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Excel Bangsal
Excel Bangsal
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P59.9 99.83
P76.0 -
Q24.0 J18.0 -
Q25.0 -
Q85.0 86.3
Q89.2 86.3
Q89.2 86.3
R02 84.01
R04.2 -
R04.2 -
R04.2 -
R10.4 -
R10.4 K30 -
R10.4 -
R10.4 K30 -
R10.4 I10 -
R10.4 I10 -
R10.4 -
R11 -
R11 A09.0 -
R11 -
R11 -
R11 -
R11 K30 N21.0 -
R11 -
R11 K30 -
R11 K30 -
R11 K30 J06.9 -
R11 N39.0 -
R11 -
R11 K30 -
R17 K81.9 -
R40.1 96.71
R40.1 96.70
R40.1 E44.0 E63.1 D33.2 -
R42 J45.9 -
R42 -
R42 -
R42 -
R42 -
R42 -
R42 -
R42 I10 -
R42 -
R42 -
R42 -
R42 -
R56.0 J20.9 -
R56.0 R11 -
R56.0 -
R57.2 A16.2 -
R57.2 E11.2 E63.1 K92.0 -
R57.2 -
R59.1 40.3
R59.1 40.51
R63.0 A41.9 E43 E63.1 -
R63.0 -
R63.0 -
R63.0 I10 -
R63.0 -
R63.0 -
R63.0 K30 -
S06.0 86.28
S06.0 86.28
S06.0 -
S06.0 -
S06.0 86.3
S06.0 -
S06.0 79.01
S06.0 93.53
S06.0 -
S06.0 -
S22.4 S06.0 -
S42.4 93.53
S52.5 79.02
S52.5 93.53
S52.6 79.02
S52.7 93.53
S60.8 86.05
S62.6 93.53
S82.4 84.01
S92.0 93.53
T14.6 86.28
T30.0 86.3
T30.3 -
T78.2 -
Z03.0 -
Z03.0 R04.2 -
Z03.8 -
Z03.8 -
Z03.8 -
Z03.8 -
Z03.8 -
Z03.8 -
Z03.8 -
Z03.8 -
Z03.8 -
Z03.8 -
Z47.0 78.67
Z51.5 -
Z51.5 -
Z51.5 -
Z51.5 -
Z53.8 -
Z54.9 -
INACBG DESKRIPSI_INAC TARIF_INACBG TOTAL_TARIF TARIF_RS NAMA_PASIEN MRN
BG
A-4-14-I PENYAKIT $2,092,500.00 $2,092,500.00 $1,805,735.00 SATRIA ARSA 739933
INFEKSI PUTRA ARIF
A-4-14-I PENYAKIT $2,929,500.00 $2,929,500.00 $5,314,785.00 FARKHAN 778150
BAKTERI DAN
INFEKSI SYAKBANI SDR
A-4-14-I PENYAKIT
PARASIT LAIN- $2,929,500.00 $2,929,500.00 $3,531,508.00 TURSIYAH 801850
BAKTERI DAN
INFEKSI
LAIN (RINGAN)
A-4-14-II PENYAKIT
PARASIT LAIN- $3,048,000.00 $3,048,000.00 $6,706,653.00 MUHAMMAD 420344
BAKTERI DAN
INFEKSI
LAIN (RINGAN) HANANDA F
A-4-14-I PENYAKIT
PARASIT LAIN- $2,929,500.00 $2,929,500.00 $3,643,833.00 WERDININGSIH 440537
BAKTERI DAN
INFEKSI
LAIN (RINGAN)
A-4-14-I PENYAKIT
PARASIT LAIN- $2,092,500.00 $2,092,500.00 $1,634,985.00 NEHMATULOH 113951
BAKTERI DAN
INFEKSI
LAIN (SEDANG)
K-4-18-II GANGGUAN
PARASIT LAIN- $2,472,100.00 $2,472,100.00 $2,598,123.00 FIRAYZA 166749
BAKTERI DAN
SISTEM
LAIN (RINGAN) ARINDRA
K-4-18-I GANGGUAN
PARASIT LAIN- $1,739,600.00 $1,739,600.00 $1,988,924.00 HANANTA 684038
PENCERNAAN SETYALIANO
SISTEM
LAIN (RINGAN) DAMAR WIJAYA
K-4-18-I GANGGUAN
LAIN-LAIN $1,491,100.00 $1,491,100.00 $2,122,109.00 NURKHAYATI 828950
PENCERNAAN
SISTEM
(SEDANG)
K-4-18-I GANGGUAN
LAIN-LAIN $1,491,100.00 $1,491,100.00 $2,972,097.00 SULAM 371833
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,242,600.00 $1,242,600.00 $1,404,839.00 RAHAYU 896550
PENCERNAAN
SISTEM
(RINGAN) NINGTYAS
K-4-18-II GANGGUAN
LAIN-LAIN $1,765,800.00 $1,765,800.00 $2,103,964.00 MISNEM 012451
PENCERNAAN ALWAHIT
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,491,100.00 $1,491,100.00 $2,584,207.00 KASMINI 008439
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,739,600.00 $1,739,600.00 $1,749,722.00 DJUWARSI 390050
PENCERNAAN
SISTEM
(SEDANG)
K-4-18-I GANGGUAN
LAIN-LAIN $1,491,100.00 $1,491,100.00 $1,845,295.00 MUHAMMAD 887850
PENCERNAAN
SISTEM
(RINGAN) ARFA HAMIZAN
K-4-18-II GANGGUAN
LAIN-LAIN $2,472,100.00 $2,472,100.00 $1,754,360.00 NUSHAIRA ARSY 737548
PENCERNAAN
SISTEM
(RINGAN) AZZAHIDAH
K-4-18-I GANGGUAN
LAIN-LAIN $1,739,600.00 $1,739,600.00 $1,483,327.00 SITI WATIYAH 471345
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,491,100.00 $1,491,100.00 $1,135,580.00 SUCHATI 131734
PENCERNAAN
SISTEM
(SEDANG)
K-4-17-I NYERI
LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,036,436.00 NUR AFIDIN 857450
PENCERNAAN
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
LAIN-LAIN $1,687,500.00 $1,687,500.00 $914,073.00 GEMINI CATUR F 227438
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $3,664,635.00 TITI TAAT 578435
GASTROENTERI
ABDOMEN
(RINGAN) & BUDIARTI
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $2,091,896.00 YULIYANTI 131744
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,320,569.00 ANDARU 705845
GASTROENTERI
ABDOMEN
(RINGAN) & KEYLAN
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $2,353,647.00 MUHAMAD 246248
GASTROENTERI PUNDARIKA
ABDOMEN
(RINGAN) & FAHRI PUTRA
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $1,777,262.00 ALGIS 985250
GASTROENTERI MUBARAK
ABDOMEN
(RINGAN) & GENANDRA
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $2,618,863.00 ATHA ZENA 717348
GASTROENTERI ARDHANI
ABDOMEN
(RINGAN) & SHAQILA
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $2,834,952.00 SOEDIRSAN 777050
GASTROENTERI DAMAYANTI
ABDOMEN
(RINGAN) &
K-4-17-II NYERI
TIS LAIN-LAIN $1,923,400.00 $1,923,400.00 $1,860,309.00 SITI MAEMUNAH 634248
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $2,812,043.00 RAKIWAN 179832
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $2,147,017.00 PARJONO 877350
GASTROENTERI
ABDOMEN
(SEDANG) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,391,077.00 TRI WALUYATI 835050
GASTROENTERI
ABDOMEN
(RINGAN) & NY
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $2,140,736.00 IKA DAMAYANTI 912650
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-II NYERI
TIS LAIN-LAIN $2,692,700.00 $2,692,700.00 $3,003,365.00 DWI 666844
GASTROENTERI
ABDOMEN
(RINGAN) & SETYANINGSIH
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,398,732.00 PARTO 027251
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $2,233,288.00 GUNAWAN 221243
GASTROENTERI
ABDOMEN
(SEDANG) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,305,961.00 ASSYIFA CAHYA 966442
GASTROENTERI
ABDOMEN
(RINGAN) & KHUMAIRA
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $1,640,904.00 ASKA 853644
GASTROENTERI
ABDOMEN
(RINGAN) & ANDRADITYA
K-4-17-II NYERI
TIS LAIN-LAIN $1,923,400.00 $1,923,400.00 $1,547,313.00 TIMAH 926943
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $3,313,413.00 MUSRINGAH 444248
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,063,094.00 SUWAR 917550
GASTROENTERI
ABDOMEN
(SEDANG) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $1,965,045.00 SOLIKHIN 444144
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $2,567,000.00 JUMIATI 571634
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,143,941.00 AMRIN 114851
GASTROENTERI
ABDOMEN
(RINGAN) &
J-4-15-I PERADANGAN
TIS LAIN-LAIN $3,999,700.00 $3,999,700.00 $2,469,374.00 DINDA AYU 906445
GASTROENTERI
DAN INFEKSI
(RINGAN) WULANDARI
J-4-15-III PERADANGAN
TIS LAIN-LAIN $6,429,000.00 $6,429,000.00 $10,473,068.00 JAROMI 570146
PERNAFASAN
DAN INFEKSI
(RINGAN) MUSLIMIN
J-4-15-I PERADANGAN
(RINGAN) $3,999,700.00 $3,999,700.00 $2,822,276.00 GINAH 899150
PERNAFASAN
DAN INFEKSI
A-4-14-II PENYAKIT
(BERAT) $2,540,000.00 $2,540,000.00 $4,260,843.00 YUDA APRIL 955450
PERNAFASAN
INFEKSI RIYANTO
A-4-14-II PENYAKIT
(RINGAN) $3,048,000.00 $3,048,000.00 $6,525,694.00 LILIS YUVIANA 089737
BAKTERI DAN
INFEKSI
A-4-14-I PENYAKIT
PARASIT LAIN- $2,092,500.00 $2,092,500.00 $6,164,850.00 NASOHAH 918050
BAKTERI DAN
INFEKSI
LAIN (SEDANG)
PARASIT LAIN-
BAKTERI DAN
LAIN (SEDANG)
PARASIT LAIN-
LAIN (RINGAN)
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $1,600,581.00 IBRAHIM AL 791145
NON-BAKTERIAL FATIH BUDIMAN
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $2,083,804.00 RAFA FAUZIYYAH 796250
LAIN (RINGAN)
NON-BAKTERIAL ANKHESYA
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,420,565.00 ANINDITA 870050
LAIN (RINGAN)
NON-BAKTERIAL KEISHA ZAHRA
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $1,462,180.00 HANUN RIVAI 007151
LAIN (RINGAN) AFIAH
NON-BAKTERIAL AKHMAD
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $1,791,597.00 DONI SAPUTRA 824844
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,980,530.00 REFALDI SURYO 875650
LAIN (RINGAN)
NON-BAKTERIAL YOGI
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,954,431.00 MISWANTO 839750
LAIN (RINGAN) ERLANGGA
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $2,790,450.00 PARYANTI 621834
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $3,330,544.00 TURGIANTO 015651
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,114,816.00 NOVA 060151
LAIN (RINGAN)
NON-BAKTERIAL NURHAYATI
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $2,360,313.00 AZZAHRA ALYA 857950
LAIN (RINGAN)
NON-BAKTERIAL SAFREDA R
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,580,985.00 TERE SAVA 596339
LAIN (RINGAN)
NON-BAKTERIAL NOVARANO
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,354,408.00 NAJWA AULIYA 389843
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $4,789,417.00 ANA PRATIWI 383450
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,593,721.00 LATIF HIDAYAT 777650
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-II INFEKSI VIRAL & $2,273,500.00 $2,273,500.00 $2,176,184.00 SULASIH 779350
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $2,284,316.00 ANIK TRI 491537
LAIN (SEDANG)
NON-BAKTERIAL WAHYUNI
A-4-13-III INFEKSI VIRAL & $3,819,500.00 $3,819,500.00 $4,423,047.00 ANISA DWI 386147
LAIN (RINGAN)
NON-BAKTERIAL WIJAYANTI
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,102,657.00 WAHYU 796850
LAIN (BERAT)
NON-BAKTERIAL HIDAYATULLOH
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $2,018,487.00 KAKHFI GEMAH 865750
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-II INFEKSI VIRAL & $2,273,500.00 $2,273,500.00 $2,992,684.00 SURYONO 119151
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $2,728,875.00 MUHANDHA 310447
LAIN (SEDANG)
NON-BAKTERIAL MALIK IBRAHIM
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,225,734.00 DANESHA 708133
LAIN (RINGAN)
NON-BAKTERIAL ALMAIRA
A-4-13-II INFEKSI VIRAL & $3,182,900.00 $3,182,900.00 $2,331,474.00 MUHANDHA 310447
LAIN (RINGAN) ZHANUM
NON-BAKTERIAL MALIK IBRAHIM
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $2,829,186.00 KARTIKA 917450
LAIN (SEDANG)
NON-BAKTERIAL PUSPITA
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,216,620.00 RIFKI NUR AZIZ 879550
LAIN (RINGAN) RATNANINGTYA
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,085,051.00 NIKEN
S LARASATI 089736
LAIN (RINGAN)
NON-BAKTERIAL SAFITRI
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,887,332.00 NUR AFIFA EKA 898650
LAIN (RINGAN)
NON-BAKTERIAL HASTUTI
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,874,965.00 CATUR 894950
LAIN (RINGAN) ARDINA
NON-BAKTERIAL WIYANTO
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $4,343,598.00 GIZELA ANNUR 489850
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,756,042.00 SUGIARTO 983850
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,920,360.00 SULEH UDIN 013251
LAIN (RINGAN)
NON-BAKTERIAL JUMALI
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,390,232.00 SUGINI 150951
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,929,059.00 RAFFASYA 109947
LAIN (RINGAN)
NON-BAKTERIAL SATRIANDRA
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,982,268.00 ASKA HAURA AL 779550
LAIN (RINGAN) PRATAMA
NON-BAKTERIAL JAUZA
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,677,366.00 AZIKA ISNAENI 840750
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,676,552.00 RISTIA RINANTI 877450
LAIN (RINGAN)
NON-BAKTERIAL HIDAYAT
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $4,877,425.00 RISTA ARMYRA 027451
LAIN (RINGAN)
NON-BAKTERIAL SANJANA
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $4,934,006.00 RASHILA 802550
LAIN (RINGAN)
NON-BAKTERIAL ZAMIRA NADINE
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $2,331,884.00 LU'MA AVARA 838150
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $5,087,478.00 SUPRIYANTORO 530948
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $6,029,559.00 PRAYOGI BUDI 773150
LAIN (RINGAN)
NON-BAKTERIAL WIBOWO
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $3,355,376.00 RICKY AGENG 227032
LAIN (RINGAN)
NON-BAKTERIAL WIBOWO
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,192,326.00 TRINANDA 804550
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,017,840.00 HARYANTO 804850
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,037,081.00 SRI AYU 793250
LAIN (RINGAN)
NON-BAKTERIAL RINAWATI
A-4-13-II INFEKSI VIRAL & $2,728,200.00 $2,728,200.00 $5,025,077.00 ENDANG 498730
LAIN (RINGAN)
NON-BAKTERIAL MULYANINGSIH
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $4,664,782.00 HARI SUSANTO 921848
LAIN (SEDANG)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $4,697,880.00 MARJOSO 915250
LAIN (RINGAN)
NON-BAKTERIAL SETIJAWAN
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,503,176.00 SYARIF 839450
LAIN (RINGAN)
NON-BAKTERIAL NURHIDAYAH
LAIN (RINGAN)
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $1,625,376.00 NURUL AZIJAH 817144
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,215,407.00 MELIYATI 023051
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $3,032,527.00 SETIANA 935844
LAIN (RINGAN)
NON-BAKTERIAL MAHARANI
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $4,709,732.00 SUWEBAH 162645
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,389,063.00 SUCI 428748
LAIN (RINGAN)
NON-BAKTERIAL YULIASTUTI SPD
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,662,333.00 ANISA MEGA TRI 160032
LAIN (RINGAN)
NON-BAKTERIAL MAHARDIKA
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $1,992,975.00 KHAIRANA 825850
LAIN (RINGAN)
NON-BAKTERIAL SHOFIYYAH
A-4-15-II INFEKSI HIV $6,884,700.00 $6,884,700.00 $8,729,450.00 AISYAH IMTIYAZ 045050
LAIN (RINGAN)
(SEDANG) PRAMESHWARI
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $2,511,333.00 LIBAN ARRIZQI 782043
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $2,276,772.00 WILDAN 102333
LAIN (RINGAN)
NON-BAKTERIAL FIRDAUS
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $1,652,623.00 LINGGA SAHRI 831050
LAIN (RINGAN)
NON-BAKTERIAL ROMADHON
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,639,609.00 SUWARNI 570334
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,590,867.00 SARNO 777950
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $5,112,392.00 SARNI 529149
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $2,414,689.00 TURSIYAH 801850
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $1,807,675.00 RUMINI 814550
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $2,948,181.00 MARSIDI 809350
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $2,778,932.00 DAFFA ULHAQ 801750
LAIN (RINGAN)
NON-BAKTERIAL ADILA ARIF
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $960,069.00 TEGUH 629250
LAIN (RINGAN)
NON-BAKTERIAL SANTOSA
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $3,097,445.00 SUKIRNO 176649
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $2,027,086.00 DWI HELA 114832
LAIN (RINGAN)
NON-BAKTERIAL HERAWATI
A-4-13-I INFEKSI VIRAL & $1,509,200.00 $1,509,200.00 $2,079,590.00 MISTUM 985150
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-II INFEKSI VIRAL & $2,273,500.00 $2,273,500.00 $1,812,687.00 UMAROH 474941
LAIN (RINGAN)
NON-BAKTERIAL
A-4-13-I INFEKSI VIRAL & $2,112,800.00 $2,112,800.00 $5,007,387.00 GALIH BUDI P 012951
LAIN (SEDANG)
NON-BAKTERIAL SDR
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $1,144,043.00 LENA TRI 114051
LAIN (RINGAN)
NON-BAKTERIAL YUNITA
A-4-13-I INFEKSI VIRAL & $1,811,000.00 $1,811,000.00 $1,812,653.00 PRIYONO 115351
LAIN (RINGAN)
NON-BAKTERIAL
A-4-14-I PENYAKIT $2,092,500.00 $2,092,500.00 $2,283,685.00 MUKHTARUDIN 837250
LAIN (RINGAN)
INFEKSI
J-4-19-I PENYAKIT PARU $3,858,300.00 $3,858,300.00 $1,209,717.00 PARLAN 792950
BAKTERI DAN
INTERSTITIAL
J-4-19-I PENYAKIT PARU
PARASIT LAIN- $4,630,000.00 $4,630,000.00 $3,035,514.00 SITI YULAEKHAH 636750
(RINGAN)
INTERSTITIAL
LAIN (RINGAN)
J-4-19-I PENYAKIT PARU $3,858,300.00 $3,858,300.00 $2,008,407.00 SUYANTI 508338
(RINGAN)
INTERSTITIAL WARISAH
J-4-19-III PENYAKIT PARU $4,832,300.00 $4,832,300.00 $1,941,522.00 ANWAR SUYUDI 650843
(RINGAN)
INTERSTITIAL
U-4-10-I NEOPLASMA $2,751,600.00 $2,751,600.00 $1,732,807.00 MISKEM 032051
(BERAT)
TELINGA,
M-1-50-I PROSEDUR $5,376,500.00 $5,376,500.00 $4,247,727.00 ROBINGAH 942350
HIDUNG, MULUT
JARINGAN
L-1-40-I PROSEDUR
DAN $3,696,900.00 $3,696,900.00 $3,127,345.00 KHOTIMAH 927550
LUNAK
PADA KULIT,
TENGGOROKAN MARWADI
L-1-30-I PEMINDAHAN
(RINGAN) $6,596,700.00 $6,596,700.00 $2,350,249.00 SUYATMO 907050
JA(RINGAN)
(RINGAN)
KULIT TANPA
L-1-50-I PROSEDUR
BAWAH KULIT $4,853,300.00 $4,853,300.00 $3,019,659.00 JEMI SUTARYO 865850
LUKA BAKAR
PADA
DAN PAYUDARA
PAYUDARA
L-1-50-I PROSEDUR
(RINGAN) $5,824,000.00 $5,824,000.00 $4,228,128.00 WIWIT 009951
(RINGAN)
PADA PAYUDARA SUPRIKHATIN
L-1-50-II PROSEDUR $7,810,900.00 $7,810,900.00 $4,927,282.00 JEMI SUTARYO 865850
(RINGAN)
PADA PAYUDARA
L-1-40-I PROSEDUR $3,696,900.00 $3,696,900.00 $1,963,483.00 AGUSHARYANTO 967850
(SEDANG)
PADA KULIT,
U-1-13-I PROSEDUR $4,887,100.00 $4,887,100.00 $2,285,213.00 DARSONO DAKI 787336
JA(RINGAN)
KELENJAR
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $3,183,500.00 SEPTIYANI 104051
LUDAH
PADA KULIT,
DAN PAYUDARA
B-4-13-I GANGGUAN
(RINGAN) $3,122,100.00 $3,122,100.00 $1,562,373.00 MARSONO 825650
JA(RINGAN)
(RINGAN)
HATI LAIN-LAIN
B-4-13-II GANGGUAN
BAWAH KULIT $3,637,100.00 $3,637,100.00 $4,317,878.00 JURI SUSILO 888450
(RINGAN)
HATI
DAN LAIN-LAIN
PAYUDARA DIARJO
B-4-13-I GANGGUAN $3,122,100.00 $3,122,100.00 $1,115,766.00 SUMIYEM 957650
(SEDANG)
(RINGAN)
HATI LAIN-LAIN
J-4-14-I TUMOR PARU $3,278,200.00 $3,278,200.00 $4,393,513.00 SATIMAN 389450
(RINGAN)
(RINGAN)
L-1-40-I PROSEDUR $3,696,900.00 $3,696,900.00 $2,665,195.00 ROHMAN 031851
PADA KULIT,
L-1-40-I PROSEDUR $3,696,900.00 $3,696,900.00 $2,610,225.00 GERI 932650
JA(RINGAN)
PADA KULIT,
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,273,287.00 KHUSNUL 961550
JA(RINGAN)
PADA
DAN KULIT,
PAYUDARA MUAMANAH
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,587,642.00 CIRONAH 359549
JA(RINGAN)
(RINGAN)
PADA KULIT,
DAN PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,143,814.00 BINTEN 141836
JA(RINGAN)
(RINGAN)
PADA KULIT,
DAN PAYUDARA
BAWAH KULIT
JA(RINGAN)
(RINGAN)
DAN PAYUDARA
BAWAH KULIT
(RINGAN)
DAN PAYUDARA
(RINGAN)
L-1-40-I PROSEDUR $3,696,900.00 $3,696,900.00 $1,887,729.00 NURWATI 964650
PADA KULIT,
L-1-40-I PROSEDUR $3,696,900.00 $3,696,900.00 $2,737,767.00 WALMI 588950
JA(RINGAN)
PADA KULIT,
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,297,027.00 SRIYANTI 900050
JA(RINGAN)
PADA
DAN KULIT,
PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,002,402.00 SUKIAH 455640
JA(RINGAN)
(RINGAN)
PADAPAYUDARA
DAN KULIT,
L-1-40-I PROSEDUR
BAWAH KULIT $5,175,700.00 $5,175,700.00 $7,597,006.00 SULASMI 041638
JA(RINGAN)
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $5,175,700.00 $5,175,700.00 $7,219,422.00 GHONIMIN 122951
JA(RINGAN)
(RINGAN)
PADA KULIT,
DAN PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,307,913.00 HADIYONO 819050
JA(RINGAN)
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,892,256.00 SALIMI 903050
JA(RINGAN)
(RINGAN)
PADAPAYUDARA
DAN KULIT,
L-1-40-I PROSEDUR
BAWAH KULIT $5,175,700.00 $5,175,700.00 $4,494,787.00 KADAR 971750
JA(RINGAN)
(RINGAN)
PADA KULIT,
DAN PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,591,123.00 KARSO SUWITO 094036
JA(RINGAN)
(RINGAN)
PADAPAYUDARA
DAN KULIT, SUKARDI
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,155,544.00 RANEM 073751
JA(RINGAN)
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,331,993.00 NIYEM 902250
JA(RINGAN)
(RINGAN)
PADAPAYUDARA
DAN KULIT,
L-1-40-I PROSEDUR
BAWAH KULIT $4,436,300.00 $4,436,300.00 $3,437,774.00 NUR ROHMAH 056351
JA(RINGAN)
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $4,436,300.00 $4,436,300.00 $4,631,390.00 WAHYONO 515339
JA(RINGAN)
(RINGAN)
PADA KULIT,
DAN PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,338,333.00 LUKI WIBOWO 045951
JA(RINGAN)
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
M-4-21-I GANGGUAN
BAWAH KULIT $2,631,000.00 $2,631,000.00 $4,122,713.00 SULUH WIGATI 114446
JA(RINGAN)
(RINGAN)
SISTEM
DAN PAYUDARA WIWIK
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,627,761.00 SARWONO 963850
MUSKULOSKELE
(RINGAN)
PADA KULIT,
DAN PAYUDARA
M-1-50-I PROSEDUR
TAL & $3,840,300.00 $3,840,300.00 $2,935,400.00 MARTOYO 961950
JA(RINGAN)
(RINGAN)
JARINGAN
JA(RINGAN)
L-1-50-I PROSEDUR
BAWAH KULIT $4,853,300.00 $4,853,300.00 $2,892,089.00 YUNIYATI 860750
LUNAK
PENGHUBUNG
PADA
DAN PAYUDARA
PAYUDARA
L-1-50-I PROSEDUR
(RINGAN)
LAIN-LAIN $6,794,700.00 $6,794,700.00 $7,404,931.00 BUDI IRIANI 170333
(RINGAN)
PADA PAYUDARA
(RINGAN)
L-1-50-I PROSEDUR $4,853,300.00 $4,853,300.00 $2,372,919.00 MUFASIROH 059550
(RINGAN)
PADA PAYUDARA
L-1-50-I PROSEDUR $4,853,300.00 $4,853,300.00 $2,038,760.00 DWI WINTARI. 902950
(RINGAN)
PADA PAYUDARA
G-4-26-II GANGGUAN - $4,820,500.00 $4,820,500.00 $7,404,056.00 DWI ASTUTI 017151
(RINGAN)
PENYAKIT
L-1-40-I PROSEDUR $4,436,300.00 $4,436,300.00 $2,828,464.00 SURAHMAT 920050
SISTEM SARAF
PADA KULIT,
D-4-13-I GANGGUAN
LAIN-LAIN SEL $2,218,100.00 $2,218,100.00 $2,069,049.00 MUHAMMAD 746146
JA(RINGAN)
DARAH
(SEDANG)MERAH ROHYAT
D-4-13-I GANGGUAN
BAWAH KULIT SEL $2,218,100.00 $2,218,100.00 $4,858,608.00 PARNI 171147
SELAIN KRISIS QUROTULL
DARAH
DAN MERAH
PAYUDARA
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $3,875,540.00 MUHAMMAD
AZAM 656549
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH TEGAR
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $7,956,704.00 KARTIKA 151644
SELAIN
(RINGAN)KRISIS NASRULLOH
DARAH MERAH
SICKLE ANGGRAINI
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $8,338,170.00 FAIZAL NOVA 424044
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH RIYANTO
D-4-13-II GANGGUAN
ANEMIA SEL SEL $3,139,300.00 $8,684,600.00 $9,317,710.00 SITI SOLEHAH 133247
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH NUR FADILAH
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $3,917,185.00 AHMAD 181648
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH KHOERUL ANAM
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $4,092,900.00 SYAFIQ AULYA 940237
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH AL GHANI
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $3,904,205.00 AFDILLA AFINI 124639
SELAIN
(SEDANG)KRISIS
DARAH
SICKLE MERAH KHUMAIROH
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $2,398,021.00 INAYAH AZMI 959240
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH ATHIFA
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $3,732,272.00 MUGHNI LABIB 339941
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $7,763,400.00 $2,834,837.00 WIKANDARU 047744
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH RIKO ROSYADI
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,661,700.00 $2,661,700.00 $7,410,791.00 FIONA MURTIA 371633
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH SARI
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $2,218,100.00 $4,398,490.00 NATHAN 904044
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH SYAHRIL GHANI
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,661,700.00 $2,661,700.00 $2,029,017.00 MEGA MUHLISIN 644640
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $2,218,100.00 $5,016,462.00 SABILA NAJWA 288644
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH ANINDIA
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,661,700.00 $2,661,700.00 $1,495,338.00 SITI 896148
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH MUMAINATUN
W-1-11-I PROSEDUR
ANEMIA SEL $1,657,100.00 $1,657,100.00 $4,479,938.00 PURWATI 108640
SELAIN
(RINGAN)KRISIS
DILATASI,
SICKLE
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $2,218,100.00 $2,456,575.00 HORIYAH 684545
KURET,
(RINGAN)
DARAH
SICKLE MERAH
D-4-13-I GANGGUAN
INTRAUTERINSEL& $2,218,100.00 $2,218,100.00 $3,053,199.00 MUTOBINGAH 612849
SELAIN
(RINGAN)KRISIS
DARAH
SERVIK MERAH
D-4-13-II GANGGUAN
ANEMIA SEL SEL $3,139,300.00 $3,139,300.00 $2,680,502.00 SUKARMI 682550
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $2,218,100.00 $3,635,985.00 SUWARNO 066149
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $2,218,100.00 $4,219,920.00 WATINEM 878850
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH
D-4-13-III GANGGUAN
ANEMIA SEL SEL $4,015,300.00 $4,015,300.00 $6,047,539.00 SUKIYAH 888350
SELAIN
(SEDANG)KRISIS
DARAH
SICKLE MERAH
D-4-13-I GANGGUAN
ANEMIA SEL SEL $2,218,100.00 $2,218,100.00 $2,735,596.00 PUJADI 150651
SELAIN
(RINGAN)KRISIS
DARAH
SICKLE MERAH
E-1-20-I PROSEDUR
ANEMIA SEL $5,581,600.00 $5,581,600.00 $3,555,196.00 NIRAH 590549
SELAIN
(RINGAN)KRISIS
PADA
SICKLETIROID,
(BERAT)
ANEMIA SEL
PARATIROID
SICKLE
DAN SALURAN
(RINGAN)
TIROGLOSAL
(RINGAN)
E-1-20-I PROSEDUR $5,581,600.00 $5,581,600.00 $3,393,196.00 JUNADIONO 043151
PADA TIROID,
E-1-20-I PROSEDUR $7,814,200.00 $7,814,200.00 $7,557,895.00 UMI PARYATUN 924350
PARATIROID
PADA TIROID,
N-4-16-I PENYAKIT
DAN SALURAN $3,842,300.00 $3,842,300.00 $6,305,422.00 SUBEKTI 438842
PARATIROID
GINJAL DAN
TIROGLOSAL
N-4-16-II PENYAKIT
DAN SALURAN $3,917,300.00 $3,917,300.00 $5,818,945.00 SITI KHASANAH 915050
SALURAN
(RINGAN) URIN
GINJAL DAN
TIROGLOSAL
E-4-10-III PENYAKIT
LAIN-LAIN $5,776,400.00 $5,776,400.00 $3,823,631.00 YULIANTO 011051
SALURAN
(RINGAN) URIN
KENCING
(RINGAN) MANIS
E-4-10-I PENYAKIT
LAIN-LAIN $3,996,700.00 $3,996,700.00 $1,802,182.00 SUTARMI 918750
& GANGGUAN
KENCING
(SEDANG)MANIS $3,996,700.00 $3,996,700.00
E-4-10-I PENYAKIT
NUTRISI/ $1,418,222.00 CHASANAH 959750
& GANGGUAN
KENCING
METABOLIK MANIS
E-4-13-I GANGGUAN
NUTRISI/ $3,294,500.00 $3,294,500.00 $3,495,300.00 SRI HARYANTI 365349
& GANGGUAN
(BERAT)
KELENJAR
METABOLIK
E-4-13-III GANGGUAN
NUTRISI/ $6,308,300.00 $6,308,300.00 $3,845,555.00 SRI HARYANTI 365349
ENDOKRIN
(RINGAN)
KELENJAR
METABOLIK
E-4-10-I PENYAKIT
LAIN-LAIN $3,330,600.00 $3,330,600.00 $1,447,874.00 WIDYANINGSIH 961646
ENDOKRIN
(RINGAN)
KENCING MANIS
(RINGAN)
E-4-10-II PENYAKIT
LAIN-LAIN $4,653,900.00 $4,653,900.00 $1,371,464.00 ABID AQILAH 693048
& GANGGUAN
KENCING
(BERAT) MANIS
E-4-11-I HIPOVOLEMIA
NUTRISI/ & $2,194,200.00 $2,194,200.00 $4,235,787.00 MINEM 168847
& GANGGUAN
GANGGUAN
METABOLIK
G-4-22-I SERANGAN
NUTRISI/ $2,525,300.00 $2,525,300.00 $815,789.00 MARWONO 577145
ELEKROLIT
(RINGAN)
KEJANG
METABOLIK MISTAM
G-4-22-I SERANGAN
(RINGAN) $3,030,400.00 $3,030,400.00 $1,464,705.00 SITI SUWARNI 076144
(RINGAN)
(SEDANG)
KEJANG
G-4-22-I SERANGAN $3,535,500.00 $3,535,500.00 $4,167,998.00 TSANIA AYU 581437
(RINGAN)
KEJANG SABRINA
G-4-22-I SERANGAN $2,525,300.00 $2,525,300.00 $1,957,667.00 IKA NUR 572750
(RINGAN)
KEJANG ISNAENI
G-4-22-I SERANGAN $2,525,300.00 $2,525,300.00 $1,021,331.00 OKTANIO FELIX 986850
(RINGAN)
KEJANG EVANDER
G-4-22-I SERANGAN $2,525,300.00 $2,525,300.00 $1,273,192.00 DEVIAH 915946
(RINGAN)
KEJANG
G-4-22-I SERANGAN $2,525,300.00 $2,525,300.00 $2,511,963.00 AMALUDIN 776050
(RINGAN)
KEJANG
G-4-16-I ISKEMIK $3,009,000.00 $3,009,000.00 $1,204,961.00 NGADIMAN 791950
(RINGAN)
TRANSIENT
G-4-16-I ISKEMIK $3,009,000.00 $3,009,000.00 $1,772,652.00 SARJONO 986950
(RINGAN)
TRANSIENT
J-1-20-I PROSEDUR $11,060,900.00 $11,060,900.00 $4,554,445.00 NINGGIARTI 950843
(RINGAN)
SISTEM
H-1-20-I PROSEDUR $4,227,800.00 $4,227,800.00 $2,324,173.00 SALIMI 645850
PERNAFASAN
EKSTRAOKULER
H-1-30-I PROSEDUR
NON-KOMPLEKS $6,433,000.00 $6,433,000.00 $3,839,159.00 NGABDUL HUDA 962050
DAN ORBITA
LENSA DAN
(RINGAN)
U-4-15-I PENYAKIT
(RINGAN) $3,078,900.00 $3,078,900.00 $2,346,217.00 MOH NUKMAN 115548
INTRA OKULER
TELINGA, HAKIM
U-4-15-I PENYAKIT
(RINGAN) $3,078,900.00 $3,078,900.00 $3,674,118.00 KARSIEM 996846
HIDUNG, MULUT
TELINGA,
U-4-15-I PENYAKIT
DAN $3,078,900.00 $3,078,900.00 $2,067,456.00 NUR HAYATI 404735
HIDUNG, MULUT
TELINGA,
TENGGOROKAN
U-4-15-I PENYAKIT
DAN $2,199,200.00 $2,199,200.00 $1,773,706.00 FRISKA LUSIANA 259050
HIDUNG,
LAIN-LAINMULUT
TELINGA,
TENGGOROKAN
U-4-15-I PENYAKIT
DAN
(RINGAN) $2,199,200.00 $2,199,200.00 $1,847,392.00 EMI FEBRIATI 969950
HIDUNG, MULUT
LAIN-LAIN
TELINGA,
TENGGOROKAN
U-4-15-I PENYAKIT
DAN
(RINGAN) $2,199,200.00 $2,199,200.00 $2,049,153.00 BARIYAH 075651
HIDUNG,
LAIN-LAINMULUT
TELINGA,
TENGGOROKAN
U-4-15-I PENYAKIT
DAN
(RINGAN) $2,639,000.00 $2,639,000.00 $2,885,760.00 DHEWI RAFIKA 008236
HIDUNG,
LAIN-LAINMULUT
TELINGA,
TENGGOROKAN WINATA
U-4-15-I PENYAKIT
DAN
(RINGAN) $3,078,900.00 $3,078,900.00 $6,501,665.00 KIARA HABIBAH 089251
HIDUNG, MULUT
LAIN-LAIN
TELINGA,
TENGGOROKAN NABILA
U-4-15-I PENYAKIT
DAN
(RINGAN) $2,639,000.00 $2,639,000.00 $3,551,836.00 FENTI APRI 305442
HIDUNG,
LAIN-LAINMULUT
TELINGA,
TENGGOROKAN RYANI
U-4-15-I PENYAKIT
DAN
(RINGAN) $2,199,200.00 $2,199,200.00 $2,936,769.00 ENDAH 963747
HIDUNG,
LAIN-LAINMULUT
TELINGA,
TENGGOROKAN SUMARSIH
U-4-13-I PERADANGAN
DAN
(RINGAN) $2,556,900.00 $2,556,900.00 $6,007,730.00 ATHAR SATRIA 928650
HIDUNG, MULUT
LAIN-LAIN
EPIGLOTIS,
TENGGOROKAN SETIATMOKO
U-4-13-I PERADANGAN
DAN
(RINGAN) $2,191,600.00 $2,191,600.00 $2,880,720.00 AMALIA SITA 134334
TELINGA
LAIN-LAIN
EPIGLOTIS,
TENGGOROKAN WARDANI
U-4-11-I DYSEQUILIBRIU
TENGAH,
(RINGAN) ISPA $1,836,400.00 $1,836,400.00 $3,266,185.00 INDRI NENA 579442
TELINGA
LAIN-LAIN
M (RINGAN)
DAN SWADESTI
I-4-17-I HIPERTENSI
TENGAH,
(RINGAN) ISPA $1,758,600.00 $1,758,600.00 $1,394,186.00 KARTINAH 182747
LARINGOTRAKEI
(RINGAN)
I-4-17-I DAN
HIPERTENSI $1,758,600.00 $1,758,600.00 $1,666,565.00 SAMSIYAH 774550
TIS (RINGAN)
LARINGOTRAKEI
(RINGAN)
I-4-17-I HIPERTENSI
TIS (RINGAN) $2,110,300.00 $2,110,300.00 $2,721,090.00 SABAR 865048
(RINGAN)
I-4-17-I HIPERTENSI $1,758,600.00 $1,758,600.00 $714,539.00 MUDIYONO 799350
(RINGAN)
I-4-17-I HIPERTENSI $2,462,000.00 $2,462,000.00 $4,511,077.00 MUSLICHAH 916550
(RINGAN)
I-4-17-I HIPERTENSI $1,758,600.00 $1,758,600.00 $1,262,163.00 SUNARDI 023151
(RINGAN)
I-4-17-I HIPERTENSI $2,110,300.00 $2,110,300.00 $2,015,185.00 LASWONO 454747
(RINGAN)
I-4-12-III KEGAGALAN $3,582,600.00 $3,582,600.00 $5,152,325.00 SITI JANAENAH 975040
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,850,809.00 RUMIYATI 792050
(BERAT)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,799,521.00 NY.KASEM AL 832150
(RINGAN)
JANTUNG SUKARJA
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $3,840,274.00 SANEM 417841
(RINGAN)
JANTUNG SUYITNO
I-4-12-III KEGAGALAN $5,015,600.00 $5,015,600.00 $3,709,243.00 SUMIRAH 203751
(SEDANG)
JANTUNG
N-4-10-I TUMOR GINJAL $3,445,100.00 $3,445,100.00 $2,321,637.00 PARNO 106834
(BERAT)
& SALURAN
URIN & GAGAL
GINJAL
(RINGAN)
N-4-10-I TUMOR GINJAL $2,460,800.00 $2,460,800.00 $3,000,596.00 MUHTIONO 436746
& SALURAN
N-4-10-II TUMOR GINJAL $3,571,600.00 $3,571,600.00 $2,481,196.00 TUMINI 565345
URIN & GAGAL
& SALURAN
N-4-10-II TUMOR
GINJAL GINJAL $4,166,900.00 $4,166,900.00 $2,553,628.00 MARNA 007143
URIN & GAGAL
& SALURAN
(RINGAN) MARWOTO
N-4-10-II TUMOR
GINJAL GINJAL $4,166,900.00 $4,166,900.00 $7,010,740.00 SYAEFULLOH 495546
URIN & GAGAL
& SALURAN
(SEDANG)
N-4-10-II TUMOR
GINJAL GINJAL $4,166,900.00 $4,166,900.00 $3,533,356.00 ISMANTO 693643
URIN & GAGAL
& SALURAN
(SEDANG)
N-4-10-II TUMOR
GINJAL GINJAL $2,976,400.00 $2,976,400.00 $2,806,523.00 MINARTO 573442
URIN & GAGAL
& SALURAN
(SEDANG)
N-4-10-II TUMOR
GINJAL GINJAL $4,166,900.00 $4,166,900.00 $7,054,075.00 SURATMI 802535
URIN & GAGAL
& SALURAN
(SEDANG)
N-4-10-I TUMOR
GINJAL GINJAL $2,952,900.00 $2,952,900.00 $3,338,495.00 AHMAD SALIM 289745
URIN & GAGAL
& SALURAN
(SEDANG)
N-4-10-II TUMOR
GINJAL GINJAL $4,166,900.00 $4,166,900.00 $5,307,427.00 NURIYANTO 039244
URIN & GAGAL
& SALURAN
(SEDANG)
N-4-10-II TUMOR
GINJAL GINJAL $4,166,900.00 $4,166,900.00 $3,623,033.00 TRIS PRAMUDI 357444
URIN & GAGAL
& SALURAN
(RINGAN)
N-4-10-I TUMOR
GINJAL GINJAL $3,445,100.00 $3,445,100.00 $2,935,881.00 BINGAH 610844
URIN & GAGAL
& SALURAN
(SEDANG)
N-4-10-II TUMOR
GINJAL GINJAL $2,976,400.00 $2,976,400.00 $6,585,001.00 MARYANTO 493339
URIN & GAGAL
& SALURAN
(SEDANG)
N-4-10-I TUMOR
GINJAL GINJAL $3,445,100.00 $3,445,100.00 $4,634,711.00 SURATMI 802535
URIN & GAGAL
& SALURAN
(RINGAN)
N-4-10-II TUMOR
GINJAL GINJAL $4,166,900.00 $4,166,900.00 $3,534,020.00 MAKMUN 412737
URIN & GAGAL
& SALURAN
(SEDANG) PRATIKNO
I-4-12-II KEGAGALAN
GINJAL $4,179,700.00 $4,179,700.00 $6,066,824.00 SITI RAHAYU 096548
URIN & GAGAL
JANTUNG
(RINGAN)
I-4-12-I KEGAGALAN
GINJAL $2,575,600.00 $2,575,600.00 $2,530,941.00 RATMI 839650
(SEDANG)
JANTUNG
(SEDANG)
I-4-12-II KEGAGALAN $4,179,700.00 $4,179,700.00 $3,285,666.00 BINGAH 610844
(RINGAN)
JANTUNG
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $3,453,911.00 RODIYAH 119551
(SEDANG)
JANTUNG
I-4-10-III INFARK $7,492,600.00 $7,492,600.00 $4,792,425.00 JEMI 180549
(SEDANG)
MYOKARD AKUT
I-4-10-II INFARK $6,240,100.00 $6,240,100.00 $6,109,524.00 SOEMARNO 119351
(BERAT)
MYOKARD AKUT
I-4-10-I INFARK $2,912,200.00 $2,912,200.00 $4,955,607.00 AGUS 910050
(SEDANG)
MYOKARD AKUT ANGGORO
I-4-10-II INFARK $7,280,100.00 $7,280,100.00 $15,112,255.00 LAILI HARUM I 375042
(RINGAN)
MYOKARD AKUT
I-4-10-II INFARK $5,200,100.00 $5,200,100.00 $2,627,347.00 MUYANTO 934749
(SEDANG)
MYOKARD AKUT
I-4-10-II INFARK $7,280,100.00 $7,280,100.00 $11,251,402.00 MACHWARI 876150
(SEDANG)
MYOKARD AKUT
I-4-10-III INFARK $7,492,600.00 $7,492,600.00 $6,496,018.00 KARSO 118551
(SEDANG)
MYOKARD AKUT RAHARJO
I-4-10-I INFARK $4,077,100.00 $4,077,100.00 $4,442,443.00 SURIP WINARTI 287741
(BERAT)
MYOKARD AKUT
I-4-10-II INFARK $5,200,100.00 $5,200,100.00 $6,438,813.00 TURYADI 022751
(RINGAN)
MYOKARD AKUT
I-4-16-I ATHEROSKLERO $2,187,000.00 $2,187,000.00 $3,490,032.00 NANI SOEWARNI 598936
(SEDANG)
SIS (RINGAN)
I-4-16-III ATHEROSKLERO $4,214,100.00 $4,214,100.00 $3,773,322.00 TUGINO 563049
SIS (BERAT)
I-4-16-II ATHEROSKLERO $2,508,400.00 $2,508,400.00 $1,678,937.00 PARDI SUMARYO 069838
SIS (SEDANG)
I-4-12-III KEGAGALAN $5,015,600.00 $5,015,600.00 $8,816,867.00 SUGIJONO 847443
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $2,296,699.00 SATIM SAROJI 643347
(BERAT)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,166,867.00 SLAMET 246047
(RINGAN)
JANTUNG RASMADI
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,817,223.00 KARMINI 899850
(RINGAN)
JANTUNG
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $1,343,228.00 SUWARJO 879440
(RINGAN)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,638,566.00 FATHUDIN 462847
(SEDANG)
JANTUNG
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $1,410,528.00 JATMIKO 201848
(RINGAN)
JANTUNG RAHARJO.
I-4-12-I KEGAGALAN $3,605,900.00 $3,605,900.00 $4,051,248.00 BUDIMAN 066448
(SEDANG)
JANTUNG
I-4-12-III KEGAGALAN $3,582,600.00 $3,582,600.00 $9,657,052.00 SAMI MARYONO 152148
(RINGAN)
JANTUNG
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $5,779,895.00 SAMINI 494450
(BERAT)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,828,081.00 MISEM 776750
(SEDANG)
JANTUNG
I-4-12-III KEGAGALAN $3,582,600.00 $3,582,600.00 $4,344,148.00 FITRIYATI 807650
(RINGAN)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,748,575.00 SUWARJO 795250
(BERAT)
JANTUNG
I-4-12-III KEGAGALAN $5,015,600.00 $5,015,600.00 $4,333,210.00 WASIYAH 633250
(RINGAN)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,884,879.00 kliwon 084851
(BERAT)
JANTUNG
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $3,575,950.00 ASEP TRI 914550
(RINGAN)
JANTUNG SAPUTRA
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $5,303,093.00 SURATMAN 981650
(SEDANG)
JANTUNG
I-4-12-III KEGAGALAN $5,015,600.00 $5,015,600.00 $3,740,695.00 SUTORI 441737
(SEDANG)
JANTUNG
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $4,958,292.00 SUHARSO 026451
(BERAT)
JANTUNG
I-4-12-III KEGAGALAN $3,582,600.00 $3,582,600.00 $5,062,913.00 MUHAYAT 025951
(SEDANG)
JANTUNG SARPAN
(BERAT)
I-4-12-I KEGAGALAN $3,090,800.00 $3,090,800.00 $1,378,791.00 MARSAN 248245
JANTUNG
I-4-12-I KEGAGALAN $3,605,900.00 $3,605,900.00 $3,460,085.00 SUGIYOTO 884747
(RINGAN)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $3,692,420.00 SLAMET 246047
(RINGAN)
JANTUNG RASMADI
I-4-12-III KEGAGALAN $3,582,600.00 $3,582,600.00 $2,890,198.00 MISBAH 046346
(RINGAN)
JANTUNG
I-4-12-II KEGAGALAN $3,582,600.00 $3,582,600.00 $3,520,215.00 KAMINTEN 955750
(BERAT)
JANTUNG
I-4-12-I KEGAGALAN $3,605,900.00 $3,605,900.00 $3,567,311.00 SALIEM 952550
(SEDANG)
JANTUNG
I-4-12-II KEGAGALAN $2,985,500.00 $2,985,500.00 $4,089,433.00 NY YANI SUMANI 834645
(RINGAN)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $2,281,529.00 SURANTI 960643
(SEDANG)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $2,304,219.00 SIMAH 959050
(RINGAN)
JANTUNG
I-4-12-I KEGAGALAN $2,575,600.00 $2,575,600.00 $1,762,794.00 ARSI DULHADI, 114151
(RINGAN)
JANTUNG NY
G-4-14-I KECEDERAAN $5,211,700.00 $5,211,700.00 $2,814,940.00 SITI SADANAH 365442
(RINGAN)
PEMBULUH
G-4-15-I KECEDERAAN $4,258,400.00 $4,258,400.00 $11,754,519.00 SRI HARTATI 010149
DARAH OTAK
PEMBULUH
G-4-15-I KECEDERAAN
DENGAN INFARK $3,041,700.00 $3,041,700.00 $1,448,600.00 REMIATI 807250
DARAH OTAK
PEMBULUH
(RINGAN)
G-4-15-I KECEDERAAN
NON SPESIFIK & $4,258,400.00 $4,258,400.00 $6,743,061.00 SECHATI 120438
DARAH OTAK
PEMBULUH
PENYUMBATAN
G-4-15-I KECEDERAAN
NON SPESIFIK & $4,258,400.00 $4,258,400.00 $5,801,938.00 SAIFOEDIN 029243
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
G-4-15-I KECEDERAAN
NON
TANPA SPESIFIK
INFARK & $3,650,100.00 $3,650,100.00 $4,392,485.00 SULASTRI 827950
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
G-4-15-I KECEDERAAN
NON SPESIFIK
TANPA INFARK & $3,041,700.00 $3,041,700.00 $2,410,116.00 TUHARTO 822950
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
G-4-15-I KECEDERAAN
NON SPESIFIK
TANPA INFARK & $3,041,700.00 $3,041,700.00 $2,227,608.00 MINARJO 836550
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
G-4-15-I KECEDERAAN
NON
TANPA SPESIFIK
INFARK & $3,041,700.00 $3,041,700.00 $1,454,532.00 DANURI REMAN 893650
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN) TN
G-4-15-I KECEDERAAN
NON SPESIFIK
TANPA INFARK & $3,041,700.00 $3,041,700.00 $2,825,090.00 SOBIROH 983750
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
G-4-15-I KECEDERAAN
NON
TANPA SPESIFIK
INFARK & $3,041,700.00 $3,041,700.00 $2,966,035.00 RATINEM 029451
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
G-4-15-I KECEDERAAN
NON SPESIFIK
TANPA INFARK & $3,041,700.00 $3,041,700.00 $3,515,029.00 RUBI 020651
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
G-4-15-I KECEDERAAN
NON
TANPA SPESIFIK
INFARK & $3,041,700.00 $3,041,700.00 $2,362,364.00 MUTHMAINAH 014551
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
G-4-15-I KECEDERAAN
NON
TANPA SPESIFIK
INFARK & $3,041,700.00 $3,041,700.00 $1,500,791.00 KARSEM 019751
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
G-4-15-I KECEDERAAN
NON SPESIFIK
TANPA INFARK & $3,041,700.00 $3,041,700.00 $1,682,784.00 SARYO 111951
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
I-4-15-I PENYAKIT
NON
TANPA SPESIFIK
INFARK & $4,262,100.00 $4,262,100.00 $2,936,143.00 SUDIONO 805050
DARAH OTAK
PRE-CEREBRAL
PEMBULUH
PENYUMBATAN
(RINGAN)
K-1-50-I PROSEDUR
NON SPESIFIK
TANPA INFARK & $4,421,500.00 $4,421,500.00 $2,310,632.00 DINA RUSTIANTI 761450
DARAH PERIFER
PRE-CEREBRAL
ANAL (RINGAN)
PENYUMBATAN
(RINGAN)
K-1-50-I PROSEDUR
DAN LAIN-LAIN
TANPA INFARK $4,421,500.00 $4,421,500.00 $2,779,933.00 KONGIDAH 042251
PRE-CEREBRAL
ANAL (RINGAN)
K-1-50-I (RINGAN)
PROSEDUR $4,421,500.00 $4,421,500.00 $2,589,069.00 TUSRI 046751
TANPA INFARK
ANAL (RINGAN)
(RINGAN)
K-1-50-I PROSEDUR $5,305,800.00 $5,305,800.00 $4,081,923.00 ALFIATUN 090851
ANAL (RINGAN) SOLEKHAH
K-1-50-I PROSEDUR $4,421,500.00 $4,421,500.00 $2,209,035.00 DARSONO 997450
ANAL (RINGAN)
K-1-50-I PROSEDUR $5,305,800.00 $5,305,800.00 $4,036,416.00 RIZKI KURNIA 932450
ANAL (RINGAN) WATI ROMADON
U-4-13-I PERADANGAN $1,826,300.00 $1,826,300.00 $1,644,624.00 ZIKRI AKBAR 830550
EPIGLOTIS, HAMIZAN
J-4-16-I SIMPLE $3,332,600.00 $3,332,600.00 $5,246,808.00 CALYA ANINDYA 823050
TELINGA
PNEUMONIA & PUTRI
J-4-16-I SIMPLE
TENGAH, ISPA $3,332,600.00 $3,332,600.00 $3,007,624.00 ANINDITA 917050
WHOOPING
PNEUMONIA
DAN & MAYLANI
J-4-16-I SIMPLE
COUGH $4,665,600.00 $4,665,600.00 $3,312,535.00 INTANIA BELLA 685049
WHOOPING
LARINGOTRAKEI
PNEUMONIA
(RINGAN) & SETIYADI
J-4-16-I SIMPLE
COUGH
TIS (RINGAN) $3,332,600.00 $3,332,600.00 $2,037,202.00 AKHBAR 728643
WHOOPING
PNEUMONIA
(RINGAN) & KUSUMA
J-4-16-I SIMPLE
COUGH $3,332,600.00 $3,332,600.00 $3,062,598.00 AZZIQRO FAQIH 014549
WHOOPING ADHIAQSA
PNEUMONIA
(RINGAN) & FIRNANDA
J-4-16-I SIMPLE
COUGH $3,332,600.00 $3,332,600.00 $1,891,176.00 ADEVVA IMELDA 898350
WHOOPING
PNEUMONIA
(RINGAN) & SALVINA
J-4-16-II SIMPLE
COUGH $4,683,100.00 $4,683,100.00 $4,444,212.00 MUHAMMAD 326550
WHOOPING
PNEUMONIA
(RINGAN) & ALFIANSYAH
J-4-16-I SIMPLE
COUGH $3,332,600.00 $3,332,600.00 $2,704,913.00 AULIA REFA 733139
WHOOPING
PNEUMONIA
(RINGAN) &
J-4-16-I SIMPLE
COUGH $3,332,600.00 $3,332,600.00 $2,709,645.00 KUSNEDI 771550
WHOOPING
PNEUMONIA
(SEDANG) &
J-4-16-I SIMPLE
COUGH $3,332,600.00 $3,332,600.00 $1,287,361.00 SUTARNO ASAN 802850
WHOOPING
PNEUMONIA
(RINGAN) & MIARJO
J-4-16-I SIMPLE
COUGH $4,665,600.00 $4,665,600.00 $6,506,034.00 WIDODO 858950
WHOOPING
PNEUMONIA
(RINGAN) &
J-4-16-I SIMPLE
COUGH $3,332,600.00 $3,332,600.00 $3,946,027.00 RAMI 824050
WHOOPING
PNEUMONIA
(RINGAN) &
J-4-16-I SIMPLE
COUGH $3,332,600.00 $3,332,600.00 $2,770,336.00 ISMAIL 972939
WHOOPING
PNEUMONIA
(RINGAN) &
J-4-16-I SIMPLE
COUGH $3,332,600.00 $3,332,600.00 $1,706,234.00 SARTIYAH 025851
WHOOPING
PNEUMONIA
(RINGAN) &
J-4-16-III SIMPLE
COUGH $8,289,600.00 $8,289,600.00 $5,931,335.00 MUZAJIMAH 612446
WHOOPING
PNEUMONIA
(RINGAN) &
J-4-16-III SIMPLE
COUGH $5,921,100.00 $5,921,100.00 $7,002,009.00 MISRINGAH 124332
WHOOPING
PNEUMONIA
(RINGAN) &
J-4-16-I SIMPLE
COUGH (BERAT) $3,332,600.00 $3,332,600.00 $2,075,450.00 MUNTARYO 293548
WHOOPING
PNEUMONIA &
COUGH (BERAT)
WHOOPING
COUGH
(RINGAN)
J-4-16-I SIMPLE $4,665,600.00 $4,665,600.00 $2,722,558.00 LASHIRA 019351
PNEUMONIA & HANUM
J-4-16-I SIMPLE $3,332,600.00 $3,332,600.00 $5,853,858.00 Tasmiyah 084840
WHOOPING ALMAHIRA
PNEUMONIA &
J-4-21-I GEJALA,
COUGH TANDA $2,661,000.00 $2,661,000.00 $2,202,160.00 ANINDHITA 962639
WHOOPING
DAN DIAGNOSIS
(RINGAN) AZZAHRA
J-4-21-I GEJALA,
COUGH TANDA $3,193,200.00 $3,193,200.00 $1,751,354.00 ADIFA 836750
SISTEM
DAN DIAGNOSIS
(RINGAN) ASHALINA
J-4-21-I GEJALA, TANDA
PERNAFASAN $2,661,000.00 $2,661,000.00 $1,643,850.00 RAFFA 369249
SISTEM ALFATHUNISA
DAN DIAGNOSIS
LAIN-LAIN HIDAYATULLOH
U-4-13-I PERADANGAN
PERNAFASAN $1,826,300.00 $1,826,300.00 $2,745,344.00 SUNARYO 636641
SISTEM
(RINGAN)
EPIGLOTIS,
LAIN-LAIN
U-4-13-I PERADANGAN
PERNAFASAN $2,191,600.00 $2,191,600.00 $3,567,453.00 SARNI 927450
TELINGA
(RINGAN)
EPIGLOTIS,
LAIN-LAIN
U-1-15-I PROSEDUR
TENGAH, ISPA $3,549,300.00 $3,549,300.00 $2,550,702.00 FITRI ANISA 818844
TELINGA
(RINGAN)
TONSIL &
DAN RAHMAN
U-1-15-I PROSEDUR
TENGAH, ISPA $3,549,300.00 $3,549,300.00 $2,390,527.00 SUTIRAH 694750
ADENOID
LARINGOTRAKEI
TONSIL
DAN &
U-1-15-I PROSEDUR
(RINGAN)
TIS (RINGAN) $3,549,300.00 $3,549,300.00 $2,233,100.00 ALFIAN NUR 841850
ADENOID
LARINGOTRAKEI
TONSIL & MAJID
U-4-13-I PERADANGAN
(RINGAN)
TIS (RINGAN) $1,826,300.00 $1,826,300.00 $890,486.00 UMI BAROKAH 470350
ADENOID
EPIGLOTIS,
U-4-13-I PERADANGAN
(RINGAN) $1,826,300.00 $1,826,300.00 $748,063.00 IHSAN 152651
TELINGA
EPIGLOTIS,
J-4-21-I GEJALA,
TENGAH,TANDA
ISPA $2,661,000.00 $2,661,000.00 $4,154,041.00 WAHYUDIN 917650
TELINGA
DAN DIAGNOSIS
J-4-21-I GEJALA,
TENGAH,TANDA
ISPA $2,661,000.00 $2,661,000.00 $2,362,148.00 SUKOYO 495946
SISTEM
LARINGOTRAKEI
DAN DIAGNOSIS
J-4-17-I PENYAKIT
PERNAFASAN
TIS PARU
(RINGAN) $2,739,200.00 $2,739,200.00 $2,335,204.00 TUKIYEM 894750
SISTEM
LARINGOTRAKEI
OBSTRUKTIF
LAIN-LAIN
J-4-17-I PENYAKIT
PERNAFASAN
TIS PARU
(RINGAN) $2,739,200.00 $2,739,200.00 $1,153,353.00 SUTIO AL 791850
KRONIS
(RINGAN)
OBSTRUKTIF
LAIN-LAIN PARNO
J-4-17-I PENYAKIT PARU
(RINGAN) $3,287,100.00 $3,287,100.00 $2,854,456.00 KASTOLANI 443648
KRONIS
(RINGAN)
OBSTRUKTIF
J-4-17-I PENYAKIT
(RINGAN) PARU $2,739,200.00 $2,739,200.00 $3,175,756.00 SUMINAH 476045
KRONIS
OBSTRUKTIF
J-4-17-I PENYAKIT
(RINGAN) PARU $2,739,200.00 $2,739,200.00 $1,654,136.00 SAMSIDI 868730
KRONIS
OBSTRUKTIF
J-4-17-II PENYAKIT
(RINGAN) PARU $3,280,300.00 $3,280,300.00 $1,719,612.00 TURIAH 561348
KRONIS
OBSTRUKTIF
J-4-17-I PENYAKIT
(RINGAN) PARU $2,739,200.00 $2,739,200.00 $2,329,650.00 CHADIK 310949
KRONIS
OBSTRUKTIF
J-4-17-I PENYAKIT
(SEDANG) PARU $2,739,200.00 $2,739,200.00 $2,986,798.00 SENI 011851
KRONIS
OBSTRUKTIF
J-4-17-I PENYAKIT
(RINGAN) PARU $3,834,900.00 $3,834,900.00 $5,785,828.00 MISTAR 859547
KRONIS
OBSTRUKTIF
J-4-17-I PENYAKIT
(RINGAN) PARU $3,834,900.00 $3,834,900.00 $4,550,801.00 SAMINGUN 056345
KRONIS
OBSTRUKTIF
J-4-17-I PENYAKIT
(RINGAN) PARU $3,834,900.00 $3,834,900.00 $4,444,052.00 TUKINI 852450
KRONIS
OBSTRUKTIF WAHYONO
J-4-17-I PENYAKIT
(RINGAN) PARU $3,834,900.00 $3,834,900.00 $2,966,578.00 BUDI HARTONO 883542
KRONIS
OBSTRUKTIF
J-4-17-I PENYAKIT
(RINGAN) PARU $2,739,200.00 $2,739,200.00 $2,128,563.00 SULFANTO 934650
KRONIS
OBSTRUKTIF
J-4-18-I ASTHMA
(RINGAN)& $2,874,200.00 $2,874,200.00 $1,912,033.00 MUHAMMAD 713038
KRONIS
BRONKIOLITIS RAFFI ABQARY
J-4-18-I ASTHMA
(RINGAN)& $2,463,600.00 $2,463,600.00 $1,366,033.00 FAREL DWI 831750
(RINGAN)
BRONKIOLITIS ADRIANSYAH
J-4-18-I ASTHMA & $2,463,600.00 $2,463,600.00 $2,355,294.00 M GHIFARI EL 237547
(RINGAN)
BRONKIOLITIS KINDI
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $2,304,484.00 ARI SETIAWAN 567448
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $1,650,847.00 TURIAH 561348
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $1,110,367.00 MANISAH 587248
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $1,547,859.00 TRISNODIHARJO 410549
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $1,672,417.00 NARTI 366347
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $2,851,069.00 SAHUMI SAWUD 029851
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $1,213,144.00 ANITA YULIANI 573549
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,874,200.00 $2,874,200.00 $5,012,189.00 ADMA 385331
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $2,671,149.00 MISKINAH 676331
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,874,200.00 $2,874,200.00 $4,153,798.00 SUWARTI 965550
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $2,924,836.00 MARSINI 953350
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,463,600.00 $2,463,600.00 $2,237,677.00 TASRIYAH 794837
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $1,656,273.00 BUDIANDRIONO 959850
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $2,641,371.00 BIZAR ULUL 936950
(RINGAN)
BRONKIOLITIS AZMI
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $2,137,708.00 ABDUL SOMAD 584347
(RINGAN)
BRONKIOLITIS
J-4-18-I ASTHMA & $2,053,000.00 $2,053,000.00 $699,860.00 TITA ADI 667341
(RINGAN)
BRONKIOLITIS KURNIAWATI
J-4-17-I PENYAKIT PARU $2,739,200.00 $2,739,200.00 $2,136,532.00 MISTEM 913135
(RINGAN)
OBSTRUKTIF
J-4-15-I PERADANGAN $3,999,700.00 $3,999,700.00 $1,350,491.00 MISKEM 818839
KRONIS
DAN INFEKSI
J-4-15-I PERADANGAN
(RINGAN) $3,999,700.00 $3,999,700.00 $6,040,091.00 SLAMET 780550
PERNAFASAN
DAN INFEKSI SUPARDI
J-4-20-I PLEURAL
(RINGAN)EFUSI $3,828,800.00 $3,828,800.00 $3,237,989.00 MAINAH 800950
PERNAFASAN
DAN
(RINGAN)
PNEUMOTORAK
(RINGAN)
J-4-20-I PLEURAL EFUSI $3,828,800.00 $3,828,800.00 $2,615,483.00 DODIK 835850
DAN SUPRAYOGI
J-4-20-I PLEURAL EFUSI $3,828,800.00 $3,828,800.00 $2,355,960.00 RUMIAH 472146
PNEUMOTORAK
DAN
J-4-20-I PLEURAL
(RINGAN)EFUSI $5,360,400.00 $5,360,400.00 $4,972,111.00 SULASTRI 441644
PNEUMOTORAK
DAN
U-4-14-I PENYAKIT
(RINGAN) $2,738,800.00 $2,738,800.00 $2,758,159.00 SARIAH 958050
PNEUMOTORAK
MULUT DAN
U-1-30-I PROSEDUR
(RINGAN) $3,823,600.00 $3,823,600.00 $3,435,851.00 PONO 041751
GIGI (RINGAN)
MULUT
U-1-30-I PROSEDUR $5,353,100.00 $5,353,100.00 $3,495,343.00 MUHAMAD 004240
(RINGAN)
MULUT RIYAD ALFAOZI
K-4-12-I GANGGUAN $2,194,200.00 $2,194,200.00 $1,517,736.00 MARNI 612450
(RINGAN)
ESOFAGUS
K-4-18-I GANGGUAN $1,491,100.00 $1,491,100.00 $1,790,592.00 ROUFAN 026051
(RINGAN)
SISTEM ISSKANDAR
K-4-18-I GANGGUAN $1,242,600.00 $1,242,600.00 $2,398,608.00 SUMIARNO 859950
PENCERNAAN
SISTEM
K-4-18-I GANGGUAN
LAIN-LAIN $1,242,600.00 $1,242,600.00 $1,438,327.00 ARU SUSILO 570939
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,242,600.00 $1,242,600.00 $698,000.00 TUMINAH 829750
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,739,600.00 $1,739,600.00 $1,113,483.00 YUNI 089346
PENCERNAAN
SISTEM
(RINGAN) ANGGITASARI
K-4-18-I GANGGUAN
LAIN-LAIN $1,242,600.00 $1,242,600.00 $1,127,617.00 SATIRAH 889050
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,739,600.00 $1,739,600.00 $1,427,860.00 SUMO 069233
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,739,600.00 $1,739,600.00 $3,107,855.00 MASIRAH 313037
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,739,600.00 $1,739,600.00 $1,033,459.00 MOHAMAD 800250
PENCERNAAN
SISTEM
(RINGAN) SETO AJI
K-4-18-I GANGGUAN
LAIN-LAIN $1,242,600.00 $1,242,600.00 $501,393.00 KISEM 237938
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,491,100.00 $1,491,100.00 $3,805,051.00 KELANA 004932
PENCERNAAN
SISTEM
(RINGAN) FRENGKY
K-4-18-I GANGGUAN
LAIN-LAIN $1,491,100.00 $1,491,100.00 $2,545,080.00 HERU BEKTI 348138
PENCERNAAN VICOLUNA
SISTEM
(RINGAN) IRAWAN
K-4-18-I GANGGUAN
LAIN-LAIN $1,242,600.00 $1,242,600.00 $3,113,297.00 KARSINEM 839850
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,491,100.00 $1,491,100.00 $2,080,024.00 WASRI 952250
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
LAIN-LAIN $1,242,600.00 $1,242,600.00 $1,135,752.00 MUTIRAH 218041
PENCERNAAN
SISTEM
(RINGAN)
K-1-13-I PROSEDUR
LAIN-LAIN $2,790,800.00 $2,790,800.00 $2,990,422.00 FADLIL MUTOHA 881450
PENCERNAAN
APPENDIK
(RINGAN)
K-1-13-I PROSEDUR
LAIN-LAIN $2,790,800.00 $2,790,800.00 $4,334,751.00 NURUL 008151
(RINGAN)
APPENDIK
(RINGAN) WAHIDAH
K-1-13-I PROSEDUR $2,790,800.00 $2,790,800.00 $3,217,954.00 NOVITA 776450
(RINGAN)
APPENDIK ANGGRAENI
K-1-11-I ADHESIOLISIS $9,271,300.00 $9,271,300.00 $12,176,696.00 SUKIRAHATI 219947
(RINGAN)
PERITONEAL
K-1-13-I PROSEDUR $2,790,800.00 $2,790,800.00 $3,458,474.00 HADI 378948
(RINGAN)
APPENDIK
K-1-13-I PROSEDUR $2,790,800.00 $2,790,800.00 $3,132,034.00 NATSIROH 791450
(RINGAN)
APPENDIK MURNIATUN
K-1-13-I PROSEDUR $3,907,100.00 $3,907,100.00 $10,448,382.00 PRASETYA 858250
(RINGAN)
APPENDIK WIDODO
K-1-13-I PROSEDUR $2,790,800.00 $2,790,800.00 $3,475,774.00 PARYATI 886550
(RINGAN)
APPENDIK
K-1-13-I PROSEDUR $3,348,900.00 $3,348,900.00 $5,440,148.00 TOBIB SAPUTRA 910750
(RINGAN)
APPENDIK
K-1-13-I PROSEDUR $2,790,800.00 $2,790,800.00 $3,581,840.00 KHOERUL 936650
(RINGAN)
APPENDIK ANWAR
K-1-13-I PROSEDUR $2,790,800.00 $2,790,800.00 $3,175,492.00 NOFIA TRUBUS 087051
(RINGAN)
APPENDIK MENTARI.
K-1-13-I PROSEDUR $2,790,800.00 $2,790,800.00 $2,961,774.00 SAHRUDIN 471945
(RINGAN)
APPENDIK SAKUM
K-1-13-I PROSEDUR $3,348,900.00 $3,348,900.00 $4,080,253.00 JAENAH 153651
(RINGAN)
APPENDIK
K-1-14-I PROSEDUR $4,528,900.00 $4,528,900.00 $4,018,600.00 DUL KHOLIB AL 130151
(RINGAN)
HERNIA ROJINGUN AL .S.
K-1-14-I PROSEDUR $5,434,700.00 $5,434,700.00 $2,852,458.00 SUKIRNO 653450
INGUINAL DAN
HERNIA
K-1-14-I PROSEDUR
FEMORAL $6,340,400.00 $6,340,400.00 $4,712,261.00 ROCHMAT 076351
INGUINAL DAN
HERNIA
(RINGAN)
K-1-14-I PROSEDUR
FEMORAL $6,340,400.00 $6,340,400.00 $7,103,936.00 HAMAM MASDI 204449
INGUINAL DAN
HERNIA
(RINGAN)
K-1-14-I PROSEDUR
FEMORAL $4,528,900.00 $4,528,900.00 $3,813,158.00 DARMAJI 204541
INGUINAL DAN
HERNIA
(RINGAN) SAHUDI
K-4-15-I OBSTRUKSI
FEMORAL $1,937,700.00 $1,937,700.00 $1,961,614.00 MICHAD 978250
INGUINAL DAN
SALURAN
(RINGAN)
K-1-40-I PROSEDUR
FEMORAL $5,786,500.00 $5,786,500.00 $6,140,682.00 ROHYAT 856250
GASTROINTESTI
SISTEM
(RINGAN)
K-4-18-I GANGGUAN
NAL (RINGAN) $1,242,600.00 $1,242,600.00 $2,305,860.00 NANISEM 830450
PENCERNAAN
SISTEM
K-4-18-II GANGGUAN
LAIN-LAIN $1,765,800.00 $1,765,800.00 $3,577,201.00 BONIAH 024851
PENCERNAAN
SISTEM
(RINGAN)
B-4-13-II GANGGUAN
LAIN-LAIN $5,091,900.00 $5,091,900.00 $5,029,793.00 ANIK SETIYANTO 686050
PENCERNAAN
HATI LAIN-LAIN
(RINGAN)
B-4-13-II GANGGUAN
LAIN-LAIN $3,637,100.00 $3,637,100.00 $3,651,363.00 SUMEDI 911250
(SEDANG)
HATI LAIN-LAIN
(SEDANG) SAMSUDIN
B-4-14-I GANGGUAN $4,366,200.00 $4,366,200.00 $5,794,883.00 LUTHFI 025051
(SEDANG)
SALURAN AFDHILIANO
B-4-14-I GANGGUAN $3,118,700.00 $3,118,700.00 $1,968,717.00 SUPRATO KIMAN 068248
EMPEDU LAIN- SURUR
SALURAN
B-4-14-II GANGGUAN
LAIN (RINGAN) $3,638,400.00 $3,638,400.00 $2,086,634.00 SURIP 569243
EMPEDU LAIN-
SALURAN
B-4-14-I GANGGUAN
LAIN (RINGAN) $3,742,500.00 $3,742,500.00 $4,660,435.00 AGUSTIN 532034
EMPEDU LAIN-
SALURAN MUTMAINAH
LAIN (SEDANG)
EMPEDU LAIN-
LAIN (RINGAN)
K-4-18-II GANGGUAN $2,119,000.00 $2,119,000.00 $4,371,744.00 TISMIATIN 326644
SISTEM
K-4-18-I GANGGUAN $1,739,600.00 $1,739,600.00 $3,118,527.00 MOHAMAD 298734
PENCERNAAN
SISTEM MUSTOFA
K-4-18-II GANGGUAN
LAIN-LAIN $1,765,800.00 $1,765,800.00 $6,962,763.00 SAMSUDIN 980550
PENCERNAAN
SISTEM
(SEDANG)
K-4-18-II GANGGUAN
LAIN-LAIN $2,472,100.00 $2,472,100.00 $4,856,586.00 MUCHLIS 775950
PENCERNAAN
SISTEM
(RINGAN)
K-4-18-II GANGGUAN
LAIN-LAIN $2,119,000.00 $2,119,000.00 $5,588,504.00 YEYEN TRIO 008139
PENCERNAAN
SISTEM
(SEDANG) KUSWORO
K-4-18-II GANGGUAN
LAIN-LAIN $1,765,800.00 $1,765,800.00 $5,448,348.00 SUBIYANTO 301041
PENCERNAAN
SISTEM
(SEDANG)
K-4-18-I GANGGUAN
LAIN-LAIN $1,242,600.00 $1,242,600.00 $2,148,155.00 SIPAH 912250
PENCERNAAN
SISTEM
(SEDANG)
K-4-18-II GANGGUAN
LAIN-LAIN $2,472,100.00 $2,472,100.00 $4,101,742.00 KARSIEM 989250
PENCERNAAN
SISTEM
(SEDANG)
K-4-18-II GANGGUAN
LAIN-LAIN $1,765,800.00 $1,765,800.00 $2,783,555.00 SITI MAEMUNAH 634248
PENCERNAAN
SISTEM
(RINGAN)
L-4-10-II PENYAKIT
LAIN-LAIN KULIT $1,473,400.00 $1,473,400.00 $4,177,012.00 LAELA ISNAENI 899050
PENCERNAAN
MAYOR
(SEDANG) THOYIBAH
M-4-17-I MASALAH
LAIN-LAIN $2,738,500.00 $2,738,500.00 $1,592,759.00 SUHARSO 914839
(SEDANG)
BAGIAN
(SEDANG)
M-4-17-I MASALAH $2,738,500.00 $2,738,500.00 $2,355,609.00 MARNI 978538
PUNGGUNG/PIN
BAGIAN
M-4-17-I MASALAH
GGANG $3,833,900.00 $3,833,900.00 $3,009,968.00 BIRRU KURNIA 405734
PUNGGUNG/PIN
BAGIAN
BELAKANG
M-1-50-I PROSEDUR
GGANG $3,840,300.00 $3,840,300.00 $2,498,574.00 FARID 787550
PUNGGUNG/PIN
(RINGAN)
JARINGAN
BELAKANG AHWANUDIN
M-4-21-I GANGGUAN
GGANG $2,192,500.00 $2,192,500.00 $1,706,099.00 ERMAN 936350
LUNAK
(RINGAN)
SISTEM
BELAKANG TASRIADI
L-1-40-I PROSEDUR
(RINGAN) $3,696,900.00 $3,696,900.00 $3,136,691.00 SUTINAH 453645
MUSKULOSKELE
(RINGAN)
PADA KULIT,
L-1-40-I PROSEDUR
TAL & $4,436,300.00 $4,436,300.00 $2,775,322.00 RUNTIK PRIYATI 130851
JA(RINGAN)
PADA KULIT,
JA(RINGAN)
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,121,624.00 SABEN 944250
JA(RINGAN)
PENGHUBUNG
PADAPAYUDARA
DAN KULIT,
L-1-40-I PROSEDUR
BAWAH KULIT
LAIN-LAIN $3,696,900.00 $3,696,900.00 $1,543,075.00 AROFINA ROSA 607939
JA(RINGAN)
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
(RINGAN) PRILIANA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,301,429.00 SISWANTO 013551
JA(RINGAN)
(RINGAN)
PADAPAYUDARA
DAN KULIT, MARSAN
L-1-40-I PROSEDUR
BAWAH KULIT $5,175,700.00 $5,175,700.00 $2,982,802.00 FADEL 972950
JA(RINGAN)
(RINGAN)
PADAPAYUDARA
DAN KULIT, MUHAMMAD
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $3,865,771.00 RIBUT 979550
JA(RINGAN)
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $3,661,624.00 MOHAMAD ARIF 130951
JA(RINGAN)
(RINGAN)
PADAPAYUDARA
DAN KULIT, HIDAYAT
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,273,516.00 WIYANTO 123251
JA(RINGAN)
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
M-4-20-I TANDA, GEJALA
BAWAH KULIT $2,177,400.00 $2,177,400.00 $1,374,471.00 SAID RIDO 382735
JA(RINGAN)
(RINGAN)
& PERADANGAN
DAN PAYUDARA UTOMO
L-1-40-I PROSEDUR
BAWAH KULIT $4,436,300.00 $4,436,300.00 $2,876,119.00 MURNI 084850
MUSKULOSKELE
(RINGAN)
PADA
DAN KULIT,
PAYUDARA
L-1-40-I PROSEDUR
TAL (RINGAN) $3,696,900.00 $3,696,900.00 $2,117,809.00 SAFIQ ABIYYU 152151
JA(RINGAN)
(RINGAN)
PADA KULIT, EDFRANS
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $2,111,278.00 SALOHI 087751
JA(RINGAN)
PADA
DAN KULIT,
PAYUDARA
N-4-11-III PERADANGAN
BAWAH KULIT $4,106,400.00 $4,106,400.00 $2,893,140.00 NASIM 556050
JA(RINGAN)
(RINGAN)
GINJAL
DAN (BERAT)
PAYUDARA
N-4-13-I BATU
BAWAH URIN
KULIT $3,249,600.00 $3,249,600.00 $1,387,302.00 ROJIKUN 896950
(RINGAN)
(RINGAN)
N-4-12-I DAN PAYUDARA
INFEKSI GINJAL $2,586,500.00 $2,586,500.00 $1,221,151.00 AHMAD 070430
(RINGAN)
DAN SALURAN SUGIONO
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $1,060,584.00 TARSONO 165451
URIN (RINGAN)
DAN SALURAN SLAMET
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $1,151,160.00 TURIYAH 692840
URIN (RINGAN)
DAN SALURAN
N-4-12-II INFEKSI GINJAL $3,999,300.00 $3,999,300.00 $1,472,146.00 SISWANTO 604850
URIN (RINGAN)
DAN SALURAN SARWONO
N-4-10-I TUMOR GINJAL $3,445,100.00 $3,445,100.00 $4,174,589.00 MUSLIMUN ABU 512346
URIN (SEDANG)
& SALURAN ZAMROH
N-4-13-I BATU URIN $3,249,600.00 $3,249,600.00 $1,593,983.00 SARNO 831850
URIN & GAGAL
(RINGAN)
N-4-13-I BATU
GINJALURIN $3,899,600.00 $3,899,600.00 $3,642,764.00 SUBADI 986650
(RINGAN)
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $2,049,491.00 SEPTI 897650
DAN SALURAN SETYOWATI
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $2,315,668.00 TIONO 622047
URIN (RINGAN)
DAN SALURAN
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $1,838,277.00 NADIYA 112851
URIN (RINGAN)
DAN SALURAN LAHTITAH
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $2,119,385.00 WIARJA 773750
URIN (RINGAN) KUMALASARI
DAN SALURAN
N-4-12-I INFEKSI GINJAL $2,586,500.00 $2,586,500.00 $1,495,647.00 FENTI 249142
URIN (RINGAN)
DAN SALURAN AGUSTINA
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $1,294,810.00 UMI SABILA 804450
URIN (RINGAN)
DAN SALURAN YASAROH
N-4-12-I INFEKSI GINJAL $3,017,500.00 $3,017,500.00 $2,868,788.00 WAKINGAH 806450
URIN (RINGAN)
DAN SALURAN
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $1,857,608.00 TURINAH 778650
URIN (RINGAN)
DAN SALURAN
N-4-12-I INFEKSI GINJAL $3,017,500.00 $3,017,500.00 $2,799,911.00 AHMAD 781436
URIN (RINGAN)
DAN SALURAN SUBAGYO
N-4-12-II INFEKSI GINJAL $3,999,300.00 $3,999,300.00 $3,345,383.00 ANDINI NIDIA 208548
URIN (RINGAN)
DAN SALURAN PUTRI
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $1,488,033.00 RIZKA AMALIA 843249
URIN (SEDANG)
DAN SALURAN RAHMA
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $1,541,277.00 SUKARDI 293746
URIN (RINGAN)
DAN SALURAN
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $1,957,468.00 NOVITA SARI 834550
URIN (RINGAN)
DAN SALURAN LUBIS
URIN (RINGAN)
N-4-12-I INFEKSI GINJAL $3,017,500.00 $3,017,500.00 $2,616,678.00 MARTUTI 843444
DAN SALURAN
N-4-12-I INFEKSI GINJAL $2,155,400.00 $2,155,400.00 $2,278,813.00 ERNI UMIYATI 777250
URIN (RINGAN)
DAN SALURAN
V-1-14-I PENGANGKATAN $6,562,900.00 $6,562,900.00 $5,992,057.00 MUSLIMIN 536250
URIN (RINGAN)
PROSTAT
V-1-10-I PROSEDUR $3,587,100.00 $3,587,100.00 $4,012,261.00 SUMARYO 070051
MELALUI
PENGANGKATAN
V-1-12-I PROSEDUR
URETRA $6,416,100.00 $6,416,100.00 $2,472,671.00 DIPATYA TRI 158751
PROSTAT
PADA SKROTUM
(RINGAN) AISSANSA
V-1-12-I PROSEDUR
KOMPLEK $6,416,100.00 $6,416,100.00 $4,865,012.00 YUSRI 139351
DAN PROSTAT
PADA SKROTUM
(RINGAN) MURWANTO
L-1-50-I PROSEDUR
KOMPLEK- $4,853,300.00 $4,853,300.00 $3,038,259.00 KHUSWATUN 381750
DAN PROSTAT
PADA PAYUDARA
MODERAT
L-1-50-I PROSEDUR
KOMPLEK- $4,853,300.00 $4,853,300.00 $2,936,942.00 SITI NGAISAH 946250
(RINGAN)
PADA PAYUDARA
MODERAT
L-1-50-I PROSEDUR $4,853,300.00 $4,853,300.00 $1,741,360.00 MUSRIFAH 161451
(RINGAN)
PADA PAYUDARA
L-1-50-I PROSEDUR $5,824,000.00 $5,824,000.00 $3,906,520.00 NURUL HIDAYATI 925750
(RINGAN)
PADA PAYUDARA
W-4-11-I INFEKSI SISTEM $2,817,000.00 $2,817,000.00 $2,328,953.00 NUR LAILA 895050
(RINGAN)
REPRODUKSI RAMADANI
W-1-11-I PROSEDUR $1,657,100.00 $1,657,100.00 $1,994,361.00 WIJEM 779850
WANITA
DILATASI,
W-1-11-I PROSEDUR
(RINGAN) $1,657,100.00 $1,657,100.00 $3,855,289.00 NAKIAH 077751
KURET,
DILATASI,
W-1-10-I PROSEDUR
INTRAUTERIN & $1,585,400.00 $1,585,400.00 $1,916,724.00 SINTA 805450
KURET,
ABORSI
SERVIK KUSTIMAH
W-1-10-I PROSEDUR
INTRAUTERIN & $1,585,400.00 $1,585,400.00 $1,656,041.00 FITRIYANI 835150
(RINGAN)
ABORSI
SERVIK
W-1-11-I PROSEDUR $1,657,100.00 $1,657,100.00 $1,940,030.00 SARNI 469440
(RINGAN)
DILATASI,
W-1-10-I PROSEDUR $1,585,400.00 $1,585,400.00 $2,173,307.00 SOPIYAH 993650
KURET,
ABORSI
W-1-10-I PROSEDUR
INTRAUTERIN & $1,585,400.00 $1,585,400.00 $2,090,756.00 BADRIYAH 124551
(RINGAN)
ABORSI
SERVIK
W-4-13-I ABORTUS $923,600.00 $923,600.00 $939,948.00 GUNIATI 798050
(RINGAN)
(RINGAN)
W-4-13-I ABORTUS $923,600.00 $923,600.00 $782,701.00 TARYATI 889850
(RINGAN)
W-1-11-I PROSEDUR $1,657,100.00 $1,657,100.00 $2,121,669.00 LISA AGUSTIN 911150
DILATASI,
W-4-13-I ABORTUS $923,600.00 $923,600.00 $616,869.00 JUHARIAH AL 956050
KURET,
(RINGAN) JUNARI
W-1-11-II PROSEDUR
INTRAUTERIN & $1,828,600.00 $1,828,600.00 $4,879,845.00 MARYATI 958950
DILATASI,
SERVIK
W-1-11-II PROSEDUR $1,828,600.00 $1,828,600.00 $5,253,805.00 APRILIA DWI 118751
KURET,
(RINGAN)
DILATASI, AZIZAH
W-4-13-I ABORTUS
INTRAUTERIN & $923,600.00 $923,600.00 $976,482.00 NIA DWI 922750
KURET,
(RINGAN)
SERVIK SUHESTI
W-1-11-I PROSEDUR
INTRAUTERIN & $1,657,100.00 $1,657,100.00 $1,931,019.00 PONIRAH 925250
(SEDANG)
DILATASI,
W-4-13-I SERVIK
ABORTUS $923,600.00 $923,600.00 $615,102.00 SITI ROKHAYATI 013651
KURET,
(SEDANG)
(RINGAN)
W-4-13-I ABORTUS
INTRAUTERIN & $923,600.00 $923,600.00 $926,692.00 MARLIAH 790750
(RINGAN)
SERVIK
O-6-13-II PERSALINAN $1,828,500.00 $1,828,500.00 $2,411,868.00 ROKHANAWATI 890250
(RINGAN)
VAGINAL
O-6-13-II PERSALINAN $2,194,200.00 $2,194,200.00 $2,586,571.00 MUNINGAH 013051
(SEDANG)
VAGINAL
O-6-13-II PERSALINAN $1,828,500.00 $1,828,500.00 $3,242,206.00 SUMIATI 988950
(SEDANG)
VAGINAL
O-6-13-II PERSALINAN $1,828,500.00 $1,828,500.00 $2,806,100.00 RUNTIK 955950
(SEDANG)
VAGINAL LARASSATI
O-6-10-I OPERASI $4,830,200.00 $4,830,200.00 $4,004,026.00 KLINEM 614550
(SEDANG)
PEMBEDAHAN
W-4-16-II GANGGUAN $2,674,300.00 $2,674,300.00 $1,873,370.00 RATMINI 314742
CAESAR
ANTEPARTUM
O-6-13-II PERSALINAN
(RINGAN) $2,194,200.00 $2,194,200.00 $3,120,079.00 CIKITA PHASA 061151
(SEDANG)
VAGINAL RUTH
W-4-16-II GANGGUAN $2,674,300.00 $2,674,300.00 $6,277,631.00 RINA 407647
(SEDANG) DAMAYANTI
ANTEPARTUM SUPRIYATIN
O-6-10-II OPERASI $7,142,800.00 $7,142,800.00 $6,745,699.00 SINTIA YANI 864750
(SEDANG)
PEMBEDAHAN
W-4-16-I GANGGUAN $1,999,800.00 $1,999,800.00 $1,803,687.00 TORSINI 014951
CAESAR
ANTEPARTUM
W-4-14-I ABORTUS
(SEDANG) $1,234,300.00 $1,234,300.00 $930,832.00 KASMIAH 839950
(RINGAN)
MENGANCAM
W-4-16-I GANGGUAN $1,999,800.00 $1,999,800.00 $809,436.00 SITI RISTATUN 029051
(RINGAN)
ANTEPARTUM BARKAH
W-4-16-I GANGGUAN $2,799,800.00 $2,799,800.00 $1,851,355.00 IKA NUR 806950
(RINGAN)
ANTEPARTUM WULANDARI
W-4-16-I GANGGUAN $2,399,800.00 $2,399,800.00 $2,486,402.00 AKHRIYANI 918234
(RINGAN)
ANTEPARTUM KELANA SARI
W-4-16-I GANGGUAN $1,999,800.00 $1,999,800.00 $694,906.00 WINARTI 793350
(RINGAN)
ANTEPARTUM
W-4-16-I GANGGUAN $1,999,800.00 $1,999,800.00 $750,126.00 AYU LESTARI 796550
(RINGAN)
ANTEPARTUM
W-4-16-I GANGGUAN $1,999,800.00 $1,999,800.00 $1,919,298.00 KUAT SEPTIANA 564837
(RINGAN)
ANTEPARTUM
O-6-10-II OPERASI $5,102,000.00 $5,102,000.00 $3,346,321.00 SUWARNI 116842
(RINGAN)
PEMBEDAHAN
O-6-10-II OPERASI $5,102,000.00 $5,102,000.00 $2,834,337.00 RATMINI 314742
CAESAR
PEMBEDAHAN
O-6-10-I OPERASI
(SEDANG) $4,830,200.00 $4,830,200.00 $3,002,948.00 SAIRAH 483648
CAESAR
PEMBEDAHAN
W-4-16-I GANGGUAN
(SEDANG) $1,999,800.00 $1,999,800.00 $2,937,971.00 WAHYU ESTI 649150
CAESAR
ANTEPARTUM SUSANTI
O-6-10-I OPERASI
(RINGAN) $5,796,300.00 $5,796,300.00 $4,239,414.00 SUMAILAH 761850
(RINGAN)
PEMBEDAHAN
CAESAR
(RINGAN)
O-6-10-I OPERASI $4,830,200.00 $4,830,200.00 $2,878,676.00 ARI AFIANA 577550
PEMBEDAHAN
O-6-10-I OPERASI $4,830,200.00 $4,830,200.00 $3,753,538.00 NIRMALA 954150
CAESAR
PEMBEDAHAN DWIYANTI
O-6-12-I PERSALINAN
(RINGAN) $1,807,500.00 $1,807,500.00 $1,878,919.00 KHATIMAH 110451
CAESAR
VAGINAL
O-6-10-I OPERASI
(RINGAN) $4,830,200.00 $4,830,200.00 $3,833,255.00 SATINAH 021251
DENGAN
PEMBEDAHAN
O-6-13-I PERSALINAN
PROSEDUR $1,544,900.00 $1,544,900.00 $3,048,120.00 YENI PUJI 982150
CAESAR
VAGINAL
SELAIN LESTARI
O-6-10-I OPERASI
(RINGAN) $4,830,200.00 $4,830,200.00 $3,265,530.00 DEWI 310543
(RINGAN)
STERILISASI &/
PEMBEDAHAN ROHMAWATI
O-6-10-I OPERASI
DILATASI $4,830,200.00 $4,830,200.00 $2,690,142.00 SITI LAMYATUN 089649
CAESAR
PEMBEDAHAN
&KURET
O-6-13-II PERSALINAN
(RINGAN) $1,828,500.00 $1,828,500.00 $2,735,283.00 SURATI 119051
CAESAR
(RINGAN)
VAGINAL
O-6-13-II PERSALINAN
(RINGAN) $1,828,500.00 $1,828,500.00 $2,761,166.00 NOVIANA 064151
(SEDANG)
VAGINAL
O-6-10-I OPERASI $4,830,200.00 $4,830,200.00 $4,260,571.00 DASINEM 060941
(SEDANG)
PEMBEDAHAN
O-6-13-II PERSALINAN $1,828,500.00 $1,828,500.00 $1,714,061.00 DITA 858850
CAESAR
VAGINAL SETYANINGRUM
W-1-11-I PROSEDUR
(RINGAN) $1,657,100.00 $1,657,100.00 $2,114,304.00 DEVI FATIMAH 320547
(SEDANG)
DILATASI,
W-1-10-I PROSEDUR $1,585,400.00 $1,585,400.00 $2,071,540.00 ENI SULASIH 649250
KURET,
ABORSI
O-6-13-II PERSALINAN
INTRAUTERIN & $1,828,500.00 $1,828,500.00 $4,106,750.00 MARLIAH 022651
(RINGAN)
VAGINAL
SERVIK
O-6-10-I OPERASI $5,796,300.00 $5,796,300.00 $4,577,561.00 NURUL 099051
(SEDANG)
(RINGAN)
PEMBEDAHAN MUFIDAH
O-6-13-II PERSALINAN $1,828,500.00 $1,828,500.00 $2,641,595.00 AAM 069150
CAESAR
VAGINAL SAMDANAH
O-6-10-I OPERASI
(RINGAN) $4,830,200.00 $4,830,200.00 $3,653,587.00 LULIANA 602150
(SEDANG)
PEMBEDAHAN
W-4-16-I GANGGUAN $1,999,800.00 $1,999,800.00 $3,949,305.00 ANI 877850
CAESAR
ANTEPARTUM
O-6-13-II PERSALINAN
(RINGAN) $1,828,500.00 $1,828,500.00 $2,566,117.00 NOFI YATINI 106851
(RINGAN)
VAGINAL
W-4-15-I PERSALINAN $2,104,300.00 $2,104,300.00 $1,728,975.00 MUSRINGAH 012851
(SEDANG)
PALSU (RINGAN) HIDAYATI
O-6-10-I OPERASI $5,796,300.00 $5,796,300.00 $5,873,965.00 YULI RUSTIANTI 788150
PEMBEDAHAN
W-4-15-I PERSALINAN $2,104,300.00 $2,104,300.00 $1,726,558.00 SEPTI MULATSIH 036444
CAESAR
PALSU (RINGAN) DUMILAH
O-6-13-I PERSALINAN
(RINGAN) $1,544,900.00 $1,544,900.00 $2,310,973.00 HENI 834050
VAGINAL TRIRAHAYU
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,542,703.00 TRIYANI 808050
(RINGAN)
VAGINAL KURNIASARI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,320,030.00 INTAN RESTI 852050
(RINGAN)
VAGINAL YUANA
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,511,516.00 AMINAH 110751
(RINGAN)
VAGINAL
O-6-10-I OPERASI $5,796,300.00 $5,796,300.00 $4,889,531.00 FAUZIZAH NUR 780250
(RINGAN)
PEMBEDAHAN UTAMI
O-6-10-I OPERASI $4,830,200.00 $4,830,200.00 $4,289,236.00 HANDESI AINUR 860450
CAESAR
PEMBEDAHAN FADILAH
O-6-10-II OPERASI
(RINGAN) $5,102,000.00 $5,102,000.00 $5,326,887.00 WINARTI 988249
CAESAR
PEMBEDAHAN
O-6-10-I OPERASI
(RINGAN) $6,762,300.00 $6,762,300.00 $5,179,372.00 ERLIANA PUTRI 515135
CAESAR
PEMBEDAHAN ENDRIANI
O-6-13-I PERSALINAN
(SEDANG) $2,162,800.00 $2,162,800.00 $2,774,729.00 IKA ASIH 860550
CAESAR
VAGINAL KUSUMA
O-6-13-I PERSALINAN
(RINGAN) $1,544,900.00 $1,544,900.00 $2,574,212.00 KUSMIYATI 826350
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,820,730.00 ZAUHAROTUN 305534
(RINGAN)
VAGINAL NAFISAH
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,716,640.00 LIA AFRIASTUTI 371733
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,875,277.00 PUPUT DINA 357948
(RINGAN)
VAGINAL WAHYU REJEKI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,304,877.00 BAWON ASTUTI 217450
(RINGAN)
VAGINAL NY
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,612,929.00 KHADMINAH 805150
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,011,665.00 SITATUN 241750
(RINGAN)
VAGINAL HIDAYATI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,314,150.00 INDRIYATI 911448
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,704,083.00 YANTI MARWATI 799050
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $1,995,018.00 SUTIYAH 799850
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,765,481.00 DESI 850250
(RINGAN)
VAGINAL SUSILOWATI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,948,315.00 YUNI 850950
(RINGAN)
VAGINAL SETIYANINGSIH
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,218,277.00 YULI ASTUTI 856550
(RINGAN)
VAGINAL
O-6-12-II PERSALINAN $2,604,900.00 $2,604,900.00 $3,887,493.00 KHUSNUL 645548
(RINGAN)
VAGINAL FITRIYAH
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,793,871.00 ALFIA PRISTI 661535
DENGAN
VAGINAL DEWI
O-6-13-I PERSALINAN
PROSEDUR $1,853,900.00 $1,853,900.00 $2,986,038.00 PRISTIA 444947
(RINGAN)
VAGINAL
SELAIN CHANDRA SAD
O-6-13-I PERSALINAN $2,162,800.00 $2,162,800.00 $2,865,159.00 ANNISAA 873350
(RINGAN)
STERILISASI &/ ZARESHA
VAGINAL
O-6-13-I PERSALINAN
DILATASI $1,544,900.00 $1,544,900.00 $2,434,409.00 FARIDA 460341
(RINGAN)&
VAGINAL
KURET
O-6-13-I PERSALINAN $2,162,800.00 $2,162,800.00 $3,449,872.00 MUAEMAH 827150
(RINGAN)
(SEDANG)
VAGINAL
(RINGAN)
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,224,894.00 TRI YULIANA 826550
VAGINAL DWI SAPUTRI
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,911,318.00 RENI 876050
(RINGAN)
VAGINAL ENDARWATI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,436,596.00 VERANITA TRI 824350
(RINGAN)
VAGINAL AGUSTINA
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,280,101.00 NUR FITRI 863550
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,607,877.00 SOFI ANITA 883750
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,371,289.00 TRI HANATI 889750
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,607,786.00 MARLINA 910450
(RINGAN)
VAGINAL SUSANTI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,334,147.00 IKA PURWANTI 824250
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,460,191.00 MELIANA 452349
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,581,991.00 RIZKA 911850
(RINGAN)
VAGINAL ANGGRAENI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,711,703.00 KARSIYEM 462549
(RINGAN)
VAGINAL
O-6-10-I OPERASI $6,762,300.00 $6,762,300.00 $8,307,630.00 YUDHITA DEWI 913050
(RINGAN)
PEMBEDAHAN RETNONINGRAT
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,375,877.00 ERLINDA 478849
CAESAR RI
VAGINAL
O-6-12-I PERSALINAN
(RINGAN) $2,168,900.00 $2,168,900.00 $3,490,844.00 RIZKI NUR 889650
(RINGAN)
VAGINAL INAYAH
O-6-10-I OPERASI $6,762,300.00 $6,762,300.00 $5,351,334.00 NGAMINAH 145142
DENGAN
PEMBEDAHAN
O-6-13-I PERSALINAN
PROSEDUR $1,853,900.00 $1,853,900.00 $3,667,487.00 SUTANTI 906450
CAESAR
VAGINAL
SELAIN
O-6-13-I PERSALINAN
(RINGAN) $1,544,900.00 $1,544,900.00 $2,529,396.00 NURHAYATI 918450
(RINGAN)
STERILISASI &/
VAGINAL
O-6-13-I PERSALINAN
DILATASI $1,853,900.00 $1,853,900.00 $2,865,141.00 THEA 893750
(RINGAN)
VAGINAL
&KURET CAHYANINGTYA
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,663,922.00 SALBIYAH 567850
(RINGAN)
(RINGAN) S CH
VAGINAL
O-6-12-I PERSALINAN $1,807,500.00 $1,807,500.00 $2,178,543.00 KHUSNUL 362150
(RINGAN)
VAGINAL KHOTIMAH
O-6-10-I OPERASI $6,762,300.00 $6,762,300.00 $10,234,903.00 FERLINA IKA 029251
DENGAN
PEMBEDAHAN YENI
O-6-13-I PERSALINAN
PROSEDUR $1,853,900.00 $1,853,900.00 $2,668,739.00 TARYATI 626451
CAESAR
VAGINAL
SELAIN
O-6-13-I PERSALINAN
(RINGAN) $1,853,900.00 $1,853,900.00 $2,543,331.00 HANIK 026251
(RINGAN)
STERILISASI &/
VAGINAL MUSYAROFAH
O-6-13-I PERSALINAN
DILATASI $1,544,900.00 $1,544,900.00 $2,647,894.00 DWI INTAN NUR 787350
(RINGAN)
VAGINAL
&KURET CHOLIFAH
O-6-10-I OPERASI $4,830,200.00 $4,830,200.00 $2,696,257.00 TAZKIA 390943
(RINGAN)
(RINGAN)
PEMBEDAHAN MIFTACHUL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,774,312.00 TRIYANI 019951
CAESAR JANNAH
VAGINAL
O-6-13-I PERSALINAN
(RINGAN) $1,544,900.00 $1,544,900.00 $1,571,409.00 YANI 016751
(RINGAN)
VAGINAL SETIYANINGSIH
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,145,561.00 PARSIAH 952350
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,294,339.00 RAHMAWATI 952950
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $3,985,154.00 ROSIANA 957850
(RINGAN)
VAGINAL PURWANTI
O-6-12-I PERSALINAN $1,807,500.00 $1,807,500.00 $2,604,330.00 HESTI 959450
(RINGAN)
VAGINAL AGUSTIANI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,860,549.00 WARTINEM 479049
DENGAN
VAGINAL
O-6-13-I PERSALINAN
PROSEDUR $1,544,900.00 $1,544,900.00 $2,152,238.00 KHONIPAH 061851
(RINGAN)
VAGINAL
SELAIN
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,266,515.00 DALYINAH 061551
(RINGAN)
STERILISASI &/
VAGINAL
O-6-13-I PERSALINAN
DILATASI $1,853,900.00 $1,853,900.00 $2,365,778.00 TIKA 369750
(RINGAN)
VAGINAL
&KURET HERMAWATI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,413,175.00 TITIN TRI 801050
(RINGAN)
(RINGAN)
VAGINAL MAELANI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,652,290.00 SALMIYAH 961549
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $1,970,843.00 NONI WIDIANTI 790050
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,161,981.00 TUGINI 791250
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,516,715.00 NOFI 791050
(RINGAN)
VAGINAL SETIYORINI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,233,395.00 TITIN TRIA 892240
(RINGAN)
VAGINAL RAHAYU
O-6-12-I PERSALINAN $1,807,500.00 $1,807,500.00 $2,067,688.00 KUSMIYATI 796650
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,327,212.00 DWI PRASTIKA 070634
DENGAN
VAGINAL
O-6-13-I PERSALINAN
PROSEDUR $1,853,900.00 $1,853,900.00 $2,352,780.00 KHANIFAH 851850
(RINGAN)
VAGINAL
SELAIN
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,602,804.00 INTAN NURUL 679348
(RINGAN)
STERILISASI &/
VAGINAL APRILIYANTI
O-6-13-I PERSALINAN
DILATASI $1,544,900.00 $1,544,900.00 $2,552,129.00 SINTA SARI 696936
(RINGAN)
VAGINAL
&KURET
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,578,992.00 MUMINAH 831250
(RINGAN)
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,423,466.00 NURI ASTUTI 834950
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,550,392.00 ERNIS SURYANI 579650
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $3,424,981.00 FITRIANI 886850
(RINGAN)
VAGINAL
(RINGAN)
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,702,400.00 HERNAWATI 914650
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,001,379.00 WALTIMAH 066435
(RINGAN)
VAGINAL
O-6-10-I OPERASI $5,796,300.00 $5,796,300.00 $4,898,497.00 GURUH SUSI 915550
(RINGAN)
PEMBEDAHAN PANGESTUTI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,865,428.00 SELI ANITA 129650
CAESAR
VAGINAL
O-6-13-I PERSALINAN
(RINGAN) $1,853,900.00 $1,853,900.00 $3,025,082.00 WIWIN SURYANI 898150
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,094,372.00 SRI WAHYUNI 895350
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,142,046.00 FITRIANTI 865950
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,241,942.00 TURWANTI 780650
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,014,631.00 SAMINI 955748
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,562,403.00 YULI TRI 901548
(RINGAN)
VAGINAL LESTARI
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,235,905.00 MUWARTI 011651
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $3,076,728.00 ROKHAYATI 011951
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,762,579.00 YUNI SUSARA 514437
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $2,162,800.00 $2,162,800.00 $3,465,627.00 MULYATI 954750
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,201,140.00 KASIH SUWARTI 112051
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,544,900.00 $1,544,900.00 $2,563,411.00 HARMINI 828750
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,676,782.00 NINING SUBEKTI 884350
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,474,768.00 MAYEM 036639
(RINGAN)
VAGINAL
O-6-12-I PERSALINAN $2,530,400.00 $2,530,400.00 $2,884,231.00 SINTIA DEWI 605045
(RINGAN)
VAGINAL
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $3,242,419.00 REZA MEILIS 819850
DENGAN
VAGINAL SETYOWATI
O-6-13-I PERSALINAN
PROSEDUR $1,853,900.00 $1,853,900.00 $2,571,661.00 DESI FITRIANA 391038
(RINGAN)
VAGINAL
SELAIN
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,846,233.00 EKA DIYANTI 796750
(RINGAN)
STERILISASI &/
VAGINAL
O-6-10-I OPERASI
DILATASI $4,830,200.00 $4,830,200.00 $2,696,846.00 SARYATI 030144
(RINGAN)
PEMBEDAHAN
&KURET
O-6-13-I PERSALINAN $1,853,900.00 $1,853,900.00 $2,614,835.00 EFI LISTYA SARI 461147
CAESAR
(RINGAN)
VAGINAL
O-6-12-I PERSALINAN
(RINGAN) $1,807,500.00 $1,807,500.00 $3,306,798.00 ERLI TRI 127935
(RINGAN)
VAGINAL YULAELY
O-6-10-I OPERASI $4,830,200.00 $4,830,200.00 $3,337,566.00 SRI ROSIFAH 012251
DENGAN
PEMBEDAHAN
W-1-11-II PROSEDUR $2,194,400.00 $2,194,400.00 $5,098,054.00 YUTI ARNI 834850
CAESAR
DILATASI,
SELAIN
W-4-17-I GANGGUAN
(RINGAN) $1,475,700.00 $1,475,700.00 $669,057.00 ERNIS SURYANI 579650
KURET,
STERILISASI
POSTPARTUM&/
O-6-13-I PERSALINAN
INTRAUTERIN
DILATASI & $1,544,900.00 $1,544,900.00 $2,400,793.00 MAINEM 018651
(RINGAN)
VAGINAL
SERVIK
&KURET
W-4-16-I GANGGUAN $1,999,800.00 $1,999,800.00 $1,144,371.00 ENDARTI 910850
(RINGAN)
(SEDANG)
(RINGAN)
ANTEPARTUM
P-8-17-II NEONATAL, BBL $5,987,500.00 $5,987,500.00 $1,956,063.00 ERLI TRI 748350
(RINGAN)
> 2499 GR YULAELY BYNY
P-8-17-I NEONATAL, BBL $3,326,400.00 $3,326,400.00 $854,255.00 KHUSNUL 745250
TANPA
> 2499 GR KHOTIMAH
P-8-17-I NEONATAL,
PROSEDUR BBL $3,991,700.00 $3,991,700.00 $1,680,142.00 YULI RUSTANTI 741550
TANPA BYNY
> 2499 GR
MAYOR BYNY
P-8-17-I NEONATAL,
PROSEDUR BBL $3,991,700.00 $3,991,700.00 $1,099,708.00 GURUH SUSI 744150
TANPA
(SEDANG)
> 2499 GR
MAYOR BYNY
P-8-17-II NEONATAL,
PROSEDUR BBL $5,987,500.00 $5,987,500.00 $1,974,155.00 ASYIVA NUR 744750
TANPA
(RINGAN)
> 2499 GR
MAYOR AZAHWA
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $980,709.00 SATINAH BYNY 747950
TANPA
(RINGAN)
> 2499 GR
MAYOR
P-8-17-I NEONATAL, BBL
PROSEDUR $3,326,400.00 $3,326,400.00 $1,091,709.00 HANDESI AINUR 745150
TANPA
(RINGAN)
> 2499 GR
MAYOR F BYNY
P-8-17-I NEONATAL,
PROSEDUR BBL $4,657,000.00 $4,657,000.00 $939,582.00 ERLIANA PUTRI 748250
TANPA
(SEDANG)
> 2499 GR
MAYOR BYNY
P-8-17-I NEONATAL,
PROSEDUR BBL $3,991,700.00 $3,991,700.00 $939,916.00 NURUL 748150
TANPA
(RINGAN)
> 2499 GR
MAYOR MUFIDAH BYNY
P-8-17-I NEONATAL,
PROSEDUR BBL $3,991,700.00 $3,991,700.00 $773,300.00 BAYI NYONYA 741350
TANPA
(RINGAN)
> 2499 GR
MAYOR SUMAILAH
P-8-17-I NEONATAL,
PROSEDUR BBL $4,657,000.00 $4,657,000.00 $1,043,309.00 MARGIYANI BY 748650
TANPA
(RINGAN)
> 2499 GR
MAYOR NY
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $849,238.00 WINARTI BY NY 748050
TANPA
(RINGAN)
> 2499 GR
MAYOR
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $1,029,942.00 RATMINI BYNY I 743750
TANPA
(RINGAN)
> 2499 GR
MAYOR
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $787,300.00 ARI AFIANA 743650
TANPA
(RINGAN)
> 2499 GR
MAYOR BYNY
P-8-17-I NEONATAL, BBL
PROSEDUR $3,991,700.00 $3,991,700.00 $820,491.00 FAUZIZAH NUR 741150
TANPA
(RINGAN)
> 2499 GR
MAYOR BYNY
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $1,808,024.00 SARYATI BY NY 743350
TANPA
(RINGAN)
> 2499 GR
MAYOR
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $590,600.00 SUWARNI BY NY 743550
TANPA
(RINGAN)
> 2499 GR
MAYOR
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $624,800.00 TAZKIA 749450
TANPA
(RINGAN)
> 2499 GR
MAYOR MIFTACHUL
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $815,800.00 NIRMALA 747550
TANPA
(RINGAN) JANAH BY NY
> 2499 GR
MAYOR DWIYANTI BY NY
P-8-13-I NEONATAL,
PROSEDUR BBL $4,989,600.00 $4,989,600.00 $768,418.00 LULIANA BYNY 745850
TANPA
(RINGAN)
2000
MAYOR- 2499 GR
PROSEDUR
TANPA
(RINGAN)
MAYOR
PROSEDUR
(RINGAN)
MAYOR
(RINGAN)
P-8-13-I NEONATAL, BBL $4,989,600.00 $4,989,600.00 $2,579,723.00 YULI ASTUTI 718150
2000 - 2499 GR BYNY
P-8-13-I NEONATAL, BBL $4,989,600.00 $4,989,600.00 $1,824,131.00 BAYI NYONYA 748850
TANPA
2000 - 2499 GR SITI LAMYATUN
P-8-13-I NEONATAL,
PROSEDUR BBL $4,989,600.00 $4,989,600.00 $2,353,361.00 SALMIYAH BYNY 718650
TANPA
2000
MAYOR - 2499 GR
P-8-13-I NEONATAL,
PROSEDUR BBL $4,989,600.00 $4,989,600.00 $1,051,302.00 RATMINI BYNY II 743850
TANPA
(RINGAN)
2000 - 2499 GR
MAYOR
P-8-13-I NEONATAL,
PROSEDUR BBL $4,989,600.00 $4,989,600.00 $3,908,069.00 QODARIYAH BY 740250
TANPA
(RINGAN)
2000
MAYOR - 2499 GR NY
P-8-13-I NEONATAL,
PROSEDUR BBL $6,985,400.00 $6,985,400.00 $1,706,453.00 SINTIA YANI 743250
TANPA
(RINGAN)
2000
MAYOR - 2499 GR BYNY
P-8-11-II NEONATAL,
PROSEDUR BBL $9,911,000.00 $9,911,000.00 $8,343,742.00 MURNI 771250
TANPA
(RINGAN)
1000
MAYOR - 1499 GR ANJARSARI, BY
P-8-08-II NEONATAL,
PROSEDUR $5,451,100.00 $5,451,100.00 $6,074,211.00 KLINEM BY NY 744850
TANPA
(RINGAN) NY
BERAT BADAN
MAYOR
P-8-08-II NEONATAL,
PROSEDUR $5,451,100.00 $5,451,100.00 $4,650,002.00 FEBI DIAN 681650
LAHIR GROUP-5
(RINGAN)
BERAT
MAYOR BADAN LESTARI BYNY
P-8-08-I NEONATAL,
DENGAN $4,609,800.00 $4,609,800.00 $1,990,283.00 DESI 714050
LAHIR GROUP-5
(SEDANG)
BERAT
SINDROMABADAN PRABAWATI
P-8-08-I NEONATAL,
DENGAN $3,841,500.00 $3,841,500.00 $1,589,269.00 CHALIMAH, BY 829650
LAHIR
DISTRESGROUP-5 BYNY
BERAT
SINDROMABADAN NY
P-8-08-I NEONATAL,
DENGAN
PERNAFASAN $3,841,500.00 $3,841,500.00 $5,573,890.00 MAUNAH BYNY 020051
LAHIR
DISTRESGROUP-5
BERAT BADAN
SINDROMA
(SEDANG)
P-8-08-I NEONATAL,
DENGAN
PERNAFASAN $3,841,500.00 $3,841,500.00 $873,234.00 DWI INTAN NUR 735550
LAHIR GROUP-5
DISTRES
BERAT
SINDROMA
(SEDANG)BADAN BY NY
P-8-08-I NEONATAL,
DENGAN
PERNAFASAN $3,841,500.00 $3,841,500.00 $1,855,524.00 VERANITA TRI A 730450
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(RINGAN)BADAN BYNY
P-8-08-II NEONATAL,
DENGAN
PERNAFASAN $5,451,100.00 $5,451,100.00 $2,824,856.00 HESTI 747650
LAHIR
DISTRESGROUP-5
BERAT BADAN
SINDROMA
(RINGAN) AGUSTIANI BY
P-8-08-II NEONATAL,
DENGAN
PERNAFASAN $6,541,300.00 $6,541,300.00 $3,191,360.00 APRILIA DANIK 742650
LAHIR
DISTRESGROUP-5 NY
BERAT
SINDROMA
(RINGAN)BADAN KIMIAWATI BYNY
P-8-08-I NEONATAL,
DENGAN
PERNAFASAN $4,609,800.00 $4,609,800.00 $978,075.00 NONI WIDIANTI 715650
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(RINGAN)BADAN BY NY
P-8-08-I NEONATAL,
DENGAN
PERNAFASAN $3,841,500.00 $3,841,500.00 $2,014,193.00 INDRIYATI BYNY 716650
LAHIR
DISTRESGROUP-5
BERAT BADAN
SINDROMA
(RINGAN)
P-8-08-I NEONATAL,
DENGAN
PERNAFASAN $3,841,500.00 $3,841,500.00 $2,871,776.00 YANTI MARWATI 716750
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(SEDANG)BADAN BYNY
P-8-08-II NEONATAL,
DENGAN
PERNAFASAN $7,631,500.00 $7,631,500.00 $3,420,057.00 EMIER KHALIF 917750
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(SEDANG)BADAN
P-8-08-II NEONATAL,
DENGAN
PERNAFASAN $5,451,100.00 $5,451,100.00 $3,647,743.00 KARTIKA BYNY 983250
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(RINGAN)BADAN
P-8-08-I NEONATAL,
DENGAN
PERNAFASAN $3,841,500.00 $3,841,500.00 $2,686,070.00 VERONIKA 745050
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(RINGAN)BADAN MYKAILLA
P-8-08-II NEONATAL,
DENGAN
PERNAFASAN $5,451,100.00 $5,451,100.00 $3,008,015.00 TURWANTI BY 734950
LAHIR GROUP-5
DISTRES TAMZANI
BERAT
SINDROMA
(RINGAN)BADAN NY
P-8-08-II NEONATAL,
DENGAN
PERNAFASAN $6,541,300.00 $6,541,300.00 $2,732,578.00 HANIK M BY NY 734850
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(SEDANG)BADAN
P-8-08-I NEONATAL,
DENGAN
PERNAFASAN $4,609,800.00 $4,609,800.00 $2,730,524.00 TARYATI BY NY 735150
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(SEDANG)BADAN
P-8-08-II NEONATAL,
DENGAN
PERNAFASAN $5,451,100.00 $5,451,100.00 $2,903,693.00 MUWARTI BY NY 735650
LAHIR GROUP-5
DISTRES
BERAT
SINDROMA
(RINGAN)BADAN
P-8-08-II NEONATAL,
DENGAN
PERNAFASAN $6,541,300.00 $6,541,300.00 $1,979,652.00 ZAUHAROTUN 716850
LAHIR
DISTRESGROUP-5
BERAT
SINDROMA
(SEDANG)BADAN BY NY
P-8-12-II NEONATAL,
DENGAN
PERNAFASAN BBL $8,259,200.00 $8,259,200.00 $5,348,266.00 SAIRAH BY NY 749350
LAHIR
DISTRESGROUP-5
1500 - 1999 GR
SINDROMA
(SEDANG)
P-8-16-I NEONATAL,
DENGAN
PERNAFASAN BBL $1,786,900.00 $1,786,900.00 $1,968,016.00 HARYANTI 713650
TANPA
DISTRES
> 2499 GR
SINDROMA
(RINGAN) PANCA BYNY
P-8-16-I NEONATAL,
PROSEDUR
PERNAFASAN BBL $2,144,200.00 $2,144,200.00 $1,939,185.00 LIA AFRI 715050
DENGAN
DISTRES
> 2499 GR
MAYOR
(SEDANG) ASTUTI BY NY
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
PERNAFASAN $1,786,900.00 $1,786,900.00 $1,138,044.00 SRI ROSIFAH 748450
DENGAN
(SEDANG)
> 2499 GR
FEKSI
(SEDANG) BYNY
P-8-16-I NEONATAL, BBL
KONGENITAL/IN $1,786,900.00 $1,786,900.00 $1,539,535.00 AMINAH BY NY 738550
DENGAN
PERINATAL
> 2499 GR
FEKSI
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $1,786,900.00 $1,786,900.00 $2,324,929.00 DWI YANTI BYNY 713450
DENGAN
PERINATAL
> 2499 GR
FEKSI
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $1,786,900.00 $1,786,900.00 $2,293,463.00 KUSMIAYTI BYNY 741950
DENGAN
PERINATAL
> 2499 GR
FEKSI
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $2,144,200.00 $2,144,200.00 $1,318,471.00 METI 802050
DENGAN
PERINATAL
> 2499 GR
FEKSI PURWANTY, BY
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $2,144,200.00 $2,144,200.00 $2,101,047.00 RENI BY NY 718450
DENGAN
PERINATAL NY
> 2499 GR
FEKSI
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $2,144,200.00 $2,144,200.00 $1,220,350.00 RIZKI NUR 731550
DENGAN
PERINATAL
> 2499 GR
FEKSI INAYAH BY NY
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $1,786,900.00 $1,786,900.00 $914,984.00 ELZA 735750
DENGAN
PERINATAL
> 2499 GR
FEKSI RAHMASARI BY
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $2,501,600.00 $2,501,600.00 $1,738,965.00 SINTIA DEWI BY 747750
DENGAN
PERINATAL NY
> 2499 GR
FEKSI NY
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $1,786,900.00 $1,786,900.00 $1,700,829.00 AAM 739250
DENGAN
PERINATAL
> 2499 GR
FEKSI SAMDANAH BY
P-8-16-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $1,786,900.00 $1,786,900.00 $1,766,935.00 BAYI NYONYA 714350
DENGAN
PERINATAL NY
> 2499 GR
FEKSI TITIN TRI
P-8-11-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $8,016,100.00 $8,016,100.00 $7,845,748.00 TRIANI 741650
DENGAN
PERINATAL MAELANI
1000
FEKSI - 1499 GR KURNIASARI BY
P-8-13-I NEONATAL, BBL
KONGENITAL/IN
(RINGAN) $4,989,600.00 $4,989,600.00 $2,428,490.00 IKA PURWANTI 714650
TANPA
PERINATAL NY
2000
FEKSI - 2499 GR BY NY
P-8-13-I NEONATAL,
(RINGAN) BBL
PROSEDUR $4,989,600.00 $4,989,600.00 $4,231,168.00 PARSIAH BY NY 736450
TANPA
PERINATAL
2000
MAYOR - 2499 GR
P-8-13-II NEONATAL,
PROSEDUR
(RINGAN) BBL $7,783,800.00 $7,783,800.00 $4,243,438.00 BAYI NYONYA 707150
TANPA
(RINGAN)
2000
MAYOR - 2499 GR ARUM
B-4-13-I GANGGUAN
PROSEDUR $3,122,100.00 $3,122,100.00 $947,600.00 BAYI NYONYA 707150
TANPA
(RINGAN) WIDIASTUTI
HATI LAIN-LAIN
MAYOR ARUM
P-8-12-I NEONATAL,
PROSEDUR BBL $5,808,700.00 $5,808,700.00 $2,647,149.00 AROFAH, BY NY 890950
(RINGAN) WIDIASTUTI
1500
MAYOR - 1999 GR 2
P-8-12-I NEONATAL, BBL $5,808,700.00 $5,808,700.00 $2,661,418.00 AROFAH, BY NY 890850
TANPA
(SEDANG)
1500 - 1999 GR 1
B-4-13-I GANGGUAN
PROSEDUR $3,122,100.00 $3,122,100.00 $802,158.00 VIKI RAMDANI 911450
TANPA
HATI
MAYORLAIN-LAIN
P-8-13-I NEONATAL,
PROSEDUR BBL $4,989,600.00 $4,989,600.00 $930,578.00 ENDARTI BYNY 910950
(RINGAN)
2000 - 2499 GR
MAYOR
TANPA
(RINGAN)
PROSEDUR
MAYOR
(RINGAN)
P-8-17-I NEONATAL, BBL $3,326,400.00 $3,326,400.00 $718,623.00 RUMIYATI BY NY 926450
> 2499 GR
P-8-17-I NEONATAL, BBL $3,326,400.00 $3,326,400.00 $700,600.00 ERNIS S BY NY 730150
TANPA
> 2499 GR
B-4-13-I GANGGUAN
PROSEDUR $3,746,500.00 $3,746,500.00 $855,548.00 GURUH SUSI 744150
TANPA
HATI
MAYORLAIN-LAIN BYNY
B-4-13-I GANGGUAN
PROSEDUR $3,122,100.00 $3,122,100.00 $776,405.00 MUTIARA 732250
(RINGAN)
HATI LAIN-LAIN
MAYOR ZAFIRAH
P-8-17-I NEONATAL, BBL $3,326,400.00 $3,326,400.00 $714,334.00 WINARTI BY NY 748050
(RINGAN) MUAZARAH
> 2499 GR
B-4-13-I GANGGUAN $3,746,500.00 $3,746,500.00 $804,600.00 ESTRIANI DEWI 740050
TANPA
HATI LAIN-LAIN BYNY
B-4-13-I GANGGUAN
PROSEDUR $3,122,100.00 $3,122,100.00 $685,600.00 ILHAM HABIBI 707950
(RINGAN)
HATI
MAYORLAIN-LAIN MUNIR
P-8-17-I NEONATAL, BBL $3,326,400.00 $3,326,400.00 $2,480,983.00 INTAN RESTI 717350
(RINGAN)
> 2499 GR YUANA BY NY
B-4-13-I GANGGUAN $3,122,100.00 $3,122,100.00 $1,133,400.00 INDRIYATI BYNY 716650
TANPA
HATI LAIN-LAIN
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $836,993.00 ARI AFIANA 743650
(RINGAN)
> 2499 GR
MAYOR BYNY
P-8-17-I NEONATAL, BBL $3,991,700.00 $3,991,700.00 $852,600.00 BAYI NYONYA 962950
TANPA
(RINGAN)
> 2499 GR AHTAMALA
P-8-13-I NEONATAL,
PROSEDUR BBL $4,989,600.00 $4,989,600.00 $843,180.00 RATMINI BYNY II 743850
TANPA ROSYDA
2000
MAYOR - 2499 GR
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $842,639.00 RATMINI BYNY I 743750
TANPA
(RINGAN)
> 2499 GR
MAYOR
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $1,131,501.00 PRILIYANINGSIH 016051
TANPA
(RINGAN)
> 2499 GR
MAYOR BYNY
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $1,169,770.00 SRI REJEKI I 740350
TANPA
(RINGAN)
> 2499 GR
MAYOR BYNY
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $779,600.00 UMI 740750
TANPA
(RINGAN)
> 2499 GR
MAYOR MAHMUDAH BY
B-4-13-I GANGGUAN
PROSEDUR $3,122,100.00 $3,122,100.00 $689,724.00 FIQRI ANUR 904750
TANPA
(RINGAN) NY
HATI
MAYORLAIN-LAIN RAMADAN
B-4-13-I GANGGUAN
PROSEDUR $3,746,500.00 $3,746,500.00 $1,149,647.00 MAHAJATI 906250
(RINGAN)
HATI LAIN-LAIN
MAYOR RAMADHAN
B-4-13-I GANGGUAN $3,746,500.00 $3,746,500.00 $1,970,937.00 FITRIANI BY NY 730750
(RINGAN)
HATI LAIN-LAIN
B-4-13-I GANGGUAN $3,746,500.00 $3,746,500.00 $642,600.00 WARDHANA 731350
(RINGAN)
HATI LAIN-LAIN HANUNG
P-8-17-I NEONATAL, BBL $3,326,400.00 $3,326,400.00 $876,714.00 KHUSNUL 745250
(RINGAN) CANDRAKUMAR
> 2499 GR KHOTIMAH
B-4-13-I GANGGUAN $3,746,500.00 $3,746,500.00 $783,095.00 WIWIN
A SURYANI 732750
TANPA BYNY
HATI LAIN-LAIN BYNY
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $825,910.00 ELZA 735750
(RINGAN)
> 2499 GR
MAYOR RAHMASARI BY
P-8-17-I NEONATAL, BBL $3,326,400.00 $3,326,400.00 $875,410.00 TAZKIA 749450
TANPA
(RINGAN) NY
> 2499 GR MIFTACHUL
P-8-17-I NEONATAL,
PROSEDUR BBL $3,326,400.00 $3,326,400.00 $629,614.00 IRMA YAGIYA S 804050
TANPA JANAH BY NY
> 2499 GR
MAYOR BYNY
I-4-18-III PENYAKIT
PROSEDUR $6,228,500.00 $6,228,500.00 $2,383,252.00 APRILIA 915150
TANPA
(RINGAN)
JANTUNG
MAYOR
I-4-19-I GANGGUAN
PROSEDUR $3,488,500.00 $3,488,500.00 $2,185,214.00 ASMA FADIYA 102842
KONGENITAL
(RINGAN)
KONDUKSI
MAYOR &
L-1-40-I PROSEDUR
DAN KATUP $3,696,900.00 $3,696,900.00 $2,390,534.00 KISWAN 164351
ARITMIA
(RINGAN)
PADA KULIT,
JANTUNG
L-1-40-I PROSEDUR
JANTUNG $3,696,900.00 $3,696,900.00 $2,439,686.00 MANISTI TULUS 847150
JA(RINGAN)
(BERAT)
PADA KULIT,
(RINGAN) RAHAYU
L-1-40-I PROSEDUR
BAWAH KULIT $3,696,900.00 $3,696,900.00 $1,985,478.00 RIA SAFITRIANA 005451
JA(RINGAN)
PADA
DAN KULIT,
PAYUDARA
M-1-80-I PROSEDUR
BAWAH KULIT $6,246,500.00 $6,246,500.00 $2,856,889.00 MURJIANTO 089951
JA(RINGAN)
(RINGAN)
ANGGOTA
DAN PAYUDARA MARWAN
J-4-21-I GEJALA,
BAWAH TANDA
KULIT $2,661,000.00 $2,661,000.00 $1,240,292.00 RASWANTO 415450
TUBUH
(RINGAN)ATAS
DAN DIAGNOSIS
PAYUDARA
J-4-21-I GEJALA,
(RINGAN)TANDA $2,661,000.00 $2,661,000.00 $1,230,686.00 SRI RAHAYU 456037
SISTEM
(RINGAN)
DAN DIAGNOSIS
J-4-21-I GEJALA, TANDA
PERNAFASAN $2,661,000.00 $2,661,000.00 $1,876,760.00 ADEM 953950
SISTEM
DAN DIAGNOSIS
LAIN-LAIN
K-4-17-I NYERI
PERNAFASAN $1,968,700.00 $1,968,700.00 $2,264,291.00 FALSYA 172946
SISTEM
(RINGAN)
ABDOMEN
LAIN-LAIN & ALMAIRA
K-4-17-I NYERI
PERNAFASAN $1,406,200.00 $1,406,200.00 $1,877,239.00 SITI AMINAH 103934
GASTROENTERI
(RINGAN) DIANDRA S.
ABDOMEN
LAIN-LAIN &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,443,428.00 MUBASIR 104949
GASTROENTERI
(RINGAN)
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,895,596.00 SUPRIYANTI 936248
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $2,283,158.00 SLAMET 806050
GASTROENTERI
ABDOMEN
(RINGAN) & ROCHAMAD
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $3,822,392.00 SUGIHARTO 363837
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $2,005,241.00 SUIMAH 985850
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $1,514,057.00 ASKANA KAYSA 373648
GASTROENTERI
ABDOMEN
(RINGAN) & ULYA
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,318,210.00 LUTHFIA 171751
GASTROENTERI
ABDOMEN
(RINGAN) & DZUROTUN
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $1,342,053.00 HANA 604133
GASTROENTERI NADZIFAH
ABDOMEN
(RINGAN) & HIKMAYANI
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $1,379,954.00 HAFIZ WAHYU 988750
GASTROENTERI
ABDOMEN
(RINGAN) & SAPUTRA
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $2,181,471.00 JULIAN ATHFAL 745543
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,687,500.00 $1,687,500.00 $2,487,912.00 REYNANDA 361042
GASTROENTERI
ABDOMEN
(RINGAN) & PUTRI WIBOWO
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $872,116.00 SADIR AL 683842
GASTROENTERI
ABDOMEN
(RINGAN) & SARYONO TN.
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,432,772.00 SUWANTI, NY 262533
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $981,845.00 TITI PUJI ASTUTI 789749
GASTROENTERI
ABDOMEN
(RINGAN) &
TIS LAIN-LAIN
GASTROENTERI
(RINGAN)
TIS LAIN-LAIN
(RINGAN)
K-4-17-I NYERI $1,406,200.00 $1,406,200.00 $1,160,812.00 MINEM 168847
ABDOMEN &
K-4-17-I NYERI $1,968,700.00 $1,968,700.00 $1,686,216.00 LILIH SUTAMI NY 790950
GASTROENTERI
ABDOMEN &
K-4-17-I NYERI
TIS LAIN-LAIN $1,968,700.00 $1,968,700.00 $2,793,252.00 SUBANDI 459543
GASTROENTERI
ABDOMEN
(RINGAN) &
K-4-17-I NYERI
TIS LAIN-LAIN $1,406,200.00 $1,406,200.00 $1,461,030.00 SITI AMANAH 115251
GASTROENTERI
ABDOMEN
(RINGAN) &
B-4-13-I GANGGUAN
TIS LAIN-LAIN $3,122,100.00 $3,122,100.00 $3,563,312.00 SUWARJO 843450
GASTROENTERI
HATI LAIN-LAIN
(RINGAN)
J-1-20-I PROSEDUR
TIS LAIN-LAIN $9,217,400.00 $9,217,400.00 $2,903,283.00 ERNIA WALIYATI 235048
(RINGAN)
SISTEM
(RINGAN)
J-1-20-I PROSEDUR $12,904,400.00 $12,904,400.00 $3,784,976.00 UNTUNG 135947
PERNAFASAN
SISTEM SANTOSO
G-4-21-I KOMA &
NON-KOMPLEKS $1,999,100.00 $1,999,100.00 $2,572,840.00 WATINI 114951
PERNAFASAN
STUPOR
(RINGAN) NON
U-4-11-I DYSEQUILIBRIU
NON-KOMPLEKS $1,574,000.00 $1,574,000.00 $3,649,943.00 MARYATI 368934
TRAUMA
M (RINGAN)
(RINGAN) SUPARDI
U-4-11-I DYSEQUILIBRIU
(RINGAN) $1,311,700.00 $1,311,700.00 $1,726,497.00 SAWIKEM 978438
M (RINGAN)
U-4-11-I DYSEQUILIBRIU $1,311,700.00 $1,311,700.00 $1,083,733.00 MAIJAH 809050
M (RINGAN)
U-4-11-I DYSEQUILIBRIU $1,311,700.00 $1,311,700.00 $1,394,816.00 MARTINI 851950
M (RINGAN)
U-4-11-I DYSEQUILIBRIU $1,311,700.00 $1,311,700.00 $1,703,754.00 NURHAYATI 878350
M (RINGAN) SAMSUL BAHARI
U-4-11-I DYSEQUILIBRIU $1,574,000.00 $1,574,000.00 $1,063,695.00 RASIYEM 152348
M (RINGAN)
U-4-11-I DYSEQUILIBRIU $1,574,000.00 $1,574,000.00 $1,813,715.00 Retno Panetep 806433
M (RINGAN)
U-4-11-I DYSEQUILIBRIU $1,311,700.00 $1,311,700.00 $2,367,615.00 YUTINAH 450649
M (RINGAN)
U-4-11-I DYSEQUILIBRIU $1,311,700.00 $1,311,700.00 $962,384.00 NANGIMAH 254434
M (RINGAN)
U-4-11-I DYSEQUILIBRIU $1,574,000.00 $1,574,000.00 $1,481,489.00 HARMADI 872248
M (RINGAN)
U-4-11-I DYSEQUILIBRIU $1,836,400.00 $1,836,400.00 $3,331,745.00 FARHAH FATHUL 068943
M (RINGAN) HASANAH
U-4-11-I DYSEQUILIBRIU $1,574,000.00 $1,574,000.00 $1,917,171.00 SUKARNI NY 953050
M (RINGAN)
G-4-22-I SERANGAN $2,525,300.00 $2,525,300.00 $1,791,520.00 ZAMEER RAFKA 714747
KEJANG ABIMANYU
G-4-22-I SERANGAN $3,030,400.00 $3,030,400.00 $1,907,288.00 ZIDNA 894050
(RINGAN)
KEJANG TAMASUKI
G-4-22-I SERANGAN $3,535,500.00 $3,535,500.00 $2,680,843.00 ELVARETTA 715842
(RINGAN) BILLAH
KEJANG ALEENA
I-4-14-II CARDIAC $2,560,200.00 $2,560,200.00 $4,873,301.00 KARTONO 880450
(RINGAN) MAHESWARI
ARREST, TIDAK
I-4-14-II CARDIAC $2,560,200.00 $2,560,200.00 $4,557,274.00 KUSNGEDI 521744
DIKETAHUI
ARREST, TIDAK PONIDI
I-4-14-I CARDIAC
(SEDANG) $2,475,100.00 $2,475,100.00 $5,037,783.00 SUPRIYONO 897534
DIKETAHUI
ARREST, TIDAK
D-1-20-I PROSEDUR
(SEDANG) $3,834,800.00 $3,834,800.00 $3,026,039.00 LAELI NUR 084146
DIKETAHUI
PADA DARAH FADHILAH
D-1-20-I PROSEDUR
(RINGAN) $3,834,800.00 $3,834,800.00 $2,252,504.00 SUMIYATI 100951
DAN ORGAN
PADA DARAH
E-4-10-I PENYAKIT
PEMBENTUK $3,996,700.00 $3,996,700.00 $6,981,168.00 MARSIJAM 837150
DAN ORGAN
KENCING
DARAH MANIS
LAIN-
E-4-10-I PENYAKIT
PEMBENTUK $3,330,600.00 $3,330,600.00 $1,224,013.00 MUNARDI 895550
& GANGGUAN
LAIN (RINGAN)
KENCING
DARAH MANIS
LAIN- SANEM
E-4-10-I PENYAKIT
NUTRISI/ $4,662,800.00 $4,662,800.00 $8,278,500.00 SOEHERI 472836
& GANGGUAN
LAIN (RINGAN)
KENCING
METABOLIK MANIS
E-4-10-I PENYAKIT
NUTRISI/ $3,330,600.00 $3,330,600.00 $2,698,631.00 JEMINTEN 115749
& GANGGUAN
(RINGAN)
KENCING
METABOLIK MANIS
E-4-10-I PENYAKIT
NUTRISI/ $3,330,600.00 $3,330,600.00 $1,860,487.00 SURIP 445246
& GANGGUAN
(RINGAN)
KENCING
METABOLIK MANIS
E-4-10-I PENYAKIT
NUTRISI/ $3,330,600.00 $3,330,600.00 $1,401,738.00 SURYATI 859550
& GANGGUAN
(RINGAN)
KENCING
METABOLIK MANIS
E-4-10-I PENYAKIT
NUTRISI/ $3,330,600.00 $3,330,600.00 $1,809,940.00 SUPARTO 744641
& GANGGUAN
(RINGAN)
KENCING
METABOLIK MANIS
G-4-25-I GEGAR
NUTRISI/OTAK $1,873,000.00 $1,873,000.00 $2,004,250.00 SUWARSIH 687650
& GANGGUAN
(RINGAN)
(RINGAN)
METABOLIK
G-4-25-I GEGAR
NUTRISI/OTAK $1,873,000.00 $1,873,000.00 $3,136,385.00 ABDUL NGALIM 852650
(RINGAN)
(RINGAN) MUDIN
G-4-25-I METABOLIK
GEGAR OTAK $2,247,600.00 $2,247,600.00 $1,705,420.00 ATHIFA 854350
(RINGAN)
(RINGAN) KAMANIA
G-4-25-I GEGAR OTAK $2,247,600.00 $2,247,600.00 $1,055,613.00 KENZIE 897350
(RINGAN) DANESHA
L-1-40-I PROSEDUR $3,696,900.00 $3,696,900.00 $3,122,418.00 ABU SAMAH 028751
PUTRA
PADA KULIT,
G-4-25-I GEGAR OTAK $1,873,000.00 $1,873,000.00 $1,362,868.00 MISTEM AMAD 802350
JA(RINGAN)
(RINGAN) DISLAM
G-4-25-I GEGAR OTAK
BAWAH KULIT $2,247,600.00 $2,247,600.00 $3,784,669.00 TRI KASIH 417433
(RINGAN)
DAN PAYUDARA
G-4-25-I GEGAR OTAK $1,873,000.00 $1,873,000.00 $2,332,830.00 SUPARMAN 210649
(RINGAN)
(RINGAN) CIPTO RAHARJO
G-4-25-I GEGAR OTAK $1,873,000.00 $1,873,000.00 $1,208,124.00 HEDI 020551
(RINGAN) HENDRIYONO
G-4-25-I GEGAR OTAK $1,873,000.00 $1,873,000.00 $1,044,358.00 ALDI 951550
(RINGAN)
J-4-13-I TRAUMA DADA $2,973,400.00 $2,973,400.00 $1,253,770.00 SUPARNO 919150
(RINGAN)
M-4-12-I FRAKTUR/DISLO $2,188,700.00 $2,188,700.00 $2,147,551.00 HAFIZ AL 753833
KASI SELAIN FURQON
M-4-12-I FRAKTUR/DISLO $2,188,700.00 $2,188,700.00 $2,131,658.00 MISLIYAH 547241
FEMUR DAN
KASI SELAIN
M-4-12-I FRAKTUR/DISLO
PELVIS $2,188,700.00 $2,188,700.00 $2,733,725.00 MUHAMMAD 955050
FEMUR DAN
KASI SELAIN
(RINGAN) HASBI
M-4-12-I FRAKTUR/DISLO
PELVIS $2,188,700.00 $2,188,700.00 $2,551,042.00 RUMINI 909350
FEMUR DAN MAULANA ZAIN
KASI SELAIN
(RINGAN)
PELVIS
FEMUR DAN
(RINGAN)
PELVIS
(RINGAN)
M-4-12-I FRAKTUR/DISLO $2,626,400.00 $2,626,400.00 $3,461,150.00 SARIMAN 289447
KASI SELAIN
L-4-13-I TRAUMA PADA $2,266,600.00 $2,266,600.00 $1,648,260.00 TONY SUGIARTO 893350
FEMUR DAN
KULIT,
M-4-12-I FRAKTUR/DISLO
PELVIS $2,188,700.00 $2,188,700.00 $2,207,088.00 TUKIMIN 111351
JARINGAN
KASI
(RINGAN) SELAIN
M-1-80-I PROSEDUR
BAWAH KULIT $6,246,500.00 $6,246,500.00 $2,696,103.00 SUNARJO RADI 958450
FEMUR DAN
ANGGOTA
DAN PAYUDARA
M-4-12-I FRAKTUR/DISLO
PELVIS $2,188,700.00 $2,188,700.00 $2,248,978.00 MOHAMAD 024651
TUBUH
(RINGAN) ATAS
KASI
(RINGAN) SELAIN SAMSUL HUDA
M-4-20-I TANDA,
(RINGAN) GEJALA $2,177,400.00 $2,177,400.00 $2,364,481.00 ROSIDI 419047
FEMUR DAN
& PERADANGAN
L-1-40-I PROSEDUR
PELVIS $3,696,900.00 $3,696,900.00 $2,906,123.00 TAMA FAJAR TRI 934550
MUSKULOSKELE
PADA
(RINGAN) KULIT, ADINA
S-4-16-I LUKA
TAL (RINGAN) BAKAR $3,833,600.00 $3,833,600.00 $895,210.00 HANDOKO 490150
JA(RINGAN)
(RINGAN)
S-4-11-I ALERGI
BAWAH DAN KULIT $2,185,500.00 $2,185,500.00 $1,972,538.00 SALAMAH 424944
SYOK
DAN PAYUDARA
J-4-15-I PERADANGAN $3,999,700.00 $3,999,700.00 $1,497,793.00 MANUN 838448
ANAFILAKTIK
(RINGAN)
DAN INFEKSI
J-4-15-I PERADANGAN
(RINGAN) $3,999,700.00 $3,999,700.00 $1,611,215.00 SUTINI 265037
PERNAFASAN
DAN INFEKSI
Z-4-12-I FAKTOR-FAKTOR
(RINGAN) $1,632,700.00 $1,632,700.00 $1,381,948.00 SUGIONO 858350
PERNAFASAN
YANG
Z-4-12-I FAKTOR-FAKTOR
(RINGAN) $1,632,700.00 $1,632,700.00 $2,315,249.00 KARMINI 982950
MEMPENGARUH
YANG
Z-4-12-I FAKTOR-FAKTOR
I STATUS $1,166,200.00 $1,166,200.00 $1,150,202.00 SUNARTO 014751
MEMPENGARUH
YANG
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
I STATUS $1,166,200.00 $1,166,200.00 $837,631.00 MARWONO 117851
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN SARNO
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN) STATUS $1,166,200.00 $1,166,200.00 $1,044,967.00 LAYEM 641533
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN) STATUS $1,166,200.00 $1,166,200.00 $1,114,773.00 SUTRISNO 876550
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN) STATUS $1,166,200.00 $1,166,200.00 $1,383,649.00 NEHAD HARDI 652634
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN) STATUS $1,166,200.00 $1,166,200.00 $660,342.00 KHUSNUL 961550
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN MUAMANAH
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN) STATUS $1,632,700.00 $1,632,700.00 $1,420,478.00 SUGIJONO 847443
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN)STATUS $1,166,200.00 $1,166,200.00 $851,924.00 TITIN 919250
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN MULDIYANTI
M-1-40-I EKSISI
I(RINGAN)
STATUSLOKAL $3,845,600.00 $3,845,600.00 $3,536,948.00 SITI NURAINI 920849
MEMPENGARUH
LAIN-LAIN
DAN
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN)
STATUS $1,632,700.00 $1,632,700.00 $1,438,612.00 ANIA SUNARTI 667848
PENGANGKATAN
LAIN-LAIN
YANG
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
ALAT
(RINGAN) FIKSASI $1,166,200.00 $1,166,200.00 $671,910.00 SATIEM 029351
MEMPENGARUH
LAIN-LAIN
YANG
INTERNAL
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN)
STATUS $1,399,400.00 $1,399,400.00 $1,114,422.00 MISNAH 517440
MEMPENGARUH
(RINGAN)
YANG
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
I STATUS $1,166,200.00 $1,166,200.00 $1,103,696.00 SUTILAH 987850
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN)
STATUS $1,166,200.00 $1,166,200.00 $2,442,370.00 WASMIN 883850
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN MINARIS
Z-4-12-I FAKTOR-FAKTOR
I(RINGAN)
STATUS $1,166,200.00 $1,166,200.00 $960,556.00 MARIKEM 004151
MEMPENGARUH
LAIN-LAIN
YANG
KESEHATAN
I(RINGAN)
STATUS
MEMPENGARUH
LAIN-LAIN
KESEHATAN
I(RINGAN)
STATUS
LAIN-LAIN
KESEHATAN
(RINGAN)
LAIN-LAIN
(RINGAN)
DPJP SEP NOKARTU SD_STATUS SD_VALUE
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009739 000275648111 SURPLUS $286,765.00
8
DR THOMAS EFENDI, SP.PD 1115R0010519V009469 000008342852 DEFISIT ($2,385,285.00)
5
DR THOMAS EFENDI, SP.PD 1115R0010619V000672 000008303565 DEFISIT ($602,008.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010619V003975 000008302753 DEFISIT ($3,658,653.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010619V006392 000008334955 DEFISIT ($714,333.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010619V007252 000053566522 SURPLUS $457,515.00
7
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V001389 000208401455 DEFISIT ($126,023.00)
2
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V001473 000020929463 DEFISIT ($249,324.00)
8
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000950 000230887762 DEFISIT ($631,009.00)
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002716 000008326089 DEFISIT ($1,480,997.00)
9
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002723 000127021786 DEFISIT ($162,239.00)
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005295 000053577584 DEFISIT ($338,164.00)
8
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005322 000008320449 DEFISIT ($1,093,107.00)
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005550 000008329422 DEFISIT ($10,122.00)
3
DR LENY ZABIDI, SP.A 1115R0010619V001255 000249911828 DEFISIT ($354,195.00)
8
DR LENY ZABIDI, SP.A 1115R0010619V006787 000273844354 SURPLUS $717,740.00
4
DR THOMAS EFENDI, SP.PD 1115R0010619V002736 000008306961 SURPLUS $256,273.00
6
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000781 000008333488 SURPLUS $355,520.00
1
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000649 000200893411 SURPLUS $369,764.00
1
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000704 000112475609 SURPLUS $773,427.00
8
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000880 000008339202 DEFISIT ($1,695,935.00)
9
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V004405 000053632173 DEFISIT ($123,196.00)
3
DR LENY ZABIDI, SP.A 1115R0010619V005551 000241938282 SURPLUS $85,631.00
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001000 000237932346 DEFISIT ($947,447.00)
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V003356 000235885354 DEFISIT ($89,762.00)
7
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V004924 000249679990 DEFISIT ($931,363.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010519V009449 000008313988 DEFISIT ($866,252.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010519V009865 000226171669 SURPLUS $63,091.00
4
DR THOMAS EFENDI, SP.PD 1115R0010619V000755 000008304016 DEFISIT ($843,343.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010619V000801 000227104065 DEFISIT ($459,517.00)
9
DR THOMAS EFENDI, SP.PD 1115R0010619V000983 000202448823 SURPLUS $15,123.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V002268 000008302948 DEFISIT ($172,036.00)
7
DR THOMAS EFENDI, SP.PD 1115R0010619V002271 000197067953 DEFISIT ($310,665.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010619V004001 000053694625 SURPLUS $7,468.00
4
DR THOMAS EFENDI, SP.PD 1115R0010619V006390 000181693486 DEFISIT ($545,788.00)
1
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V000812 000053536130 SURPLUS $100,239.00
8
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V001373 000228248066 SURPLUS $46,596.00
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000850 000053813713 SURPLUS $376,087.00
4
DR THOMAS EFENDI, SP.PD 1115R0010619V001364 000008325301 DEFISIT ($1,625,913.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010619V001930 000053602181 SURPLUS $343,106.00
8
DR THOMAS EFENDI, SP.PD 1115R0010619V004550 000008335762 SURPLUS $3,655.00
7
DR THOMAS EFENDI, SP.PD 1115R0010619V004553 000127174028 DEFISIT ($598,300.00)
5
DR THOMAS EFENDI, SP.PD 1115R0010619V007263 000259280161 SURPLUS $262,259.00
7
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V009874 000275668243 SURPLUS $1,530,326.00
7
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000084 000261597218 DEFISIT ($4,044,068.00)
5
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V002276 000053709384 SURPLUS $1,177,424.00
3
dr GEDE PERDANA PUTERA, Sp. PD 1115R0010619V005864 000053547367 DEFISIT ($1,720,843.00)
4
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V001379 000276864238 DEFISIT ($3,477,694.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010619V001927 000053695940 DEFISIT ($4,072,350.00)
5
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V007732 000245009375 SURPLUS $512,219.00
8
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V000093 000234883122 DEFISIT ($272,804.00)
6
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V000754 000246193993 DEFISIT ($1,307,765.00)
1
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V002650 000138810506 SURPLUS $650,620.00
5
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000445 000274324534 SURPLUS $19,403.00
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000702 000063765686 DEFISIT ($471,330.00)
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V001262 000164968423 DEFISIT ($1,445,231.00)
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002733 000138530993 DEFISIT ($979,450.00)
5
dr GEDE PERDANA PUTERA, Sp. PD 1115R0010619V005319 000101774695 DEFISIT ($1,821,344.00)
4
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V007728 000053551350 SURPLUS $394,384.00
9
DR LENY ZABIDI, SP.A 1115R0010619V000666 000118384078 DEFISIT ($549,313.00)
4
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009748 000131235715 DEFISIT ($1,071,785.00)
1
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009818 000227727596 DEFISIT ($1,241,608.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010519V008982 000108457187 DEFISIT ($3,280,217.00)
5
DR THOMAS EFENDI, SP.PD 1115R0010519V009452 000053563008 DEFISIT ($1,084,521.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010519V009479 000240042345 SURPLUS $97,316.00
6
DR THOMAS EFENDI, SP.PD 1115R0010519V009856 000112476642 DEFISIT ($473,316.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010619V000037 000008307360 DEFISIT ($603,547.00)
9
DR THOMAS EFENDI, SP.PD 1115R0010619V000097 000053546304 SURPLUS $406,543.00
3
DR THOMAS EFENDI, SP.PD 1115R0010619V000945 000008338231 SURPLUS $94,313.00
1
DR THOMAS EFENDI, SP.PD 1115R0010619V006391 000235324713 DEFISIT ($719,184.00)
3
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V000828 000008312312 DEFISIT ($616,075.00)
2
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V001916 000183962796 DEFISIT ($1,112,934.00)
6
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V002698 000008312312 SURPLUS $851,426.00
2
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V002701 000182724294 DEFISIT ($716,386.00)
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000671 000053575888 DEFISIT ($707,420.00)
4
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V001215 000008327201 DEFISIT ($972,251.00)
5
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002300 000101778882 DEFISIT ($1,378,132.00)
6
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002743 000053681687 DEFISIT ($365,765.00)
8
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V003079 000109002349 DEFISIT ($2,230,798.00)
1
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V003351 000053675802 DEFISIT ($1,246,842.00)
9
dr GEDE PERDANA PUTERA, Sp. PD 1115R0010619V005312 000053668978 DEFISIT ($411,160.00)
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V007224 000101771070 SURPLUS $118,968.00
6
DR LENY ZABIDI, SP.A 1115R0010519V009036 000169689656 DEFISIT ($1,419,859.00)
2
DR LENY ZABIDI, SP.A 1115R0010619V000014 000046079940 DEFISIT ($473,068.00)
3
DR LENY ZABIDI, SP.A 1115R0010619V000031 000216875960 DEFISIT ($168,166.00)
8
DR LENY ZABIDI, SP.A 1115R0010619V000692 000053569908 DEFISIT ($167,352.00)
9
DR LENY ZABIDI, SP.A 1115R0010619V003999 000110927197 DEFISIT ($3,066,425.00)
1
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009741 000162061710 DEFISIT ($2,821,206.00)
6
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V002263 000188154705 DEFISIT ($520,884.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010519V008597 000017245601 DEFISIT ($2,974,678.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010519V009002 000017394452 DEFISIT ($3,916,759.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010519V009437 000119470220 DEFISIT ($1,544,376.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010519V009861 000053562998 DEFISIT ($683,126.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010519V009872 000053471705 DEFISIT ($508,640.00)
5
DR THOMAS EFENDI, SP.PD 1115R0010619V000072 000008310538 DEFISIT ($924,281.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010619V000677 000110602755 DEFISIT ($2,296,877.00)
9
DR THOMAS EFENDI, SP.PD 1115R0010619V001376 000109627367 DEFISIT ($2,551,982.00)
5
DR THOMAS EFENDI, SP.PD 1115R0010619V001912 000008302653 DEFISIT ($2,585,080.00)
9
DR THOMAS EFENDI, SP.PD 1115R0010619V002264 000126920962 SURPLUS $6,024.00
1
DR THOMAS EFENDI, SP.PD 1115R0010619V004004 000152544678 SURPLUS $185,624.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V004540 000053679603 DEFISIT ($706,207.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010619V004911 000185584863 DEFISIT ($1,221,527.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010619V004925 000008323943 DEFISIT ($2,596,932.00)
5
DR THOMAS EFENDI, SP.PD 1115R0010619V005316 000016272764 DEFISIT ($1,276,263.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V005836 000127227634 DEFISIT ($1,549,533.00)
7
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V000819 000245954102 SURPLUS $119,825.00
5
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V008560 000261325441 DEFISIT ($1,844,750.00)
1
DR ARIS SUNARDI, MSI MED,SPA 1115R0010519V009485 000228901147 DEFISIT ($398,533.00)
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000726 000014798523 DEFISIT ($163,972.00)
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000766 000116739112 SURPLUS $460,177.00
4
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000982 000008323909 DEFISIT ($1,526,809.00)
7
DR THOMAS EFENDI, SP.PD 1115R0010519V009451 000101795795 DEFISIT ($81,667.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010519V009468 000008327578 DEFISIT ($3,301,392.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010519V009491 000008303565 DEFISIT ($301,889.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010519V009854 000053811934 DEFISIT ($298,475.00)
7
DR THOMAS EFENDI, SP.PD 1115R0010619V000452 000008339318 DEFISIT ($835,381.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V000655 000008310541 DEFISIT ($666,132.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010619V000700 000259090659 SURPLUS $549,131.00
9
DR THOMAS EFENDI, SP.PD 1115R0010619V001910 000007793072 DEFISIT ($984,645.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V003357 000115391788 DEFISIT ($216,086.00)
7
DR THOMAS EFENDI, SP.PD 1115R0010619V003985 000053668766 DEFISIT ($570,390.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010619V004371 000224808477 SURPLUS $460,813.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V006387 000008307359 DEFISIT ($2,894,587.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V007253 000188513079 SURPLUS $666,957.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V007268 000127495476 DEFISIT ($1,653.00)
9
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000968 000053691204 DEFISIT ($191,185.00)
3
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000069 000053536556 SURPLUS $2,648,583.00
2
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000635 000185698578 SURPLUS $1,594,486.00
3
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V001243 000108481787 SURPLUS $1,849,893.00
8
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V002265 000184955905 SURPLUS $2,890,778.00
1
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V004508 000053538772 SURPLUS $1,018,793.00
4
DR WAHYU PRIYATNO, SP. B 1115R0010619V002243 000008322831 SURPLUS $1,128,773.00
9
DR MADE YUDHA SU, SP.B 1115R0010619V002713 000053654077 SURPLUS $569,555.00
1
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004507 000053483810 SURPLUS $4,246,451.00
5
DR MADE YUDHA SU, SP.B 1115R0010619V000948 000053583966 SURPLUS $1,833,641.00
9
DR MADE YUDHA SU, SP.B 1115R0010619V005272 000014910868 SURPLUS $1,595,872.00
1
DR MADE YUDHA SU, SP.B 1115R0010619V006378 000053583966 SURPLUS $2,883,618.00
9
DR MADE YUDHA SU, SP.B 1115R0010619V003955 000053564649 SURPLUS $1,733,417.00
6
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004521 000053676462 SURPLUS $2,601,887.00
3
DR WAHYU PRIYATNO, SP. B 1115R0010619V005815 000053528000 SURPLUS $513,400.00
5
dr GEDE PERDANA PUTERA, Sp. PD 1115R0010619V005854 000053620349 SURPLUS $1,559,727.00
5
DR THOMAS EFENDI, SP.PD 1115R0010619V001265 000261921915 DEFISIT ($680,778.00)
9
DR WAHYU PRIYATNO, SP. B 1115R0010619V005977 000057302523 SURPLUS $2,006,334.00
9
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V008087 000053770620 DEFISIT ($1,115,313.00)
3
DR MADE YUDHA SU, SP.B 1115R0010619V005291 000053730664 SURPLUS $1,031,705.00
7
DR MADE YUDHA SU, SP.B 1115R0010619V001367 000053496152 SURPLUS $1,086,675.00
8
DR MADE YUDHA SU, SP.B 1115R0010619V003987 000053517423 SURPLUS $1,423,613.00
3
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004509 000053823817 SURPLUS $1,109,258.00
1
DR WAHYU PRIYATNO, SP. B 1115R0010619V002240 000053647627 SURPLUS $1,553,086.00
4
DR MADE YUDHA SU, SP.B 1115R0010619V002718 000053525991 SURPLUS $1,809,171.00
3
DR MADE YUDHA SU, SP.B 1115R0010619V005170 000172787797 SURPLUS $959,133.00
1
DR NUGROHO KURNIANTO, SP.B 1115R0010619V001860 000101786959 SURPLUS $1,399,873.00
1
DR WAHYU PRIYATNO, SP. B 1115R0010619V002238 000053798742 SURPLUS $1,694,498.00
9
DR NUGROHO KURNIANTO, SP.B 1115R0010619V006852 000008341662 DEFISIT ($2,421,306.00)
3
DR NUGROHO KURNIANTO, SP.B 1115R0010619V006853 000008346993 DEFISIT ($2,043,722.00)
6
DR MADE YUDHA SU, SP.B 1115R0010519V009487 000053567648 SURPLUS $1,388,987.00
8
DR NUGROHO KURNIANTO, SP.B 1115R0010619V001893 000242572515 SURPLUS $804,644.00
6
DR NUGROHO KURNIANTO, SP.B 1115R0010619V003061 000008314393 SURPLUS $680,913.00
4
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004512 000148105044 SURPLUS $1,105,777.00
9
DR WAHYU PRIYATNO, SP. B 1115R0010619V004897 000053741843 SURPLUS $1,541,356.00
8
DR NUGROHO KURNIANTO, SP.B 1115R0010619V001831 000053574066 SURPLUS $1,364,907.00
9
DR WAHYU PRIYATNO, SP. B 1115R0010619V005526 000242623357 SURPLUS $998,526.00
7
DR MADE YUDHA SU, SP.B 1115R0010619V002613 000274808285 DEFISIT ($195,090.00)
8
DR NUGROHO KURNIANTO, SP.B 1115R0010619V005833 000053590861 SURPLUS $1,358,567.00
1
DR MADE YUDHA SU, SP.B 1115R0010619V002618 000244421826 DEFISIT ($1,491,713.00)
6
DR MADE YUDHA SU, SP.B 1115R0010619V003828 000200897552 SURPLUS $1,069,139.00
2
DR MADE YUDHA SU, SP.B 1115R0010619V003992 000101794531 SURPLUS $904,900.00
4
DR MADE YUDHA SU, SP.B 1115R0010619V001363 000223537857 SURPLUS $1,961,211.00
6
DR MADE YUDHA SU, SP.B 1115R0010619V001366 000140895742 DEFISIT ($610,231.00)
4
DR NUGROHO KURNIANTO, SP.B 1115R0010619V001835 000053713121 SURPLUS $2,480,381.00
5
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004708 000053508997 SURPLUS $2,814,540.00
1
DR EKO PUDJI ANTONO, SP.S 1115R0010619V005534 000008313576 DEFISIT ($2,583,556.00)
6
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004685 000183131153 SURPLUS $1,607,836.00
8
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V007262 000246718451 SURPLUS $149,051.00
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002697 000246772452 DEFISIT ($2,640,508.00)
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009753 000126560950 DEFISIT $3,887,860.00
7
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001634 000126161516 DEFISIT ($193,304.00)
2
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001650 000126238213 DEFISIT ($574,770.00)
1
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001667 000128112356 DEFISIT ($633,110.00)
2
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001677 000053690069 DEFISIT $3,846,215.00
2
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001848 000197158645 DEFISIT $3,670,500.00
1
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001852 000126112932 DEFISIT $3,859,195.00
9
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V003062 000207400242 DEFISIT $5,365,379.00
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V003063 000126379997 DEFISIT $4,031,128.00
8
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V003064 000101784568 DEFISIT $4,928,563.00
4
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001658 000008309268 DEFISIT ($4,749,091.00)
9
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001679 000242561674 DEFISIT ($2,180,390.00)
1
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V004504 000225522154 SURPLUS $632,683.00
1
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V001595 000229386793 DEFISIT ($2,798,362.00)
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000784 000262126034 SURPLUS $1,166,362.00
8
dr SUSANTO RAHMAD N, Sp.OG 1115R0010619V002244 000101783408 DEFISIT ($2,822,838.00)
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005825 000053799530 DEFISIT ($238,475.00)
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V007721 000053512962 DEFISIT ($835,099.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010519V008099 000053618283 SURPLUS $458,798.00
9
DR THOMAS EFENDI, SP.PD 1115R0010519V009863 000053520469 DEFISIT ($1,417,885.00)
7
DR THOMAS EFENDI, SP.PD 1115R0010619V000684 000053448336 DEFISIT ($2,001,820.00)
9
DR THOMAS EFENDI, SP.PD 1115R0010619V001257 000053610108 DEFISIT ($2,032,239.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010619V005250 000132646287 DEFISIT ($517,496.00)
3
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004515 000053795299 SURPLUS $2,026,404.00
4
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004517 000053812642 SURPLUS $2,188,404.00
4
DR WAHYU PRIYATNO, SP. B 1115R0010619V007239 000163487295 SURPLUS $256,305.00
9
DR THOMAS EFENDI, SP.PD 1115R0010519V009489 000008342562 DEFISIT ($2,463,122.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010619V001903 000108464368 DEFISIT ($1,901,645.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010619V004923 000248989478 SURPLUS $1,952,769.00
5
DR THOMAS EFENDI, SP.PD 1115R0010619V001991 000190268621 SURPLUS $2,194,518.00
8
DR THOMAS EFENDI, SP.PD 1115R0010619V006381 000274263764 SURPLUS $2,578,478.00
5
DR THOMAS EFENDI, SP.PD 1115R0010619V000693 000243697845 DEFISIT ($200,800.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010619V004539 000243697845 SURPLUS $2,462,745.00
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005843 000235324383 SURPLUS $1,882,726.00
6
DR LENY ZABIDI, SP.A 1115R0010619V002720 000242706222 SURPLUS $3,282,436.00
9
dr THOMAS EFENDI, Sp.PD 1115R0010619V001386 000053432070 DEFISIT ($2,041,587.00)
6
DR EKO PUDJI ANTONO, SP.S 1115R0010519V009836 000200896966 SURPLUS $1,709,511.00
1
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000879 000008322789 SURPLUS $1,565,695.00
3
DR EKO PUDJI ANTONO, SP.S 1115R0010619V001236 000146032311 DEFISIT ($632,498.00)
3
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003968 000053654556 SURPLUS $567,633.00
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V004002 000172690746 SURPLUS $1,503,969.00
6
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V003347 000053685694 SURPLUS $1,252,108.00
1
DR EKO PUDJI ANTONO, SP.S 1115R0010519V009440 000053580777 SURPLUS $13,337.00
6
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000068 000129473054 SURPLUS $1,804,039.00
8
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003371 000008309078 SURPLUS $1,236,348.00
8
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005563 000274384091 SURPLUS $6,506,455.00
2
DR ASTI AYUDIANINGRUM, SP.M 1115R0010619V007222 000053554356 SURPLUS $1,903,627.00
9
dr ASTI AYUDIANINGRUM, Sp.M 1115R0010619V006845 000053695443 SURPLUS $2,593,841.00
3
DR YUNAN ARDI S, SP.THT- KL 1115R0010519V008989 000008337384 SURPLUS $732,683.00
9
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V003060 000143916016 DEFISIT ($595,218.00)
4
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V004535 000107926306 SURPLUS $1,011,444.00
7
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V004890 000204365818 SURPLUS $425,494.00
1
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V004892 000202056995 SURPLUS $351,808.00
2
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V005818 000218990082 SURPLUS $150,047.00
3
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V005819 000118715808 DEFISIT ($246,760.00)
3
DR MADE YUDHA SU, SP.B 1115R0010619V006299 000224726023 DEFISIT ($3,422,765.00)
1
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V003893 000205217477 DEFISIT ($912,836.00)
8
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V005817 000126235750 DEFISIT ($737,569.00)
4
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V003057 000020119338 DEFISIT ($3,450,830.00)
9
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V003976 000053634524 DEFISIT ($689,120.00)
5
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V004927 000107833970 DEFISIT ($1,429,785.00)
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005797 000053527208 SURPLUS $364,414.00
5
DR THOMAS EFENDI, SP.PD 1115R0010519V009428 000053693009 SURPLUS $92,035.00
8
DR THOMAS EFENDI, SP.PD 1115R0010519V009445 000008341643 DEFISIT ($610,790.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010619V000441 000053571665 SURPLUS $1,044,061.00
2
DR THOMAS EFENDI, SP.PD 1115R0010619V001915 000008315783 DEFISIT ($2,049,077.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V004542 000053820870 SURPLUS $496,437.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V004700 000008314564 SURPLUS $95,115.00
4
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V003346 000220148186 DEFISIT ($1,569,725.00)
5
DR LAILY DJIHAN, SP.JP 1115R0010619V000067 000053578449 SURPLUS $724,791.00
9
DR LAILY DJIHAN, SP.JP 1115R0010619V000773 000053816681 SURPLUS $776,079.00
2
DR LAILY DJIHAN, SP.JP 1115R0010619V002248 000053612791 DEFISIT ($854,774.00)
7
DR THOMAS EFENDI, SP.PD 1115R0010619V005523 000006331393 SURPLUS $1,306,357.00
1
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000988 000008347767 SURPLUS $1,123,463.00
6
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002247 000053700126 DEFISIT ($539,796.00)
6
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V003075 000242574423 SURPLUS $1,090,404.00
6
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005288 000181099189 SURPLUS $1,613,272.00
1
DR THOMAS EFENDI, SP.PD 1115R0010519V009878 000245324224 DEFISIT ($2,843,840.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010619V000985 000190565867 SURPLUS $633,544.00
2
DR THOMAS EFENDI, SP.PD 1115R0010619V001375 000224934379 SURPLUS $169,877.00
7
DR THOMAS EFENDI, SP.PD 1115R0010619V001880 000183232559 DEFISIT ($2,887,175.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010619V001917 000181109176 DEFISIT ($385,595.00)
7
DR THOMAS EFENDI, SP.PD 1115R0010619V002732 000173030838 DEFISIT ($1,140,527.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010619V003994 000008344101 SURPLUS $543,867.00
3
DR THOMAS EFENDI, SP.PD 1115R0010619V004547 000180791017 SURPLUS $509,219.00
7
DR THOMAS EFENDI, SP.PD 1115R0010619V004891 000053654021 DEFISIT ($3,608,601.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V006393 000183232559 DEFISIT ($1,189,611.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010619V006793 000014872196 SURPLUS $632,880.00
2
DR THOMAS EFENDI, SP.PD 1115R0010619V006383 000008314465 DEFISIT ($1,887,124.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010619V000980 000053733785 SURPLUS $44,659.00
5
DR THOMAS EFENDI, SP.PD 1115R0010619V001921 000180791017 SURPLUS $894,034.00
7
DR THOMAS EFENDI, SP.PD 1115R0010619V006389 000053489159 DEFISIT ($468,411.00)
8
DR LAILY DJIHAN, SP.JP 1115R0010619V003372 000101788225 SURPLUS $2,700,175.00
7
DR LAILY DJIHAN, SP.JP 1115R0010619V006611 000006331323 SURPLUS $130,576.00
3
DR LAILY DJIHAN, SP.JP 1115R0010619V001294 000169148739 DEFISIT ($2,043,407.00)
3
DR LAILY DJIHAN, SP.JP 1115R0010519V009482 000008305887 DEFISIT ($7,832,155.00)
3
DR LAILY DJIHAN, SP.JP 1115R0010619V003054 000235327295 SURPLUS $2,572,753.00
2
DR LAILY DJIHAN, SP.JP 1115R0010619V000698 000008320989 DEFISIT ($3,971,302.00)
3
DR LAILY DJIHAN, SP.JP 1115R0010619V006606 000053517424 SURPLUS $996,582.00
4
DR LAILY DJIHAN, SP.JP 1115R0010619V007225 000128244794 DEFISIT ($365,343.00)
5
DR LAILY DJIHAN, SP.JP 1115R0010619V004691 000101772974 DEFISIT ($1,238,713.00)
2
DR LAILY DJIHAN, SP.JP 1115R0010619V003973 000006331186 DEFISIT ($1,303,032.00)
1
DR LAILY DJIHAN, SP.JP 1115R0010619V004510 000008311028 SURPLUS $440,778.00
5
DR LAILY DJIHAN, SP.JP 1115R0010619V005866 000053634250 SURPLUS $829,463.00
1
DR LAILY DJIHAN, SP.JP 1115R0010619V000039 000008327671 DEFISIT ($3,801,267.00)
7
DR LAILY DJIHAN, SP.JP 1115R0010619V000690 000274575069 SURPLUS $278,901.00
9
DR LAILY DJIHAN, SP.JP 1115R0010619V000949 000246027608 SURPLUS $1,408,733.00
8
DR LAILY DJIHAN, SP.JP 1115R0010619V002274 000053583404 SURPLUS $758,377.00
5
DR LAILY DJIHAN, SP.JP 1115R0010619V002721 000053483576 SURPLUS $1,642,272.00
5
DR LAILY DJIHAN, SP.JP 1115R0010619V003080 000247273027 SURPLUS $937,034.00
7
DR LAILY DJIHAN, SP.JP 1115R0010619V005527 000154570653 SURPLUS $1,574,972.00
9
DR LAILY DJIHAN, SP.JP 1115R0010619V005822 000008324599 DEFISIT ($445,348.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010619V001771 000053679147 DEFISIT ($6,074,452.00)
6
DR LAILY DJIHAN, SP.JP 1115R0010519V009453 000238025239 DEFISIT ($2,794,395.00)
7
DR LAILY DJIHAN, SP.JP 1115R0010519V009486 000101794622 SURPLUS $747,519.00
5
DR LAILY DJIHAN, SP.JP 1115R0010619V000018 000173070432 DEFISIT ($761,548.00)
9
DR LAILY DJIHAN, SP.JP 1115R0010619V000090 000053597412 SURPLUS $827,025.00
9
DR LAILY DJIHAN, SP.JP 1115R0010619V001347 000276438296 SURPLUS $682,390.00
2
DR LAILY DJIHAN, SP.JP 1115R0010619V001388 000187304353 SURPLUS $690,721.00
7
DR LAILY DJIHAN, SP.JP 1115R0010619V001662 000214039180 DEFISIT ($590,450.00)
1
DR LAILY DJIHAN, SP.JP 1115R0010619V003333 000053667365 DEFISIT ($2,317,593.00)
5
DR LAILY DJIHAN, SP.JP 1115R0010619V003854 000008329666 SURPLUS $1,274,905.00
4
DR LAILY DJIHAN, SP.JP 1115R0010619V004003 000053796303 DEFISIT ($1,972,792.00)
9
DR LAILY DJIHAN, SP.JP 1115R0010619V004008 000108459057 DEFISIT ($1,480,313.00)
3
DR LAILY DJIHAN, SP.JP 1115R0010619V004254 000015795087 SURPLUS $1,712,009.00
6
DR LAILY DJIHAN, SP.JP 1115R0010619V005325 000005206398 SURPLUS $145,815.00
6
DR LAILY DJIHAN, SP.JP 1115R0010619V005533 000246027608 DEFISIT ($1,116,820.00)
8
DR LAILY DJIHAN, SP.JP 1115R0010619V005853 000053689013 SURPLUS $692,402.00
8
DR LAILY DJIHAN, SP.JP 1115R0010619V005869 000245892097 SURPLUS $62,385.00
1
DR LAILY DJIHAN, SP.JP 1115R0010619V006037 000147587743 SURPLUS $38,589.00
1
DR LAILY DJIHAN, SP.JP 1115R0010619V006362 000053538422 DEFISIT ($1,103,933.00)
5
DR LAILY DJIHAN, SP.JP 1115R0010619V006844 000053733298 SURPLUS $294,071.00
4
DR LAILY DJIHAN, SP.JP 1115R0010619V007125 000217904667 SURPLUS $271,381.00
6
DR LAILY DJIHAN, SP.JP 1115R0010619V007260 000053668176 SURPLUS $812,806.00
6
DR EKO PUDJI ANTONO, SP.S 1115R0010619V007259 000008326016 SURPLUS $2,396,760.00
8
DR EKO PUDJI ANTONO, SP.S 1115R0010519V009850 000008345340 DEFISIT ($7,496,119.00)
9
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000017 000212861364 SURPLUS $1,593,100.00
6
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000723 000008323379 DEFISIT ($2,484,661.00)
8
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000826 000015984886 DEFISIT ($1,543,538.00)
4
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000827 000008318406 DEFISIT ($742,385.00)
3
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000938 000053701891 SURPLUS $631,584.00
7
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000953 000101794409 SURPLUS $814,092.00
8
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003050 000053606779 SURPLUS $1,587,168.00
7
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003349 000053499382 SURPLUS $216,610.00
7
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003983 000053585950 SURPLUS $75,665.00
4
DR EKO PUDJI ANTONO, SP.S 1115R0010619V004913 000053710655 DEFISIT ($473,329.00)
5
DR EKO PUDJI ANTONO, SP.S 1115R0010619V005549 000053594328 SURPLUS $679,336.00
3
DR EKO PUDJI ANTONO, SP.S 1115R0010619V005553 000053470000 SURPLUS $1,540,909.00
1
DR EKO PUDJI ANTONO, SP.S 1115R0010619V006865 000257458595 SURPLUS $1,358,916.00
5
DR NUGROHO KURNIANTO, SP.B 1115R0010519V009866 000053561371 SURPLUS $1,325,957.00
4
DR NUGROHO KURNIANTO, SP.B 1115R0010619V003329 000053523669 SURPLUS $2,110,868.00
3
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004519 000053600522 SURPLUS $1,641,567.00
5
DR NUGROHO KURNIANTO, SP.B 1115R0010619V005816 000101791504 SURPLUS $1,832,431.00
1
DR NUGROHO KURNIANTO, SP.B 1115R0010619V005823 000169761484 SURPLUS $1,223,877.00
1
dr WAHYU PRIYATNO, Sp. B 1115R0010619V003331 000053662672 SURPLUS $2,212,465.00
1
DR MADE YUDHA SU, SP.B 1115R0010619V002711 000234900914 SURPLUS $1,269,384.00
5
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V000758 000209787741 SURPLUS $181,676.00
9
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V001341 000276851098 DEFISIT ($1,914,208.00)
1
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V002253 000276913719 SURPLUS $324,976.00
9
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V003279 000249155436 SURPLUS $1,353,065.00
3
DR LENY ZABIDI, SP.A 1115R0010619V000977 000226942538 SURPLUS $1,295,398.00
5
DR LENY ZABIDI, SP.A 1115R0010619V001467 000262352059 SURPLUS $270,002.00
7
DR LENY ZABIDI, SP.A 1115R0010619V004532 000276960704 SURPLUS $1,441,424.00
5
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V004520 000276026881 SURPLUS $238,888.00
4
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V006382 000206841537 SURPLUS $627,687.00
9
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V008990 000053539994 SURPLUS $622,955.00
2
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V009873 000053685757 SURPLUS $2,045,239.00
1
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000667 000008345556 DEFISIT ($1,840,434.00)
9
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000978 000053528515 DEFISIT ($613,427.00)
7
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V002237 000161651672 SURPLUS $562,264.00
8
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V004009 000053642899 SURPLUS $1,626,366.00
1
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000817 000008321663 SURPLUS $2,358,265.00
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000994 000053480543 DEFISIT ($1,080,909.00)
5
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005528 000053662240 SURPLUS $1,257,150.00
1
DR LENY ZABIDI, SP.A 1115R0010619V005834 000262295746 SURPLUS $1,943,042.00
7
DR THOMAS EFENDI, SP.PD 1115R0010519V008526 000169690304 DEFISIT ($2,521,258.00)
2
DR LENY ZABIDI, SP.A 1115R0010619V004000 000205685870 SURPLUS $458,840.00
5
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V000964 000275442326 SURPLUS $1,441,846.00
8
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V006379 000249611752 SURPLUS $1,017,150.00
1
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V005530 000219812319 DEFISIT ($919,044.00)
9
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V007228 000208590699 DEFISIT ($1,375,853.00)
3
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V004199 000225589821 SURPLUS $998,598.00
6
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V006363 000101771854 SURPLUS $1,158,773.00
7
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V006839 000053422371 SURPLUS $1,316,200.00
9
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V003332 000053771712 SURPLUS $935,814.00
6
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V007240 000053780282 SURPLUS $1,078,237.00
8
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V001932 000053594993 DEFISIT ($1,493,041.00)
2
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V005875 000178666087 SURPLUS $298,852.00
4
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V002739 000169685848 SURPLUS $403,996.00
1
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000053 000101797290 SURPLUS $1,585,847.00
9
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V002236 000008331235 SURPLUS $432,644.00
7
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V003327 000238024616 DEFISIT ($436,556.00)
5
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V003370 000053593617 SURPLUS $1,085,064.00
3
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V006863 000053753133 SURPLUS $1,560,688.00
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V001007 000053632618 SURPLUS $409,550.00
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005294 000053556955 DEFISIT ($247,598.00)
7
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V009454 000008337607 DEFISIT ($1,950,928.00)
7
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V009835 000131123397 DEFISIT ($715,901.00)
3
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000631 000186556002 DEFISIT ($609,152.00)
6
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V003355 000147027567 SURPLUS $868,322.00
3
DR THOMAS EFENDI, SP.PD 1115R0010519V009446 000161676434 SURPLUS $610,637.00
2
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V006358 000203481153 SURPLUS $962,167.00
9
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V000763 000275960991 SURPLUS $1,097,567.00
3
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V001206 000249564984 SURPLUS $108,306.00
6
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V004537 000053641728 DEFISIT ($251,484.00)
9
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V009495 000053753133 SURPLUS $402,153.00
3
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000425 000053568944 SURPLUS $942,633.00
8
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000954 000189639602 SURPLUS $505,141.00
8
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V001489 000053656141 SURPLUS $380,583.00
4
dr ESTININGTYAS WARDHANI, Sp.P 1115R0010619V003982 000053625541 DEFISIT ($798,069.00)
4
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V004541 000053583554 SURPLUS $839,856.00
2
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V004704 000008311622 DEFISIT ($2,137,989.00)
5
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V005558 000204183858 DEFISIT ($618,149.00)
3
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V005821 000008341277 DEFISIT ($1,279,598.00)
5
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V005852 000182355269 DEFISIT ($871,836.00)
5
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V005877 000143710047 SURPLUS $225,923.00
9
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V006386 000179245964 SURPLUS $396,727.00
2
DR LENY ZABIDI, SP.A 1115R0010619V003049 000276902675 DEFISIT ($588,371.00)
8
dr THOMAS EFENDI, Sp.PD 1115R0010619V000046 000143837643 DEFISIT ($84,708.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010619V000070 000101772310 SURPLUS $1,353,140.00
4
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V003376 000053752418 SURPLUS $602,668.00
8
dr ESTININGTYAS WARDHANI, Sp.P 1115R0010619V007959 000053645525 SURPLUS $2,649,209.00
8
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V008538 000053777335 DEFISIT ($2,040,391.00)
4
DR ESTININGTYAS WARDHANI, SP.P 1115R0010519V009517 000257402066 SURPLUS $590,811.00
5
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V001267 000200896759 SURPLUS $1,213,317.00
1
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V001889 000202569932 SURPLUS $1,472,840.00
2
dr ESTININGTYAS WARDHANI, Sp.P 1115R0010619V002722 000008327301 SURPLUS $388,289.00
6
DR MADE YUDHA SU, SP.B 1115R0010619V006059 000053673176 DEFISIT ($19,359.00)
2
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004514 000101799173 SURPLUS $387,749.00
2
DR WAHYU PRIYATNO, SP. B 1115R0010619V007726 000183639425 SURPLUS $1,857,757.00
5
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005839 000054727717 SURPLUS $676,464.00
4
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V004007 000250101333 DEFISIT ($299,492.00)
9
dr GEDE PERDANA PUTERA, Sp. PD 1115R0010619V000664 000053528104 DEFISIT ($1,156,008.00)
1
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000734 000209322187 DEFISIT ($195,727.00)
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000780 000053628563 SURPLUS $544,600.00
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000872 000204151515 SURPLUS $626,117.00
6
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V001260 000201017385 SURPLUS $114,983.00
9
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V003083 000008329640 SURPLUS $311,740.00
5
DR THOMAS EFENDI, SP.PD 1115R0010519V009424 000127372374 DEFISIT ($1,368,255.00)
9
DR THOMAS EFENDI, SP.PD 1115R0010519V009539 000008325504 SURPLUS $706,141.00
9
DR THOMAS EFENDI, SP.PD 1115R0010619V000450 000053717334 SURPLUS $741,207.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V000640 000165856290 DEFISIT ($2,313,951.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010619V001233 000008307506 DEFISIT ($1,053,980.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010619V001607 000169443044 DEFISIT ($1,870,697.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V005844 000235785232 DEFISIT ($588,924.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010619V007270 000052467061 SURPLUS $106,848.00
4
DR MADE YUDHA SU, SP.B 1115R0010619V000991 000053624814 DEFISIT ($199,622.00)
6
DR MADE YUDHA SU, SP.B 1115R0010619V003980 000053578198 DEFISIT ($1,543,951.00)
1
DR NUGROHO KURNIANTO, SP.B 1115R0010519V009450 000121649883 DEFISIT ($427,154.00)
6
DR WAHYU PRIYATNO, SP. B 1115R0010619V002245 000008342309 DEFISIT ($2,905,396.00)
2
DR MADE YUDHA SU, SP.B 1115R0010619V000021 000053520577 DEFISIT ($667,674.00)
7
DR MADE YUDHA SU, SP.B 1115R0010619V000052 000053428219 DEFISIT ($341,234.00)
7
DR MADE YUDHA SU, SP.B 1115R0010619V000665 000019947464 DEFISIT ($6,541,282.00)
8
DR MADE YUDHA SU, SP.B 1115R0010619V001246 000053827508 DEFISIT ($684,974.00)
2
DR MADE YUDHA SU, SP.B 1115R0010619V001894 000275178845 DEFISIT ($2,091,248.00)
2
DR MADE YUDHA SU, SP.B 1115R0010619V002717 000053592174 DEFISIT ($791,040.00)
9
DR MADE YUDHA SU, SP.B 1115R0010619V005326 000053598045 DEFISIT ($384,692.00)
3
DR WAHYU PRIYATNO, SP. B 1115R0010619V005842 000053646648 DEFISIT ($170,974.00)
6
DR WAHYU PRIYATNO, SP. B 1115R0010619V007241 000143999182 DEFISIT ($731,353.00)
1
DR NUGROHO KURNIANTO, SP.B 1115R0010619V006851 000275601480 SURPLUS $510,300.00
6
DR MADE YUDHA SU, SP.B 1115R0010619V003977 000226692370 SURPLUS $2,582,242.00
1
DR MADE YUDHA SU, SP.B 1115R0010619V006254 000008490842 SURPLUS $1,628,139.00
8
DR WAHYU PRIYATNO, SP. B 1115R0010619V003324 000008320460 DEFISIT ($763,536.00)
5
DR WAHYU PRIYATNO, SP. B 1115R0010619V007238 000200893637 SURPLUS $715,742.00
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V004533 000243764614 DEFISIT ($23,914.00)
1
DR MADE YUDHA SU, SP.B 1115R0010619V000641 000053749600 DEFISIT ($354,182.00)
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000759 000053717653 DEFISIT ($1,063,260.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010619V004502 000053615285 DEFISIT ($1,811,401.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010519V008113 000163543729 SURPLUS $62,107.00
4
DR THOMAS EFENDI, SP.PD 1115R0010619V001374 000243008180 DEFISIT ($14,263.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V004506 000008333810 DEFISIT ($1,428,683.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V004551 000053693403 SURPLUS $1,149,983.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V005876 000053589714 SURPLUS $1,551,766.00
6
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005867 000008324477 DEFISIT ($917,935.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010519V009442 000224972601 DEFISIT ($2,252,744.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010619V000051 000008311178 DEFISIT ($1,378,927.00)
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V003082 000101783433 DEFISIT ($5,196,963.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010519V009441 000008325203 DEFISIT ($2,384,486.00)
5
DR THOMAS EFENDI, SP.PD 1115R0010519v009862 000207688534 DEFISIT ($3,469,504.00)
7
DR THOMAS EFENDI, SP.PD 1115R0010619V000626 000126893697 DEFISIT ($3,682,548.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010619V001792 000053513234 DEFISIT ($905,555.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V003957 000143916016 DEFISIT ($1,629,642.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010619V004919 000226171669 DEFISIT ($1,017,755.00)
4
SAADATUL HURIYAH,M.SC,SP.KK 1115R0010619V002277 000101777905 DEFISIT ($2,703,612.00)
1
DR EKO PUDJI ANTONO, SP.S 1115R0010519V009394 000232653586 SURPLUS $1,145,741.00
4
DR EKO PUDJI ANTONO, SP.S 1115R0010619V005845 000053563673 SURPLUS $382,891.00
2
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003716 000017323151 SURPLUS $823,932.00
5
DR MADE YUDHA SU, SP.B 1115R0010519V009431 000053837453 SURPLUS $1,341,726.00
2
DR MADE YUDHA SU, SP.B 1115R0010619V003837 000053673501 SURPLUS $486,401.00
3
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004534 000053614329 SURPLUS $560,209.00
6
DR NUGROHO KURNIANTO, SP.B 1115R0010619V006870 000246983096 SURPLUS $1,660,978.00
2
DR WAHYU PRIYATNO, SP. B 1115R0010619V002246 000053495609 SURPLUS $1,575,276.00
5
DR WAHYU PRIYATNO, SP. B 1115R0010619V007227 000273871075 SURPLUS $2,153,825.00
4
DR WAHYU PRIYATNO, SP. B 1115R0010619V005505 000053641385 SURPLUS $1,395,471.00
8
DR NUGROHO KURNIANTO, SP.B 1115R0010619V003051 000008302759 SURPLUS $2,192,898.00
7
DR NUGROHO KURNIANTO, SP.B 1115R0010619V003059 000276768391 DEFISIT ($168,871.00)
4
DR NUGROHO KURNIANTO, SP.B 1115R0010619V007191 000276212567 SURPLUS $35,276.00
2
DR NUGROHO KURNIANTO, SP.B 1115R0010619V007703 000251815611 SURPLUS $1,423,384.00
3
DR WAHYU PRIYATNO, SP. B 1115R0010619V002239 000245911934 SURPLUS $802,929.00
2
DR WAHYU PRIYATNO, SP. B 1115R0010619V003334 000242549228 SURPLUS $1,560,181.00
2
DR WAHYU PRIYATNO, SP. B 1115R0010619V007236 000263069724 SURPLUS $1,579,091.00
3
DR WAHYU PRIYATNO, SP. B 1115R0010619V007242 000249549966 SURPLUS $1,585,622.00
9
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000771 000101773065 SURPLUS $1,213,260.00
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002727 000053582191 SURPLUS $1,862,298.00
7
dr GEDE PERDANA PUTERA, Sp. PD 1115R0010619V007719 000275513951 SURPLUS $1,365,349.00
2
dr GEDE PERDANA PUTERA, Sp. PD 1115R0010619V008000 000053809048 SURPLUS $1,094,816.00
1
DR THOMAS EFENDI, SP.PD 1115R0010519V009827 000053693864 SURPLUS $1,004,240.00
8
DR THOMAS EFENDI, SP.PD 1115R0010619V001804 000231410933 SURPLUS $2,527,154.00
8
DR THOMAS EFENDI, SP.PD 1115R0010619V003997 000008329053 DEFISIT ($729,489.00)
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000770 000053697749 SURPLUS $1,655,617.00
5
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V004215 000245164246 SURPLUS $256,836.00
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002712 000053519222 SURPLUS $105,909.00
2
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V003074 000169688281 DEFISIT ($160,268.00)
4
DR LENY ZABIDI, SP.A 1115R0010619V006868 000161651059 SURPLUS $317,123.00
7
DR THOMAS EFENDI, SP.PD 1115R0010519V009396 000053794732 SURPLUS $36,015.00
4
DR THOMAS EFENDI, SP.PD 1115R0010519V009855 000008310171 SURPLUS $1,090,853.00
3
DR THOMAS EFENDI, SP.PD 1115R0010519V009860 000053764604 SURPLUS $860,590.00
8
DR THOMAS EFENDI, SP.PD 1115R0010619V000013 000008304828 SURPLUS $148,712.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V000984 000101777312 SURPLUS $297,792.00
2
DR THOMAS EFENDI, SP.PD 1115R0010619V000992 000008325711 SURPLUS $217,589.00
9
DR THOMAS EFENDI, SP.PD 1115R0010619V001655 000101777754 SURPLUS $653,917.00
3
DR THOMAS EFENDI, SP.PD 1115R0010619V002169 000053603257 SURPLUS $667,367.00
4
DR THOMAS EFENDI, SP.PD 1115R0010619V002272 000053486778 SURPLUS $614,123.00
3
DR THOMAS EFENDI, SP.PD 1115R0010619V002273 000148866580 SURPLUS $197,932.00
1
DR THOMAS EFENDI, SP.PD 1115R0010619V003360 000008346054 SURPLUS $400,822.00
3
DR THOMAS EFENDI, SP.PD 1115R0010619V004549 000053585020 DEFISIT ($123,413.00)
1
DR MADE YUDHA SU, SP.B 1115R0010519V008528 000053532454 SURPLUS $570,843.00
4
DR WAHYU PRIYATNO, SP. B 1115R0010619V004894 000221713274 DEFISIT ($425,161.00)
2
DR MADE YUDHA SU, SP.B 1115R0010619V007705 000274682893 SURPLUS $3,943,429.00
4
DR WAHYU PRIYATNO, SP. B 1115R0010619V007237 000053863067 SURPLUS $1,551,088.00
2
DR MADE YUDHA SU, SP.B 1115R0010619V001362 000275437118 SURPLUS $1,815,041.00
2
DR WAHYU PRIYATNO, SP. B 1115R0010619V002249 000053668300 SURPLUS $1,916,358.00
4
DR MADE YUDHA SU, SP.B 1115R0010619V007699 000201005932 SURPLUS $3,111,940.00
4
DR WAHYU PRIYATNO, SP. B 1115R0010619V002242 000142885136 SURPLUS $1,917,480.00
2
DR LENY ZABIDI, SP.A 1115R0010619V002737 000276628811 SURPLUS $488,047.00
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010519V009483 000053621630 DEFISIT ($337,261.00)
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V004898 000053711578 DEFISIT ($2,198,189.00)
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010519V009869 000053603131 DEFISIT ($331,324.00)
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000897 000053369987 DEFISIT ($70,641.00)
5
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V008017 000101777922 DEFISIT ($282,930.00)
9
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V003993 000053770852 DEFISIT ($587,907.00)
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V006360 000053842310 DEFISIT ($505,356.00)
8
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000602 000053612408 DEFISIT ($16,348.00)
2
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001264 000053587297 SURPLUS $140,899.00
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001370 000053680208 DEFISIT ($464,569.00)
5
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005865 000053619696 SURPLUS $306,731.00
9
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V006368 000213203193 DEFISIT ($3,051,245.00)
6
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V006798 000202286955 DEFISIT ($3,425,205.00)
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000043 000053675584 DEFISIT ($52,882.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V001892 000053777503 DEFISIT ($273,919.00)
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005310 000101822158 SURPLUS $308,498.00
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000045 000204313432 DEFISIT ($3,092.00)
4
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V003081 000053469810 DEFISIT ($583,368.00)
9
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005313 000258121382 DEFISIT ($392,371.00)
5
DR LENY ZABIDI, SP.A 1115R0010619V003490 000143715581 DEFISIT ($1,413,706.00)
8
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005863 000276511658 DEFISIT ($977,600.00)
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V003328 000053750229 SURPLUS $826,174.00
6
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V003353 000262611858 SURPLUS $800,930.00
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V008111 000180384367 DEFISIT ($925,879.00)
4
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002719 000101800243 DEFISIT ($3,603,331.00)
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000952 000219945797 SURPLUS $397,101.00
8
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V005556 000101788711 SURPLUS $196,113.00
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000981 000053816604 SURPLUS $303,468.00
6
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V003989 000208884742 SURPLUS $1,190,364.00
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000016 000208642809 SURPLUS $948,445.00
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000775 000178587416 DEFISIT ($86,602.00)
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000073 000263780220 SURPLUS $1,304,894.00
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000094 000053664629 SURPLUS $1,249,674.00
5
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V006385 000053556893 SURPLUS $80,502.00
8
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001365 000053675021 SURPLUS $1,755,679.00
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V001372 000262611858 SURPLUS $2,267,663.00
3
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V004516 000053624703 SURPLUS $1,827,252.00
3
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V004893 000208560110 DEFISIT ($938,171.00)
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010519V009421 000276526150 SURPLUS $1,556,886.00
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V001371 000017037769 SURPLUS $1,951,524.00
4
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005858 000259275482 SURPLUS $1,076,662.00
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V006789 000275665624 DEFISIT ($71,419.00)
7
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V004903 000053494171 SURPLUS $996,945.00
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V003335 000145311902 DEFISIT ($1,503,220.00)
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V007731 000053479599 SURPLUS $1,564,670.00
6
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005285 000169685865 SURPLUS $2,140,058.00
9
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V006652 000053820372 DEFISIT ($906,783.00)
3
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V008027 000053481062 DEFISIT ($932,666.00)
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V003084 000247706727 SURPLUS $569,629.00
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000656 000053535619 SURPLUS $114,439.00
1
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005289 000053629655 DEFISIT ($457,204.00)
5
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V007700 000053631803 DEFISIT ($486,140.00)
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V004545 000053494398 DEFISIT ($2,278,250.00)
9
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005529 000275496246 SURPLUS $1,218,739.00
9
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005859 000053640991 DEFISIT ($813,095.00)
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010519V009494 000053527118 SURPLUS $1,176,613.00
5
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000682 000053741839 DEFISIT ($1,949,505.00)
4
dr SUSANTO RAHMAD N, Sp.OG 1115R0010619V005857 000275305635 DEFISIT ($737,617.00)
9
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005314 000185220193 SURPLUS $375,325.00
4
DR SUSANTO RAHMAD N, SP.OG 1115R0010519V009419 000016323873 DEFISIT ($77,665.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V005948 000008303107 SURPLUS $377,742.00
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000883 000101765368 DEFISIT ($766,073.00)
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000019 000008332408 DEFISIT ($688,803.00)
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000613 000169688950 DEFISIT ($775,130.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V006838 000053673531 DEFISIT ($966,616.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010519V008539 000152615253 SURPLUS $906,769.00
3
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V003986 000053773527 SURPLUS $540,964.00
3
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V004895 000235335660 DEFISIT ($224,887.00)
6
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005296 000231354453 SURPLUS $1,582,928.00
3
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V000787 000019790371 DEFISIT ($611,929.00)
1
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V000822 000053640682 DEFISIT ($1,029,312.00)
7
DR NUNGKY NUGROHO W, SP. OG 1115R0010519V009492 000008303044 DEFISIT ($966,830.00)
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010519V009493 000153210149 DEFISIT ($862,740.00)
8
DR NUNGKY NUGROHO W, SP. OG 1115R0010519V009857 000053565693 DEFISIT ($1,330,377.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010519V009858 000169689853 DEFISIT ($759,977.00)
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010519V009868 000053729280 DEFISIT ($1,068,029.00)
9
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000428 000101779730 DEFISIT ($1,466,765.00)
8
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000429 000053711797 DEFISIT ($769,250.00)
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000440 000054770759 DEFISIT ($1,159,183.00)
8
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000443 000216872087 DEFISIT ($450,118.00)
5
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000444 000053507507 DEFISIT ($1,220,581.00)
5
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000447 000053527443 DEFISIT ($1,403,415.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000642 000053547346 DEFISIT ($673,377.00)
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000646 000020116856 DEFISIT ($1,282,593.00)
2
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000720 000008306070 DEFISIT ($939,971.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000735 000143817012 DEFISIT ($1,132,138.00)
9
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000736 000228875293 DEFISIT ($702,359.00)
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000783 000053583167 DEFISIT ($889,509.00)
2
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000820 000113916118 DEFISIT ($1,287,072.00)
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000824 000052452492 DEFISIT ($1,679,994.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000838 000008307783 DEFISIT ($1,057,418.00)
9
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000849 000276523807 DEFISIT ($1,891,696.00)
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000947 000200892900 DEFISIT ($1,735,201.00)
3
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000993 000053629494 DEFISIT ($1,062,977.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001190 000053540093 DEFISIT ($826,389.00)
2
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001278 000251977270 DEFISIT ($753,886.00)
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001292 000138957863 DEFISIT ($1,789,247.00)
5
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001369 000202638003 DEFISIT ($915,291.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001377 000008302372 DEFISIT ($728,091.00)
7
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001464 000053613077 DEFISIT ($1,166,803.00)
5
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001552 000008314062 DEFISIT ($1,545,330.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001642 000053715904 DEFISIT ($830,977.00)
7
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001756 000169459384 DEFISIT ($1,321,944.00)
4
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001856 000019368694 SURPLUS $1,410,966.00
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001871 000213558747 DEFISIT ($1,813,587.00)
6
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001922 000213203073 DEFISIT ($984,496.00)
3
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V003058 000020057388 DEFISIT ($1,011,241.00)
6
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V003462 000053599322 DEFISIT ($1,119,022.00)
2
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V003480 000223632804 DEFISIT ($371,043.00)
3
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V003971 000130912648 DEFISIT ($3,472,603.00)
7
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V004005 000276516583 DEFISIT ($814,839.00)
7
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V004006 000262494066 DEFISIT ($689,431.00)
3
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V004899 000053549218 DEFISIT ($1,102,994.00)
1
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V004922 000053615081 SURPLUS $2,133,943.00
2
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005552 000053613509 DEFISIT ($1,229,412.00)
5
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005554 000201005968 DEFISIT ($26,509.00)
4
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005846 000053705081 DEFISIT ($600,661.00)
2
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005849 000153275393 DEFISIT ($749,439.00)
2
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005874 000128959955 DEFISIT ($2,131,254.00)
8
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V006384 000053669561 DEFISIT ($796,830.00)
5
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V006869 000101789732 DEFISIT ($1,315,649.00)
2
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V007736 000053658571 DEFISIT ($607,338.00)
4
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V007737 000053803520 DEFISIT ($721,615.00)
8
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V007738 000184450499 DEFISIT ($511,878.00)
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010519V009488 000101760375 DEFISIT ($868,275.00)
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000044 000053579573 DEFISIT ($1,107,390.00)
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000047 000169530890 DEFISIT ($116,943.00)
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000048 000274822163 DEFISIT ($308,081.00)
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000049 000053544097 DEFISIT ($971,815.00)
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000074 000101770659 DEFISIT ($688,495.00)
9
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000095 000053527041 DEFISIT ($260,188.00)
9
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000601 000101771427 DEFISIT ($782,312.00)
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000612 000183403888 DEFISIT ($498,880.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000617 000053771833 DEFISIT ($1,057,904.00)
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000705 000053600792 DEFISIT ($1,007,229.00)
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000760 000192870563 DEFISIT ($725,092.00)
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000881 000053613506 DEFISIT ($878,566.00)
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000951 000053556854 DEFISIT ($1,005,492.00)
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V001250 000219498704 DEFISIT ($1,571,081.00)
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V001670 000227726570 DEFISIT ($1,157,500.00)
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V001870 000225942871 DEFISIT ($1,456,479.00)
4
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V001911 000017098902 SURPLUS $897,803.00
9
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V002275 000053604515 DEFISIT ($1,320,528.00)
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V002593 000244485103 DEFISIT ($1,171,182.00)
4
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V002731 000053678932 DEFISIT ($1,549,472.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V003354 000053689650 DEFISIT ($597,146.00)
6
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V004503 000101529655 DEFISIT ($697,042.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V004536 000053549760 DEFISIT ($1,469,731.00)
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V004765 000213531330 DEFISIT ($708,503.00)
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V004995 000053823463 DEFISIT ($691,005.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005293 000152939477 DEFISIT ($1,531,828.00)
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005841 000053536582 DEFISIT ($1,217,679.00)
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V006317 000189385171 DEFISIT ($1,302,827.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619v007007 000276918310 DEFISIT ($656,240.00)
1
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000788 000053655021 DEFISIT ($1,018,511.00)
9
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V000995 000203728109 DEFISIT ($822,882.00)
5
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005324 000128812369 DEFISIT ($620,868.00)
4
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V005850 000184039765 DEFISIT ($353,831.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010519V009758 000144678567 DEFISIT ($1,388,519.00)
3
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000035 000169824670 DEFISIT ($717,761.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000096 000245443871 DEFISIT ($992,333.00)
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000811 000053514869 SURPLUS $2,133,354.00
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V002729 000206529756 DEFISIT ($760,935.00)
6
dr SUSANTO RAHMAD N, Sp.OG 1115R0010619V005292 000053697412 DEFISIT ($1,499,298.00)
1
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005202 000053632034 SURPLUS $1,492,634.00
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000885 000227794922 DEFISIT ($2,903,654.00)
8
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005286 000053556854 SURPLUS $806,643.00
5
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V005559 000235331679 DEFISIT ($855,893.00)
3
DR NUNGKY NUGROHO W, SP. OG 1115R0010619V001361 000053774679 SURPLUS $855,429.00
3
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V006191 000277146385 SURPLUS $4,031,437.00
7
dr PRIYO BUDI S. M. Kes, Sp.A 1115R0010619V003723 000276988844 SURPLUS $2,472,145.00
2
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V000427 000276831872 SURPLUS $2,311,558.00
8
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V002699 000276928057 SURPLUS $2,891,992.00
1
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V003984 000276983654 SURPLUS $4,013,345.00
5
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V005308 000277094482 SURPLUS $2,345,691.00
7
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V005774 000277099354 SURPLUS $2,234,691.00
1
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V006237 000277138749 SURPLUS $3,717,418.00
3
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V006280 000277150999 SURPLUS $3,051,784.00
4
DR DYAH PERWITASARI, M.SC SP.A 1115R0010519V009870 000276822365 SURPLUS $3,218,400.00
5
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V005545 000277129037 SURPLUS $3,613,691.00
2
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V006180 000277147452 SURPLUS $2,477,162.00
3
DR LENY ZABIDI, SP.A 1115R0010619V002224 000276899719 SURPLUS $2,296,458.00
4
DR LENY ZABIDI, SP.A 1115R0010619V002266 000276919268 SURPLUS $2,539,100.00
5
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009781 000276808737 SURPLUS $3,171,209.00
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V000807 000276840652 SURPLUS $1,518,376.00
4
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001779 000276877201 SURPLUS $2,735,800.00
4
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V005459 000277113120 SURPLUS $2,701,600.00
6
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V006802 000277167731 SURPLUS $2,510,600.00
5
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V000423 000276831963 SURPLUS $4,221,182.00
9
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V000814 000276840873 SURPLUS $2,409,877.00
9
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V005798 000277132727 SURPLUS $3,165,469.00
2
DR LENY ZABIDI, SP.A 1115R0010619V000607 000276835596 SURPLUS $2,636,239.00
6
DR LENY ZABIDI, SP.A 1115R0010619V002222 000276899749 SURPLUS $3,938,298.00
7
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009409 000276785740 SURPLUS $1,081,531.00
1
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V001904 000276887790 SURPLUS $5,278,947.00
9
DR LENY ZABIDI, SP.A 1115R0010519V009438 000276772328 SURPLUS $1,567,258.00
8
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V003638 000276986242 DEFISIT ($623,111.00)
1
DR ARIS SUNARDI, MSI MED,SPA 1115R0010519V008521 000276714953 SURPLUS $801,098.00
8
DR ARIS SUNARDI, MSI MED,SPA 1115R0010519V009852 000276814296 SURPLUS $2,619,517.00
9
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V001240 000276839954 SURPLUS $2,252,231.00
8
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V005307 000277088723 DEFISIT ($1,732,390.00)
8
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V005522 000277119226 SURPLUS $2,968,266.00
1
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V001358 000276852713 SURPLUS $1,985,976.00
5
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V007230 000277233781 SURPLUS $2,626,244.00
4
DR LENY ZABIDI, SP.A 1115R0010519V008988 000276750267 SURPLUS $3,349,940.00
6
DR LENY ZABIDI, SP.A 1115R0010619V000422 000276829406 SURPLUS $3,631,725.00
8
DR LENY ZABIDI, SP.A 1115R0010619V000610 000276836124 SURPLUS $1,827,307.00
3
DR LENY ZABIDI, SP.A 1115R0010619V000643 000276837002 SURPLUS $969,724.00
8
DR LENY ZABIDI, SP.A 1115R0010619V002221 000276901528 SURPLUS $4,211,443.00
4
DR LENY ZABIDI, SP.A 1115R0010619V003995 000277003804 SURPLUS $1,803,357.00
4
DR LENY ZABIDI, SP.A 1115R0010619V004329 000277001828 SURPLUS $1,155,430.00
8
DR LENY ZABIDI, SP.A 1115R0010619V004524 000277040875 SURPLUS $2,443,085.00
4
DR LENY ZABIDI, SP.A 1115R0010619V004900 000277069149 SURPLUS $3,808,722.00
9
DR LENY ZABIDI, SP.A 1115R0010619V005305 000277094823 SURPLUS $1,879,276.00
6
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V005547 000277132589 SURPLUS $2,547,407.00
8
DR DYAH PERWITASARI, M.SC SP.A 1115R0010519V009875 000276830436 SURPLUS $4,561,648.00
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V005532 000277122506 SURPLUS $2,910,934.00
5
DR LENY ZABIDI, SP.A 1115R0010519V009841 000276815044 DEFISIT ($181,116.00)
1
DR DYAH PERWITASARI, M.SC SP.A 1115R0010519V009876 000276829604 SURPLUS $205,015.00
8
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V005544 000277127808 SURPLUS $648,856.00
6
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V007243 000277241046 SURPLUS $247,365.00
6
DR LENY ZABIDI, SP.A 1115R0010519V009832 000276804303 DEFISIT ($538,029.00)
6
DR LENY ZABIDI, SP.A 1115R0010619V000606 000276835687 DEFISIT ($506,563.00)
7
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009871 000276822054 SURPLUS $825,729.00
9
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V002118 000276846402 SURPLUS $43,153.00
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V002216 000276901173 SURPLUS $923,850.00
9
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V005525 000277117051 SURPLUS $871,916.00
4
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V006644 000277155926 SURPLUS $762,635.00
8
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V006795 000277183823 SURPLUS $86,071.00
5
PRIYO BUDI S. M.KES., DR.SP.A 1115R0010519V009844 000276815267 SURPLUS $19,965.00
8
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V000424 000276831687 SURPLUS $170,352.00
3
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V001359 000276856271 SURPLUS $2,561,110.00
8
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V006185 000277145153 SURPLUS $758,432.00
8
DR DYAH PERWITASARI, M.SC SP.A 1115R0010519V008964 000276740208 SURPLUS $3,540,362.00
9
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V002241 000276740208 SURPLUS $2,174,500.00
9
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V003629 000276985808 SURPLUS $3,161,551.00
8
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V003633 000276985750 SURPLUS $3,147,282.00
4
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V001832 000276880081 SURPLUS $2,319,942.00
4
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V001905 000276888083 SURPLUS $4,059,022.00
5
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V002724 000276921458 SURPLUS $2,607,777.00
8
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V003052 000276946458 SURPLUS $2,625,800.00
6
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V004896 000276928057 SURPLUS $2,890,952.00
1
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V005548 000277129126 SURPLUS $2,345,695.00
1
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V007701 000277147452 SURPLUS $2,612,066.00
3
DR LENY ZABIDI, SP.A 1115R0010619V000426 000276727019 SURPLUS $2,941,900.00
5
DR LENY ZABIDI, SP.A 1115R0010619V000609 000276835436 SURPLUS $2,436,500.00
8
DR LENY ZABIDI, SP.A 1115R0010619V001238 000276842022 SURPLUS $845,417.00
6
DR LENY ZABIDI, SP.A 1115R0010619V003326 000276836124 SURPLUS $1,988,700.00
3
DR LENY ZABIDI, SP.A 1115R0010619V003970 000276919268 SURPLUS $2,489,407.00
5
DR LENY ZABIDI, SP.A 1115R0010619V003981 000276932373 SURPLUS $3,139,100.00
6
DR LENY ZABIDI, SP.A 1115R0010619V003990 000276899749 SURPLUS $4,146,420.00
7
DR LENY ZABIDI, SP.A 1115R0010619V003991 000276899719 SURPLUS $2,483,761.00
4
DR LENY ZABIDI, SP.A 1115R0010619V005521 000277089136 SURPLUS $2,194,899.00
7
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V000614 000276780322 SURPLUS $2,156,630.00
1
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V000615 000276816528 SURPLUS $2,546,800.00
9
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V002226 000276891456 SURPLUS $2,432,376.00
3
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V002250 000276911969 SURPLUS $2,596,853.00
5
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V004543 000276900244 SURPLUS $1,775,563.00
7
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V004889 000277053705 SURPLUS $3,103,900.00
9
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V005536 000276988844 SURPLUS $2,449,686.00
2
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V005543 000277128736 SURPLUS $2,963,405.00
7
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V006841 000277117051 SURPLUS $2,500,490.00
4
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V006843 000277113120 SURPLUS $2,450,990.00
6
DR PRIYO BUDI S. M. KES, SP.A 1115R0010519V009877 000276828492 SURPLUS $2,696,786.00
3
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V002251 000276914985 SURPLUS $3,845,248.00
6
DR ARIS SUNARDI, MSI MED,SPA 1115R0010619V000816 000206676341 SURPLUS $1,303,286.00
8
DR MADE YUDHA SU, SP.B 1115R0010619V007716 000053547551 SURPLUS $1,306,366.00
8
DR MADE YUDHA SU, SP.B 1115R0010619V001368 000053681429 SURPLUS $1,257,214.00
2
DR MADE YUDHA SU, SP.B 1115R0010619V003988 000053807723 SURPLUS $1,711,422.00
8
DR MADE YUDHA SU, SP.B 1115R0010619V006262 000053620431 SURPLUS $3,389,611.00
6
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000085 000053513632 SURPLUS $1,420,708.00
1
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000089 000053780722 SURPLUS $1,430,314.00
7
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V006374 000216872812 SURPLUS $784,240.00
1
DR DYAH PERWITASARI, M.SC SP.A 1115R0010519V009470 000219692703 DEFISIT ($295,591.00)
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000727 000053646034 DEFISIT ($471,039.00)
4
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V004991 000053575117 DEFISIT ($37,228.00)
7
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V005321 000101773722 DEFISIT ($489,396.00)
3
DR THOMAS EFENDI, SP.PD 1115R0010619V000541 000249977421 DEFISIT ($314,458.00)
9
DR THOMAS EFENDI, SP.PD 1115R0010619V002725 000015893140 DEFISIT ($1,853,692.00)
4
DR THOMAS EFENDI, SP.PD 1115R0010619V003364 000053566644 DEFISIT ($599,041.00)
3
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V001387 000231204964 SURPLUS $173,443.00
4
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V005560 000142390553 SURPLUS $87,990.00
5
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V003373 000128957807 SURPLUS $345,447.00
2
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V003611 000151735311 SURPLUS $588,746.00
9
DR PRIYO BUDI S. M. KES, SP.A 1115R0010619V005320 000226905373 DEFISIT ($493,971.00)
1
DR THOMAS EFENDI, SP.PD 1115R0010519V008559 000207599107 DEFISIT ($800,412.00)
4
dr THOMAS EFENDI, Sp.PD 1115R0010519V009429 000216562435 SURPLUS $534,084.00
7
DR THOMAS EFENDI, SP.PD 1115R0010519V009447 000138945453 DEFISIT ($26,572.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010519V009532 000053646311 SURPLUS $424,355.00
2
DR THOMAS EFENDI, SP.PD 1115R0010619V000034 000053432070 SURPLUS $245,388.00
6
DR THOMAS EFENDI, SP.PD 1115R0010619V000087 000008329140 SURPLUS $282,484.00
9
DR THOMAS EFENDI, SP.PD 1115R0010619V003365 000008334440 DEFISIT ($824,552.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010619V007266 000235324824 DEFISIT ($54,830.00)
6
DR THOMAS EFENDI, SP.PD 1115R0010619V000442 000053805282 DEFISIT ($441,212.00)
6
DR EKO PUDJI ANTONO, SP.S 1115R0010519V009444 000053586667 SURPLUS $6,314,117.00
1
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003362 000008308098 SURPLUS $9,119,424.00
9
DR EKO PUDJI ANTONO, SP.S 1115R0010619V007265 000053592179 DEFISIT ($573,740.00)
5
DR EKO PUDJI ANTONO, SP.S 1115R0010519V009041 000008318287 DEFISIT ($2,075,943.00)
1
DR EKO PUDJI ANTONO, SP.S 1115R0010519V009480 000108466594 DEFISIT ($414,797.00)
7
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000033 000053717707 SURPLUS $227,967.00
1
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000616 000101773708 DEFISIT ($83,116.00)
7
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000679 000179851217 DEFISIT ($392,054.00)
5
DR EKO PUDJI ANTONO, SP.S 1115R0010619V002730 000008326137 SURPLUS $510,305.00
3
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003998 000152537171 DEFISIT ($239,715.00)
5
DR EKO PUDJI ANTONO, SP.S 1115R0010619V005311 000216562900 DEFISIT ($1,055,915.00)
4
DR EKO PUDJI ANTONO, SP.S 1115R0010619V005820 000053550749 SURPLUS $349,316.00
2
DR EKO PUDJI ANTONO, SP.S 1115R0010619V005861 000008332460 SURPLUS $92,511.00
8
DR EKO PUDJI ANTONO, SP.S 1115R0010619V006630 000008306628 DEFISIT ($1,495,345.00)
6
DR EKO PUDJI ANTONO, SP.S 1115R0010619V007258 000008331997 DEFISIT ($343,171.00)
4
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V002738 000249058758 SURPLUS $733,780.00
3
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V003055 000249912099 SURPLUS $1,123,112.00
9
DR DYAH PERWITASARI, M.SC SP.A 1115R0010619V007264 000245779068 SURPLUS $854,657.00
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000975 000053674814 DEFISIT ($2,313,101.00)
2
DR THOMAS EFENDI, SP.PD 1115R0010619V000701 000257393709 DEFISIT ($1,997,074.00)
9
DR THOMAS EFENDI, SP.PD 1115R0010619V006871 000244470719 DEFISIT ($2,562,683.00)
2
DR MADE YUDHA SU, SP.B 1115R0010619V001385 000129188343 SURPLUS $808,761.00
3
DR WAHYU PRIYATNO, SP. B 1115R0010619V005832 000216872392 SURPLUS $1,582,296.00
4
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V001890 000008321088 DEFISIT ($2,984,468.00)
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002726 000053561212 SURPLUS $2,106,587.00
7
DR THOMAS EFENDI, SP.PD 1115R0010519V008484 000007564715 DEFISIT ($3,615,700.00)
8
DR THOMAS EFENDI, SP.PD 1115R0010519V008992 000101781473 SURPLUS $631,969.00
5
DR THOMAS EFENDI, SP.PD 1115R0010619V000451 000101771852 SURPLUS $1,470,113.00
5
DR THOMAS EFENDI, SP.PD 1115R0010619V000661 000053509359 SURPLUS $1,928,862.00
3
DR THOMAS EFENDI, SP.PD 1115R0010619V000976 000053534609 SURPLUS $1,520,660.00
8
DR MADE YUDHA SU, SP.B 1115R0010519V008961 000207405100 DEFISIT ($131,250.00)
1
DR MADE YUDHA SU, SP.B 1115R0010619V000618 000053669590 DEFISIT ($1,263,385.00)
7
DR MADE YUDHA SU, SP.B 1115R0010619V000636 000186151241 SURPLUS $542,180.00
2
DR MADE YUDHA SU, SP.B 1115R0010619V003056 000204684655 SURPLUS $1,191,987.00
4
DR MADE YUDHA SU, SP.B 1115R0010619V003978 000228293731 SURPLUS $574,482.00
1
DR NUGROHO KURNIANTO, SP.B 1115R0010519V009820 000053579448 SURPLUS $510,132.00
9
DR NUGROHO KURNIANTO, SP.B 1115R0010619V001908 000132234804 DEFISIT ($1,537,069.00)
9
DR NUGROHO KURNIANTO, SP.B 1115R0010619V006842 000053607181 DEFISIT ($459,830.00)
4
DR WAHYU PRIYATNO, SP. B 1115R0010619V004914 000053584217 SURPLUS $664,876.00
8
DR WAHYU PRIYATNO, SP. B 1115R0010619V005840 000216873286 SURPLUS $828,642.00
7
DR WAHYU PRIYATNO, SP. B 1115R0010619V002235 000053509743 SURPLUS $1,719,630.00
9
DR NUGROHO KURNIANTO, SP.B 1115R0010619V003375 000216562642 SURPLUS $41,149.00
7
DR WAHYU PRIYATNO, SP. B 1115R0010619V004538 000108447759 SURPLUS $57,042.00
9
DR WAHYU PRIYATNO, SP. B 1115R0010619V007232 000221407950 DEFISIT ($545,025.00)
3
DR NUGROHO KURNIANTO, SP.B 1115R0010619V001909 000238024067 DEFISIT ($362,342.00)
5
DR NUGROHO KURNIANTO, SP.B 1115R0010619V006850 000008059422 DEFISIT ($834,750.00)
3
DR WAHYU PRIYATNO, SP. B 1115R0010619V003330 000200893270 SURPLUS $618,340.00
4
DR NUGROHO KURNIANTO, SP.B 1115R0010619V007251 000053780758 DEFISIT ($18,388.00)
7
DR MADE YUDHA SU, SP.B 1115R0010619V006375 000053581935 SURPLUS $3,550,397.00
3
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004523 000101771115 DEFISIT ($60,278.00)
6
dr MADE YUDHA SU, Sp.B 1115R0010619V005290 000053633113 DEFISIT ($187,081.00)
7
DR MADE YUDHA SU, SP.B 1115R0010619V000012 000235327648 SURPLUS $790,777.00
4
DR WAHYU PRIYATNO, SP. B 1115R0010619V006388 000245274459 SURPLUS $2,938,390.00
6
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000874 000143491821 SURPLUS $212,962.00
6
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000637 000262560516 SURPLUS $2,501,907.00
6
DR ESTININGTYAS WARDHANI, SP.P 1115R0010619V000650 000053504636 SURPLUS $2,388,485.00
5
DR EKO PUDJI ANTONO, SP.S 1115R0010619V000653 000008343089 SURPLUS $250,752.00
8
DR EKO PUDJI ANTONO, SP.S 1115R0010619V003345 000008342811 DEFISIT ($682,549.00)
9
DR EKO PUDJI ANTONO, SP.S 1115R0010619V005555 000053506017 SURPLUS $15,998.00
9
DR EKO PUDJI ANTONO, SP.S 1115R0010619V007717 000053652612 SURPLUS $328,569.00
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V002978 000053766596 SURPLUS $121,233.00
2
DR LAILY DJIHAN, SP.JP 1115R0010619V000691 000263479562 SURPLUS $51,427.00
8
DR MADE YUDHA SU, SP.B 1115R0010619V002270 000101797930 DEFISIT ($217,449.00)
1
DR MADE YUDHA SU, SP.B 1115R0010619V002714 000053517423 SURPLUS $505,858.00
3
DR MADE YUDHA SU, SP.B 1115R0010619V005287 000008327671 SURPLUS $212,222.00
7
DR WAHYU PRIYATNO, SP. B 1115R0010619V002267 000053816019 SURPLUS $314,276.00
6
DR NUGROHO KURNIANTO, SP.B 1115R0010619V004695 000112471131 SURPLUS $308,652.00
3
DR GEDE PERDANA PUTERA, SP. PD 1115R0010619V000870 000008324528 SURPLUS $194,088.00
5
dr NUNGKY NUGROHO W, Sp. OG 1115R0010619V003979 000053465024 SURPLUS $494,290.00
2
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V000036 000275504180 SURPLUS $284,978.00
5
DR YUNAN ARDI S, SP.THT- KL 1115R0010619V003956 000108501589 SURPLUS $62,504.00
1
DR MADE YUDHA SU, SP.B 1115R0010619V001384 000185421040 DEFISIT ($1,276,170.00)
7
DR SUSANTO RAHMAD N, SP.OG 1115R0010619V004518 000276526302 SURPLUS $205,644.00
6
KASUS ANAK DAN BAYI
NO DIAGNOSA PRIMER DAN KODE ICD DIAGNOSA SEKUNDER KODE ICD 9
10 DAN KODE ICD 10
8 A91 : DHF -
trombositopeni , IGG IGM mendukung dan
tata laksana obat/terapi
10 B08.2 J00 -
VIRAL EXANTHEM RHINOPARINGITIS
anamnesa dan pengobatannya anamnesa dan pengobatannya
11 B20.6 D64.9 -
B20.6 DG PNEUMONIA ANEMIA
HASIL Rontgen PNEMUNONIA dan
terapi/pengobatanya serta hasil tes vct
12 B34.9 -
VIRAL INFECTION
demam yg tidak spesisik penyebabnya
13 D50.9 99.04
ANEMIA DEFISIENSI BESI TRANSFUSI
hasil lab anemia def besi
14 D56.1 99.04
THALASEMIA MAYOR TRANSFUSI
lab feritin
TOP UP EXJADE/FERIPROX 5,545,300
16 D56.9 99.04
THALASEMIA TRANSFUSI
hasil lab
18 E43 R63.3 -
GIZI BURUK ANOREXIA
lembar asuhan gizi klinik anamnesa
19 G40.9 -
EPILEPSI
anamnesa dan terapi pengobatannya
20 G41.9 -
STATUS EPILEPTICUS
anamnesa dan terapi pengobatannya
21 J00 -
RHHINOPHARINGITIS
anamnesa dan terapi pengobatannya
22 J18.0 -
BRONKOPNEUMONIA -
Pneumonia dapat didiagnosis sesuai dengan
KMK RI No. HK. 02.02/MENKES/514/2015 yaitu
jika pada foto toraks terdapat infiltrat baru
atau infiltrate progresif ditambah dengan 2
atau lebih gejala dibawah ini : 1. Batuk-batuk
bertambah 2. Perubahan karakteristik dahak /
purulent 3. Suhu tubuh > 38°C (aksila) /
riwayat demam 4. Pemeriksaan fisik :
ditemukan tanda-tanda konsolidasi, suara
napas bronkial dan ronki 5. Leukosit > 10.000
atau < 4500
23 J18.0 D64.9 -
BRONKOPNEUMONIA ANEMIA
Pneumonia dapat didiagnosis sesuai dengan
KMK RI No. HK. 02.02/MENKES/514/2015 yaitu
jika pada foto toraks terdapat infiltrat baru
atau infiltrate progresif ditambah dengan 2
atau lebih gejala dibawah ini : 1. Batuk-batuk
bertambah 2. Perubahan karakteristik dahak /
purulent 3. Suhu tubuh > 38°C (aksila) /
riwayat demam 4. Pemeriksaan fisik :
ditemukan tanda-tanda konsolidasi, suara
napas bronkial dan ronki 5. Leukosit > 10.000
atau < 4500
24 J18.9 -
PNEUMONIA
Pneumonia dapat didiagnosis sesuai dengan
KMK RI No. HK. 02.02/MENKES/514/2015 yaitu
jika pada foto toraks terdapat infiltrat baru
atau infiltrate progresif ditambah dengan 2
atau lebih gejala dibawah ini : 1. Batuk-batuk
bertambah 2. Perubahan karakteristik dahak /
purulent 3. Suhu tubuh > 38°C (aksila) /
riwayat demam 4. Pemeriksaan fisik :
ditemukan tanda-tanda konsolidasi, suara
napas bronkial dan ronki 5. Leukosit > 10.000
atau < 4500
25 J20.9 -
BRONCHITIS -
hasil Rontgen dan pengobatannya -
26 J45.9 -
ASTHMA 93.94
anamnesa dan pengobatannya 93.94
27 J45.9 A09.9 -
ASTHMA GEA
anamnesa dan pengobatannya anamnesa dan pengobatannya
28 K30 -
DISPEPSIA
anamnesa dan pengobatannya
29 N39.0 -
ISK
30 N76.4 -
ABSCES VULVA
31 P03.3 : LAHIR VE
32 P36.9 : SEPSIS
33 P21.1 : ASFIKSIA SEDANG
34 P03.3 : LAHIR VE
35 P03.4 : LAHIR SC
36 P07.0 : BBLSR CATATAN :
Birth weight 999 g or less.
37 P07.1 : BBLR NO : 31 sd 51 tarifnya
Birth weight 1000-2499 g. berbeda-beda dipengaruhi
38 P07.2 : LAHIR PREMATURE < 28 MINGGU oleh berat badan dan tanggal lahir
52 Q21.0 : VSD
anamnesa, pem fisiks, hasil echo dan
pengobatannya
53 Q21.1 : ASD
anamnesa, pem fisiks, hasil echo dan
pengobatannya
54 Q25.0 -
PDA PATENT DUCTUS ARTERIOSUS
anamnesa, pem fisiks, hasil echo dan
pengobatannya
55 R10.4 -
KOLIK ABDOMEN
anamnesa dan pengobatannya
56 R11 -
VOMITUS
anamnesa dan pengobatannya
57 R11 A09.0 -
VOMITUS GEA
anamnesa dan pengobatannya anamnesa, hasil lab feses dan pengobatannya
58 R56.0 J20.9 -
KDK BRONCHITIS -
anamnesa dan pengobatannya hasil Rontgen dan pengobatannya -
59 R56.0 R11
KDK VOMITUS
anamnesa dan pengobatannya anamnesa dan pengobatannya
60 R56.0
KDK
anamnesa dan pengobatannya
KELAS TARIF
RAWAT INA
CBG
KELAS 1 2,929,500
KELAS 2 2,511,000
KELAS 3 2,092,500
KELAS 1 2,472,100
KELAS 2 2,119,000
KELAS 3 1,765,800
KELAS 1 1,739,600
KELAS 2 1,491,100
KELAS 3 1,242,600
KELAS 1 2,472,100
KELAS 2 2,119,000
KELAS 3 1,765,800
KELAS 1 1,968,700
KELAS 2 1,687,500
KELAS 3 1,406,200
KELAS 1 1,968,700
KELAS 2 1,687,500
KELAS 3 1,406,200
KELAS 1 2,112,800
KELAS 2 1,811,000
KELAS 3 1,509,200
KELAS 1 2,112,800
KELAS 2 1,811,000
KELAS 3 1,509,200
KELAS 1 3,182,900
KELAS 2 2,728,200
KELAS 3 2,273,500
KELAS 1 2,112,800
KELAS 2 1,811,000
KELAS 3 1,509,200
KELAS 1 6,884,700
KELAS 2 5,901,200
KELAS 3 4,917,700
KELAS 1 2,112,800
KELAS 2 1,811,000
KELAS 3 1,509,200
KELAS 1
KELAS 2 2,661,700
KELAS 3 2,218,100
KELAS 1 3,105,300
KELAS 2 2,661,700
KELAS 3 2,218,100
KELAS 1 4,395,100
KELAS 2 3,767,200
KELAS 3 3,139,300
KELAS 1 3,105,300
KELAS 2 2,661,700
KELAS 3 2,218,100
KELAS 1 3,105,300
KELAS 2 2,661,700
KELAS 3 2,218,100
KELAS 1 6,515,500
KELAS 2 5,584,700
KELAS 3 4,653,900
KELAS 1 3,535,500
KELAS 2 3,030,400
KELAS 3 2,525,300
KELAS 1 3,535,500
KELAS 2 3,030,400
KELAS 3 2,525,300
KELAS 1 2,556,900
KELAS 2 2,191,600
KELAS 3 1,826,300
KELAS 1 4,665,600
KELAS 2 3,999,100
KELAS 3 3,332,600
KELAS 1 6,556,400
KELAS 2 5,619,800
KELAS 3 4,683,100
KELAS 1 4,665,600
KELAS 2 3,999,100
KELAS 3 3,332,600
KELAS 1 3,725,400
KELAS 2 3,193,200
KELAS 3 2,661,000
KELAS 1 2,874,200
KELAS 2 2,463,600
KELAS 3 2,053,000
KELAS 1 2,874,200
KELAS 2 2,463,600
KELAS 3 2,053,000
KELAS 1 1,739,600
KELAS 2 1,491,100
KELAS 3 1,242,600
KELAS 1 3,017,500
KELAS 2 2,586,500
KELAS 3 2,155,400
KELAS 1 3,286,500
KELAS 2 2,817,000
KELAS 3 2,347,500
31 sd 51 tarifnya
eda-beda dipengaruhi
berat badan dan tanggal lahir
KELAS 1 4,218,400
KELAS 2 3,615,800
KELAS 3 3,013,200
KELAS 1 4,218,400
KELAS 2 3,615,800
KELAS 3 3,013,200
KELAS 1 4,069,900
KELAS 2 3,488,500
KELAS 3 2,907,100
KELAS 1 1,968,700
KELAS 2
KELAS 3
KELAS 1 1,968,700
KELAS 2 1,687,500
KELAS 3 1,406,200
KELAS 1 1,968,700
KELAS 2 1,687,500
KELAS 3 1,406,200
KELAS 1 3,535,500
KELAS 2 3,030,400
KELAS 3 2,525,300
KELAS 1 3,535,500
KELAS 2 3,030,400
KELAS 3 2,525,300
KELAS 1 3,535,500
KELAS 2 3,030,400
KELAS 3 2,525,300
KASUS PENYAKIT DALAM, SARAF, JANTUNG, DAN PARU
1 A01.0
dibuktikan dengan hasil KELAS 2 2,511,000
tubex mendukung atau
widal 1/320 serta
mendapatkan
tatalakasana/terapi obat
-
KELAS 3 2,092,500
KELAS 3 1,765,800
KELAS 3 1,242,600
KELAS 3 1,765,800
KELAS 3 1,242,600
KELAS 3 1,406,200
KELAS 3 1,406,200
KELAS 3 1,923,400
KELAS 3 1,406,200
KELAS 3 1,923,400
KELAS 3 1,923,400
KELAS 3 1,406,200
KELAS 3 3,999,700
KELAS 3 3,999,700
KELAS 3 3,999,700
KELAS 3 2,092,500
KELAS 3 2,273,500
KELAS 3 2,273,500
KELAS 3 1,509,200
dibuktikan dengan
hasil tubex
mendukung atau
widal 1/320 serta
mendapatkan
tatalakasana/terapi
obat
KELAS 3 2,728,200
KELAS 3 1,509,200
KELAS 3 2,273,500
KELAS 3 1509200
KELAS 3 1,509,200
KELAS 3 1,509,200
KELAS 3 1,509,200
KELAS 3 1,509,200
KELAS 3 1,509,200
KELAS 3 1,509,200
KELAS 3 1,509,200
KELAS 3 2,273,500
KELAS 3 3,858,300
KELAS 3 3,858,300
KELAS 3 3,637,100
KELAS 3 3,122,100
KELAS 3 6,311,300
49 D33.2 : TUMOR OTAK - KELAS 1 4,143,800
HASIL RO , ANAMNESA, KELAS 2 3,551,800
PEMERIKSAAN FISIK DAN
PENGOBATANNYA
KELAS 3 2,959,900
KELAS 3 3,139,300
KELAS 3 2,218,100
KELAS 3 2,218,100
KELAS 3 3,139,300
KELAS 3 2,218,100
KELAS 3 3,917,300
KELAS 3 5,214,200
KELAS 3 3,330,600
KELAS 3 4,653,900
KELAS 3 4,653,900
KELAS 3 5,257,000
KELAS 3 3,330,600
KELAS 3 2,194,200
KELAS 3 3,770,200
KELAS 3 2,525,300
KELAS 3 1,758,600
KELAS 3 1,758,600
KELAS 3 1,758,600
KELAS 3 2,575,600
77 I11.0 : HT, HHD, CHF K30 : DISPEPSIA E44.0 : MODERATE KELAS 1 5,015,600
PEM
-
TENSI, HASIL RO THORAX ANAMNESA DAN ASUHAN KELAS 2 4,299,100
CARDIOMEGALI DAN PENGOBATANNYA GIZI/KONSUL GIZI
PENGOBATANNYA KLINIK
KELAS 3 3,582,600
I11.0 : HT, HHD, CHF J18.9 : PNEUMONIA KELAS 1 5,015,600
78 -
TENSI, HASIL RO THORAX Pneumonia dapat KELAS 2 4,299,100
CARDIOMEGALI DAN didiagnosis sesuai
PENGOBATANNYA dengan KMK RI No.
HK.
02.02/MENKES/514
/2015 yaitu jika
pada foto toraks
terdapat infiltrat
baru atau infiltrate
progresif ditambah
dengan 2 atau lebih
gejala dibawah ini :
1. Batuk-batuk
bertambah 2.
Perubahan
karakteristik
dahak / purulent 3.
Suhu tubuh > 38°C
(aksila) / riwayat
demam 4.
Pemeriksaan fisik :
ditemukan tanda-
tanda konsolidasi,
suara napas
bronkial dan ronki
5. Leukosit > 10.000
atau < 4500
KELAS 3 3,582,600
KELAS 3 2,976,400
KELAS 3 2,976,400
KELAS 3 4,377,800
KELAS 3 2,460,800
KELAS 3 2,460,800
KELAS 3 2,976,400
KELAS 3 2,976,400
KELAS 3 2,976,400
KELAS 3 2,976,400
KELAS 3 2,976,400
KELAS 3 2,460,800
KELAS 3 2,985,500
KELAS 3 2,575,600
KELAS 3 2,985,500
KELAS 3 2,985,500
KELAS 3 5,200,100
97 I21.1 : STEMI INFERIOR D64.9 : ANEMIA J81 : EDEM PULMO I50.0 : CHF - KELAS 1 10,489,600
HASIL EKG/ECHO DAN TATA Anemia sebagai GEJALA KLINIS HASIL RO THORAX KELAS 2 8,991,100
LAKSANANYA diagnosis sekunder SESAK, TAKIKARDI. CARDIOMEGALI
adalah anemia RONKI DAN ADA DAN
yang disebabkan TATALAKSANANYA TATALAKSANANYA
oleh : 1. Komplikasi YANG TEREKAM
penyakit utamanya DALAM RESUME
(dimana terapi MEDIS DAN ADA
anemia berbeda TERAPI DIURETIK
dengan terapi ATAU OKSIGEN
utamanya), YANG DIBERIKAN
contoh : pasien
kanker payudara yg
diradioterapi, pada
perjalanannnya
timbul anemia
maka anemia
tersebut dapat
dimasukkan
diagnosa sekunder
dan stadium lanjut,
dll) yang
memerlukan
transfusi darah dan
eritropoetin harus
dimasukkan 2.
Anemia gravis (Hb
< 8) pada penyakit
kronik (contoh :
gagal ginjal kronik,
kanker, dll) ke
dalam diagnosis
sekunder karena
memerlukan
pengobatan khusus
yg berbeda dari
penyakit dasarnya.
KELAS 3 7,492,600
KELAS 3 5,200,100
KELAS 3 5,200,100
KELAS 3 5,200,100
KELAS 3 5,200,100
KELAS 3 3,010,100
105 I25.9 : IHD I11.9 : HHD - KELAS 1 2,187,000
HASIL EKG/ECHO DAN TATA ANAMNESA, PEM KELAS 2 1,874,600
LAKSANANYA FISIK, TENSI DAN
TATALAKSANANANY
A
KELAS 3 1,562,100
KELAS 3 2,508,400
KELAS 3 2,575,600
KELAS 3 3,582,600
KELAS 3 3,582,600
111 I50.0 CHF I25.9 : IHD - KELAS 1 3,605,900
HASIL RO THORAX KELAS 2 3,090,800
CARDIOMEGALI DAN
TATALAKSANANYA
KELAS 3 2,575,600
KELAS 3 2,985,500
KELAS 3 2,985,500
114 I50.1 : CHF EDEM PULMO K30 : DISPEPSIA E63.1 : Imbalance of KELAS 1 4,179,700
constituents of food
intake
-
HASIL RO THORAX ANAMNESA DAN ASUHAN KELAS 2 3,582,600
CARDIOMEGALI, EDEM PENGOBATANNYA GIZI/KONSUL GIZI
PULMO, DAN KLINIK
TATALAKSANANYA
KELAS 3 2,985,500
115 I50.1 : CHF DAN EDEM E44.0 : Moderate E88.8 : Other KELAS 1 5,015,600
PULMO protein-energy specified metabolic
malnutrition disorders
HASIL RO THORAX ASUHAN ASUHAN KELAS 2 4,299,100
CARDIOMEGALI, EDEM GIZI/KONSUL GIZI GIZI/KONSUL GIZI
PULMO, DAN KLINIK KLINIK
TATALAKSANANYA
KELAS 3 3,582,600
KELAS 3 2,575,600
KELAS 3 2,575,600
KELAS 3 3,582,600
KELAS 3 2,575,600
KELAS 3 3,582,600
KELAS 3 2,985,500
KELAS 3 2,985,500
KELAS 3 3,582,600
KELAS 3 2,985,500
KELAS 3 3,582,600
KELAS 3 3,582,600
KELAS 3 2,985,500
KELAS 3 2,985,500
KELAS 3 3,722,700
KELAS 3 3,041,700
131 I64 : SNH E11.9 : DM - KELAS 1 4,258,400
HASIL CT HASIL LAB KELAS 2 3,650,100
SCAN/ALGORITMA DAN GLUKOSA DAN
TATALAKSANA NYA PENGOBATANNYA
KELAS 3 3,041,700
KELAS 3 3,041,700
KELAS 3 3,332,600
134 J18.9 : PNEUMONIA R64 : CACEXIA E43 : SEVERE PEM - KELAS 1 8,289,600
Pneumonia dapat ANAMNESA DAN ASUHAN KELAS 2 7,105,300
didiagnosis sesuai dengan PENGOBATANNYA GIZI/KONSUL GIZI
KMK RI No. HK. KLINIK
02.02/MENKES/514/2015
yaitu jika pada foto toraks
terdapat infiltrat baru atau
infiltrate progresif
ditambah dengan 2 atau
lebih gejala dibawah ini : 1.
Batuk-batuk bertambah 2.
Perubahan karakteristik
dahak / purulent 3. Suhu
tubuh > 38°C (aksila) /
riwayat demam 4.
Pemeriksaan fisik :
ditemukan tanda-tanda
konsolidasi, suara napas
bronkial dan ronki 5.
Leukosit > 10.000 atau <
4500
KELAS 3 5,921,100
135 J18.9 : PNEUMONIA R54 : SENILITY E43 : SEVERE PEM I11.9 : HHD - KELAS 1 8,289,600
Pneumonia dapat ANAMNESA DAN ASUHAN TENSI, KELAS 2 7,105,300
didiagnosis sesuai dengan PENGOBATANNYA GIZI/KONSUL GIZI ANAMNESA,
KMK RI No. HK. KLINIK PEMERIKSAAN
02.02/MENKES/514/2015 FISIK DAN
yaitu jika pada foto toraks PENGOBATANNYA
terdapat infiltrat baru atau
infiltrate progresif
ditambah dengan 2 atau
lebih gejala dibawah ini : 1.
Batuk-batuk bertambah 2.
Perubahan karakteristik
dahak / purulent 3. Suhu
tubuh > 38°C (aksila) /
riwayat demam 4.
Pemeriksaan fisik :
ditemukan tanda-tanda
konsolidasi, suara napas
bronkial dan ronki 5.
Leukosit > 10.000 atau <
4500
KELAS 3 5,921,100
KELAS 3 4,683,100
KELAS 3 3,332,600
KELAS 3 3,332,600
KELAS 3 3,332,600
KELAS 3 2,661,000
KELAS 3 2,661,000
KELAS 3 2,739,200
KELAS 3 2,739,200
KELAS 3 2,739,200
KELAS 3 2,739,200
J44.1 : PPOK AKSESERBASI B90.9 : SEQUELE TB KELAS 1 3,834,900
146 -
ANAMNESA, PEM FISIK, ANAMNESA, PEM KELAS 2 3,287,100
RO, DAN TATA LAKSANA FISIK, RO, DAN TATA
NYA LAKSANA NYA
KELAS 3 2,739,200
KELAS 3 2,739,200
KELAS 3 2739200
KELAS 3 3,280,300
KELAS 3 2,739,200
KELAS 3 2,053,000
KELAS 3 2,053,000
KELAS 3 2,053,000
KELAS 3 2,053,000
KELAS 3 2,739,200
KELAS 3 3,999,700
KELAS 3 3,999,700
KELAS 3 3,828,800
KELAS 3 3,828,800
KELAS 3 3828800
163 K21.9 : GERD 34.91 KELAS 1 3,071,900
ANAMNESA DAN WSD KELAS 2 2,633,100
PENGOBATANNYA
KELAS 3 2,194,200
KELAS 3 1,242,600
KELAS 3 1,242,600
KELAS 3 1,242,600
KELAS 3 1,242,600
KELAS 3 1,242,600
KELAS 3 1,937,700
KELAS 3 1,242,600
KELAS 3 3,122,100
-
HASIL USG DAN KELAS 2 4,366,100
PENGOBATANNYA
KELAS 3 3,638,400
KELAS 3 3,638,400
KELAS 3 3,638,400
KELAS 3 1,765,800
KELAS 3 1,765,800
KELAS 3 1,765,800
KELAS 3 3,830,100
KELAS 3 3,830,100
KELAS 3 2,155,400
KELAS 3 4,813,800
KELAS 3 2,460,800
KELAS 3 3,919,400
KELAS 3 2,155,400
KELAS 3 3,999,300
KELAS 3 3,999,300
KELAS 3 2,155,400
KELAS 3 2,155,400
N39.0 : ISK K80.2 : KELAS 1 3,017,500
CHOLELITHIASIS
DAN CHOLECYSTITIS
205 -
RO, KELAS 2 2,586,500
ANAMNESA,PEM
FISIK DAN
1. Gejala klinis yang khas PENGOBATANNYA
(minimal satu): sakit
kencing, nyeri perut bagian
bawah, nyeri tekan
suprapubic, anyang-
anyangan, nyeri pinggang,
nyeri ketok costovertebral
angle (CVA) dengan atau
tanpa disertai demam dan
jumlah lekosit urin lebih
dari 10/LPB 2. Kultur urin
positif
KELAS 3 2,155,400
KELAS 3 3,999,300
N39.0 : ISK K30 : DISPEPSIA J00 : KELAS 1 3,017,500
RHINOPHARINGITIS
-
ANAMNESA DAN ANAMNESA DAN KELAS 2 2,586,500
PENGOBATANNYA PENGOBATANNYA
1. Gejala klinis yang khas
(minimal satu): sakit
kencing, nyeri perut bagian
bawah, nyeri tekan
suprapubic, anyang-
anyangan, nyeri pinggang,
nyeri ketok costovertebral
angle (CVA) dengan atau
tanpa disertai demam dan
jumlah lekosit urin lebih
dari 10/LPB 2. Kultur urin
positif
KELAS 3 2,155,400
KELAS 3 2,155,400
209 O14.1 : PEB K30 : DISPEPSIA - KELAS 1 3,744,000
ANAMNESA DAN KELAS 2 3,209,200
PENGOBATANNYA
KELAS 3 2,674,300
KELAS 3 2,661,000
KELAS 3 2,661,000
KELAS 3 1,406,200
KELAS 3 1,406,200
KELAS 3 1,406,200
KELAS 3 1,406,200
KELAS 3 1,406,200
KELAS 3 3,122,100
KELAS 3 1,999,100
223 96.71
ANAMNESA DAN HASIL USG VENTILATOR < KELAS 2 11,060,900
PENGOBATANNYA 96 JAM
KELAS 3 9,217,400
-
ANAMNESA DAN CT SCAN KEPALA ASUHAN KELAS 2 1,574,000
PENGOBATANNYA GIZI/KONSUL GIZI
KLINIK
KELAS 3 1,311,700
KELAS 3 1,311,700
KELAS 3 1,311,700
R57.0 : SHOCK
KARDIOGENIK
230
Kondisi Syok Kardiogenik
dapat menjadi diagnosis
sekunder terutama pada
pasien penyakit jantung
dengan bukti tertulisnya
kriteria klinis dalam rekam
medis berupa :1.
Penurunan Tekanan Darah
a. TD < 90 mmHg tanpa
inotropik, atau b. TD < 80
mmHg dengan inotropik2.
Penurunan Ejection
Fraction (EF < 50%)
KELAS 3 2,475,100
232 R63.0 : ANOREXIA A16.2 : TB PARU E63.1 : Imbalance of K92.0 : KELAS 1 4,662,800
constituents of food HEMATEMESIS
intake
-
ANAMNESA DAN KELAS 2 3,996,700
PENGOBATANNYA
KELAS 3 3,330,600
KELAS 3 3,330,600
234 R63.0 : ANOREXIA E63.1 : Imbalance E43 : SEVERE PEM KELAS 1 4,662,800
of constituents of
food intake
-
ANAMNESA DAN ASUHAN ASUHAN KELAS 2 3,996,700
PENGOBATANNYA GIZI/KONSUL GIZI GIZI/KONSUL GIZI
KLINIK KLINIK
KELAS 3 3,330,600
KELAS 3 3,999,700
KELAS 3 2,860,900
CA BIOPSY
NASOPHARING NASOPHARINX KELAS 2 3,302,000
HASIL PA KELAS 3 2,751,600
TUMOR
MOUTH AND
SALIVARY
GLAND EXCISION SKIN KELAS 2 4,436,300
LAP OPERASI KELAS 3 3,696,900
TUMOR INTRA
ABDOMEN KELAS 2 3,746,500
LAP OPERASI KELAS 3 3,122,100
STRUMA NON
TOXIC GOITRE THYROIDECTOMY KELAS 2 6,697,900
KELAS 3 5,581,600
HEMOROID
INTERNA WITH
KOPLIKASI KELAS 2 5,305,800
KELAS 3 4,421,500
ABSCES
PERITONSILAR KELAS 2 2,191,600
KELAS 3 1,826,300
inguinal
hernia, with
obstruction,
without
gangrene
KELAS 2 5,434,700
KELAS 3 4,528,900
inguinal
hernia, with
obstruction,
with gangrene
KELAS 2 5,434,700
KELAS 3 4,528,900
ILEUS LAPAROTOMY
OBSTRUCTION EXPLORASI KELAS 2 6,943,900
KELAS 3 5,786,500
BLADDER
BLADDER NECK NECK
BPH OBSTRUCTION PROSTATECTOMY INCISION KELAS 2 7,875,400
KELAS 3 6,562,900
FRACTUR
RADIUS
LOWER END CLOSE REDUCTION KELAS 2 2,626,400
KELAS 3 2,188,700
FRACTUR
RADIUS
LOWER END GIPS KELAS 2 2,626,400
KELAS 3 2,188,700
FRACTUR
RADIUS AND
ULNA LOWER
END CLOSE REDUCTION KELAS 2 2,626,400
KELAS 3 2,188,700
MULTIPLE
FRAKTUR FORE
ARM GIPS KELAS 2 2,626,400
KELAS 3 2,188,700
BURN
UNSPECIFIED
DEGREE EXCISION SKIN KELAS 2 4,436,300
KELAS 3 3,696,900
85 S06.9
CKR
86 S06.9 SHOCK
CKR R57.9
VITAL SIGN DAN
ANAMNESA
MENDUKUNG
SERTA
MENDAPAT
TATALAKSANA
SHOCK
87 K35.3 A41.9
SEPSIS
APENDICITIS
DENGAN
PERITONITIS
-Penegakan
diagnosis sepsis
dapat mengikuti
kriteria SIRS
(systemic
inflamatory
response
syndrome) yaitu
terdiri dari
minimal 2
keadaan: 1.
Temperatur
>38,5 derajat
celcius atau <36
derajat celcius 2.
Denyut Jantung
>90 x/menit 3.
Frekuensi
pernafasan
>20x/menit atau
PaCO2 <32
mmHg (Pada
pemeriksaan
AGDA) 4.
Terdapat respons
tubuh terhadap
fokal infeksi,
peradangan, dan
stres dengan
hasil
laboratorium
menunjukkan
leukositosis dan
wajib
melampirkan
bukti kultur
darah dengan
hasil bakterimia.
KASUS OBSGYN/KANDUNGAN
NO DIAGNOSA DIAGNOSA DIAGNOSA DIAGNOSA KODE ICD 9 KODE KELAS TARIF INA
PRIMER DAN SEKUNDER SEKUNDER SEKUNDER ICD 9 RAWAT CBG
KODE ICD 10 DAN KODE DAN KODE ICD DAN KODE ICD
ICD 10 10 10
KELAS 3 1,828,500
KELAS 3 1,828,500
KELAS 3 1,828,500
KELAS 3 5,102,000
KELAS 3 5,102,000
KELAS 3 1,999,800
KELAS 3 1,999,800