LAPORAN BULANAN PENGOBATAN DAN PEMULIHAN KESEHATAN

20 PENYAKIT YANG DIRUJUK

SEKSI PELAYANAN KESEHATAN DASAR ( Yandas ) DINAS KESEHATAN KOTA BANDUNG
UPT Puskesmas : Kopo BULAN : Juni
Puskesmas : Cibaduyut Wetan TAHUN : 2019
RESTRIBUSI UMUM /BAYAR BPJS NON PBI BPJS PBI APBD BPJS PBI APBN ASURA
JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN
NO KODE KODE KODE KODE KODE
NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU
ICD ICD ICD ICD ICD
L P L P L P L P L P L P L P L P

Unilateral or
Perforation of unspecified
tympanic Congestive heart inguinal hernia,
1 H72.9 membrane, 1 I50.0 failure 2 1 K40.9 without 1 F20 Schizophrenia 2
unspecified obstruction or
gangrene

Foreign body on Infantile cerebral Tuberculosis of Cutaneous

2 T15.9 external eye, part 1 G80.9 palsy, unspecified 2 A18.3 intestines, 1 L02.9 abscess, furuncle 2
peritoneum and and carbuncle,
unspecified
mesenteric glands unspecified

3 E14.9 Unspecified 1 1 E14.9 Unspecified 1 H50.9 Strabismus, 1

diabetes mellitus diabetes mellitus unspecified

4 N18.9 Chronic renal 2 R07.4 Chest pain, 1 H26.1 Traumatic 1

failure unspecified cataract
Postprocedural
disorder of eye
5 H59.9 1 K04.1 Necrosis of pulp 1 Z96.1 Pseudophakia 1
and adnexa,
unspecified

Disorder of skin
and Iron deficiency
Asthma,
6 L98.9 subcutaneous 1 D50.9 anaemia, 1 J45.9 unspecified 1
tissue, unspecified
unspecified

Other and
7 K74.6 unspecified 1 K02.1 Caries of dentine 1 R51 Headache 1
cirrhosis of liver

Acute
subendocardial Recurrent
8 I21.4 1 R06.0 Dyspnoea 1 F33 depressive 1
myocardial disorder
infarction

Supervision of Supervision of
9 Z34.8 other normal 1 Z34.8 other normal 1 L40.0 Psoriasis vulgaris 1
pregnancy pregnancy

Fatty (change of)

Moderate
10 H25.9 Senile cataract, 1 1 K76.0 liver, not 1 F71.9 mental 1
unspecified elsewhere retardation
classified
 Sequelae of
stroke, not
11 H26.9 Cataract, 1 O44 Placenta praevia 1 I69.4 specified as 1
unspecified haemorrhage or
infarction

Tuberculous
12 A18.2 peripheral 1 K04.1 Necrosis of pulp 1
lymphadenopathy

Pathological Multiple delivery,

fracture, not
13 M84.4 elsewhere 1 O84.2 all by caesarean 1
classified section

Bacterial infection, Congestive heart

14 A49.9 unspecified 1 I50.0 failure 1

Prolonged
15 O48 pregnancy 1

16 H11.0 Pterygium 1
Hyperplasia of
17 N40 1
prostate
18
19
20

21 Total jumlah         Total jumlah         Total jumlah         Total jumlah        

Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya

                                       

 
KUNJUNGAN TOTAL 0 0 1 1 0 5 1 5 6 0 0 2 6 6 0 0 11 8
 

Mengetahui,
Kepala Puskesmas

dr. Yuli Novariza

NIP. 19760709 200801 2 007
 ASURANSI LAINNYA
JUMLAH KUNJUNGAN
NAMA PENYAKIT KASUS LAMA KASUS BARU
L P L P

         

         

         

         

         

         

         
          

         

         

         

Total jumlah        
Penyakit Lainnya

         

         

         

Bandung, 26 Juni 2019

Penanggung Jawab Program Pemulkes

dr. Irfan Herdiyansyah

NIP. 19880916 201903 1 004
 LAPORAN BULANAN PENGOBATAN DAN PEMULIHAN KESEHATAN
20 PENYAKIT YANG DIRUJUK
SEKSI PELAYANAN KESEHATAN DASAR ( Yandas ) DINAS KESEHATAN KOTA BANDUNG
UPT Puskesmas : Kopo BULAN : Juli
Puskesmas : Cibaduyut Wetan TAHUN : 2019
RESTRIBUSI UMUM /BAYAR BPJS NON PBI BPJS PBI APBD BPJS PBI APBN ASU
JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN
NO KODE KODE KODE KODE KODE
NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU
ICD ICD ICD ICD ICD
L P L P L P L P L P L P L P L P
Respiratory
Tuberculous Staphylococcal tuberculosis, not
1 A18.2 peripheral 1 L00 scalded skin 1 G51 Facial nerve 1 1 A16 confirmed 1 1 1
lymphadenopathy syndrome disorders bacteriologically or
histologically

Sequelae of
stroke, not Other congenital Disorders of
2 I69.4 specified as 1 Q55.6 malformations of 1 H52 refraction and 2
haemorrhage or penis accommodation
infarction

Chronic
Excessive and
obstructive frequent Other senile
3 J44.9 pulmonary 1 N92.1 menstruation with 1 H25.8 cataract 1 1
disease,
irregular cycle
unspecified

Chronic obstructive Other abnormal

Congestive heart
4 I50.0 failure 1 J44.9 pulmonary disease, 1 N93 uterine and vaginal 1
unspecified bleeding

Other and
Other senile Hypertrophy of
5 H25.8 1 J35.1 1 N83.2 unspecified ovarian 1
cataract tonsils cysts

Respiratory Benign lipomatous Stroke, not

tuberculosis, not neoplasm of skin specified as
6 A16 confirmed 1 D17.1 1 I64 1
and subcutaneous haemorrhage or
bacteriologically tissue of trunk infarction
or histologically

Rheumatoid Tuberculous
7 M06.9 arthritis, 1 A18.2 peripheral 1
unspecified lymphadenopathy

Respiratory
tuberculosis, not Thyrotoxicosis
8 A16 confirmed 1 E05 [hyperthyroidism] 1
bacteriologically or
histologically

Primary
9 O62.0 inadequate 1 O36.4 Maternal care for 1
contractions intrauterine death
 Systemic lupus
10 M32.9 erythematosus, 1
unspecified
11 R18 Ascites 1
Chronic renal
12 N18 failure 1

Chronic obstructive
13 J44.9 pulmonary disease, 1
unspecified

Maternal care for

14 O32.9 malpresentation of 1
fetus, unspecified

15 R06.0 Dyspnoea 1
Epilepsy,
16 G40.9 1
unspecified
17
18
19
20

21 Total jumlah         Total jumlah         Total jumlah         Total jumlah        

Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya

                                       

 
KUNJUNGAN TOTAL 0 0 0 1 0 1 1 2 2 0 2 2 3 3 3 5 3 9
 

Mengetahui,
Kepala Puskesmas

dr. Yuli Novariza

NIP. 19760709 200801 2 007
 ASURANSI LAINNYA
JUMLAH KUNJUNGAN
NAMA PENYAKIT KASUS LAMA KASUS BARU
L P L P

         

         

         

         

         

         

         
          

         
         

         

Total jumlah        
Penyakit Lainnya

         

          36

         

Bandung, 25 Juli 2019

Penanggung Jawab Program Pemulkes

dr. Irfan Herdiyansyah

NIP. 19880916 201903 1 004
 LAPORAN BULANAN PENGOBATAN DAN PEMULIHAN KESEHATAN
20 PENYAKIT YANG DIRUJUK
SEKSI PELAYANAN KESEHATAN DASAR ( Yandas ) DINAS KESEHATAN KOTA BANDUNG
UPT Puskesmas : Kopo BULAN : Agustus
Puskesmas : Cibaduyut Wetan TAHUN : 2019
RESTRIBUSI UMUM /BAYAR BPJS NON PBI BPJS PBI APBD BPJS PBI APBN ASU
JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN
NO KODE KODE KODE KODE KODE
NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU
ICD ICD ICD ICD ICD
L P L P L P L P L P L P L P L P

Sequelae of stroke,
Closed fracture of Generalized
1 S52.80 other parts of 1 I50.0 Congestive heart 1 1 R59.1 enlarged lymph 1 I69.4 not specified as 1 1
forearm failure nodes haemorrhage or
infarction

Stroke, not Anaemia in other

2 I64 specified as 1 D63.8 chronic diseases 1 I50.0 Congestive heart 1
haemorrhage or classified failure
infarction elsewhere

Infection of resence of
3 H25.9 Senile cataract, 1 O86.0 obstetric surgical 1 Z97.5 (intrauterine) 1
unspecified contraceptive
wound
device

Disorders of Disorder of
Schizophrenia,
4 H52 refraction and 1 F20.9 unspecified 1 H81.9 vestibular function, 1
accommodation unspecified

Connective and
Prolonged other soft tissue of Sequelae of
5 O48 1 D21.2 1 B90 1
pregnancy lower limb, tuberculosis
including hip

Tuberculosis of
lung, Benign neoplasm
6 A16.0 bacteriologically 1 K40 Inguinal hernia 1 D36 of other and 1
and histologically unspecified sites
negative

Encephalitis,
7 E86 Volume depletion 1 F21 Schizotypal 1 G04 myelitis and 1
disorder encephalomyelitis

Other abortion,
Complete or Obstructed labour
8 O05.5 unspecified, 1 O64.0 due to incomplete 1
complicated by rotation of fetal
genital tract and head
pelvic infection
 Other specified
Closed Fracture of disorders of teeth
9 S22.00 thoracic vertebra 1 K08.8 and supporting 1
structures

Tuberculosis of
10 A18.3 intestines, 1 G80.9 Infantile cerebral 1
peritoneum and palsy, unspecified
mesenteric glands

Antepartum
haemorrhage, not Pre-eclampsia,
11 O46 elsewhere 1 O14.9 unspecified 1
classified

12 N18.5 Chronic renal 1

failure, stage V

13 F20.9 Schizophrenia, 1
unspecified
Severe pre-
14 O14.1 eclampsia 1
Pleural effusion,
15 J90 not elsewhere 1
classified
Pleural effusion,
16 O67.9 not elsewhere 1
classified

Tuberculosis of
lung,
17 A16.0 bacteriologically 1
and histologically
negative

Other specified
disorders of eye
18 H58.8 and adnexa in 1
diseases classified
elsewhere

Benign lipomatous
19 D17.9 neoplasm, 1
unspecified
Hordeolum and
20 H00 1
chalazion

Total jumlah Total jumlah Total jumlah Total jumlah

21                                
Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya

                                       

 
KUNJUNGAN TOTAL 0 0 1 0 0 1 0 6 1 0 1 2 3 5 4 1 4 12
 

Mengetahui,
Kepala Puskesmas
 dr. Yuli Novariza
NIP. 19760709 200801 2 007
 ASURANSI LAINNYA
JUMLAH KUNJUNGAN
NAMA PENYAKIT KASUS LAMA KASUS BARU
L P L P

         

         

         

         

         

         

         
          

         

         

         

Total jumlah
       
Penyakit Lainnya

         

          40

         

Bandung, 26 Agustus 2019

Penanggung Jawab Program Pemulkes
 dr. Irfan Herdiyansyah
NIP. 19880916 201903 1 004
 LAPORAN BULANAN PENGOBATAN DAN PEMULIHAN KESEHATAN
20 PENYAKIT YANG DIRUJUK
SEKSI PELAYANAN KESEHATAN DASAR ( Yandas ) DINAS KESEHATAN KOTA BANDUNG
UPT Puskesmas : Kopo BULAN : September
Puskesmas : Cibaduyut Wetan TAHUN : 2019
RESTRIBUSI UMUM /BAYAR BPJS NON PBI BPJS PBI APBD BPJS PBI APBN ASU
JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN
NO KODE KODE KODE KODE KODE
NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU
ICD ICD ICD ICD ICD
L P L P L P L P L P L P L P L P
Disorders of Disorders of
Congestive heart Congestive heart
1 H52 refraction and 1 I50.0 1 1 H52 refraction and 3 I50.0 1 1 2
accommodation failure accommodation failure

Other and Congestive heart Disorders of

2 J45.9 Asthma, unspecified 1 K74.6 unspecified 1 I50.0 1 1 H52 refraction and 4
cirrhosis of liver failure accommodation

Unspecified
Tuberculosis of Rheumatic heart
abortion Atherosclerotic
3 O06.4 incomplete, without 1 A18.8 other specified 1 I09.9 disease, 1 I25.1 heart disease 1 1
complication organs unspecified

Unspecified Tuberculosis of
Unspecified abortion lung,
4 E14.9 diabetes mellitus, 1 1 O06.4 incomplete, 1 A16.0 bacteriologically 2
without
complication without and histologically
complication negative

Excessive, frequent
5 G80.9 Infantile cerebral 1 I20.0 Unstable angina 1 N92 and irregular 1
palsy, unspecified menstruation

Stroke, not
Presence of specified as Thyrotoxicosis,
6 Z96.1 intraocular lens 1 I64 haemorrhage or 1 E05.9 unspecified 1
infarction

Umbilical hernia Tuberculosis of

without Schizophrenia, intestines,
7 K42.9 1 F20.9 1 A18.3 1
obstruction or unspecified peritoneum and
gangrene mesenteric glands

Other and
8 I45.1 unspecified right 1 G40.9 Epilepsy, 1 N20 Calculus of kidney 1
bundle-branch unspecified and ureter
block

Tuberculous
9 N18.5 Chronic renal 1 A18.2 peripheral 1 F20.5 Residual 1
failure, stage 5 schizophrenia
lymphadenopathy

10 S82.2 Fracture of shaft 1 H25.9 Senile cataract, 1 F20.0 Paranoid 1

of tibia unspecified schizophrenia
 Unspecified
Retention of diabetes mellitus, Angioneurotic
11 R33 urine 1 E14.9 without 1 T78.3 oedema 1
complication

Pre-existing
essential
hypertension
12 G44.0 Cluster headache 1 O44.1 Placenta praevia 1 O10.0 complicating 1
syndrome with haemorrhage pregnancy,
childbirth and the
puerperium

Other
postprocedural
13 M96.8 1 H11.0 Pterygium 1
musculoskeletal
disorders

Maternal care for Thalassaemia,

14 O33.9 disproportion, 1 D56.9 1
unspecified unspecified

Moderate mental
Superficial injury of retardation
15 S40.9 shoulder and 1 F71.9 Without mention 1
upper arm,
unspecified of impairment of
behaviour

Recurrent
16 J30.0 Vasomotor rhinitis 1 F33 depressive disorder 1

17 J45.9 Asthma, 1
unspecified

Other abortion,
Complete or
18 O05.8 unspecified, 1
complicated by
genital tract and
pelvic infection

19
20

Total jumlah Total jumlah Total jumlah Total jumlah

21 Penyakit Lainnya         Penyakit Lainnya         Penyakit Lainnya         Penyakit Lainnya        

                                       

 
KUNJUNGAN TOTAL 0 0 1 2 0 5 4 3 2 0 2 5 4 8 6 4 5 11
 

Mengetahui,
Kepala Puskesmas
 dr. Yuli Novariza
NIP. 19760709 200801 2 007
 ASURANSI LAINNYA
JUMLAH KUNJUNGAN
NAMA PENYAKIT KASUS LAMA KASUS BARU
L P L P

         

         

         

         

         

         

         
          

         

         

         

Total jumlah
Penyakit Lainnya        

         

          59

         

Bandung, 27 September 2019

Penanggung Jawab Program Pemulkes
 dr. Irfan Herdiyansyah
NIP. 19880916 201903 1 004
 LAPORAN BULANAN PENGOBATAN DAN PEMULIHAN KESEHATAN
20 PENYAKIT YANG DIRUJUK
SEKSI PELAYANAN KESEHATAN DASAR ( Yandas ) DINAS KESEHATAN KOTA BANDUNG
UPT Puskesmas : Kopo BULAN : Oktober
Puskesmas : Cibaduyut Wetan TAHUN : 2019
RESTRIBUSI UMUM /BAYAR BPJS NON PBI BPJS PBI APBD BPJS PBI APBN ASU
JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN
NO KODE KODE KODE KODE KODE
NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU
ICD ICD ICD ICD ICD
L P L P L P L P L P L P L P L P
Tuberculous Tuberculous
Chronic renal
1 A18.2 peripheral 1 N18.5 1 1 A18.2 peripheral 1 1 1 D56 Thalassaemia 1
lymphadenopathy failure, stage 5 lymphadenopathy

Internal
haemorrhoids
2 I84.1 1 G40 Epilepsy 2 H25 Senile cataract 1
with other
complications

Generalized Disorder of
3 N40 Hyperplasia of 1 R59.1 enlarged lymph 1 H52.7 refraction, 1 1
prostate
nodes unspecified

Pre-existing
hypertension
Chronic renal complicating
4 G40 Epilepsy 1 N18.5 1 O10 1
failure, stage 5 pregnancy,
childbirth and the
puerperium

Tuberculous
peripheral Unspecified Presence of
5 A18.2 1 R31 1 Z96.1 1
lymphadenopath haematuria intraocular lens
y

Stroke, not
Congestive heart specified as
6 I50.0 failure 1 I64 haemorrhage or 1
infarction

Other congenital
7 Q55.6 malformations of 1 H26 Other cataract 1
penis

Chronic obstructive
8 J44.9 pulmonary disease, 1 O14.1 Severe pre- 1
eclampsia
unspecified
 Other maternal
infectious and
parasitic diseases
complicating
pregnancy,
childbirth and the
Chronic renal
9 O98.8 puerperium 1 N18.5 1
[Extracted from failure, stage 5
ICD-10 Second
Edition, 2005,
Pregnancy,
childbirth and the
puerperium

Ventricular septal
10 Q21.0 defect 1 O84 Multiple delivery 1

11 N62 Hypertrophy of 1 O20.0 Threatened 1

breast abortion
Rheumatoid Generalized
12 M06.9 arthritis, 1 R59.1 enlarged lymph 1
unspecified nodes
Urinary calculus,
13 N20.9 unspecified 1

Excessive and
14 N92.1 frequent 1
menstruation with
irregular cycle

15 G40.9 Epilepsy, 1
unspecified
Non-insulin-
16 E11 dependent 1
diabetes mellitus
Benign neoplasm
17 D36.9 of unspecified site 1

Tuberculosis of
lung,
18 A16.0 bacteriologically 1
and histologically
negative

Meningitis,
19 G03.9 1
unspecified

Chronic obstructive
pulmonary disease
20 J44.1 with acute 1
exacerbation,
unspecified

Total jumlah Total jumlah Total jumlah Total jumlah

21                             1 1
Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya
                                       

 
KUNJUNGAN TOTAL 0 0 0 1 0 2 2 2 0 0 3 4 5 3 7 5 4 7
 

Mengetahui,
Kepala Puskesmas

dr. Yuli Novariza

NIP. 19760709 200801 2 007
 ASURANSI LAINNYA
JUMLAH KUNJUNGAN
NAMA PENYAKIT KASUS LAMA KASUS BARU
L P L P

         

         

         

         

         

         

         
          

         

         

         

Total jumlah
       
Penyakit Lainnya
         

          44

         

Bandung, 26 Oktober 2019

Penanggung Jawab Program Pemulkes

dr. Irfan Herdiyansyah

NIP. 19880916 201903 1 004
 LAPORAN BULANAN PENGOBATAN DAN PEMULIHAN KESEHATAN
20 PENYAKIT YANG DIRUJUK
SEKSI PELAYANAN KESEHATAN DASAR ( Yandas ) DINAS KESEHATAN KOTA BANDUNG
UPT Puskesmas : Kopo BULAN : November
Puskesmas : Cibaduyut Wetan TAHUN : 2019
RESTRIBUSI UMUM /BAYAR BPJS NON PBI BPJS PBI APBD BPJS PBI APBN ASU
JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN
NO KODE KODE KODE KODE KODE
NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU
ICD ICD ICD ICD ICD
L P L P L P L P L P L P L P L P
Chronic
Observation for obstructive
1 Z03.0 suspected 2 J44.9 pulmonary 2 1 F20.9 Schizophrenia, 1 1 I50.0 Congestive heart 1 2 2
tuberculosis disease, unspecified failure
unspecified

Tuberculosis of Tuberculosis of
lung, lung,
Dengue Congestive heart
2 A91 1 I50.0 1 1 A16.0 bacteriologically 2 A16.0 bacteriologically 1 1
hemorraghic fever failure and histologically and histologically
negative negative

Atherosclerotic
3 A01.0 Thypoid fever 1 I25.9 cardiovascular 1 H81.8 Other disorders of 1 E04.9 Nontoxic goitre, 1
disease, so vestibular function unspecified
described

Maternal care due Loss of teeth due

4 J33.9 Nasal polyp, 1 O34.2 to uterine scar 1 K08.1 to accident, 1
unspecified from previous extraction or local
surgery perodontal disease

Prolonged Other acute Tuberculous

5 O48 1 J01.8 1 A18.2 peripheral 1
pregnancy sinusitis
lymphadenopathy

Stroke, not Disorder of Haemorrhage from

specified as respiratory
6 I64 haemorrhage or 1 H52.7 refraction, 1 R04.9 passages, 1
infarction unspecified unspecified

Non insulin
Stroke, not dependenr
Cerebal palsy, specified as diabetes mellitus
7 G80.9 unspecified 1 I64 haemorrhage or 1 E11.6 with other 1
infarction specified
complications

Foreugn body in Clonic hemifacial Hepatomegaly and

8 T15.0 cornea 1 G51.3 spasm 1 R16.0 splenomegaly, NEC 1

Disorder of
Osteroporosis, Severe pre
9 H52.7 refraction, 1 M81.9 1 O14.1 1
unspecified eclampsia
unspecified
 Maternal care for
Radiculpathy
10 O33.9 dispropotion, 1 M54.12 1
unspecified cervical region

Tuberculous
11 A18.2 peripheral 1 M54.3 Sciata 1
lymphadenopathy

Bacterial
meningoencephali
12 G04.2 tis and 1 P59.9 Neonatal jaundice 1
meningomyelitis,
NEC

Other specified
Tuberculosis of
13 Z48,8 surgical follow up 1 A17.9 nervous system 1
care

14 O22.1 Genital varices in 1 N18.5 Chronic renal 1

pregnancy failure, stage 5
Benign neoplasm
15 D36.9 of unspecified site 1 O30.0 Twin pregnancy 1

Unspecified
Severe pre diabetes mellitus,
16 O14.1 eclampsia 1 E14.9 without 1
complication

HIV disease
resulting in
17 B20 1
infections and
parasitic disease

Chronic obstructive
18 J44.9 pulmonary disease, 1
unspecified

Other disorders of
19 H53.3 binucular vision 1

Schizophrenia,
20 F20.9 1
unspecified

Total jumlah Total jumlah Total jumlah Total jumlah

21                           3 2 2
Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya Penyakit Lainnya

                                       

 
KUNJUNGAN TOTAL 0 0 1 3 0 5 2 1 4 0 4 2 5 7 6 9 9 8
 
 ASURANSI LAINNYA
JUMLAH KUNJUNGAN
NAMA PENYAKIT KASUS LAMA KASUS BARU
L P L P

         

         

         

         

         

         

         
          

         

         

         

Total jumlah
       
Penyakit Lainnya

         

         

         
 LAPORAN BULANAN PENGOBATAN DAN PEMULIHAN KESEHATAN
20 PENYAKIT YANG DIRUJUK
SEKSI PELAYANAN KESEHATAN DASAR ( Yandas ) DINAS KESEHATAN KOTA BANDUNG
UPT Puskesmas : Kopo BULAN : Desember
Puskesmas : Cibaduyut Wetan TAHUN : 2019
RESTRIBUSI UMUM /BAYAR BPJS NON PBI BPJS PBI APBD BPJS PBI APBN ASU
JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN JUMLAH KUNJUNGAN
NO KODE KODE KODE KODE KODE
NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU NAMA PENYAKIT KASUS LAMA KASUS BARU
ICD ICD ICD ICD ICD
L P L P L P L P L P L P L P L P

Respiratory
tuberculosis
Bronchopneumonia, Congestive heart Congestive heart unspecified,
1 J18.0 unspecified 1 I50.0 failure 1 I50.0 failure 1 1 A15.9 confirmed 2
bacteriologically
and histologically

Tuberculous
Hyperglycemia, Unspecified Congestive heart
2 R73.9 1 E14.9 1 A18.2 peripheral 1 1 I50.0 1
hyperglycemic diabetes mellitus lymphadenopathy failure

Respiratory
tuberculosis
3 Z34.8 Supervision of other 1 H53.2 Diplopia 1 A15.9 unspecified, 1 E14.9 Unspecified 1
normal pregnancy confirmed diabetes mellitus
bacteriologically
and histologically

Other and
4 K74.6 unspecified 1 E14.9 Unspecified 1 N91.2 Amenorrhoea, 1
cirrhosis of liver diabetes mellitus unspecified

Other and Stroke, not Tuberculosis of

5 I45.1 unspecified right 1 I64 specified as 1 A18.8 other specified 1
bundle-branch haemorrhage or organs
block infarction

Respiratory
tuberculosis
unspecified, Moderate mental
6 H25 Senile cataract 1 A16.9 without mention of 1 F71.9 1
retardation
bacteriological or
histological
confirmation

Atherosclerotic
7 I25.0 cardiovascular 1 Z96.1 Presence of 1 K80.8 Other cholelithiasis 1
disease, so intraocular lens
described

Unilateral or
unspecified
inguinal hernia, Pleural effusion,
8 K40.9 without 1 J90 not elsewhere 1
classified
obstruction or
gangrene
 Respiratory
tuberculosis
Postprocedural
disorder of eye and unspecified,
9 H59.9 adnexa, 1 A16.9 without mention of 1
bacteriological or
unspecified histological
confirmation

Other
postprocedural Arthritis,
10 M96.8 musculoskeletal 1 M13.9 unspecified 1
disorders

Chronic obstructive
11 J44.9 pulmonary disease, 1 E07.9 Disorder of thyroid, 1
unspecified unspecified

Unspecified
abortion Chronic obstructive
12 O06.2 Incomplete, 1 J44.9 pulmonary disease, 1
complicated by unspecified
embolism

Disorder of
13 E07.9 thyroid, 1 H11.0 Pterygium 1
unspecified
Chronic renal Old myocardial
14 N18.5 1 I25.2 1
failure, stage V infarction

Recurrent
depressive
Rheumatic heart
disorder, current
15 I09.9 disease, 1 F33.2 1
episode severe
unspecified without psychotic
symptoms

Epilepsy, Paranoid
16 G40.9 1 F20.0 1
unspecified schizophrenia
Atherosclerotic
17 I25.1 1
heart disease
18
19
20

21 Total jumlah         Total jumlah         Total jumlah         Total jumlah  

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KUNJUNGAN TOTAL 0 0 2 1 0 4 3 0 0 0 5 5 3 5 7 4 3 4
 
 ASURANSI LAINNYA
JUMLAH KUNJUNGAN
NAMA PENYAKIT KASUS LAMA KASUS BARU
L P L P

         

         

         

         

         

         

         
          

         

         

         

Total jumlah        
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