 401147 CTEV
64 ANTONI ROMLI 394683 PPOK
65 IMAS SUFFY ALAWIYAH 319854 APP AKUT
66 M HILMI 405413 TYPHOID FEVER
67 SUHAYA 405448 HT
68 NDANG BIN JINAN 405408 HIL
69 M TEGUH MAULANA 405519 CLAVUS
70 HJ SAYIDAH 389483 SIROSIS HEPATITIS
71 SOPANDI 332753 UNSTEABLE ANGINA
72 masturah 405157 TB PARU
73 NADA NADIRA ZALFA 397665 DADRS
74 ELANG YUSUF 313964 MYALGIA THORAC
75 SITI FATIMAH 311555 AB. INKOMPLIT
76 TUTI HERAWATI 379434 RADICULOPATHY LUMBAR
77 hanny susilawat 332506 VERTIGO PERIPHERAL
78 LORETTA, NY 371870 VIRAL INFECTION
79 LASMIATI 311497 AB. INKOMPLIT
80 DESY SUSILAWATI 405501 DENGUE FEVER
81 N SITI SUMARNI 373604 DMT2
82 WATI RAHMAWATI 405570 FAM
83 RINI KARTINI 405317 APP AKUT
84 ANISA AUREL HAERANy 351430 BRONCHOPNEUMONIA
85 muhamad angga ramadan 352475 ANEMIA
86 NINGSIH 399707 VIRAL INFECTION
87 YUANITA AMELIA 405594 LETSU
88 JUANDI 368214 CAP + KP
89 A SUHERMAN 391208 BPH
90 NISRIN AULIA HERMANTO 343531 DADRS
91 N. RIA SULASTRI 405588 TUMOR MAMAE S
92 NOVAN FIRDAUS 353600 TOF
93 ANITA 405587 CYSTA MAMAE
94 ERNAWATI 402955 RIW. SC
95 OYOK 404825 BATU PYELUM
96 DINI PURWANTI 329729 DYSPEPSIA
97 nagata al habsy 405499 TYPHOID FEVER
98 DRAJAT 377081 LIPOMA
99 HERYANTO 405509 FRAKTUR TIBIA FIBULA
100 muhammad restu arisoeroyo 405688 BBL ai SC
101 HJ.DINI INDRIA SUMARA 405447 RIW. SC
102 nagata al habsy 405499 NEONATAL HYPERBILIRUBIN
103 LALA KOMALA SARI BT HAMLI 376647 DKP
104 OMAN 404620 ULKUS DM
105 hana bilcis ramadhani 405559 RESPIRATORY FAILURE ec TRANSIENT TACHY
106 WINDA LISTIANI 325964 CPD
107 RAHMAT HIDAYAT 405228 STT LABIALIS
108 SRI SUMARTINI 405728 OSTEOMA
109 EEM MASTIRAH 405188 KP AKTIF dg EFFUSI PL
110 asshyfa fazzah 397234 DADRS
111 SUHALIB 370251 UAP
112 TINI SUMARTINI 325207 VASCULITIS
113 SOPIAH 405742 GASTRITIS AKUT
114 shafa aliyah sudrajat 399232 THALASEMIA
115 Arisfa Dwi Pramuditha 337311 DHF
116 MUHAMAD 405552 STROKE INFARK
117 A BAIHAQI 388451 ATROFI OTAK ec INFARK
118 MUHAMMAD FADHILAH MAU 405264 BRONCHOPNEUMONIA
119 IPIT 405504 STROKE INFARK
120 SOPYAN Z 404557 BPH
121 DEWI YULIANTI 330321 POST DATE
122 ENGKOS KOSASIH, H 325075 DIARE AKUT
123 ATIKAH SUMIATI 403882 SNNT
124 YAYA TARSIAH 405669 HT
125 assyifatu haifa schalan 389693 DHF
126 muhamad farhan abiansyah 355601 TYPHOID FEVER
127 zakia nursahidah 405774 ANEMIA DEF FE
128 SUGIHARTANTO 405485 FORNIER GANGRENE
129 GREGORIUS MARSELINO 397256 DIARE AKUT
130 NURHAYATI 336491 RL
131 H. MOHAMAD AZIS 397902 CARDIOMYIPATHY ISCH
132 ABRAHAM APRILIO RIZKY 341414 KDS
133 SOBUR ABDULOH 405693 EFFUSI PLEURA
134 SRI SUPENI 331863 BO
135 NENI ROHAENI BT SAFEI 404776 MYOM UTERI
136 HASTUTI 405860 KPD + PLSENTA LETAK
137 TUTI YULIANTI 405767 TRIGGER FINGER
138 HJ. ROHMAH 402775 DYSPEPSIA
139 khayla 405661 BRONCHOPNEUMONIA
140 asep somantri 405722 HIL
141 RESI RIZKYANI 392022 FAM
142 FAJAR MUH FADLI 405645 DHF
143 Lani Yuliani 405830 STT
144 USEN 383345 HHD-DC
145 ENDANG KARNAEN 376776 BPH
146 AZRI NAYLA RAHMA 405810 ISK
147 APIDIN 362146 GANGLION
148 muhammad wildan khaidir 405795 DADRS
149 lia subekt 312669 ASMA BR
150 Fitri Nuraeni 405764 STT
151 ASTRID DWI ANNANTI 383042 PERITONITIS SUSP TB
152 Syamsudin 349074 TYPHOID FEVER
153 anditha khanza azzahra 395516 BACTERIAL INFECTION
154 RANI RATNASARI 319368 POST DATE
155 YAYAN DARYANTO 32855 CHOLESISTITIS
156 hj. salwa andreanny 391956 TUMOR MAMAE S
157 m. daos 405719 HT
158 RUSMALA DEWI 399459
159 ALIVIA OKTAVIANI 351215 TYPHOID FEVER
160 tarsih suminarsih 405857 SOL
161 CUCU HERLINA 405599 CKD dg ANEMIA
162 BUDI KUSMEDI 405861 KP AKTIF
163 SEPTIANA MARCELINA S 405919 VIRAL INFECTION
164 FITRI HANDAYANI 405961 HAP
165 RUSMI 405907 ABSES MANDIBULLA
166 IMA ROHIMAH 349459 AB. IMMINENS
167 INDAH MULHATI 320478 AB. IMMINENS
168 ANNA MUSTIKA ATI 325484 ABSES
169 akbar wijaya ramadhan 405880 BBL ai SC
170 MUHAMMAD MUBAROK 379666 TYPHOID FEVER
171 DEDEH KURNIASIH 405807 CHOLESISTITIS
172 khayra 405776 BRONCHOPNEUMONIA
173 RATNASIH 319300 GASTRITIS
174 TAMAN 386324 DC ec HHD
175 MAYONG 405839 HIL
176 SYARIF RANDIRA 405962 VIRAL INFECTION
177 NADA NADIRA ZALFA 397665 INFEKSI VIRAL AKUT
178 YONGKY NOVARA, SE 406008 TYPHOID FEVER
179 ANANTO 360097 VIRAL INFECTION
180 widaningsih 389474 UTI
181 NUNUNG SUNENGSIH 406002 GEA
182 ASEP SOFYAN 325136 VIRAL INFECTION
183 naura zulfa mustka 398454 DIARE AKUT
184 ANING ROHANI 401825 KP AKTIF dg INFEKSI 2n
185 Dini Asyiah 338835 OLIGOGYDRAMNION
186 NYAI MULYATI 405986 UTI
187 UJANG MASRIA 406015 GEA
188 ANDHIKA NUGRAHA RAHADIA 363143 GASTRITIS AKUT
189 I DESTI JATI PUTRI 405974 ANEMIA
190 Yulia Anggraeni Trisnawat 332131 TYPHOID FEVER
191 JAJANG MUSTOPA 405988 ILEUS OBSTRUKTIF
192 KOYAH ROKAYAH 402492 HT
193 M Nadirul Irfan 405978 DHF
194 SYAQILA FADIA HAYA 405890 VIRAL INFECTION
195 DEDEN SAPUTRA 406001 MELENA
196 MEGI YANTI 393063 VIRAL INFECTION
197 JARKASIH 316141 VIRAL INFECTION
198 NIAH 406020 STROKE INFARK EMBOLI
199 NAI NURHAYATI 406114 AB. IMMINENS
200 YULI ANGGRAENI 392534 PID
201 ATIKAH 393452 PLASENTA LETAK REND
202 cellia quensya rahmat 406069 BBL ai SC
203 R YAYAN SOFYAN 399793 DC ec HHD
204 YAYAH SETIAWATI 406094 HODKIN'S LYMPHOMA
205 M. KHOIRUL AZIZ 406086 CLAVUS
206 AWANG DARMAWAN 364619 PNEUMONIA
207 MOH IHSAN MAULANA 406046 UTI
208 DIDI TARMADI 352790 UAP
209 AJI, H 405711 ICH
210 ANNISA ZAHRA DWI APRILIAN 406072 TYPHOID FEVER
211 RATNASIH 319300 HEG
212 IMAS 406138 LIPOMA ar BRACHII
213 ALI IHSAN FAUZI 406113 HERNIA INGUINAL
214 EMIL JAMILAH 362180 HEMMOROID INTERNA
215 KUDRIN R SIHOTANG 360497 SUSP EPIDERMOID CA
216 H ENDANG 393752 STT
217 NITA NOVITA 381846 EMPYEMA ec TB
218 dewi SUMIRAH 354179 ASMA BR
219 ODAH JARODAH 327043 PERDARAHAN PERVAGINA
220 NANI SURYANI 406010 MASSA OVARI
221 I SOPIAH 381394 CH dg MELENA
222 MAEMUNAH 406185 HT KRISIS
223 et nurmayant 406226 SUSP TYPHOID FEVER
224 RETNI HUTAHURUK 406088 DC ec AHD
225 ADI ZAMALUDIN 406075 FEBRIS ec SUSP TYPHOID
226 KEN KEISHA FAUZIAH 406527 DHF
227 OHIM 393948 STT
228 UNSIAH 406045 KEJANG BANGKITAN ec
229 H TAJUSOLIHIN 403071 MILD COGNITIVE IMPA
230 KARLINA 390352 HEG
231 INDAH NURLAELA 406161 EKLAMPSIA
232 afdhal reyhan alfarisyi 406171 BBL ai SC
233 NURUL HERAWATI 351404 GEA
234 EGY ARIA PUTRA 406216 VARICELLA
235 NAJWA SAFITRI 302672 SLEEP APNEU
236 ADE NUR HAYATI 406198 GANGLION DI TANGAN
237 ELA NURLAELA ROBIATUL 403147 PRESENTASI BOKONG
238 ROHANAH 309603 DC-HHD
239 ANNISA FITRIA APRIYANTI 363409 PARTUS SPONTAN (EMRG)0
240 TIA GUSTIANI 405211 NEURITIS
241 DINA MELLAN WULANSARI 366784 FAM
242 ONENG LAHIRIAH 425363 susp myom uteri pulang karena haid
243 luthfi hardi saputra 382816 BRONCHOPNEUMONIA
244 PARHAN AL LIJIK 404068 ADRENOLEUKODYSTROP
245 lilis nurhayat 390418 KPD
246 JASMINE SINTA ARAFAH 386070 DADRS
247 sukaesih 406184 KP AKTIF
248 SUGENG 406143 STT
249 OOM KOMARIAH 406291 DMT2
250 MAMAN 381881 UAP
251 NENENG HADIATI, NY 390865 EFFUSI PLEURA
252 TATI 406374 HT
253 OYOK 406357 GASTRITIS AKUT
254 IIP SYARIFUDDIN 405782 HIL
255 DEDE NENI ROHMANI 406152 PERITONITIS ec APP PE
256 DANISH RIFIAN AXEL 406354 HERNIA INGUINAL
257 AMIR KOMARUDIN 406196 HEMMOROID INTERNA
258 MATARI 406339 LYMPHADENOPATHY
259 AMELIAFITRIANI 406208 ABSES
260 WADI 385705 ESRD ON HD
261 HJ.IDAWATI 403523 DC ec HHD
262 TUBAGUS SUJANA DIWIRYA 406206 KP
263 habibi sahid 406429 CTEV
264 SUKAESIH 386633 GASTRITIS
265 ADING GADASASMITA 406090 UAP
266 M IMANUL HAQ EL FAQIH 404202 HEMMOROID INTERNA
267 NELI NURHASANAH 351406 ABSES MAMAE
268 ZENAL ARIFIN RACMANDANI 406399 HIL
269 HANA ANISA 381768 FAM
270 RANTYA SEPTIANTI 406153 SLEEP APNEU
271 SHELA YUSPIANA PUTRI 406415 MUCOCELE LABIALIS
272 aina talita zahran 393451 ISPA
273 aqila zulfa nur arifin 400490 DADRS
274 ADJUK SYAPEI 382469 DEHIDRASI
275 NIJAH 406466 PERDARAHAN PERVAGINA
276 TRICIPTO BUDIHARTO 406374 TYPHOID FEVER
277 SEKAR LARASATI 301233 VIRAL INFECTION
278 M. RAIHAN 406379 PERITONITIS ec APP PERFORASI
279 ZAHRA AULIA ANWAR 406442 TYPHOID FEVER
280 Hendra Sopian 303898 HIL
281 EMIN 406334 HIL
282 OCID 302329 HIL
283 RENISRIPURWAISTIAN 406246 HT
284 YATI ROHAYATI 300098 ULKUS PEPTIKUM BLEE
285 EVA NOVIANA 358188 DHF
286 RIDAH 330319 STROKE INFARK
287 epon 395442 ACIDOSIS METABOLIK
288 ADE SUPRIATNA 361766 HEMATEMESIS MELENA ec GASTROPATI NS
289 Dikky Drajat 405686 MHI
290 fuad abdullah zein 406264 ORCHITIS
291 YAYANSURYANTI 406573 HT
292 SITI MARYAM, NY 357910 VIRAL INFECTION
293 SARI 406402 SNNT
294 RUSKAT SUMANTRI 406421 STT
295 MAWAR YUANITA 357456 OLIGOGYDRAMNION
296 ASTRID DWI ANNANTI 383042 LYMPHADENOPATY
297 M Faeyza al Farizi 389631 ISPA
298 HERDIANANUGRAHA 403432 TYPHOID FEVER
299 CARMISUMARNI 344676 PLASENTA PREVIA
300 ASEP ABDULAH 379794 DYSPNEU
301 PURWO HADI S 371027 DHF
NO NAMA PASIEN NO. MR DIAGNOSA PRIMER
1 VIDISHA PAMESWARI 350280 TONSILITIS HYPERTROPIKA

2 NY. HARNI 370515 ISK
3 NY. HARNI 370515 CHOLELITHIASIS
4 INDAH DWI PRATIWI 359768 DADRS
5 EKI NOPANDI 336671 ABSES
6 FETTY OKTAVIAN 334254 APP AKUT
7 SUHENDAR , TN 404066 TRIGGER FINGER
8 ERNI HERAWATI 338199 GEA
9 ACIH SUWARSIH 307676 VARICELLA
10 DIMAS ESTU NUGRAHA 406038 HERPES ZOOSTER
11 ELFITRA 318004 KOLIK ABD ec dd UTI/ B
12 WIRANATA 344239 TYPHOID FEVER
13 RIA SETIYANINGSIH 406433 STT
14 RISDIANTO 406188 DENGUE FEVER
15 NELLY FITRIYANTI PAKPAHAN 316346 DENGUE FEVER
16 TENI ANGGRAENI 509639 STT
17 IDA NENGSIH 316567 HEG
18 MUHAMMAD IRFAN MAUL 355355 HEMMOROID INTERNA
INSULIN E10
LANTUS
NOVOMIX
NOVORAPID
AVIDRA
Rekapitulasi INA CBGs Bulan JULI
DIAGNOSA KODE ICD

TINDAKAN
SEKUNDER UTAMA
ERMOID CA DIGITI EKSISI D48.1

EKSISI D24
A90
KISTA HEPAR A15.0
PARTUS SPONTAN J45.9
A91
B05.9
EKSISI D36.7
TYPHOID FEVER A91
ISHMULOBECTOMY E04.9
ISK A01.0
B34.9
NEONATAL CONVULSIVENTILATOR >96 JAM P28.5
EKSISI D48.1
ANEMIA ec PERDARAHAN K29.1
ILEUS OBSTRUKTIF K74.6
SHOCK + EFFUSI PLEURA A91
P39.9
O20.0
CDH K76.0
SUTURE PRIMER T14.1
PARTUS SC SCTP O44.1
A90
URS + TURP N40
J44.9
RIW. SC + PARTUS SCSCTP O33.2
A01.0
EXPLORASI + EKSISI D48.1
DYSPEPSIA + HT + AKI + DM I20.9
URETERAL MEATOTOMY + AFF STENT N20.0
URETERAL MEATOTOMY + AFF STENT N99.1
TYPHOID FEVER A90
K56.6
c SUSP MYOM UTERI TRANSFUSI Z51.3
TOF + TYPHOID FEVER A91
CHOLELITHIASIS + DMT2 + HT K81.9
A90
IAPPENDICULAR LE K35.2
TYPHOID FEVER + ISPA A90
PARTUS SPONTAN O14.9
ANEMIA LE + EKSISI I71.4
DIARE AKUT K56.0
KURET O05.4
UTI A01.0
c MASSA CERVIX TRANSFUSI Z51.3
Z51.5
SYNDROME DYSPEPSIA A91
K30
T. CORPORIS J06.9
HYDRONEFROSIS URETERAL MEATOTOMY + AFF STENT N13.1
LETSU + PARTUS SC SCTP O42.0
O21.0
A09
P03.4
POST DATE + RIW. SCSCTP O33.2
BRONCHOPNEUMONIA A01.0
HAN PERVAGINA KURET N93.9
ETEROLITHIASIS NEFHROSTOMY N20.1
SLE K29.1
P03.4
K29.1
ACHILLES TENDON LANGTHENING Q66.0
HHD + CKD + DM J44.9
APPENDECTOMY K35.9
DHF A01.0
POLINEUROPATI + DIARE AKUT I10
HERNIORHAPY + ADHESIOLYSIS + OMENTECTOMY K46.0
INFEKSI SEKUNDER DEBRIDEMENT EKSISI L84
K74.6
HHD-DC + ESRD I20.0
CAP + DYSPEPSIA A15.0
A09
M79.1
KURET O05.4
PATHY LUMBAR M54.16
H81.3
FLUOR ALBUS B34.9
KURET O05.4
A90
STROKE INFARK + HT I63.9
EKSISI D24
APPENDECTOMY K35.1
PNEUMONIA J18.0
TRANSFUSI Z51.3
HT + CAD B34.9
DMT2 A15.0
TURP N40
A09
SUBCUTANEOUS MASTECTOMY D24
GASTRITIS J06.8
EKSISI N60.0
PYELOTOMY N20.0
K30
A01.0
EKSISI D17.9
ORIF S82.2
P03.4
HYPERBILIRUBIN P59.9
DEBRIDEMENT EKSISI E11.5
RY FAILURE ec TRANSIENT TACHYPNEU OF NEWBORN P28.5
RIW. SC + PARTUS SCSCTP O33.2
EKSISI D48.1
EKSISI D16.4
BSK A16.5
A09
HHD I20.9
M05.26
K29.1
TRANSFUSI Z51.3
TYPHOID FEVER A91
HT I63.9
DYSPEPSIA I63.9
PNEUMONIA J18.0
HT + HYPERLIPIDEMIA I63.9
ANEMIA URS + TURP + TRANSFUSI N40
CPD + PARTUS SC SCTP O48
DMT2 + DKD +HT A09
DYSPEPSIA + OA GENU I10
A91
A01.0
D50.9
DM + SEPSIS LE + DRAINAGE N49.8
HYPOKALEMIA A09
DMT2 + HT M54.16
DC + DMT2 + DKD I25.5
TOF J06.8
WSD J90
KURET O02.0
HT + HHD + ANEMIA HTSOB + TRANSFUSI D25.9
PARTUS SC SCTP O42.0 + O4
RELEASE THUMB M65.3
DEHIDRASI + DMT2 + HT K30
PNEUMONIA J18.0
HERNIORHAPY K40.9
EKSISI D24
ENCEPHALOPATHY + TOF A91
EKSISI D48.1
ESRD I13.1
N40
N39.0
EKSISI M67.4
A09
J45.9
EKSISI
LYMPHADENITIS TB + MYOM UTERI + HYPOKALEMIA A18.3 + K6
A01.0
A49.9
KPD + PARTUS SC SCTP O48
HT K80.8
BIOPSI D24
DYSPEPSIA I10
M54.5
ISPA A01.0
DM + APHASIA MOTORIK E11.9
DM + HHD-DC I13.1
DM A15.0
UTI B34.9
O46.9
K12.2
O20.0
O20.0
DMT2 DEBRIDEMENT E11.5
P03.4
A01.0
DMT2 + CAD K80.8
PNEUMONIA J18.0
ISK K29.1
ESRD I13.1
HERNIORHAPY K40.9
KDS B34.9
DIARE AKUT B34.9
A01.0
DRUG ERUPTION B34.9
N39.0
HT A09
VOMITUS B34.9
A09
KOLIK ABD ec dd/ UTI /BSK + ESRD-HHD-CAD+ HYPOKALSEMIAI13.1
FATTY LIVER N39.0
A09
ENTERITIS AKUT K29.1
GASTRITIS EROSIVE ec DYSPEPSIA K25.0
R50.9
K56.6
I10
TYPHOID FEVER A91
ISPA B34.9
ANEMIA ec PERDARAHAN K92.1
HERPES ZOOSTER B02.9
B34.9
FARK EMBOLI I63.4
O20.0
N73.9
P03.4
ESRD + DM I13.1
ANEMIA C81.9
EKSISI L84
DC-HHD J18.9
SYNCOPE N39.0
HT I20.0
HT + KP + ISK I61.9
DHF A01.0
UTI O21.0
EKSISI D17.9
HERNIORHAPY K40.9
OID INTERNA HEMMOROIDECTOMY I84.2
BIOPSY EKSISI D48.1
EKSISI D48.1
PUNGSI PLEURA A16.5
J45.9
HAN PERVAGINA N93.9
D39.1
ANEMIA ec MELENA TRANSFUSI K74.6
I10
ISK N39.0
GE dg ANEMIA + CKD I13.1
SUSP TYPHOID A01.0
A91
EKSISI D48.1
HYPONATREMIA + HYPOCALSCEMIA + HYPOKALSEMIA G04.9
SEQ. STROKE F06.7
O21.0
P03.4
A09
SCABIES B01.9
UVULOPLASTI G47.0
EKSISI M67.4
AKI + HYPOGLIKEMIA I13.1
ONTAN (EMRG)0 O80.9
EPILEPSI M79.26
BIOPSI EKSISI D24
m uteri pulang karena haid z51.5
PNEUMONIA J18.0
STRESS ULCER E71.3
ISPA A09
HT + CAD A15.0
EKSISI + FLAP D48.1
ABSES INCISION E11.2
HHD + NP I20.0
J90
I10
HT + HYPOKALEMIA K27.9
HERNIORHAPY K40.9
SEPSIS LE + APPENDECTOMY K35.0
HYDROCELE HERNIORHAPY + HYDROCELECTOMY K40.9
OID INTERNA HAEMMOROIDECTOMY I84.2
BIOPSI I88.9
DEBRIDEMENT L02.9
DMT2
I11.9
DMT2 A15.0
Q66.0
HT K29.1
HT I20.0
OID INTERNA HEMMOROIDECTOMY I84.2
DEBRIDEMENT EKSISI N61
HERNIORHAPY K40.9
EKSISI D24
UVULAPLASTY G47.3
MUCOCELECTOMY D10.3
J06.9
A09
E86
HAN PERVAGINA KURET N93.9
A01.0
B34.9
IS ec APP PERFORASI LE + APPENDECTOMY K35.0
ISPA A01.0
HERNIORHAPY K40.9
HERNIORHAPY K40.9
HERNIORHAPY K40.9
I10
TENDINITIS SHOULDER + HT + DM K27.4
A91
HT + DM I63.9
E87.2
ESIS MELENA ec GASTROPATI NSAID dd rupturvarises eopagus k25.0
EPIDURAL HEMATOME CRANIOTOMY S09.9
N45.9
UNSTEABLE ANGINA I10
B34.9
deHIDRASI + DMT2 +EKSISI D48.1
LYMPADECTOMY I88.8
DADRS J06.9
A01.0
O44.1
R06.0
A91
DIAGNOSA KODE ICD

TINDAKAN
SEKUNDER UTAMA
HYPERTROPIKA TONSILECTOMY J35.2

N39.0
NEFROLITHIASIS K80.8
A09
DEBRIDEMENT EKSISI L02.9
APPENDECTOMY K35.9
RELEASE M65.3
A09
B01.9
VIRAL INFECTION B02.9
MELENA ec GASTRITIS EROSIVE + HT K29.1 + K92
DHF A01.0
EKSISI D48.1
A90
TYPHOID FEVER A90
EKSISI D48.1
ASMA O21.0
THROMBOSED HEMMOROIDECTOMY + THROMBECT I84.0
KODE ICD KODE TINDAKAN KELAS HARGA RS
SECUNDER
86.3 I 9,311,957.00
85.21 III 6,768,347.00
II 2,313,401.00
K76.8 I 6,976,000.00
O80.9 II 2,812,500.00
I 7,655,185.00
I 2,614,242.00
86.3 II 8,560,914.00
A01.0 I 14,993,081.00
6.31 I 16,190,188.00
N39.0 III 5,194,418.00
II 1,656,398.00
P91.6 + P59.9 96.72 II 32,735,975.00
83.49 II 8,425,361.00
D50.0 I 3,259,300.00
K56.5 III 3,532,100.00
R56.8 + J90 I 9,220,840.00
II 1,529,899.00
II 2,511,940.00
G44.0 II 10,446,550.00
67.7 I 9,648,559.00
O82.9 74.4 II 9,592,448.00
II 4,493,119.00
58.22 + 60.29 II 15,660,124.00
II 6,158,072.00
O34.2 + O82.9 74.4 II 9,492,753.00
II 3,620,593.00
83.09 + 83.49 II 12,754,684.00
K30 + I10 + E11.2 I 6,669,004.00
56.1 + 59.8 II 18,492,542.00
56.1 + 59.8 III 16,391,846.00
A01.0 II 3,329,188.00
II 4,429,565.00
990.3 II 3,292,860.00
J06.8 + A01.0 II 4,025,516.00
K80.8 + E10.9 + I10 I 4,792,164.00
I 3,284,254.00
54.11 I 16,357,334.00
A01.0 + J06.9 II 3,150,497.00
O80.9 II 4,277,404.00
D64.9 54.11 + 99.03 I 23,139,967.00
A09 III 16,476,132.00
69.02 II 5,441,838.00
N39.0 I 6,190,426.00
99.03 III 4,453,393.00
II 1,526,140.00
K30 II 3,610,613.00
I 3,479,096.00
B35.4 I 4,060,532.00
56.1 + 97.65 II 19,491,964.00
O32.9 + O82.9 74.4 I 12,099,398.00
I 2,871,316.00
I 3,777,563.00
II 1,658,356.00
O82.9 74.4 II 9,049,080.00
O48 + O34.2 + O82. 74.4 III 7,855,488.00
J18.0 II 4,323,922.00
69.02 III 1,749,385.00
N18.0 55.02 II 13,446,764.00
M32.9 II 3,329,400.00
II 1,556,591.00
I 6,511,463.00
83..85 I 11,377,683.00
I13.1 + E11.9 II 4,270,395.00
47.09 II 11,923,785.00
A91 II 5,556,897.00
G62.9 + A09 III 4,563,167.00
53.00 + 54.4 II 9,851,988.00
86.22 II 4,626,047.00
II 5,618,661.00
I13.1 I 4,723,194.00
K30 I 19,465,057.00
II 2,900,101.00
II 2,407,265.00
69.02 II 5,180,748.00
I 2,712,300.00
I 2,168,100.00
N89.8 I 2,827,100.00
69.02 II 4,567,833.00
I 5,877,347.00
E10.9+ I10 II 5,222,036.00
85.21 II 7,908,508.00
47.09 II 12,727,853.00
II 3,613,032.00
99.03 I 3,513,779.00
I10 + I25.1 III 2,920,731.00
O32.9 II 4,873,290.00
E11.9 II 2,884,397.00
60.29 III 17,285,541.00
II 1,839,382.00
85.34 III 6,970,663.00
K29.7 II 2,718,979.00
85.21 II 8,314,981.00
O82.9 74.4 II 9,281,620.00
55.11 III 16,891,287.00
III 1,866,915.00
II 3,046,781.00
83.49 III 8,035,951.00
79.36 I 21,970,273.00
II 1,606,338.00
O82.9 74.4 I 12,242,086.00
II 2,137,629.00
O82.9 74.4 II 10,150,493.00
86.22 II 8,341,035.00
II 6,544,617.00
O34.2 + O82.9 74.4 II 9,543,558.00
86.3 II 7,306,583.00
83.49 II 8,049,672.00
N39.0 II 4,677,567.00
II 2,674,905.00
I11.9 II 8,953,136.00
II 3,032,247.00
II 2,591,242.00
99.03 I 2,344,672.00
A01.0 II 3,432,513.00
III 6,537,527.00
K30 III 3,844,294.00
II 3,865,691.00
I10 + E78.5 II 8,807,619.00
D62 58.22 + 60.29 + 99III 32,768,100.00
O33.2 + O82.9 74.4 III 7,684,224.00
E11.2 + I10 I 3,991,400.00
6.31 III 8,761,769.00
K30 + M19.97 I 7,029,802.00
II 6,427,968.00
III 2,005,111.00
III 2,360,340.00
E11.8 + A41.9 I 10,875,700.00
E87.5 III 2,425,974.00
E11.9 + I10 I 6,406,732.00
I51.9 + E11.2 II 9,872,691.00
R56.0 I 1,741,576.00
34.04 II 3,264,000.00
69.09 II 5,901,270.00
I11.9 + D62 68.4 + 99.03 I 15,379,751.00
O82.9 74.4 I 10,567,278.00
82.01 I 11,120,341.00
E86 + E11.9 + I10 I 4,743,400.00
II 8,815,312.00
53 III 8,081,856.00
85.21 III 7,794,369.00
G93.4 + J06.8 II 7,085,659.00
83.49 II 8,444,873.00
III 3,664,911.00
I 5,531,160.00
II 1,728,431.00
83.49 II 8,626,594.00
II 2,203,763.00
II 3,725,218.00
II 8,374,509.00
A18.2 + D25.9 + E87.5 III 9,643,810.00
II 3,310,833.00
II 1,516,886.00
O42.0 + O82.9 74.4 III 8,534,670.00
I10 II 2,675,824.00
85.12 I 8,312,798.00
K30 I 7,476,230.00
II 4,241,138.00
J06.9 II 2,626,463.00
R90.9 + R47.0 I 5,564,144.00
D63.8 + E11.2 I 10,579,562.00
E11.9 I 4,654,959.00
N39.0 II 2,339,105.00
III 1,070,413.00
II 2,305,713.00
II 2,471,884.00
II 2,223,170.00
86.22 II 8,677,025.00
II 1,187,012.00
II 2,727,639.00
E11.9 + I25.1 II 6,040,843.00
II 5,618,015.00
N39.0 II 3,077,429.00
I51.9 III 3,196,593.00
53 III 8,474,374.00
R56.0 II 1,855,906.00
A09 II 2,245,581.00
II 1,686,133.00
T88.7 II 3,175,287.00
III 1,659,806.00
I10 I 4,283,016.00
R11 II 2,167,164.00
III 3,084,329.00
Z92.8 + R10.4 + I25.1 + E83.5 III 3,236,300.00
O80.9 II 11,256,944.00
K76.0 I 6,548,915.00
II 1,780,199.00
A09 I 3,139,614.00
D50.0 I 3,256,100.00
I 2,179,700.00
II 4,955,705.00
I 4,598,850.00
A01.0 I 5,735,465.00
J06.9 I 3,107,808.00
D62 II 5,605,894.00
I 3,476,410.00
I 2,955,760.00
II 4,297,610.00
II 1,788,450.00
II 1,378,011.00
O82.9 74.4 II 8,966,584.00
II 1,276,820.00
E11.9 I 4,530,800.00
I 3,752,143.00
83.49 II 7,015,744.00
I11.9 I 18,380,169.00
R55 II 3,355,467.00
I10 I 5,837,000.00
I10 + A15.0 + N39.0 I 29,788,247.00
A91 I 5,575,793.00
N39.0 II 5,577,272.00
83.49 II 7,698,909.00
53 II 8,479,284.00
49.46 II 9,555,698.00
83.21 I 8,939,677.00
83.49 I 9,559,601.00
34.72 III 1,499,205.00
II 2,042,467.00
I 2,714,813.00
II 7,959,487.00
K92.1 + D62 99.03 III 4,485,281.00
II 2,213,981.00
III 3,223,149.00
D64.9 I 7,804,512.00
II 5,712,081.00
III 2,584,777.00
83.49 III 7,916,723.00
E87.1 + E87.6 + E83.5 III 6,037,391.00
I69.3 I 3,720,797.00
I 3,621,456.00
O82.9 74.4 II 16,386,591.00
II 979,299.00
I 2,827,100.00
B86 I 3,257,200.00
27.79 II 8,513,646.00
82.21 I 9,329,495.00
O82.9 74.4 III 7,501,240.00
E16.2 III 5,001,295.00
II 5,099,300.00
G40.9 II 4,198,192.00
85.12 II 10,198,985.00
II 1,356,630.00
III 3,094,831.00
K27.9 II 4,178,931.00
O80.9 II 4,896,277.00
J06.9 II 1,758,619.00
I10 + I25.1 II 4,366,480.00
86.3 + 86.75 I 10,575,855.00
86.04 I 7,705,066.00
I11.9 + G62.9 I 4,632,943.00
I 1,669,212.00
III 2,414,567.00
I10 + E87.6 III 2,944,917.00
53 II 9,937,264.00
A41.9 54.11 I 14,885,898.00
N43.9 53 + 63.1 II 8,925,814.00
49.46 I 10,747,761.00
40.11 I 9,552,254.00
86.22 II 8,379,475.00
E11.2 I 3,942,909.00
I 7,358,231.00
I 4,792,694.00
III 1,255,930.00
I10 II 1,861,600.00
I10 I 5,837,000.00
49.46 II 7,841,007.00
86.22 II 80,019,990.00
53 III 7,988,195.00
85.21 II 9,916,340.00
27.79 I 11,568,127.00
27.43 III 6,363,170.00
I 2,614,546.00
III 1,390,693.00
I 5,468,820.00
69.09 III 2,646,164.00
II 2,888,846.00
I 2,720,200.00
54.11 II 12,591,340.00
J06.9 II 3,653,100.00
53 II 9,406,129.00
53 III 7,820,844.00
53 II 7,948,781.00
II 3,595,057.00
M75.8 + I10 + E11.9 II 5,379,912.00
II 6,264,825.00
I10 + E11.9 III 4,404,705.00
III 1,467,381.00
III 1,683,587.00
S06.41 + S06.2 1.24 II 74,188,727.00
III 4,634,813.00
I20.0 I 5,639,287.00
II 2,331,600.00
6.31 III 8,999,203.00
83.49 II 9,227,688.00
O82.9 74.4 II 8,938,822.00
40 III 6,690,400.00
A09 II 2,117,996.00
II 2,245,849.00
I 2,003,180.00
III 1,450,484.00
III 723,754.00
2,022,335,002.00
KODE ICD KODE TINDAKAN KELAS HARGA RS

SECUNDER
28.2 I 9,359,341.00
I 2,170,700.00
N20.0 I 5,349,873.00
II 2,320,758.00
86.22 I 8,412,297.00
47.09 I 9,545,710.00
82.01 I 10,291,200.00
II 2,845,309.00
I 6,836,700.00
B34.9 I 3,570,787.00
I10 + R10.4 I 6,157,968.00
A91 I 6,416,738.00
83.49 II 4,272,430.00
I 4,787,698.00
A01.0 II 5,233,306.00
83.49 II 6,455,573.00
J45.9 I 4,148,817.00
49.47 II 8,795,168.00
106,970,373.00
HARGA INA CBGS NAMA DOKTER
4,583,900.00 dr. PITRAJAYA, Sp.B

2,331,600.00 dr. MIFTAH., Sp.PD
6,976,000.00 dr. MIFTAH., Sp.PD
2,416,400.00 dr. MAULIA, Sp.OG
2,720,200.00 dr. DEDE LIA, Sp.A
2,720,200.00 dr. PARAMITA, Sp.A
3,568,700.00 dr. MR. KURNIA, Sp.PD
3,259,300.00 dr. MIFTAH, Sp.PD+
3,532,100.00 dr. A. BARUNA. Sp.PD
3,965,400.00 dr. WIWIN, Sp.A
2,289,200.00 dr. WIWIN, Sp.A
2,799,100.00 dr. A. BARUNA, Sp.PD
9,643,500.00 dr. DJOKO, Sp.B 9,643,500.00
2,331,600.00 dr. A. BARUNA, Sp.PD
7,427,400.00 dr. RENNY, Sp.U
2,878,100.00 dr. A. BARUNA, Sp.PD
4,826,600.00 dr. SARJUNAS, Sp.OG
5,845,600.00 dr. GHUNA, Sp.OT
4,509,100.00 dr. MR. KURNIA, Sp.,PD
3,113,300.00 DR. YUDI, Sp.U 3,113,300.00
2,594,400.00 DR. YUDI, Sp.U 2,594,400.00
3,398,900.00 dr. MIFTAH., Sp.PD
3,266,900.00 dr. MIFTAH., Sp.PD
2,720,200.00 dr. MIFTAH., Sp.PD
3,398,900.00 dr. WIWIN, Sp.A
9,122,400.00 dr. DJOKO, Sp.B
2,331,600.00 dr. WIWIN, Sp.A
3,891,400.00 dr. A. BARUNA, Sp.PD
2,490,300.00 dr. WIWIN, Sp.A
12,108,700.00 DR. YUDI, Sp.U
2,827,100.00 dr. A. BARUNA, Sp.PD
4,906,600.00 dr. WIWIN, Sp.A
13,705,200.00 dr. RENNY, Sp.U
1,861,600.00 dr. MIFTAH, Sp.PD
1,995,800.00 dr. A. BARUNA, Sp.PD
6,819,800.00 dr. GHUNA, Sp.OT
3,698,000.00 dr. A. BARUNA, Sp.PD
3,398,900.00 dr. PARAMITA, Sp.A 3,398,900.00
4,315,900.00 dr. A. BARUNA, Sp.PD
6,812,300.00 dr. DJOKO, Sp.B
2,712,300.00 dr. ADE, Sp.S
2,168,100.00 dr. ZUHAIRA, Sp.S
6,189,500.00 dr. YUDI. Sp.U
5,098,500.00 dr. DJOKO, Sp.B
10,090,500.00 dr. YUDI. Sp.U
12,767,000.00 dr. GHUNA, Sp.OT
5,631,000.00 dr. NUNUNG, Sp.OG
3,929,100.00 dr. DJOKO, Sp.B
3,865,000.00 dr. RIEN, Sp.JP
3,398,900.00 dr. WIWIN, Sp.A
2,929,900.00 dr. MEDIA, Sp.S
3,545,100.00 dr. ZUHAIRA, Sp.S 3,545,100.00
3,515,900.00 dr. MEDIA,Sp.S
7,524,800.00 dr. RENNY, Sp.U
2,827,100.00 dr. A. BARUNA, Sp.PD
1,552,100.00 dr. A. BARUNA, Sp.PD
16,456,600.00 dr. YUDI, Sp.U 16,456,600.00
3,326,100.00 dr. WIWIN, Sp.A
2,712,300.00 dr. A. BARUNA, Sp.PD
3,575,100.00 dr. A. BARUNA, Sp.PD
2,490,300.00 dr. WIWIN, Sp.A
3,264,000.00 dr. A. BARUNA, Sp.PD
10,422,500.00 dr. NUNUNG, Sp.OG
7,272,500.00 dr. GHUNA, Sp.OT
3,891,400.00 dr. A. BARUNA, Sp.PD
5,098,500.00 dr. DJOKO, Sp.B
3,398,900.00 dr. WIWIN, Sp.A
2,788,900.00 dr. YUDI, Sp.U
1,860,600.00 dr. WIWIN, Sp.A
1,862,800.00 dr. A. BARUNA, Sp.PD
4,169,300.00 dr. A. BARUNA, Sp.PD
3,329,400.00 dr. A. BARUNA, Sp.PD
3,329,400.00 dr. WIWIN, Sp.A
2,800,200.00 dr. A. BARUNA, Sp.PD
4,457,100.00 dr. A. BARUNA, Sp.PD
4,743,400.00 dr. ZUHAIRRA, Sp.S
2,323,100.00 drg, FRANKY, Sp.BM
3,725,100.00 dr. A. BARUNA, Sp.PD
3,329,400.00 dr. WIWIN, Sp.A
2,800,200.00 dr. A. BARUNA, Sp.PD
2,793,700.00 dr. A. BARUNA, Sp.PD
2,791,900.00 dr. A. BARUNA, Sp.PD
2,331,600.00 dr. DEDE LIA, Sp.A
2,791,900.00 dr. A. BARUNA, Sp.PD
2,331,600.00 dr. DEDE LIA, Sp.A
2,171,800.00 dr. DEDE LIA, Sp.A
3,884,300.00 dr. A. BARUNA, Sp.PD
3,965,400.00 dr. WIWIN, Sp.A
3,515,900.00 dr. MEDIA,Sp.S
1,995,800.00 dr. WIWIN, Sp.A
3,793,200.00 dr. A. BARUNA, Sp.PD
5,845,600.00 dr. DJOKO, Sp.B
6,819,800.00 dr. DJOKO, Sp.B
4,170,700.00 dr. DEASY, Sp.P
1,862,800.00 dr. DEASY, Sp.P
1,943,000.00 dr. FITRIYATI
4,871,300.00 dr. DJOKO, Sp.B
3,102,100.00 dr. MEDIA,S p.S 3,102,100.00
2,376,500.00 dr. MEDIA, Sp.S
9,643,500.00 dr. DJOKO, Sp.B 9,643,500.00
4,345,900.00 dr. DJOKO, Sp.B
3,808,000.00 dr. DEASY, Sp.P
3,183,700.00 dr. A. BARUNA, Sp.PD
2,328,100.00 dr. A. BARUNA, Sp.PD
15,128,700.00 dr. DJOKO, Sp.B 15,128,700.00
4,283,900.00 dr. DJOKO, Sp.B
3,632,200.00 dr. A. BARUNA, Sp.PD
1,547,500.00 dr. ANDRI, Sp.OT 1,547,500.00
1,861,600.00 dr. A. BARUNA, Sp.PD
5,225,100.00 dr. DJOKO, Sp.B
5,671,900.00 dr. RICHARD, Sp.THT
4,051,400.00 dr. DJOKO, Sp.B
2,313,800.00 dr. A. BARUNA, Sp.PD
3,329,400.00 dr. A. BARUNA, Sp.PD
6,812,300.00 dr. DJOKO, Sp.B
2,502,400.00 dr. SARJUNAS. Sp.PD
1,861,600.00 dr. A. BARUNA, Sp.PD
2,331,600.00 dr. A. BARUNA, Sp.PD
14,817,000.00 dr. ROLLAN, Sp.BS 14,817,000.00
5,845,600.00 dr. DJOKO, Sp.B
3,535,500.00 dr. DJOKO, Sp.B
1,548,800.00 dr. UJANG
1,942,900.00 dr. HISKIA
1,158,922,300.00

3,792,700.00 dr. A. BARUNA, Sp.PD
7,272,500.00 dr. GHUNA, Sp.OT
2,423,100.00 dr. A. BARUNA, Sp.PD
5,845,600.00 dr. DJOKO, Sp.B 5,845,600.00
2,720,200.00 dr. A. BARUNA, Sp.PD
3,398,900.00 dr. A. BARUNA, Sp.PD 3,398,900.00
5,845,600.00 dr. DJOKO, Sp.B 5,845,600.00
3,335,500.00 dr. DJOKO, Sp.B
65,097,900.00
APS
Rekapitulasi INA CBGs Bulan AGUSTUS
HARI
PERAWATAN
1 YATI SUMIARTI 406385 7 SLE ANEMIA

2 MUNANDAR YAMIN 406439 6 STROKE PERDARAHAN HT
3 SUSI SURYANITA 375956 2 LESION PERVAGINA
4 WARSITO 394251 14 DC ec HHD
5 HADA, TN 330568 9 FAILED BACK SYNDROMTETRAPARESE + CLONUS
6 HJ. TIEN SURATINI 406581 2 STENOSIS URETER HYDRONEFROSIS
7 KANANG 371098 2 BATU URETER
8 IMAM SUSANTO 325146 2 DJ STENT IN SITU
9 WAWAN BIN JONO 397590 2 BATU URETER
10 NIANURMIATI 329681 1 LYMPHADENOPATHY
11 devi nugroho adiningrat 403078 6 SN ISK
12 ZENALMUTAQIN 406355 8 RADIKULOPATI LUMBALDYSPEPSIA + BRONCHITIS
13 NANI 403212 2 DJ STENT IN SITU
14 KURAESIN 406448 4 MYOM UTERI
15 GANDI 406056 3 EPIDIDIMORCHITIS
16 SUMIATI 310935 3 HEG
17 HJ SAYIDAH 389483 4 DIARE ANEMIA
18 RODIAH 320769 3 HEG
19 TIDAK BISA DI KLAIM (DOKMOG)
20 MARSANDI FIRDAUS 406643 5 TYPHOID FEVER
21 ENDANG KARNAEN 376776 4 BPH SISTITIS
22 KURNIASIH 403919 4 BATU STAGHORN HYDRONEFROSIS
23 CUCU KOMYATI 401747 12 CAD STEMI
24 H.AHMAD NAZIR BIN ROMLI 406388 4 HIL
25 ASEP HERMANTO 406451 4 HEMMOROID INTERNA
26 DINDA FARHATUN NUFUS 406133 4 CYSTA OVARY
27 YENI BT. ATIP 406636 3 LYMPHADENITIS
28 KHANSA KHOERUNNISA 365782 4 HFMD
29 KUSNADI 406766 2 GASTRITIS AKUT
30 MAFGAN SUPRIYADI 380308 5 ASMA
31 DESY RUSLINAH 393393 4 NEURITIS , NEURALGIA RL
32 WULAN APRILIAN 326641 4 BRONCHOPNEUMONIAASD
33 Naura Najwatushofia 395330 3 BRONCHOPNEUMONIA
34 ADELIA RAHMAWATI 406597 5 TOF
35 HILMA HALIMATUSSADIA 406713 4 BRONCHOPNEUMONIA
36 IRMA ROSMAWATI 406194 5 PEB PARTUS SC
37 sabrina julia putri 406661 4 BBL
38 saabira julia putri 406662 4 BBL
39 NURUL HERAWATI 351404 2 KPSW PARTUS SPONTAN
40 SYATIBI 404450 5 HIL
41 H ABUBAKAR 300431 3 DMT2 HT + VERTIGO PERIFER + BI
TIDAK
42 DITAGIHKAN KARENA APS
43 TITIN SUHARTINI 398318 6 SNNT
44 H WARSA HIDAYAT 406554 6 HIL
45 WARYA AYUT 398373 5 BPH
46 VIA FITRIA 406640 6 PERBAIKAN K.U PRA OP
47 rachmat hidayat 406764 4 HHD-DC CAD
48 RUMI RIYANTI 406768 3 TYPHOID FEVER
BANYUANDRA
49 RIFA HALIMARTA304629 4 TOF
50 MUHAMMAD NASRUDDIN ZA 406718 4 BRONCHOPNEUMONIA
51 h.muhamad ikin sodikin 406613 6 GASTRITIS TB PENGOBATAN + CKD
52 hj JULAEHA 406777 3 HT TTH + DM
53 IWAN SEPTIADI 406699 3 HEMMOROID INTERNA
54 SUPRIYATI 339237 6 DIABETIC ANEMIA
55 MUCHIN 406550 8 METASTASE ADENOMA ar CLAVICULA
56 SRI MUNAWAROH AINI 363475 2 PARTUS SPONTAN ASMA
57 bunga aulia kurnia 406725 4 BRONCHOPNEUMONIA
58 RADEN SRI SURYATI 406763 5 CRADIOMEGALY DC
59 HALIMAH 384095 5 CHF CHOLELITHIASIS
60 zahra maulida rahman 406770 4 DADRS
61 IMI JD ACHMAD 406787 4 CAD
62 Abdal Aziz 385463 5 TB PARU
63 CARMISUMARNI 344676 2 AB. IMMINENS
64 ENI GUSTIANINGSIH 406210 5 MYOM UTERI
65 KENDI 406667 6 CAD RECENT AMI INFE CAD ANTEROSEPTAL + DYSPEPSIA
66 LILIS ROMLAH 406706 7 DENGU FEVER DMT2
67 EEM KOMARIAH 406779 5 HEMATEMESIS ec GASTRHT
68 revando aditya abiyyu 406772 5 BRONCHOPNEUMONIA
69 FITRI LISTIANI 393684 3 HEG
70 ARUS AHMAD NOOR MAOSY 406715 7 GASTRITIS AKUT HT
71 DAFFA DARREL SYANDANA 406867 3 DADRS
72 M RIZKIMAULANA 406796 2 TONSILOADENOIDITIS HYPERTROPI
73 yaya 406972 2 STT
74 WATI 365697 2 TUMOR MAMAE
75 Itang Supriatna 405015 3 TYPHOID FEVER
76 SALMAN B WANDA 406985 3 BO KRONIS
77 MUJIONO WATIMAN 391677 3 CAD HHD-DC + AF + TENDINITIS SHOULDER
78 JULIANTY DWININGTIAS, A 350176 3 RIW. SC 2X PARTUS SPONTAN
79 MUHAMAD BAYU AL-FAHRIZ 407010 2 HERNIA HYDROCELE
80 SRI PURWANINGSIH 406977 2 LYMPADENOPATHY
81 GILANGRD 365847 4 BRONCHOPNEUMONIA
82 zahra syafina 406863 5 TYPHOID FEVER
83 YUSI ARISTA 321621 2 GASTRITIS AKUT
84 PIPIH 406908 4 DENGU FEVER
85 KASUM 365646 5 HT DM ULCER
86 TITIN 407006 2 UROLITHIASIS
87 TEDI 406919 3 SD
88 ARIARDIANSYAH 406866 4 TYPHOID FEVER
89 aryasatya surya putra 406990 3 BBL
90 TSANIA LATHIFATULH, AN 352855 5 BRONCHOPNEUMONIA
91 eden lina lisnawat 403516 5 CYSTA OVARY
92 YAYAT GANDA KUSMITA 406932 2 CLAVUS
93 E. KARTINI . NY. HJ 406449 4 ASMA URTIKARIA + HYPOGLIKEMI +
94 PATIMAH 374558 5 ESRD ANEMIA + DC-HHD
95 tail mutail 403170 6 ISCHEMIC CARDIOMYOCHF
96 ZAHROTUS ZITAS 366868 4 TYPHOID FEVER
97 HERDIANANUGRAHA 403432 4 HSP
98 RATU IIS AISAH 406864 6 NEFROLITHIASIS
99 AMIR HUSAIN 406998 3 DADRS
100 TINILUCI 343705 3 VIRAL INFECTION AMENORHEA SEKUNDER
101 muhammad zaki adhiyastha 390229 3 DADRS
102 ONENG LAHIRIAH 405363 5 MYOM UTERI APP AKUT
103 UUN UNERY 396432 5 PLASENTA PTEVIA
104 carsit bint arim 406670 4 RIW. SC 2X PARTUS SC
105 RICHA AUDIA 407007 3 SD TYPHOID FEVER
106 EUIS ROHAYATI 404452 4 GEA DCM
107 MASRA UHANDA 388371 5 ISK CAD
108 IHUN SUPRIYADI 406403 3 ABSES
109 nisa fhatmah azahro raihan 401575 4 DADRS
110 kevin raditya pratama 376435 4 STATUS EPILEPTIKUS
111 AI NURYANTI BINTI DANA 391644 4 PARTUS SPONTAN
112 EMI SRI ASTUTI 407028 4 FAM
113 yat 384715 2 DYSPEPSIA DM
114 YULISAH WIHARYANTI 407058 5 TYPHOID FEVER
115 REVAN NUR ZEIN 388029 1 CANCEL OP HIDROCELE KRN TB
116 YUDA ADITYA PERMANA 397787 6 TYPHOID FEVER
117 EVA YANTI 330197 6 KISTA OVARY
118 AGUNG PRATISTHA 335302 5 TONSILITIS AKUT HT
119 ADITYA YANUAR L 379404 3 ISPA
120 RATNASARI 333694 4 DF
121 SITI DJULAEHA 358931 2 GANGLION
122 NANA NURHANA 386971 2 POLYP ENDOCERVIX
123 ETI B 335015 2 TUMOR MAMAE
124 EKA PURWATI 406995 5 CERVICALGIA
125 Sarwoko Pamungkas 377718 2 ACS
126 1 EPISODE
127 MOHAMMAD AZKAL AZKIYA 327847 5 PNEUMONIA
128 TARSEM 407148 4 ISPA DM + HT
129 muhamad audi megantara 378910 5 ISPA DADRS
130 nurul hajijah fauziah 398315 6 DADRS
131 dias faturrohman 395000 4 DHF
132 AZKA ZAINUL HAQ 407155 3 TYPHOID FEVER RHINOFARINGITIS
133 M PRATAMA 407162 3 COLITIS RHINOFARINGITIS
134 H. LILI MAWARDI 406996 7 CAD HT + KP TERAPI + OA
135 Nadia Azra Razani 384108 4 DADRS
136 SAKINAH DINAR AZZAHRA 371446 4 ISPA VIRAL INNFECTION
137 DEDEAMELIA 321028 5 HSP
138 DEWI KURNIASIH 407157 3 PERBAIKAN K.U PRA OP MYOM
139 YAKOBUS KOWE KAPO 406887 5 EFFUSI PLEURA ec TB
140 RANI NURAENI 392654 2 TUMOR MAMAE
141 WARIH 401635 3 NEFROLITHIASIS HYDRONEFROSIS + CKD
142 nevan melviano 406540 15 RESPIRATORY FAILURE EC STATUS CONVULSION EC MENINGITIS + SEPSIS
143 NARKUM 406107 12 STROKE PIS ESRD + DC-HHD + KP AKTIF
144 anis hernasri 394676 4 PLEURAPNEUMONIA CHF ec HHD + DMT2
145 SITI RODIYATI 382152 3 TUMOR THYROID
146 ISWANTI 407223 2 TUMOR MAMAE
147 k sunaryo 407033 3 HIL
148 ACEP NURYANA 407078 2 TUMOR HIDUNG
149 SITI NURLAELA 406886 4 CPD RIW. SC + PARTUS SC
150 by sit nurlaela 407173 3 BBL
151 shafa aliyah sudrajat 399232 3 PERBAIKAN KU THALASEMIA
152 R WAHYUNINGSIH 390346 5 PERBAIKAN KU CA MAMAE
153 DJEDJEN 361710 6 STROKE INFARK DM + HT
154 ai sit rohmah 306893 5 DIARE AKUT
155 SEPTIAN JAGAT NATA 337297 8 KDS DHF
156 WARGI 407043 5 KP CAP
157 yayah sutarsih 407161 4 CHF ec HHD
158 DIKA PRATAMA 407126 5 TYPHOID FEVER
159 UJANG SUHERMAN 307509 1 HYPOGLIKEMIA
160 euis HASANAH 406993 2 SHOCK HYPOGLYCEMI
161 DEDE HIDAYAT, H 407146 6 TYPHOID FEVER THROMBOCITOPENIA
162 MIRA WATI 407088 2 TUMOR MAMAE
163 EVA SISDWI ASTUTI 375762 2 LYMPHADENOPATHY
164 WINI OKTAVIANE 342775 2 GANGLION
165 DESI KARTIKA SARI 378171 4 MYOM UTERI
166 CARMISUMARNI 344676 2 PERDARAHAN PERVAGINA
167 diniratu syafa annida priatna 389188 3 VOMITUS
168 rizky dewa saputra 402983 3 BRONCHOPNEUMONIA
169 wulan eliana 407283 3 BRONCHOPNEUMONIA
170 ENENG SUMIATI 392556 10 STROKE INFARK AF
171 M HAYKAL FARDHIANSYAH N 373713 5 BRONCHOPNEUMONIAASMA
172 HARIS SHABIQ 406942 4 SLEEP APNEU
173 NUNUNG SUWARSIH 406976 3 TUMOR THYROID
174 TUHFATUN NAFIAH 407230 3 HEMMOROID INTERNA
175 JUNSON YUSAK SUMENDAP 407142 5 ABSES PERIANAL ABSES FEMUR
176 AI SUSILAWATI 407038 2 TUMOR MAMAE
177 AZIS MAULANA RAMADHAN 407245 3 FRACTURE CLAVICULA
178 RAYNA DIAGIZAHRA AMELIA 377223 3 HFMD
179 IKA YUNIATI 364793 5 TYPHOID FEVER
180 MICHO MAULANA S 326021 4 TYPHOID FEVER GASTRITIS
181 NENENG HADIATI, NY 390865 2 EFFUSI PLEURA
182 RIFA FATIHATU DZAKWAN 407385 3 DADRS
183 TUTANG SUTISNA ATMAJA 407244 6 RL
184 NINING. S 400989 2 STT
185 muhammad azmi hail purwa 407221 2 CTEV
186 yaya sunarya 405563 2 URETHRA STENOSIS VESICOLITHIASIS
187 CAWIH 370653 7 BATU STAGHORN HYDRONEFROSIS + CKD
188 Nursalam 406284 2 URETHRA STRICTURE VESICOLITHIASIS
189 SITI SALEHA S 407163 4 TYPHOID FEVER UTI
190 FITRI NOVITASARI 407440 2 RHINOFARINGITIS
191 ZAKY MUBAROK 404611 3 DADRS ISPA + KDS
192 WIWIN WINARTI, NY. 407274 5 STROKE INFARK BELSS PALSY
193 MUHAMAD ALZAM ZIKRI HA 407432 3 DADRS
194 ENANG MUSTOFA 351721 6 TYPHOID FEVER
195 DIDIN NUR PRASETYAWAN 407222 3 OSTEOMYELITIS
196 SUGIHASTUTI 407022 6 CHOLELITHIASIS
197 EMPIN SUPINAH 396633 5 TUMOR THYROID
198 h.muhamad ikin sodikin 406613 5 CRF ec BATU GINJAL DEHIDRASI + GASTROPATI
199 MUHAMAD RIFKY MEGI WIJ 407251 7 APP
200 Rega Haerunnisa 398260 4 TUMOR THYROID
201 SUMIYATI BT CASID 403760 3 TANSFUSI CA CERVIX
202 FERDIAN YUNIZAR 394111 8 TYPHOID FEVER DHF
203 JIAN RUBEN PRISMA LAKUN 319065 3 ANGIOEDEMA ASMA
204 NAYLA AZHALIA SAFITRI 338552 4 DADRS
205 ANDHIKA NUGRAHA RAHA 363143 3 DEHIDRASI
206 Hendro Haryanto 403419 3 DISENTRI DEHIDRASI
207 DUKI 407527 2 NEFROLITHIASIS HYDRONEFROSIS
208 DINA RIZKY 390468 2 ANENCHEPAL
209 OMA PARTINI 380280 8 NEFROLITHIASIS SEPSIS
210 ERNI SUSILAWATI 407369 7 NEUROSA
211 SOLEH CHAERUDIN 407344 5 HEMMOROID INTERNATROMBUS
212 GITA LESTARI 301813 4 CPD RIW. SC + PARTUS SC
213 GUSTAFA ABIMANYU 407542 4 BBL
214 ARSYAkIRA PUTRI MUSTIKA 407538 4 BBL
215 NAZWA MAULIDA RIZKI 378403 6 DADRS LTB
216 leila luthfi nabillah 407472 5 VIRAL INFECTION
217 eroh 407296 8 SUSP LEUKEMIA AKUT
218 NURSITI AWALIYAH 406845 9 CKB SAH
219 SIPIN 335445 1 OF SUSP DF
220 bariyah 407368 1 HYPOGLIKEMIA
221 TUTANG SUTISNA ATMAJA 335297 7 DYSTONIA HT + HYPERURICEMIA
222 MULYATI 405202 2 FAM
223 nurin nazwa nurisma 407259 2 CORPUS ALIENUM
224 revando aditya abiyyu 406772 5 BRONCHOPNEUMONIADADRS
225 TOMMY W 348912 3 ISPA GASTRITIS
226 DEDEH ROKAYAH 407562 4 ISK
227 SITI ROCHMAT, NY. 376466 3 CHF ec MITRAL VALPEPCAD HHD AF + DYSPEPSIA
228 WADI 385705 7 UAP CARDIAC SIROSIS
229 CICI 398026 4 DCM DC + DMT2 + EFFUSI + TB
230 RIZKA FEBRIYANTI CAHYADI 386301 3 TUMOR LINGUA
231 ASEP SUHERMAN 399743 7 BATU STAGHORN
232 DEDEH 389534 11 HT DC EC HHD + KP + PLEURA
233 ANDIRANSYAH 380523 3 ASMA
234 MUHAMMADSEPTIANRAMA 339603 4 TYPHOID FEVER ASMA
235 SILVIA MAYESTISSA SITORUS 396257 6 TB PARU
236 NENISULISTIANI 407695 2 ABSES RETROAURICULAR
237 ETI B 335015 3 PHYLLODES BREAST
238 ade supriadi 407720 2 STT
239 RENI NURAENI 354734 4 KET
240 SUGIHASTUTI 407022 5 GASTRITIS KRONIS ULKUS PEPTIKUM
241 GILANG RAMADHAN 407727 2 DADRS
242 DAFFA NAUFAL PRATAMA 365408 2 HIL OBSTRUCTION
243 SURATINAH 407635 4 DC ec HHD ANEMIA ON CHRONIC
244 lakshamana alauna wijaya 357098 3 HFMD
245 SUNARDI, TN 377831 6 ISK DMT2 + CKD
246 HARIS NURHAKIM 407654 4 TYPHOID FEVER
247 ALFITRa KHUMAIRA Nada 362767 4 TYPHOID FEVER ISPA
248 reka chintya sari 405895 7 TYPHOID FEVER DADRS + GASTRITIS
249 NaUfAL BINTANG PRAYOGA 386475 3 DADRS
250 Aura Nourida Allya W 362026 3 ISPA KDS
251 ZAKY MUBAROK 404611 3 KDS ISPA
252 ANIH 405518 8 ESRD ANEMIA
253 RESHA FEBRIAN MAULANA 398087 2 HIL OBSTRUCTION
254 ZULRACHMAN 363649 3 FRACTURE FEMUR
255 MUJIMAN 307762 3 LYMPHADENOPATHY
256 NANAH HASANAH 407671 2 TUMOR MAMAE
257 MUHYADI 407724 2 GANGLION
258 EHA MUSLIHAT 399318 7 KISTA OVARIUM
259 USEP SAPTUMI 392930 4 CHF ec CAD OMI DM
260 T.MUFIZAR 403569 5 ISCHEMIC CARDIOMYOCHF + CKD + DM
261 H ENDANG 393752 4 HT ULKUS DECUBITUS + UTI
262 Fatyya Aulia Ramadhani 407791 2 DADRS
263 ENAH 407578 6 HT VIRAL INFECTION
264 YAYAN SOPIAN 400123 3 PERBAIKAN KU HEMMOROID
265 MUHAMMAD FAKHRI ASSOB 349554 6 DADRS PERIANAL RASH
266 SARMANSUHERMAN 407581 6 PNEUMONIA
267 DWI ANDRIYANI PERTIWI 350873 6 TYPHOID FEVER
268 RISKY MAULANA WIJAYA 327080 4 TYPHOID FEVER ISPA
269 RUHYATI 381429 6 DMT2 + DKD DYSPEPSIA + ANEMIA
270 CICIH 367798 7 DCM CAP
271 ANNISARAMADHANI 322621 5 TYPHOID FEVER
272 RIZALDI SAHPUTRA 407771 5 TOF GASTRITIS
273 ANDI MUSTAFIAH 308709 5 CAP DIARE AKUT
274 ombi 397719 5 GASTRITIS
275 INDAH PINASTI 343778 5 HEMMOROID INTERNA
276 UMNI 383635 2 STT
277 YANI WAHYUNI 300684 3 GEA KISTA LOBUS
278 DEDDY SUPRIADY KUSBIN 395270 3 CA COLON ANEMIA
279 MUHAMAD AHSYAN SADILI 348544 4 TYPHOID FEVER ISPA
280 m. arfal kautsar 379068 6 TYPHOID FEVER ISPA
281 muhammad shakil al-fath 407798 3 HBR
282 DEWI PATIMAH 407668 5 ASMA PARTUS SC
283 B . HARTINI 407714 4 UAP OA
284 ASEP SUTISNA 407632 7 HHD ESRD + ANEMIA
285 RIKA MUSTIKA 393143 4 KPSW PARTUS SC
286 KORLIN , S.PD.I 407158 15 CELULITIS DG SEPSIS HYPOALBUMINEMIA + AKI + ANEMIA + DM + HEPATITI
287 NENI 407966 2 PERITONITIS DIFUSE SEPSIS
288 R SOEPENA K, SH, TN 369975 9 CAD RECENT AMI PPOK + ANEMIA
289 EPONG MULYATI 388345 3 GASTRITIS AKUT
290 YAYA 402008 2 NEFROLITHIASIS
291 MAHPUDIN 403266 2 DJ STENT IN SITU
292 SITI SUTINAH 304943 5 ANAK BESAR PARTUS SC
293 LILIS LISNAWATI 407844 4 CPD PARTUS SC
294 yasmin gustar 407837 4 BBL
295 HALIMAH 384095 7 CHF ec HHD + AF PLEURAPNEUMONIA
296 Naura Najwatushofia 395330 3 DADRS
297 ADITYA YANUAR L, AN 379404 6 DHF ISPA
298 kayla khairunissa 407828 5 RHINOBRONCHITIS
299 ROCHMAT. NY 390655 4 DIARE AKUT
300 RESTI CANTIKASARI 407456 1 HYPERPIREXIA
301 OMAH, HJ, NY 407543 2 VES
302 sauri 389810 3 STT FAC FACIALIS
303 POPON 407785 2 STT
304 YATAT 407799 2 STT LUMBAL
305 RIZKA FEBRIYANTI CAHYAD 385301 4 PENDARAHAN POST EKSISI
306 mugi rahayu slamet 403493 2 PAPILOMA GLUTEAL
307 NUNUNG SUNENGSIH 406002 5 VERTIGO PERIFER HT + DYSLIPIDEMIA
308 hj epon memunah 407822 6 DMT2 CAD + DYSLIPIDEMIA
309 ERNI SULISTYOWATI 407741 5 POST DATE PARTUS SC
310 naura dwi larasat 407882 4 BBL
311 DENI HENDRAWAN 366145 5 FRAKTURE RADIUS ULNA
312 AAM HAMZAH 362225 10 HEPATITIS AKUT
313 DANI SETIAWAN 351918 4 OSTEOMYELITIS
314 EUIS ATIKAH 408042 2 GANGLION
315 NARMI 399205 4 CHOLELITHIASIS POLYP EMPEDU
316 EVI NOVIARTI 408064 2 STT THORAX
317 ARI 408090 2 AB. INKOMPLIT
318 NANI BT OTONG 407963 3 HHD ANEMIA
319 FAJAR RIDA 407997 3 TYPHOID FEVER TOF
320 ZAENAL ARIFIN 376718 3 PPOK
321 H. OJO SUKARJO 388992 3 ABSES
322 EVA LENI 407915 2 TUMOR MAMAE
323 INAH KARTINI 408040 2 CLAVUS
324 NAGHIF VIBI MAHDAVIKIA 407627 3 TUMOR TRIGLOSSAL
325 ENDANG SUPRIYATNA BIN 405704 5 BPH CYSTITIS
326 AIDAH, NY 372676 2 STT
327 WARNIAH 407899 5 GASTRITIS AKUT
328 KRISTIANTI GILI 407969 3 GEA
329 MUHAMAD ARIA NOVVIDI 367010 4 VIRAL INFECTION HT + OA
330 BIMA FAIRUZ AZKA 408017 3 MHI
331 ABDUL MALIK SIDIQ 407900 6 DADRS HYPOKALEMIA
332 Muhamad Fergiansyah Ra 396495 3 TOF
333 I. NYOMAN ARIASA. SH 393611 5 CAD STEMI
334 SUHENDI 407961 5 NEFROLITHIASIS
335 MUHAMAD RAIHAAN SHID 407857 7 TYPHOID FEVER
336 SUMARNO 355102 4 ESRD HCAP
337 YUNI NURHASANAH 402483 2 ABSES
338 EVI NOPIYANI 301598 2 STT LUMBAL
339 YUYUN ARSITA 408049 2 PAPILOMA MAMAE
340 WATI 365697 4 CA MAMAE
341 neulis s 373896 2 STT
342 MUSTOFA 407710 9 KP AKTIF SEPSIS + YSPEPSIA + ANEMIA
343 FEDERICA BAKRI MOEBIN 408048 5 TYPHOID FEVER
344 UTISAH 305515 6 HT HHD + CHF
345 IRWANTO 407986 4 HIL
346 NENENG.T 305754 4 HT CAD
347 TRI BUDIYANTO 388488 4 ESRD ec GLOMERULOANEMIA
348 nola naila 407788 4 SLEEP APNEU
349 LISNAWATI 384827 2 GANGLION
350 AHMAD ZAENAL MUSTOP 407945 3 HERNIA
351 epon 408035 2 GANGLION
352 NANDA SRI NURHAYATI 408189 2 CLAVUS
353 MINARTI,NY 408088 5 HT UTI + DM
354 SAEPUDIN 407760 11 CKD NEFROLITHIASIS
355 SUTARTI 324279 4 VES + KPD PARTUS SC
356 CACIH SETIAWATIE 328632 OF
357 ASTUTI, NY 407956 PIS
358 JEIHAN FAUZIYYA PODUN 378736 3 BO
359 Teguh Permana , SE 314243 2 HT DYSLIPIDEMIA
360 NADINE AURELIA FADILAH 408074 4 TYPHOID FEVER
361 ALIF FAIRUZ 314225 3 TOF
362 rosmelina munthe 408218 4 DF
363 RUKIDAH 408153 5 ISK HT + HHD + CAD
364 YAYAH NURASIAH 380235 3 PARTUS SPONTAN
365 ASWAN ABDULLAH 386111 5 APP AKUT
366 KAMILA KHOERUNNISA 305256 4 TYPHOID FEVER
367 TIEN DEWI ABSAH 407834 5 FRAKTUR RADIUS
368 muhammad fakhri al fath 408221 3 BBL
369 ONIH NURYANI 326687 4 KISTA COKLAT
370 ADE CASMIRAH 408313 2 RESPIRATORY DISTRESS
371 nurul hajijah fauziah 398315 4 MORBILI
372 KIKO DAVARIO MASYHUR 407745 5 MALUNION FRAKRUR FEMUR
373 IDAH DJUBAEDAH 408065 3 TYPHOID FEVER
1 MUSTOPA 335779 STT

2 INDRA DAMAYANTI 406757 PARATYPHOID FEVER
3 elsa astut 406511 STENOSIS URETER NEFROLITHIASIS + HYDRO
4 NINING. S 403136 7 CHOLELITHIASIS CHOLECYSTITIS + VES
5 ENI NURAENI 406991 6 TYPHOID FEVER DHF
6 TIAS NURMALAWAPA 407100 6 TYPHOID FEVER
7 DEDE SAEPUDIN 407059 4 TYPHOID FEVER
8 YUSUP ADRIANTO 406881 11 NEFROTIK SYNDROME
9 SABRINA QAIREEN ANGGHA 391691 5 COLITIS STOMATITIS
10 NINING. S 403136 3 CHOLELITHIASIS ADHESI BILIER
11 JEJEN 407528 4 GEA
12 NY. NIA NENTRIANA 349498 5 AB. IMMINENS HEG
13 SULASTRI 325941 3 TUMOR MAMAE
14 KOKOM KOMARIAH 300526 4 LBP
15 SLAMAT 364671 11 DC ec HHD ESRD + DHF
16 RAFA ANARGYA 323091 4 APP AKUT
17 YOYO HARTOYO 408210 4 GEA
INSULIN E10
LANTUS
NOVOMIX
NOVORAPID
AVIDRA
INA CBGs Bulan AGUSTUS
KODE ICD KODE ICD KODE

TINDAKAN TINDAKAN KELAS HARGA RS
UTAMA SECUNDER
M32.9 D63.8 I 4,352,700.00

I61.9 I10 I 3,029,700.00
REPAIR PERVAGINA S39.9 70.79 I 12,784,485.00
I11.9 I 16,091,260.00
M96.1 II 6,296,271.00
URETEROTOMY + INSERSI STENT N35.9 N13.3 56.2 + 59.8 I 22,003,335.00
MEATAL URETEROTOMY + LITOTRIPSI + AFF STENT N20.1 56.0 + 97.65 III 16,695,928.00
MEATAL URETEROTOMY + AFF STENT N99.1 97.65 II 19,634,146.00
MEATAL URETEROTOMY + LITOTRIPSI + AFF STENT N20.1 56.0 + 97.65 III 16,695,928.00
BIOPSI I88.8 40.11 I 9,531,383.00
N04.9 N39.0 II 3,121,671.00
BRONCHITIS M54.1 K30 + J40 II 6,208,820.00
MEATAL URETEROTOMY + AFF STENT N99.1 97.65 III 15,969,065.00
TAH D25.9 68.4 II 12,078,792.00
N45.9 II 2,624,118.00
O21.0 II 1,949,487.00
A09 D63.8 II 4,504,829.00
O21.0 II 1,773,061.00
A01.0 II 2,674,848.00
TURP N40 N30.9 60.29 I 22,657,690.00
NEFROTOMY N13.3 55 III 21,078,140.00
I21.3 III 20,010,797.00
HERNIORHAPY K40.9 53.29 III 8,264,870.00
HEMMOROIDECTOMY I84.2 49.46 III 7,445,323.00
CYSTECTOMY N83.2 65.29 III 9,625,784.00
INCISION I88.8 40 II 7,914,894.00
B08.4 II 2,571,845.00
K29.1 I 2,355,591.00
J45.9 II 4,873,396.00
M79.28 M54.16 II 3,639,804.00
J18.0 Q21.0 II 3,505,587.00
J18.0 I 3,842,061.00
J06.8 II 3,416,472.00
J18.0 I 3,988,309.00
SCTP O14.1 O82.9 74.4 II 9,745,266.00
P03.4 II 1,693,730.00
P03.4 II 1,714,280.00
O42.9 O80.9 I 5,461,628.00
HERNIORHAPY K40.9 53 I 11,946,792.00
O PERIFER + BI E11.9 I10 + H81.0 + A49.9 III 1,942,900.00
ISHMULOBECTOMY E04.9 6.31 I 14,137,431.00
HERNIORHAPY K40.9 53 I 12,848,723.00
TURP N40 60.29 III 17,319,117.00
TRANFUSI Z51.3 99.03 II 4,665,449.00
I11.9 I25.1 III 2,975,633.00
A01.0 II 2,700,156.00
J06.8 II 2,871,461.00
J18.0 III 3,090,934.00
K25.9 Z92.8 + N18.0 I 6,836,700.00
I10 G44.2 + E11.9 I 3,273,674.00
HEMMOROIDECTOMY I84.2 49.46 I 9,589,090.00
E10.9 D63.8 II 7,774,833.00
C79.5 I 10,056,572.00
O80.9 J45.9 I 6,838,505.00
J18.0 II 4,479,462.00
I51.7 I51.9 I 5,928,675.00
I50.0 K80.8 I 6,057,212.00
A09 II 2,700,085.00
I25.1 II 2,931,678.00
A16.2 II 2,721,419.00
O20.0 I 2,492,030.00
TAH D25.9 68.4 III 11,449,108.00
OSEPTAL + DYSPEPSIA I21.0 K30 III 12,448,127.00
A90 E11.9 I 6,952,534.00
K25.0 D63.8 + I10 III 5,472,070.00
J18.0 III 4,539,369.00
O21.0 I 2,892,367.00
K29.1 I10 I 7,553,969.00
A09 I 2,440,879.00
TONSILECTOMYADENOIDITIS J35.3 28.3 II 7,693,050.00
EKSISI + ADVANCEMENT FLAP D48.1 86.74 II 6,823,918.00
EKSISI D24 85.24 III 7,290,013.00
A01.0 I 3,267,945.00
J21.0 II 1,787,104.00
AF + TENDINITIS SHOULDER I25.1 I11.9 + I48 + M75.9 I 4,170,900.00
SCTP O34.2 O82.9 74.4 II 8,662,780.00
HERNIORHAPY + HYDROCELECTOMY K46.9 N43.3 53.9 + 63.1 II 8,934,847.00
LYMPHADECTOMY I88.8 40.29 II 7,473,659.00
J18.0 II 4,295,470.00
A01.0 II 3,624,922.00
K29.1 II 4,798,378.00
A90 II 3,178,705.00
I10 E10.5 III 3,584,766.00
N20.1 II 2,145,066.00
K30 II 2,645,380.00
A01.0 II 3,181,423.00
P03.4 II 1,920,485.00
J18.0 II 7,431,075.00
SO + ASPIRASI N83.2 65.49 II 9,643,478.00
EKSISI L84 83.49 II 7,467,262.00
HYPOGLIKEMI + J45.9 L50.9 + E16.2 I 2,827,100.00
Z49.0 D63.8 I 5,917,255.00
I25.5 I50.0 I 7,841,608.00
A01.0 II 2,794,538.00
D69.0 II 2,403,110.00
N20.0 II 4,457,721.00
A09 I 2,667,047.00
B34.9 N91.1 II 2,419,393.00
A09 I 2,278,942.00
TAH + APPENDECTOMY D25.9 K35.9 58.4 + 47.09 II 15,835,740.00
O44.1 I 4,204,432.00
SCTP O34.2 O82.9 74.4 I 11,057,113.00
K30 A01.0 I 3,891,400.00
A09 I42.0 I 3,991,400.00
N39.0 I25.1 II 3,642,121.00
DEBRIDEMENT L02.9 86.22 II 8,215,339.00
A09 II 2,599,254.00
G41.9 III 5,632,010.00
O80.9 II 5,888,899.00
EKSISI D24 85.21 III 7,772,786.00
K30 E10.9 I 2,315,124.00
A01.0 III 2,755,164.00
Z51.5 II 853,079.00
A01.0 II 3,994,357.00
N83.2 II 5,057,779.00
J03.9 I10 III 3,583,356.00
J06.9 II 1,753,180.00
A90 III 2,227,929.00
EKSISI M67.4 82.21 III 6,964,460.00
EKSISI + KURET N84.1 67.39 + 69.09 III 7,073,836.00
BIOPSI D24 85.12 III 6,534,176.00
M54.2 II 5,488,505.00
I24.9 I 4,384,770.00
J18.0 I 3,931,383.00
J06.9 E11.9 + I10 II 2,696,405.00
J06.9 A09 I 3,705,306.00
A09 III 1,912,968.00
A91 II 2,948,198.00
A01.0 J06.8 II 2,203,626.00
K52.9 J06.8 I 2,684,953.00
I25.1 I10 + Z92.8 + M19.9 I 3,264,200.00
A09 II 2,512,557.00
J06.9 B34.9 I 4,088,274.00
D69.0 II 3,176,453.00
TRANSFUSI Z51.3 99.03 III 2,416,460.00
PUNKSI PLEURA A16.5 I 5,259,088.00
BIOPSI D24 85.12 I 9,940,993.00
URS + AFF STENT N13.2 58.22 + 97.65 II 19,739,689.00
ONVULSION EC MENINGITIS + SEPSIS G00.9 P28.5 + P90 II 24,809,397.00
HD + KP AKTIF I61.9 I13.1 + A15.0 I 4,973,673.00
J18.8 I11.0 + E11.9 III 4,953,280.00
THYROIDECTOMY D34 6.4 I 11,768,086.00
EKSISI D24 85.21 II 9,003,910.00
HERNIORHAPHY K40.9 53.29 II 9,002,111.00
EKSISI D14.0 21.32 II 7,551,592.00
SCTP O33.9 O34.2 + O82. 74.4 II 10,129,543.00
P03.4 II 1,139,050.00
TRANSFUSI Z51.3 99.03 I 2,726,367.00
TRANSFUSI Z51.3 99.03 I 5,777,412.00
I63.9 E11.9 + I10 I 7,938,549.00
A09 III 2,773,050.00
A91 R56 II 7,427,231.00
A15.0 III 2,105,847.00
I11.0 I 3,439,856.00
A01.0 II 2,689,007.00
E16.2 III 914,788.00
E16.2 III 886,918.00
A01.0 D69.6 99.03 II 9,134,752.00
EKSISI D24 85.21 II 9,134,752.00
EKSISI I88.8 40.26 II 7,257,510.00
EKSISI M67.4 82.21 I 8,748,740.00
TAH D25.9 68.4 I 14,705,399.00
N93.9 I 6,628,416.00
R11 II 1,522,253.00
J18.0 II 2,189,156.00
J18.0 III 1,685,191.00
I63.9 I48 II 16,419,400.00
J18.0 J45.9 II 6,020,201.00
UVULAPALATOLARYNGOPLASTY G47.3 27.79 I 12,335,322.00
TOTAL THYROIDECTOMY D34 6.4 I 12,517,305.00
HEMMOROIDECOMY I84.2 49.46 II 7,351,181.00
INCISION K61.0 L02.4 49.12 II 10,089,361.00
EKSISI D24 85.21 II 8,698,432.00
ORIF S42.0 79.39 I 14,326,574.00
B08.4 I 2,033,938.00
A01.0 II 3,576,746.00
A01.0 K29.1 II 2,188,716.00
PUNGSI PLEURA J90 34.91 I 3,106,462.00
A09 II 1,711,798.00
M54.16 I 2,712,300.00
EKSISI D48.1 83.49 III 5,835,111.00
RELEASE TENDON Q66.0 83.85 II 11,294,012.00
MEATOTOMY URETHRA + LITOTRIPSI N35.9 N21.0 58.1 + 57.0 III 15,844,101.00
PYELOLITHOTOMY N13.3 N18.0 55.11 I 30,570,953.00
MEATOTOMY URETHRA + LITOTRIPSI N35.9 N21.0 58.5 + 57.0 I 22,867,233.00
A01.0 N39.0 III 2,437,522.00
J06.8 II 1,514,608.00
A09 K06.9 + R56.0 II 2,529,096.00
I63.9 G51.0 I 5,449,154.00
A09 III 1,169,314.00
A01.0 I 4,650,074.00
DEBRIDEMENT + AB. BEAD M86.98 77.69 + 86.75 II 14,204,137.00
CHOLECYSTECTOMY K80.8 51.22 II 12,502,339.00
THYROIDECTOMY D34 6.31 I 14,625,541.00
GASTROPATI N20.0 N18.9 + E86 + K25.9 I 3,259,300.00
LE K35.0 54.11 I 7,947,700.00
TOTAL THYROIDECTOMY D34 6.4 II 11,470,022.00
Z51.3 99.03 II 2,721,856.00
A01.0 A91 II 5,786,510.00
T78.3 J45.9 II 3,044,273.00
A09 II 1,952,008.00
E86 I 2,388,751.00
A09 II 3,664,002.00
N13.2 II 2,191,514.00
O35.0 II 1,649,362.00
N20.9 A41.9 III 6,367,341.00
F48.9 I 11,389,873.00
HEMMOROIDECTOMY + THROMBECTOMY I84.0 49.46 I 11,793,095.00
SCTP O33.2 O34.2 + O82. 74.4 II 9,323,464.00
P03.4 II 1,584,030.00
P03.4 I 2,723,272.00
A09 J40 II 4,204,606.00
B34.9 II 2,674,332.00
C95.0 III 3,443,283.00
VENTILATOR S09.9 I60.9 97.62 III 32,143,103.00
R50.9 III 765,173.00
E16.2 III 1,401,695.00
G24.9 I10 + E79.0 II 3,820,000.00
BIOPSY D24 85.12 II 8,232,118.00
EXPLORASI S99.9 83.01 III 6,197,418.00
J18.0 A09 III 5,153,336.00
J06.9 K29.7 II 2,192,236.00
N39.0 III 2,298,748.00
+ DYSPEPSIA I34.1 I25.1 + I13.1 I 3,610,852.00
I20.0 K76.1 I 8,948,787.00
+ EFFUSI + TB I42.0 I51.9 + E11.9 + A15.6 I 5,144,343.00
EKSISI D10.0 25.1 II 8,686,500.00
NEPHROTOMY N20.0 55.01 I 26,561,941.00
KP + PLEURA I11.9 A16.5 II 10,086,902.00
J45.9 I 3,285,311.00
A01.0 J45.9 II 3,194,135.00
A15.0 I 5,383,406.00
INCISION RETROAURICULAR H70.1 20.21 II 7,504,119.00
RADICAL MASTECTOMY D24 85.45 III 8,733,631.00
EKSISI D48.1 83.49 III 6,857,529.00
SALPINGEKTOMI O00.9 66.4 II 11,314,654.00
k29.0 II 3,397,735.00
A09 II 1,352,257.00
HERNIORHAPY K40.0 53 I 10,405,952.00
I11.9 D63.8 II 3,561,063.00
B08.4 I 2,512,491.00
N39.0 E11.9 + N18.9 I 6,184,574.00
A01.0 III 2,044,542.00
A01.0 J06.9 II 2,531,903.00
A01.0 A09 + K29.1 III 3,259,800.00
A09 II 1,828,927.00
J06.9 R56.0 I 2,866,575.00
J06.9 R56.0 II 2,138,908.00
N18.0 D63.8 I 11,029,539.00
HERNIORHAPY K40.3 53 II 7,181,239.00
REMOVE IMPLANT S72.9 78.65 I 14,372,852.00
EKSISI I88.8 40.29 II 9,389,867.00
EKSISI D24 85.21 III 6,574,585.00
EKSISI M67.4 83.31 II 7,598,806.00
N83.2 I 7,608,573.00
I25.2 I50.0 + E11.9 II 2,860,885.00
I25.5 I50.0 + N18.9 + E11.9 III 2,203,583.00
I10 L89 + N39.0 I 3,472,622.00
A09 II 1,313,736.00
I10 B34.9 III 3,427,767.00
TRANSFUSI Z51.3 99.03 II 4,259,152.00
A09 L22 I 4,463,918.00
J18.9 II 5,013,983.00
A01.0 II 3,929,539.00
A01.0 J06.9 II 2,675,251.00
E11.2 K30 + D63.8 II 5,979,946.00
I42.0 J18.9 III 4,912,950.00
A01.0 II 3,319,113.00
J03.8 K29.7 II 2,989,451.00
J18.9 A09 II 5,145,294.00
K29.7 I 4,233,244.00
HEMMOROIDECTOMY I84.2 49.46 II 8,306,205.00
EKSISI D48.1 83.49 III 4,120,034.00
A09 K76.1 I 3,991,400.00
C18.9 99.03 II 5,561,947.00
A01.0 J06.9 III 1,631,505.00
A01.0 J06.9 III 3,010,646.00
P59.9 II 1,985,872.00
SCTP J45.9 O82.9 74.4 II 10,670,685.00
I20.0 M19.9 I 4,509,100.00
I13.1 D63.8 II 6,275,622.00
SCTP O42.9 O82.9 74.4 I 5,631,000.00
MINEMIA + AKI + ANEMIA + DM + HEPATITIS + OSTEOMYELITIS L03.9 A41.9 I 7,099,300.00
K65.0 A41.9 II 2,660,510.00
I21.0 J44.9 + D62 I 8,860,000.00
K29.1 I 2,171,800.00
URS + AFF STENT N20.0 58.22 + 97.65 III 12,765,177.00
URS + AFF STENT N20.0 58.22 + 97.65 III 12,785,422.00
SCTP O66.2 O82.9 74.4 II 9,860,921.00
SCTP O33.9 O82.9 74.4 III 8,433,444.00
P03.4 II 1,830,705.00
I11.0 I48 + J18.8 I 7,920,780.00
A09 I 2,297,686.00
A91 J06.9 II 4,783,886.00
J20.9 II 2,955,099.00
A09 I 3,665,413.00
R50.9 III 785,801.00
I49.3 III 2,096,489.00
EKSISI D48.1 83.49 II 9,317,909.00
EKSISI D48.1 83.49 II 11,045,569.00
EKSISI D48.1 83.49 III 6,696,868.00
REPAIR + LIGASI T81.0 25.59 II 9,059,820.00
EKSISI + FLAP D36.7 86.75 III 5,941,920.00
H81.0 I10 + E78.5 I 4,678,167.00
E11.9 I25.1 + E78.5 I 5,178,838.00
SCTP O48 O82.9 74.4 II 8,997,676.00
P03.4 II 1,718,327.00
ORIF S52.7 79.32 II 21,780,951.00
B15.9 I 11,287,644.00
AB. BEADS M86.97 86.75 II 17,125,952.00
EKSISI M67.4 82.21 I 10,054,114.00
CHOLECYSTECTOMY + ADHESIOLSIS BILIER K80.8 D41.4 51.22 + 54.59II 10,386,523.00
EKSISI D48.1 83.49 I 9,790,137.00
KURET O05.4 69.02 III 4,620,335.00
I11.9 D63.8 III 3,910,834.00
A01.0 J03.8 I 2,186,916.00
J44.9 II 2,782,839.00
DEBRIDEMENT L02.9 86.22 I 9,249,310.00
BIOPSI D24 85.12 I 10,051,968.00
EKSISI L84 83.49 III 6,380,729.00
TRIGLOSSECTOMY D34 25.3 I 12,273,365.00
TURP N40 N30.9 60.29 III 15,227,580.00
EKSISI D48.1 83.49 I 9,859,758.00
K29.1 II 3,382,419.00
A09 II 2,588,796.00
B34.9 I10 + M10.0 II 3,953,210.00
S09.9 I 5,285,826.00
A09 E876 II 4,152,184.00
J03.8 II 2,079,185.00
I21.3 I 7,722,475.00
N20.0 II 3,433,081.00
A01.0 II 5,227,826.00
N18.0 J18.9 I 6,597,184.00
EKSISI L02.9 86.3 I 10,752,983.00
EKSISI D48.1 83.49 I 9,262,345.00
EKSISI D24 85.21 II 7,500,708.00
RADICAL MASTECTOMY C50.9 85.45 III 9,207,711.00
EKSISI D48.1 83.49 I 9,614,495.00
PEPSIA + ANEMIA A15.0 A41.9 + K30 I 15,350,534.00
A01.0 I 3,305,704.00
I11.0 I 6,969,659.00
HERNIORHAPY K40.9 53.29 II 9,391,744.00
I10 I25.1 II 3,921,715.00
N05.9 N18.9 + D63.8 II 4,113,963.00
UVULA OPERATION G47.3 27.79 III 7,714,382.00
EKSISI M67.4 82.21 II 6,914,864.00
HERNIORHAPY K40.9 53.29 III 8,663,704.00
EKSISI M67.4 83.31 III 6,766,388.00
EKSISI L84 83.49 II 7,437,070.00
I10 N39.0 II 4,380,349.00
N18.9 N20.9 I 14,169,570.00
SCTP I41.9 + O42. O82.9 74.4 II 8,260,426.00
R50.9 III 950,046.00
I61.9 III 2,096,416.00
KURET O02.0 69.09 I 7,003,701.00
I10 E78.5 I 3,598,861.00
A01.0 II 2,553,829.00
J03.8 II 2,865,784.00
A90 II 2,576,747.00
N39.0 I11.9 + I25.1 III 2,877,102.00
O80.9 II 2,615,036.00
APPENDECTOMY K35.9 47.09 II 9,344,315.00
A01.0 I 3,394,174.00
ORIF S52.8 79.32 I 23,303,018.00
P03.4 II 1,448,947.00
SOD N80.1 65.49 II 11,696,565.00
J80 III 882,377.00
B05.9 III 1,886,147.00
REFRAKTURASI + ORIF S72.9 M84.0 78.75 + 79.35I 13,059,600.00
A01.0 I 3,884,300.00
2,388,736,233.00
KODE ICD KODE ICD KODE

TINDAKAN UTAMA SECUNDER TINDAKAN KELAS HARGA RS
BIOPSI D48.1 83.21 II 8,324,767.00

A01.4 I 3,170,345.00
URETEROTOMY + INSERSI URETER STENT N35.9 N13.3 56.2 + 59.8 II 21,832,388.00
K80.8 K81.8 + I49.3 II 4,155,509.00
A01.0 A91 II 5,532,225.00
A01.0 II 4,380,877.00
A01.0 II 3,329,400.00
N04.9 II 6,823,015.00
A09 K12.2 I 3,991,400.00
CHOLECYSTECTOMY + ADHESIOLYSIS BILIER K80.8 K83.8 51.22 + 54.59 II 13,775,243.00
A09 II 2,414,163.00
O20.0 O21.0 I 3,728,807.00
EKSISI D24 85.21 I 8,951,325.00
M54.5 II 2,324,900.00
I13.1 A91 II 26,804,852.00
APPENDECTOMY K35.0 47.09 I 9,193,137.00
A09 I 2,827,100.00
131,559,453.00
4,352,700.00 dr. A. BARUNA, Sp.PD

3,029,700.00 dr. MEDIA, Sp.S
2,324,900.00 dr. MEDIA, Sp.S
14,126,800.00 dr. YUDI, Sp.U
6,172,400.00 dr. YUDI, Sp.U
3,113,300.00 dr. YUDI, Sp.U
6,172,400.00 dr. YUDI, Sp.U
3,490,700.00 dr. DEDE LIA, Sp.A
2,594,400.00 dr. YUDI, Sp.U
2,390,500.00 dr. RENNY, Sp.U
3,421,100.00 dr. A. BARUNA, Sp.PD

10,534,700.00 dr. YUDI, Sp.U
12,108,700.00 dr. YUDI, Sp.U
4,011,800.00 dr. A. BARUNA, Sp.PD
4,242,600.00 dr. DJOKO, Sp.B
3,102,100.00 dr. MEDIA, Sp.S
1,942,900.00 dr. MEDIA, Sp.S
6,189,500.00 dr. YUDI, Sp.U
1,399,400.00 dr. DJOKO, Sp.B
3,183,700.00 dr. A. BARUNA, Sp.PD
3,259,100.00 dr. DEASY, Sp.P
6,095,900.00 dr. DJOKO, Sp.B
4,903,700.00 dr. A. BARUNA, Sp.PD
3,198,500.00 dr. A. BARUNA, Sp.PD
3,792,700.00 dr. DJOKO, Sp.B
5,004,900.00 dr. DEASY, Sp.P
4,011,800.00 dr. A. BARUNA, Sp.PD
2,720,200.00 dr. A. BARUNA, Sp.PD
8,265,800.00 dr. DJOKO, Sp.B
5,098,500.00 dr. DJOKO, Sp.B
2,875,000.00 dr. YUDI, Sp.U
1,862,800.00 dr. A. BARUNA, Sp.PD
4,170,900.00 dr. A. BARUNA, Sp.PD
3,149,200.00 dr. DJOKO, Sp.B
4,242,600.00 dr. DJOKO, Sp.B
1,861,600.00 dr. A. BARUNA, Sp.PD
2,331,600.00 dr. MIFTAh, Sp.PD
2,173,300.00 dr. DEASY, Sp.P
4,170,900.00 dr. R. BAYU, Sp.JP
2,331,600.00 dr. A. BARUNA, Sp.PD
1,860,600.00 dr. A. BARUNA, Sp.PD
5,098,500.00 dr. DJOKO, Sp.B
3,891,400.00 dr. RIXTON
2,774,500.00 dr. A. BARUNA, Sp.PD
1,542,100.00 dr. A. BARUNA, Sp.PD
2,324,900.00 dr. ADE, Sp.S
4,509,100.00 dr. R. BAYU, Sp.JP

1,829,000.00 dr. A. BARUNA, Sp.PD
3,329,400.00 dr. DEDE LIA, Sp.A
2,827,100.00 dr. DEDE LIA, Sp.A
5,839,000.00 dr. DEASY, Sp.P
2,464,300.00 dr. RENNY, Sp.U
8,082,600.00 dr. DEASY, Sp.P
6,705,900.00 dr. DJOKO, Sp.B
6,118,200.00 dr. DJOKO, Sp.B
1,632,600.00 dr. DJOKO, Sp.B
4,101,800.00 dr. ADE, Sp.S
2,355,800.00 dr. A. BARUNA, Sp.PD
1,942,900.00 dr. UJANG
1,942,900.00 dr. HISKIA
4,996,100.00 dr. DJOKO, Sp.B
6,118,200.00 dr. DJOKO, Sp.B
4,242,600.00 dr. DJOKO, Sp.B
2,423,100.00 dr. DEDE LIA, Sp.A
6,705,900.00 dr. DJOKO, Sp.B
5,225,100.00 dr. DJOKO, Sp.B
7,036,800.00 dr. DJOKO, Sp.B
6,118,200.00 dr. DJOKO, Sp.B
8,797,700.00 dr. ANDRI, Sp.OT
3,808,000.00 dr. DEASY, Sp.P
2,712,300.00 dr. MEDIA, Sp.S
4,871,300.00 dr. DJOKO, Sp.B
5,845,600.00 dr. GHUNA, Sp.OT
6,172,400.00 dr. YUDI, Sp.U
14,126,800.00 dr. RENNY, Sp.U
8,661,400.00 dr. YUDI, Sp.U
1,829,000.00 dr. DEDE LIA, Sp.A
8,265,800.00 dr. GHUNA, Sp.OT
6,705,900.00 dr. DJOKO, Sp.B
5,747,900.00 dr. DJOKO, Sp.B
1,399,400.00 dr. A. BARUNA, Sp.PD
2,423,100.00 dr. A. BARUNA, Sp.PD
2,464,300.00 dr. YUDI, Sp.U
6,714,200.00 dr. RENNY, Sp.U
3,891,400.00 dr. DJOKO, Sp.B
2,331,600.00 dr. DEDE LIA, Sp.A
8,770,300.00 dr, IS, Sp.An
1,556,900.00 dr. FITHRI YANTI
3,249,400.00 dr. MEDIA, Sp.S
1,550,500.00 dr. A. BARUNA, Sp.PD
6,440,200.00 dr. R. BAYU, Sp.JP
5,182,000.00 dr. A. BARUNA, Sp.PD
4,063,100.00 dr. A. BARUNA, Sp.PD
4,861,600.00 dr. DJOKO, Sp.B
14,126,800.00 dr. YUDI, Sp.U
2,173,300.00 dr. DEDE LIA, Sp.A
4,612,400.00 dr. DJOKO, Sp.B
5,098,500.00 dr. DJOKO, Sp.B
4,871,300.00 dr. DJOKO, Sp.B
1,861,600.00 dr. DJOKO, Sp.B
4,997,900.00 dr. DJOKO, Sp.B
3,252,500.00 dr. A. BARUNA, Sp.PD
4,530,800.00 dr. A. BARUNA, Sp.PD
4,283,900.00 dr. DJOKO, Sp.B
4,139,400.00 dr. GHUNA, Sp.OT
4,242,600.00 dr. DJOKO, Sp.B
5,098,500.00 dr. DJOKO, Sp.B
5,845,600.00 dr. DJOKO, Sp.B
3,575,100.00 dr. R. BAYU, Sp.JP
2,979,200.00 dr. R. BAYU, Sp.JP
1,399,400.00 dr. DJOKO, Sp.B
4,170,100.00 dr. A. BARUNA, Sp.PD
5,225,100.00 dr. DJOKO, Sp.B
4,871,300.00 dr. DJOKO, Sp.B
3,991,400.00 dr. A. BARUNA, Sp.PD
5,116,400.00 dr. DJOKO, Sp.B
8,860,000.00 dr. A. BARUNA, Sp.PD
2,053,600.00 dr. RENNY, Sp.U
2,053,600.00 dr. RENNY, Sp.U
10,145,900.00 dr. R. BAYU, Sp.JP
2,827,100.00 dr. DEDE LIA, Sp.A
1,858,600.00 dr. DEDE LIA, Sp.A
2,827,100.00 dr. A. BARUNA, Sp.PD
8,265,800.00 dr. DJOKO, Sp.B
5,845,600.00 dr. DJOKO, Sp.B
4,871,300.00 dr. DJOKO, Sp.B
4,860,600.00 dr. DJOKO, Sp.B
68,882,000.00 dr. DJOKO, Sp.B
6,233,600.00 dr. GHUNA, Sp.OT
3,265,600.00 dr. A. BARUNA, Sp.PD
8,265,800.00 dr. GHUNA, Sp.OT
6,481,200.00 dr. DJOKO, Sp.B
4,315,900.00 DR. R. BAYU, Sp.JP
287,810.00 dr. DEASY, Sp.P
7,175,900.00 dr. DJOKO, Sp.B
7,524,800.00 dr. RENNY, Sp.U
6,819,800.00 dr. DJOKO, Sp.B
3,421,100.00 dr. DEDE LIA, Sp.A
5,419,700.00 dr. A. BARUNA, Sp.PD
4,865,100.00 dr. A. BARUNA, Sp.PD
4,583,900.00 dr. DJOKO, Sp.B
6,819,800.00 dr. DJOKO, Sp.B
6,118,200.00 dr. DJOKO, Sp.B
5,098,500.00 dr. DJOKO, Sp.B
6,233,600.00 dr. DJOKO, Sp.B
3,569,900.00 dr. DJOKO, Sp.B
4,530,800.00 dr. A. BARUNA, Sp.PD
4,457,100.00 dr. A. BARUNA, Sp.PD
1,550,500.00 dr. A. BARUNA, Sp.PD
7,272,500.00 dr. GHUNA, Sp.OT
1,548,800.00 dr. FITRI YATI
13,003,500.00 dr. GHUNA, Sp.OT
1,569,445,610.00

3,884,300.00 dr. A. BARUNA, Sp.PD
12,108,700.00 dr. YUDI, Sp.U
4,906,600.00 DR. MR. KURNIA, Sp.PD
3,991,400.00 dr. DEDE LIA, Sp.A
13,890,800.00 dr. DJOKO, Sp.B
2,423,100.00 dr. A. BARUNA, Sp.PD
7,137,800.00 dr. DJOKO, Sp.B
5,195,300.00 DR. MR. KURNIA, Sp.PD
79,911,100.00
HARI
Tanggal
NO NAMA PASIEN NO. MR Tanggal Keluar PERAWATA
Masuk N
1 KASTEM 400390 26-Aug-15 01-Sep-15 7
2 SRI YANTO 408327 26-Aug-15 01-Sep-15 2
3 RUSLI 402230 28-Aug-15 01-Sep-15 5
4 RESTU GUSTIAWAN 403365 29-Aug-15 01-Sep-15 4
5 M RAESHA 381295 28-Aug-15 01-Sep-15 5
6 WARTI 321893 29-Aug-15 01-Sep-15 4
7 RATNA JUWITHA 408282 29-Aug-15 01-Sep-15 4
8 RATMI 407756 29-Aug-15 01-Sep-15 4
9 AYU NURLATIFAH 390175 30-Aug-15 01-Sep-15 3
10 AGUS RAHMAN 408224 29-Aug-15 01-Sep-15 4
11 RASIM 402122 31-Aug-15 01-Sep-15 2
12 U KHOERUDIN 408318 30-Aug-15 02-Sep-15 4
13 DEDI SUHERMAN 380063 30-Aug-15 02-Sep-15 4
14 TAIL MUTAIL 403170 28-Aug-15 02-Sep-15 6
15 M AZKA 400459 28-Aug-15 02-Sep-15 6
16 ADWA TSABITA 359620 30-Aug-15 02-Sep-15 4
17 WAHD 383727 25-Aug-15 02-Sep-15 9
18 CAWIH 370653 30-Aug-15 02-Sep-15 4
19 GARNICYA F 408066 01-Sep-15 02-Sep-15 2
20 MULYANI 408279 31-Aug-15 02-Sep-15 3
21 ROSMINI 408131 01-Sep-15 02-Sep-15 2
22 GINA FARADILAH 302904 28-Aug-15 02-Sep-15 7
23 NOVI APRILIANTI 311115 31-Aug-15 01-Sep-15 2
24 SITI MARIAM 333620 30-Aug-15 03-Sep-15 5
25 UJUN JUARSIH 408157 28-Aug-15 03-Sep-15 7
26 TATI SUHARYATI 402616 28-Aug-15 03-Sep-15 7
27 FAIZAL UMARULAH 408395 01-Sep-15 03-Sep-15 3
28 M REVAN 356150 29-Aug-15 03-Sep-15 6
29 RIGO ASUNJAW 408411 01-Sep-15 03-Sep-15 3
30 ZUNAIRA HANIFATUL 408291 30-Aug-15 03-Sep-15 5
31 UPIT 317076 25-Aug-15 03-Sep-15 9
32 ONIS ROSDIATI 402217 31-Aug-15 03-Sep-15 4
33 IHAB SUPRIATNA 354222 31-Aug-15 03-Sep-15 4
34 M IQBAL 408445 02-Sep-15 03-Sep-15 2
35 ASEP SOLIHIN 372839 31-Aug-15 03-Sep-15 4
36 M RAMDAN 408280 02-Sep-15 03-Sep-15 2
37 PUTRI AYUDAWATI 408424 01-Sep-15 03-Sep-15 3
38 PENNY DWINA 393223 31-Aug-15 03-Sep-15 4
39 M RAIHAN 307009 31-Aug-15 03-Sep-15 4
40 APONG SUHAETI 397199 02-Sep-15 03-Sep-15 2
41 IZZA HILYAH 408326 31-Aug-15 04-Sep-15 5
42 ARINI YUSRIANA 408475 02-Sep-15 04-Sep-15 3
43 WINDA AGUSTINA, NY 341484 01-Sep-15 04-Sep-15 4
44 WINDA AGUSTINA, BY 408465 01-Sep-15 04-Sep-15 4
45 AAN ANI NOVIANI 408160 28-Aug-15 04-Sep-15 8
46 DESI WIDIARTI 408000 03-Sep-15 04-Sep-15 2
47 SHILFANIA ADIVA 387804 01-Sep-15 04-Sep-15 4
48 MADIA KURNIAWAN 402405 04-Sep-15 04-Sep-15 1
49 SITI HABSOH 407705 01-Sep-15 05-Sep-15 5
50 ARJUNA ABID 408529 02-Sep-15 05-Sep-15 4
51 DODO WIRAHIMARDJA 408391 31-Aug-15 05-Sep-15 6
52 BUDI SISWANDI 408047 04-Sep-15 05-Sep-15 2
53 TATI HARTATI 370718 04-Sep-15 05-Sep-15 2
54 RASINAH 399902 02-Sep-15 05-Sep-15 4
55 BIMA FAIRUZ 408017 02-Sep-15 05-Sep-15 4
56 ALDILA VIRA 408474 02-Sep-15 05-Sep-15 4
57 FEDERICA BAKRI 408048 01-Sep-15 05-Sep-15 5
58 ARA KOSWARA 388892 03-Sep-15 05-Sep-15 3
59 MIAH 372224 05-Sep-15 05-Sep-15 1
60 AAM HAMZAH 362225 05-Sep-15 05-Sep-15 1
61 KONIRAH 400835 31-Aug-15 05-Sep-15 6
62 CASIM 408650 04-Sep-15 05-Sep-15 2
63 ASEP SAEPULOH 408461 01-Sep-15 06-Sep-15 6
64 OIS HOLISOH 380613 05-Sep-15 06-Sep-15 2
65 HENDARTO 408281 29-Aug-15 06-Sep-15 9
66 JUMENA 408607 04-Sep-15 06-Sep-15 3
67 MISKAD SAPUTRA 328843 04-Sep-15 06-Sep-15 3
68 ANNISA RAHMAT 392889 04-Sep-15 06-Sep-15 3
69 ADE NURYANI 408497 02-Sep-15 06-Sep-15 5
70 ADRIEL AURELIA 384530 28-Aug-15 02-Sep-15 6
71 EKO SUTRISNO 404833 03-Sep-15 04-Sep-15 2
72 M ZAHID WIJAYA 336966 04-Sep-15 07-Sep-15 4
73 FADILAH RAHMAT 363107 05-Sep-15 07-Sep-15 3
74 ANDIKA NURMAULANA 408680 05-Sep-15 07-Sep-15 3
75 M DAFFA FAUZAN 408693 05-Sep-15 07-Sep-15 3
76 GILANG BADRIKA 376543 04-Sep-15 07-Sep-15 4
77 ANISA PUTRI 344657 04-Sep-15 07-Sep-15 4
78 FARREL RAFANA 342123 02-Sep-15 07-Sep-15 6
79 YULIANTI 408696 05-Sep-15 07-Sep-15 3
80 WARYA ATUT 398373 04-Sep-15 07-Sep-15 4
81 DEDE MAELANI 408636 04-Sep-15 07-Sep-15 4
82 ANDRI SURATMAN 408078 04-Sep-15 07-Sep-15 4
83 MALIKA ANASYA 408596 03-Sep-15 07-Sep-15 5
84 DZIKRI AIDI NASIR 408704 05-Sep-15 08-Sep-15 4
85 NUR SYIFA 408563 03-Sep-15 08-Sep-15 6
86 GARDJITA 408654 04-Sep-15 08-Sep-15 5
87 YUYU YUNINGSIH 408812 07-Sep-15 08-Sep-15 2
88 NUNUNG MASDUKI 408715 05-Sep-15 08-Sep-15 4
89 SARTINI 408567 03-Sep-15 08-Sep-15 6
90 DEVI SILVIA 408494 07-Sep-15 09-Sep-15 3
91 EVI KURNIAWATI 332677 05-Sep-15 09-Sep-15 5
92 USUP SAEPUDIN 408727 06-Sep-15 09-Sep-15 4
93 LENI RANTNASARI 303632 07-Sep-15 09-Sep-15 3
94 IIS ROHAYATIN 408689 05-Sep-15 09-Sep-15 5
95 FITRI ANDRIYANI 408887 08-Sep-15 09-Sep-15 2
96 NIKEN YULIFIA 346881 07-Sep-15 09-Sep-15 3
97 SUWENTI 408840 08-Sep-15 09-Sep-15 2
98 LATIFAH HANOUM 408488 02-Sep-15 09-Sep-15 8
99 NENG NURJANAH 408614 07-Sep-15 09-Sep-15 3
100 ILHAM REZA S 318323 08-Sep-15 09-Sep-15 2
101 DWIYANTI SAMAYANTI 386185 04-Sep-15 09-Sep-15 6
102 SUNARDI 377831 07-Sep-15 09-Sep-15 3
103 SHALWA NURAINI 408770 08-Sep-15 09-Sep-15 2
104 LALU DADANG 333472 06-Sep-15 09-Sep-15 4
105 ACIH 408736 06-Sep-15 09-Sep-15 4
106 AHMAD DAFA 408881 08-Sep-15 09-Sep-15 2
107 M NAZRUDIN ZAKI 406718 07-Sep-15 09-Sep-15 3
108 ANI ANGGRAENI 371686 05-Sep-15 09-Sep-15 5
109 NIDA RIANA 400750 07-Sep-15 09-Sep-15 3
110 SHAFA ALIYAH 399232
111 NURJANAH 331791 07-Sep-15 09-Sep-15 3
112 DEDEH NURAENI 400991 07-Sep-15 09-Sep-15 3
113 M FAZA, BY 408814 07-Sep-15 09-Sep-15 3
114 ZAENAL ARIFIN 376718 04-Sep-15 09-Sep-15 6
115 SUSANTI 372392 07-Sep-15 09-Sep-15 3
116 ABU HASAN 408761 07-Sep-15 09-Sep-15 3
117 CARINAH 401608 07-Sep-15 10-Sep-15 4
118 KRISNAWATI, NY 351169 06-Sep-15 10-Sep-15 5
119 KRISNAWATI, BY 408780 07-Sep-15 10-Sep-15 4
120 NURJANAH, BY 408815 07-Sep-15 10-Sep-15 4
121 ROHMAT 408740 07-Sep-15 10-Sep-15 4
122 SUGENG BUDI 372622 08-Sep-15 10-Sep-15 3
123 UU SULAEMAN 327504 09-Sep-15 10-Sep-15 2
124 RATMI 407756 05-Sep-15 10-Sep-15 6
125 BILAL HABIBI 408885 08-Sep-15 11-Sep-15 4
126 QAIREN QATRUNADA 397634 08-Sep-15 11-Sep-15 4
127 FIKRI HIDAYAH 409013 10-Sep-15 11-Sep-15 2
128 ABID SHAQILA 408939 09-Sep-15 11-Sep-15 3
129 RIDWAN SAEPULOH 408830 07-Sep-15 11-Sep-15 5
130 ELMIRA SYAVIRA 404477 09-Sep-15 11-Sep-15 3
131 HANNA APRILIA 391206 08-Sep-15 11-Sep-15 4
132 LILIS SURYANI 403956 10-Sep-15 11-Sep-15 2
133 WISNU RISNAWAN 404815 10-Sep-15 11-Sep-15 2
134 AGUSTI AULIA 408668 09-Sep-15 11-Sep-15 3
135 ANO 371423 07-Sep-15 11-Sep-15 5
136 AQILAH SHASIE 351314 10-Sep-15 12-Sep-15 3
137 RATNA NINGSIH 374072 09-Sep-15 12-Sep-15 4
138 IMAS 402042 09-Sep-15 12-Sep-15 4
139 RIKI PRIAHAMDANI 408981 11-Sep-15 12-Sep-15 2
140 SOPIAN SUPRIADI 404263 11-Sep-15 12-Sep-15 2
141 MARYAM MARZUKI 396687 09-Sep-15 12-Sep-15 4
142 FADLI ROSADI 352518 11-Sep-15 13-Sep-15 3
143 RIZKI MUNAZAT 408967 10-Sep-15 13-Sep-15 4
144 RAHMA ALIYA 374464 09-Sep-15 13-Sep-15 5
145 IDA ROSTIKA 408663 05-Sep-15 13-Sep-15 9
146 CHAIRUNISA 408679 09-Sep-15 13-Sep-15 5
147 ADE MATIN 404025 08-Sep-15 13-Sep-15 6
148 HALIMAH 384095 09-Sep-15 13-Sep-15 5
149 RAHMAN 408838 10-Sep-15 13-Sep-15 4
150 SUEB SUPANDI 408844 09-Sep-15 13-Sep-15 5
151 SITI MUTOHAROH, NY 343461 13-Sep-15 13-Sep-15 2
152 SITI MUTOHAROH, BY
153 ZIARA LULA SYAKILA 408960 07-Sep-15 12-Sep-15 5
154 SRI DADI MULYANINGSI 408673 09-Sep-15 13-Sep-15 6
155 TITI PURBAWANTI 409025 11-Sep-15 14-Sep-15 4
156 TANZA JAYA 390182 11-Sep-15 14-Sep-15 4
157 ASEP 408796 09-Sep-15 14-Sep-15 6
158 SRI WAHYUNI 381445 10-Sep-15 14-Sep-15 5
159 FADIA NURAFIFA 409110 13-Sep-15 14-Sep-15 2
160 HANAPI 408959 09-Sep-15 14-Sep-15 6
161 UIH 363345 09-Sep-15 14-Sep-15 6
162 IMAS SUMASTI 408908 09-Sep-15 14-Sep-15 6
163 TAMSIL ISWANDI 360522 11-Sep-15 14-Sep-15 4
164 SUMARNO 355102 08-Sep-15 14-Sep-15 7
165 DELIA DESIANI 391477 08-Sep-15 15-Sep-15 8
166 MAMAN SULAEMAN 409094 12-Sep-15 15-Sep-15 4
167 M DARWIS 408909 09-Sep-15 15-Sep-15 7
168 ANSYEILA NUR 364508 09-Sep-15 15-Sep-15 7
169 HUSEN BAZRI 373587 14-Sep-15 15-Sep-15 2
170 ACEP JUNAEDI 356931 11-Sep-15 15-Sep-15 5
171 RIDWAN HADI 370323 11-Sep-15 15-Sep-15 5
172 AJENG TRIHANDAYANI 407290 14-Sep-15 15-Sep-15 2
173 ADE IS SOBANDI 348462 13-Sep-15 15-Sep-15 3
174 TANSURO 398247 08-Sep-15 15-Sep-15 8
175 JIBRIL AL SHIDIQ 409045 14-Sep-15 16-Sep-15 3
176 NAMAZA CAGRI 404091 13-Sep-15 16-Sep-15 4
177 NOVI PUSPITA 409088 12-Sep-15 16-Sep-15 5
178 YAYAN SOPIAN 400123 14-Sep-15 16-Sep-15 3
179 SUPRIATNA 409228 15-Sep-15 16-Sep-15 2
180 FARIZ ALFARIZI 370947 14-Sep-15 16-Sep-15 3
181 SITI MULYANAH 408961 09-Sep-15 16-Sep-15 8
182 TAUFIQ RAMDANI 390719 08-Sep-15 16-Sep-15 9
183 YAN MULIANA 345188 15-Sep-15 16-Sep-15 2
184 AL NATA CHANDRA 392513 15-Sep-15 16-Sep-15 2
185 NIAH 406020 14-Sep-15 16-Sep-15 3
186 MELLY AMELIA 409239 15-Sep-15 16-Sep-15 2
187 SRI WAHYUNI 409029 11-Sep-15 16-Sep-15 6
188 MASRA UHANDA 388371 17-Sep-15 16-Sep-15 5
189 ERNA RAHNAWATI,NY 365852 29-Sep-15 30-Sep-15 2
190 WAWAN SETIAWAN 408340 31-Aug-15 03-Sep-15 4
191 MULYANA NURUL 408797 14-Sep-15 17-Sep-15 4
192 RANI 409153 14-Sep-15 17-Sep-15 4
193 NYAI HARTINI 409145 14-Sep-15 17-Sep-15 4
194 MARTAULINA S 346440 14-Sep-15 17-Sep-15 4
195 ZUNAIRA HANIFATUL 408291 14-Sep-15 17-Sep-15 4
196 AUDRI PUTRA 323317 13-Sep-15 17-Sep-15 5
197 HANNA NAILAH 409125 13-Sep-15 17-Sep-15 5
198 KASIH OKTAVIANI 409028 11-Sep-15 17-Sep-15 7
199 DERI TRI PRIBADI 402545 15-Sep-15 17-Sep-15 3
200 UUN UNERI 396432 14-Sep-15 17-Sep-15 4
201 ISAH BT CAPA, NY 409063 11-Sep-15 17-Sep-15 7
202 ISAH BT CAPA, BY 409218 15-Sep-15 17-Sep-15 3
203 SAAM 409148 17-Sep-15 18-Sep-15 2
204 DEDEH MASKANAH 389394 14-Sep-15 18-Sep-15 5
205 RINA NURAENI 404095 15-Sep-15 18-Sep-15 4
206 SITI MASITOH 383207 17-Sep-15 18-Sep-15 2
207 TITIN SETIANINGSIH 409364 16-Sep-15 18-Sep-15 3
208 YOSI NURBAETI 409288 16-Sep-15 18-Sep-15 3
209 ANDRIAN PUTRA 347665 16-Sep-15 18-Sep-15 3
210 ENTIN 389028 15-Sep-15 18-Sep-15 4
211 MUHNINGTYAS 409424 16-Sep-15 18-Sep-15 4
212 RAKHA JUNIOR 337738 14-Sep-15 18-Sep-15 5
213 M NABIL 409115 13-Sep-15 18-Sep-15 6
214 ROKAYAH 356478 16-Sep-15 18-Sep-15 3
215 ERNELI, NY 407766 17-Sep-15 18-Sep-15 2
216 ERNELI, BY 409778
217 AGUS HERMANA 409255 17-Sep-15 18-Sep-15 2
218 ADELIA PELITA 386331 16-Sep-15 19-Sep-15 4
219 M RAFA BUDIMAN 409287 16-Sep-15 19-Sep-15 4
220 TITIN KURNIASIH 408675 14-Sep-15 19-Sep-15 6
221 NINING SUNINGSIH 398703 12-Sep-15 19-Sep-15 8
222 KURNIASIH 403919 18-Sep-15 19-Sep-15 2
223 KANEM 409467 18-Sep-15 19-Sep-15 2
224 AMINAH 409781 17-Sep-15 19-Sep-15 3
225 ANUNG MAULANA 409213 14-Sep-15 19-Sep-15 6
226 IDA ROSTIKA 408663 18-Sep-15 19-Sep-15 2
227 AJAT SUDRAJAT 409065 18-Sep-15 19-Sep-15 2
228 AGUS PRIANTO 385462 16-Sep-15 18-Sep-15 3
229 ALFIE PRANAJA 409233 15-Sep-15 20-Sep-15 6
230 ANI AGUSTINA 398170 14-Sep-15 18-Sep-15 5
231 GER DEBORA LUMBAN 409775 17-Sep-15 20-Sep-15 4
232 REFI NURALFIAN 405843 14-Sep-15 16-Sep-15 3
233 SITI NURAFIFAH 409574 16-Sep-15 19-Sep-15 4
234 SYAEFUL NAZMUDIN 376366 19-Sep-15 21-Sep-15 3
235 ALBYAN IBNU 409878 18-Sep-15 21-Sep-15 4
236 NURYANI 388949 18-Sep-15 21-Sep-15 4
237 ARDI NATA 409752 17-Sep-15 21-Sep-15 5
238 TAKRIB 381151 17-Sep-15 21-Sep-15 5
239 ADI SANDRO 409634 18-Sep-15 21-Sep-15 4
240 YEYEN NURPAYANTI 409251 17-Sep-15 21-Sep-15 5
241 HERI SUBAGIO 409654 19-Sep-15 21-Sep-15 3
242 M RAMDAN 409181 17-Sep-15 21-Sep-15 5
243 ENCEP SUGANDA 379564 17-Sep-15 21-Sep-15 5
244 BASUNI RAHMAN 409858 18-Sep-15 21-Sep-15 4
245 NURLELA 409170 19-Sep-15 22-Sep-15 4
246 RYAN HEMAWAN 408348 13-Sep-15 22-Sep-15 10
247 FARIZ NAUFAL HAKIM 386755 16-Sep-15 22-Sep-15 7
248 MUHAMAD YUSUP 409193 14-Sep-15 22-Sep-15 9
249 CARMINAH 409977 21-Sep-15 22-Sep-15 2
250 SITI ANISA 409345 16-Sep-15 22-Sep-15 7
251 PANDI SETIA 378546 20-Sep-15 22-Sep-15 3
252 ALMIRA NANDA 352106 20-Sep-15 22-Sep-15 3
253 ENEN RUSMIAH 409958 21-Sep-15 22-Sep-15 2
254 ALDI SUBAGJA 403363 21-Sep-15 22-Sep-15 2
255 DWI SEVA DEWI 378738 18-Sep-15 22-Sep-15 5
256 MUNASIH 409857 18-Sep-15 22-Sep-15 5
257 DIANA NOVITA 322566 20-Sep-15 23-Sep-15 4
258 ANANDA IKHSAN 352315 20-Sep-15 23-Sep-15 4
259 SITI ROBIAH 357413 20-Sep-15 23-Sep-15 4
260 OYOK 380357 19-Sep-15 23-Sep-15 5
261 DADI ROSADI 409874 18-Sep-15 23-Sep-15 6
262 TAMSIL ISWANDI 360522 16-Sep-15 23-Sep-15 8
263 ROSI FAJRIN 409913 21-Sep-15 23-Sep-15 3
264 MAHMUDIN 408002 20-Sep-15 23-Sep-15 4
265 DEDEH KARYATI 333163 20-Sep-15 23-Sep-15 4
266 ASRIL TOMY 407604 20-Sep-15 23-Sep-15 4
267 ANY SUGIANI 409209 17-Sep-15 23-Sep-15 7
268 OYOK ABAS 303251 10-Sep-15 23-Sep-15 14
269 ENTIN HOTIMAH 409927 19-Sep-15 24-Sep-15 6
270 YAYAN ARYANTO 409368 16-Sep-15 24-Sep-15 9
271 LILIS SURYANI 408786 22-Sep-15 24-Sep-15 3
272 RESLI SILABAN 311003 20-Sep-15 24-Sep-15 5
273 IDA ROPIATUL 409973 23-Sep-15 24-Sep-15 2
274 DUDUNG SUHERMAN 410024 23-Sep-15 24-Sep-15 2
275 UMAR HAMDAN 409845 22-Sep-15 24-Sep-15 3
276 AISAH 368520 18-Sep-15 24-Sep-15 7
277 M SABIAN 320223 05-Sep-15 09-Sep-15 5
278 AGNI ZILVILIA 409782 17-Sep-15 19-Sep-15 3
279 M OPIK TAUFIK 409951 20-Sep-15 25-Sep-15 6
280 NANANG SOPIAN 398922 23-Sep-15 25-Sep-15 3
281 EUIS IDA 409942 20-Sep-15 25-Sep-15 6
282 GAVIN NALADIVA 410072 22-Sep-15 25-Sep-15 4
283 DESIH, NY 383777 19-Sep-15 25-Sep-15 7
284 WANTIAH 408515 22-Sep-15 25-Sep-15 4
285 IRFAN AFANDI 410009 21-Sep-15 25-Sep-15 5
286 NESHA ANINDYA 409062 22-Sep-15 25-Sep-15 4
287 CICIH NURJANAH 383517 24-Sep-15 25-Sep-15 2
288 YEYEN HARDIYENI 399122 22-Sep-15 25-Sep-15 4
289 LIES SITI AMINAH 371278 23-Sep-15 26-Sep-15 4
290 M JUAN AGUSTIAN 394491 25-Sep-15 26-Sep-15 2
291 NAAN 410127 23-Sep-15 27-Sep-15 5
292 NAYLA AZHALIA 338552 25-Sep-15 27-Sep-15 3
293 IDAWATI 403523 24-Sep-15 27-Sep-15 4
294 ADE PURWANTY 334976 25-Sep-15 27-Sep-15 3
295 MAHMUD 409959 21-Sep-15 23-Sep-15 3
296 SANTA 403026 22-Sep-15 27-Sep-15 6
297 EDI KUSNEDI 400724 24-Sep-15 27-Sep-15 3
298 FADILAH FIRDAUS 410073 22-Sep-15 25-Sep-15 4
299 FAUZIAH 410151 24-Sep-15 28-Sep-15 5
300 IRAH SALBIAH 409240 24-Sep-15 28-Sep-15 5
301 DYALUTHIA ANGGARI 408480 25-Sep-15 28-Sep-15 4
302 FAUZAN BACHTIAR 409846 18-Sep-15 28-Sep-15 11
303 NASSILA SEPTIANI 410175 25-Sep-15 28-Sep-15 4
304 JUAN MAHENDRA 410185 25-Sep-15 28-Sep-15 4
305 DWI ANTHI PUTRI 410238 26-Sep-15 28-Sep-15 3
306 SYATIR AUFA HANUN 305229 23-Sep-15 28-Sep-15 6
307 GISELA ALYA 407227 26-Sep-15 28-Sep-15 3
308 DEDI TARMIDI 410097 26-Sep-15 28-Sep-15 3
309 RISHA DIAH 410118 26-Sep-15 28-Sep-15 3
310 NONO SUWITNO 409892 19-Sep-15 19-Sep-15 1
311 M ALBY LUTHFY 367969 26-Sep-15 29-Sep-15 3
312 EEN ROHAENI 410280 27-Sep-15 29-Sep-15 3
313 M SUBHAN 410203 26-Sep-15 29-Sep-15 4
314 EFFENDY AHROM 387461 22-Sep-15 29-Sep-15 8
315 DEVI YULIANI 410219 28-Sep-15 29-Sep-15 2
316 WAYA 410177 28-Sep-15 29-Sep-15 2
317 SUMANTA 403495 23-Sep-15 29-Sep-15 7
318 YAYAN SIROKI 302806 27-Sep-15 29-Sep-15 3
319 ASEP TAUFIK 344429 10-Sep-15 12-Sep-15 3
320 NAZILA DIKARNIA 408993 28-Sep-15 30-Sep-15 3
321 AGUS MULYANA 331570 25-Sep-15 30-Sep-15 6
322 SITI NURANI 410254 26-Sep-15 30-Sep-15 5
323 M FATHIR 330052 28-Sep-15 30-Sep-15 3
324 LIANA 400628 26-Sep-15 30-Sep-15 5
325 IGOH ILHAM 384565 26-Sep-15 30-Sep-15 5
326 JUWITA DEWI 410364 29-Sep-15 30-Sep-15 2
327 KORY KUSUMAH 410192 25-Sep-15 30-Sep-15 6
328 DERIO GITARA 410279 27-Sep-15 30-Sep-15 4
329 FADILAH FIRDAUS 410073 28-Sep-15 30-Sep-15 3
330 ENTIN WARTINI 410298 29-Sep-15 30-Sep-15 2
331 NELLY 407948 28-Sep-15 30-Sep-15 3
332 E SUHERMAN 410220 26-Sep-15 30-Sep-15 5
333 KUSNA 409783 28-Sep-15 30-Sep-15 3
334 REZA SILVIA 410271 27-Sep-15 30-Sep-15 4
335 NICHOLAS JOHANES 351762 28-Sep-15 30-Sep-15 3
336 LILI BIN MARWAN 410110 23-Sep-15 30-Sep-15 8
337 SUHAYA, TN 405448 28-Sep-15 28-Sep-15 1
338 ENAH, NY 410464 30-Sep-15 30-Sep-15 1
339 ITA SONJAYA, TN 371999 21-Sep-15 25-Sep-15 5
1 SAGARA RASA ATINING 364328 30-Aug-15 01-Sep-15 3

2 DEWI YULIAWATI 408315 30-Sep-15 01-Sep-15 3
3 YENI KISMIAWATI 408122 31-Aug-15 01-Sep-15 2
4 YONGKIE SEPDIANARTA 372688 31-Aug-15 03-Sep-15 4
5 HENDRA SUHENDRA 323865 30-Aug-15 03-Sep-15 5
6 RIAN SETIADI 408519 02-Sep-15 04-Sep-15 3
7 HARIS DAWLAH 524347 03-Sep-15 07-Sep-15 5
8 KODIM WINARTO 524706 04-Sep-15 08-Sep-15 5
9 BUDI SANTOSA 317708 05-Sep-15 10-Sep-15 6
10 DZIYAH GHAZY MAHASIN 409102 12-Sep-15 14-Sep-15 3
11 KASIH OKTAVIANI 372689 10-Sep-15 14-Sep-15 5
12 JENAL ABIDIN 409072 12-Sep-15 16-Sep-15 5
13 ELSA ASTUTI 530978 18-Sep-15 19-Sep-15 2
14 SITI RUBIAH 528275 14-Sep-15 18-Sep-15 5
15 WATI RACHMAWATI 531046 18-Sep-15 19-Sep-15 2
16 BILQIS NUR ZAHRA 322134 16-Sep-15 18-Sep-15 3
17 PIPIN HANDAYANI 347786 13-Sep-15 19-Sep-15 7
18 PARMIYATI 530839 18-Sep-15 22-Sep-15 5
19 TITIN HENDRAYATI 409615 17-Sep-15 20-Sep-15 4
20 ELFITRA 318004 21-Sep-15 24-Sep-15 4
21 RIZQI FAUZHI HIDAYAT 410071 22-Sep-15 25-Sep-15 4
22 ANGGIE PERMATA SARI 381926 26-Sep-15 28-Sep-15 3
23 FIKRI DWI RAMDANI 360176 21-Sep-15 28-Sep-15 8
24 YASMIN NAYLA JAZILAH 410139 24-Sep-15 28-Sep-15 5
25 KUSTARI 365049 18-Sep-15 28-Sep-15 11
26 RAHMA AULIA 361697 20-Sep-15 25-Sep-15 6
27 AULIA SYIFA 310680 26-Sep-15 29-Sep-15 4
28 AMELIA AGUSTINA 319589 27-Sep-15 30-Sep-15 4
29 AGUS SUPRIATNA 370277 11-Sep-15 26-Sep-15 15
DIAGNOSA KODE ICD KODE ICD KODE KEL
DIAGNOSA PRIMER TINDAKAN
SEKUNDER UTAMA SECUNDER TINDAKAN AS
AMI HT - I21.9 I10 - 2

ABSES MAMAE - DEBRIDEMENT N61 - 86.22 2
ABSES PERIANAL SEPSIS INSISI ABSES PERIANAL K61.0 A41.9 49.01 1
TYPOID FEVER - - A01 - - 3
DADR-S - - A09 - - 1
DYSPEPSIA HT+TTH - K30 I10+G44.2 - 2
TYPOID FEVER - - A01 - - 2
CA. CERVIX CKD - C53.9 N18.9 - 2
BRONCHOPNEUMONIA+TB DC+AKUT- KIDNEY - A15.0 -
I51.9+N17. - 2
DCM INJURY(AKI) - I42.0 9+K30+I20 - 2
NEFROLITHIASIS +DYSPEPSIA+ACS
UTI CYSTOCOPY+AFF DJ STENT N20.0 .0
N39.0 57.32+97.65 1
GEA HT - A09 I10 - 2
CAD Angina Pectory Syndrome - I25.1 I20.9 - 1
ISCHEMIC CARDIOMIOPATY CHF+AF - I25.5 I50.0+I48 - 1
hydrocephalus - - G91.9 - - 2
BACTERIAL INFECTION - - A49.9 - - 2
PUSTULOSA VARICELLA - L08.9 B01.9 - 2
Disrupton of operaton wound, not elsewhe CKD+ANEMIAExplor PlANK+NEPROTOMY+ T81.3 N18.9+D63.854.0+55.2 1
Tonsil Hypertropy - Tonsilectomy J35.2 - 23.2 2
ABSES MAMAE - INSISI ABSES MAMAE N61 - N61 2
STT VAGINA - EKSISI STT D48.1 - 83.09 2
TYPOID FEVER - - A01.0 - - 1
STT - EKSISI D48.1 - 83.49 2
LETAK LINTANG PARTUS SC SCTP O32.1 O82.9 74.4 1
DM TYPE 2 - - E11.9 - - 2
DM TYPE 2 CA. MAMAE - E11.9 C50.9 - 2
GASTRITIS Akut - - k29.1 - - 2
TYPOID FEVER BP - A01 J40 - 2
TONSILITIS AKUT DYSPEPSIA - J03.8 K30 - 3
MORBILI+PNEMONIA BP - B05.2+J17.1 - - 1
HT STROK PIS(Perdarhan Intra Celebral) - I10 I61.9 - 2
PRESENCE OF UROGENITAL IMPLANTS UTI CYSTOCOPY+AFF DJ STENT Z96.0 N39.0 57.32+97.65 1
FRAKTUR TIBIA FIBULA - Implan Z47.0 - 78.67 2
STT - EKSISI LESION D48.1 - 83.39 2
FRAKTUR TIBIA FIBULA - ORIF+Bone Gift S82.2 - 79.36+78.07 1
TUMOR TRIGLOSAL - TRIGLOSECTOMY D34 - 25.3 2
GEA - - A09 - - 2
RHINITIS ALERGI CEPHALGIA - J30.4 R51 - 1
ASMA BR SERANGAN BERAT - - J45 - - 1
HAEMATEMESIS PNEUMONIA+SEPSIS+CKD+HYPERCALCEMIA+DMT2+ANEMIA
Tranfusi+Injeksi Antbiotk
J18.9+A41.9+N18.9+E83.5+E11.9+D64.9
K92.0 99.03+99.21 2
STATUS EPILEPTICUS BP - G41.9 J18.0 - 2
DIARE AKUT DADRS ISPA - A09 J06.9 - 2
CPD RIW. SC + PARTUS SCTP O33.2 O34.2 + O82.9 74.4 2
BBL - - P03.4 - - 2
KET(ETOPIK PREGNANCY) - SOS O99.0 - 65.49 2
STT - BIOPSI STT D48.1 - 83.21 2
TYPOID FEVER TB PARU - A01.0 A15.0 - 1
ESRD HYPERCALCEMIA+DMT2+ANEMIA - N18.0E83.5+e11.9+D63.8 - 1
BAYI BESAR PARTUS SC SCTP O66.2 O82.9 74.4 2
BBL - - P03.4 - - 2
TB MENINGITIS DM T2 - A17.0 E11.9 - 1
BATU URETER DISTAL+HYDRONEFROSIS - URETEROTOMI N13.2 - 56.2 3
STENOSIS URETER+HYDRONEFROSIS URETEROTOMI N13.1 56.2 3
CA. MAMAE - RADICAL MASTECTOMY C50.9 - 85.45 2
OEDEMA - - S06.1 - - 1
BACTERIAL INFECTION TONSILO FARINGITIS - A49.9 J03.8 - 2
DYSPEPSIA TONSILO FARINGITIS - K30 J06.8 - 1
VERTIGO HT - I10 R42 - 2
STEMI CAD - I21.9 I25.1 - 3
ESRD HYPERCALCEMIA - N18.0 E83.5 - 1
PARTUS SC Gagal Induksi+KPD SCTP O82.9 O61.9+O42.1 74.4 3
PNEUMOTHORAX SEPSIS - J93.9 A41.9 - 3
DENGUE FEVER - - A90 - - 2
GEA - - A09 - - 1
TRAUMATIC HAEMORAGE PARPLEGIA+NEUROGENIC BLADER - S06.6 G82.2+N31.9 - 3
HHD DC+CKD+MYALGIA - I13.1 M79.19 - 1
TB PARU - - A15.0 - - 2
VIRAL INFECTION - - B34.9 - - 1
KISTA OVARY - EKSISI KISTA N82.3 - 65.29 2
BP COW MILK ALLERG - J18.0 T78.1 - 1
NEFROLITHIASIS Hydronefrosis+UTI - N13.3 N39.0+N23 - 1
TYPOID FEVER ISPA - A01.0 J06.9 - 3
TONSILO FARINGITIS VIRAL INFEKSI - J06.8 B34.9 - 3
SYNDROME DISPEPSIA - - K30 - - 2
BP - - J18.0 - - 2
TONSILO FARINGITIS KDS+DADRS - J06.8 R56+A09 - 3
BACTERIAL INFECTION TFA+RIW EPILEPS - A49.9 J06.8+Z82.0 - 2
TYPOID FEVER GASTRITIS - A01 K29.1 - 1
SISA PLACENTA - KURETASE O94 - 69.2 2
BATU URETER ISK URETEROTOMI N20.1 N39.0 56.2 3
GAMELLI Letak Sungsang+Pa SCTP O34.2 O32.1+O82.9 74.4 1
HYDROCELLE - HYDROCELECTOMY N43.2 - 63.1 1
TYPOID FEVER ISPA - A01 J06.9 - 1
TYPOID FEVER DERMATITIS ATOPI - A01.0 L30.9 - 1
TYPOID FEVER DENGUE FEVER - A01.0 A91 - 3
AB INCOMPLETE - KURETASE O05.4 - 69.02 3
VERTIGO PERIPHERAL TTH - H81.3 G44.2 - 1
KISTA OVARY - BSO N83.2 - 65.61 3
TB PARU EFUSI PLEURA PUNGSI PLEURA A15.0 J90 34.91 2
MYALGIA GASTRITIS - M79.19 K29.1 - 2
MENOMETRORAGIA - KURETASE N92.1 - 69.09 1
ASMA DM T2 - J45 E11.9 - 1
FAM - BIOPSI D24 - 85.12 2
GYNECOMATIA - EKSISI N62 - 85.21 2
APP AKUT - APENDECTOMY K35.0 - 47.09 1
DM TYPE 2 - DEBRIDEMENT E11.9 - 86.22 1
STT - EKSISI D48.1 - 83.49 2
BP ASMA - J18.0 J45.9 - 2
UAP CEPHALGIA - I20.0 R51 - 2
MORBILI DIARE AKUT - B05.9 A09 - 2
ASMA - - J45.9 - - 3
KDC TONSILO FARINGIT J06.8 R56 - - 1
PRESENTASI BOKONG PARTUS SC SCTP O32.9 O82.9 74.4 2

ASMA PARTUS SC SC J45 O82.9 74.4 2
BBLR SC - - P03.4 - - 2
BP PPOK - J18.0 J44.9 - 2
GERD PALPITATION - K21.9 R02.0 - 1
ANEMIA ESRD+ht TRANFUSI I12.0 D36.8 99.03 3
HT UAP - I10 I20.0 - 2
GAGAL INDUKSI KPD+PARTUS SC O61.8 O42.9 O82.9 74.4 2
BBL - - P03.4 - - 2
RESPIRATORY FAILURE ec TRANSIENT TAC IKTERIK NEONATU - P28.5 P59.9 - 2
HERNIA - HERNIORRHAPLY K40.9 - 53.29 2
TOMOR a.r COLLI DEX - EKSISI LUAS+FLAP D23.4 - 86.74 1
STT a.r PLNTAR PEDIS - EKSISI D48.1 - 83.49 2
AKI HYPERCALEMIA - N17.9 E87.5 - 2
ISPA KONSTIPASI - J06.9 K59.0 - 2
ISPA HIPERPIREKSIA HERNIA J06.8 R50.9 - 1
AB IMINEN - - O20.0 - - 2
BACTERIAL INFECTION - - A49.9 - - 2
DHF ISPA - A91 J06.9 - 2
BP COW MILK ALLERG - J18.0 T78.1 - 2
APP CRONIS - APENDECTOMY K35.9 - 47.09 2
MULTIPLE VERUCA - MULTIPLE EKSISI BIBIR B07 - 27.43 2
STT SUBMANDIBULA - BIOPSI D37.0 - 83.21 3
SLEEP APNOEA - UVULOPLASTI G47.3 - 27.79 1
CKD HEPATITIS C - N18.9 B17.1 - 1
KDS VIRAL INFEKSI+V - B34.9 E87.1+R56.0+R11 - 1
HERNIA - HERNIOTOMY+HERNIORRHAPLY K40.9 - 53.29 2
TUMOR TYROID - TYROIDECTOMY D34 - 6.39 3
STT - BIOPSI D48.1 - 83.21 1
STT MAMAE - EKSISI D24 - 85.21 3
VIRAL INFECTION ESRD+Anemia TRANFUSI B34.9 N18.0+D64.9 99.03 1
PNH - - D59.5 - - 1
TYPOID FEVER TONSILO FARINGIT - A01 J06.8 - 3
DHF TYPOID FEVER - A91 A01.0 - 1
DM TYPE 2+DKD FATTY LIVER+HHD+ - E11.2K76.0+I13.1+N21.0 - 1
TYPOID FEVER PENGOBATAN TB+ - A01.0 Z92.2+D64.9 - 2
TB PARU DM T2 - A15.0 E11.9 - 2
CHOLELITHIASIS - CHOLECYSTECTOMY + ADHESIOLSIS K80.8
BILIER - 51.22+54.59 1
KPD PARTUS SPONTAN - O80.9 O42.9 - 1
BP - - J18.0 - - 2
ANEMIA MENOMETRORAGI TRANFUSI D64.9 N92.0 99.03 1
GASTRITIS Akut - - K29.1 - - 2
BP TYPOID FEVER - J18.0 A01.0 - 2
RIW SC PARTUS SC SC O34.2 O82.9 74.4 2
SUSP TB PARU - - Z03.0 - - 2
DC AKUT AKI+DYSPEPSIA - I51.9 N17.9+K30 - 1
STRUMA - - E04.9 - - 3
DM T2 HT+DYSPEPSIA+VE - E11.9I10+K30+R42+N39.0 - 2
PLEURAL EFUSI TB PENGOBATAN+ - J90 Z92.2+N18.9 - 3
ESRD ec GLOMERULOPATHY N05.9 N18.9 1
DIARE AKUT DADRS KISTA LIVER+SIROS - A09 K76.8+K76+.1 - 3
STATUS ASMATICUS - - J46 - - 2
FRAKTUR TIBIA MLEINIS MEDIALIS REMOVE IMPLANT S82.4 S82.5 78.67 1
HEMOROID - Anoscopy+hemoroidectomy+Trombectomy
I84.2 - 49.21+49.46+49.47
2
FAM DEX - EKSISI D24 - 85.21 3
BPPV HT H81.1 I10 - - 1
ESRD+HHD ANEMIA TRANFUSI I13.1 D64.9 99.03 1
DADRS - - A09 - - 1
TYPOID FEVER SUSP KP - A01.0 Z03.0 - 2
ANEMIA - TRANFUSI D64.9 - 99.03 2
MENINGOENCEPHALITIS - - G404.2 - - 1
BP - - J18.0 - - 2
KP KTIF HYPOCALACEMIA - A15.0 E83.5 - 1
TYPOID FEVER ENCEPHALOPATY+ TRANFUSI G93.4+D69.6+D61.9+G40.9+J06.9
A01.0 99.03 2
STT A/R OCIPITAL - EKSISI D48.1 - 83.39 2
PIMOSIS - CIRCUMSISI N47 - 6.40 2
STT a/r AXILLA - EKSISI LUAS D48.1 - 83.49 2
PARTUS SPONTAN KPD - O80.9 O42.9 - 2
BBLR - - P03.4 - - 2
UTI NEFROLITHIASIS+ - N39.0 I25.1 - 2
PERDARAHAN POST PARTUM - - O99.4 - - 1
FRAKTUR FINGER - DEBRIDEMENT+ORIF S62.6 - 79.39
TYPOID FEVER GASTRITIS - A01.0 K29.7 - 3
HT LBP+E83.5 - I10 M54.59+E83.5 - 1
ABSES - - L02.9 - - 3
PERDARAHAN ANTEPARTUM ANEMIA TRANFUSI O46.0 D64.9 99.03 2
MORBILI ISPA - B05.9 J06.9 - 1
MORBILI - - B05.9 - - 2
BACTERIAL INFECTION(NEWBORN) NEONATAL HRB - P39.9 P59.9 - 2
VARISES LIGASI VARISES - I86.1 - 38.5 2
PLACENTA PREVIA RIW SC+PARTUS S SC O44.0 O34.2 + O82.9 74.4 1
HT(obg) HYPERTYROID+RIW SC O10.0 E05.9+O34.2 74.4 2
BBLR SC COW MILK ALLERG - P03.4 T78.1 - 2
BENIGN LIPOMATUS - BIOPSI D17.9 - 40.11 2
APP AKUT - APPENDICTOMY K35.9 - - 2
SNTT - TYROIDECTOMY E04.9 - 6.39 2
METATARSAL TULANG(PERBAIKAN KU) - - Z51.5 - - 2
BP - - J18.0 - - 2
DADRS - - A09 - - 2
STROKE INFARK PTOSIS+PARESE N V - I64 H02.4+G83.1 - 1
DYSPEPSIA HYPOCALACEMIA - K30 E83.5 - 1
ASMA BR TYPOID FEVER - J45 A01.0 - 2
BP - - J18 - - 2
HT DG VERTIGO ESRD - I13.1 - - 1
KPD LAHIR SPONTAN - O80.9 O42.9 - 1
STT MANDIBULA - BIOPSI D37.0 - 83.21 3

DADRS - - A09 - - 2
HT HIDRONEFROSIS+N - I10 N13.2+R42 - 3
TYPOID FEVER ANXIETAS - A01.0 F41.9 - 1
DJ STENT IN SITU UTI REMOVE STENT Z96.0 N39.0 59.8 2
BATU URETER UTI URETEROTOMI N20.1 5.62 3
GASTRITIS Akut DM T2+N18.9+I10 - K29.1 E11.2+I10 - 1
DHF - - A91 - - 1
BATU URETER ISK URETEROTOMI N20.1 N39.0 5.62 1
BATU URETER HYDRONEFROSIS
URETEROTOMI+URETER STENTN13.2 - 5.62+97.65 3
OF EC VI - - B34.9 - - 2
BBLR - - P03.9 - - 1
GEA - - A09 - - 2
LONG LABOUR PARTUS SC SC O63.9 O82.9 74.4 3
URTI - - J06.9 - - 1
GASTRITIS Akut - - K29.1 - - 2
DIARE AKUT - - A09 - - 2
GASTRITIS Akut HHD+OA+HEMORO - K29.1I11.9+M19.9+I84.9 - 2
MORBILI - - B05.9 - - 1
FRAKTUR TIBIA OSTEOMYELITIS
DEBRIDEMENT+SEQUESTRECTOMYS82.2 M86.97 79.66+77.07 2
ABSES PERIANAL - DEBRIDEMENT K61.0 - 86.28 3
HEMANGIOMA - EKSISI D18.0 - 86.3 2
STT - EKSISI D48.1 - 83.39 1
HILL DEX HYDROCELEHERNIORHAPY + HYDROCELECTOMYK46.9 N43.3 53.29+63.1 1
CAD UAP+DISPEPSIA+I - I25.1 I20.0+K30+I10 - 1
STROKE INFARK CAD+HHD,DC - I63.9 I25.1+I11.9 - 1
TOMOR MAMAE - EKSISI BREAST D24 - 85.21 2
NEFROLITHIASIS CYSTOCOPY+NEPROTOMY+INSERSI
HYDRONEFROSIS+U N13.2
AF
N20.0+N13.3+N39.0
57.32+55.01+59.8+55.11
2
DADRS TONSILO FARINGIT - A09 J06.8 - 2
PERITONITIS - - K65.0 - - 2
TYPOID FEVER KP AKTIF - A01.0 Z92.8 - 2
TTH HT+ISPA+DISLIPID - G44.2 I10+J06.9+E78.5 - 1
MORBILI - - B05.9 - - 2
GANGLION - EKSISI M67.4 - 83.39 2
MUTRIPLE STT A/R PLANTAR PEDIS - EKSISI D48.1 - 83.39 1
GASTRITIS - - K29.7 - - 2
PERIAPENDICULAR - LAPARATOMY EXPLORATORY+APENDICTOMY
K35.1 - 54.11+47.09 1
DYSPEPSIA - - K30 - - 2
TYPOID FEVER GASTRITIS - A01.0 K29.7 - 2
CYSTA KIDNEY HT - N28.1 I10 - 2
HHD CKD+VERTIGO - I13.1 R42 - 3
HERNIA ADHESI+SEPSIS+S
HERNIORAPHY+HERNIOTOMY+ADHENOLISIS
K04.9 N50.8+A41.9+I6453.9+54.59 3
HT HHD+DC+KP KTIF - I11.9 Z92.8 - 3
HEMOROID INTERNA - - I84.2 - 49.46+49.21+49.47
2
CKD CRONIC GOUT HYDRONEFROSIS N18.9 M10.99+N13.3 - 1
KISTA OVARY ANEMIA PASCA OP SOD+TRANFUSI N83.2 D62 65.49+99.03 1
VESICOLITHISIS NEFROLITHIASIS+CCYSTOCOPY+LITOTRIPSI N21.0 N20.0+N30.957.32+56.0 1
CARDIOMIOPATY ISCHEMIC ULKUS PEDIS+PLE - I42.9E11.5+J90+I48+I51.9 - 1
HCAP CAD+HHD,DC - J18.9 I25.9+I11.9 - 1
RHINITIS PPOK+TB PARU+V - J31.0 J44.9+A15.0+R42 - 2
TB PARU - - A15.0 - - 2
POLIP NASAL SINUSITIS MAXILAR
POLIPECTOMY + FESS J33.9 J32.0 22.9+21.31 1
CDP RIW SC+PARTUS S SC+MOW O33.0 O34.2 + O82.9 74.4 3
SLEEP APNOEA - UVULOPLASTI G47.3 - 27.79 2
STT - EKSISI D48.1 - 83.39 1
MULTIPLE LIPOMA - EKSISI D17.9 - 83.39 3
HCAP (PNEMONIA) HHD+CKD - J18.9 I13.1 - 3
ISPA DYSPEPSIA - J06.9 K30 - 1
MHI - - S09.9 - - 1
TYPOID FEVER FEBRIS - A01.0 R50.9 - 2
DHF - - A91 - - 3
BP - - J18.0 - - 2
HHD,DC DMT2+CKD - I11.9 E11.2 - 2
KISTA OVARY - SOS N83.2 - 65.49 2
HEMOROID ABSES PERIANAL EKSISI HEMOROID I84.2 K61.0 49.46 2
PERIAPENDICULAR - LE+APENDECTOMY+ADHESI K35.1 - 54.11+47.09+54.59
2
CHF ESRD - I13.2 - - 1
PEB PARTUS SC SCTP O14.1 O82.9 74.4 2
HYPOCALCEMIA UTI+VERTIGO - E83.2 N39.0+R42 - 2
MULTIPLE STT - EKSISI D48.1 - 83.39 2
OA LBP+UTI+I10 - M19.9M54.59+N39.0+I10 - 2
HHD HT ST 2+LIPOMA - I11.9 D17.9 1
GEA - - A09 - - 1
PPOK FATTY LIVER+HYP - J44.9 K76.0+E87.6 - 1
CAD UAP+PPOK+DYSPE - I25.1 I20.0+J44.9+K30 - 3
HCAP (PNEMONIA) ESRD - J18.9 Z992.2 - 3
BBL - - P03.4 - - 2
HEG - - O21.0 - - 2
CKD+DMT2 HT+CALCANEUS S - E11.2 I10+M77.3+E16.2 - 3
UTI - - N39.0 - - 2
TYPOID FEVER TB PARU - A01.0 A15.0 - 2
ABSES - - L02.9 - - 2
DADRS TONSILO FARINGI - A09 J06.8 - 2
EPILEPSI FEBRIS - G40.9 R50.9 - 2
SEPSIS PNEMONIA+VOM - A41.9J18.9+R11+N39.0 - 1
HEMOROID EXTERNAL - HEMOROIDECTOMY+ANOSCOPY
I85.5 - 49.46+49.21 2
STT - EKSISI D48.1 - 83.39 2
DR. FITRIYATI STROKE PIS - I61.9 - - 3
BP - - J18.0 - - 2
DYSPEPSIA - - K30 - - 1
ISPA BACTERIAL INF+ - J06.9 A49.9+R56.0 - 2
DYSPEPSIA BRONHITIS+GOUT - K30 J20.9+M10.09 - 1
STT - EKSISI D48.1 - 83.39 2
STT - EKSISI D48.1 - 83.39 1
CKD ESRD - N18.9 - 2
TYPOID FEVER GEA - A01.0 A09 - 2
TONSILO FARINGITIS+VOMITUS - J06.8 - - 2
KEJANG DEMAM - - R56.0 - - 2
DADRS VOMITUS - A09 R11 - 1
VERTIGO PERIPHERAL DM T2 - H81.3 E11.9 - 3
ASMA BR - - J45.9 - - 3
HIPER BILIRUBIN - - P59.9 - - 2
GANGLION - EKSISI GANGLION TANGANM67.4 - 82.21 2
DM T2 CEPHALGIA - E11.9 R51 - 2
CAD HHD,DC+BURGER - I25.1 I11.9+I73.1 - 1
UTI COLIK ABD - N39.0 R10.4 - 2
VARISELA ZOSTER - B01.9 - 2
CHEST PAIN - - R07.4 - - 1
MIELITIS TB - - A17.8+G05.0 - - 3
DM T2 GERIATRI SYND - E11.9 R54 - 3
PENURUNAN KESADARAN - - R55 - - 3
TYPOID FEVER DF+DMT2+DKD - A01.0 A90+E11.2 - 1
TONSILITIS AKUT SUSP TB - J03.9 A15.0 - 1

COLIC ABD - - R10.4 - - 1
FAM - BIOPSI N61 - 85.12 2
UTI HYPOCALCEMIA+U - N39.0 E83.5 J06.9 2
OBS. FEBRIS - - R50.9 - - 2
BRONKHITIS AKUT - - J20.9 - - 1
PERITONSILAR ABSES ABSES SUBMANDI - J36 K12.2 - 2
DILI HEP C - K71.8 B17.1 - 2
DADRS NON - - A09 - - 2
ASTIGMA MYOPI PARTUS SC SC H52.2 O82.9 74.4 2
BATU URETER URETHAL MEATOTOMY N20.1 5.81 2
SNNT - ISHMULOBECTOMY E04.9 - 6.31 2
STT - EKSISI D48.7 - 83.39 2
BP SUSP TB - J18.0 Z03.0 - 2
VIRAL INFEKSI ANEMIA - B34.9 D50.9 - 1
HHD+DC DYSPEPSIA - I11.9 K30 - 1
VIRAL INFEKSI DRUG ERUPTION - B34.9 T88.7 - 1
DIARE AKUT HEPATITIS B - A09 B16.9 - 3
ISPA HIPERPIREKSIA - J06.9 R50.9 - 2
STT - EKSISI D24 - 85.21 2
ASMA BR - - J45 - - 1
DADRS DIAPER RUSH - A09 L22 - 2
HCAP ESRD+SVT - J18.9 Z92.2+I47.1 - 2
GASTRITIS MORBILLI - K29.1 B05.9 - 2
STROK PIS ESRD - I61.9 Z92.2 - 1
10,057,725.00 4,814,100.00 8,859,825 dr. MR. Kurnia, Sp.PD

7,280,325.00 1,862,100.00 3,872,025 dr. Pitrajaya, SP.B
5,028,443.00 7,145,700.00 4,830,943 dr. Djoko, SP.B
2,098,737.00 2,774,500.00 1,847,737 dr. Paramita, SP.A
3,938,860.00 2,827,100.00 3,418,860 dr. Paramita, SP.A
3,686,646.00 3,335,500.00 2,804,646 dr. Miftah, Sp.Pd
3,315,607.00 3,329,400.00 3,065,607 dr. ACHMAD BARUNA, SP.PD
4,460,800.00 2,328,600.00 3,492,491 dr. Sarjunas, Sp.OG
2,462,470.00 5,004,900.00 1,889,470 dr. Paramita, SP.A
18,690,827.00 3,450,900.00 9,506,327 DR. RENNY, SP.U
2,994,494.00 2,423,100.00 2,603,494 dr. MR. Kurnia, Sp.PD
4,270,902.00 3,264,200.00 2,735,802 dr. Raden Bayu, Sp. Jp
5,472,208.00 4,170,900.00 4,330,808 dr. Bayu, SP.JP
3,971,910.00 3,962,200.00 3,497,910 dr. Paramita, SP.A
1,891,702.00 3,329,400.00 1,431,202 DR. DEDE LIA, SP.A
7,328,463.00 5,007,300.00 6,472,463 dr. Miftah, Sp.Pd
23,293,501.00 11,709,700.00 13,822,501 DR. RENNY, SP.U
8,879,761.00 2,121,400.00 5,501,961 DR. RICHARD, SP.THT
7,908,774.00 6,118,200.00 4,453,474 dr. Djoko, SP.B
9,202,055.00 5845600 4,732,755 dr. Maulia, Sp.OG
3,884,300.00 3,884,300.00 3,884,300 dr. Miftah, Sp.Pd
6,731,754.00 5,845,600.00 3,531,454 dr. Pitrajaya, SP.B
15,457,460.00 5,631,000.00 9,665,020 dr. Maulia, Sp.OG
7,255,765.00 2,331,500.00 6,513,265 dr. Miftah, Sp.Pd
5,836,160.00 2,331,500.00 5,171,160 dr. Miftah, Sp.Pd
2,178,070.00 1,861,600.00 1,432,070 dr. Miftah, Sp.Pd
3,976,017.00 4,906,600.00 3,274,017 dr. Paramita, SP.A
1,945,053.00 1,524,100.00 1,627,053 dr. Paramita, SP.A
3,010,299.00 9,269,700.00 2,444,299 dr. Paramita, SP.A
23,583,835.00 6,285,700.00 21,773,335 dr. Miftah, Sp.Pd
19,980,710.00 3,433,200.00 10,891,210 DR. RENNY, SP.U
12,998,773.00 3,548,000.00 6,287,273 dr. Ghuna, Sp.OT
7,854,720.00 5,845,600.00 4,512,920 dr. Djoko, SP.B
21,381,039.00 12,767,000.00 11,907,039 dr. Ghuna, Sp.OT
8,635,181.00 6,150,800.00 5,156,181 dr. Djoko, SP.B
3,138,519.00 2,423,100.00 2,706,019 dr. Miftah, Sp.Pd
5,658,805.00 2,133,800.00 4,353,305 DR. ZUHAIRA, SP.S
3,653,235.00 2,173,300.00 2,967,735 dr. Paramita, SP.A
3,599,270.00 4,146,900.00 3,349,270 dr. MR. Kurnia, Sp.PD
5,798,980.00 2,674,000.00 5,214,480 dr. Paramita, SP.A
2,363,733.00 2,423,100.00 1,826,733 dr. Paramita, SP.A
9,473,724.00 4,826,600.00 7,320,224 dr. Sarjunas, Sp.OG
1,691,491.00 1,995,800.00 903,491 dr. Paramita, SP.A
16,216,785.00 6,327,300.00 10,883,285 dr. Sarjunas, Sp.OG
7,505,158.00 1,857,000.00 4,179,858 dr. Pitrajaya, SP.B
3,123,469.00 4,996,100.00 2,553,969 dr. Paramita, SP.A
4,826,600.00 4826600 4,826,600 dr. Maulia, Sp.OG
1,590,440.00 1,995,800.00 1,590,440 dr. Paramita, SP.A
4,743,400.00 3,258,400.00 4,743,400 dr. MR. Kurnia, Sp.PD
14,141,308.00 10,090,500.00 10,870,808 DR. YUDI, SP. U
14,016,433.00 10,090,500.00 10,693,433 DR. YUDI, SP. U
11,590,312.00 6,118,200.00 7,961,812 dr. Djoko, SP.B
2,629,494.00 3,892,700.00 2,111,994 dr. Pitrajaya, SP.B
3,035,154.00 3,329,400.00 2,561,154 dr. Paramita, SP.A
4,636,631.00 3,891,400.00 4,012,631 dr. Paramita, SP.A
8,348,496.00 4438400 6,753,496 dr. Sarjunas, Sp.OG
5,475,161.00 6,116,900.00 1,944,961 DR. DEASY, SP.P
4,806,139.00 2,331,600.00 4,218,639 DR. MIFTAH, SP.PD
9,188,388.00 3,473,800.00 8,988,388 DR. ZUHAIRA, SP.S
3,372,255.00 5,004,900.00 2,981,255 dr. Miftah, Sp.Pd
12,291,849.00 6,327,300.00 7,277,999 dr. Sarjunas, Sp.OG
4,865,096.00 4,865,100.00 4,865,096 dr. Paramita, SP.A
2,875,000.00 2,875,000.00 2,875,000 DR. RENNY, SP.U
1,502,787.00 2,774,500.00 1,302,787 dr. Paramita, SP.A
1,784,725.00 1,524,100.00 1,533,725 dr. Paramita, SP.A
1,908,450.00 3,335,500.00 1,630,950 dr. Paramita, SP.A
2,071,842.00 4,170,100.00 1,752,842 dr. Paramita, SP.A
2,211,930.00 1,778,800.00 1,926,930 dr. Paramita, SP.A
2,560,401.00 3,329,400.00 2,163,901 dr. Paramita, SP.A
4,630,972.00 4,996,100.00 3,818,972 dr. Paramita, SP.A
6,313,410.00 3,279,100.00 4,068,910 dr. NUNUNG, SP.OG
16,269,919.00 11,421,000.00 12,900,419 DR. YUDI, SP. U
12,536,182.00 5,631,000.00 8,052,682
19,398,557.00 5,361,600.00 10,458,557 DR. YUDI, SP. U
3,884,300.00 3,883,400.00 3,884,300 DR. DEDE LIA, SP.A
3,367,154.00 3,884,300.00 2,956,154 dr. Paramita, SP.A
4,206,988.00 2,832,400.00 3,787,988 dr. Paramita, SP.A
4,110,341.00 3,884,300.00 2,890,841 dr. Miftah, Sp.Pd
3,813,901.00 2,732,600.00 2,279,901 dr. Maulia, Sp.OG
2,186,100.00 2,168,100.00 2,186,100 DR. ADE, SP.S
11,070,076.00 5,272,800.00 7,361,126 dr. Sarjunas, Sp.OG
2,974,278.00 5,004,900.00 2,234,278 DR. DEASY, SP.P
4,260,638.00 2,331,600.00 3,786,638 DR. MIFTAH, SP.PD
4,732,168.00 3,279,100.00 2,529,168 dr. Sarjunas, Sp.OG
7,572,726.00 3,825,600.00 3,949,726 dr. Maulia, Sp.OG
5,258,966.00 3,279,100.00 3,097,466 dr. Maulia, Sp.OG
8,183,760.00 6,118,200.00 4,894,460 dr. Pitrajaya, SP.B
7,670,810.00 6,118,200.00 4,417,510 dr. Pitrajaya, SP.B
13,010,050.00 3,985,400.00 7,816,250 dr. Pitrajaya, SP.B
8,020,440.00 4,345,900.00 4,637,140 dr. Pitrajaya, SP.B
8,126,346.00 5,845,600.00 4,873,046 dr. Pitrajaya, SP.B
8,725,028.00 4,170,100.00 7,782,028 DR. DEASY, SP.P
3,449,094.00 3,865,000.00 2,913,994 DR. MEDIA, SP.S
1,364,862.00 2,331,600.00 1,164,862 DR. DEDE LIA, SP.A
2,272,250.00 1,552,400.00 1,974,250 dr. Paramita, SP.A
2,983,210.00 3,329,400.00 2,983,210 dr. Paramita, SP.A
2,994,587.00 2,490,300.00 2,635,587 dr. Paramita, SP.A
8,885,789.00 4,826,600.00 6,773,789 dr. Maulia, Sp.OG

9,647,870.00 4,826,600.00 7,244,870 dr. Maulia, Sp.OG
1,226,627.00 1,995,800.00 726,627 dr. Paramita, SP.A
5,096,939.00 5,860,100.00 4,846,939 DR. DEASY, SP.P
4,942,797.00 3,236,300.00 4,516,697 dr. MR. Kurnia, Sp.PD
4,625,648.00 5,179,100.00 3,662,548 dr. MR. Kurnia, Sp.PD
9,963,891.00 4,826,600.00 7,810,391 dr. NUNUNG, SP.OG
1,739,002.00 1,995,800.00 951,002 dr. Paramita, SP.A
4,569,334.00 4,190,800.00 4,203,334 dr. Paramita, SP.A
11,693,514.00 4,283,900.00 8,137,014 dr. Pitrajaya, SP.B
11,409,667.00 9,643,500.00 5,191,667 dr. Djoko, SP.B
7,605,316.00 5,845,600.00 4,299,516 dr. Djoko, SP.B
6,648,643.00 3,883,500.00 6,021,943 dr. MR. Kurnia, Sp.PD
2,022,670.00 1,829,000.00 1,698,170 DR. DEDE LIA, SP.A
3,030,210.00 2,133,800.00 2,562,210 DR. DEDE LIA, SP.A
1,616,445.00 1,677,400.00 1,314,745 dr. Maulia, Sp.OG
2,255,756.00 3,329,400.00 1,931,256 dr. Paramita, SP.A
4,003,653.00 2,331,600.00 3,637,653 dr. Paramita, SP.A
2,076,167.00 4,170,100.00 1,755,167 dr. Paramita, SP.A
9,003,220.00 3,416,000.00 5,470,420 dr. Djoko, SP.B
7,130,691.00 4,861,600.00 3,841,391 dr. Pitrajaya, SP.B
6,930,670.00 1,556,400.00 4,371,870 dr. Pitrajaya, SP.B
10,064,106.00 5,671,900.00 4,745,106 DR. RICHARD, SP.THT
2,462,734.00 2,720,200.00 1,811,734 dr. Paramita, SP.A
13,235,737.00 4,283,900.00 7,801,737 dr. Djoko, SP.B
9,588,666.00 4,789,900.00 7,143,666 dr. Djoko, SP.B
9,174,267.00 2,166,600.00 4,238,467 dr. Pitrajaya, SP.B
6,342,712.00 5,098,500.00 3,749,912 dr. Pitrajaya, SP.B
7,652,801.00 3,257,200.00 1,997,420 dr. MR. Kurnia, Sp.PD
2,719,980.00 2,774,500.00 2,434,980 dr. Paramita, SP.A
4,655,250.00 3,965,400.00 4,189,750 dr. Paramita, SP.A
5,065,934.00 5,004,900.00 4,450,434 DR. DEASY, SP.P
13,828,494.00 7,561,400.00 8,189,994 dr. Djoko, SP.B
7,996,033.00 3,569,900.00 5,370,233 dr. Pitrajaya, SP.B
11,177,763.00 4,997,900.00 6,244,463 dr. Pitrajaya, SP.B
4,062,776.00 2,819,100.00 2,821,776 dr. Maulia, Sp.OG
4,366,128.00 4,170,100.00 3,801,128 dr. Paramita, SP.A

6,020,151.00 2,172,900.00 6,020,151 dr. MR. Kurnia, Sp.PD
3,323,091.00 1,861,600.00 2,834,991 DR. MIFTAH, SP.PD
2,823,626.00 9,699,100.00 2,390,626 dr. Paramita, SP.A
9,180,300.00 3,569,900.00 6,488,500 dr. Pitrajaya, SP.B
9,096,007.00 4,826,600.00 7,053,007 dr. NUNUNG, SP.OG
1,884,513.00 5,004,900.00 1,392,513 DR. DEDE LIA, SP.A
6,949,705.00 9,086,800.00 6,273,705 dr. MR. Kurnia, Sp.PD
3,499,502.00 2,091,100.00 3,082,502 dr. MR. Kurnia, Sp.PD
3,501,639.00 4,490,000.00 3,301,639 DR. DEASY, SP.P
18,651,826.00 2,820,700.00 17,924,726 DR. MIFTAH, SP.PD
5,340,052.00 3,329,400.00 4,855,052 dr. Paramita, SP.A
8,699,720.00 1,862,800.00 6,543,220 dr. Paramita, SP.A
13,335,460.00 4,139,400.00 5,519,460 dr. Ghuna, Sp.OT
10,163,779.00 4,283,900.00 6,701,279 dr. Pitrajaya, SP.B
9,433,481.00 5,225,100.00 5,857,481 dr. Djoko, SP.B
6,432,152.00 5,098,500.00 3,820,852 dr. Djoko, SP.B
2,905,500.00 2,168,100.00 2,905,500 DR. MIFTAH, SP.PD
11,581,771.00 4,530,800.00 10,695,271 DR. MIFTAH, SP.PD
1,877,406.00 3,329,400.00 1,704,406 dr. Paramita, SP.A
2,992,324.00 2,827,100.00 2,578,824 dr. Paramita, SP.A
3,682,013.00 3,329,400.00 3,280,013 dr. Paramita, SP.A
2,692,160.00 1,862,500.00 2,378,660 dr. MR. Kurnia, Sp.PD
5,273,985.00 3,258,400.00 4,559,485 DR. MIFTAH, SP.PD
2,195,451.00 4,170,100.00 1,736,451 dr. Paramita, SP.A
6,519,179.00 6,976,000.00 5,798,679 dr. MR. Kurnia, Sp.PD
9,598,663.00 4,906,600.00 8,068,663 DR. DEDE LIA, SP.A
7,965,073.00 5,845,600.00 4,623,273 dr. Djoko, SP.B
4,288,882.00 1,455,200.00 4,032,882 dr. Djoko, SP.B
9,466,779.00 5,845,600.00 6,004,279 dr. Djoko, SP.B
3,222,821.00 2,416,400.00 2,574,821 dr. Sarjunas, Sp.OG
3,132,716.00 1,995,800.00 2,361,716 dr. Paramita, SP.A
7,277,867.00 2,919,500.00 6,192,467 dr. Maulia, Sp.OG
8,797,000.00 8,797,700.00 8,797,000 dr. Ghuna, Sp.OT
2,355,879.00 2,774,500.00 2,069,879 dr. Paramita, SP.A
4,924,178.00 6,241,150.00 3,228,178 dr. MR. Kurnia, Sp.PD
4,110,817.00 3,346,300.00 3,791,817 dr. Sarjunas, Sp.OG
3,238,433.00 2,720,200.00 2,796,433 dr. Paramita, SP.A
3,980,417.00 3,884,300.00 3,460,417 DR. DEDE LIA, SP.A
2,969,914.00 2,331,600.00 2,719,914 DR. DEDE LIA, SP.A
6,477,082.00 2,351,500.00 6,047,582 dr. Paramita, SP.A
8,479,233.00 4,595,600.00 5,112,433 dr. Djoko, SP.B
11,281,478.00 5,631,000.00 7,590,478 dr. NUNUNG, SP.OG
11,205,182.00 5,326,100.00 8,830,082 dr. Sarjunas, Sp.OG
1,241,187.00 1,995,800.00 599,687 dr. Paramita, SP.A
7,129,961.00 4,242,600.00 3,876,661 dr. Pitrajaya, SP.B
10,414,079.00 3,416,000.00 7,083,279 dr. Pitrajaya, SP.B
14,784,693.00 5,747,900.00 10,436,693 dr. Pitrajaya, SP.B
5,155,758.00 3,279,100.00 2,952,758 dr. Sarjunas, Sp.OG
1,898,712.00 1,399,400.00 1,615,712 dr. Pitrajaya, SP.B
2,538,192.00 4,170,100.00 2,423,692 dr. Paramita, SP.A
1,935,397.00 2,423,100.00 1,610,897 dr. Paramita, SP.A
5,980,164.00 3,296,100.00 4,820,164 DR. ZUHAIRA, SP.S
2,797,810.00 5,837,000.00 1,861,310 dr. MR. Kurnia, Sp.PD
4,129,029.00 2,706,900.00 3,459,029 dr. Paramita, SP.A
5,139,931.00 4,170,100.00 4,542,431 dr. Paramita, SP.A
2,875,000.00 2,716,700.00 2,875,000 dr. MR. Kurnia, Sp.PD
4,159,790.00 2,819,100.00 3,489,290 dr. Maulia, Sp.OG
6,992,298.00 1,556,400.00 3,979,978 dr. Pitrajaya, SP.B

1,706,605.00 2,774,500.00 1,454,605 dr. Paramita, SP.A
2,130,405.00 2,423,100.00 1,764,405 dr. Paramita, SP.A
17,001,917.00 2,942,600.00 11,558,417 DR. YUDI, SP. U
14,334,097.00 10,090,500.00 11,097,597 DR. YUDI, SP. U
4,990,211.00 2,720,200.00 3,437,711 dr. MR. Kurnia, Sp.PD
20,812,835.00 14,126,800.00 11,796,335 DR. YUDI, SP. U
14,368,220.00 10,090,500.00 11,079,220 DR. YUDI, SP. U
2,486,589.00 2,331,600.00 2,167,589 dr. MR. Kurnia, Sp.PD
6,573,101.00 2,328,400.00 2,517,912 dr. Paramita, SP.A
2,991,912.00 2,423,100.00 6,134,101 dr. MR. Kurnia, Sp.PD
8,125,850.00 4,022,100.00 5,982,350 dr. Sarjunas, Sp.OG
2,720,200.00 2,133,800.00 2,083,927 dr. MR. Kurnia, Sp.PD
3,884,300.00 3,884,300.00 3,884,300 dr. MR. Kurnia, Sp.PD
2,233,650.00 2,423,100.00 1,873,150 DR. YURIKA, SP.A
2,749,162.00 2,720,200.00 2,593,662 DR. YURIKA, SP.A
13,973,948.00 13,724,000.00 7,549,448 dr. Ghuna, Sp.OT
7,905,600.00 2,779,600.00 5,484,100 dr. Pitrajaya, SP.B
10,505,746.00 3,929,100.00 6,434,391 dr. Pitrajaya, SP.B
9,891,827.00 6,819,800.00 4,097,027 dr. Djoko, SP.B
13,099,284.00 4,997,900.00 7,517,784 dr. Djoko, SP.B
4,170,900.00 4,170,900.00 3,264,200 dr. Raden Bayu, Sp. Jp
8,057,515.00 6,118,200.00 4,602,215 dr. Djoko, SP.B
23,920,132.00 12,108,700.00 18,061,132 DR. RENNY, SP.U
3,572,723.00 2,423,100.00 2,894,223 dr. Paramita, SP.A
6,119,894.00 3,329,400.00 5,551,894 DR. YURIKA, SP.A
3,045,624.00 2,330,800.00 2,732,124 dr. Djoko, SP.B
4,348,382.00 3,329,400.00 3,182,382 dr. Paramita, SP.A
2,616,772.00 2,176,900.00 1,278,772 DR. MIFTAH, SP.PD
2,153,623.00 2,331,600.00 1,834,623 dr. Paramita, SP.A
8,686,482.00 5,845,600.00 5,361,182 dr. Pitrajaya, SP.B
8,890,532.00 6,819,800.00 3,663,232 dr. Djoko, SP.B
13,403,522.00 7,947,700.00 7,437,522 dr. Pitrajaya, SP.B
2,646,061.00 3,335,500.00 1,872,061 dr. Paramita, SP.A
3,258,029.00 3,329,400.00 2,484,029 dr. Paramita, SP.A
14,741,096.00 16,218,400.00 11,754,096 dr. Djoko, SP.B
15,243,985.00 3,183,700.00 15,043,985 dr. MR. Kurnia, Sp.PD
8,607,865.00 5,225,100.00 5,015,365 dr. Djoko, SP.B
22,413,124.00 10,422,500.00 13,545,624 dr. Maulia, Sp.OG
21,312,594.00 8,641,400.00 12,228,494 DR. RENNY, SP.U
4,170,900.00 4,865,100.00 4,170,900 DR. RIEN, SP.JP
8,766,295.00 5,004,900.00 8,012,795 DR. DEASY, SP.P
12,166,549.00 5,381,100.00 6,848,049 DR. RICHARD, SP.THT
9,426,598.00 4,022,100.00 7,831,998 dr. Sarjunas, Sp.OG
8,555,111.00 4,861,600.00 5,076,111 DR. RICHARD, SP.THT
11,419,724.00 6,819,800.00 6,243,924 dr. Djoko, SP.B
7,350,482.00 4,871,300.00 5,126,982 dr. Pitrajaya, SP.B
5,022,345.00 3,884,300.00 3,884,300 dr. Paramita, SP.A
2,694,032.00 2,133,800.00 2,133,800 DR. DEDE LIA, SP.A
4,332,066.00 3,892,700.00 3,902,066 dr. Pitrajaya, SP.B
2,724,348.00 3,329,400.00 2,327,848 dr. MR. Kurnia, Sp.PD
3,421,352.00 1,943,000.00 2,903,352 dr. MR. Kurnia, Sp.PD
2,940,617.00 4,170,100.00 1,995,617 DR. DEDE LIA, SP.A
12,480,252.00 6,327,300.00 7,420,752 dr. Sarjunas, Sp.OG
10,937,859.00 7,036,800.00 7,273,359 dr. Pitrajaya, SP.B
9,816,002.00 6,812,300.00 6,223,502 dr. Djoko, SP.B
3,180,556.00 5,338,800.00 3,289,056 dr. MR. Kurnia, Sp.PD
9,389,945.00 4,826,600.00 7,097,845 dr. Paramita, SP.A
3,905,959.00 3,107,400.00 3,534,559 dr. MR. Kurnia, Sp.PD
7,421,860.00 5,845,600.00 4,116,060 dr. Djoko, SP.B
3,939,767.00 3,734,400.00 3,543,267 dr. MR. Kurnia, Sp.PD
1,568,149.00 2,331,600.00 1,568,149 DR. YURIKA, SP.A
4,534,369.00 4,457,100.00 4,534,369 DR. MIFTAH, SP.PD
2,827,100.00 2,827,100.00 2,827,100 DR. MIFTAH, SP.PD
10,059,155.00 2,979,200.00 9,315,955 DR. MIFTAH, SP.PD
1,306,473.00 2,351,500.00 9,118,473 dr. Paramita, SP.A
3,348,909.00 2,502,400.00 3,065,909 dr. Maulia, Sp.OG
2,192,600.00 1,860,600.00 1,832,100 dr. MR. Kurnia, Sp.PD
7,026,140.00 3,329,400.00 6,469,140 dr. Paramita, SP.A
2,097,148.00 2,800,400.00 1,778,148 dr. Paramita, SP.A
2,511,075.00 2,423,100.00 2,150,575 dr. Paramita, SP.A
2,085,181.00 1,859,300.00 1,843,681 DR. ZUHAIRA, SP.S
4,592,937.00 4,578,400.00 4,230,937 dr. Paramita, SP.A
1,599,340.00 2,423,100.00 1,216,340 DR. YURIKA, SP.A
7,411,641.00 5,225,100.00 3,992,341 dr. Djoko, SP.B
8,163,343.00 5,845,600.00 4,744,043 dr. Djoko, SP.B
1,965,506.00 2,164,000.00 990,506 DR. FITRIYATI
2,449,712.00 4,170,100.00 1,721,712 dr. Paramita, SP.A
2,314,539.00 2,134,600.00 1,540,539 dr. Paramita, SP.A 326 JUWITA DE
7,524,647.00 3,891,400.00 6,193,647 DR. MIFTAH, SP.PD
7,635,898.00 5,845,600.00 4,294,098 dr. Djoko, SP.B
7,461,851.00 5,845,600.00 4,120,051 dr. Djoko, SP.B
1,611,991.00 1,829,000.00 1,292,991 dr. Paramita, SP.A
4,519,649.00 3,884,300.00 2,225,649 DR. MIFTAH, SP.PD
3,337,642.00 1,859,300.00 2,427,642 dr. Paramita, SP.A
2,731,262.00 2,827,100.00 2,320,262 dr. Paramita, SP.A
2,651,669.00 1,548,700.00 2,341,669 DR. ZUHAIRA, SP.S
1,608,306.00 1,552,400.00 1,293,306 DR. DEDE LIA, SP.A
3,303,499.00 3,329,400.00 533,521 dr. MR. Kurnia, Sp.PD
1,900,531.00 2,423,100.00 1,481,531 DR. YURIKA, SP.A
2,129,058.00 2,351,500.00 1,804,558 dr. Paramita, SP.A
10,199,982.00 6,233,600.00 4,973,482 dr. Pitrajaya, SP.B
2,331,500.00 2,331,500.00 2,331,500 DR. ZUHAIRA, SP.S
3,335,500.00 1,860,600.00 3,335,500 dr. MR. Kurnia, Sp.PD
4,289,344.00 4,797,900.00 3,838,344 DR. ZUHAIRA, SP.S
1,039,787.00 1,942,900.00 926,787.00 DR. DWIANA
1,153,799.00 4,282,900.00 1,040,799.00 DR. DWIANA
4,996,100.00 4,996,100.00 5,352,826.00 dr. ACHMAD BARUNA, SP.PD
2,284,078.00 2,490,300.00 dr. Paramita, SP.A

2,981,133.00 2,827,100.00 dr. MR. Kurnia, Sp.PD
7,832,923.00 6,118,200.00 dr. Pitrajaya, SP.B
2,136,246.00 3,329,400.00 dr. Paramita, SP.A
4,148,485.00 2,787,800.00 dr. MR. Kurnia, Sp.PD
1,542,804.00 1,868,300.00 dr. MR. Kurnia, Sp.PD
2,168,400.00 2,168,400.00 DR. DEDE LIA, SP.A
3,379,489.00 2,134,600.00 DR. RICHARD, SP.THT
5,864,719.00 4,238,500.00 DR.R ACHMAD, SP.PD
1,915,302.00 2,423,100.00 dr. Paramita, SP.A
9,163,097.00 4,826,600.00 DR. SARJUNAS, SP.OG
2,827,100.00 2,827,100.00 DR.R ACHMAD, SP.PD
17,328,433.00 7,406,900.00 DR. YUDI, SP.U
15,001,035.00 5,747,900.00 dr. Pitrajaya, SP.B
7,086,810.00 5,845,600.00 DR. DJOKO, SP.B
2,142,229.00 4,170,100.00 dr. Paramita, SP.A
7,638,387.00 3,257,200.00 DR. MIFTAH, SP.PD
4,233,823.00 4,457,100.00 DR.R ACHMAD, SP.PD
3,145,053.00 3,257,200.00 DR.R ACHMAD, SP.PD
2,685,255.00 3,326,100.00 DR.R ACHMAD, SP.PD
2,304,292.00 1,829,000.00 DR. DEDE LIA, SP.A
7,990,049.00 6,118,200.00 DR. DJOKO, SP.B
5,127,336.00 2,173,300.00 dr. Paramita, SP.A
2,315,407.00 2,423,100.00 DR. DEDE LIA, SP.A
26,747,995.00 5,860,100.00 DR.R ACHMAD, SP.PD
3,711,245.00 3,329,400.00 dr. Paramita, SP.A
2,847,474.00 1,861,600.00 dr. Paramita, SP.A
3,108,605.00 3,884,300.00 dr. Paramita, SP.A
59,999,976.00 3,029,700.00 DR. ADE, SP.S
410364
APS
HARI
NO NAMA PASIEN NO. MR Tanggal Masuk Tanggal Keluar PERAWATAN
1 DEVI KANIA 385842 28-Sep-15 01-Oct-15 4

2 RIZKY DWI ARYA 410345 28-Sep-15 01-Oct-15 4
3 M NUR FIRDAUS 350642 29-Sep-15 01-Oct-15 3
4 BAYU NUGRAHA 410391 29-Sep-15 01-Oct-15 3
5 M ARFA JATNIKA 410340 28-Sep-15 01-Oct-15 4
6 ROBIAH 389707 28-Sep-15 01-Oct-15 4
7 ROSADI MULYA 410325 28-Sep-15 01-Oct-15 4
8 WIWIT SULASTRI 410026 28-Sep-15 01-Oct-15 4
9 ALIEFTA JANATHAN 410333 28-Sep-15 01-Oct-15 4
10 M KODRAT 410282 28-Sep-15 01-Oct-15 4
11 TITI S 410234 30-Sep-15 01-Oct-15 2
12 SITI ROPIAH 410100 30-Sep-15 01-Oct-15 2
13 PANDI SETIA 378546 29-Sep-15 01-Oct-15 3
14 LIS MARDIANA, NY 330879 30-Sep-15 01-Oct-15 2
15 RIWEN 409101 28-Sep-15 02-Oct-15 5
16 NENENG HADIATI 390865 01-Oct-15 02-Oct-15 2
17 ROSANTIKA MELIATI 410338 28-Sep-15 02-Oct-15 5
18 NADIN ZAHRA 410422 29-Sep-15 02-Oct-15 4
19 ZAENAL ARIFIN 376718 26-Sep-15 02-Oct-15 7
20 NURJANAH 389932 01-Oct-15 02-Oct-15 2
21 DEDEN ROHIMAT 410408 01-Oct-15 02-Oct-15 2
22 SHANTI MULYANTI 410302 01-Oct-15 02-Oct-15 2
23 M SALMAN 410444 01-Oct-15 02-Oct-15 2
24 TAIL MUTAIL 403170 27-Sep-15 02-Oct-15 6
25 ROKAYAH 356478 01-Oct-15 02-Oct-15 2
26 MAMAN SUHERMAN 410341 28-Sep-15 02-Oct-15 8
27 SITI ALIYAH 409173 29-Sep-15 03-Oct-15 5
28 SYIFA NURFAUZIAH 410210 02-Oct-15 03-Oct-15 2
29 T. MUFIZAR 403569 28-Sep-15 03-Oct-15 6
30 KHAIRUNISA ABIDIN 410475 30-Sep-15 03-Oct-15 4
31 FITRI YULIANTI 407317 26-Sep-15 03-Oct-15 8
32 KIKI INDRA RUKMANA 410243 02-Oct-15 03-Oct-15 2
33 NINA HERLINA 410191 01-Oct-15 03-Oct-15 3
34 DADAN RAMDANI 383221 30-Sep-15 03-Oct-15 4
35 MURAD 408929 30-Sep-15 03-Oct-15 4
36 DANIEL TAMPUBOLAN 395522 01-Oct-15 03-Oct-15 2
37 ENDAT DARSIM 354025 01-Oct-15 03-Oct-15 3
38 JAENAH 410578 02-Oct-15 04-Oct-15 3
39 M NAJIB 410431 30-Sep-15 04-Oct-15 5
40 ALFIE PRANAJA 409233 01-Oct-15 04-Oct-15 4
41 MARYATI 409458 03-Oct-15 04-Oct-15 2
42 WINA INDRIYANI 410465 30-Sep-15 04-Oct-15 5
43 HENI SUHAENI 368042 29-Sep-15 04-Oct-15 6
44 RIKA RAHAYU, NY 404396 02-Oct-15 04-Oct-15 3
45 RIKA RAHAYU, BY/ ADIVA EL, BY 410573 02-Oct-15 04-Oct-15 3
46 YULIS TSALASIH, NY 376884 01-Oct-15 04-Oct-15 4
47 YULIS TSALASIH, BY 410574 02-Oct-15 04-Oct-15 3
48 YUYUN YULIANAH, NY 353351 01-Oct-15 04-Oct-15 4
49 YUYUN YULIANAH, BY 410529 01-Oct-15 04-Oct-15 4
50 KAMILA APRILIA 410480 01-Oct-15 05-Oct-15 5
51 NURAZIZAH KANCANA 410541 02-Oct-15 05-Oct-15 4
52 REYHAN FATHUR 378110 02-Oct-15 05-Oct-15 4
53 SITI SAADAH 410515 01-Oct-15 05-Oct-15 5
54 FAKHIRA HALWA 382854 03-Oct-15 05-Oct-15 3
55 M.A. RASYKUL RAFIF 408738 30-Sep-15 05-Oct-15 6
56 ISMAN NATADIPURA 356184 02-Oct-15 05-Oct-15 4
57 GITA ROSA 409249 29-Sep-15 05-Oct-15 7
58 TRI BUDIYANTO 388488 01-Oct-15 05-Oct-15 5
59 UWAS 410046 29-Sep-15 05-Oct-15 7
60 IHA SOLIHA 409974 02-Oct-15 05-Oct-15 4
61 RIAN RUSMANA 410531 02-Oct-15 05-Oct-15 4
62 DZAKY NESTA ABIDZAR 408477 04-Oct-15 06-Oct-15 3
63 NADIYYA KHOERUNISA 357836 03-Oct-15 06-Oct-15 4
64 REFALINA HIDAYAH 410639 04-Oct-15 06-Oct-15 3
65 ZILFA S 384390 03-Oct-15 06-Oct-15 4
66 INA YULI NINGSIH 410641 04-Oct-15 06-Oct-15 3
67 SAID MUNANDAR 403509 03-Oct-15 06-Oct-15 4
68 SYIFA IRMAYANTI 333652 29-Sep-15 06-Oct-15 8
69 ARSAKA AL FATHI 388717 03-Oct-15 06-Oct-15 4
70 YANI MULYANI 410555 02-Oct-15 06-Oct-15 5
71 FAKHIRA KAMILA F 351508 11-Oct-15 13-Oct-15 3
72 M NIJAM 393668 01-Oct-15 07-Oct-15 7
73 ATFATUL SYAHLA 356061 05-Oct-15 07-Oct-15 3
74 SHIDQIYAH JULIANTI 384183 05-Oct-15 07-Oct-15 3
75 M FERDIANSYAH 389332 05-Oct-15 07-Oct-15 3
76 MIRNA NURBAETI 410721 06-Oct-15 07-Oct-15 2
77 YUNITA ZAENAL 410716 05-Oct-15 07-Oct-15 3
78 WINDA RAHAYU 410624 03-Oct-15 07-Oct-15 5
79 WULAN AGUSTINA 410687 06-Oct-15 07-Oct-15 2
80 NAGHIF VIBI 407627 05-Oct-15 07-Oct-15 3
81 JIHAN SEPTIANI 368890 06-Oct-15 07-Oct-15 2
82 H MAHMUDIN 408002 04-Oct-15 07-Oct-15 4
83 EDI SUPRIADI 410328 28-Sep-15 07-Oct-15 10
84 M KHADINDA KHUMAR 410516 06-Oct-15 07-Oct-15 2
85 UMINAH 408977 02-Oct-15 07-Oct-15 6
86 AKMAL AULIA YAZID 342031 03-Oct-15 06-Oct-15 4
87 UMI SALAMAH, NY 410484 01-Oct-15 04-Oct-15 4
88 UMI SALAMAH, BY 410528 01-Oct-15 04-Oct-15 4
89 MAULANA MUHAMAD 307482 06-Oct-15 08-Oct-15 3
90 PUTRA FATURAHMAN 410782 06-Oct-15 08-Oct-15 3
91 PETRUS 388083 05-Oct-15 08-Oct-15 4
92 EKA MULYANI 395297 07-Oct-15 08-Oct-15 2
93 RENI ANGGRAENI, NY 410792 06-Oct-15 08-Oct-15 3
94 YUNITA ZAENAL 408532 05-Oct-15 08-Oct-15 4
95 DEVANO FEBIAN 410669 06-Oct-15 08-Oct-15 3
96 IPAN KUSTIAWAN 410734 07-Oct-15 08-Oct-15 2
97 TITIN ROHAETIN 410724 06-Oct-15 08-Oct-15 3
98 TITI 378336 07-Oct-15 08-Oct-15 2
99 WADI 385705 05-Oct-15 08-Oct-15 4
100 NUNUNG SUWARSIH 406976 07-Oct-15 08-Oct-15 2
101 ENGKOS KOSASIH 325075 06-Oct-15 08-Oct-15 3
102 GHAZWAT RUJAIK 410754 07-Oct-15 08-Oct-15 2
103 DEDEH KOMARIAH 376451 06-Oct-15 09-Oct-15 4
104 SUWIT ROWIAH 410746 08-Oct-15 09-Oct-15 2
105 ISWANTO 410869 08-Oct-15 09-Oct-15 2
106 DJAENAL ABIDIN 410562 06-Oct-15 09-Oct-15 4
107 M RIZKY SAPUTRA 303447 05-Oct-15 09-Oct-15 5
108 MEMED SUPRIADI 383782 06-Oct-15 09-Oct-15 4
109 IKHWAN RIZKY 313022 07-Oct-15 09-Oct-15 3
110 CAHYA MUHAMAD 410857 08-Oct-15 09-Oct-15 2
111 WASITO 354004 07-Oct-15 09-Oct-15 3
112 ENDANG SURIJA 410817 07-Oct-15 09-Oct-15 3
113 MUSTIAH 405609 07-Oct-15 09-Oct-15 3
114 UDIN DJAENUDIN 410704 05-Oct-15 09-Oct-15 5
115 AI SITI AISAH 410743 08-Oct-15 10-Oct-15 3
116 ALUNA BILQIS 384421 05-Oct-15 10-Oct-15 6
117 HALIMAH LAISAIHA 410835 07-Oct-15 10-Oct-15 4
118 ABAN HIDAYAT 410800 09-Oct-15 10-Oct-15 2
119 TIEN SURATINI 406581 09-Oct-15 10-Oct-15 2
120 ASEP SUHERMAN 399743 09-Oct-15 10-Oct-15 2
121 TITIN KURNIASIH 408675 09-Oct-15 10-Oct-15 2
122 HALID SODIKIN 377515 09-Oct-15 10-Oct-15 2
123 SITI NURAJIJAH 410732 06-Oct-15 10-Oct-15 5
124 SOPANDI 332753 07-Oct-15 10-Oct-15 4
125 YUNITA PUTRI, NY 342996 10-Oct-15 10-Oct-15 2
126 YUYUN YULIYANAH 410529 08-Oct-15 10-Oct-15 3
127 AHMAD NIAMILAH 410960 09-Oct-15 11-Oct-15 3
128 HINDUN 382705 06-Oct-15 11-Oct-15 6
129 M ZAKY MUNANDAR 398543 09-Oct-15 10-Oct-15 2
130 M ALFIANSYAH 307537 08-Oct-15 12-Oct-15 5
131 DELIA NURASYIFA 401342 10-Oct-15 12-Oct-15 3
132 AJI SODIKIN 411019 11-Oct-15 13-Oct-15 3
133 ABDUR ROUF 386687 10-Oct-15 12-Oct-15 3
134 M FAIZ FADILA 410843 07-Oct-15 12-Oct-15 6
135 ZAENAL ARIFIN 376718 11-Oct-15 12-Oct-15 2
136 M RIFKI DWI PUTRA 343428 07-Oct-15 12-Oct-15 6
137 FEBBY MUSTIKA 383010 08-Oct-15 12-Oct-15 5
138 MEISYA MUTIARA 410933 09-Oct-15 12-Oct-15 4
139 SYEILA PUJIRAHANTI 315835 07-Oct-15 12-Oct-15 6
140 AGUS KOMARUDIN 410947 09-Oct-15 12-Oct-15 4
141 NAZKA ZIDAN 328997 08-Oct-15 12-Oct-15 5
142 EUIS ROHAETI 410928 10-Oct-15 12-Oct-15 3
143 M ARIEF 401999 09-Oct-15 12-Oct-15 4
144 JAJA BIN CACA 387877 07-Oct-15 12-Oct-15 6
145 EDI PURWONO 410618 09-Oct-15 12-Oct-15 4
146 TATI AYATI 411110 13-Oct-15 13-Oct-15 2
147 TANTI NALIA 373880 12-Oct-15 13-Oct-15 2
148 YAYU PURNAMA 411036 12-Oct-15 13-Oct-15 3
149 YUMIYATI 410922 10-Oct-15 13-Oct-15 4
150 WIWI WIDANINGSIH 373421 05-Oct-15 13-Oct-15 9
151 HERYANTO 405509 09-Oct-15 13-Oct-15 5
152 SANDY AGUNG RESPATI 410568 09-Oct-15 11-Oct-15 3
153 NURAINI 354643 09-Oct-15 14-Oct-15 6
154 M FHADLAN 410909 08-Oct-15 14-Oct-15 7
155 DAFFA HANIF 397821 13-Oct-15 14-Oct-15 2
156 SUPARMI 380631 05-Oct-15 13-Oct-15 9
157 ABD, RAHMAN 375818 11-Oct-15 13-Oct-15 3
158 DENI SUPRAPTO 331916 12-Oct-15 15-Oct-15 4
159 ALMAIRA FATIMATUL 381818 12-Oct-15 15-Oct-15 4
160 M RIZKY NUR 404514 09-Oct-15 15-Oct-15 7
161 RUSDI SURYADI 410988 13-Oct-15 15-Oct-15 3
162 KARNA 410856 12-Oct-15 15-Oct-15 4
163 M IQBAL 405012 11-Oct-15 15-Oct-15 5
164 FIRLI HERTATI 410517 12-Oct-15 15-Oct-15 4
165 AGNIA NURSILMI 410930 12-Oct-15 15-Oct-15 4
166 EMEILYA DWI 410998 10-Oct-15 15-Oct-15 6
167 AHMAD GINANJAR 308449 12-Oct-15 15-Oct-15 4
168 RAY AGUNG 410970 13-Oct-15 15-Oct-15 3
169 ROMDAN 411060 13-Oct-15 15-Oct-15 3
170 ACHMAD FARHAN 410997 10-Oct-15 15-Oct-15 6
171 YUYU SUSI ANDRIANI 315270 12-Oct-15 15-Oct-15 4
172 HILDA HUWEIDA 326251 12-Oct-15 15-Oct-15 4
173 ANJAR HERMANA 411046 12-Oct-15 15-Oct-15 4
174 CINTYA POPPY ANISA 410907 08-Oct-15 16-Oct-15 4
175 KHANYA IRNI AZKIYA 411170 14-Oct-15 16-Oct-15 3
176 JUAN MAHENDRA 410185 12-Oct-15 16-Oct-15 5
177 ADRIANUS HARTAKA 410706 13-Oct-15 16-Oct-15 4
178 DADANG ISKANDAR 410992 12-Oct-15 16-Oct-15 5
179 NEPI WINDASARI 410931 15-Oct-15 16-Oct-15 2
180 ASNI SURYANI 352111 15-Oct-15 16-Oct-15 2
181 SHINTA SITI 319631 15-Oct-15 16-Oct-15 2
182 ACIH 411034 12-Oct-15 16-Oct-15 5
183 IIS KOMALASARI 411182 14-Oct-15 16-Oct-15 3
184 CINDY OKTAVIANI 411080 13-Oct-15 16-Oct-15 4
185 MARGANA 411143 13-Oct-15 17-Oct-15 5
186 MARIA ULVA 377126 16-Oct-15 17-Oct-15 2
187 M ARKAAN KHIZAN 411098 13-Oct-15 17-Oct-15 5
188 M GILANG 411194 15-Oct-15 17-Oct-15 3
189 DIZKAVIRGINIA ARIANI 411145 13-Oct-15 17-Oct-15 5
190 YUKY REZA ADITYA 406556 14-Oct-15 17-Oct-15 4
191 NURMALIHAH 410657 15-Oct-15 17-Oct-15 3
192 HUSEN AL IDRUS 411100 15-Oct-15 17-Oct-15 3
193 YUDISTIRA 410943 12-Oct-15 17-Oct-15 6
194 RASHA NARESWARI 300074 14-Oct-15 17-Oct-15 4
195 AYUNDA ARAYA LUTVI 411251 15-Oct-15 18-Oct-15 4
196 SAID JUDISTIRA 411132 13-Oct-15 18-Oct-15 6
197 M AZMI HAIL 393935 15-Oct-15 18-Oct-15 4
198 MARYATI 411169 14-Oct-15 18-Oct-15 5
199 MARJANI KAMAL 411193 14-Oct-15 18-Oct-15 5
200 DIDING SAEFUDIN 404238 15-Oct-15 18-Oct-15 4
201 DESINTIA PUTRI 411134 13-Oct-15 18-Oct-15 6
202 UUN KURNIASIH 411210 15-Oct-15 18-Oct-15 4
203 RINA RAHMI 302781 16-Oct-15 18-Oct-15 3
204 NINA INDRIYANI 411218 17-Oct-15 18-Oct-15 2
205 UUN KURNIASIH, BY 411250 15-Oct-15 18-Oct-15 4
206 OLIVIA AL HUSNA 386178 16-Oct-15 19-Oct-15 4
207 AFIQA ASTRI 411035 16-Oct-15 19-Oct-15 4
208 YULIA SUHARTATI 376722 15-Oct-15 19-Oct-15 5
209 NOCK SUBINI 411187 14-Oct-15 19-Oct-15 6
210 NAZWA MAULIDA 378403 15-Oct-15 19-Oct-15 5
211 SITI JUROWIYAH 411346 17-Oct-15 19-Oct-15 3
212 ASEP GUNAWAN 411130 13-Oct-15 19-Oct-15 7
213 REYSHA PUTRI 396579 13-Oct-15 19-Oct-15 7
214 IDA RAHMAWATI 411274 16-Oct-15 19-Oct-15 4
215 HARTIYANI 381739 15-Oct-15 19-Oct-15 5
216 VERAWATI FAZRIN 383000 15-Oct-15 18-Oct-15 4
217 MUSTIAH 405609 16-Oct-15 18-Oct-15 3
218 SOPANDI 332753 12-Oct-15 18-Oct-15 7
219 IMAN 346993 18-Oct-15 20-Oct-15 3
220 JULLYANA JUNAEDI 411273 16-Oct-15 20-Oct-15 5
221 SAMI 411454 19-Oct-15 20-Oct-15 2
222 ISUM SUMIATI 411185 14-Oct-15 20-Oct-15 7
223 ROMI INDRA 411266 19-Oct-15 20-Oct-15 2
224 R GURNITA WIJAKSANA 411407 19-Oct-15 20-Oct-15 2
225 ENY HANDAYANI 411325 19-Oct-15 20-Oct-15 2
226 LIA WULANSARI 411183 14-Oct-15 20-Oct-15 7
227 NINA HERLINA, NY 307261 17-Oct-15 20-Oct-15 4
228 NINA HERLINA, BY 411364 17-Oct-15 20-Oct-15 4
229 IIS KOMALASARI, BY 411197 15-Oct-15 20-Oct-15 6
230 SULASTRI 410331 09-Oct-15 10-Oct-15 2
231 SUGANDA 409250 19-Oct-15 21-Oct-15 3
232 MAMUN MULYANA 392562 18-Oct-15 21-Oct-15 4
233 AHMAD FATHIR 411378 18-Oct-15 21-Oct-15 4
234 AHADIAT ARDIAN 411402 19-Oct-15 21-Oct-15 3
235 AHMAD FAUZI 411192 14-Oct-15 21-Oct-15 8
236 M RIZKI KURNIAWAN 411310 16-Oct-15 21-Oct-15 6
237 RIZKY AGUSTIAN 304617 18-Oct-15 21-Oct-15 4
238 DEWI TISNAWATI 305030 21-Oct-15 21-Oct-15 2
239 ANITA 326637 18-Oct-15 21-Oct-15 4
240 SARIP 411295 20-Oct-15 21-Oct-15 2
241 IJAH 368160 20-Oct-15 21-Oct-15 2
242 DENI CANDRA 410982 20-Oct-15 22-Oct-15 3
243 IKHSAN MAULANA 411042 21-Oct-15 22-Oct-15 2
244 FERDY RIZKY 312593 19-Oct-15 22-Oct-15 4
245 DJAENAL ABIDIN 410562 19-Oct-15 22-Oct-15 4
246 ARSYA MIKHA 353969 19-Oct-15 22-Oct-15 4
247 NIRMALA FITRIANI 411498 20-Oct-15 22-Oct-15 3
248 HILMAN NAWAWI 361328 19-Oct-15 22-Oct-15 4
249 HILYA NURMALA 302631 18-Oct-15 22-Oct-15 5
250 M RAZIQ ARSYAD 396895 19-Oct-15 22-Oct-15 4
251 DYAH KARTIKASARI, NY 398450 20-Oct-15 22-Oct-15 3
252 DYAH KARTIKASARI, BY 411506 20-Oct-15 22-Oct-15 3
253 YATI SURYATI 358469 19-Oct-15 22-Oct-15 4
254 LILIS ANGELA 409978 21-Oct-15 22-Oct-15 2
255 NADYA FAUJIA 411527 21-Oct-15 22-Oct-15 2
256 ENI ROHAENI 400101 19-Oct-15 22-Oct-15 4
257 SUCIKA SUKMAWATI 411566 21-Oct-15 22-Oct-15 2
258 ANGGUN LESTARI 325702 19-Oct-15 22-Oct-15 4
259 PEPEN SUPENA 300360 16-Oct-15 21-Oct-15 6
260 MESYA NOVAYANTI 411509 20-Oct-15 23-Oct-15 4
261 GLADYOSA SHALIHAH 411383 18-Oct-15 23-Oct-15 6
262 AINI WIDIANINGSIH 359654 22-Oct-15 23-Oct-15 2
263 RAISABINA FAHEMA 411384 18-Oct-15 23-Oct-15 6
264 AUFA ZAHIRA 411382 18-Oct-15 23-Oct-15 6
265 ELSA ILMA 411214 15-Oct-15 23-Oct-15 9
266 MUHYI 388766 21-Oct-15 23-Oct-15 3
267 RIKI SOMANTRI 411614 22-Oct-15 23-Oct-15 2
268 ISAL ABDUSALAM 411425 19-Oct-15 23-Oct-15 5
269 IKA SRI WAHYUNI 392183 21-Oct-15 23-Oct-15 3
270 OKTAVIANI LATIFAH 341251 20-Oct-15 23-Oct-15 4
271 YENI HENDALIYAH 411574 22-Oct-15 23-Oct-15 2
272 HENI NURAENI 411562 21-Oct-15 23-Oct-15 3
273 UUM MURTASIAH 411488 22-Oct-15 23-Oct-15 2
274 ELIYAH 410360 21-Oct-15 23-Oct-15 3
275 SYARIF HIDAYAT 411334 21-Oct-15 23-Oct-15 3
276 NURI BRILIANA 361812 22-Oct-15 24-Oct-15 3
277 NISA AULIA FEBRIANI 363803 22-Oct-15 24-Oct-15 3
278 ENI HASANAH 396222 20-Oct-15 24-Oct-15 5
279 SYAEFUL MAULANA 387949 19-Oct-15 24-Oct-15 6
280 NURHIDAYAH 411570 21-Oct-15 24-Oct-15 4
281 INDRI NURHERYANI 388582 23-Oct-15 24-Oct-15 2
282 AHMAD TAUFIK 372398 21-Oct-15 24-Oct-15 4
283 SUNDARI 411370 18-Oct-15 24-Oct-15 7
284 FATHAN REIHANDITYA 411522 20-Oct-15 24-Oct-15 5
285 PIPIH DIARTI 411438 20-Oct-15 24-Oct-15 5
286 YUYUN YUNENGSIH 351636 22-Oct-15 24-Oct-15 3
287 NINING YUNINGSIH 373770 23-Oct-15 24-Oct-15 2
288 NIA ROSMIATI 410844 23-Oct-15 24-Oct-15 2
289 MELI ROSDIANA 334749 22-Oct-15 24-Oct-15 3
290 EKO FEBRIANTO 411446 21-Oct-15 24-Oct-15 4
291 SANDY AGUNG RESPATI 410568 23-Oct-15 24-Oct-15 2
292 EKA ELIA 411578 22-Oct-15 24-Oct-15 3
293 NURLAELA LUBIS 410777 23-Oct-15 24-Oct-15 2
294 WIWI WIDANINGSIH 373421 16-Oct-15 24-Oct-15 9
295 RINA CHAERUNI, NY 411514 22-Oct-15 24-Oct-15 3
296 RINA CHAERUNI, BY 411662 22-Oct-15 24-Oct-15 3
297 KOKOM KOMARIAH, NY 407239 23-Oct-15 25-Oct-15 3
298 KOKOM KOMARIAH, BY 411697 23-Oct-15 25-Oct-15 3
299 JULITA PUTRI 411698 23-Oct-15 26-Oct-15 4
300 KHANSA NOVIA 403653 23-Oct-15 26-Oct-15 4
301 NURTATI 411674 22-Oct-15 26-Oct-15 5
302 NADINE SETIARA 411814 25-Oct-15 26-Oct-15 2
303 YUDHA PRATAMA 411737 23-Oct-15 26-Oct-15 4
304 OYOK SUSILAWATI 411638 22-Oct-15 26-Oct-15 5
305 BAYU WIJAYA 312793 23-Oct-15 26-Oct-15 4
306 WIDANINGSIH 407916 18-Oct-15 26-Oct-15 9
307 QADRATUNNADA MALCA 411589 21-Oct-15 26-Oct-15 6
308 ADRIAN OKTA 411364 23-Oct-15 26-Oct-15 4
309 EDI ISNANDI 411387 18-Oct-15 26-Oct-15 9
310 PUTRI MELIASARI 348760 23-Oct-15 26-Oct-15 4
311 NENI WERDINI 394422 23-Oct-15 26-Oct-15 4
312 BENI IRAWAN 411824 26-Oct-15 26-Oct-15 1
313 ADI MERCY 411120 25-Oct-15 26-Oct-15 2
314 ABIDZAR MULLER 411726 23-Oct-15 25-Oct-15 3
315 ENUNG HARYATI 342978 24-Oct-15 26-Oct-15 3
3
316 RADO FEBRIANSYAH 341518 22-Oct-15 24-Oct-15
317 M HANIF RASYAAD 411604 22-Oct-15 24-Oct-15 3
318 MAMAT SELAMET 411731 23-Oct-15 27-Oct-15 5
319 LILI HALIMATUSADIJA 345118 25-Oct-15 27-Oct-15 3
320 TATANG SURYANA 411694 23-Oct-15 27-Oct-15 5
321 ABAS 384996 23-Oct-15 27-Oct-15 5
322 ADE ROKAYAH 411513 22-Oct-15 23-Oct-15 2
323 HADI HOERUNISA 332317 10-Oct-15 13-Oct-15 4
324 MOH FAJAR 403619 04-Oct-15 07-Oct-15 4
325 M SAKTI AJI 386351 26-Oct-15 28-Oct-15 3
326 M ZAINUL 306362 27-Oct-15 28-Oct-15 2
327 SITI JULAEHA 411845 26-Oct-15 28-Oct-15 3
328 PIPIN WIJAKSANA 341744 24-Oct-15 28-Oct-15 5
329 SUMIATI 310935 26-Oct-15 28-Oct-15 3
330 JUHARI 411799 24-Oct-15 28-Oct-15 5
331 TRI BUDIYANTO 388488 23-Oct-15 28-Oct-15 6
332 PATIMAH 374558 24-Oct-15 28-Oct-15 5
333 BANDI 379212 23-Oct-15 28-Oct-15 6
334 ALIF MA'RUF 304090 23-Oct-15 28-Oct-15 6
335 MOH KHOLIS 411683 27-Oct-15 28-Oct-15 2
336 YULEN YULIANI 341396 26-Oct-15 28-Oct-15 3
337 IMAS KHODIJAS 411707 23-Oct-15 23-Oct-15 1
338 DEAN MAULANA 411794 24-Oct-15 29-Oct-15 6
339 MAULIA ANDINI 401727 24-Oct-15 29-Oct-15 6
340 ALPIAN RIZKI 411902 26-Oct-15 29-Oct-15 4
341 WATI BT CAMAN 411736 23-Oct-15 29-Oct-15 7
342 DILA ANANDA 411906 27-Oct-15 29-Oct-15 3
343 DIAN SOFIANA 411631 22-Oct-15 29-Oct-15 8
344 UNIATI 366915 24-Oct-15 29-Oct-15 6
345 ABDUL AZIZ 411863 28-Oct-15 29-Oct-15 2
346 TEGUH PRAYITNO 411357 17-Oct-15 28-Oct-15 12
347 DINDA AINUN 386595 26-Oct-15 30-Oct-15 5
348 ADRIYAN SANTANA 371747 28-Oct-15 30-Oct-15 3
349 ARKA FAHREZA 410379 28-Oct-15 30-Oct-15 3
350 M RIZKI FAUZAN 411965 28-Oct-15 30-Oct-15 3
351 ARNENGSIH 372623 26-Oct-15 30-Oct-15 5
352 DESY NURUL 411734 23-Oct-15 30-Oct-15 8
353 AZZAHRA REVANA 308872 29-Oct-15 30-Oct-15 2
354 GITA OKTAVIANI 390039 26-Oct-15 30-Oct-15 5
355 MUJINO HERI 334038 27-Oct-15 30-Oct-15 4
356 NINA INDRIYANI 411218 28-Oct-15 30-Oct-15 3
357 KIKO DAVARIO 407745 26-Oct-15 30-Oct-15 5
358 DIAN NURJANAH 411782 24-Oct-15 31-Oct-15 7
359 SALSA FITRIANI 405320 25-Oct-15 31-Oct-15 7
360 GALANG PERMANA 377512 28-Oct-15 31-Oct-15 4
361 RANGGALAWE 357494 30-Oct-15 31-Oct-15 2
362 ENGKUS 411678 28-Oct-15 31-Oct-15 4
363 M YAHYA 376778 30-Oct-15 31-Oct-15 2
364 WAWAN BIN JONO 397590 30-Oct-15 31-Oct-15 2
365 KURNIASIH 403919 30-Oct-15 31-Oct-15 2
366 NINA HERLINA 412064 29-Oct-15 31-Oct-15 3
367 RD RAIHANA 412085 29-Oct-15 31-Oct-15 3
368 SHELVIE 348209 07-Oct-15 10-Oct-15 4
369 TITA RUHITA, NY 358656 28-Oct-15 30-Oct-15 3
370 NARENDRA 343695 28-Oct-15 31-OKT-15 4
NO NAMA PASIEN NO. MR Tanggal Masuk Tanggal Keluar
1 WINDA NUR FARIDHAH 410370 01-Oct-15 02-Oct-15 2

2 ANGGITA YULIANTI 369438 30-Sep-15 03-Oct-15 4
3 FEBI INDRIYANI 347873 01-Oct-15 04-Oct-15 4
4 ADI RIYANTO 348588 30-Sep-15 01-Oct-15 2
5 LINDAH AYU WIBOWO 366576 28-Sep-15 01-Oct-15 4
6 HARUN ARROSYID 410490 01-Oct-15 05-Oct-15 5
7 ALIA MARTIANA 321008 04-Oct-15 10-Oct-15 7
8 YUSUP NURYANA 407193 07-Oct-15 10-Oct-15 4
9 M. YUSUF 410854 07-Oct-15 09-Oct-15 3
10 RIMA ROSDIANA 410554 05-Oct-15 08-Oct-15 4
11 YESI AGUSTINA 410570 02-Oct-15 12-Oct-15 11
12 DINA MELANI 410964 10-Oct-15 12-Oct-15 3
13 VIRZHA SHIDQI AL AFSARI 410785 06-Oct-15 12-Oct-15 7
14 WILLY WILIARDANI P 316474 06-Oct-15 13-Oct-15 8
15 WIRANATA 344239 13-Oct-15 15-Oct-15 3
16 GILBRAN NOEL H 390975 14-Oct-15 15-Oct-15 2
17 PIPIH LATIFAH 411276 17-Oct-15 18-Oct-15 2
18 ZAKI FADHILLAH MUJAHID 411308 16-Oct-15 19-Oct-15 4
19 VICKRYAH ILMA RUDANTARI 411238 15-Oct-15 20-Oct-15 6
20 NENAH JUNAENAH 313349 21-Oct-15 22-Oct-15 2
21 DENI SETIAWAN 351170 21-Oct-15 24-Oct-15 4
22 MOCHAMAD RAIHAN 411534 21-Oct-15 23-Oct-15 3
23 GEORVANNO VICTORIA H 397996 21-Oct-15 23-Oct-15 5
24 AKBAR PUTRA PRIATNA 411761 24-Oct-15 26-Oct-15 3
25 YASMIN NAYLA JAZILAH 410139 23-Oct-15 26-Oct-15 4
26 ETI 411684 23-Oct-15 27-Oct-15 5
27 MIRA ROSMALIA 322514 23-Oct-15 27-Oct-15 5
28 YUYUN YULIANTI 348840 27-Oct-15 29-Oct-15 3
29 MUHAMMAD RAKHAN AL HAFIDZ 411903 27-Oct-15 28-Oct-15 2
30 MOCHAMAD RAIHAN 411534 25-Oct-15 30-Oct-15 6
Rekapitulasi INA CBGs Bulan OKTOBER
DIAGNOSA PRIMER DIAGNOSA SEKUNDER TINDAKAN
UTI PYELONEPRITIS -
BP DADRS -
TYPOID FEVER - -
PARATYPOID FEVER - -
TYPOID FEVER - -
CAP TYPOID FEVER -
VARICELLA - -
CPD PARTUS SC SC
TYPOID FEVER - -
GASTRITIS erosif DM T2 -
TUMOR - -
TUMOR MAMAE - BIOPSI MAMAE
HIL - HERNIORAPHY
LETAK KEPALA PARTUS SPONTAN SPONTAN
CKD - -
PLEURAL EFUSION - PUNGSI PLEURA
TYPOID FEVER - -
ISPA - -
CAP PPOK -
AB INCOMPLITE - KURET
STT RADIUS - EKSISI
HYPERTROPY OF TONSIL - TONSILEKTOMY
FRAKTUR RADIUS ULNA - CLOSE REDUCTION+CASTING UNDER FIXATION
CHF ISCHEMIC CARDIO+AF+CHF+TB PARU -
ESRD ANEMIA CRONIC -
STROKE INFARK HT+ASMA+HHD -
MENINGITIS TB TONSILOFARINGITIS+OEDEMA+BRONKHITIS -
CELEBRAL PALSY DELAYED DEVELOPMENT+MAL NUTRISI -
ISCHEMIC CARDIOMYOPA CKD+DMT2+CHF -
BILIRUBIN - -
ADNEXITIS DISPEPSIA+typoid fever -
ABSES - INCISION
KISTA BRACHIAL - EKSISI KISTA BRANCHIAL
HILL - HERNIORAPHY
CHOLELITHIASIS CHOLECYSTITIS+FATTY LIVER CHOLECYSTEKTOMY+ADHESION
ILEUS PARSIAL HEMOROID -
PPOK ISCHEAMIK CARDIOMIOPATY+HT+DC+CKD+NEPROLITHIASIS -
DIARE - -
TYPOID FEVER BP -
BILIRUBIN - -
GAGAL INDUKSI KPD+PARTUS SC SC
DM T2 TTH -
LETAK SUNGSANG PARTUS SC SC
BBL - -
DKP PARTUS SC SC
BBL COW MILK -
LETAK SUNGSANG DM+PARTUS SC SC
BBL COW MILK -
TYPOID FEVER DHF -
TYPOID FEVER - -
TYPOID FEVER RHINO FARINGITIS -
HYPERTYROID DYSPEPSIA -
DIARE AKUT RHINO FARINGITIS .
BP - -
TYPOID FEVER - -
PERDARHAN VAGINA PARTUS SC SC
CHF EC HHD ESRD+ANEMIA -
TUMOR INTRA ABDOMEN ANEMIA LE
RIW SC BLM LMA ASMA BR SC
EPILEPSI BACTERIAL INFECTION -
DADRS - -
TYPOID FEVER - -
TYPOID FEVER DIARE AKUT -
GEA HHD+OA -
GEA - -
ANEMIA HHD+ESRD -
TYPOID FEVER ISPA+KDS -
TYPOID FEVER TB PARU -
CPD PARTUS SC SC
TYPOID FEVER ISPA -
BP CELEBRAL PALSY -
TYPOID FEVER OTITIS MEDIA -
BRONKHITIS TYPOID FEVER -
DADRS DIAPER RUSH -
BBL - -
APP - APENDICTOMY
FAM - EKSISI
ABSES SUBMANDIBULAR - INCISION
FAM - EKSISI
UROLITHIASIS CKD+HIDRONEFROSIS+HT+SIROSIS
PEMASANGAN DJ STENT+LITOTRIPSI BATU+INJECTION ANTIBIOTIC
HT HEMIPLEGIA+STROK -
PHIMOSIS HYDROCELE CIRCUMSISION+HYDROCELEKTOMY
FRAKTUR FEMORAL FEM - HEMI HIP ARTHOPATHY
TYPOID FEVER - -
CPD PARTUS SC -
BBL COW MILK -
ISPA ASMA -
BACTERIAL INFECTION - -
HEMOROID - HEMOROIDEKTOMY
PARTUS SPONTAN - PARTUS SPONTAN
RIW SC BLM LMA PARTUS SC SC
HYDROCELE - HYDROCELEKTOMY
STT EKSISI
GEA - -
ULKUS PEDIS - DEBRIDEMENT SKIN
DIARE AKUT ESRD -
ABSES a/r COLLI - INCISION
HERPETIC NEURALGIA - -
VERUCA TEMPORAL - EKSISI
CA MAMAE - -
TUMOR GLOBULO MAKSIL - EKSTERPASI MAKSILA
KISTA ATEROMA - EKSISI
PERITONITIS+APP - LE+APENDICTOMY
VIRAL INFECTION - -
TUMOR GINJAL EPILEPSI+CEPHALGIA+SOL -
DYSPEPSIA ISPA -
VIRAL INFECTION - -
NEFROLITHIASIS COLIC RENAL -
CELULITIS DMT2+HYPONATREMIA -
BPPV DMT2+CKC+CKD+HT+SEQUALE STRK -
CHIROSIS HEPATIS HYPOALBUMIN+CHOLELITHIASIS+MELENA -
HEMATOMA VAGINA - INCISION
DADRS DIAPER RUSH+CMPA -
VIRAL INFECTION TONSILITIS AKUT -
KISTA PAROTITIS - BIOPSI+EKSISI
BATU URETER DJ STENT+ISK+COLIC RENAL URETEROTOMY
BATU URETER DJ STENT+ISK+COLIC RENAL URETERAL MEATOTOMY
BATU URETER HIDRONEFROSIS+ISK+COLIK RENAL URETEROTOMY
BATU URETER HIDRONEFROSIS+ISK+COLIK RENAL URETEROTOMY
LS PARTUS SC SC
ESRD SYOK PERDARAHAN+HYPOGLYCAEMIA -
BILIRUBIN - -
DIARE AKUT - -
ASMA DYSPEPSIA -
RHINO BRONKHITIS - -
TYPOID FEVER - -
DADRS - -
GEA - -
THALASEMIA - TRANSFUSI
DIARE AKUT - -
PP0K - -
TYPOID FEVER ISPA -
ASMA SUSP PPCM+HEMOROID -
RHINO BRONKHITIS KONSTIPASI -
TYPOID FEVER ISPA -
TYPOID FEVER - -
BP - -
LIPOMA - BIOPSI
HEMOROID - HEMOROIDEKTOMY
HT HHD+ESRD+CAD -
FISTULA COLLI - FISTULEKTOMY+ANOSCOPY
FAM DEX - EKSISI
HERNIA - HERNIORAPHY
HHD,DC ESRD -
CAD STEMI DM T2 -
EQUINAS DEFORMITY ACHILES LIMB LENGH DISC OPEN+OSTEOMYELITIS DEBRIDEMENT+ANGKLE FUSION
GASTRITIS AKUT DMT2+DKD+CKD -
TYPOID FEVER - -
CRONIC WOUND A/R PEDI - DEBRIDEMENT+NPWT
CAD HHD+DC+TB PARU+DM+DKD+ANEMIA -
DCM DC+DMT2+DKD+HT+BR AKUT -
NEFROLITHIASIS - -
TYPOID FEVER ISPA -
DIARE AKUT - -
MILD HEAD INJURY - -
GEA UTI -
TYPOID FEVER HYPONATREMIA -
PEB PARTUS SC SC
KISTA HEMATOM - EKSISI
APPENDICULAR INFILTRA - LE+APP+ADHESION
ABSES - DEBRIDEMENT+INCISION
SINUSITIS MAX BILATERA POLYP NASAL POLYTEKTOMY+FESS
STT - EKSISI
TYPOID FEVER GASTRITIS -
TYPOID FEVER - -
TYPOID FEVER - -
HILL DEX - HERNIORAPHY
COLITIS RHINO FARINGITIS -
BP - -
MORBILI STOMATITIS -
NEUROFIBROMA A/R PED ULKUS DM -
HEMOROID - HEMOROIDEKTOMY+ANOSCOPY
TUMOR MAMAE SIN - EKSISI
STT - EKSISI
GEA - -
CHF PPOK -
ANEMIA PARTUS SPONTAN -
DKP PARTUS SC SC
PP0K DYSPEPSIA -
BLIGHT OVUM - KURET
TYPOID FEVER - -
BACTERIAL INFECTION - -
BP 0 -
DADRS TFA -
KISTA OVARY/ DERMOID - SOD
TROMBOCYTOPENIA NEFROLITHIASIS TRANSFUSI
TYPOID FEVER - -
TYPOID FEVER - -
DADRS - -
PNEMONIA - -
STROKE CELEBRAL DISLIPIDEMIA+HT+HEMIPARASE -
TB PARU - -
TYPOID FEVER - -
TB PARU TYPOID FEVER -
PEB PARTUS SC -
APP AKUT - APENDICTOMY
TUMOR MAMAE - BIOPSI
BBL - -
TYPOID FEVER - -
TYPOID FEVER RHINO FARINGITIS -
TYPOID FEVER - -
TYPOID FEVER ISK+TB+DMT2 -
LARINGO TRACHEA BRONH - -
ANEMIA IN PREGNANCY PARTUS SPONTAN PARTUS SPONTAN+TRANSFUSI
STROK INTRA CELEBRAL DISLIPIDEMIA+HT+HEMIPARASE -
EPILEPSI AKI+ISK+OBESITAS+HERNIA -
TYPOID FEVER UTI+DM T2 -
TUMOR TYROID - TYROIDECTOMY
TYPOID FEVER - -
GASTRITIS - -
ESRD ENCEPHALOPATHY+SHOCK+HYPOGLICEMIA+SEPSIS INJEKSI ANTIBIOTIK
HYDRONEFROSIS NEFROLITHIASIS+SEPSIS+DM -
TYPOID FEVER TONSILITIS AKUT -
AB INCOMPLITE - -
TYPOID FEVER DENGUE FEVER -
STT - EKSISI
KISTA ATEROMA - EKSISI
GIANT CLAVUS - EKSISI
CHOLELITHIASIS - CHOLECYSTEKTOMY
LS PARTUS SC SC
BBL - -
MAS DISTRES RESPIRATORY -
HIPOGLYCEMIA DMT2+HT+PLEURAL EFUSION -
DM T2 DEHIDRASI -
TTH SEQUELE STROK+HT+HIPERKALEMIA -
DADRS - -
TB PARU - -
TYPOID FEVER DHF -
UTI - -
TYPOID FEVER - -
RIW SC DM KEHAMILAN+PEB+PARTUS SC SC
MULTIPLE LIPOMA - EKSISI
STT - EKSISI
CHF RHD -
GAGAL OPERASI SLEEP APNEU+TONSILO FARINGITIS -
TYPOID FEVER - -
GEA - -
VARISELLA - -
GEA - -
VIRAL INFECTION - -
TYPOID FEVER ISPA+SYNDROM DYSPEPSIA -
DADRS - -
LETAK SUNGSANG PARTUS SC -
BBL - -
ANEMIA ESRD -
TWIN PRAGNANCY KPD+PARTUS SPONTAN PARTUS SPONTAN
KISTA BARTOLINI PARTUS SC SC
CORPUS ALIENUM TRACK - EKSTRAKSI BENDA ASING TRACKEA
TYPOID FEVER - -
EFUSI PLEURA - -
ISPA - -
DADRS - -
ASD - -
DADRS - -
HIPERBILIRUBIN - -
DENGUE FEVER - -
HILL DEX - HERNIORAPHY+omentectomy
LIMPADENOPTI COLLI - EKSISI
DENGUE FEVER - -
VIRAL INFECTION EPISTAKSIS -
BP CP+STATUS EPILEPTICUS+LENOX GASTRO SYNDROME -
ABSES PEDIS - DEBRIBEMENT
ABSES THORAX EKSISI -
GIANT LIPOMA - EKSISI
KISTA TIROID - EKSISI TYROID
STT PEDIS - EKSISI
TYPOID FEVER - -
TYPOID FEVER ISPA -
DYSPEPSIA DMT2+K80.8 -
DADRS ISPA -
HEPATITIS C SIROSIS HEPTIS PUNGSI PLEURA
GASTRITIS - -
TB PARU - -
OA TB PARU -
DADRS - -
DENGUE FEVER - -
BLIGHT OVUM - KURET
TUMOR MAMAE - EKSISI
HYPERTROPI OF TONSIL - TONSILEKTOMY
CRONIC WOUND A/R PEDI - DEBRIDEMENT+NPWT
RIW SC PARTUS SC SC
BURSITIS PRE PATELAR - BURSECTOMY
ESRD EDEMA PARU+LIVER+RL+HHD,DC -
RIW SC PARTUS SC SC
BBL - -
RIW SC PARTUS SC 74.4
BBL - -
TYPOID FEVER - -
VIRAL INFECTION - -
PREMATUR KONTRAKSI - -
KDS - -
DADRS - -
DMT2 - -
ASMA VIRAL INF+TYPOID FEVER -
TUMOR PARU DILI+PLEURAL EFUSION -
TYPOID FEVER BRONKHIALITIS -
NEONATAL HYPERBILIRUB - -
NECROSIS OMENTUM PERITONITIS DIFFUSE+HILL DEXTRA LE+54.4
HEMOROID - EKSISI
DMT2 - -
CAD UAP+DM+CKD -
BPPV CRF -
EPILEPSI - -
BARTHOLINI - INCISION
Enteroviral vesicular - -
pharyngitis
TYPOID FEVER BRONKHITIS AKUT -
TYPOID FEVER - -
CHF AF+DYSPEPSIA -
SEQUELE STROK AB+HT+LBP -
GASTROPATI ESRD -
MYALGIA - -
TYPOID FEVER - -
DADRS - -
GASTRITIS AKUT DYSPEPSIA -
GEA - -
GASTRITIS ANKYLOSIS SPONDILITIS -
DISPEPSIA IN PREGNANC DISPEPSIA .
TB PARU - -
PNEMONIA ESRD -
GLOMENEPRITIS ESRD -
COMBUSTIO G 2 20% - DEBRIDEMENT
PERIAPENDIKULAR ABSES - LAPARTOMY EXSPLORASI
STT - EKSISI
IUFD - KURET
KOMA UREMIKUM ESRD+HT -
TONSILIIS AKUT - -
DADRS ISPA -
KDS ISPA -
DM T2 CHF+CAD -
DYSPEPSIA VARISELLA -
MENINGITIS LIVER -
HHD OA+HYPERCALSEMIA+DISLIPIDEMIA -
HYPERTROPI OF TONSIL - TONSILEKTOMY
FR CLAVICULA PNEUMOTORAX ORIF+INSERSI
DHF TYPOID FEVER -
DADRS - -
DADRS TB PARU -
VARISELLA - -
GASTRITIS TENDINITIS SHOULDER -
TYPOID FEVER BRONKHITIS AKUT -
HIPERTROPY TONSIL - TONSILEKTOMY
OLIGOHYDRONION PROLONG REGNANCY+PARTUS SC SC
FAM - EKSISI
FRAKTUR FEMUR - ORIF+BONE GRAF+REMOVE IMPLANT
EPILEPSI DIARE AKUT -
TYPOID FEVER - -
BRONKHITIS VARISELLA -
TB PLEURA - -
STT ATEROMA - EKSISI
BATU URETER - URETEROTOMY
BATU URETER DJ STENT URS+LITOTRIPSI URETER+AFF STENT
COLIK ABD - -
ISPA - -
VERTIGO COLIC ABDOMENT -
TYPOID FEVER - -
STT - EKSISI
TYPOID FEVER - -
TFA - -
GANGLION - EKSISI GANGLION
APP AKUT - APPENDICTOMY
ABSES PERIANAL - DEBRIDEMENT
DYPSNEU - -
SYNDROM PERIFORMIS LBP -
MORBILI - -
HEMOROID EK&INT - ANOSCOPY+HEMOROIDEKTOMY
TONSILIIS AKUT - -
DIARE AKUT - -
CAD UAP BRONKHITIS AKUT -
HYPERPIREKSIA - -
VOMITUS - -
STT - EKSISI
FHARINGITIS - -
GEA - -
TUMOR THORAX - EKSISI
EPILEPSI HYPERCALCEMIA+VI -
BP - -
LARINGO TRACHEA BRONH - -
TYPOID FEVER - -
DIARE AKUT - -
HHD DC+DMT2+DKD+SEQUALE STROK -
GASTRITIS - -
GEA - -
KDS ISPA -
DIARE AKUT RHINO BRONKHITIS -
KODE ICD KODE ICD SECUNDER KODE TINDAKAN KELAS HARGA RS
UTAMA
HARGA INA CBGS
N39.0 N12 - 2 3,817,967 1,860,600.00
J18.0 A09 - 2 2,821,525 4,170,100.00
A01.0 - - 3 1,516,472 2,774,500.00
A01.4 - - 2 2,199,403 3,329,400.00
A01.0 - - 2 2,710,865 3,329,400.00
J18.9 A01.0 - 3 3,305,214 7,082,600.00
B01.9 - - 2 2,614,634 2,331,600.00
O33.0 O82.9 74.4 2 8,794,943 4,826,600.00
A01.0 - - 1 3,459,827 3,884,300.00
K29.0 E11.9 - 1 2,720,000 2,171,800.00
D48.1 - 83.39 1 10,637,961 6,819,800.00
D24 - 85.12 1 9,505,507 7,137,800.00
K46.9 - 53.29 1 11,701,583 4,997,900.00
O32.2 O80.9 73.59 1 4,134,435 2,819,100.00
N18.9 - - 3 3,596,558 1,940,500.00
J90 - 34.91 1 2,598,044 3,808,000.00
A01.0 - - 2 4,506,929 3,329,400.00
J06.9 - - 2 2,599,537 1,829,000.00
J18.9 J44.9 - 2 7,853,770 5,860,100.00
O05.4 - 69.02 2 4,863,631 3,279,100.00
D48.1 - 83.39 2 7,958,591 5,845,600.00
J35.3 - J35.3 2 7,284,573 2,121,400.00
S52.60 - 79.12+93.53 2 11,504,113 6,233,600.00
I50.0 I25.5+I48+I50.0+A15.0 - 1 10,367,433 8,332,900.00
Z99.2 D63.8 - 1 3,575,100 3,433,200.00
I63.9 I10+J45.9+I11.9 - 1 3,296,300 4,101,800.00
A17.0+G01 J06.8+G93.6+J40 - 1 7,398,180 6,345,500.00
G80.9 R62.9+E46 - 2 2,823,210 2,801,300.00
I25.5 E11.2+I50.0 - 3 3,758,557 2,979,200.00
P59.9 - - 2 2,493,311 1,995,800.00
N70.9 K30+a01 - 1 9,152,504 2,544,100.00
L02.9 - 86.04 2 6,877,932 2,800,400.00
Q18.0 - - 2 9,444,021 5,713,700.00
K40.9 - 53.29 3 7,603,021 3,569,900.00
K80.8 K81.9 51.22+54.59 2 15,108,384 13,890,800.00
K56.0 I84.2 - 2 3,032,557 2,325,300.00
J44.9 I25.5+I13.1 - 1 4,314,300 4,314,300.00
A09 - - 3 2,019,652 2,355,800.00
A01.0 J18.0 - 1 4,622,943 4,622,900.00
P59.9 - - 1 2,566,280 3,265,600.00
O05.4 - 69.02 2 4,843,650 3,279,100.00
O61.9 O42.9+O82.9 74.4 2 9,651,277 4,826,600.00
E11.9 G44.2 - 1 5,012,366 2,720,000.00
O32.1 O82.9 - 2 8,874,051 4,826,600.00
P03.4 - - 2 1,225,835 1,995,800.00
O33.8 O82.9 74.4 2 8,977,783 4,826,600.00
P03.4 T78.1 - 3 1,221,050 1,995,800.00
O32.1 O24.9+O82.9 74.4 3 8,564,317 4,438,400.00
P03.4 T78.1 - 3 1,183,399 1,663,200.00
A01.0 A91 - 2 3,986,458 4,906,600.00
A01.0 - - 1 2,941,814 3,884,300.00
A01.0 J06.8 - 2 2,698,984 3,329,400.00
E05.9 K30 - 3 3,885,510 2,091,100.00
J06.8 - - 1 2,076,257 2,827,100.00
J18.9 - - 2 4,524,497 4,170,100.00
A01.0 - - 2 2,539,931 3,329,400.00
O46.9 O82.9 74.4 2 12,078,723 4,826,600.00
I13.2 D64.9 - 2 5,094,836 7,142,500.00
D17.5 D64.9 54.11 3 21,434,698 6,516,000.00
O34.2 J45.9+O82.9 74.4 2 4,286,600 4,826,600.00
A49.9 G40.9 - 2 2,994,066 1,859,300.00
A09 - - 2 1,975,510 2,423,100.00
A01.0 - - 1 3,908,004 3,884,300.00
A01.0 A09 - 3 1,704,581 2,774,500.00
A09 I11.9+M19.99 - 2 3,532,176 1,423,100.00
A09 - - 2 1,868,230 2,423,100.00
D64.9 I13.1 - 1 3,734,338 2,716,700.00
A01.0 J06.9+R56 - 2 5,001,449 4,282,400.00
A01.0 A15.0 - 2 2,967,925 4,282,400.00
O33.0 O82.9 74.4 1 12,025,641 5,631,000.00
A01.0 J06.9 - 2 2,590,996 3,329,400.00
J18.0 G80.9 - 2 5,233,571 4,170,100.00
A01.0 H66.9 - 1 2,689,384 3,884,300.00
J40 A01.0 - 1 2,832,637 6,226,100.00
A09 L22 - 2 1,897,059 2,423,100.00
O05.4 - 69.02 1 5,554,928 3,825,600.00
P03.4 - - 1 1,769,050 2,328,400.00
K35.9 - 47.09 2 9,730,988 3,416,000.00
D24 - 85.21 2 7,440,214 6,118,200.00
K12.2 - 86.04 1 9,807,799 2,710,300.00
D24 - 85.21 3 7,120,762 5,098,500.00
N13.2 I10+A41.9 59.8+56.0+99.21 1 22,570,175 13,615,200.00
I10 G81.9+I64 - 1 17,235,951 7,333,300.00
N47 N43.3 6.40+6.31 1 5,361,600 5,361,600.00
S72.29 - 81.4 1 11,171,600 11,171,600.00
A01.0 - - 1 3,884,300 3,884,300.00
O33.0 O82.9 - 2 7,214,004 4,826,600.00
P03.4 T78.1 - 2 1,368,234 1,995,800.00
J06.9 J45.9 - 2 1,738,972 1,829,000.00
A49.9 - - 3 1,664,884 2,774,500.00
I84.2 - 49.46 1 10,606,249 6,095,900.00
O05.4 - 69.02 2 4,627,618 3,279,100.00
O80.9 - 73.59 2 4,526,579 2,416,400.00
O34.2 O82.9 74.4 1 11,003,393 5,631,000.00
N43.3 - 63.1 2 7,742,413 4,595,600.00
D48.1 - 83.39 3 6,334,182 4,871,300.00
A09 - - 2 2,582,633 2,423,100.00
L98.4 - 86.28 2 7,022,547 2,786,300.00
A09 Z49.0 - 1 5,644,710 2,827,100.00
L02.9 - 86.04 1 9,524,609 3,267,100.00
B02.2+G53.0 - - 1 3,637,200 3,637,200.00
B07 - 83.39 2 7,528,459 5,845,600.00
- C50.9 - 1 3,088,100 3,088,100.00
K09.1 - 22.62 2 7,486,580 4,612,400.00
L72.1 - 83.39 2 9,116,961 5,845,600.00
K35.9 - 47.09+54.11 2 10,567,481 6,812,300.00
B34.9 - - 3,046,617 2,331,600.00
D41.9 G40.9+R51+R90.0 - 1 3,967,789 2,169,200.00
K30 J06.9 - 2 2,236,088 3,335,500.00
B34.8 - - 1 2,192,765 2,720,200.00
N20.0 N23 - 2 2,692,339 2,464,300.00
L03.9 E11.9+E87.1 - 1 5,841,900 5,841,900.00
H81.1 E11.2+I10+I69.4 - 1 3,255,900 3,255,900.00
K74.6 E88.0+K80.8+K92.0 - 1 4,944,900 4,994,900.00
N89.8 - 70.14 2 7,363,610 3,276,700.00
A09 L22+T78.1 - 2 3,498,628 2,423,100.00
B34.9 J03.9 - 2 3,706,503 2,331,600.00
K11.2 - 83.21+83.39 1 9,367,656 6,819,800.00
N20.1 - 56.2 1 19,515,756 14,126,800.00
N20.1 - 56.1 1 19,472,899 14,126,800.00
N13.2 - 56.2 3 14,289,455 10,090,500.00
N13.2 - 56.2 2 16,460,663 12,108,700.00
O32.1 O82.9 74.4 1 11,561,303 5,631,000.00
N18.0 R57.1+E16.2 - 1 11,313,000 6,061,200.00
O80.9 - 73.59 2 3,758,943 2,416,400.00
P59.9 - - 3 1,998,543 2,332,600.00
A09 - - 2 2,029,203 2,423,100.00
J45.9 K30 - 3 4,815,727 1,552,400.00
J20.9 - - 2 1,889,165 1,858,600.00
A01.0 - - 2 3,705,463 3,329,400.00
A09 - - 2 1,763,702 2,423,100.00
A09 - - 2 2,870,747 2,423,100.00
D56.9 - 99.03 1 3,634,008 2,172,900.00
A09 - - 2 3,017,551 2,423,100.00
J44.9 - - 2 2,114,443 2,878,100.00
A01.0 J06.9 - 1 5,737,036 3,884,300.00
J45.9 J44.9+I84.8 - 2 3,525,045 2,812,500.00
J20.9 K59.0 - 2 3,305,887 1,858,600.00
A01.0 J06.9 - 2 4,231,425 3,329,400.00
A01.0 - - 2 2,409,577 3,329,400.00
J18 - - 2 5,896,102 4,170,100.00
D17.9 . 83.21 3 6,951,372 1,551,700.00
I84.2 - 49.46 1 10,408,448 6,095,900.00
I13.1 I25.9 - 2 7,408,089 2,328,600.00
K60.3 - 49.12+49.21 1 10,410,571 6,095,900.00
O05.4 - 69.02 2 4,362,651 3,279,100.00
O05.4 - 69.02 2 5,037,426 3,279,100.00
D24 - 85.21 2 8,339,614 6,118,200.00
K40.9 - 53.29 1 10,931,576 4,997,900.00
I11.9 N18.0 - 2 9,222,909 3,820,400.00
I25.9 E11.9 - 1 6,942,888 3,264,200.00
M21.6 S86.0+M21.9+M86.67 81.11+83.85 1 8,797,700 13,681,600.00
K29.1 E11.9 - 3 4,691,930 2,328,100.00
A01.0 - - 1 4,556,618 3,884,300.00
S91.7 - 83.22+93.59 1 10,534,354 2,048,300.00
I25.1 I119+E11.2+A15.0 - 1 4,170,900 4,170,900.00
I42.0 I11.9+E11.2+J20.9 - 1 4,063,100 4,063,100.00
N20.0 - - 2 3,464,204 2,464,300.00
A01.0 J06.9 - 1 3,109,540 3,884,300.00
A09 - - 2 3,882,835 2,423,100.00
S09.9 - - 2 3,111,492 3,336,600.00
A09 N39.0 - 1 3,559,029 3,991,400.00
A01.0 E87.1 - 2 4,078,122 4,282,400.00
O14.1 O82.9 - 2 9,654,986 4,826,600.00
D36.1 - 83.39 2 9,181,563 5,845,600.00
K35.1 - 54.11+47.09+54.59 1 14,401,993 7,947,700.00
L02.9 - 86.22+86.04 1 10,802,115 3,267,100.00
J01.0 J33.9 22.9+21.31 1 7,987,933 5,381,100.00
D48.1 - 83.39 2 7,506,212 5,845,600.00
A01.0 K29.7 - 1 3,884,300 3,884,300.00
A01.0 - - 1 2,508,313 3,884,300.00
A01.0 - - 1 3,884,300 3,884,300.00
K40.9 - 53.29 2 10,599,195 4,283,900.00
K51.9 J02.9 - 3 4,326,254 2,331,500.00
J18.0 - - 2 2,864,083 4,170,100.00
B05.9 K12.1 - 2 2,634,884 2,791,900.00
D36.9 E14.5 - 2 12,672,362 11,727,100.00
I85.4 - 49.21 1 12,946,626 6,095,900.00
D24 - 85.21 2 7,531,722 6,118,200.00
D48.1 - 83.39 2 7,693,131 4,871,300.00
A09 - - 1 2,152,074 2,027,100.00
I50.0 J44.9 - 2 5,130,337 7,142,500.00
O99.0 O80.9 - 2 4,910,783 2,859,900.00
O33.9 O82.9 74.4 3 7,745,710 4,022,100.00
J44.9 K30 - 3 4,139,421 2,398,400.00
O02.0 - 69.02 2 4,985,807 3,279,100.00
A01.9 - - 2 3,582,970 3,329,400.00
A49.9 - - 1 3,631,993 3,884,300.00
J18.9 - - 1 5,661,962 4,865,100.00
A09 J06.8 - 2 1,952,543 2,423,100.00
D27 - 65.49 2 16,878,555 6,327,300.00
K40.9 - 53.29 1 10,294,657 4,997,900.00
D69.6 N20.0 99.03 2 9,323,001 4,720,400.00
A01.0 - - 1 3,884,300 3,884,300.00
A01.0 - - 1 3,237,166 3,884,300.00
A09 - - 2 3,590,542 2,423,100.00
J18.9 - - 1 3,802,942 4,865,100.00
I63.9 E78.5+I10+G81.9 - 1 7,994,203 7,463,200.00
A15.0 - - 2 3,056,408 5,004,900.00
A01.0 - - 2 2,403,779 3,329,400.00
A15.0 A01.0 - 2 5,030,096 7,945,500.00
O14.1 O82.9 - 1 11,637,646 5,631,000.00
K35.9 - K35.9 2 8,170,140 3,416,000.00
D24 - - 2 7,618,221 6,118,200.00
P03.4 - - 2 1,655,588 1,995,800.00
A01.0 - - 2 2,505,517 3,329,400.00
A01.0 J06.8 - 3 2,304,380 2,774,500.00
A01.0 - - 2 3,674,455 3,329,400.00
A01.0 N39.0A15.0+E11.9 - 2 4,791,991 4,791,900.00
J40 - - 2 4,562,686 1,858,600.00
O99.0 O80.9 73.59+99.03 2 4,233,699 2,859,900.00
I63.4 E78.5+I10+G81.9 - 1 11,287,251 7,463,200.00
G40.9 N17.9+G41.8+N39.0+E66.8+K40.9 - 2 8,289,329 1,674,000.00
A01.0 N39.0+E11.9 - 1 5,003,561 4,996,100.00
D34 - 6.39 3 14,032,331 4,789,900.00
A01.0 - - 2 3,329,400 3,329,400.00
K29.7 - - 1 2,827,100 2,171,800.00
z99.2 G93.4+R57.9+E16.2+A41.9 99.21 1 19,749,469 5,729,800.00
E13.2 A41.9+E11.9 - 3 2,618,572 6,714,200.00
A01.0 J03.9 - 2 3,222,681 3,329,400.00
O05.4 - - 2 5,703,346 3,279,100.00
A01.0 A91 - 2 4,718,460 4,282,400.00
D48.1 - 83.39 3 7,121,872 4,871,300.00
L72.1 - 83.39 1 9,760,465 2,172,400.00
L84 - 83.39 2 7,547,454 5,845,600.00
K80.8 - 51.22 2 17,678,816 6,481,200.00
O32.1 O82.9 74.4 2 8,820,153 4,826,600.00
P03.4 - - 2 1,679,862 1,995,800.00
P011 P22.9 - 2 8,562,946 5,946,500.00
E16.2 E11.9+I10+J90 - 3 963,667 1,942,900.00
E11.9 E86 - 3 1,491,182 1,942,900.00
G44.2 I69.3+I10+E87.5 - 1 4,808,553 2,715,600.00
A09 - - 1 3,359,096 2,827,100.00
A15.0 - - 2 2,429,431 5,004,900.00
A01.0 A91 - 2 6,381,194 4,906,600.00
N39.0 - - 2 2,977,183 1,860,600.00
A01.0 - - 2 2,674,084 3,329,400.00
O05.4 - 69.02 2 4,547,304 3,279,100.00
O34.2 O24.9+O24.9+O14.9+O82.9 74.4 2 10,710,917 5,326,100.00
D17.9 - 83.39 2 9,515,103 5,845,600.00
D48.1 - 83.39 3 6,676,557 4,871,300.00
I50.0 I09.9 - 1 2,464,771 5,338,800.00
Z53.0 G47.3+J06.8 - 2 1,135,079 1,399,400.00
A01.0 - - 1 3,155,645 3,884,300.00
A09 - - 2 3,292,155 2,423,100.00
B01.9 - - 2 2,437,315 2,331,600.00
A09 - - 2 2,483,791 2,423,100.00
B34.9 - - 2 2,928,180 2,331,600.00
A01.0 J06.9+K30 - 2 2,908,492 3,329,400.00
A09 - - 2 3,228,680 2,423,100.00
O32.1 O82.9 - 2 9,219,489 4,826,600.00
P03.4 - - 2 1,105,358 1,995,800.00
D64.9 N18.0 - 1 5,000,980 3,433,200.00
O05.4 - 69.02 2 5,043,767 3,279,100.00
O30.0 042.9+080.9 73.59 3 2,524,131 2,788,700.00
N75.0 O82.9 74.4 3 8,476,578 4,022,100.00
T17.4 - 98.2 2 4,388,669 1,858,600.00
A01.0 - - 1 2,827,100 3,884,300.00
J90 - - 2 5,009,400 3,264,000.00
J06.9 - - 2 2,459,689 1,829,000.00
A09 - - 2 3,834,197 2,423,100.00
Q21.1 - - 2 1,686,461 3,693,400.00
A09 - - 2 4,126,009 2,423,100.00
P59.9 - - 2 3,074,877 1,995,800.00
A90 - - 2 5,276,821 2,331,600.00
K40.9 N13.3 53.29+54.4 2 9,724,331 4,283,900.00
I88.8 - 40.29 2 9,352,589 4,242,600.00
A90 - - 2 3,370,014 2,331,600.00
B34.9 R04.0 - 2 2,390,440 2,791,900.00
J18.0 G80.9+G41.9+G40.4 - 1 6,461,680 6,836,700.00
L02.9 - 86.22 2 7,229,190 2,800,400.00
L02.9 - 86.28 2 8,328,895 2,800,400.00
D36.0 - 83.39 3 6,867,168 4,871,300.00
E04.1 - 6.31 3 8,641,827 4,789,900.00
D48.1 - 83.39 1 10,095,464 6,819,800.00
A01.0 - - 2 1,759,566 3,329,400.00
A01.0 ISPA - 2 2,057,071 3,329,400.00
K30+E11.9+K80.8 - - 1 4,643,818 3,891,400.00
A09 J06.9 - 3 2,467,655 2,355,800.00
B17.1 K74.6 54.91 3 2,147,788 1,332,600.00
K29.7 - - 2 1,664,492 1,861,600.00
A15.0 - - 2 3,074,361 5,004,900.00
M19.9 A15.0 - 1 9,667,022 4,356,800.00
A09 - - 2 2,707,189 2,423,100.00
A09 - - 2 3,101,986 2,331,600.00
O80.9 - 73.59 2 3,170,646 2,416,400.00
O02.0 - 69.02 3 3,510,727 2,732,600.00
D24 - 85.21 2 7,190,697 6,118,200.00
J35.3 - 28.3 2 7,965,494 2,121,400.00
K40.9 - 53.29 2 8,807,475 4,283,900.00
89.17 - 86.22+93.59 1 10,613,891 2,048,300.00
O33.9 O82.9 74.4 2 8,569,654 4,826,600.00
M71.98 - 83.5 1 13,072,646 6,819,800.00
N18.0 J18+K76.9+M54.16+I11.9 - 2 7,365,867 4,911,300.00
O33.9 O82.9 74.4 1 11,473,975 5,631,000.00
P03.4 - - 1 1,789,163 2,328,400.00
O34.2 - - 2 9,190,588 4,826,600.00
O03.4 - - 2 1,225,952 1,995,800.00
A01.0 - - 2 2,310,805 3,329,400.00
B34.9 - - 2 4,220,448 2,331,600.00
O62.4 - - 3 2,349,903 2,085,300.00
R56 - - 2 1,487,948 1,859,300.00
A09 - - 2 2,292,891 2,423,100.00
E11.2 - - 1 5,609,478 3,632,200.00
J45 B34.9+A01 - 1 6,957,479 3,158,200.00
D38.1 K71.9+J90 - 2 8,581,464 5,336,700.00
A01.0 J21.9 - 1 4,969,680 3,884,300.00
P59.9 - - 2 2,298,144 2,298,100.00
K55.9 K65.0+K40.9 - 1 18,036,979 15,128,700.00
I84.9 - 49.46 3 6,849,108 4,354,200.00
E11.9 - - 1 2,720,000 2,720,000.00
I25.1 I20.0+E11.2 - 2 3,415,000 3,575,100.00
H81.1 N18.9 - 1 3,255,900 3,255,900.00
G40.9 - - 2 1,859,300 1,859,300.00
N75.0 - 71.22 2 8,130,136 3,276,700.00
B08.5 - - 1
2,720,100 2,133,800.00
A01.0 J21.9 - 2 3,172,995 3,329,400.00
A01.0 - - 2 3,816,704 3,329,400.00
I50.0 I48+K30 - 1 4,390,366 8,332,900.00
I64 J45.9+I10+M54.59 - 1 7,637,036 3,296,100.00
K31.9 N18.0 - 3 6,673,755 4,169,300.00
D24 - 85.21 1 9,239,715 7,137,800.00
M79.19 - - 1 5,175,267 2,170,800.00
A01.0 - - 1 4,301,190 3,884,300.00
A09 - - 2 1,857,686 2,423,100.00
K29.7 . - 2 1,590,008 1,861,600.00
A09 - - 3 2,707,008 2,355,800.00
K29.7 M24.68 - 1 4,575,271 2,171,800.00
O99.8 K30 - 2 1,824,676 2,502,400.00
A15.0 - - 2 3,425,807 5,004,900.00
J18.9 Z99.2 - 2 12,082,595 4,170,100.00
N05.9 N18.0 - 1 5,069,574 2,820,700.00
T31.1 - 86.28 1 16,744,585 3,805,600.00
K35.1 - 54.11 2 11,258,143 6,812,300.00
D48.1 - 83.39 2 8,987,031 5,845,600.00
O36.4 - 69.02 2 6,728,844 3,279,100.00
N19.0 N18.0+I10 - 3 1,977,166 1,940,500.00
J03.9 - - 1 5,209,700 2,133,800.00
A09 J06.9 - 2 3,070,132 2,423,100.00
R56.0 J06.9 - 2 2,449,961 1,859,300.00
E11.9 I50.0+I25.1 - 3 6,112,320 4,448,800.00
K30 B05.9 - 1 2,836,380 3,891,400.00
G03.9 K75.9 - 1 6,897,896 5,026,800.00
I11.9 M19.99+M71.46+E78.5 - 1 6,123,173 6,042,200.00
J35.2 - - 2 7,472,653 2,121,400.00
S42.0 J93.9 79.39+34.04 1 10,500,000 10,590,400.00
A91 A01.0 - 2 3,718,699 3,398,900.00
A09 - - 1 2,370,013 2,827,100.00
A09 A15.0 - 2 2,140,283 3,421,100.00
B05.9 - - 1 2,014,822 2,720,200.00
K29.7 M75.8 - 1 5,696,833 2,171,800.00
A01.0 J20.9 - 1 7,164,722 3,884,300.00
J35.3 - 28.3 2 7,380,732 2,121,400.00
O41.0 O48+O82.9 74.4 3 8,259,965 4,022,100.00
K40.9 - 53.29 3 7,919,250 3,569,900.00
D24 - 85.21 2 10,559,607 6,118,200.00
S72.9 79.35+78.03+78.65 - 1 29,585,327 13,033,500.00
A01.0 A15.0 - 3 4,637,417 3,568,700.00
G40.9 A09 - 3 2,960,425 1,549,400.00
A01.0 - - 1 2,960,379 3,884,300.00
J20.9 B05.9 - 2 1,483,796 1,858,600.00
A15.6 - - 2 4,467,535 5,004,900.00
L72.1 - . 2 7,477,883 5,845,600.00
N20.1 - 56.2 3 11,623,555 10,090,500.00
N20.1 N99.1 58.22+56.0+97.65 2 14,174,629 10,048,300.00
R10.4 - - 1 2,827,100 2,827,100.00
J06.9 - - 1 2,133,800 2,133,800.00
R42 R10.4 - 2 4,165,253 1,858,400.00
O80.9 - 73.59 2 6,584,180 2,416,400.00
A01.0 - - 1 3,884,300 3,884,300.00
UTAMA HARGA INA CBGS
D48.1 - D48.1 1 9,051,956 6,819,800.00
A01.9 - - 1 2,469,452 3,884,300.00
J06.8 - - 1 2,796,253 2,133,800.00
M67.4 - 82.21 2 6,947,964 6,233,600.00
K35.9 - 47.09 2 10,668,401 3,416,000.00
K61.0 - 86.28 2 8,461,594 3,335,500.00
R06.0 - - 1 6,864,095 2,168,400.00
M62.95 M54.59 - 1 3,181,713 2,040,600.00
B05.9 - - 1 2,255,478 2,720,200.00
I84.5 I84.2 49.21+49.46 2 7,156,982 5,225,100.00
A01.0 A15.0 - 2 9,364,148 4,282,400.00
J03.9 - - 2 3,096,550 1,829,000.00
A09 - - 2 3,401,333 2,423,100.00
I25.1+I20.9 J20.9 . 1 12,678,156 3,264,200.00
R50.9 - - 1 1,662,712.00 2,179,700.00
R11 - - 2 981,341.00 2,423,100.00
D48.1 - 83.39 2 6,890,803.00 5,845,600.00
J02.9 - - 2 1,422,869.00 1,829,000.00
A09 - - 1 2,827,100.00 2,827,100.00
D36.7 - 83.39 1 9,238,147.00 6,819,800.00
G40.9 E83.5+B34.9 - 1 3,585,678.00 1,723,800.00
J18.0 - - 1 2,527,158.00 4,865,100.00
J40 - - 2 5,575,196.00 1,858,600.00
A01 - - 1 2,519,510 3,884,300.00
A09 - - 2 1,788,649 2,423,100.00
I11.9 E11.2+I69.3 - 2 4,620,663 5,179,100.00
K29.7 - - 1 3,699,930 2,171,800.00
A09 - - 1 3,365,518 2,827,100.00
R56.0 J06.9 - 1 1,859,236 2,169,200.00
A09 J20.9 - 1 3,886,161 2,827,100.00
- 26,800.00
- 14,600.00
NAMA DOKTER
3,421,467 dr. MR. Kurnia, Sp.PD

2,461,025 dr. Paramita, SP.A
2,986,214 dr. DEASY, SP.P
6,641,443 dr. Sarjunas, Sp.OG
5,229,861 dr. Djoko, SP.B
2,697,435 dr. Maulia, Sp.OG
3,243,558 dr. ACHMAD BARUNA, SP.PD
2,239,037 dr. DEDE LIA, SP.A
6,943,770 dr. RIEN, SP.JP
4,031,273 dr. RICHARD, SP.THT
5,002,113 dr. GHUNA, SP.OT
8,785,833 dr. Raden Bayu, Sp.Jp
3,296,300 dr. MEDIA, SP.S
6,774,180 dr. ZUHAIRA, SP.S
10,707,884 dr. Djoko, SP.B
1,801,652 dr. Miftah, Sp.Pd
579,335 dr. Paramita, SP.A
2,332,984 dr. YURIKA, SP.A
17,431,698 dr. Djoko, SP.B
3,905,914 dr. PITRAJAYA, SP.B
13,466,175 dr. RENNY, SP.U
11,171,600 dr. ANDRI, SP.OT
2,283,839 dr. YUDI, SP.U
10,733,756 dr. YUDI, SP.U
10,401,399 dr. YUDI, SP.U
11,052,955 dr. YUDI, SP.U
11,221,663 dr. YUDI, SP.U
2,411,492 dr. Ade, SP.S
3,736,199 dr. NUNUNG, SP.OG
11,245,331 dr. Djoko, SP.B
2,333,572 dr. RENNY, SP.U
963,667 dr. DEDI NASWALDI
689,079 dr. Richard, Sp.Tht
3,218,669 dr. Richard, Sp.Tht
7,838,964
4,103,808 dr. Djoko, Sp.B
dr. DEDE LIA, SP.A

2,720,100
2,389,008 DR. MR. KURNIA, SP.PD
1,977,166 dr. DWIANA SARI
5,968,896 dr. Zuhaira, Sp.S
2,644,699 DR. MR. KURNIA, SP.PD
8,334,555 dr. YUDI, SP.U
8,883,129 dr. YUDI, SP.U
NAMA DOKTER
dr. PITRAJAYA, SP.B

DR. MR. KURNIA, SP.PD
dr. ACHMAD BARUNA, SP.PD
dr. PITRAJAYA, SP.B
dr. PITRAJAYA, SP.B
dr. PITRAJAYA, SP.B
DR. MIFTAH, SP.PD
dr. Zuhaira, Sp.S
DR. PARAMITA, SP.A
dr. Djoko, Sp.B
dr. Miftah, Sp.PD
dr. YURIKA, SP.A
dr. Miftah, Sp.PD
DR. PARAMITA, SP.A
DR. PARAMITA, SP.A
dr. Djoko, Sp.B
dr. Yurika, Sp.A
dr. Djoko, Sp.B
dr. MEDIA, SP.S
DR. PARAMITA, SP.A
DR. PARAMITA, SP.A
DR. PARAMITA, SP.A
DR. YURIKA, SP.A
DR. MIFTAH, SP.PD
dr. DEDE LIA, SP.A
DR. YURIKA, SP.A
APS
HARI
1 RIZKY MAULANA 379952 27-Oct-15 01-Nov-15 6

2 FITRI PUSPITASARI 309951 31-Oct-15 01-Nov-15 2
3 RIPKI SETIAWAN 411854 26-Oct-15 01-Nov-15 7
4 ADE LILIATUN 412032 28-Oct-15 01-Nov-15 5
5 DINA RIZKY, NY 390468 31-Oct-15 01-Nov-15 2
6 PUTRI AULIYAH 412255 31-Oct-15 02-Nov-15 3
7 SUSI HERLINA 304797 31-Oct-15 02-Nov-15 3
8 TUTI ROSITA 412095 30-Oct-15 02-Nov-15 4
9 SAKINAH DINAR 371446 28-Oct-15 02-Nov-15 6
10 JUKI 327148 23-Oct-15 02-Nov-15 11
11 PEPEN SUPENA 300360 27-Oct-15 02-Nov-15 7
12 MITA BUDI 412284 01-Oct-15 02-Nov-15 2
13 DARHIM 411687 31-Oct-15 02-Nov-15 3
14 WAWAN GUNAWAN 395177 31-Oct-15 02-Nov-15 3
15 ENTAS 411859 26-Oct-15 02-Nov-15 8
16 IYAT SUPRIATNA 337243 31-Oct-15 02-Nov-15 3
17 REGA HAERUNISA 398260 31-Oct-15 02-Nov-15 3
18 NURFARIDATUL 412112 31-Oct-15 02-Nov-15 3
19 AISAH, NY 411270 30-Oct-15 02-Nov-15 4
20 AISAH, BY 412147 30-Oct-15 02-Nov-15 4
21 SUMARNO 355102 27-Oct-15 02-Nov-15 7
22 M DAFFA 375329 31-Oct-15 02-Nov-15 3
23 NURBAETI 412049 29-Oct-15 02-Nov-15 5
24 YETI HERMAWATI 412093 29-Oct-15 02-Nov-15 5
25 M AFIQ RAISAH 412280 01-Oct-15 03-Nov-15 3
26 NAUFAL BINTANG 386475 30-Oct-15 03-Nov-15 5
27 KASTEM 400390 30-Oct-15 03-Nov-15 5
28 ALKIYA FARHAN 412138 01-Oct-15 03-Nov-15 3
29 NABILA KARTIKA 343010 29-Oct-15 03-Nov-15 6
30 AMINAH 412004 28-Oct-15 03-Nov-15 7
31 ROSIT A SIDIK 412145 30-Oct-15 03-Nov-15 5
32 DARA AYUNDA 412065 29-Oct-15 03-Nov-15 6
33 MAHMUDIN 408002 02-Oct-15 03-Nov-15 2
34 RISKA DAMAYANTI 410537 31-Oct-15 03-Nov-15 4
35 USEP SAEPULOH 412195 02-Oct-15 03-Nov-15 2
36 NINING SARTIKA 408069 02-Oct-15 03-Nov-15 2
37 AI SITI AISAH 410743 02-Oct-15 03-Nov-15 2
38 ALING CARLI 412153 02-Oct-15 03-Nov-15 2
39 ADIBA RAISHA 382159 01-Nov-15 04-Nov-15 4
40 AZHAR SEPTIAN 397651 29-Oct-15 03-Nov-15 6
41 GUSNA KURNIATI 389757 01-Oct-15 03-Nov-15 3
42 SRI KEMALA DEWI 386568 30-Oct-15 03-Nov-15 5
43 KOKON SUTRANINGSIH 369513 31-Oct-15 03-Nov-15 4
44 NENENG NURHAYATI 412301 02-Oct-15 03-Nov-15 2
45 CAWIH 370653 02-Oct-15 03-Nov-15 2
46 RISDHA OKTAVIANI 412321 02-Oct-15 04-Nov-15 3
47 NABILA ZAHWA 399155 02-Oct-15 04-Nov-15 3
48 M FAIZ KENZIE 412266 01-Oct-15 04-Nov-15 4
49 ADE YAYAT 352832 29-Oct-15 04-Nov-15 7
50 SYAMSUL ARIFIN 412313 03-Oct-15 04-Nov-15 2
51 ENCANG 412120 02-Oct-15 04-Nov-15 3
52 SRI MARLINA 412326 03-Oct-15 04-Nov-15 2
53 BEBY QIANDRA 337998 01-Oct-15 04-Nov-15 4
54 TITI JUHATY 412111 30-Oct-15 04-Nov-15 6
55 ROKAYAH 356478 29-Oct-15 04-Nov-15 7
56 YUDI WAHYUDIN 365922 24-Oct-15 02-Nov-15 10
57 YASIN 300283 30-Oct-15 03-Nov-15 5
58 BUNGA AULIA 406725 01-Oct-15 05-Nov-15 5
59 DALFA NAFSIYAH 412322 02-Oct-15 05-Nov-15 4
60 M MUBAROK 379666 04-Oct-15 05-Nov-15 2
61 NAFISYATUL ASYRI 412068 29-Oct-15 05-Nov-15 8
62 M DARWIS 409856 30-Oct-15 05-Nov-15 7
63 OYOK SUSILAWATI 411638 02-Oct-15 05-Nov-15 4
64 WASITO 411221 01-Oct-15 05-Nov-15 5
65 LISA NURJANAH 411996 04-Oct-15 05-Nov-15 2
66 MAMAN SUPARMAN 412409 04-Oct-15 05-Nov-15 2
67 LUSI NURAJIZAH, NY 412293 01-Oct-15 05-Nov-15 5
68 LUSI NURAJIZAH, BY 412315 02-Oct-15 05-Nov-15 4
69 ELFRIS TARUNA 412462 04-Oct-15 05-Nov-15 2
70 BADRUDIN 393639 03-Oct-15 05-Nov-15 3
71 BUKHARA 412526 04-Nov-15 06-Nov-15 3
72 FAUZIA AFIYATUL 412341 04-Nov-15 06-Nov-15 3
73 ENEN EPONG 410737 29-Oct-15 06-Nov-15 9
74 TETI PERMAWATI 412501 04-Nov-15 06-Nov-15 3
75 SUNYANI 403031 29-Oct-15 06-Nov-15 9
76 SUKAESIH 406103 03-Nov-15 06-Nov-15 4
77 ENENG LINA 412306 03-Nov-15 06-Nov-15 4
78 NADYA FAUZIA 411529 21-Oct-15 06-Nov-15 16
79 ANI PATIMAH 403241 03-Nov-15 07-Nov-15 5
80 M ZAKI 390229 04-Nov-15 07-Nov-15 4
81 SUMARNO 300272 05-Nov-15 07-Nov-15 3
82 JAHZARA ALZALIA 412371 02-Nov-15 07-Nov-15 6
83 ATMA HENDRA 401031 02-Nov-15 07-Nov-15 6
84 DHIAZ YULIANTI 412543 05-Nov-15 07-Nov-15 3
85 MARATUL MUKAROMAH 412571 06-Nov-15 07-Nov-15 2
86 SITI MUDRIKAH 412537 06-Nov-15 07-Nov-15 2
87 MAYA NAILUFHAR, NY 412580 05-Nov-15 07-Nov-15 3
88 SRI BADRIYAH 351209 04-Nov-15 08-Nov-15 5
89 NANI SUMARNI 410498 06-Nov-15 08-Nov-15 3
90 HERU SUPRIYOTNO 412651 07-Nov-15 08-Nov-15 2
91 M YUSUF ISMAIL 401359 04-Nov-15 08-Nov-15 5
92 YAYAH HAYATI 352161 06-Nov-15 08-Nov-15 3
93 ADIBA RAISHA 382159 06-Nov-15 08-Nov-15 3
94 EDI ISNADI 411387 04-Nov-15 08-Nov-15 5
95 SIAU LING 399651 04-Nov-15 08-Nov-15 5
96 OOM ROMLAH 391717 04-Nov-15 08-Nov-15 5
97 ASRUL AFUARDY 351977 06-Nov-15 08-Nov-15 3
98 DEVINA CHANDRA 412628 07-Nov-15 08-Nov-15 2
99 SALMAN AL FARISI 408849 07-Nov-15 08-Nov-15 2
100 NELY 407948 05-Nov-15 08-Nov-15 4
101 NELIH NURSAADAH 412469 04-Nov-15 08-Nov-15 5
102 WIWI WIDANINGSIH 373421 03-Nov-15 08-Nov-15 6
103 HERNANDEZ MASSA 404357 06-Nov-15 09-Nov-15 4
104 EDAH SUKAEDAH 412461 04-Nov-15 09-Nov-15 6
105 MUNIROH 412438 05-Nov-15 09-Nov-15 5
106 M BAGAS AL BARRA 403160 06-Nov-15 09-Nov-15 4
107 NURUL HAJIJAH 398315 03-Nov-15 09-Nov-15 7
108 SANTI NURHAYATI 412694 07-Nov-15 09-Nov-15 3
109 R SITI KAMALIYAH 412345 05-Nov-15 09-Nov-15 5
110 DEVY KUSTINI, NY 402757 06-Nov-15 09-Nov-15 4
111 DEVY KUSTINI, BY 412644 06-Nov-15 09-Nov-15 4
112 TETI PERMAWATI, BY 412520 04-Nov-15 09-Nov-15 6
113 ENDA SUHENDA 412504 06-Nov-15 09-Nov-15 4
114 SHAKILA IRDINA 412642 06-Nov-15 08-Nov-15 3
115 FRANKY STEVANUS 412584 06-Nov-15 07-Nov-15 2
116 ABDUL ROZAK 412296 02-Nov-15 07-Nov-15 6
117 RASHA NARESWARI 300074 29-Oct-15 08-Nov-15 11
118 M YUSUF SUGURI 412465 04-Nov-15 06-Nov-15 3
119 LUSI FAUZIYANTI 342226 06-Nov-15 10-Nov-15 5
120 M FARHAN ABIANSYAH 355601 07-Nov-15 10-Nov-15 4
121 TAMSIL ISWANDI 360522 10-Nov-15 10-Nov-15 2
122 ABD. RAHMAN 375818 04-Nov-15 10-Nov-15 7
123 PATRIANI 412695 08-Nov-15 10-Nov-15 3
124 SARWINAH 371450 10-Nov-15 10-Nov-15 2
125 OMIH, NY 412683 07-Nov-15 10-Nov-15 4
126 OMIH, BY 412693 07-Nov-15 10-Nov-15 4
127 FAJAR NURSIDIK 412637 06-Nov-15 10-Nov-15 5
128 CICIH 393829 07-Nov-15 10-Nov-15 4
129 EDAH YULIANTI 387101 07-Nov-15 10-Nov-15 4
130 ENDIH SUPATIMAN 412452 03-Nov-15 10-Nov-15 7
131 SOMA SOMANTRI 380651 02-Nov-15 10-Nov-15 9
132 BAGAS RISKY 387662 01-Nov-15 07-Nov-15 7
133 ASEP KHAIDIR 383195 09-Nov-15 11-Nov-15 3
134 ADE APRIANA 334369 09-Nov-15 11-Nov-15 3
135 TETI YULIANTI 362974 09-Nov-15 11-Nov-15 3
136 SAHLA NURAFIFAH 412677 07-Nov-15 11-Nov-15 5
137 MARSIAH 386903 05-Nov-15 11-Nov-15 7
138 DEBI MUTHIASARI 412775 10-Nov-15 11-Nov-15 2
139 ASEP NURDIANA 371226 10-Nov-15 11-Nov-15 2
140 CAHYADI SURATMAN 301121 10-Nov-15 11-Nov-15 5
141 HJ. MASITOH 412572 07-Nov-15 11-Nov-15 5
142 INGGRIANI SRI K 379496 28-Oct-15 11-Nov-15 15
143 SLAMET DARWOTO 398008 03-Nov-15 11-Nov-15 4
144 DINI NURMANINGSIH 357951 09-Nov-15 10-Nov-15 2
145 HEPRIANSYAH 412641 06-Nov-15 07-Nov-15 2
146 NINA SRIYANI 412521 06-Nov-15 06-Nov-15 1
147 WANDA BIN SUWANDI 379157 06-Nov-15 06-Nov-15 1
148 FAIREL ARSYAD 398138 09-Nov-15 12-Nov-15 4
149 M LUTHFI 325797 10-Nov-15 12-Nov-15 3
150 ANINDITA KHAIRUNISA 395116 09-Nov-15 12-Nov-15 4
151 AQEELA KHANZA 411693 09-Nov-15 12-Nov-15 4
152 DARHIM 411687 09-Nov-15 12-Nov-15 4
153 KARLINA 390352 09-Nov-15 12-Nov-15 4
154 ENCIM 381106 10-Nov-15 12-Nov-15 3
155 SYIFA RAMADHINA 412846 10-Nov-15 12-Nov-15 3
156 SITI NURHAYATI 321779 12-Nov-15 13-Nov-15 2
157 LALU DADANG 333472 06-Nov-15 12-Nov-15 7
158 IDA 412868 11-Nov-15 12-Nov-15 2
159 RATNA SARI 412691 09-Nov-15 12-Nov-15 4
160 RASEM 412794 11-Nov-15 12-Nov-15 2
161 RUSMIATI 309483 11-Nov-15 12-Nov-15 2
162 RENALDI ARDIANSYAH 412817 11-Nov-15 12-Nov-15 2
163 JUHARDI 412847 10-Nov-15 12-Nov-15 3
164 BARKAH YUNIARTO 412862 10-Nov-15 12-Nov-15 3
165 FATHIRA ARRAYAN 412681 07-Nov-15 07-Nov-15 1
166 TUTI SUSILAWATI 409384 11-Nov-15 13-Nov-15 3
167 LIANA 400628 06-Nov-15 13-Nov-15 8
168 SRI HASTUTI 412961 12-Nov-15 13-Nov-15 2
169 IPIK FIKRIAH 412805 10-Nov-15 13-Nov-15 4
170 DEDE ROSMAWATI 388363 09-Nov-15 13-Nov-15 5
171 ELVINA ADINATA 364192 09-Nov-15 13-Nov-15 5
172 OKTAVIANI LATIFAH 341251 09-Nov-15 13-Nov-15 5
173 M PRAM PRASETYO 412666 07-Nov-15 13-Nov-15 7
174 JULIYANA JUNAEDI 411273 12-Nov-15 13-Nov-15 2
175 SAROHA HASIBUAN 378696 11-Nov-15 14-Nov-15 4
176 ANENG FATIMAH 412710 08-Nov-15 14-Nov-15 7
177 M KHOIRUNIZAM 412689 10-Nov-15 14-Nov-15 5
178 RANDHIKA FEBRIAN 383626 06-Nov-15 14-Nov-15 9
179 ISUN 412855 10-Nov-15 14-Nov-15 5
180 ENTAY WIYANA 412789 10-Nov-15 14-Nov-15 5
181 RAHMAT 407257 12-Nov-15 14-Nov-15 3
182 M RIZAL HERDIANSYAH 324303 12-Nov-15 14-Nov-15 3
183 UYAT SUYATNA 412827 12-Nov-15 14-Nov-15 3
184 SUSILAWATI, NY 412927 11-Nov-15 14-Nov-15 4
185 SUSILAWATI, BY 412946 11-Nov-15 14-Nov-15 4
186 SITI MASITOH 413059 13-Nov-15 14-Nov-15 2
187 SUHENDI 407961 12-Nov-15 14-Nov-15 3
188 AEP KURNIA 412772 12-Nov-15 15-Nov-15 4
189 STEWARD G.L 338308 14-Nov-15 15-Nov-15 2
190 OMIH, BY 412693 13-Nov-15 15-Nov-15 3
191 GALIH PAMUNGKAS 300473 12-Nov-15 15-Nov-15 4
192 NENG MEI MUSTIKA 412936 12-Nov-15 15-Nov-15 4
193 DINI MALARY 383208 12-Nov-15 15-Nov-15 4
194 RUSLANI 412834 12-Nov-15 15-Nov-15 4
195 INDA WATI 328957 13-Nov-15 15-Nov-15 3
196 NENENG SYAMSIAH 413118 14-Nov-15 16-Nov-15 3
197 IYOH 402789 13-Nov-15 16-Nov-15 4
198 ULFA HASANAH 412762 10-Nov-15 16-Nov-15 7
199 DAFFA HAFIZAH 413042 13-Nov-15 16-Nov-15 4
200 ARTI SETIA PRIBADI 413010 12-Nov-15 16-Nov-15 5
201 NENDEN RUBIKANIA 412926 13-Nov-15 16-Nov-15 4
202 SHELY LUCIANI 385021 12-Nov-15 16-Nov-15 5
203 YANAH SUPRIYANAH 382882 10-Nov-15 16-Nov-15 7
204 ANI SUMIATI 385501 12-Nov-15 13-Nov-15 2
205 SUHAENAH LARASATI 335418 12-Nov-15 14-Nov-15 3
206 TUTI WIARSIH 406979 13-Nov-15 16-Nov-15 4
207 SUCI HERMAN 317668 11-Nov-15 17-Nov-15 7
208 NAURA MARINKA 412999 12-Nov-15 17-Nov-15 6
209 M BASYITH ALFIAN 388430 13-Nov-15 17-Nov-15 5
210 ADE KOSASIH 413047 14-Nov-15 17-Nov-15 4
211 IYUT 413173 16-Nov-15 17-Nov-15 2
212 DEVNI DZAKIRA JASMIN 412644 11-Nov-15 17-Nov-15 7
213 ADE SUPRIATNA 361766 11-Nov-15 17-Nov-15 7
214 WIWI WIDANINGSIH 373421 11-Nov-15 17-Nov-15 7
215 DAFFA RAMDHAN 412213 16-Nov-15 17-Nov-15 2
216 SINDU WAHYONO 412955 16-Nov-15 17-Nov-15 2
217 JIBRIL AL SHIDIQ 409045 14-Nov-15 17-Nov-15 4
218 REZA ADITYA 400446 14-Nov-15 17-Nov-15 4
219 RADITYA PRAYOGA 413091 14-Nov-15 17-Nov-15 4
220 AL DAFFA SAKHA 413120 14-Nov-15 17-Nov-15 4
221 RAHMA ZIKRY 412942 11-Nov-15 17-Nov-15 7
222 TATANG MULYANA 326006 16-Nov-15 17-Nov-15 2
223 TRI BUDIYANTO 388488 09-Nov-15 17-Nov-15 9
224 OOM 393052 10-Nov-15 17-Nov-15 8
225 EUIS YULIANI 401918 14-Nov-15 18-Nov-15 5
226 SANDI 413055 13-Nov-15 18-Nov-15 6
227 ASEP SAEPUDIN 412947 12-Nov-15 18-Nov-15 7
228 KHANSA KHOERUNISA 365782 15-Nov-15 18-Nov-15 4
229 M SYAHRIL 412996 16-Nov-15 18-Nov-15 3
230 ENENG ROHAYATI 413201 17-Nov-15 18-Nov-15 2
231 MIA WULANDARI 413169 17-Nov-15 18-Nov-15 2
232 FENNY RAHAYU 384160 17-Nov-15 18-Nov-15 2
233 MEIZSA NABILA 413034 14-Nov-15 14-Nov-15 2
234 BADRI SUGIRI 413188 16-Nov-15 19-Nov-15 4
235 NENG KUSMINI 303677 17-Nov-15 19-Nov-15 3
236 SANELIA NUR FIANI 358147 17-Nov-15 19-Nov-15 3
237 AHMAD ZACKY 413311 18-Nov-15 19-Nov-15 2
238 M SIMARMATA 314971 18-Nov-15 19-Nov-15 2
239 SURCI 331695 17-Nov-15 19-Nov-15 3
240 R SITI FATIMAH 316612 15-Nov-15 19-Nov-15 5
241 EDI YATNA 411475 13-Nov-15 19-Nov-15 7
242 NAJWA KHAIRA 402848 15-Nov-15 19-Nov-15 5
243 SARNIKA HERLIANI 413186 18-Nov-15 19-Nov-15 2
244 IKA WIJAYANTI 412837 16-Nov-15 19-Nov-15 4
245 RETNOWATI 413193 18-Nov-15 19-Nov-15 2
246 M ALI 407154 14-Nov-15 19-Nov-15 6
247 M YAHYA 376778 17-Nov-15 19-Nov-15 3
248 HANIE FITRI, BY 413358 18-Nov-15 19-Nov-15
249 HIDAYAT MUSTOFA 401958 17-Nov-15 20-Nov-15 4
250 ALISHA SAFIYA 396311 18-Nov-15 20-Nov-15 3
251 DETTY HENARISYAH 413236 16-Nov-15 20-Nov-15 5
252 RISTY ANJANI 413164 16-Nov-15 20-Nov-15 5
253 NINDA QASMIDA 375226 17-Nov-15 20-Nov-15 4
254 SITI NURHAYATI 321779 19-Nov-15 20-Nov-15 2
255 NABILA AYU QANITA 382709 16-Nov-15 20-Nov-15 5
256 NUNUNG 410485 19-Nov-15 20-Nov-15 2
257 EVA YANTI 330197 16-Nov-15 20-Nov-15 5
258 RINI HERLINAWATI 413184 19-Nov-15 20-Nov-15 2
259 MIMIN 413289 18-Nov-15 20-Nov-15 3
260 RULI APRILIANI 387516 18-Nov-15 20-Nov-15 3
261 SUANAH 400756 16-Nov-15 21-Nov-15 6
262 ADIN MULYANA 413301 17-Nov-15 21-Nov-15 5
263 RAKA ATHAYA 345488 18-Nov-15 21-Nov-15 4
264 SARAH 413244 17-Nov-15 21-Nov-15 5
265 ALDA AHSANUNISA 374566 19-Nov-15 21-Nov-15 3
266 AGUS RIYANTO 413227 16-Nov-15 21-Nov-15 6
267 IDA RUHIDA 413070 17-Nov-15 21-Nov-15 5
268 RATNAWATI 317870 18-Nov-15 21-Nov-15 4
269 SITI ULYA 340483 20-Nov-15 21-Nov-15 2
270 WASKIM 401358 19-Nov-15 21-Nov-15 3
271 BABAM ABU BAKAR 402178 20-Nov-15 21-Nov-15 2
272 YUSUP ENCUP 413248 17-Nov-15 21-Nov-15 5
273 YEYEN 410441 18-Nov-15 21-Nov-15 4
274 IDAWATI 403523 19-Nov-15 21-Nov-15 3
275 ROKAYAH 356478 17-Nov-15 21-Nov-15 5
276 M AHRIL 392337 18-Nov-15 20-Nov-15 3
277 EMI SUMIATI 413557 18-Nov-15 21-Nov-15 4
278 NADYA FAUZIA, BY 1 411528 21-Oct-15 19-Nov-15 30
279 AAN SUYATMI 412788 10-Nov-15 16-Nov-15 7
280 DESWENDI 384937 16-Nov-15 20-Nov-15 5
281 GUGUN GUMILAR 386902 20-Nov-15 22-Nov-15 3
282 M ADLI FAIRUZ 413418 19-Nov-15 22-Nov-15 4
283 JOANA DEVI 413218 20-Nov-15 22-Nov-15 3
284 UUN UNASIH 413081 14-Nov-15 22-Nov-15 9
285 MASIH BT MANGKIN 413348 18-Nov-15 22-Nov-15 5
286 RATNAWATI, BY 413376 19-Nov-15 22-Nov-15 4
287 EUIS ROSMIATI 411544 20-Nov-15 22-Nov-15 3
288 ETI SETIAWATI 413066 14-Nov-15 14-Nov-15 1
289 MARDIAH 413043 13-Nov-15 13-Nov-15 1
290 EVE NISMA 410012 16-Nov-15 19-Nov-15 4
291 EUIS MARFUAH 413268 17-Nov-15 20-Nov-15 4
292 MASIH BT MANGKIN, BY 413396 19-Nov-15 22-Nov-15 4
293 MIA LESTARI , NY 413462 21-Nov-15 23-Nov-15 3
294 DAMA , TN 413443 21-Nov-15 23-Nov-15 3
295 RAKHA SAIFA 413128 15-Nov-15 23-Nov-15 9
296 SUHAETI 413232 16-Nov-15 23-Nov-15 8
297 OYAH 413375 20-Nov-15 23-Nov-15 4
298 BAYU 413431 20-Nov-15 23-Nov-15 4
299 ZENOBIA 396101 17-Nov-15 23-Nov-15 7
300 SUHARJO 374532 19-Nov-15 23-Nov-15 5
301 JASHENDRI 324723 20-Nov-15 23-Nov-15 4
302 OOM SURJADI 355042 18-Nov-15 23-Nov-15 6
303 MAEMUNAH 413432 20-Nov-15 24-Nov-15 5
304 UDIN WAHYUDIN 336559 21-Nov-15 24-Nov-15 4
305 RUDJIONO 353780 21-Nov-15 24-Nov-15 4
306 MARYAMAH 413510 21-Nov-15 24-Nov-15 4
307 M AUDI 378910 20-Nov-15 24-Nov-15 5
308 SYADZIA RIKZANTI 395096 19-Nov-15 24-Nov-15 6
309 LINDA NUR SEPTIANI 395828 19-Nov-15 24-Nov-15 6
310 RUMTIJAH 413162 16-Nov-15 24-Nov-15 9
311 NIA KUSTINAH 413337 23-Nov-15 24-Nov-15 2
312 SOMA SOMANTRI 380651 23-Nov-15 24-Nov-15 2
313 HALIMAH 384095 12-Nov-15 24-Nov-15 3
314 ASIKIN 413143 15-Nov-15 15-Nov-15 1
315 KEYLA ASENDA 413499 21-Nov-15 22-Nov-15 2
316 FRISCA M SEMBIRING 413517 22-Nov-15 25-Nov-15 4
317 EGI SAPUTRA 403564 23-Nov-15 25-Nov-15 3
318 I NYOMAN 413540 23-Nov-15 25-Nov-15 3
319 KHIAR ZINAN 412780 20-Nov-15 25-Nov-15 6
320 SUGENG 385977 21-Nov-15 25-Nov-15 5
321 DEWI NOVIANTI 394311 24-Nov-15 25-Nov-15 2
322 RUSKIM 413559 23-Nov-15 25-Nov-15 3
323 WULAN AGUSTINA 410687 23-Nov-15 25-Nov-15 3
324 DAMAI YANTI, NY 352205 23-Nov-15 25-Nov-15 3
325 DAMAI YANTI, BY 413599 23-Nov-15 25-Nov-15 3
326 DIAN DARMAWAN 399692 23-Nov-15 25-Nov-15 3
327 ADIVA RYANITA 400595 23-Nov-15 25-Nov-15 4
328 HASSYA JUNAYRA 389104 23-Nov-15 26-Nov-15 5
329 CUCU MULYANI 375351 22-Nov-15 26-Nov-15 5
330 WAWAN SAFARI 413518 22-Nov-15 26-Nov-15 5
331 YULAN MULYANTI 413659 22-Nov-15 26-Nov-15 3
332 REYSHA ANGELIA 369721 24-Nov-15 26-Nov-15 6
333 OPIE ANDARESTA 413558 21-Nov-15 26-Nov-15 3
334 YULI YULIANTI 413553 24-Nov-15 26-Nov-15 3
335 KOMISARI 400652 24-Nov-15 26-Nov-15 5
336 AYYASH MUHAMAD 397820 22-Nov-15 26-Nov-15 3
337 ARIS RISNANDAR 348921 24-Nov-15 26-Nov-15 5
338 NURATHIFAH NOVIANTI 413713 22-Nov-15 26-Nov-15 2
339 RATNASARI 407732 26-Nov-15 26-Nov-15 4
340 M FARIH MUBAROK 413537 23-Nov-15 26-Nov-15 4
341 SALMA ALIEFA 413539 23-Nov-15 26-Nov-15 4
342 MISDA 413503 23-Nov-15 26-Nov-15 6
343 DINDA TRIHAPSARI 328319 21-Nov-15 26-Nov-15 5
344 NANO KARYANA 413331 22-Nov-15 26-Nov-15 5
345 DIKY PRATAMA 413328 22-Nov-15 26-Nov-15 2
346 AURA NOURIDA 362026 25-Nov-15 26-Nov-15 3
347 MASRA UHANDA 388371 24-Nov-15 26-Nov-15 3
348 WASITO 413575 17-Nov-15 19-Nov-15 4
349 TRIKORAWATI 413535 23-Nov-15 26-Nov-15 6
350 ATIN 318755 22-Nov-15 27-Nov-15 5
351 HIKSAN JUMANDIRI 344205 23-Nov-15 27-Nov-15 6
352 RAHMAT HIDAYAT 412574 22-Nov-15 27-Nov-15 4
353 MULYATI 370910 21-Nov-15 27-Nov-15 7
354 OYOK AISYAH 413461 21-Nov-15 27-Nov-15 8
355 ENDANG SULASTRI 333984 20-Nov-15 27-Nov-15 3
356 PINA AGUSTIN 413649 25-Nov-15 27-Nov-15 4
357 DEDEH KOMARIAH 376451 24-Nov-15 27-Nov-15 3
358 SUMARTINI 408746 25-Nov-15 27-Nov-15 7
359 CECEP H 342547 21-Nov-15 27-Nov-15 7
360 SILMI AULIA 405478 21-Nov-15 27-Nov-15 2
361 SRI FIANINGSIH 413607 27-Nov-15 28-Nov-15 6
362 AGUSTINUS 402125 23-Nov-15 28-Nov-15 6
363 OLIH 413551 23-Nov-15 28-Nov-15 6
364 DADAN RAMADANI 383221 23-Nov-15 28-Nov-15 3
365 AI SUAIDAH 413577 26-Nov-15 28-Nov-15 5
366 YESYA MAUDI RIZKY 377235 24-Nov-15 28-Nov-15 6
367 LINA HERLINA 413690 23-Nov-15 28-Nov-15 4
368 AMIN BIN NUSA 383789 25-Nov-15 28-Nov-15 6
369 JAMIWIYATI 413595 23-Nov-15 28-Nov-15 6
370 SAAN SOBARI 365977 26-Nov-15 29-Nov-15 4
371 ENENG HADIJAH 349953 24-Nov-15 29-Nov-15 6
372 YUNITA APRIANTI 413854 28-Nov-15 29-Nov-15 2
373 ASEP IRAWAN 412824 27-Nov-15 29-Nov-15 3
374 ZAHRA AULIA ANWAR 406442 26-Nov-15 29-Nov-15 4
375 CAMELIA 404445 25-Nov-15 29-Nov-15 5
376 YAYAH 393440 26-Nov-15 26-Nov-15 1
377 EPON MAEMUNAH 407822 22-Nov-15 30-Nov-15 9
378 ALISHA SAFIYA 396311 25-Nov-15 30-Nov-15 3
379 SAFIRA RAISHA 399220 26-Nov-15 30-Nov-15 5
380 UNUS PRIJATNA 413864 29-Nov-15 30-Nov-15 2
381 FITRI ARISKA PRAMITA 322222 28-Nov-15 30-Nov-15 3
382 NOTO SUWARNO 330842 25-Nov-15 30-Nov-15 6
383 RAISSA FITRI 405833 23-Nov-15 30-Nov-15 8
384 M ALZAMA 369597 26-Nov-15 30-Nov-15 5
385 SYIFA APRILIANI PUTRI 413196 27-Nov-15 30-Nov-15 4
386 SUSILAWATI 403884 27-Nov-15 30-Nov-15 4
387 M BAGAS AL BARRA 403160 25-Nov-15 30-Nov-15 6
388 EUIS HATININGSIH 413818 28-Nov-15 30-Nov-15 3
389 ALAN KARLAN 413862 28-Nov-15 29-Nov-15 2
390 ISNA MAULIDA 392524 19-Nov-15 24-Nov-15 6
391 MICKE KADIR 383358 26-Nov-15 30-Nov-15 5
NO
1 DAMIN 317046 30-Oct-15 02-Nov-15 1
2 SAEPUDIN 411556 29-Oct-15 01-Nov-15 CHOLE
3 DANI CAHYADI 351205 30-Oct-15 02-Nov-15 4
4 AMARDINATA 381933 02-Nov-15 03-Nov-15 2
5 REDI SUPREDI 412403 04-Nov-15 05-Nov-15 2
6 ALAN ISKANDAR 342766 03-Nov-15 05-Nov-15 3
7 IDA NENGSIH 316567 03-Nov-15 05-Nov-15 3
8 RATNA NINGSIH 355088 02-Nov-15 04-Nov-15 3
9 DAMIN 317046 06-Nov-15 08-Nov-15 3
10 NAZMAH PUTRI 406775 06-Nov-15 07-Nov-15 2
11 AZAHRA NABILA KAMILA 412282 01-Nov-15 06-Nov-15 6
12 AAS SUMARSIH 317858 03-Nov-15 06-Nov-15 4
13 DADAN ARIFIN 341964 04-Nov-15 06-Nov-15 3
14 UPIT ROHANI 412291 03-Nov-15 05-Nov-15 3
15 FERDIAN ARVIN 411958 27-Nov-15 05-Nov-15 5
16 ICIH 413207 17-Nov-15 18-Nov-15 2
17 FIRTIYANA SUNARYA 317740 16-Nov-15 17-Nov-15 2
18 HANIF BIMO PRASETYO 412703 08-Nov-15 10-Nov-15 3
19 ASEP SEPTIYANA 340728 14-Nov-15 16-Nov-15 3
20 DESTI ETIKA 396721 10-Nov-15 12-Nov-15 3
21 QHOLBY SILMI HASANAH 385546 11-Nov-15 14-Nov-15 4
22 RINA NOVITASARI 329371 12-Nov-15 13-Nov-15 2
23 AQEELA KHANZA SETIADI 411693 15-Nov-15 20-Nov-15 6
24 KARSONO 306982 17-Nov-15 19-Nov-15 3
25 DAFFA AL FATHIR 317001 17-Nov-15 20-Nov-15 4
26 INDRA ABI PERMANA 413276 18-Nov-15 20-Nov-15 3
27 ANDHIKA ANSHORI 396708 14-Nov-15 16-Nov-15 3
28 HANIE FITRIE YANTIE 338570 18-Nov-15 19-Nov-15 2
29 KAWINDRA SALMAN 344053 22-Nov-15 25-Nov-15 4
30 EVI NURLATIFAH 413359 18-Nov-15 21-Nov-15 4
31 EDI JUNAEDI 386824 01-Nov-15 05-Nov-15 5
32 ULFY SILVIANA NOVIZA 413609 23-Nov-15 27-Nov-15 5
33 DANI ANGGARA 413693 25-Nov-15 28-Nov-15 4
34 GITA SYLVIA 413487 25-Nov-15 27-Nov-15 3
35 M. SUHADA 320322 23-Nov-15 29-Nov-15 7
Total 421 Pasien

421 1667576400
Rekapitulasi INA CBGs Bulan NOVEMBER
TYPOID FEVER - -
GANGLION - EKSISI GANGLION
TYPOID FEVER - -
BACTERIAL INFEKSI - -
CHEST PAIN - -
VIRAL INFEKSI TYPOID FEVER -
VIRAL INFEKSI - -
DM T2 CELULITIS -
TB PLEURA - -
VESICOLITIS - SECTIO ALTA
STT - EKSISI
DIABETES ABSES SIROSIS HEPATIS+SELULITIS CIROSIS DEDRIDEMENT
HILL - HERNIORAPHY
LIMPADENITIS COLLI - BIOPSI+EKSTERPASI
FAM - EKSISI
LETAK SUNGSANG PARTUS SC SC
BBL COW MILK ALERGI -
DYSPEPSIA - -
BP - -
CA. CERVIX ANEMIA BIOPSI
HHD DMT2 -
DYSPEPSIA - -
UTI - -
DRUG ERUPTION DC-HHD+HYPOCALCEMIA -
UTI RHINO BRONKHITIS -
GASTRITIS - -
DC UAP+VIRAL INFEKSI -
BP LARINGITIS -
CKD PYELOLITHIASIS+UTI+POS OP LITOTRIPSI URETEROSCOPY+AFF STENT
PEB SLE+PARTUS SC SC
LIMPADENITIS COLLI - BIOPSI
GIANT CLAVUS - EKSISI
KISTA BARTOLINI - INSISI
STT - EKSISI
PHARINGITIS AKUT - -
TYPOID FEVER UTI -
VIRAL INFEKSI - -
TYPOID FEVER - -
CAD . -
NEFROLITHIASIS HEMATURIA -
POS OP NEFROLITHIASIS+NEFROTOMY DEX+STENOSIS UP JUNTION DEX+CKD+CYSTITIS
CYSTOSCOPY+AFF DJ STENT
SYNDROME CROUP - -
TYPOID FEVER - -
MORBILI DADRS -
TB PARU TYPOID FEVER -
STT - EKSISI
HILL - HERNIORAPHY
FAM - EKSISI
TYPOID FEVER ISPA -
LBP UTI+NEFROLITHIASIS -
HHD CHF+BP+ESRD -
HEPATITIS B KRONIS EKSASERBASI AKUT -
TYPOID FEVER - -
DYSPEPSIA - -
ISPA DADRS -
DYSPEPSIA - -
BP DADRS -
BACTERIAL INFEKSI TB PARU -
DM T2 CKD+HIPOKALEMIA -
URETEROLITHIASIS HIDRONEFROSIS+CYSTITIS URETEROTOMI
LIMPADENITIS COLLI - EKSISI
STT - EKSISI
LS PARTUS SC SC
BBL - -
HILL - HERNIORAPHY
STROK INFARK DISLIPIDEMIA+HT -
STROK INFARK - -
PROLONG PRAGNANCY BAYI BESAR+PARTUS SPONTAN -
CA MAMAE KELENJAR GETAH BENING+ANEMIA MASTECTOMY+TRANSFUSI
KISTA OVARIUM - SOD
PLACENTA PREVIA RIW. SC+PARTUS SC SC
LOW BIRTH WEIGHTASPEXIA+RESPIRATORY DISTRES+HYPOKALEMIA+SEPSIS+NH RJP+INTUBASI+VENTILATOR
STRUK INFARK CAD -
DADRS - -
VIRAL INFEKSI - -
DADRS - -
HHD SIROSIS HEPATIS+ASCITES+HIPOALBUMIN+AKI -
CLACUS - EKSISI
TUMOR MAMAE MASTITIS -
BAYI BESAR PARTUS SPONTAN PARTUS SPONTAN
DM T2 NEUROPATY -
DIARE AKUT DMT2+VERTIGO -
DIARE AKUT DEHIDRASI -
GASTRITIS HT+PPOK+AKI -
HEG - -
DIARE AKUT VSD+PDA -
TB PARU DMT2+CAD -
TBPARU CANDIDIASIS -
HEDEACHE - -
POLYMYALGIA - -
LYMPADENOPATHY COLLI - EKSISI
CHOLELITHIASIS - CHOLECYSTECTOMI
APP PERITONITIS KISTA OVARIUM APENDICTOMY+LAPARATOMY
DYSPEPSIA ESRD -
TYPOID FEVER - -
VIRAL INFEKSI KP AKTIF -
HEMIPLAGIA SOL(SPACE OCUPING LESION -
BRONKHITIS - -
BP - -
AB INCOMPLIT - KURET
KISTA OVARIUM - SOD
LETAK SUNGSANG PARTUS SC -
BBL - -
BBL HIPER BILIRUBIN -
TYPOID FEVER UTI+CKD -
DIARE AKUT - -
GEA - -
HT AKI -
BACTERIAL INFEKSI GASTRITIS -
ASMA - -
TYPOID FEVER - -
ISPA - -
TB EFUSI PLRURA+ESRD -
CKD HIPERKALEMIA+DC+DCM+DMT2 -
HT KEHAMILAN PARTUS SPONTAN PARTUS SPONTAN
PLACENTA PREVIA PARTUS SC SC
APP PERITONITIS SEPSIS APENDICTOMY+LAPARATOMY
HEMOROID INTERNAL . EKSISI
HEMOROID INTERNAL . EKSISI+SPHINETEROCTOMY LATERAL
CHOLELITHIASIS CHOLECYSTITIS CHOLECYSTECTOMI
CHF PNEMONIA+PLEURAL EFUSI+ESRD -
TYPOID FEVER DADRS -
NEFROLITHIASIS UTI+RENAL COLIC -
TYPOID FEVER - -
TYPOID FEVER - -
BP - -
TYPOID FEVER DMT2+HHD+HT+HIDROCELE -
STT - EKSISI
STT - EKSISI
STT - EKSISI
TYROID GLAND - TYROIDECTOMI
TB PLEURA - WSD/CTT
STROK INFARK ESRD -
SNNT - -
CAD GASTRITIS+CHEST PAIN -
FEVER - -
FEVER COLIK ABD -
DADRS - -
BP - -
DADRS - -
DIARE AKUT - -
NEFROLITHIASIS - -
HEG - -
DENGUE FEVER TYPOID FEVER -
TYPOID FEVER - -
ASMA PNEMONIA -
RHD PARTUS SPONTAN PARTUS SPONTAN
SNTT ANEMIA TYROIDECTOMI+TRANFUSI
CA MAMAE BIOPSI -
DENGUE FEVER TYPOID FEVER -
COLIC RENAL - -
FEVER CONVULSION -
TYPOID FEVER - -
GASTROPATI DM T2 -
AB INCOMPLIT ANEMIA IN PREGNANCY KURET+TRANSFUSI
CPD PARTUS SC SC
KISTA OVARIUM - SOD+ADHESI+LE
BP - -
BP CP -
BP - -
HYPERTROPI OF TONSIL - TONSILECTOMY
STROK HT+ATASIA -
TYPOID FEVER - -
BP - -
DADRS DIAPER RUSH+TYPOID FEVER -
CHF - DISPEPSIA
CHF EC HRD+HHD -
STT - EKSISI
STT - EKSISI
STT - EKSISI
PROLONG PRAGNANCY PARTUS SC SC
BBL - -
FISTUL ANI - FISTULECTOMY
ABSES - INSISI DRAINAGE+NECROTOMY DEBRIDEMENT
HIPER BILIRUBIN - -
TYPOID FEVER - -
HEMOROID INTERNAL - HEMOROIDECTOMY
HILL - HERNIORAPHY
VARICOCELE - VARICOCELEKTOMY
DYSPEPSIA - -
AB IMINEN - -
GERD PHARINGITIS AKUT -
STROK PERDARAHAN - -
ISK - -
GASTRITIS - -
HEMOROID INTERNAL - HEMOROIDECTOMY
ANEMIA IN PREGNANCY PARTUS SC SC+TRANSFUSI
UAP DISPEPSIA+ESRD+BRONKHITIS -
ABSES MAMAE - EKSISI
KISTA MAMAE - EKSISI
DYSPEPSIA OA+M51.2+G47.0 -
RADIKULOPATI NEUROPATI -
DIARE AKUT - -
DF DYSPAPSIA+HT -
TYPOID FEVER - -
CA CERVIX - BIOPSI
HIPER BILIRUBIN - BLUE LIGHT
GEA HYPOKALEMIA -
CHF HHD -
HILL - HERNIORAPHY
STT - EKSISI
TYPOID FEVER ISPA -
BP TYPOID FEVER -
TYPOID FEVER BP -
MORBILI TB PARU -
STROK PIS CHFEC HHD+ESRD -
TB CHF+HHD+DISPEPSIA -
HT AMI+ESRD -
UTI Cephalgia -
GOUT ARTRITIS HT -
TYPOID FEVER DENGUE FEVER -
HFMD DEHIDRASI -
UNDESCENDED TESTICLE HILL DEBRIBEMENT+HERNIORAPHY
FAM - EKSISI
VERUCA - EKSISI
MASTOIDINITIS - MYRINGOPLASTY+SIMPLE MASTOIDECTOMY
PARONIKIA - DEBRIDEMENT
TYPOID FEVER - -
HT TTH -
KANDIDIASIS - -
DYSPEPSIA - -
ANEMIA IN PREGNANCY - TRNSFUSI

CAD DC+CKD+TB PARU+DRUG ERUPTION+HIPONATREMIA -
TB PARU CHF -
DADRS PERIANAL RAS -
HILL - DEBRIDEMENT+INSISI DRAINASE
STT - EKSISI
CA. COLON DEHIDRASI -
HERNIA - HERNIORPHY
BPPV - -
VIRAL INFEKSI - -
VIRAL INFEKSI - -
TYPOID FEVER - -
STOMATITIS DADRS -
DIARE AKUT - -
RHD AF+CHF -
KISTA OVARIUM ANEMIA SOD
TONSILO ADENOID - TONSILEKTOMI
HEMOROID INTERNAL - EKSISI+ANOSCOPY
TYPOID FEVER - -
DM T2 CELULITIS -
DENGUE FEVER - -
TYPOID FEVER ISPA -
RHD CHF+AF -
VARICELLA - -
HEMOROID INTERNAL - -
UNSTABLE ANGINA - -
HEMOROID INTERNAL PARTUS SC SC
SEPTUM VAGINA - EKSISI
ABSES PEDIS - DEBRIDEMENT
STT - EKSISI
HILL PERLENGKETAN OMENTUN HERNIORAPHY+OMENTECTECTOMY
KISTA OVARIUM - SOS
TUMOR TORAX - EKSISI
CHF EC HHD - -
DIARE AKUT - -
VIRAL INFEKSI ISPA+HIPOCALCEMIA -
LOW BIRTH WEIGHTASPEXIA+RESPIRATORY DISTRES+HYPOKALEMIA+SEPSIS+NH BLUE LIGHT
MYALGIA CA. MAMAE+POST OP -
CAD STEMI -
DHF - -
DIARE AKUT - -
TUMOR MAMAE - DEBRIBDEMENT
MASSA INTRA ABDOMEN - -
CPD PARTUS SC -
BBLR - -
GEA - -
CAD - -
VL A/R OCIPITAL - .
TYPOID FEVER ISPA -
CELULITIS DMT2 -
BBL - -
STT - EKSISI+DEBRIDEMENT
DC EC HHD EFUSI PERICARDIAL -
TYPOID FEVER ISPA -
DADRS TYPOID FEVER -
CHOLELITHIASIS - -
HERNIA UMBILICAL - HERNIORAPHY
UAP NSTEMI+STROKE+HT -
PPOK - -
TYPOID FEVER - -
STROK INFARK - -
LBP - -
DADRS ISPA -
TYPOID FEVER UTI -
ASMA GRAVIDA -
ETOPIK PRAGNANCY APP APENDIKTOMI+SOS
TONSILO ADENOID - TONSILEKTOMI
EFUSI PLEURA TB PARU+DM T2+CKD ON HD -
STROK INFARK ANEMIA 99.03
STROK INFARK - -
DIARE AKUT KDK -
DENGUE FEVER - -
ILEUS - -
TRAUMA THORAX - -
DADRS - -
VERTIGO PERIFER - -
AB IMINENS - .
STT - EKSISI
FAM - -
LETAK MUKA PARTUS SC SC
TYPOID FEVER ESRD -
DADRS - -
DADRS - -
GASTRITIS - -
LBP HT -
GEA - -
DHF - -
FAM - EKSISI
MASTITIS EKSISI+DEBRIDEMENT -
AB IMINEN HEG -
BP ASMA -
GEA - -
MYOMA UTERI - TAH
BACTERIAL INFEKSI - -
TYPOID FEVER - -
LBP ANOREXIA -
TB PARU EFUSI PLEURA -
STT - EKSISI
VIRAL INFEKSI - -
GEA CAD -
CHF EC HHD ESRD -
ASMA - -
TB PARU EFUSI PLEURA -
TYPOID FEVER - -
LIPOMA - EKSISI
CYSTA LIVER - SPLENECTOMY
LBP OSTEOMYELETIS -
TIA - EKSISI
PERITONITIS - LA+ADHESI+CYSTOSCOPY
VIRAL INFEKSI HT+HIPONATREMIA+CAD -
CAD STEMI+ESRD+HT -
CHF EC HHD HYPERKALEMIA+HYPERCALCIUM -
DEHIDRASI KANDIDIASIS+ISPA -
NS HIPOALBUMIN+AKI -
TYPOID FEVER - -
GEA - -
HILL - HERNIORAPHY
RIW SC PARTUS SC 74.4
APP - APENDICTOMY
POS DATE RIW SC+PARTUS SC SC
UAP HIPERLIPIDEMIA -
DEMENSIA DMT2+GEA -
GEA - -
CKD ANEMIA -
PROLONG PRAGNANCY PARTUS SPONTAN PARTUS SPONTAN
HIDROCELE - HIDROCELECTOMY
GASTRITIS - -
KP AKTIF - -
A09 - -
DM T2 SELULITIS -
TYPOID FEVER - -
BPH - -
HEG - -
STROK - -
TYPOID FEVER - -
BP - -
DADRS - -
TYPOID FEVER - -
BP - -
GERD HT+DMT2 -
CAD OEDEMA -
DADRS - -
HT ESRD+KIPOKALEMIA+HIPERCALCEMIA RESUSITASI
HILL - HERNIORAPHY
HEADACHE - -
SNTT - FNAB
STT - EKSISI
STT - EKSISI+DEBRIBEMENT
ASMA GRAVIDA -
GASTROPATI HERNIA -
DIARE AKUT - -
TYPOID FEVER - -
ASMA GASTRITIS -
DYSPEPSIA VERTIGO+DM T2 -
INTOKSIKASI MAKANAN SEPSIS+MOF INTUBASI+VENTILATOR+INJEKSI ANTIBIOTIC
REUMATIC FEVER TYPOID FEVER -
STT - EKSISI
CTS - RELEASE CTS
DADRS - -
STT - EKSISI
HEG - -
VARICELLA - -
HEG - -
DIARE AKUT - -
FISTULA ANI - FISTULECTOMI+ANOSCOPY+DEBRIBEMENT
TYPOID FEVER PHARINGITIS AKUT -
DIARE AKUT - -
VIRAL INFEKSI ISPA -
PARTUS SEROTINUS PARTUS SPONTAN PARTUS SPONTAN
MORBILI INFEKSI KULIT+BP -
TYPOID FEVER - -
TYPOID FEVER GEA -
DYSPEPSIA - -
STT - EKSISI
HYPERTROPI OF TONSI - TONSILEKTOMI
CAD HT -
1665244900 2331500
UTAMA
HARGA INA CBGS
A01.0 - - 3 3,296,646 2,774,500.00
M67.4 - 82.21 2 7,203,163 6,233,600.00
A01.0 A15.0 - 2 4,362,561 4,828,400.00
A01.0 - - 2 4,314,077 3,329,400.00
O80.9 O80.9 73.59 2 3,819,068 2,416,400.00
A49.9 - - 2 1,832,674 3,329,400.00
R07.4 - - 2 2,644,760 3,865,000.00
B34.9 A01.0 - 2 3,222,648 3,398,900.00
A49.9 - - 1 5,266,627 2,720,200.00
E11.9 L03.9 - 2 8,100,274 2,331,500.00
A16.5 - - 2 4,823,764 5,004,900.00
O80.9 - 73.59 2 3,203,227 2,416,400.00
N21.0 - 57.19 1 11,719,475 8,278,000.00
D48.1 - 83.39 3 6,314,628 4,871,300.00
E11.4 K74.6+L03.8 86.22 3 11,685,998 2,585,100.00
K40.9 - 53.29 3 7,229,803 3,569,900.00
I88.8 - 40.11+40.29 2 7,968,415 4,242,600.00
D24 - 85.21 2 8,229,945 6,118,200.00
O32.1 O82.9 74.4 3 7,817,033 4,022,100.00
P03.4 T78.1 - 3 925,748 1,663,200.00
K30 - - 1 10,467,760 3,891,400.00
J18.0 - - 2 4,170,100 4,170,100.00
C53.9 D64 67.12 1 10,050,221 6,097,700.00
I11.9 E11.9 - 1 4,457,100 4,457,100.00
K30 - - 2 1,575,125 3,335,500.00
N39 - - 2 2,707,531 1,860,600.00
L27.1 I11.9+E83.5 - 2 2,782,020 2,165,700.00
N39.0 J20.9 - 2 2,072,902 1,860,600.00
K29.7 - - 1 5,360,668 2,171,800.00
I15.9 I20.0+B34.9 - 2 6,269,279 7,551,400.00
J20.9 - - 1 4,506,068 2,168,400.00
J18.0 J04.0 - 2 6,601,494 4,174,100.00
N18.9 N12+N39.0+Z98.8 56.31+97.65 1 17,620,656 3,433,200.00
I14.1 M32.9+O82.9 74.4 2 10,522,895 4,826,600.00
I88.8 - 40.11 2 7,723,646 4,242,600.00
L84 - 83.39 2 7,548,101 5,845,600.00
N75.0 - 71.22 2 7,929,715 3,276,700.00
D48.1 - 83.39 2 7,647,790 5,845,600.00
J02.9 - - 2 2,913,986 1,829,000.00
A01.0 N39 - 2 4,282,400 4,282,400.00
B34.9 - - 2 2,331,600 2,331,600.00
A01.0 - - 2 3,329,400 3,329,400.00
I25.1 I20.0+I50.0+E11.9 - 1 4,170,900 4,170,900.00
N20.9 R31 - 1 2,875,000 2,875,000.00
Z98.8 N20.0+Q62.1+Z46.6+N18.9+N30.9 57.32+97.65 1 18,367,603 3,433,200.00
J05.0 - - 2 2,673,276 1,829,000.00
A01.0 - - 1 2,217,587 3,884,300.00
B05.9 A09 - 2 2,402,457 2,331,600.00
A15.0 A01.0 - 1 5,837,246 9,269,700.00
D48.1 - 83.39 2 7,440,193 5,845,600.00
K40.9 - 53.29 3 6,433,334 3,569,900.00
D24 - 85.21 2 7,850,216 6,118,200.00
A01.0 J06.9 - 2 3,237,221 3,329,400.00
M54.59 N39.0+Z99.2 - 1 3,814,500 3,814,500.00
I13.2 J18 - 1 10,145,900 10,145,900.00
B16.9 J44.1 - 1 4,944,900 4,944,900.00
A01.0 - - 2 3,329,400 3,329,400.00
K30 - - 2 2,437,339 3,335,500.00
J06.9 A09 - 2 3,107,909 1,829,000.00
K30 - - 2 1,481,979 3,335,500.00
J18.0 A09 - 2 5,927,247 4,170,100.00
A49.9 A15.0 - 1 6,835,072 3,884,300.00
E11.2 E87.6 - 1 6,333,445 3,632,200.00
N13.2 N30.9 - 2 19,161,094 13,705,200.00
I88.8 - 83.39 2 7,273,299 4,242,600.00
D48.1 - 83.39 1 10,564,886 6,819,800.00
O32.1 O82.9 74.4 2 9,539,352 4,826,600.00
P03.4 - - 2 1,745,512 2,351,500.00
K40.9 - 53.29 3 8,445,425 3,569,900.00
I63.9 E78.5+I10 - 3 5,700,811 4,101,800.00
A01.4 - - 2 1,809,157 3,329,400.00
J20.9 - - 1 2,739,294 2,168,400.00
I63.9 - - 3 9,289,181 2,929,900.00
O48 O66.2+O80.9 - 2 3,639,756 2,859,900.00
C50.9 C77.9 85.41 1 26,338,293 12,907,300.00
N83.2 - 65.49 1 15,060,965 7,381,900.00
O44.0 O34.2+O82.9 74.4 1 12,427,030 5,631,000.00
P07.1 P21.1+P22.8+E87.6+P36.9+P59.996.05+96.70+99.60 3 41,549,568 10,888,100.00
I63.9 I25.1 - 3 4,920,014 2,929,900.00
A09 - - 1 3,364,552 2,827,100.00
B34.9 - - 2 2,019,528 2,331,600.00
A09 - - 1 4,782,820 2,827,100.00
I11.9 K74.6+R18+E88.0+N17.9 - 2 4,834,048 3,113,300.00
K61.0 - 86.28 2 7,551,302 3,335,500.00
L84 - 83.39 2 7,365,918 5,845,600.00
85.21 - - 2 7,428,447 6,118,200.00
O86.2 O80.9 73.59 1 3,306,989 2,819,100.00
E11.6 G58.9 - 2 2,428,680 2,631,500.00
A09 E11.6+R42 - 1 2,760,199 3,991,400.00
A09 E86 - 1 2,605,596 2,827,100.00
K29.1 I10+J44.9+N17.9 - 2 5,024,857 4,146,900.00
O21.0 - - 2 2,064,483 2,502,400.00
A09 I23.2+Q25.0 - 2 1,952,320 2,423,100.00
A15.0 E11.9+I25.1 - 1 4,952,981 5,839,000.00
A15.0 M37.9 - 1 5,717,116 6,976,000.00
R51 - - 1 6,669,554 2,176,900.00
M35.3 - - 3 2,007,585 2,234,800.00
D24 - 85.21 2 8,217,958 6,118,200.00
I88.8 - 40.29 2 8,381,552 4,242,600.00
K80.8 - 51.22 2 9,810,855 6,481,200.00
K35.0 N83.2 47.09+54.19 2 9,480,121 6,812,300.00
K30 - - 5,236,346 3,335,500.00
A01.0 - - 2 1,988,243 3,329,400.00
B34.9 Z92.8 - 3 5,912,088 1,943,000.00
G81.9 R90.0 - 3 3,968,924 2,333,700.00
J20.9 - - 2 3,505,741 1,858,600.00
J18.0 - - 3 5,464,878 3,475,100.00
O04.5 - 69.02 2 5,768,460 3,279,100.00
N83.2 - 65.49 1 14,374,441 7,381,900.00
O32.1 O82.9 74.4 2 9,059,076 4,826,600.00
p03.4 - - 2 1,548,665 1,995,800.00
P03.9 P59.9 - 2 3,064,137 1,995,800.00
A01.0 N39.0+N18.9 - 2 4,282,400 4,282,400.00
A09 - - 2 2,054,027 2,423,100.00
A09 - - 2 1,926,597 2,423,100.00
I10 N17.9 - 1 3,632,200 3,632,200.00
A49.9 K29.7 - 1 3,884,300 3,884,300.00
J45.9 - - 2 2,249,255 1,862,800.00
A01.0 - - 1 4,094,153 3,884,300.00
J06.9 - - 1 3,333,232 2,133,800.00
A16.5 - - 3 1,519,901 4,170,700.00
N18.9 E87.5+I42.0+I51.9+E11.9 - 1 10,324,929 4,530,800.00
O16.1 O80.9 73.59 2 3,668,953 2,416,400.00
O05.4 - 69.02 2 4,623,063 3,279,100.00
O44.0 O82.9 74.4 2 9,161,281 4,826,600.00
P03.4 T78.1 - 2 1,708,716 1,995,800.00
K35.1 - 47.09+54.19+99.21 2 11,037,320 12,967,400.00
I84.2 - 49.46 2 8,732,451 5,225,100.00
I84.2 K60.3 49.46+49.52 2 7,806,675 5,225,100.00
K80.8 K81.9 51.22 1 18,568,524 7,561,400.00
I50.0 J18.9+J90+Z99.2 - 1 9,907,502 10,145,900.00
A01.0 A09 - 2 3,329,400 3,329,400.00
N20.0 N39.0+N23 - 1 3,311,667 3,450,900.00
A01.0 - - 2 2,385,512 3,329,400.00
A01.0 - - 1 2,851,237 3,884,300.00
J18.0 - - 2 3,256,369 4,170,100.00
A01.0 E11.9+I11.9+N43.3 - 1 7,212,896 3,884,300.00
D48.1 - 83.39 3 6,859,649 4,871,300.00
D48.1 - 83.39 1 10,143,576 6,819,800.00
D48.1 - 83.39 2 6,976,196 5,845,600.00
D34 - 6.39 1 14,400,816 6,705,900.00
A16.5 - 34.04 2 18,781,078 5,004,900.00
I63.9 Z99.2 - 1 3,406,800 4,101,800.00
E04.9 - - 2 2,436,722
I25.1 K29.7+R07.4 - 3 1,345,979 2,331,600.00
R50.9 - - 3 885,476 1,556,900.00
R50.9 R10.4 - 3 935,203 1,556,900.00
A09 - - 3 2,002,630 2,355,800.00
J18.0 - - 1 3,336,341 4,865,100.00
A09 - - 2 2,401,036 2,423,100.00
A09 - - 2 2,335,086 2,423,100.00
N20.0 - - 1 4,315,841 2,875,000.00
O21.0 - - 1 3,738,797 2,919,500.00
A90 A01.0 - 1 2,984,588 3,965,400.00
A01.0 - - 1 3,801,888 3,884,300.00
O05.4 O04.5 69.02 2 4,618,412 3,279,100.00
J45.9 J18 - 2 11,151,580 4,170,100.00
I09.9 I80.9 73.59 3 4,343,872 2,013,600.00
E04.9 D63.9 6.39 3 10,506,455 7,641,300.00
C50.9 - 85.12 3 7,948,192 5,098,500.00
D24 - 85.21 1 9,193,276 7,137,800.00
K40.9 - 53.29 3 8,110,023 3,569,900.00
A90 A01.0 - 1 3,965,400 3,965,400.00
N23 - - 1 2,170,800 2,170,800.00
R50.9 R56.8 - 3 965,375 1,986,700.00
A01.0 - - 2 2,584,681 3,329,400.00
K31.9 E11.9 - 3 4,836,017 2,779,600.00
O05.4 O99.0 69.09+99.03 2 5,757,021 3,279,100.00
33.9 8.29 74.4 1 11,106,800 5,631,000.00
N83.2 - 65.49+54.59+54.11 3 14,207,654 6,516,000.00
J18.0 - - 3 2,256,454 3,475,100.00
J18.0 G80.8 - 1 6,419,008 4,865,100.00
J18.0 - - 3 4,079,630 3,475,100.00
J35.3 - 28.2 2 7,743,287 2,121,400.00
I63.9 I10+G11.8 - 2 4,533,888 3,515,900.00
A01.0 - - 1 10,097,028 3,884,300.00
J18.0 - . 2 3,272,980 5,004,900.00
A09 L22+A01.0 - 2 4,737,061 3,329,400.00
I50.0 K30 - 2 5,546,303 4,575,900.00
I13.1 - - 1 4,769,378 2,716,700.00
D48.1 - 83.39 2 9,008,630 5,845,600.00
D48.1 - 83.39 1 7,241,038 4,871,300.00
D48.1 - 83.39 - 7,494,347 4,871,300.00
O48 O82.9 74.4 3 8,222,227 4,022,100.00
P03.4 - - 3 1,163,454 1,663,200.00
O05.4 - 69.02 2 5,179,941 3,279,100.00
K60.3 - 49.12 2 9,145,219 5,225,100.00
K40.9 - 53.29 2 4,283,900 4,283,900.00
L02.9 - 86.04+86.28 2 5,983,951 2,800,400.00
P59.9 - - 2 1,820,841 1,995,800.00
A01.0 - - 3 1,572,678 2,774,500.00
I84.1 - 49.46 2 9,722,839 5,225,100.00
I84.2 - 49.46 1 11,923,784 6,095,900.00
I86.1 - 6.13 1 7,798,800 7,798,800.00
K30 - - 2 3,335,500 3,335,500.00
O20.0 - - 2 1,831,251 1,677,400.00
K21.9 J02.9 - 2 4,302,178 1,862,400.00
I63.9 - - 2 6,478,659 3,515,900.00
N39.0 - - 2 2,475,605 1,860,600.00
K29.7 - - 2 4,791,495 1,861,600.00
I84.2 - 49.21+49.46 2 7,622,546 5,225,100.00
O99.0 O82.9 - 2 9,683,005 4,826,600.00
I20.0 K30+Z99.2+J20.9 - 1 8,374,501 4,509,100.00
N61 - 85.21 2 7,896,558 6,118,200.00
N61 - 85.21 2 8,600,590 6,118,200.00
K30 M19.99+M51.2+G47.0 - 3 2,890,925 2,779,600.00
M54.19 G58.9 - 2 4,491,428 3,102,100.00
A09 - - 2 3,210,547 2,423,100.00
A90 K30+I10 - 3 2,889,781 1,943,000.00
A01.0 - - 2 2,545,737 3,329,400.00
C53.9 - 67.12 3 4,273,838 2,730,600.00
P59.9 - 99.82 2 3,578,267 1,995,800.00
A09 E87.6 - 2 5,500,814 3,421,100.00
I11.0 - - 2 6,781,665 4,575,900.00
K40.9 - 53.29 2 4,411,105 4,283,900.00
D48.1 - 83.39 1 9,808,788 6,819,800.00
A01.0 J06.9 - 2 2,470,200 3,329,400.00
A01.0 K29.7 - 2 2,224,920 3,329,400.00
J18.0 A01.0 - 2 3,005,553 9,699,100.00
A01.0 J18.0 - 2 2,406,571 4,906,600.00
B05.8 A15.0 - 2 4,178,475 2,791,900.00
I61.9 I13.2 - 1 9,466,875 4,508,800.00
A15.0 I11.0+K30 - 2 9,376,388 7,945,500.00
I10 I21.9 Z99.2 1 13,363,738 7,333,300.00
N39.0 R581 - 1 4,257,231 2,715,600.00
M10.9 I10 - 1 6,585,434 2,905,500.00
A01.0 A90 - 1 7,868,389 4,996,100.00
B08.4 E86 - 2 2,282,067 2,331,600.00
Q53.1 K40.9 49.46+86.28 3 6,848,602 4,354,200.00
D24 - 85.21 2 7,962,388 6,118,200.00
B07 - 86.3 3 7,415,073 3,274,200.00
H70.9 - 1.9420.41 2 7,158,700 5,713,700.00
L03.0 - 86.27 2 6,604,603 2,800,400.00
A01.0 - - 2 3,220,167 3,329,400.00
I10 G44.2 - 2 1,605,581 3,820,400.00
B37.9 - - 2 1,537,034 2,323,100.00
K30 - - 2 1,657,376 3,335,500.00
2,224,188
O99.0 - 99.03 2 3,045,090 1,863,500.00
I25.1 I42.0+N18.9+A15.0+L27.0+E87.1 - 2 4,207,495 3,575,100.00
A15.0 I50.0 - 2 6,214,238 5,979,400.00
A09 A60.1 - 2 3,306,077 2,423,100.00
O05.4 - 69.02 2 5,411,023 3,279,100.00
L02.9 - 86.28+86.04 2 9,046,416 2,800,400.00
D48.1 - 83.39 2 7,451,237 5,845,600.00
C18.7 E86 - 1 5,969,100 3,433,200.00
K40.9 - 53.29 2 8,141,918 4,283,900.00
1,092,890
H81.1 - - 2 2,885,038 1,858,400.00
B34.9 - - 3 1,206,479 1,943,000.00
B34.9 N39.0+N18.9 - 1 3,897,220 2,720,200.00
A01.0 - - 2 4,401,758 3,329,400.00
K12.1 A09 - 2 2,451,644 2,123,100.00
O05.4 - 69.02 2 5,041,029 3,279,100.00
A09 - - 2 2,735,998 2,423,100.00
I09.9 I48+I50.0 - 2 1,531,382 7,551,400.00
N83.2 - 65.49 2 13,681,230 6,327,300.00
J35.3 - 2.82 2 7,561,975 2,121,400.00
I84.1 - 49.46+49.21 2 7,411,692 5,225,100.00
A01.0 - - 1 3,329,400 3,884,300.00
E11.9 L03.9 - 2 4,086,388 2,331,500.00
A90 - - 2 3,396,866 2,331,600.00
A01.0 J06.9 - 2 2,633,071 3,329,400.00
I09.9 I50.0+I48 - 3 3,337,949 6,292,900.00
B01.9 - - 2 2,333,596 2,331,600.00
I84.8 - - 2 4,238,530 3,335,500.00
I20.0 - - 2 5,628,240 3,865,000.00
I84.8 O82.9 74.4 2 8,782,222 4,826,600.00
O34.6 - 70.33 2 8,345,778 3,276,700.00
L02.9 - 86.22 2 8,838,467 2,800,400.00
D48.1 - 83.39 3 6,695,623 4,871,300.00
K40.9 K66.0 53.29+54.4 2 10,215,838 6,812,300.00
N83.2 - 65.49 2 7,572,629 6,327,300.00
D36.7 - 34.4 1 10,205,708 4,052,300.00
I13.0 - - 1 5,558,426 5,338,800.00
A09 - - 2 2,434,106 2,423,100.00
B34.9 J06.9+E83.5 - 3 2,291,411 2,326,600.00
P07.1 P22.0+P21.1 99.82 3 26,752,518 11,116,200.00
M79.19 C50.9+Z48.8 - 1 2,170,800 2,170,800.00
I25.1 I21.9 - 1 5,419,700 5,419,700.00
A91 - - 2 2,086,201 2,331,600.00
A09 - - 2 1,807,554 2,423,100.00
D24 - 83.28 2 8,493,920 6,118,200.00
C76.2 - - 2 10,393,018 3,671,500.00
O33.0 O82.9 - 2 9,095,564 4,826,600.00
P03.4 - - 2 1,627,371 1,995,800.00
A09 - - 2 2,423,100 2,423,100.00
I25.1 - - 3 1,264,063 2,331,600.00
S09.9 - - 3 832,653 2,780,500.00
A01.0 J06.9 - 2 3,329,400 3,329,400.00
L03.9 E11.9 - 2 2,800,400 2,800,400.00
P03.4 - - 2 1,436,371 1,995,800.00
D48.1 - 83.39+86.28 2 8,505,602 5,845,600.00
K40.9 - 53.29 3 5,332,256 3,569,900.00
A01.0 K29.7 - 3 5,035,064 2,774,500.00
I11.0 I31.3 - 3 7,649,934 4,315,900.00
K40.9 - 53.29 3 7,542,700 3,569,900.00
A01.0 J06.9 - 3 1,928,916 2,774,500.00
A09 A01.0 - 1 4,130,300 3,884,300.00
K80.8 - - 1 5,629,655 3,266,900.00
K42.0 - 53.29 1 6,528,566 4,997,900.00
I20.0 I25.9+I64+I10 - 2 8,039,160 3,865,000.00
J44.9 - - 2 5,855,973 2,878,100.00
A01.0 - - 1 4,760,925 3,884,300.00
I63.9 - - 3 4,947,596 2,929,900.00
M54.59 - - 1 3,940,613 2,712,300.00
A09 J06.9 - 1 3,907,351 2,827,100.00
A01.0 N39.0 - 2 3,413,601 4,282,400.00
J45.9 O99.5 - 1 5,275,217 2,173,300.00
K35.9 O00.9 47.09+65.49 1 15,439,446 7,444,600.00
J35.3 - 2.82 2 8,066,041 2,121,400.00
A16.5 E11.9+Z99.2 - 1 3,157,337 5,839,000.00
I63.9 - - 1 23,936,837 6,030,300.00
I63.9 - - 3 899,095 2,354,400.00
A09 R56.0 - 3 926,165 3,326,100.00
A90 - - 2 3,092,364 2,331,600.00
K56.7 - - 1 3,943,629
S29.9 - - 1 3,161,482 2,168,400.00
A09 - - 2 3,268,398 2,423,100.00
H81.3 - - 1 5,466,431 2,168,100.00
O20.0 - - 2 1,389,182 2,502,400.00
D48.1 - 83.39 3 6,516,477 4,871,300.00
D24 - 85.21 2 7,825,351 6,118,200.00
O32.9 O82.9 74.4 2 9,343,390 4,826,600.00
P03.4 T78.1 - 2 1,259,616 1,995,800.00
A01.0 Z99.2 - 1 3,884,300 3,884,300.00
A09 - - 2 2,300,695 2,423,100.00
A09 - - 1 3,840,960 2,827,100.00
K29.7 - - 3 2,308,118 1,551,300.00
M54.59 - - 2 3,967,887 2,324,900.00
A09 - - 2 2,689,260 2,423,100.00
A91 - - 2 4,056,835 2,331,600.00
N61 - 85.21 2 8,291,219 6,118,200.00
N61 - 85.21+86.28 3 7,099,156 5,098,500.00
O20.0 O21.0 - 2 2,712,665 1,677,400.00
J18.0 J45.9 - 1 3,193,794 4,865,100.00
A09 - - 2 2,990,961 2,423,100.00
O05.4 - 69.02 1 6,624,166 3,825,600.00
O25.9 - 68.39 3 11,898,277 5,272,800.00
A49.9 - - 2 2,979,988 3,329,400.00
A01.0 - - 2 2,699,576 3,329,400.00
M54.59 R63.0 - 2 4,130,166 2,324,900.00
A01.0 - - 2 3,400,119 3,329,400.00
A16.5 - - 2 6,333,921 5,979,400.00
D48.1 - 83.39 2 7,191,775 5,845,600.00
B34.9 - - 1 2,250,709 2,720,200.00
A09 I25.1 - 2 2,423,100 2,423,100.00
I13.0 Z99.2 - 3 4,296,626 4,448,800.00
J45.9 - - 2 6,916,340 1,862,800.00
A16.5 J45.9 - 2 7,323,870 5,004,900.00
A01.0 - - 2 4,708,485 3,329,400.00
D17.9 - 83.39 1 12,599,080 6,819,800.00
K76.8 - 4.15 3 11,930,733 4,591,500.00
M54.59 M86.9 - 2 6,457,246 2,324,900.00
D17.5 - 83.39 2 9,857,667 5,845,600.00
K65.9 - 54.11+54.59+57.32 3 8,590,152 5,677,000.00
B34.9 I10+E87.1+I25.1 - 1 3,257,200 3,257,200.00
I25.1 I21.9+Z99.2+I10 - 1 10,723,943 7,419,700.00
I13.0 E87.5+E83.5 - 1 11,819,201 8,332,900.00
E86 B37.0+J06.9 - 1 2,328,870 2,710,300.00
N03.7 E88.0+N19 - 2 6,261,380 3,400,700.00
A01.0 - 1 4,647,685 3,884,300.00
A09 - - 3 5,719,264 2,355,800.00
K40.9 - 53.29 3 7,668,511 3,569,900.00
O34.2 O82.9 74.4 3 8,254,079 4,022,100.00
K35.9 - 47.09 1 12,790,653 3,985,400.00
O48 O34.2+O82.9 74.4 1 11,547,621 5,631,000.00
I20.0 E78.5 - 2 6,977,410 3,865,000.00
F03 E11.9+A09 - 2 5,537,000 3,196,300.00
A09 - - 2 3,390,182 2,423,100.00
N18.9 D63.9 - 2 7,762,683 3,883,500.00
O48 O80.9 - 2 3,303,101 2,859,900.00
N43.3 - 63.1 1 9,517,120 5,361,600.00
K29.7 - - 2 2,769,966 1,861,600.00
A15.0 - - 2 4,484,125 5,004,900.00
A09 - - 3 856,143 2,355,800.00
E11.9 L03.8 - 2 5,973,195 2,331,500.00
A01.0 - - 3 2,753,028 2,774,500.00
A01.4 - - 1 3,909,419 3,884,300.00
N40 - - 1 2,984,406 2,788,900.00
O21.0 - - 2 2,324,310 2,502,400.00
I63.9 - - 3 5,593,271 2,164,000.00
A01.0 - - 1 6,887,720 3,884,300.00
J18.0 - - 2 5,134,456 4,170,100.00
A09 - - 2 2,375,033 2,423,100.00
A01.0 - - 2 3,294,486 3,329,400.00
J18.0 - - 2 6,128,359 4,170,100.00
K21.9 I10+E11.9 - 1 2,172,800 2,172,800.00
I25.1 R60.9 - 3 1,158,907 2,331,600.00
A09 - - 1 2,827,100 2,827,100.00
I10 Z99.2+E87.6+E83.5 99.6 2 4,745,300 5,179,100.00
K40.9 - 53.29 1 9,385,716 4,997,900.00

K61.0 - 86.28 1 9,245,490 3,891,400.00
R51 - - 2 3,959,856 1,965,900.00
E04.9 - - 1
D48.1 - 83.39 2 6,356,512 5,845,600.00
D48.1 - 83.39+86.28 2 6,542,452 5,845,600.00
J45.9 O99.5 - 1 3,417,342 2,173,300.00
D24 - 85.21 2 8,006,411 6,118,200.00
K31.9 K40.9 - 1 3,088,848 3,891,400.00
A09 - - 1 1,965,029 2,827,100.00
A01.0 - - 2 4,239,284 3,329,400.00
J45.9 K29.7 - 2 3,733,043 1,862,800.00
K30 R42+E11.2 - 1 3,520,285 3,891,400.00
T62.8 A41.9+R54 96.05+96.71+99.21 2 15,416,904 13,988,500.00
I00 A01.0 - 1 11,259,146 8,565,900.00
D48.1 - 83.39 2 8,499,316 5,845,600.00
G56.0 - 4.43 1 14,332,424 1,191,800.00
A09 - - 2 1,650,850 2,423,100.00
D48.1 - 83.39 2 8,145,352 5,845,600.00
O21.0 - - 2 1,440,137 2,502,400.00
B01.9 - 1 2,720,200 2,720,300.00
O21.0 - - 1 1,518,493 2,919,500.00
A09 - - 2 2,461,215 2,423,100.00
K60.3 - 49.12+49.21+86.28 1 9,144,309 6,095,900.00
A01.0 - J02.9 1 2,569,501 3,884,300.00
A09 - - 1 1,820,446 2,827,100.00
B34.9 ISPA - 2 1,658,954 2,331,600.00
O48 O80.9 73.59 2 2,565,442 2,859,900.00
B05.9 L08.8+J18.9 - 1 2,951,760 3,965,400.00
A01.0 - - 2 3,671,284 3,329,400.00
A01.0 A09 - 2 6,812,306 3,329,400.00
K30 - - 2 2,868,127 3,335,500.00
D48.1 - 83.39 2 8,065,821 5,845,600.00
J35.3 - 2.82 1 8,065,821 2,475,000.00
I25.1 I10 - 1 8,860,297 5,419,700.00
1667576400
EPK INA
1667576400 1667554100
NAMA DOKTER

4,103,893 dr. Nanda, Sp.B
13,642,594 dr. RENNY, SP.U
8,807,181 DR. ADE, SP.S
18,734,793 dr. Nanda, Sp.B
5,612,554 DR. ADE, SP.S
3,584,924 DR. ADE, SP.S
10,334,524 dr. Nanda, Sp.B
13,860,578 dr. Nanda, Sp.B
2,361,722 RAJAL
1,345,979 dr. FITHRI YANTI
885,476 dr. FITHRI YANTI
965,375 dr. DWIANA SARI
4,208,987 dr. Richard, Sp. Tht
3,799,888 dr. Media, Sp.S
1,809,188 RAJAL
648,890 BAYI SEHAT
2,494,038 dr. Ade, Sp.S
907,382 dr. Raden Bayu, Sp.Jp
6,764,222 dr. Nunung, Sp.OG
1,264,063 dr. DEDI N
7,503,160 DR. RIEN, SP.JP
21,859,237 dr. Media, Sp.S
899,095 dr. DWIANA SARI
2,402,406 dr. YUDI, SP.U
5,142,271 dr. Ade, Sp.S
1,158,907 dr. FITRIYATI
NAMA DOKTER
dr. PITRAJAYA, SP.B
dr. PITRAJAYA, SP.B
dr. Ade, Sp.S
RAJAL
dr. Nanda, Sp.B
dr. Nanda, Sp.B
dr. Miftah, Sp.Pd
dr. Nanda, Sp.B
dr. Miftah, Sp.Pd
dr. YURIKA, SP.A
dr. Paramita, SP.A
dr. Miftah, Sp.Pd
dr. MR. Kurnia, Sp.PD
dr. Miftah, Sp.PD
DR. PARAMITA, SP.A
dr. Djoko, SP.B
DR. GHUNA, SP.OT
dr. DEDE LIA, SP.A
dr. PITRAJAYA, SP.B
dr. Sarjunas, Sp.OG
dr. Sarjunas, Sp.OG
dr. Paramita, SP.A
dr. Djoko, SP.B
dr. DEDE LIA, SP.A
dr. Paramita, SP.A
dr. Nunung, Sp.OG
dr. YURIKA, SP.A
dr. Paramita, SP.A
dr. PITRAJAYA, SP.B
dr. Richard, Sp. Tht
dr. Miftah, Sp.PD
22300
APS
Rekapitulasi IN
HARI
1 LILIS UMIATI 386285 28-Nov-15 01-Dec-15 4

2 ANDINI GUSTRIANA 413875 29-Nov-15 01-Dec-15 3
3 APONG JUARNINGSIH 413877 30-Nov-15 01-Dec-15 2
4 AFRIZA WAHYU FIRDAUS 386810 29-Nov-15 01-Dec-15 3
5 IMI JD AHMAD 406787 29-Nov-15 01-Dec-15 3
6 MONA NAMIRA NUR 413778 27-Nov-15 01-Dec-15 5
7 ERNAWATI 413773 30-Nov-15 01-Dec-15 2
8 TRIA INDRIYANI 402319 28-Nov-15 01-Dec-15 4
9 TRI DARMA OCTAVIANI 413678 28-Nov-15 01-Dec-15 4
10 ENGKAS 413623 28-Nov-15 01-Dec-15 4
11 SAHLAN SOLIHIN 388402 26-Nov-15 01-Dec-15 6
12 SURIP SUSANTO 399160 24-Nov-15 01-Dec-15 8
13 AUFA AKMAL NURAIHAN 364064 30-Nov-15 02-Dec-15 3
14 FITRI ANDRIANI 396171 28-Nov-15 02-Dec-15 5
15 SHIRLI 315951 30-Nov-15 02-Dec-15 3
16 DEWI PERMATASARI 413485 01-Dec-15 02-Dec-15 2
17 NURHAPIPI 405694 30-Nov-15 02-Dec-15 3
18 ANDRIAN BUDIMAN 389577 29-Nov-15 02-Dec-15 4
19 ASEP FIRDAOS 408560 01-Dec-15 02-Dec-15 2
20 SOPANDI 386317 26-Nov-15 02-Dec-15 7
21 NANDA WULANSARI 400217 29-Nov-15 02-Dec-15 4
22 NOERLINA, NY 413913 30-Nov-15 02-Dec-15 3
23 EPON 413636 30-Nov-15 02-Dec-15 3
24 TANTI NURFITRIAN 414084 02-Dec-15 03-Dec-15 2
25 LISA ANGGRAENI 413105 01-Dec-15 03-Dec-15 3
26 M KHAIRIL MUFID 396597 01-Dec-15 03-Dec-15 3
27 NATASYA LORENZA 413827 28-Nov-15 03-Dec-15 6
28 UJANG SOFYAN 390894 27-Nov-15 03-Dec-15 7
29 EVA SEVINA YUSUF 414136 03-Dec-15 03-Dec-15 2
30 SANDI IBRAHIM 413391 02-Dec-15 03-Dec-15 2
31 IDA FARIDA 383814 02-Dec-15 03-Dec-15 3
32 M HASAN 414089 02-Dec-15 03-Dec-15 2
33 HABIL MUNIF 413520 22-Nov-15 03-Dec-15 12
34 YATI SURYATI 358469 30-Nov-15 03-Dec-15 4
35 DARHIM 411687 27-Nov-15 03-Dec-15 6
36 RASTIYEM, NY 413848 30-Nov-15 03-Dec-15 4
37 RASTIYEM, BY 413968 30-Nov-15 03-Dec-15 4
38 AMINAH 413872 29-Nov-15 04-Dec-15 6
39 FARHAN AGUS 414049 01-Dec-15 04-Dec-15 4
40 ARKA REFANDI 414010 01-Dec-15 04-Dec-15 4
41 M ROBI FIRDAUS 366048 01-Dec-15 04-Dec-15 4
42 HADA 330568 29-Nov-15 04-Dec-15 7
43 ANANDA IKHSAN 352315 29-Nov-15 04-Dec-15 6
44 KIRANIA AZZAHRA 413997 01-Dec-15 04-Dec-15 4
45 ENI ROHAENI 384744 02-Dec-15 04-Dec-15 3
46 SOFYAN ALYAHYA 414080 02-Dec-15 04-Dec-15 3
47 IRMA YULIANA 414085 02-Dec-15 04-Dec-15 3
48 FIRMAN 413299 30-Nov-15 04-Dec-15 5
49 DEWI NOVIANTY 394311 02-Dec-15 04-Dec-15 3
50 WAWAN NIRWANTO 400781 29-Nov-15 04-Dec-15 6
51 WARYI 413878 30-Nov-15 04-Dec-15 5
52 MS SOLIHIN 414064 02-Dec-15 04-Dec-15 3
53 SOLIHIN 413912 01-Dec-15 04-Dec-15 4
54 DESIRMA 383210 01-Dec-15 04-Dec-15 4
55 AMAH KULSUM 414045 01-Dec-15 04-Dec-15 4
56 OMAN ABDURAHMAN 370654 30-Nov-15 04-Dec-15 3
57 YUSUF MAULANA 414121 30-Dec-99 05-Dec-15 4
58 NAUVAL RADITYA 376701 04-Dec-15 05-Dec-15 2
59 LILIS ROMLAH 406706 02-Dec-15 05-Dec-15 4
60 MEMEN ABDUROHMAN 414063 02-Dec-15 05-Dec-15
61 SAEHA 413965 30-Nov-15 05-Dec-15 6
62 ADANG SURAHMAN 308424 28-Nov-15 05-Dec-15 8
63 LERIEN NATANIEZA 399419 02-Dec-15 05-Dec-15 4
64 EPON MAEMUNAH 407822 03-Dec-15 05-Dec-15 3
65 E SUHERMAN 410220 02-Dec-15 05-Dec-15 4
66 RAIF EL RAFIF 414214 04-Dec-15 06-Dec-15 3
67 OCXINORA 300820 04-Dec-15 06-Dec-15 3
68 DINDA SEPTIYANI 414131 03-Dec-15 06-Dec-15 4
69 DAYAN BIN EMAD 414104 04-Dec-15 06-Dec-15 3
70 RINAWATI 414095 02-Dec-15 06-Dec-15 5
71 ADIK BIN RIIN 414018 02-Dec-15 05-Dec-15 4
72 CUCU NURHASANAH 408085 04-Dec-15 05-Dec-15 2
73 IRFAN RAMDANI 414044 01-Dec-15 05-Dec-15 5
74 NURHANA UTAMI 414189 04-Dec-15 05-Dec-15 2
75 DADANG A. HARTONO 414246 04-Dec-15 06-Dec-15 3
76 DORA CLARA 381901 03-Dec-15 07-Dec-15 5
77 CUCU CUNAYAH 414123 02-Dec-15 07-Dec-15 6
78 ASNI SURYANI 414026 04-Dec-15 07-Dec-15 4
79 MALIKA SHIDIQIA 383188 04-Dec-15 07-Dec-15 4
80 INNE DESIYA 383610 04-Dec-15 07-Dec-15 4
81 RENI ANIKE 413977 01-Dec-15 07-Dec-15 7
82 KOMARA YUDHA 414180 03-Dec-15 07-Dec-15 5
83 muhamad haikal putra 413712 25-Nov-15 07-Dec-15 13
84 IYOH 402789 04-Dec-15 08-Dec-15 5
85 DEVAN HERDIANA 332779 05-Dec-15 08-Dec-15 4
86 SHINTA NUR SYIFA 411532 06-Dec-15 08-Dec-15 3
87 M DEVIRZHA PUTRA 414286 05-Dec-15 08-Dec-15 4
88 M HILMI SYAUHAQI 414238 07-Dec-15 08-Dec-15 2
89 NAUFAL BINTANG 386475 07-Dec-15 08-Dec-15 2
90 DANI DHANIAL 300977 05-Dec-15 08-Dec-15 4
91 SARI NURHENI 397943 05-Dec-15 08-Dec-15 4
92 NACIH BT TASIR 414187 03-Dec-15 08-Dec-15 6
93 KIKI ARYANTO 414271 05-Dec-15 08-Dec-15 4
94 NYAI SUMIATI 413588 07-Dec-15 08-Dec-15 2
95 NURLATIFAH 414395 07-Dec-15 08-Dec-15 2
96 YANAH NURJANAH 412803 07-Dec-15 08-Dec-15 2
97 IMAY 371045 07-Dec-15 08-Dec-15 3
98 SUNYANI 403031 07-Dec-15 08-Dec-15 2
99 SUKAMAD 374182 08-Dec-15 09-Dec-15 2
100 NAZARUDIN 414324 06-Dec-15 09-Dec-15 4
101 RIDAH 330319 05-Dec-15 09-Dec-15 5
102 SUPRIADI 389493 04-Dec-15 09-Dec-15 9
103 FAIQ FIRJATULLAH 414390 08-Dec-15 09-Dec-15 2
104 NELY 407948 05-Dec-15 09-Dec-15 5
105 NARKUM 406107 08-Dec-15 09-Dec-15 2
106 EMI SUMIATI 396745 04-Dec-15 09-Dec-15 6
107 FERY IRAWAN 402400 07-Dec-15 08-Dec-15 2
108 EGI SAPUTRA 403564 04-Dec-15 08-Dec-15 5
109 ARY APRIANI 348772 30-Nov-15 08-Dec-15 9
110 M RAFLI AKBAR 414231 04-Dec-15 10-Dec-15 7
111 KEYLA ARSIFA 414366 08-Dec-15 10-Dec-15 3
112 ASTRI SRI RAHAYU 304306 03-Dec-15 10-Dec-15 8
113 MINA DARIL MUNTAZAH 414061 07-Dec-15 10-Dec-15 4
114 SUSANTI RACHIM 414314 05-Dec-15 10-Dec-15 6
115 JAMIN 414340 07-Dec-15 10-Dec-15 4
116 AULIA PUTRI 304678 05-Dec-15 10-Dec-15 6
117 ADANG SURAHMAN 308424 06-Dec-15 10-Dec-15 5
118 ICIH 414300 08-Dec-15 10-Dec-15 3
119 ARMENG KOTO 414147 03-Dec-15 10-Dec-15 8
120 UJANG HAMBALI 414442 08-Dec-15 10-Dec-15 3
121 CHACHA ADYLLA PUTRI 413960 30-Nov-15 10-Dec-15 11
122 NUNUNG MASDUKI 408715 07-Dec-15 09-Dec-15 3
123 DEDAH MULYATI 414459 08-Dec-15 11-Dec-15 4
124 RINI MARDASIH 414422 08-Dec-15 11-Dec-15 4
125 DARHIM 411687 07-Dec-15 11-Dec-15 5
126 ATIN CUHAYATIN 414429 08-Dec-15 11-Dec-15 3
127 SUHAEMI 408010 10-Dec-15 11-Dec-15 2
128 M RIDWAN SALEH 414359 07-Dec-15 11-Dec-15 5
129 NOVI HERYANI, NY 389656 08-Dec-15 11-Dec-15 4
130 ATHAYA KIRANA, BY 414460 08-Dec-15 11-Dec-15 4
131 RINI OKTAVIA, NY 411243 10-Dec-15 11-Dec-15 2
132 SEKAR PUTRI 414469 09-Dec-15 11-Dec-15 3
133 RIMARDA JULIANTI 394379 05-Dec-15 11-Dec-15 7
134 DZAKWAN RIZKY 385828 06-Dec-15 11-Dec-15 6
135 RODHI HIDAYAT 414316 06-Dec-15 11-Dec-15 6
136 JIRONAH RATNA 414448 08-Dec-15 11-Dec-15 4
137 MEY ASTUTI 414440 10-Dec-15 11-Dec-15 2
138 M SUHENDI 414629 11-Dec-15 12-Dec-15 2
139 M SEPTIAN RAMADANI 3339603 10-Dec-15 12-Dec-15 3
140 HASANUDIN ASHAF 414410 08-Dec-15 12-Dec-15 5
141 ASEP SANDI 379133 08-Dec-15 12-Dec-15 5
142 ENI HASANAH 396222 07-Dec-15 12-Dec-15 6
143 ENDANG 414542 11-Dec-15 12-Dec-15 2
144 SANEH 414398 07-Dec-15 12-Dec-15 6
3
145 YAYAN DARYANTO 328553 11-Dec-15 13-Dec-15
146 YUNENGSIH 414315 09-Dec-15 13-Dec-15 5
147 RIZKY ADITYA 414424 08-Dec-15 13-Dec-15 6
148 WIATININGSIH 414621 11-Dec-15 13-Dec-15 3
149 EMAN SULAEMAN 414342 07-Dec-15 13-Dec-15 7
150 MALIKI 414462 09-Dec-15 13-Dec-15 5
151 YOGA ADITYA 341757 10-Dec-15 13-Dec-15 4
152 ACIH 414345 07-Dec-15 13-Dec-15 7
153 FARHAN REZKYA 374491 11-Dec-15 14-Dec-15 4
154 ASEP ANSHORI 414565 10-Dec-15 14-Dec-15 5
155 AULIA REVINKA 414555 10-Dec-15 14-Dec-15 5
156 DIZKAVIRGINIA 411145 08-Dec-15 14-Dec-15 7
157 LISDA NURWIDAYANTI 353140 11-Dec-15 14-Dec-15 4
158 KIMI 310062 12-Dec-15 14-Dec-15 3
159 DERIO GITARA 410279 10-Dec-15 14-Dec-15 5
160 WIWI WIDANINGSIH 373421 09-Dec-15 14-Dec-15 6
161 NYAI SUMIATI 413588 10-Dec-15 14-Dec-15 5
162 TYNA ISNAWATY 414672 12-Dec-15 14-Dec-15 3
163 NUNUNG NURHASANAH 399881 10-Dec-15 14-Dec-15 5
164 ASSHYFA FAZZAH 397234 12-Dec-15 14-Dec-15 3
165 AKMAL FAEZA 414599 11-Dec-15 15-Dec-15 5
166 WARTINI 414617 11-Dec-15 15-Dec-15 5
167 JONO 337080 11-Dec-15 15-Dec-15 5
168 DIDING AHDIN 414682 12-Dec-15 15-Dec-15 4
169 HODIJAH 344663 12-Dec-15 15-Dec-15 4
170 YAKYA BIN DURAIS 414521 10-Dec-15 15-Dec-15 6
171 HINARYA 414223 07-Dec-15 15-Dec-15 9
172 FALAH ABDILAH 414526 10-Dec-15 15-Dec-15 6
173 YUSI RAHMAWATI 380785 14-Dec-15 15-Dec-15 2
174 SITI SUHARTINI 383955 13-Dec-15 15-Dec-15 3
175 NURHASANAH 414591 11-Dec-15 15-Dec-15 5
176 YANTI 414781 14-Dec-15 15-Dec-15 2
177 BILQIS NUR APRILIA 414478 09-Dec-15 15-Dec-15 7
178 RYAN HERMAWAN 408348 14-Dec-15 15-Dec-15 2
179 WASITO 411221 14-Dec-15 15-Dec-15 2
180 TAMAN 386324 07-Dec-15 15-Dec-15 9
181 MARYAH SARININGSIH 414566 11-Dec-15 15-Dec-15 5
182 MEYLIAWATI 402634 13-Dec-15 15-Dec-15 3
183 JUWITA 410364 13-Dec-15 16-Dec-15 4
184 REGAN ABYAN 379177 13-Dec-15 16-Dec-15 4
185 MEFA ELSAFIAH 411171 14-Dec-15 16-Dec-15 3
186 KASWIYAH 330266 14-Dec-15 16-Dec-15 3
187 EHAT SUSILA 375345 11-Dec-15 16-Dec-15 6
188 SOLEH HIDAYAT 414734 14-Dec-15 16-Dec-15 3
189 HEPRIANSYAH 412641 14-Dec-15 16-Dec-15 3
190 ENDANG GUNAWAN 414143 10-Dec-15 16-Dec-15 7
191 PUTRI FAIQAH 404345 12-Dec-15 16-Dec-15 5
192 CHARISTA SESILYA 383903 12-Dec-15 16-Dec-15 5
193 DADENG SUPRIATNA 413684 15-Dec-15 16-Dec-15 2
194 JUJU 414688 13-Dec-15 16-Dec-15 4
195 SUCI FEBRIYANTI 414530 14-Dec-15 16-Dec-15 3
196 SANTI PERMATASARI 414751 15-Dec-15 16-Dec-15 2
197 ADITYA NUGRAHA 329485 14-Dec-15 17-Dec-15 4
198 IPIT 414695 13-Dec-15 17-Dec-15 5
199 ODE SUPRIATNA 414699 13-Dec-15 17-Dec-15 5
200 WIWIN WIDANENGSIH 414838 16-Dec-15 17-Dec-15 2
201 ENDIN SURYAHDIN 414704 13-Dec-15 17-Dec-15 5
202 WIDANINGSIH 404799 15-Dec-15 17-Dec-15 3
203 RIZKY SURYANA 414832 15-Dec-15 17-Dec-15 3
204 SAPRI HIDAYAT 396927 12-Dec-15 17-Dec-15 6
205 ARDHITA AULIAWATI 353605 16-Dec-15 17-Dec-15 2
206 CHIKA PUTRI 413943 16-Dec-15 17-Dec-15 2
207 UJU 369105 16-Dec-15 17-Dec-15 2
208 ADE AHYADE 414724 15-Dec-15 17-Dec-15 3
209 TRI MULYANTI, NY 414113 14-Dec-15 17-Dec-15 4
210 TRI MULYANTI, BY 414771 14-Dec-15 17-Dec-15 4
211 MANTA 414497 11-Dec-15 17-Dec-15 7
212 ELVIRA CALLISTA 325225 14-Dec-15 16-Dec-15 3
213 DEDEH KOMARIAH 376451 11-Dec-15 16-Dec-15 6
214 SUPARSIH 413501 14-Dec-15 18-Dec-15 5
215 LISTINA 403133 15-Dec-15 18-Dec-15 4
216 TJAH YULIANTI 398621 16-Dec-15 18-Dec-15 3
217 TUTI HERAWATI 414383 14-Dec-15 18-Dec-15 5
218 DEDEH HAMIDAH 414821 15-Dec-15 18-Dec-15 4
219 DADANG SHOLAHUDIN 414756 14-Dec-15 18-Dec-15 5
220 HAMDANI 414261 17-Dec-15 18-Dec-15 2
221 DIDAN NABHAN 414877 17-Dec-15 18-Dec-15 2
222 AKMAL WIRA 414789 16-Dec-15 18-Dec-15 3
223 ANTON JABARI 414492 15-Dec-15 18-Dec-15 4
224 SOPANDI 392821 14-Dec-15 18-Dec-15 5
225 AFLAH ALAIKA 322453 18-Dec-15 19-Dec-15 2
226 NANO KARYANA 413331 15-Dec-15 19-Dec-15 5
227 NISA MAULIDA 414822 15-Dec-15 19-Dec-15 5
228 SALSABILA ALMUHAROM 309219 16-Dec-15 19-Dec-15 4
229 FIRDA KHAIRUNISA 371738 16-Dec-15 19-Dec-15 4
230 INTAN PAMUNGKAS 386537 15-Dec-15 19-Dec-15 5
231 NURSANTI 406517 16-Dec-15 19-Dec-15 4
232 MAMAN 407036 16-Dec-15 19-Dec-15 4
233 KURNIA INDAH 412969 15-Dec-15 19-Dec-15 5
234 M JAKARIA 414841 18-Dec-15 19-Dec-15 2
235 EGHA PUSPITADEWI 361526 17-Dec-15 19-Dec-15 3
236 RASIDI 413587 15-Dec-15 19-Dec-15 5
237 SRI SAPTINI 414705 13-Dec-15 19-Dec-15 7
238 NUR HASAROH, NY 399618 16-Dec-15 19-Dec-15 4
239 NUR HASAROH, BY 414864 16-Dec-15 19-Dec-15 4
240 ARDHITA AULIAWATI, BY 414834 16-Dec-15 19-Dec-15 4
241 HANA HARISMA 411767 16-Dec-15 19-Dec-15 4
242 NAZWA NARHUM 414952 17-Dec-15 19-Dec-15 3
243 JANIFAR FARIANSA 415023 18-Dec-15 20-Dec-15 3
244 NENI HANDAYANI 375378 17-Dec-15 20-Dec-15 4
245 NURHAYATI 333954 18-Dec-15 20-Dec-15 3
246 LENI BUDIARTI 414906 17-Dec-15 20-Dec-15 4
247 NURAENI 311271 16-Dec-15 20-Dec-15 5
248 TAUFIQ HIDAYAT 361321 17-Dec-15 20-Dec-15 4
249 SEPTIAN FIROZ 413243 18-Dec-15 20-Dec-15 3
250 ARYA DONA 414823 15-Dec-15 20-Dec-15 6
251 MISDA 413503 14-Dec-15 20-Dec-15 7
252 ROHENDI 414696 13-Dec-15 20-Dec-15 8
253 LOUISA DIANDRA 414999 18-Dec-15 20-Dec-15 3
254 JABAR MALIK 387855 16-Dec-15 20-Dec-15 5
255 NAYUM 414515 16-Dec-15 20-Dec-15 5
256 AMUY MA'MUR 350777 19-Dec-15 20-Dec-15 2
257 JAYADI PUTRA 415021 18-Dec-15 21-Dec-15 4
258 PUJI NURANI 373048 17-Dec-15 21-Dec-15 5
259 TUTI WIDIASTUTI 414793 17-Dec-15 21-Dec-15 5
260 DITA RIZKIKA 407833 17-Dec-15 21-Dec-15 5
261 YANAH SUPIYANAH 382882 15-Dec-15 17-Dec-15 2
262 AGUS SUHARDJA 400853 11-Dec-15 11-Dec-15 1
263 NERSIH 411907 10-Dec-15 11-Dec-15 2
264 SANTI 414892 17-Dec-15 17-Dec-15 1
265 NANA RUKMANA 415066 20-Dec-15 22-Dec-15 3
266 RIZKY ANUGRAH 307807 15-Dec-15 22-Dec-15 8
267 KHAELA FIRZATULLAH 415052 19-Dec-15 22-Dec-15 4
268 HABIBI KAINDRA 387898 18-Dec-15 22-Dec-15 5
269 KANIA PRAWITA, NY 320406 21-Dec-15 22-Dec-15 2
270 YAYAN DARYANA 414946 21-Dec-15 22-Dec-15 2
271 KHUSNUL KHOTIMAH 335759 21-Dec-15 22-Dec-15 2
272 HERMAN 415022 18-Dec-15 22-Dec-15 5
273 PERI PRIADI 365848 21-Dec-15 22-Dec-15 2
274 DENI GUNAWAN 372167 17-Dec-15 22-Dec-15 2
275 PUJI NURANI 415020 18-Dec-15 21-Dec-15 4
276 NOVIANTI 370587 14-Dec-15 15-Dec-15 2
277 IIS ISKANDAR 414983 18-Dec-15 23-Dec-15 6
278 TIA GUSTIANI 405211 20-Dec-15 23-Dec-15 4
279 YUYU YUHANA 414612 20-Dec-15 23-Dec-15 4
280 TATANG SUHERMAN 406794 21-Dec-15 23-Dec-15 3
281 ROHMAT 415186 22-Dec-15 23-Dec-15 2
282 IDA RUHIDA 413070 16-Dec-15 23-Dec-15 8
283 WILDAN FIRDAUS 400742 22-Dec-15 23-Dec-15 2
284 NADIA HASNA 414934 17-Dec-15 23-Dec-15 7
285 RATU DEWI BAYU, NY 414386 20-Dec-15 23-Dec-15 4
286 RATU DEWI BAYU, BY 415150 21-Dec-15 23-Dec-15 2
287 DILA AGUSTIA 317041 20-Dec-15 23-Dec-15 4
288 FADHIL YAQDAN 401660 21-Dec-15 23-Dec-15 3
289 DZAKWAN JULIAN 415053 19-Dec-15 23-Dec-15 5
290 CINTA DHAFITHA 380401 19-Dec-15 23-Dec-15 5
291 ELJUNA BISYANI 395071 17-Dec-15 23-Dec-15 7
292 LIA 415139 21-Dec-15 24-Dec-15 4
293 KOKOM KOMARIAH 414849 20-Dec-15 24-Dec-15 5
294 JAJAT SUDRAJAT 377569 19-Dec-15 24-Dec-15 6
295 IDJAH 414004 21-Dec-15 24-Dec-15 4
296 YOYOH 396735 19-Dec-15 24-Dec-15 6
297 WINDARI SOPIANTI 341015 21-Dec-15 24-Dec-15 4
298 IDA 415076 20-Dec-15 24-Dec-15 5
299 AI KOKOM 415067 20-Dec-15 24-Dec-15 5
300 ROSMANSYAH 404969 20-Dec-15 24-Dec-15 5
301 M. A. RASYKUL 408938 20-Dec-15 24-Dec-15 5
302 ARISAH 413828 22-Dec-15 24-Dec-15 3
303 A JUANGSIH 407196 21-Dec-15 25-Dec-15 5
304 EPON MAEMUNAH 407822 23-Dec-15 25-Dec-15 3
305 AZKA AZIZAN 374476 18-Dec-15 25-Dec-15 8
306 UMAS 414998 18-Dec-15 25-Dec-15 6
307 NURSANTI 406517 21-Dec-15 25-Dec-15 5
308 BARIAH 414646 20-Dec-15 25-Dec-15 6
309 HERMAN 415100 21-Dec-15 25-Dec-15 5
310 SURYADI 323370 21-Dec-15 26-Dec-15 6
311 INDRIANI 415012 21-Dec-15 26-Dec-15 6
312 DIMAS SALSABILA 310163 19-Dec-15 26-Dec-15 8
313 REZKI BAEHAKI 411855 20-Dec-15 26-Dec-15 7
314 HEDI PENI 414997 18-Dec-15 26-Dec-15 9
315 DAFFA HAFIZH 413042 22-Dec-15 26-Dec-15 5
316 YAYAN DARYANTO 328553 22-Dec-15 26-Dec-15 5
317 M ADITYA 414003 22-Dec-15 26-Dec-15 5
318 ISAH KOMALASARI 415030 22-Dec-15 26-Dec-15 5
319 TIAZ PUTRI 319911 19-Dec-15 23-Dec-15 5
320 TASWI 413350 21-Dec-15 24-Dec-15 4
321 LUSIANA SILALAHI 406934 22-Dec-15 24-Dec-15 3
322 NURHASANAH 415173 22-Dec-15 24-Dec-15 3
323 DETI KURNIA, NY 316472 21-Dec-15 24-Dec-15 4
324 DETI KURNIA, BY 415219 22-Dec-15 24-Dec-15 3
325 EMOD 415054 20-Dec-15 23-Dec-15 4
326 METTI 393217 23-Dec-15 27-Dec-15 5
327 NANI YOSMANI 415397 26-Dec-15 27-Dec-15 2
328 TATANG SURYATNA 414882 23-Dec-15 27-Dec-15 5
329 DESI SITI BARIYAH 415325 24-Dec-15 27-Dec-15 4
330 DAMI 415107 26-Dec-15 27-Dec-15 2
331 MUALIM 415166 22-Dec-15 27-Dec-15 6
332 AJENG WIDY 413706 26-Dec-15 27-Dec-15 2
333 M FERI 415293 26-Dec-15 27-Dec-15 2
334 NAFARO ALFARIZY 415334 24-Dec-15 27-Dec-15 4
335 SUSI YULIANTY 406712 25-Dec-15 27-Dec-15 3
336 DARPI WIGUNA 415086 21-Dec-15 27-Dec-15 7
337 NURLAELA 371074 26-Dec-15 27-Dec-15 2
338 IIS SUMIATI 375993 24-Dec-15 28-Dec-15 5
339 SABRINA PUTRI 415411 26-Dec-15 28-Dec-15 3
340 NAILA SAIDAH 368457 23-Dec-15 28-Dec-15 6
341 MARIYAH 415288 25-Dec-15 28-Dec-15 4
342 CUCUN CUNAYAH 338285 22-Dec-15 23-Dec-15 2
343 ASNIH 370105 26-Dec-15 28-Dec-15 3
344 DEDEH KMARIAH 376451 19-Dec-15 23-Dec-15 5
345 TRI BUDIYANTO 388488 23-Dec-15 26-Dec-15 4
346 LILIS SUMIATI 354377 22-Dec-15 27-Dec-15 6
347 SUTAMI 380772 21-Dec-15 28-Dec-15 8
348 MIRA HERAWATI 368596 25-Dec-15 26-Dec-15 2
349 AMIR HUSAIN 406998 27-Dec-15 29-Dec-15 3
350 UDJU DJUHARA 343779 27-Dec-15 29-Dec-15 3
351 ASEP SUDRAJAT 415160 22-Dec-15 29-Dec-15 8
352 IDING 407234 25-Dec-15 29-Dec-15 5
353 EVA SIDWI ASTUTI 375762 26-Dec-15 29-Dec-15 4
354 SARJAN 415385 25-Dec-15 29-Dec-15 5
355 EVA SRI UBAYA 415338 24-Dec-15 29-Dec-15 5
356 ARIE HARDIANA 415387 25-Dec-15 29-Dec-15 5
357 ARKAAN 415304 27-Dec-15 29-Dec-15 3
358 LIAWATI 415578 28-Dec-15 29-Dec-15 2
359 SAHLAN SOLIHIN 388042 28-Dec-15 29-Dec-15 2
360 ROFIK 301891 28-Dec-15 29-Dec-15 2
361 AZZAHIRA PUJI 385293 23-Dec-15 29-Dec-15 7
362 RIFDAH ZHAFIRA 371294 20-Dec-15 23-Dec-15 4
363 YUYU YULIATI 415335 24-Dec-15 29-Dec-15 6
364 IR SYAMSUL HAVID 415534 27-Dec-15 29-Dec-15 3
365 M REGI WIRAKUSNI 415191 25-Dec-15 30-Dec-15 6
366 M ZIDAN 415344 24-Dec-15 30-Dec-15 7
367 DEVY ALAWIANI 335321 27-Dec-15 30-Dec-15 4
368 AANG YUSUF 370280 28-Dec-15 30-Dec-15 3
369 M ZAID AL ADAWI 415568 28-Dec-15 30-Dec-15 3
370 ILMA SALIMATU NISA 410363 28-Dec-15 30-Dec-15 3
371 A SUNARYA 415384 25-Dec-15 30-Dec-15 6
372 GIGANTEO ONADIO 415150 28-Dec-15 30-Dec-15 3
373 SUTRISNO 415177 22-Dec-15 30-Dec-15 9
374 CUCUN CUNAYAH 415691 29-Dec-15 30-Dec-15 6
375 NURLAELA 415192 28-Dec-15 30-Dec-15 3
376 SRI MULIDIAWATI 355361 29-Dec-15 30-Dec-15 2
377 NURMALASARI 393917 28-Dec-15 30-Dec-15 3
378 HANIFAH 375496 26-Dec-15 30-Dec-15 5
379 TUTI ANDRIANI 351742 28-Dec-15 30-Dec-15 3
380 EGIS JULIANSYAH 415179 28-Dec-15 30-Dec-15 3
381 M ADITYA KURNIAWAN 415684 29-Dec-15 30-Dec-15 2
382 ADE WUTU 415479 28-Dec-15 30-Dec-15 3
383 SUKAESIH 415606 28-Dec-15 30-Dec-15 3
384 KOKOM KOMARIAH 415543 27-Dec-15 30-Dec-15 4
385 MEYLIAWATI 402634 26-Dec-15 30-Dec-15 5
386 SUPIATI 415213 22-Dec-15 23-Dec-15 2
387 AHMAD ZAKARIA 415168 22-Dec-15 29-Dec-15 8
388 MULYANA 389102 28-Dec-15 31-Dec-15 4
389 SUPARMAN 409765 28-Dec-15 31-Dec-15 4
390 GIARSIH 312291 27-Dec-15 31-Dec-15 5
391 MULQIYAH ERNAWATI 412721 29-Dec-15 31-Dec-15 3
392 NENI ARYANI 364673 27-Dec-15 31-Dec-15 5
393 ROYASIH 415655 28-Dec-15 31-Dec-15 4
394 RIFDAH ZHAFIRA 371294 28-Dec-15 30-Dec-15 3
395 FAHRIE IRDIANSYAH 415535 27-Dec-15 30-Dec-15 4
396 EFFENDI 355575 29-Dec-15 31-Dec-15 2
397 RADINDA PUTRI 415644 28-Dec-15 31-Dec-15 4
398 ILAH JAMILAH 415767 30-Dec-15 31-Dec-15 2
399 KRISNA SUYUDI 415591 30-Dec-15 31-Dec-15 2
400 MOCH FAUZAN 368174 28-Dec-15 31-Dec-15 4
401 WAWAN 415762 30-Dec-15 31-Dec-15 2
402 KHALIL BALGIZ 388150 29-Dec-15 31-Dec-15 3
NO NAMA PASIEN
1 FINA RATU BALGIST 414023 01-Dec-15 03-Dec-15 3
2 RINDA 413957 30-Nov-15 04-Dec-15 5
3 AISYA 390846 28-Nov-15 04-Dec-15 7
4 MUHAMAD RIDWAN 414302 05-Dec-15 07-Dec-15 3
5 KEISHA ALIKA PUTRI AGNI 414249 04-Dec-15 07-Dec-15 4
6 RISMA MAHARDIKA 375261 05-Dec-15 08-Dec-15 4
7 ENDANG SUHENDAR 386880 04-Dec-15 08-Dec-15 5
8 YUMNA FAHIRA 405926 05-Dec-15 08-Dec-15 4
9 YOYOH 320425 07-Dec-15 10-Dec-15 4
10 APENDI 344709 10-Dec-15 12-Dec-15 3
11 CLEINE FEBRY 406450 11-Nov-15 12-Dec-15 2
12 NAYLA MAISHA FATIHA 414409 08-Dec-15 11-Dec-15 4
13 TETY SOFIA 375659 08-Dec-15 11-Dec-15 4
14 DIDIN SAHBUDIN 414643 12-Dec-15 15-Dec-15 4
15 SITI NUROHMAH, NY + BY 414783 15-Dec-15 16-Dec-15 2
16 ALIYYA ADILAH 388415 19-Dec-15 21-Dec-15 2
17 SUKARSIH 414977 17-Dec-15 20-Dec-15 4
18 UMI KULSUM 414556 17-Dec-15 21-Dec-15 5
19 EVA NOVIANTI 415048 19-Dec-15 22-Dec-15 4
20 RIKA RAKHMAWATI 414982 18-Dec-15 20-Dec-15 3
21 ATIN 415046 19-Dec-15 21-Dec-15 3
22 SRI HAYATI MARDIANA 393358 21-Dec-15 23-Dec-15 3
23 AGUS EKO BUDI SANTOSO 414808 15-Dec-15 24-Dec-15 10
24 ANI RAHAYU 388680 28-Dec-15 30-Dec-15 3
25 ELFITRA 318004 28-Dec-15 31-Dec-15 4
ekapitulasi INA CBGs Bulan DESEMBER
DIAGNOSA PRIMER DIAGNOSA SEKUNDER HARGA RS
HARGA INA CBGS
BRONKHITIS DYSPEPSIA+HIPOKALEMIA 5,380,178 3,281,300.00
VIRAL INFECTION - 2,187,400 2,331,600.00
UTI - 1,941,267 2,323,200.00
VIRAL INFECTION - 1,394,653 2,331,600.00
HT CAD+VIRAL INFECTION 2,407,685 3,820,400.00
TYPOID FEVER ISPA 3,953,314 3,800,300.00
FAM - 8,444,296 6,118,200.00
FAM - 10,198,730 7,137,800.00
STT EKSISI 10,657,068 6,819,800.00
CKD DMT2+HT+ANEMIA 6,416,707 3,101,800.00
HHD+DC ESRD+J90 5,089,303 5,238,100.00
EFUSI PLEURAL ESRD+AF 17,279,510 5,388,000.00
VIRAL INFECTION STOMTITIS 2,791,900 2,791,900.00
ASMA TTH 4,123,792 1,862,800.00
TUMOR TORAX - 10,623,474 5,845,600.00
SLEEP APNOEA - 7,719,887 4,861,600.00
BRONKHITIS ESRD 2,452,401 2,173,300.00
ESRD CAP 4,563,827 4,911,300.00
TB PARU EFUSI PLEURA 2,214,423 4,170,700.00
CAP PPOK 6,850,494 5,860,100.00
ASMA GRAVIDA 3,676,894 2,173,300.00
POST DATE PARTUS SPONTAN 3,699,290 2,859,900.00
STT - 8,368,955 6,118,200.00
GEA TYPOID FEVER 1,937,352 3,540,100.00
DYSPEPSIA - 2,289,565 3,335,500.00
DIARE AKUT - 2,634,770 2,827,100.00
DIARE AKUT BRONKHITIS 3,861,514 2,423,100.00
CAP PPOK 6,752,040 6,836,700.00
AB INCOMPLITE - 6,399,867 3,825,600.00
TONSILITIS - 7,786,730 2,121,400.00
STT - 10,264,059 7,137,800.00
TUMOR PEDIS - 8,444,232 3,290,400.00
DIARE AKUT SEPSIS+DEVELOVE MENTAL DELAYED 15,231,178 3,540,100.00
CAD DC+ANEMIA 8,164,429 4,170,900.00
WOUND DEHINSENCE HYPOALBUMIN 6,751,436 1,862,900.00
P. SEROTINUS ANEMIA+PARTUS SC 10,327,092 4,826,600.00
BBLR - 1,547,186 1,995,800.00
LESION HT 5,191,484 3,102,100.00
TYPOID FEVER - 2,675,026 3,329,400.00
DIARE AKUT - 1,998,673 2,355,800.00
DADRS - 2,546,826 2,423,100.00
FAILED BACK SYNDROME CAUD EQUINA SYNDROME 4,674,180 2,324,900.00
HEPATITIS TYPHOSAT ISPA 4,247,393 2,799,100.00
DADRS HYPOKALEMI 2,829,211 3,421,100.00
ANEMIA POST KEMOTERAPI 2,291,775 1,552,100.00
STT - 8,635,644 5,845,600.00
AB INCOMPLITE - 5,622,488 3,279,100.00
TYPOID FEVER - 3,362,959 2,774,500.00
BLIGHT OVUM - 5,065,151 3,279,100.00
TYPOID FEVER - 4,986,520 3,884,300.00
UAP VIRAL INFECTION 5,570,668 4,509,100.00
STT EKSISI 8,029,234 4,871,300.00
HERNIA - 9,692,694 4,283,900.00
EFUSI PLEURAL ESRD 3,614,647 3,264,000.00
TYPOID FEVER - 3,884,300 3,884,300.00
LOW BACK PAINT HT 3,807,949 2,712,300.00
VIRAL INFECTION - 2,290,275 2,331,600.00
KDS - 1,204,634 1,859,300.00
DC+DCM DMT2+ckd 3,745,759 4,063,100.00
4,397,112 4,063,100.00
TYPOID FEVER DHF 5,137,743 4,906,600.00
TB PARU PPOK 8,885,981 5,979,400.00
VIRAL INFECTION - 2,660,983 2,331,600.00
ULKUS DIABETIKUM - 9,954,966 4,345,900.00
ULKUS DIABETIKUM - 10,638,280 4,345,900.00
COLITIS - 2,658,616 2,423,100.00
AB IMINENS - 2,564,163 1,677,400.00
CPD PARTUS SPONTAN 9,414,319 4,826,600.00
HERNIA - 6,981,588 3,569,900.00
ASMA RESPIRATORY FAILURE 3,998,828 2,343,800.00
HIL - 11,639,245 4,997,900.00
HEMANGIOMA - 8,030,261 3,929,100.00
DENGUE SYOK SYNDROM TYPOID FEVER 6,214,316 3,398,900.00
TUMOR MAMAE - 8,136,827 6,118,200.00
CML (Chronic Myeloid Le - 4,044,782 3,259,900.00
PERDARAHAN PERVAGIN ANEMIA 5,505,167 2,557,200.00
BP HHD 4,755,544 4,170,100.00
TYPOID FEVER - 3,418,208 3,329,400.00
DADRS - 2,469,775 2,423,100.00
GASTRITIS Erosit ANEMIA 5,093,340 2,793,700.00
CYSTA DUCTUS CHOL - 6,094,564 2,800,200.00
HERNIA - 4,283,900 4,283,900.00
trnsiens tachypnoe
RESPIRATORY
of ne
FAILURE+NH+STATUS EPILEPTICUS+BRAIN DAMAGE+ENCEHALOPATY
27,602,025 7,061,600.00
UAP HT 3,783,069 3,865,000.00
TYPOID FEVER - 2,910,540 3,329,400.00
DADRS TB PARU 2,022,574 3,421,100.00
DADRS - 2,454,079 2,423,100.00
CLAVUS TERINFEKSI INFEKSI KULIT 9,189,584 4,583,900.00
FIMOSIS ISK+KISTA A/R GLANDS PENIS 7,273,362 6,267,700.00
DYSPEPSIA - 2,379,650 3,335,500.00
GEA HIPOCALEMIA 2,802,570 3,421,100.00
DF HYPOKALEMIA 5,546,391 3,257,200.00
BATU URETER HYDRONEFROSIS 2,391,094 2,053,600.00
BATAL OPERASI MYOMA UTERI 1,601,549 1,632,600.00
AB INCOMPLITE - 4,820,166 3,279,100.00
AB INCOMPLITE - 4,464,193 2,732,600.00
D QUERVAIN TRIGGER THUMB 12,820,257 4,583,900.00
ANEMIA POST OP 1,879,399 2,172,900.00
HIPERKALEMIA ESRD 3,171,468 2,313,800.00
TTH HT 3,933,950 1,865,900.00
DYSPEPSIA DMT2+HT+TTH 2,959,210 3,183,700.00
EPILEPSI CEPHALGIA 4,454,891 1,859,300.00
REPTUR TENDON SKIN LOS+INFEKSI 5,999,894 4,871,300.00
GASTRITIS - 1,861,600 1,861,600.00
ESRD - 3,327,509 2,716,700.00
MENOMERTRORAGHIA ESRD 3,607,718 1,552,900.00
GEA - 2,827,100 2,827,100.00
APP PEROTINITIS - 12,947,960 7,947,700.00
TUMOR COLON - 31,020,914 11,204,900.00
UTI DENGUE FEVER 3,452,457 2,787,800.00
VIRAL INFECTION ISPA 1,916,562 2,331,600.00
TYPOID FEVER - 5,428,580 3,329,400.00
ASMA - 2,473,418 1,862,800.00
PID DYSMENORHEA+DYSPEPSIA 6,481,857 2,544,100.00
ESRD HIPERKLEMIA 2,794,698 4,530,800.00
CAP BEKS TB 3,896,239 4,170,100.00
TUMOR DIDINDING ABD - 8,016,566 5,677,000.00
AKALASIA DEHIDRASI 9,408,405 1,862,400.00
PPOK DYSPEPSIA 3,357,800 3,357,800.00
DSS TYPOID FEVER 15,210,165 3,398,900.00
BPPV - 2,168,100 2,168,100.00
ASMA - 2,311,870 1,862,800.00
CAD STEMI+DMT2 6,168,570 2,797,900.00
WOUND DEHINSENCE ANEMIA 4,470,638 2,942,600.00
TUMOR MAMAE - 10,160,363 6,118,200.00
CTS TFCC ARTRITIS 9,771,741 1,061,200.00
HERNIA - 10,008,259 4,283,900.00
INERSIA UTERI SS 12,442,647 5,631,000.00
BBL - 2,197,358 2,743,400.00
GAMELI PARTUS SPONTAN 3,093,940 3,346,400.00
DADRS - 1,538,875 2,423,100.00
BP - 5,388,441 4,170,100.00
DIARE AKUT - 3,823,405 2,827,100.00
PERITONITIS APPENDICU - 11,696,369 6,812,300.00
APP PEROTINITIS - 12,924,024 7,947,700.00
TUMOR A/R PEDIS SIN - 7,420,639 5,845,600.00
STROK INFARK HT+HIPERCALSEMIA 2,476,215 2,825,200.00
DMT2+DKD Sequale strok 5,975,593 3,632,200.00
OSTEOCHONDROMA A/R - 13,336,185 6,284,000.00
EMPYEMA GALL BLADER CHOLELITHIASIS+ADHESI BILIER 16,377,963 7,561,400.00
TUMUR A/R SHOULDER - 7,486,443 4,871,300.00
EFUSI PERICARDI DC+HHD+ANEMIA 9,055,746 6,292,900.00
-
CHOLELITHIATIS 2,921,854 2,800,200.00
DADRS - 4,940,596 2,423,100.00
VIRAL INFECTION DRUG ALERGI 4,730,908 2,331,600.00
HEG - 1,843,799 2,502,400.00
DHF HYPONATREMIA+HYPOCALCEMIA 9,369,384 3,257,200.00
STROK INFARK HT+GOUT+HEMIPLAGIA 6,890,902 7,463,200.00
BP MORBILI 3,485,588 4,170,100.00
TB PARU DC+HHD+ANEMIA 10,453,641 6,976,000.00
ESRD HYPERKALEMIA 2,785,624 4,530,800.00
STROOK PIS HEMIPRASE 5,818,056 2,596,800.00
FARINGITIS - 1,945,698 1,524,100.00
TYPOID FEVER TB PARU 5,731,291 4,996,100.00
TYPOID FEVER - 4,576,054 3,329,400.00
GEA HT+HHD 2,857,714 3,820,400.00
DADRS VIRAL INFECTION 2,425,312 2,423,100.00
DCM DC+ESRD 5,632,760 3,033,400.00
MIOMA UTERI - 22,095,996 7,381,900.00
PLACENTA PREVIA PARTUS SC 5,631,000 5,631,000.00
TB PARU HEMAPTOE+DMT2+HT 4,261,548 5,004,900.00
ISPA TFA 2,831,806 1,829,000.00
DADRS - 2,622,637 2,423,100.00
DYSPEPSIA - 4,782,549 3,335,500.00
TYPOID FEVER VIRAL INFECTION 5,070,116 3,329,400.00
CA. COLON - 6,489,912 1,632,600.00
CAD ISKEMIK+DC+HT+DYSPEPSIA 3,684,953 2,331,600.00
DCM DC+AF+NEPRITIS+KISTA KIDNEY 5,527,584 3,482,600.00
TB PARU PNEMOTHORAX+DMT2 11,223,711 4,982,800.00
BRONKHITIS - 5,150,280 1,858,600.00
TYPOID FEVER - 2,301,344 3,329,400.00
SYNDROME GERIATRI - 3,968,888 6,459,800.00
TB PARU - 3,410,148 5,004,900.00
AB INCOMPLITE - 5,248,062 3,279,100.00
DADRS ISPA+VIRAL INFEKSI 3,996,348 2,423,100.00
POST OP PYELOLITOTOM STENOSOS+CYSTITIS+HIDRONEFROSIS 14,895,460 10,048,300.00
POST OP PASANG DJ STE CYSTITIS+SEPSIS 14,843,438 3,722,100.00
TB PARU COPD+CAD+ESRD 14,358,810 4,982,800.00
DHF DRUG ERUPTION 3,257,200 3,257,200.00
GASTRITIS DMT2+CAD 2,171,800 2,171,800.00
DIARE AKUT TB PARU 2,218,154 2,355,800.00
RHINO BRONKHITIS - 3,838,050 2,168,400.00
DADRS - 1,326,801 2,355,800.00
CAD UAP+HHD+DMT2 1,945,223 3,183,700.00
DENGUE FEVER - 4,706,778 2,331,600.00
HT SEQ STROK+CAD 2,076,801 3,183,700.00
VIRAL INFECTION ISPA 2,125,185 2,331,600.00
LIMPADENOPATY DM+DKD+ULCER 9,459,914 5,012,300.00
BP MORBILI 2,740,102 7,945,500.00
CLAVUS TERINFEKSI - 7,440,005 5,845,600.00
UAP HT+DYSPEPSIA 4,509,100 4,509,100.00
TUMOR DI SUPRACLAVIC - 8,231,481 5,845,600.00
CLAVUS - 7,545,328 5,845,600.00
BP - 4,102,640 4,170,100.00
STROK PIS - 7,125,126 2,596,800.00
BPH HYDRONEFROSIS 3,506,039 2,905,600.00
ISPA - 2,081,735 2,133,800.00
HT TTH 4,699,157 4,457,100.00
UTI PROLAPS UTERI 2,654,220 1,860,600.00
DIARE AKUT - 2,188,162 2,423,100.00
VIRAL INFECTION FIBROMYALGIA 6,126,335 2,720,200.00
HT IN PREGNANCY PARTUS SPONTAN 3,069,897 3,346,400.00
HYPERTROPY OF TONSIL - 8,006,006 2,121,400.00
STT - 7,529,245 5,845,600.00
HILL - 8,656,166 4,283,900.00
LETAK SUNGSANG PARTUS SC 9,757,434 4,826,600.00
BBL - 1,787,516 1,995,800.00
UNSTABLE ANGINA ESRD 3,612,229 3,220,800.00
VIRAL INFECTION - 2,331,600 2,331,600.00
GASTROPATI C. MAMAE 3,891,400 3,891,400.00
FRAKTUR SPINE AND PELP MULTIPLE FRKTUR 4,239,145 2,884,700.00
TYPOID FEVER CAD+HT+DM T2 2,747,604 2,774,500.00
VIRAL INFECTION - 2,352,502 2,331,600.00
SOL - 8,565,591 3,515,900.00
ILEUS CA.CERVIX+ANEMIA+CKD 4,728,000 3,447,800.00
STROK INFARK HT+HEMIPLAGIA 6,836,912 7,463,200.00
LIMPADENITIS - 7,827,309 4,242,600.00
HERNIA - 7,590,564 4,283,900.00
HERNIA - 6,968,106 3,569,900.00
HERNIA - 7,962,276 3,569,900.00
HAEMATEMESIS - 3,335,500 3,335,500.00
BACTERIAL INF - 2,414,922 3,884,300.00
EFFUSI PLEURA - 4,984,275 3,264,000.00
DENGUE FEVER TYPOID FEVER 3,993,074 3,965,400.00
TYPOID FEVER - 2,145,791 2,774,500.00
DADRS - 2,143,758 2,423,100.00
TYPOID FEVER ANEMIA 6,814,316 4,282,400.00
VAGINITIS ACUT KISTA OVARI 5,070,556 2,180,700.00
TYPOID FEVER TB PARU 2,980,133 4,282,400.00
FRAKTUR TIBIA VULNUS GRANOLOSUM 17,577,237 10,943,200.00
HIPERTROPI TONSIL - 7,171,485 2,121,400.00
GALACTOCELL ABSES - 9,429,079 7,137,800.00
ARTRITIS Osteomyelits 13,860,034 11,436,700.00
TYPOID FEVER DHF 5,724,400 5,724,400.00
ECLAMSIA PARTUS SC 9,461,868 4,826,600.00
BBL - 1,600,790 1,995,800.00
BBL - 2,508,417 1,995,800.00
MENOMERTORAGHIA - 7,913,372 3,825,600.00
RHINO BRONKHITIS - 1,815,327 1,858,600.00
GASTRITIS DYSPEPSIA 2,649,936 2,171,800.00
DYSPEPSIA - 3,201,625 3,335,500.00
DADRS HT 4,119,793 2,827,100.00
TYPOID FEVER - 2,936,577 3,329,400.00
DHF - 3,784,968 2,331,600.00
TYPOID FEVER GASTRITIS 1,913,590 2,774,500.00
RHINO FARINGITIS KDS 1,987,301 2,134,600.00
DENGUE FEVER - 7,135,276 2,720,200.00
SPONDILITIS TB - 8,067,124 3,916,200.00
HHD CHF+AKI+ASIDOSIS 14,728,775 8,332,900.00
HERNIA - 6,792,131 3,569,900.00
STT - 10,677,540 6,819,800.00
TUMOR TYROID - 9,813,537 4,789,900.00
ACS CAD+NSTEMI+CAP+HYPERGLIKEMIA 6,885,900 6,885,900.00
TONSILITIS DYSPEPSIA 2,921,361 1,829,000.00
CPD PARTUS SC 10,431,408 4,826,600.00
MIOMA UTERI - 12,867,576 6,327,300.00
KISTA OVARIUM - 12,426,336 6,327,300.00
CHOLELITHIASIS DMT2+ESRD 13,738,589 7,561,400.00
CHEST PAINT - 815,884 3,220,800.00
CHF HHD+SEPSIS 835,098 4,448,800.00
SUSP STROKE INFARK - 909,023 2,929,900.00
GEA HT 3,819,075 2,423,100.00
DENGUE FEVER - 4,666,208 2,331,600.00
VIRAL INFECTION - 1,980,292 2,331,600.00
BP - 3,041,759 4,865,100.00
PROLONG PRAGNANCY PARTUS SPONTAN 3,454,909 2,859,900.00
SOFT TISUE INFECTION DISLOKASI PIP JOINT v M Dex 9,011,105 6,233,600.00
GANGLION - 9,310,420 6,233,600.00
DHF - 6,834,298 2,720,200.00
PNEMONIA ESRD 2,987,251 4,865,100.00
AB INCOMPLITE - 12,448,300 6,812,300.00
BBLR - 1,537,781 1,995,800.00
TALIPES EQUINOVARUS MICROCEPHALY 11,645,666 5,845,600.00
CAD DECOM CORDIS+SIROSIS CARDIAC 4,295,206 3,575,100.00
GASTRITIS AKUT - 4,211,706 1,861,600.00
DIARE AKUT HHD+DM+CKD 3,531,449 3,421,100.00
GEA - 4,458,579 2,827,100.00
GASTRITIS AKUT - 1,662,956 1,861,600.00
ABSES HEPAR - 15,121,678 6,812,300.00
UNION # RADIUS DEX - 10,036,705 2,956,700.00
DHF DIARE AKUT 9,362,471 2,720,300.00
ANEMIA IN PREGNANCY PARTUS SC 10,360,266 4,826,600.00
BBL - 1,408,477 1,995,800.00
BACTERIAL INF - 2,727,590 3,329,400.00
DADRS MORBILI 2,520,624 2,827,100.00
DADRS - 2,563,179 2,423,100.00
BRONKHIOLITIS - 4,883,602 2,173,300.00
HEPATITIS A DADRS 3,662,197 2,332,600.00
AB IMINEN - 2,464,337 1,677,400.00
HT STROK INFAR+CARDIOMEGALI+DISLIPIDEMIA 4,122,991 5,238,100.00
STROK INFARK AF+DISPEPSIA+HT 6,129,208 6,397,000.00
CHF HHD+AKI+HT+DYSPEPSIA 5,151,181 4,448,800.00
ISCHIALGIA DYSPEPSIA 6,257,555 2,712,300.00
KOLIK ABDOMENT - 3,438,538 2,423,100.00
MELENA - 4,944,947 3,335,500.00
MHI - 5,325,520 3,336,600.00
CAP CAD+PPOK 6,498,374 6,836,700.00
BP - 4,532,789 4,170,100.00
PROLONG PRAGNANCY PARTUS SPONTAN 2,890,529 2,859,900.00
CHF EC HHD+KP AKTIF - 4,750,147 8,312,900.00
DMT2 DIABETIC FOOT 3,002,354 4,345,900.00
DADRS - 4,159,600 2,423,100.00
CAD DECOMPCORDIS+HT+DMT2 9,954,335 3,264,200.00
KISTA OVARIUM - 12,900,000 6,976,700.00
KISTA OVARIUM - 10,178,723 6,327,300.00
PSMBA CKD 7,325,011 5,003,200.00
HIV CANDIDIASIS ORAL 5,618,557 3,267,500.00
TYPOID FEVER - 3,677,135 2,774,500.00
TYPOID FEVER DENGUEFEVER+HIPERTIROID+ABSES 6,932,969 4,996,100.00
ASMA - 5,771,658 4,170,700.00
HEMOROID TIPOID FEVER 7,960,407 7,160,400.00
HILL - 8,641,158 4,283,900.00
CHOLELITHIASIS ADHESI BILIER 10,135,983 6,481,200.00
HEMANGIOMA - 12,565,802 6,819,800.00
KISTA OVARIUM - 12,433,414 6,327,300.00
TYPOID FEVER - 3,284,754 3,329,400.00
TUMOR TIROID - 8,640,230 4,789,900.00
HYPERTIROID PARTUS SC 7,899,505 4,438,400.00
FAM - 8,891,211 6,118,200.00
BEKAS SC PARTUS SC 8,921,378 4,826,600.00
BBL - 1,405,267 2,351,500.00
PERFORASI - 7,989,645 2,779,600.00
DMT2 HYPOGLICAEMIA+UTI+DEHIDRASI 5,259,212 4,065,800.00
ALERGI ANGIODEMA+URTICARIA 1,720,833 1,565,900.00
CAD UAP 5,136,043 4,170,900.00
TYPOID FEVER - 3,258,704 3,329,400.00
FAM - 6,943,815 5,098,500.00
HILL INKASERATA - 10,064,721 3,569,900.00
FAM - 7,641,990 6,118,200.00
STT - 8,057,844 5,845,600.00
BP DIARE AKUT 3,562,199 4,170,100.00
GASTRITIS - 1,694,124 1,861,600.00
DHF - 5,692,252 2,331,600.00
STT - 7,397,353 5,845,600.00
GASTRITIS - 2,258,942 1,551,300.00
VIRAL INFECTION PHARINGITIS 1,888,253 2,331,600.00
VIRAL INFECTION - 4,095,980 2,331,600.00
SPONDILITIS DM+HT 3,430,025 2,681,600.00
MUCOCELE - 9,292,015 5,671,900.00
GEA HIPOKALEMIA+DMT2 3,991,400 3,991,400.00
CA. MAMAE PARONEOPLASTIC SNDYM+gastrit 4,225,500 4,225,500.00
ESRD - 4,836,290 1,399,400.00
IUFD PARTUS SPONTAN 20,368,235 3,336,600.00
DMT2 CHOLELITHIASIS 2,720,000 2,720,000.00
TYPOID FEVER - 890,895 2,774,500.00
ASMA - 2,736,650 2,173,300.00
BPH - 2,831,222 2,390,500.00
EDEMA SCROTUM NEFROLITHIASIS+NEUROGE 6,214,307 3,486,700.00
CAD CHF+DM 3,016,792 2,979,200.00
TYPOID FEVER - 3,182,261 3,329,400.00
DENGUE FEVER - 3,171,843 3,398,900.00
NEFROLITHIASIS+HYDRON ISK 4,568,279 2,464,300.00
APP - 3,538,928 3,335,500.00
TYPOID FEVER RHINOBRONKHITIS 2,917,556 3,884,300.00
AB INCOMPLITE - 4,572,297 3,279,100.00
ESRD - 2,775,347 1,166,200.00
TRIGER FINGER - 11,346,227 7,540,800.00
BP MORBILI 5,478,386 7,945,500.00
DADRS PERIANAL RUSH 2,454,183 2,423,100.00
DENGUE FEVER - 2,720,200 2,720,200.00
GEA - 2,827,100 2,827,100.00
RHINOBRONKHITIS ISK 4,300,464 3,100,400.00
ISK - 3,237,994 2,170,700.00
ASMA - 3,962,472 2,173,300.00
TYPOID FEVER - 2,331,392 3,329,400.00
DADRS - 1,834,160 2,423,100.00
GASTRITIS HEMATEMESIS 5,175,312 1,551,300.00
HIPERBILIRUBIN - 2,085,046 2,799,100.00
HYPERALDOSTERONISM HT+CKD+E11.9 9,121,547 5,005,900.00
APP APENDICULR PERITON - 4,801,580 3,279,200.00
IUFD - 5,297,243 3,279,100.00
STT - 7,013,358 5,845,600.00
TUMOR MAMAE - 9,798,668 7,137,800.00
HILL - 10,050,505 4,997,900.00
TUMOR MAMAE - 9,678,841 7,137,800.00
MULTIPLE CLAVUS - 8,165,182 5,845,600.00
STT -
TUMOR COLI - 7,615,308 5,845,600.00
FAM - 7,410,647 5,098,500.00
4,965,345 1,940,500.00
GEA - 2,827,100 2,827,100.00
CAP SEPSIS+BRONCO SPASME+HHD+DMT2 9,231,098 11,315,600.00
OA DERMATITIS 2,849,406 2,490,400.00
VIRAL INFECTION VERTIGO 4,216,027 2,720,200.00
ASMA - 3,396,935 1,862,800.00
MALUNION # FIBULA Osteomyelits 11,276,284 9,011,400.00
CPD RIW SC+PARTUS SC 10,641,450 4,826,600.00
VIRAL INFECTION CKD 2,456,320 2,791,900.00
VIRAL INFECTION - 2,331,600 2,331,600.00
IMPETIGO STOMATITIS 4,469,973 5,841,900.00
ESRD - 2,176,700 1,632,600.00
TYPOID FEVER - 2,632,072 3,329,400.00
STT - 7,981,637 5,145,600.00
KISTA PAROTID - 7,607,456 4,184,700.00
SYNDACTYLY - 8,443,958 6,233,600.00
STT - 7,147,174 4,871,300.00
HILL - 7,830,574 4,283,900.00
DIARE AKUT DERMTITIS 2,002,155 2,827,100.00

ASMA - 5,190,775 2,173,300.00
TYPOID FEVER DYSPEPSIA 6,346,202 3,329,400.00
BACTERIAL INF KDS 2,128,587 4,282,400.00
UTI - 2,681,457 2,170,700.00
DRUG ERUPTION - 2,193,851 2,172,400.00
ASMA - 3,707,216 1,862,800.00
DIARE AKUT - 2,423,100 2,423,100.00
CHOLELITHIASIS - 15,511,040 7,561,400.00
CA RECTUM - 8,358,807 6,095,900.00
DADRS - 1,678,797 2,827,100.00
DADRS BATUK 3,369,219 2,827,100.00
PERITONITIS APENDICUL - 10,886,557 7,947,700.00
TYPOID FEVER - 3,200,215 3,884,300.00
KPD PARTUS SPONTAN 4,279,269 2,416,400.00
DADRS - 1,690,945 2,423,100.00
CYSTA BARTOLINI - 3,130,921 3,276,700.00
SPONDILITIS TB - 58,911,588 9,797,400.00
TYPOID FEVER - 2,596,267 3,329,400.00
GEA HT 2,827,100 2,827,100.00
GEA - 2,045,320 2,423,100.00
TYPOID FEVER - 3,884,300 3,884,300.00
STEROID CUSHING+GASTROPATI 7,046,163 2,178,500.00
AB IMINENS PLACENTA PREVIA 3,283,689 1,677,400.00
DILI HEP B+NEPROLITHIASIS 4,091,021 4,994,900.00
BER
NAMA DOKTER

766,653 dr. YURIKA, SP.A
849,634 dr. YURIKA, SP.A
2,109,094 DR. YUDI, SP.U
6,453,757 DR. GHUNA, SP.OT
3,991,891 dr. Ade, Sp.S
2,720,200 dr. Ade, Sp.S
6,182,241 DR. GHUNA, SP.OT
8,303,685 DR. ANDRI, SP.OT
10,687,463 dr. Djoko, SP.B
dr. Djoko, SP.B

2,303,854
5,385,556 dr. Ade, Sp.S
10,092,211 dr. DEASY, SP.P
6,620,626 dr. Ade, Sp.S
3,157,039 DR. YUDI, SP.U
3,724,145 dr. Ghuna, Sp.Ot
7,349,868 dr. Sarjunas, Sp.Og
4,100,372 dr. Nunung, Sp.Og
2,882,625 dr. Susilo, Sp.Pd
815,884 dr. Fitriyat
835,098 dr. Riston
909,023 dr. Dedi Naswaldi
2,552,909 dr. Dedi Naswaldi
890,895 DR. STYANA
2,559,222 DR. YUDI, SP.U
4,724,345
NAMA DOKTER
dr. YURIKA, SP.A
dr. Paramita, SP.A
dr. Paramita, SP.A
dr. YURIKA, SP.A
dr. Paramita, SP.A
dr. DEASY, SP.P
dr. Nanda, Sp.B
dr. PITRAJAYA, SP.B
dr. Djoko, SP.B
dr. Paramita, SP.A
dr. Paramita, SP.A
dr. Djoko, SP.B
dr. Sarjunas, Sp.Og
dr. Paramita, SP.A
dr. Sarjunas, Sp.Og
dr. Ghuna, Sp.Ot
dr. Susilo, Sp.pd
dr. Miftah, Sp.Pd
dr. Maulia, Sp.OG

Rekap BPJS Ri 2015 Update

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Rekapitulasi INA CBGs Bulan Januari (LAPORAN MEDREK)

KODE KODE ICD

dr. YUDI, Sp.U

dr. MIFTAH, Sp.PD

dr. GHUNA, Sp.OT

dr. RENNY, Sp.U

KODE KODE ICD KODE

1 ETI SULASTRI 397340 ISK DM N39.0 E11.6 I 5,491,963.00 3,252,500.00

dr. MR. KURNIA, Sp.PD

dr. PARAMITA, Sp.A

dr. PARAMITA, Sp.A

dr. MIFTAH, Sp.PD

DIAGNOSA DIAGNOSA KODE ICD KODE ICD KODE

414 WANIS PULAILAH 325412 TENDINOSIS SHOULDER M75.8 II 1,638,652.00 1,857,000.00

dr. SARJUNAS, Sp.OG

dr. WIWIN, Sp.A

dr. MEDIA, Sp.S TUNGGU PENANGGUHAN

KODE ICD KODE ICD

dr. DEASY, Sp.P

dr. WIWIN, Sp.A

421 NURHAYATI 403348 FARINGITIS KRONIS TONSILITIS HYPERTROPCOUTER PHARYNG + TONSILECTO

1 WIDIYATI 400708 NEFROLITHIASIS HYDRONEFROSIS ESWL

C50.9 85.12 I 7,822,341.00 7,137,800.00

K80.8 51.22 II 12,410,922.00 6,481,200.00

N20.0 98.51 II 8,382,258.00

J31.2 J35.1 29.99 + 28.2 III 6,956,595.00 1,767,900.00

KODE ICD KODE ICD

N13.2 98.51 I 8,995,000.00

dr. PARAMITA, Sp.A

dr. RICHARD, Sp.THT

dr. RENNY, Sp.U 14,126,800.00

1 AHYAR 401647 GASTRITIS KRONIS DC + CAD

1 TETI MARYATI 397121 NP SLE IULKUS DECUBITUS

YUYUN YUNENGSIH,NY POST DATE

J06.9 R56.0 III

R11 R50.9 III

2,112,083.00 2,171,800.00 dr. TOTO

2,225,425.00 1,778,800.00 dr. PARAMITA, Sp.A

HARGA RS HARGA INA CBGS NAMA DOKTER

68,967,305.00 7,341,900.00 dr. MIFTAH, Sp.PD

NO NAMA PASIEN NO. MR DIAGNOSA PRIMER

1 SUMARNI JD MASNA MUHAT 405282 SUSP EPIDERMOID CA DIGITI

NO NAMA PASIEN NO. MR DIAGNOSA PRIMER

1 VIDISHA PAMESWARI 350280 TONSILITIS HYPERTROPIKA

DIAGNOSA KODE ICD

ERMOID CA DIGITI EKSISI D48.1

DIAGNOSA KODE ICD

HYPERTROPIKA TONSILECTOMY J35.2

KODE ICD KODE TINDAKAN KELAS HARGA RS

4,583,900.00 dr. PITRAJAYA, Sp.B

HARGA INA CBGS NAMA DOKTER

2,475,000.00 dr. RICHARD, Sp.THT

1 YATI SUMIARTI 406385 7 SLE ANEMIA

NO NAMA PASIEN NO. MR DIAGNOSA PRIMER DIAGNOSA SEKUNDER

1 MUSTOPA 335779 STT

KODE ICD KODE ICD KODE

M32.9 D63.8 I 4,352,700.00

KODE ICD KODE ICD KODE

BIOPSI D48.1 83.21 II 8,324,767.00