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NO MRS KRS ICD 10

1 2/1/2023 2/2/2023 M99.59


2 2/1/2023 2/2/2023 D33.2
3 1/29/2023 2/2/2023 Z48.9;T90.2
4 1/27/2023 2/2/2023 M51.1;M15.2;J95.2;J18.9;M54.59
5 1/29/2023 2/3/2023 S06.00;I61.2;S06.4;J96.0;E87.3;E87.2
6 1/31/2023 2/6/2023 D33.2;J96.0;E87.2;E14.9
7 2/2/2023 2/6/2023 Z48.9;T90.2
8 1/30/2023 2/6/2023 M51.0;S32.7;E87.2;I49.1;J96.0;M43.19
9 2/8/2023 2/9/2023 D33.2
10 2/8/2023 2/9/2023 D33.2
11 2/2/2023 2/11/2023 S06.51;J18.9;A41.9;E87.2;J96.0;D64.9;E87.3
12 2/7/2023 2/13/2023 D33.2;J96.0;E87.3
13 2/6/2023 2/15/2023 D33.2;J96.0;E87.2;E87.3
14 2/9/2023 2/15/2023 D33.2;J96.0;E87.3
15 2/14/2023 2/18/2023 D33.2;J96.0;E87.3
16 2/14/2023 2/19/2023 D33.0;E87.3;J96.0
17 2/13/2023 2/20/2023 M99.29;J96.0
18 2/11/2023 2/22/2023 D33.2;J96.0;E87.3
19 2/18/2023 2/23/2023 S06.5;J96.0
20 2/17/2023 2/23/2023 S06.9;J96.0;I60.9
21 2/22/2023 2/23/2023 D33.2
22 2/22/2023 2/23/2023 D33.2
23 2/22/2023 2/27/2023 Z48.9;T90.2

NO MRS KRS ICD 10


2/1/2023 2/6/2023 J90;I50.0
2/1/2023 2/6/2023 D38.1;J44.0;I10
1/30/2023 2/7/2023 C78.2;J43.8
2/8/2023 2/10/2023 J18.9;I50.0
2/6/2023 2/10/2023 A16.0;D64.9
2/7/2023 2/11/2023 B90.9
2/7/2023 2/11/2023 D38.1;J44.8
2/7/2023 2/13/2023 B90.9;K80.2;N30.9
2/14/2023 2/16/2023 D38.5
2/9/2023 2/20/2023 J44.0;I50.1;I49.3
2/16/2023 2/21/2023 A16.0;D64.9
2/20/2023 2/24/2023 Z51.5;C34.9
2/19/2023 2/24/2023 J44.0;I50.0;I25.5;I35.1;E11.9
2/22/2023 2/25/2023 J44.8;A41.9
2/25/2023 2/28/2023 J44.0;I11.0
2/23/2023 2/28/2023 J18.9

NO MRS KRS ICD 10


2/1/2023 2/2/2023 N36.2
2/7/2023 2/8/2023 N35.9
2/13/2023 2/14/2023 N39.9;A41.9
2/15/2023 2/16/2023 C67.9
2/20/2023 2/21/2023 N13.1
2/21/2023 2/22/2023 N43.4
2/20/2023 2/23/2023 N13.2
2/28/2023 2/28/2023 Z96.0

NO MRS KRS ICD 10


1/26/2023 2/1/2023 E14.5;A41.9
2/1/2023 2/1/2023 I82.9
2/2/2023 2/2/2023 J93.9
2/2/2023 2/3/2023 N18.5
2/2/2023 2/5/2023 E11.5;E87.5
2/7/2023 2/8/2023 E14.5
2/9/2023 2/9/2023 T82.4
2/6/2023 2/10/2023 I77.2
2/7/2023 2/10/2023 S25.8;D64.9;I10
2/12/2023 2/13/2023 T82.4
2/13/2023 2/15/2023 J93.9
2/14/2023 2/15/2023 I83.2
2/18/2023 2/19/2023 J93.8;J96.0
2/15/2023 2/20/2023 E14.5;K27.9;A41.9
2/21/2023 2/21/2023 N18.5
2/22/2023 2/22/2023 N18.5
2/23/2023 2/23/2023 N18.5
2/21/2023 2/28/2023 J43.8;A16.0

NO MRS KRS ICD 10


2/1/2023 2/3/2023 D69.6;D61.3
1/29/2023 2/3/2023 Z51.5;C22.7;R52.2;I49.1
2/8/2023 2/13/2023 Z51.5;C24.9;R57.1
2/15/2023 2/16/2023 E11.9;I50.0;E87.1;E16.2
2/12/2023 2/16/2023 K60.5;K61.0;A41.9;D64.9;E11.7
2/16/2023 2/19/2023 D69.6;D64.9
2/20/2023 2/23/2023 A01.0
2/22/2023 2/23/2023 K29.7;N80.9
2/22/2023 2/24/2023 K76.0;B20.4;K27.9;R11
2/22/2023 2/25/2023 N18.4;I50.0
2/25/2023 2/27/2023 K76.0;K27.9;I50.0;R11
2/25/2023 2/27/2023 A09.9;R11;I50.0

NO MRS KRS ICD 10


2/10/2023 2/12/2023 D10.1
NO MRS KRS ICD 10
1/30/2023 2/2/2023 A15.0;J85.1;A41.9
1/30/2023 2/2/2023 J85.2
1/30/2023 2/4/2023 A15.0;D64.9;K76.8
2/2/2023 2/6/2023 A16.0
2/5/2023 2/7/2023 A16.0;D64.9
2/4/2023 2/8/2023 J44.0;I10
2/2/2023 2/8/2023 C34.9;J18.9
2/5/2023 2/8/2023 A15.0;N18.1;J44.0
2/10/2023 2/11/2023 R59.1
2/8/2023 2/11/2023 A16.0;R17;K76.8;E11.9
2/9/2023 2/13/2023 J90;E88.0
2/8/2023 2/13/2023 B20.0;E10.9;R74.0
2/7/2023 2/14/2023 A15.0;I27.9;I50.0
2/10/2023 2/14/2023 A15.6
2/12/2023 2/15/2023 A15.0
2/12/2023 2/15/2023 G40.6;C34.9
2/5/2023 2/15/2023 A16.0;J43.8
2/13/2023 2/16/2023 J47;J96.0;I20.1
2/9/2023 2/16/2023 J90;D38.1
2/13/2023 2/16/2023 A15.0
2/15/2023 2/17/2023 J44.1;I50.0
2/14/2023 2/17/2023 A15.0;D64.9
2/8/2023 2/17/2023 A16.0;E87.6
2/17/2023 2/18/2023 A16.5;R74.0
2/16/2023 2/18/2023 J93.8;I10
2/16/2023 2/20/2023 D38.5
2/19/2023 2/21/2023 J18.9
2/18/2023 2/21/2023 J18.9;J44.1;I11.9
2/17/2023 2/21/2023 J90;I50.0
2/20/2023 2/21/2023 C78.0;C79.8
2/20/2023 2/22/2023 J18.9;A41.9
2/16/2023 2/22/2023 I87.1;E88.0
2/20/2023 2/22/2023 J90;D64.9
2/17/2023 2/22/2023 J93.8
2/22/2023 2/23/2023 A16.0;E87.6
2/20/2023 2/23/2023 J86.9
2/23/2023 2/23/2023 J42;I10
2/20/2023 2/24/2023 D38.1;K81.9;N40
2/21/2023 2/24/2023 A16.5
2/23/2023 2/25/2023 A16.0
2/23/2023 2/25/2023 A16.5
2/22/2023 2/25/2023 A16.0

NO MRS KRS ICD 10


1/30/2023 2/3/2023 K80.0;K83.1
2/7/2023 2/8/2023 K40.9
2/16/2023 2/18/2023 K80.1;K59.0
2/19/2023 2/21/2023 M72.69;L02.8
2/20/2023 2/22/2023 K80.1
2/21/2023 2/23/2023 N45.9
2/21/2023 2/28/2023 D37.6;E87.6;E88.0

NO MRS KRS ICD 10


1/27/2023 2/1/2023 K80.1;R17
2/5/2023 2/7/2023 A01.0;K27.9;N34.2

NO MRS KRS ICD 10


1/28/2023 2/1/2023 J93.0;J96.0
2/1/2023 2/1/2023 J96.0;A41.9
1/31/2023 2/1/2023 J18.9;B90.9
1/31/2023 2/3/2023 J44.1;K52.9;K30;A09.9
1/31/2023 2/3/2023 J44.0;I50.0;I27.9;R06.0
1/31/2023 2/3/2023 A16.0;K82.9
2/2/2023 2/5/2023 C85.9;I87.1
2/1/2023 2/6/2023 J90;J18.9;I48;I50.0
1/30/2023 2/6/2023 J93.8;R06.0
1/31/2023 2/7/2023 A15.6;E88.0;E10.6
2/6/2023 2/8/2023 B20.6
2/6/2023 2/8/2023 J90;D38.1;R04.2
2/9/2023 2/10/2023 D38.1;B90.9;R06.0
2/6/2023 2/10/2023 C78.2;K80.2;N17.9
2/8/2023 2/10/2023 A18.2;D64.9
2/9/2023 2/11/2023 B20.6;E88.0
2/7/2023 2/11/2023 J18.9;B90.9;E10.9
2/6/2023 2/11/2023 R04.2;B90.9;D64.9
2/8/2023 2/11/2023 J90;I87.1;D38.1;R06.0
2/10/2023 2/12/2023 A15.0
2/9/2023 2/12/2023 A15.0;R06.0
2/7/2023 2/12/2023 A15.0;I50.0;I49.3;I35.1

NO MRS KRS ICD 10


2/2/2023 2/3/2023 I11.0
1/31/2023 2/4/2023 I50.1;I25.1
2/13/2023 2/16/2023 I11.0
2/24/2023 2/27/2023 I50.1;J44.1

NO MRS KRS ICD 10


1/29/2023 2/1/2023 P28.5;P92.9;P59.9;S90.2;P24.8;P22.9;P74.1;P36.9;P80.9
2/6/2023 2/9/2023 A91
1/31/2023 2/12/2023 P74.0;P36.9;J93.1;P28.5;P91.0;P61.6;P80.9;P59.9;P22.9;Q2
2/22/2023 2/26/2023 P59.0;P03.9
2/20/2023 2/28/2023 P24.8;P74.1;P92.0;P36.9;P22.0;P59.9;P54.0

NO MRS KRS ICD 10


2/2/2023 2/6/2023 I48;I50.1;E11.7
2/17/2023 2/20/2023 I50.0;J18.9;J90
2/24/2023 2/26/2023 I20.1;I50.0

NO MRS KRS ICD 10


2/1/2023 2/2/2023 M24.58
2/1/2023 2/2/2023 S34.8
1/30/2023 2/2/2023 S42.8
2/2/2023 2/3/2023 S34.8
2/7/2023 2/8/2023 M65.99
2/8/2023 2/9/2023 M65.99
2/9/2023 2/10/2023 M15.9
2/8/2023 2/10/2023 T81.3;L08.9
2/13/2023 2/14/2023 S34.6
2/13/2023 2/14/2023 M51.0
2/8/2023 2/14/2023 S72.0;E11.7;I10
2/14/2023 2/15/2023 M51.0
2/14/2023 2/15/2023 M24.59
2/14/2023 2/16/2023 M65.99
2/21/2023 2/22/2023 M24.59
2/21/2023 2/22/2023 M22.9
2/23/2023 2/24/2023 M24.59
2/23/2023 2/24/2023 M51.0
2/24/2023 2/25/2023 S52.1
2/24/2023 2/25/2023 M51.0
ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- M-4-17-I MASALAH 3,358,700 809,120 TJOE TJHOE WAN
- G-4-26-I GANGGUAN 3,116,000 874,793 SUKARDI
02.06 G-1-10-II KRANIOTOM 16,541,400 22,052,458 ANA ROKAYA
96.71;80.51;81.33 M-1-03-III PROSEDUR 31,984,400 63,074,372 USWATUH HASANAH
02.31;96.72;02.39;31.1 J-1-01-III VENTILASI 54,404,100 47,644,613 KUSWANDI
01.51;01.24;96.72 J-1-02-III VENTILASI 51,849,100 35,780,998 JUMAANI
02.06 G-1-10-II KRANIOTOM 16,541,400 18,456,143 SUHAENI EKAWATI
96.72;80.51 J-1-02-III VENTILASI 51,849,100 47,879,607 MARWIYANI
- G-4-26-I GANGGUAN 3,116,000 877,058 MUJIONO
- G-4-26-I GANGGUAN 3,630,100 995,756 YULIATIN
96.72;31.1;01.24 J-1-01-III VENTILASI 54,404,100 58,283,403 MUHAMMAD RIDWAN
96.72;01.51;01.24 J-1-02-III VENTILASI 51,849,100 41,799,657 WAIBAH
07.62;96.72 J-1-02-III VENTILASI 51,849,100 44,177,479 SUKARDI
01.51;01.24;96.72 J-1-02-III VENTILASI 51,849,100 43,350,273 KARIYANTO
01.51;01.24;96.72 J-1-02-III VENTILASI 51,849,100 31,087,814 MASDUKI
01.24;96.72 J-1-02-III VENTILASI 68,959,400 43,869,552 SISWANTO
80.51;96.72 J-1-02-III VENTILASI 68,959,400 56,483,976 YUNI SUGIWARTI
01.51;01.24;31.1;96.72 J-1-01-III VENTILASI 54,404,100 65,168,230 ABDULLA
01.24;96.72 J-1-02-III VENTILASI 60,404,200 33,321,611 MU'INAH
31.1;96.72;02.31;02.39 J-1-01-III VENTILASI 54,404,100 49,575,813 MISTUR
- G-4-26-I GANGGUAN 3,116,000 887,308 SITI MAHMUDA
- G-4-26-I GANGGUAN 3,116,000 913,182 SYAIBATUN
02.06 G-1-10-II KRANIOTOM 22,000,000 28,643,903 MUHAMMAD CHUSI
833,554,000 736,007,119 97,546,881

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- J-4-20-II PLEURAL E 6,571,300 8,604,537 SUPARMIN
- J-4-21-II GEJALA, T 4,607,400 5,326,198 AGUS WISNU SWASTIKA
34.04 J-4-14-II TUMOR PA 7,568,800 6,302,685 JAET
- J-4-16-II SIMPLE P 6,045,400 4,081,707 PAINI
- J-4-15-II PERADANGA 5,767,700 4,141,212 DIDIK JUNAEDI
- J-4-19-I PENYAKIT P 6,186,100 3,326,179 SUHIRMAN
- J-4-21-II GEJALA, T 4,607,400 5,360,126 PAINI
- J-4-19-II PENYAKIT 6,021,900 4,918,941 SUSI SUSANTI
- J-4-21-I GEJALA, T 3,803,900 2,793,954 ABD.BAHRI
- J-4-17-III PENYAKIT 5,924,400 18,663,220 MUTASLIMAH
- J-4-15-II PERADANGA 5,767,700 3,761,874 HARIASIH
- Z-4-12-I FAKTOR-FA 1,975,000 6,523,573 RUSNANI
- J-4-17-II PENYAKIT 4,514,600 6,730,767 GATOT SUBROTO
- J-4-17-III PENYAKIT 5,924,400 4,797,505 INDRIYANI
- J-4-17-III PENYAKIT 5,924,400 5,783,169 IMAM JUMADI
- J-4-16-I SIMPLE PN 3,692,700 4,573,431 TRISNAWATI
84,903,100 95,689,078 (10,785,978)

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
58.39 N-1-40-I PROSEDUR 6,693,400 5,735,531 MISNIYATI
58.1;58.5;58.6 N-1-40-I PROSEDUR 6,693,400 4,569,407 MURSID
- N-4-16-III PENYAKIT 6,395,000 1,739,441 MUHAMAT NOR
57.0 N-1-40-I PROSEDUR 8,902,200 8,163,973 FREEDY
56.31;59.8 N-4-13-I BATU URIN 3,442,100 6,591,478 ABD. HAMIM
63.2 V-1-13-I PROSEDUR 4,104,600 5,497,399 GESANG WIBOWO
59.8;56.2 N-1-20-I PROSEDUR 8,175,800 10,067,727 MURSIDI
97.62 Z-4-12-I FAKTOR-FA 1,678,400 2,239,063 MUHAMAT NOR
46,084,900 44,604,019 1,480,881

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
84.11 M-1-30-III PROSEDUR 15,356,500 11,787,579 SUCI
38.00;38.95 I-1-20-I PROSEDUR 15,495,000 15,440,709 ANIK SUGIYARTI
97.49 J-4-20-I PLEURAL E 4,030,800 2,131,951 MOH. HAFID
38.95 N-1-12-I MEMBUAT B 5,138,500 6,258,970 SUKARNO
84.11 M-1-30-II PROSEDUR 10,739,500 8,364,858 WARDA
84.11 M-1-30-I PROSEDUR 6,627,600 4,849,653 MARIYAM
38.95 N-1-12-I MEMBUAT B 4,410,800 12,278,763 ENJO
39.59 I-1-20-I PROSEDUR 15,495,000 7,663,583 KREMUN A. R.
97.49;34.79 J-1-30-II PROSEDUR 15,129,700 3,865,169 SAMUNAH
38.95 N-1-12-I MEMBUAT B 4,410,800 1,406,376 ENJO
34.04 J-4-20-I PLEURAL E 5,525,600 3,710,630 MUHAMMAD SUYANTO
38.50 I-1-17-I LIGASI DA 10,336,000 7,411,595 MOHAMMAD FADLI
34.04 J-4-20-III PLEURAL E 7,941,800 3,170,428 RICKI ADE SETIYAWAN
86.22 I-4-15-III PENYAKIT 7,324,100 11,854,600 WARDA
39.27 N-1-12-I MEMBUAT B 4,410,800 3,220,528 SAMINAH
39.27 N-1-12-I MEMBUAT B 4,410,800 4,274,829 ETNA RUSYANTI
39.27 N-1-12-I MEMBUAT B 4,410,800 3,195,775 JUHARMAN
34.73 J-1-30-II PROSEDUR 18,728,700 24,029,489 BEGINA
159,922,800 134,915,485 25,007,315

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- D-4-11-III GANGGUAN 7,901,800 1,414,178 SITI MASTUFAH
- Z-4-12-II FAKTOR-FA 4,024,600 6,404,477 MIRAH EKO WINARSIH
- Z-4-12-III FAKTOR-FA 7,217,500 3,994,983 SENISA
- E-4-10-II PENYAKIT 4,899,400 3,644,000 SAMSU'DIN
49.73 K-1-50-III PROSEDUR 8,626,800 10,173,329 LILIK MUSLIMAH
- D-4-11-II GANGGUAN 5,811,400 2,511,580 SITI MASTUFAH
- A-4-14-I PENYAKIT I 2,929,800 3,446,193 LILY WAHYUNI S.
- K-4-11-I GASTRITIS 2,623,800 1,975,740 DINDA FADIYA QUROTA AI
- B-4-13-II GANGGUAN 3,984,800 2,680,226 ROBIATUL ADAWIYAH
- N-4-10-II TUMOR GIN 3,399,400 3,413,318 SUMARYONO
- B-4-13-II GANGGUAN 3,984,800 2,145,023 MISYANA
- K-4-17-II NYERI ABD 2,484,100 2,549,534 SRI RAHAYU
57,888,200 44,352,581 13,535,619

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
25.3;25.59 U-1-11-I PROSEDUR 7,840,800 4,502,293 THIRFA WILLYANZAHRA ZA
7,840,800 4,502,293 3,338,507
ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- J-4-15-III PERADANGA 7,308,800 3,259,342 MOCH YATIM HIDAYAT
- J-4-15-I PERADANGA 5,894,400 4,397,729 MOHAMAD NANANG KOSI
- J-4-15-II PERADANGA 5,767,700 5,601,530 MOHAMMAD RAMLI
- J-4-15-I PERADANGA 4,431,900 5,369,075 SUMIATI
- J-4-15-II PERADANGA 7,671,000 3,953,448 DEWI NASTIKA SARI
- J-4-17-I PENYAKIT 3,958,400 6,607,494 DEKKI KURNIAWAN WIDO
- J-4-14-III TUMOR PAR 8,954,600 7,456,341 KHOLILI BASUKI
- J-4-15-II PERADANGA 5,767,700 4,567,596 ABDULLAH
- D-4-14-I GANGGUAN 2,504,300 1,353,188 KHOIRUM MISBAHUL UM
- J-4-15-II PERADANGA 7,671,000 6,973,602 DENOK SRI WAHYUATI
34.04 J-4-20-II PLEURAL E 8,739,800 7,792,844 SUMARBIYATI
- A-4-15-I INFEKSI HI 3,458,200 6,337,954 HARLIFAH
- J-4-15-II PERADANGA 5,767,700 8,916,505 EKA NOVITASARI
- J-4-15-I PERADANGA 5,163,100 5,877,275 ARISMAN
- J-4-15-I PERADANGA 4,431,900 4,048,448 SUHAIDI
- G-4-22-I SERANGAN 2,658,600 3,673,163 UMAR
34.04 J-4-15-II PERADANGA 5,767,700 12,193,420 BEGINA
- J-4-17-III PENYAKIT 5,924,400 4,701,700 NAWAWI
34.91 J-4-20-I PLEURAL E 4,743,000 6,998,616 SULASMI
- J-4-15-I PERADANGA 4,431,900 3,581,125 MUHAMMAD RIZKI RAMAD
- J-4-17-II PENYAKIT 4,514,600 3,355,247 SUHARTONO
- J-4-15-II PERADANGA 5,767,700 3,466,608 BAMBANG JUNAIDI
34.21;38.93 J-1-30-II PROSEDUR 18,728,700 21,496,209 NGADERI HERIYANTO
34.91 J-4-15-I PERADANGA 4,431,900 3,934,495 PALUPI INDRIASARI
34.04;34.52 J-1-10-I PROSEDUR 21,170,000 14,713,662 SUPARNI
- J-4-21-I GEJALA, T 2,860,100 3,771,221 SHANIYA
- J-4-16-I SIMPLE PN 4,302,000 2,126,468 SUARMA
- J-4-16-II SIMPLE P 5,189,200 3,056,878 NAWAWI
34.91 J-4-20-II PLEURAL E 8,739,800 8,747,342 CHUNAIFAH
- J-4-14-II TUMOR PA 7,568,800 2,515,482 TOTOK SUGIARTO
- J-4-16-III SIMPLE PN 6,560,900 7,637,843 SATUMAN
- I-4-15-II PENYAKIT 6,103,400 5,223,525 WASIS
34.91 J-4-20-II PLEURAL E 6,571,300 4,578,860 YANTO
34.04 J-4-20-I PLEURAL E 4,743,000 6,773,139 AHMAD SAMSUL ARIFIN
- J-4-15-II PERADANGA 5,767,700 2,692,932 IMAM BASORIH
34.04 J-4-15-I PERADANGA 5,894,400 4,545,289 SUMARBIYATI
- J-4-17-I PENYAKIT 3,958,400 2,270,949 SURADI
- J-4-21-I GEJALA, T 3,803,900 5,799,841 HERY SULAWESIONO
34.91 J-4-15-I PERADANGA 4,431,900 3,315,558 MUNTAMAH
- J-4-15-I PERADANGA 5,894,400 2,841,525 SUPIYATUN
34.91 J-4-15-I PERADANGA 5,894,400 5,857,466 HADI SUPRAYITNO
- J-4-15-I PERADANGA 4,431,900 3,878,984 NGADERI HERIYANTO
258,344,500 236,259,918 22,084,582

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- B-4-14-II GANGGUAN 5,685,100 4,920,681 IVA DAMAYANTI
53.9 K-1-12-I PROSEDUR 4,606,600 5,102,786 MULYADI
- B-4-14-I GANGGUAN 3,282,900 2,952,048 JUMISA
83.39;83.09 M-1-50-II PROSEDUR 8,596,900 10,662,158 FAHMI SURYA PUTRA
51.23 B-1-14-I CHOLESIST 8,648,900 5,833,309 NURIYA
- V-4-11-I PENYAKIT 3,363,300 2,564,163 AGUS SUBANDI
- B-4-13-II GANGGUAN 4,642,200 8,004,714 SENISA
38,825,900 40,039,859 (1,213,959)

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- B-4-14-II GANGGUAN 4,274,500 5,430,833 AHMAD AFANDI
- A-4-14-I PENYAKIT I 2,566,400 3,351,182 WEMPI YOSANOVA FARER
6,840,900 8,782,015 (1,941,115)

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
34.04 J-4-20-III PLEURAL E 9,252,200 9,456,360 MUHAMMAD SUYANTO
- J-4-11-III KEGAGALAN 5,592,100 2,687,473 SARTO
- J-4-16-I SIMPLE PN 3,692,700 3,759,751 PONADI
- J-4-17-I PENYAKIT 3,958,400 3,664,403 SARIJA
- J-4-17-II PENYAKIT 4,514,600 3,471,618 RAUDOH
- J-4-15-I PERADANGA 4,431,900 3,061,456 PUTRI ELIVIA NURUL AQM
- C-4-11-II LIMFOMA & 5,140,400 2,842,924 HERMAN
34.91 J-4-20-III PLEURAL E 7,941,800 8,386,303 AMINATUS ZEHRO
34.04 J-4-20-I PLEURAL E 4,743,000 6,816,455 NGADERI HERIYANTO
34.04 J-4-15-II PERADANGA 5,767,700 11,394,411 ROBITH NIDHOM
- A-4-15-I INFEKSI HI 3,458,200 3,428,238 NUR HAYATI
34.91 J-4-20-I PLEURAL E 4,743,000 3,966,359 BONIRAN
33.22 J-4-21-I GEJALA, T 2,860,100 3,105,541 ROMLA
33.22;34.91 J-4-14-III TUMOR PAR 8,954,600 5,801,878 JAENAL ARIFIN
- D-4-14-II GANGGUAN 4,100,100 3,509,944 IMAM BASORIH
- A-4-15-II INFEKSI HI 5,176,500 6,911,893 SUMIYATUN
- J-4-16-I SIMPLE PN 3,692,700 3,931,701 PONADI
- J-4-21-I GEJALA, T 2,860,100 4,925,350 JAMMIL
34.91 J-4-20-II PLEURAL E 6,571,300 3,540,368 MUHAMMAD ANDRI NURC
34.04 J-4-15-I PERADANGA 5,163,100 6,303,629 MUHAMMAD SUYANTO
- J-4-15-I PERADANGA 4,431,900 3,016,657 SUGIRNO
- J-4-15-III PERADANGA 9,720,700 11,926,106 MURDIATI
116,767,100 115,908,818 858,282

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- I-4-12-I KEGAGALAN 2,755,200 2,369,288 MUJAYANAH
- I-4-12-I KEGAGALAN 2,755,200 5,241,907 MISLI
- I-4-12-I KEGAGALAN 3,209,800 4,789,635 IIN HASTIATI
- I-4-12-II KEGAGALAN 3,255,300 2,617,850 SALIM P YULIS
11,975,500 15,018,680 (3,043,180)

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- P-8-13-II NEONATAL, 8,194,300 7,657,516 BAYI NYONYA WAKI'AH
- A-4-13-I INFEKSI VI 2,193,300 3,008,099 YOLANDA INKA SABRINA
96.71;38.91;38.92;99.15 P-8-17-II NEONATAL, 6,724,900 26,590,386 BAYI NYONYA IMROATUL
99.83 B-4-13-I GANGGUAN 3,828,700 4,321,560 BAYI NYONYA EFIATUL HA
- P-8-13-II NEONATAL, 8,742,400 15,090,329 BAYI NYONYA HALIMATUS
29,683,600 56,667,890 (26,984,290)

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
- I-4-19-II GANGGUAN 4,777,000 6,698,891 JUMISA
34.91 I-4-12-III KEGAGALAN 4,742,000 4,054,900 SATINAH
- I-4-20-II ANGINA PE 3,680,400 2,458,322 SATINAH
13,199,400 13,212,113 (12,713)

ICD 9 INACBG
DESKRIPSI_INACBG
KLAIM INA TARIF_RS NAMA_PASIEN
80.86 M-1-40-I EKSISI LO 4,583,500 5,952,147 JUMAATI
03.09 G-1-30-I PROSEDUR 11,350,300 7,128,721 NORHAYATI
79.12;80.44 M-1-80-I PROSEDUR 7,920,000 19,286,291 HENDRI ADISURJONO
- G-4-17-I GANGUAN S 3,515,700 755,234 SUNDARI
80.76 M-1-70-I PROSEDUR 15,385,400 6,418,030 ENANG HARIONO
80.76 M-1-70-I PROSEDUR 11,568,000 5,866,387 ERNI MUJAYANA
80.16 M-1-70-I PROSEDUR 15,385,400 8,519,547 MUHAMMAD SYAIKHURRO
79.66 M-1-70-I PROSEDUR 11,568,000 5,057,827 MULYONO
- G-4-17-I GANGUAN S 3,515,700 806,507 IMAMAH
03.09 G-1-30-I PROSEDUR 11,350,300 7,378,498 LAMINA
81.40 M-1-20-II PROSEDUR 16,631,400 28,537,477 WIN WARNI
- M-4-17-I MASALAH 3,834,300 1,106,787 ALWI
80.46 M-1-70-I PROSEDUR 11,568,000 7,836,729 FAINESTY VIVIC EKODANI
80.76 M-1-70-I PROSEDUR 11,568,000 6,347,484 SULASMI HJ.
80.94 M-1-80-I PROSEDUR 7,920,000 4,828,082 MADE MARDIKA
- M-4-12-I FRAKTUR/D 3,598,900 980,000 DR. AMELIA PRISDIANI
80.97 M-1-70-I PROSEDUR 11,568,000 5,858,759 SRI ASTUTIK
03.09 G-1-30-I PROSEDUR 9,742,700 6,187,123 IMAMAH
80.12;81.96 M-1-60-I PROSEDUR 7,659,100 6,119,366 SIRATMIYATI
03.09 G-1-30-I PROSEDUR 12,957,800 7,376,575 ALWI
193,190,500 142,347,571 50,842,929
MRN DPJP
22007155 DR ANDRE KUSUMA,SP.BS
23000501 DR ANDRE KUSUMA,SP.BS
22007488 DR ANDRE KUSUMA,SP.BS
23000419 DR ANDRE KUSUMA,SP.BS
23000451 DR ANDRE KUSUMA,SP.BS
23000043 DR ANDRE KUSUMA,SP.BS
22007835 DR ANDRE KUSUMA,SP.BS
23000465 DR ANDRE KUSUMA,SP.BS
23000603 DR ANDRE KUSUMA,SP.BS
22004297 DR ANDRE KUSUMA,SP.BS
23000531 DR ANDRE KUSUMA,SP.BS
23000155 DR ANDRE KUSUMA,SP.BS
23000501 DR ANDRE KUSUMA,SP.BS
23000176 DR ANDRE KUSUMA,SP.BS
23000726 DR ANDRE KUSUMA,SP.BS
23000500 DR ANDRE KUSUMA,SP.BS
23000690 DR ANDRE KUSUMA,SP.BS
22002170 DR ANDRE KUSUMA,SP.BS
23000807 DR ANDRE KUSUMA,SP.BS
23000803 DR ANDRE KUSUMA,SP.BS
23000106 DR ANDRE KUSUMA,SP.BS
23000059 DR ANDRE KUSUMA,SP.BS
23000006 DR ANDRE KUSUMA,SP.BS

MRN DPJP
22004801 DR ANIK SUKMAWATI, SP.P
21001103 DR ANIK SUKMAWATI, SP.P
22008591 DR ANIK SUKMAWATI, SP.P
23000494 DR ANIK SUKMAWATI, SP.P
9001748 DR ANIK SUKMAWATI, SP.P
16006529 DR ANIK SUKMAWATI, SP.P
23000410 DR ANIK SUKMAWATI, SP.P
8005870 DR ANIK SUKMAWATI, SP.P
23000219 DR ANIK SUKMAWATI, SP.P
23000655 DR ANIK SUKMAWATI, SP.P
23000761 DR ANIK SUKMAWATI, SP.P
22004638 DR ANIK SUKMAWATI, SP.P
23000808 DR ANIK SUKMAWATI, SP.P
22005965 DR ANIK SUKMAWATI, SP.P
23000898 DR ANIK SUKMAWATI, SP.P
23000886 DR ANIK SUKMAWATI, SP.P

MRN DPJP
22008598 DR SEPTA SURYA WAHYUDI,SP.URO
22006211 DR SEPTA SURYA WAHYUDI,SP.URO
23000224 DR SEPTA SURYA WAHYUDI,SP.URO
23000407 DR SEPTA SURYA WAHYUDI,SP.URO
22003418 DR SEPTA SURYA WAHYUDI,SP.URO
23000692 DR SEPTA SURYA WAHYUDI,SP.URO
22008684 DR SEPTA SURYA WAHYUDI,SP.URO
23000224 DR SEPTA SURYA WAHYUDI,SP.URO

MRN DPJP
23000416 DR SETIADI DRAJAD, SP.BTKV
17001426 DR SETIADI DRAJAD, SP.BTKV
8005729 DR SETIADI DRAJAD, SP.BTKV
20004702 DR SETIADI DRAJAD, SP.BTKV
23000511 DR SETIADI DRAJAD, SP.BTKV
23000585 DR SETIADI DRAJAD, SP.BTKV
22004002 DR SETIADI DRAJAD, SP.BTKV
23000583 DR SETIADI DRAJAD, SP.BTKV
23000584 DR SETIADI DRAJAD, SP.BTKV
22004002 DR SETIADI DRAJAD, SP.BTKV
21001938 DR SETIADI DRAJAD, SP.BTKV
23000586 DR SETIADI DRAJAD, SP.BTKV
15000995 DR SETIADI DRAJAD, SP.BTKV
23000511 DR SETIADI DRAJAD, SP.BTKV
23000843 DR SETIADI DRAJAD, SP.BTKV
22008462 DR SETIADI DRAJAD, SP.BTKV
23000880 DR SETIADI DRAJAD, SP.BTKV
23000558 DR SETIADI DRAJAD, SP.BTKV

MRN DPJP
22007152 dr SULIH YEKTI NGUTAMANI, Sp.PD
22005753 DR SULIH YEKTI NGUTAMANI, SP.PD
22008520 DR SULIH YEKTI NGUTAMANI, SP.PD
23000719 DR SULIH YEKTI NGUTAMANI, SP.PD
22008670 dr SULIH YEKTI NGUTAMANI, Sp.PD
22007152 dr SULIH YEKTI NGUTAMANI, Sp.PD
17000294 dr SULIH YEKTI NGUTAMANI, Sp.PD
22007596 DR SULIH YEKTI NGUTAMANI, SP.PD
23000863 dr SULIH YEKTI NGUTAMANI, Sp.PD
23000866 DR SULIH YEKTI NGUTAMANI, SP.PD
23000459 DR SULIH YEKTI NGUTAMANI, SP.PD
10000806 DR SULIH YEKTI NGUTAMANI, SP.PD

MRN DPJP
22007731 DR ULFA,SP.BP.
MRN DPJP
21006808 dr. DEVI AMBARWATI, Sp.P
23000471 dr. DEVI AMBARWATI, Sp.P
23000477 dr. DEVI AMBARWATI, Sp.P
23000291 dr. DEVI AMBARWATI, Sp.P
12009659 dr. DEVI AMBARWATI, Sp.P
23000530 dr. DEVI AMBARWATI, Sp.P
23000512 dr. DEVI AMBARWATI, Sp.P
23000557 dr. DEVI AMBARWATI, Sp.P
23000663 dr. DEVI AMBARWATI, Sp.P
21004819 dr. DEVI AMBARWATI, Sp.P
23000628 dr. DEVI AMBARWATI, Sp.P
23000612 dr. DEVI AMBARWATI, Sp.P
21009206 dr. DEVI AMBARWATI, Sp.P
23000661 dr. DEVI AMBARWATI, Sp.P
23000678 dr. DEVI AMBARWATI, Sp.P
22004353 dr. DEVI AMBARWATI, Sp.P
23000558 dr. DEVI AMBARWATI, Sp.P
22006451 dr. DEVI AMBARWATI, Sp.P
23000641 dr. DEVI AMBARWATI, Sp.P
23000681 dr. DEVI AMBARWATI, Sp.P
22004483 dr. DEVI AMBARWATI, Sp.P
22007165 DR. DEVI AMBARWATI, SP.P
23000397 dr. DEVI AMBARWATI, Sp.P
8002977 dr. DEVI AMBARWATI, Sp.P
23000762 dr. DEVI AMBARWATI, Sp.P
23000769 dr. DEVI AMBARWATI, Sp.P
14006065 dr. DEVI AMBARWATI, Sp.P
22006451 dr. DEVI AMBARWATI, Sp.P
23000784 dr. DEVI AMBARWATI, Sp.P
23000825 dr. DEVI AMBARWATI, Sp.P
23000827 dr. DEVI AMBARWATI, Sp.P
23000760 dr. DEVI AMBARWATI, Sp.P
23000837 dr. DEVI AMBARWATI, Sp.P
23000792 dr. DEVI AMBARWATI, Sp.P
23000061 dr. DEVI AMBARWATI, Sp.P
23000628 dr. DEVI AMBARWATI, Sp.P
23000854 dr. DEVI AMBARWATI, Sp.P
23000814 dr. DEVI AMBARWATI, Sp.P
23000850 dr. DEVI AMBARWATI, Sp.P
23000877 dr. DEVI AMBARWATI, Sp.P
23000879 dr. DEVI AMBARWATI, Sp.P
23000397 dr. DEVI AMBARWATI, Sp.P

MRN DPJP
23000474 DR. FAHRIANSYAH MEGA PRATAMA
18004065 DR. FAHRIANSYAH MEGA PRATAMA
23000529 DR. FAHRIANSYAH MEGA PRATAMA
15003846 DR. FAHRIANSYAH MEGA PRATAMA
23000840 DR. FAHRIANSYAH MEGA PRATAMA
23000857 DR. FAHRIANSYAH MEGA PRATAMA
22008520 DR. FAHRIANSYAH MEGA PRATAMA

MRN DPJP
23000433 DR. INDRA SP PD
23000556 DR. INDRA SP PD

MRN DPJP
21001938 DR. MOVITA HIDAYATI.,SP.P
23000491 DR. MOVITA HIDAYATI.,SP.P
21004373 DR. MOVITA HIDAYATI.,SP.P
19001978 DR. MOVITA HIDAYATI.,SP.P
16000888 DR. MOVITA HIDAYATI.,SP.P
22008565 DR. MOVITA HIDAYATI.,SP.P
23000400 DR. MOVITA HIDAYATI.,SP.P
23000493 DR. MOVITA HIDAYATI.,SP.P
23000397 DR. MOVITA HIDAYATI.,SP.P
23000486 DR. MOVITA HIDAYATI.,SP.P
23000573 DR. MOVITA HIDAYATI.,SP.P
23000563 DR. MOVITA HIDAYATI.,SP.P
5002122 DR. MOVITA HIDAYATI.,SP.P
23000562 DR. MOVITA HIDAYATI.,SP.P
23000061 DR. MOVITA HIDAYATI.,SP.P
23000640 DR. MOVITA HIDAYATI.,SP.P
21004373 DR. MOVITA HIDAYATI.,SP.P
5002225 DR. MOVITA HIDAYATI.,SP.P
23000280 DR. MOVITA HIDAYATI.,SP.P
21001938 DR. MOVITA HIDAYATI.,SP.P
23000636 DR. MOVITA HIDAYATI.,SP.P
20002866 DR. MOVITA HIDAYATI.,SP.P

MRN DPJP
22000371 DR. PIPIET WULANDARI, SP.J
22008630 DR. PIPIET WULANDARI, SP.J
12009928 DR. PIPIET WULANDARI, SP.J
23000907 DR. RATNA PANCASARI, SP.J

MRN DPJP
23000452 DR. RIRIN WAHYUNINGTYASTUTIK, SP.A
23000572 DR. RIRIN WAHYUNINGTYASTUTIK, SP.A
23000479 DR. RIRIN WAHYUNINGTYASTUTIK, SP.A
23000871 DR. RIRIN WAHYUNINGTYASTUTIK, SP.A
23000841 DR. RIRIN WAHYUNINGTYASTUTIK, SP.A

MRN DPJP
23000529 ELFAN MOELJONO, SP.J
13002632 ELFAN MOELJONO, SP.J
13002632 ELFAN MOELJONO, SP.J

MRN DPJP
22003097 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
22002541 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000478 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000515 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
19002395 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
22006591 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
21003819 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000330 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000680 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
6001086 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000616 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
22005837 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000627 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
19005854 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000823 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000842 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
11001506 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000680 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
23000896 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT
22005837 I GUSTI BAGUS INDRA ANGGANUGRAHA,DR.,SP.OT

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