POLI JANTUNG

TGL : 3-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJA KONSULTA DIAGNOSA KELENGKAPAN BERKTINDA KET
NG N
U L BPJS / NO SEP KLAIM PERAWAT KAN
1 138961 0407R00404170000097 AFRIZAL 49 L L CPC, PHT
2 138863 0407R00404170000113 AGUS RIFAI 50 L L HT, CAD EKG
3 148923 0407R00404170000183 ANRI 51 L L CHF, ICM, DM 2
4 153392 0407R00404170000182 arsya aiza rahman 11 P L CHF, MR PHIL RHEUMATIC

5 174244 0407R00404170000376 DARMAWAN 66 L B CAD EKG

6 169102 0407R00404170000159 DAVID KALE LUDJI 64 L L CHF, ICM, DM 2
7 9797 0407R00404170000151 EkA WIDADA 47 L L CHF, ICM, HHD, DM 2, AV
8 171982 1 ERMAWATI SAMOSIR 29 P L POST MVR
9 169207 0407R00404170000232 KUSWADI 48 L L CAD
10 169832 0407R00404170000257 LIJNDAWATI MANIK 43 P L CAD
11 165222 0407R00404170000365 MASIYAMA 54 P L TIROID HEART, HHD
12 100566 0407R00404170000253 MOHAMAD HARUN 66 L L CHF, ICM
13 82768 0407R00404170000313 MUSTIKA 35 L L CHF, ICM
14 49578 0407R00404170000133 NUR AINI 65 P L CHF, HHD
15 64799 0407R00404170000368 NURHAYATI 45 P L CAD EKG
16 168728 0407R00404170000373 RANI BETARIA MANUL 23 P L CHF, PPCM
17 171092 0407R00404170000259 RUMIATI 63 P L CAD, HHD
18 145760 0407R00404170000405 RUSMINI 67 P L CHF, DCM, AF
19 166909 0407R00404170000205 SAFIAH 70 P L CHF, CAD, CPC
20 169487 0407R00404170000177 SAININGSIH 54 P L CHF, HHD, CAD
21 128131 0407R00404170000288 SALAM 56 L L CHF
22 174220 0407R00404170000261 SALOPEN HENDRA 35 L B ARITMIA EKG
23 174285 0407R00404170000312 SOPYAN 38 L B ANGINA PECTORIS EKG
24 153198 0407R00404170000264 SULASTRI ADELINA 46 L L CAD
25 64940 0407R00404170000099 SUPRIJANTO 57 L L CHF, HHD, CAD
26 169517 0407R00404170000221 SUSILAWATI 41 P L CAD
27 156016 0407R00404170000378 TINUR SIHOMBING 66 P L CHF, CAD, HHD, VES,
DISLIPIDEMIA
28 114875 0407R00404170000408 TONI SUHARTONO 42 L L HHD
29 137558 0407R00404170000309 UDUS 70 L L CHF, PROLAPS MITRAL
30 146013 0407R00404170000166 ZAHIRMAN 42 L L CHF, CAD
JUMLAH 1 29
 POLI JANTUNG
TGL : 4-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/LPENUNJANGKONSULTAN DIAGNOSA KELENGKAPAN BERKAS
TINDAKAN KET
U L BPJS / NO SEP KLAIM PERAWAT
1 141888 0407R00404170000488 M. ALI RENGUR 70 L L CHD, HHD EKG
2 12562 0407R00404170000534 UNAH BINTI SANAN 63 P L CHF, HHD
3 21443 0407R00404170000579 Juardi 55 L L VES (ARITMIA)
4 174348 0407R00404170000649 FITRI SALMIATI 18 P B ASD SEKUNTUM ECHO
5 138159 0407R00404170000674 Tuan SUMARDI 66 L L CHF ,HHD ,CHF, HHD, DM 2
6 155776 0407R00404170000800 JAMES SIREGAR 36 L L PJK
JUMLAH 6

POLI JANTUNG
TGL : 4-4-2017
NAMA DOKTER : dr. Afdalun A. H, Sp.JP.FIHA.FAsCC

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/LPENUNJANGKONSULTAN DIAGNOSA KELENGKAPAN BERKAS
TINDAKAN KET
U L BPJS / NO SEP KLAIM PERAWAT
1 161249 1 OMAR KAREEM A 1 L L VSD PM
2 20604 0407R00404170000574 SUTIKNO 53 L L CAD POST PCI
3 11285 0407R00404170000613 MARDIAH 46 L P CHF, CAD, HHD
4 174345 1 WANRI SIREGAR 44 B L RBBB
5 174386 0407R00404170000735 SITI KALIMATUS SAD 39 B P CHF, CAD EKG RO
6 49465 0407R00404170000763 ROSDIANA SINAGA 42 L P CAD, GERD EKG
7 83031 0407R00404170000779 SYAFARUDIN 73 L L CHF, HHD, CAD
8 83030 0407R00404170000781 ROSMAWATI 72 L P CAD, HHD, HT
9 111453 0407R00404170000789 HARTINAH 61 L P CAD
10 174207 1 DWI JONIANTO 35 B L CHF, HHD EKG DARI PARU
JUMLAH 2 8
 POLI JANTUNG
TGL : 5-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANG KONSUL DIAGNOSA KELENGKAPAN BE TINDAK KET
TAN
U L BPJS / NO SEP KLAIM PERAWAT AN
1 117757 0407R00404170000870 ADRIZAL 37 L L VES ARITMIA
2 165546 0407R00404170001061 AFRIZAL 40 L L CHF, RHEUMATIC SEVERE AR + HT
3 149300 0407R00404170000944 DARMIN 53 L L CHF, HHD
4 6882 0407R00404170000942 DASMITA 52 P L CHF, CAD, HT
5 82866 0407R00404170000869 DEDI FEBRIANDI 45 L L dr. Yani HHD
Christina,
Sp.KFR
6 169223 0407R00404170000974 DESMIZON 50 L L CHF, CM , EFUSI PERICARD, ARITMIA
7 164901 0407R00404170000999 DESSY SETEPHANY 22 P L TIROID HEART
8 161484 0407R00404170000957 DWI PUJI ASTUTI 39 P L CHF, TIROID
9 127759 0407R00404170000889 GODLIN ARITONANG 30 L L CHF, HHD
10 136806 0407R00404170001006 HANIPAH 42 P L CHF, HHD, MSI
11 139536 0407R00404170000984 HOTMIAN HARIANJA 37 P L CHF, RHD MSI
12 141782 0407R00404170000853 JHON FADLI 58 L L CAD
13 154024 0407R00404170000960 LIDIA NELLY 38 P L CHF, DISFUNGSI DAITOLIK
14 128650 0407R00404170000998 LIEM KHIE MING 71 L L CHF, ICM, AAA
15 174476 1 NURAINI 61 P B CHF EKG DARI SARAF
16 170365 0407R00404170000897 NURUL CHOLIFAH 46 P L CHF, CM
17 95325 0407R00404170000952 Nyoya ALIMAR T 77 P L CJHF, CAD, HHD
18 30300 0407R00404170000976 Nyoya IKA TOGIARTA 38 P L dr. Eri Siti, MS (MITRAL STENOSIS) + AF
Sp.PK.,M.Kes
19 125730 0407R00404170001027 Nyoya RENNI HUTAU 43 P L CHF, HHD, MR
20 168866 0407R00404170000956 RAUN NAINGGOLAN 47 L L CHF, ICM, MAG
21 156780 0407R00404170000994 ROHANI 61 P L CHF, HHD
22 154380 0407R00404170001017 ROSMINI 64 P L CHF, HHD, DM 2
23 44946 0407R00404170001055 SAPARUDIN 58 L L CHF, VES, AR
24 173146 0407R00404170000875 SOLICHIN BIN YASIN 69 L L CHF, CARDIOMIOPATI, MR
25 141038 0407R00404170000951 SRI FETRA NETTI 42 P L CHF, DISFUNGSI DIATOLIK EKG
26 111102 0407R00404170001066 SRI RAHAYU 56 P L CAD, HHD
27 168903 0407R00404170000973 SRI SUPRIATIN 23 P L VSD
28 171848 0407R00404170000908 WORO BUDI ASTUTI 45 L L CHF, HHD
29 174469 0407R00404170000997 YATIMAH 60 P B CHF, CAD, HHD EKG
JUMLAH 29
 POLI JANTUNG
TGL : 7-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA
3
NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANGKONSULTAN DIAGNOSA KELENGKAPAN BERK TINDA KET
U L BPJS / NO SEP KLAIM PERAWAT KAN
1 60601 0407R00404170001189 ABDUL RAHMAN MA 65 L L CAD EKG SEP 6-4
2 173048 0407R00404170001262 AGUS SUPARNO 49 L L CHF, HHD SEP 6-4
3 148301 0407R00404170001531 BING YONG 11 L L VSD + PDA
4 159800 0407R00404170001211 BULIDAR HUTABARA 45 L L CAD SEP 6-4
5 10038 0407R00404170001553 ECIN KURAESIN 65 P L CAD, HHD
6 87493 0407R00404170001300 ELI KOMARIAH 50 P L CAD, HHD SEP 6-4
7 147985 0407R00404170001355 ERNAILUS 62 P L RV FAILURE + CEFALGIA + GASTRITIS SEP 6-4
8 174614 1 ERNAWATI HARAHAP 39 P L CHF, CAD LOW EF
9 147984 1 ERVANILA 29 P L CHF (-) PALPILTASI SEP 6-4
10 172005 0407R00404170001244 HAFNAWILIS 63 P L CAD, HT SEP 6-4
11 152745 0407R00404170001558 HARIF GUNAWAN 22 L L VES
12 158342 0407R00404170001465 HERMON NABABAN 44 L L CAD
13 164465 0407R00404170001524 M.FAHROZI 17 L L POST OP ENDOCARDITIS INVECTIVE
14 113350 0407R00404170001444 MAKLIA SIHOTANG 34 P L CHF, RHD MSI, AR
15 160028 0407R00404170001387 MANAMBA SIHOMB 41 L L ANGINA PECTORIS + GASTRITIS SEP 6-4
16 105316 0407R00404170001513 MANGITE HUTAGAOL 58 L L CPC, CHF, ICM
17 15858 0407R00404170001474 NAHAR BIN UMAR 65 L L dr. Eri Siti, Sp.PK.,M.KesCHF, CAD, DM 2
18 40995 0407R00404170001517 Nasrun 79 L L CHF, ICM
19 64799 0407R00404170001591 NURHAYATI 45 P L CHF, CAD, HHD EKG
20 136303 0407R00404170001551 NYAI BINTI JAHAMA 47 P L CAD, HHD
21 125163 1 Nyoya TATIK YULIANT 55 P L CAD, HHD, DM 2 DARI PD
22 173204 1 PELIPUS PAO 57 L L CHF, CAD SEP 6-4
23 160177 1 PINKY MUTIA BELLA 7 P L CHF, RHD MR
24 30450 0407R00404170001276 PONIJO SUPARMIN 56 L L CHF, ICM SEP 6-4
25 121881 0407R00404170001512 SAHRIDANI 40 P L CAD
26 142993 1 STEPHANUS BATA 46 L L CHF, CAD DARI SARAF
27 136876 0407R00404170001528 SULIKAH 29 P L TIROID CM
28 38661 0407R00404170001533 SUPARLI 53 L L CHF, ICM, DM 2
29 147485 0407R00404170001595 TIURMA REZEKI HUT 39 P L CHF, MVR
30 12380 0407R00404170001484 YASIN 43 L L dr. Eri Siti, Sp.PK.,M.KesCAD 3VD
31 78249 0407R00404170001309 YULDALITA 49 P L CAD, HHD, CHF SEP 6-4
32 131767 0407R00404170001433 YUSMAINAR 59 P L CAD, HHD
 33 20438 0407R00404170001491 ZAINAL EFENDI 38 L L EFUSI PERICARD
JUMLAH 3 1 29
 POLI JANTUNG
TGL : 10-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANG KONSULTAN DIAGNOSA KELENGKAPAN BERKATINDA KET
U L BPJS / NO SEP KLAIM PERAWAT KAN
1 90754 0407R00404170002064 AISYAH 4 P L dr. Yani Christina, Sp.KFR TOF
2 174829 0407R00404170002071 ALFUADI 52 L B CHF, HHD EKG
3 169218 0407R00404170001898 ARIPIN LUMBAN R 49 L L HHD
4 117554 0407R00404170002013 AULIA 9 P L VSD
5 167215 0407R00404170001966 DAHRUM NABABA 54 L L HT
6 149141 0407R00404170001953 DIAN NOVITA 44 P L CHF, HHD
7 113935 0407R00404170002008 E SUKAESIH 65 P L CHF, ICM
8 62796 0407R00404170001796 FARIDAH 52 P L CHF, HHD
9 155135 0407R00404170001857 HASRIL SUDIN 65 L L CHF, ICM, HT, GASTRITIS
10 16252 0407R00404170001887 IBNU SUTOWO 57 L L CHF, ICM, HHD
11 74734 0407R00404170001963 IRMA SURYANI 40 P L TIROID CM
12 126053 0407R00404170001974 ISTANTO 47 L L SND
13 152214 0407R00404170002063 JOHNSON SITEPU 42 L L CHF, ICM
14 138979 0407R00404170002084 JUPINUS GINTING 40 L L AR, AP, HT
15 67775 0407R00404170002051 KOW KIM HUAT 62 L L CHF, VALVULAR ASI
16 21351 0407R00404170001922 LENI SURYATY 38 P L CHF, VES, CM
17 168330 0407R00404170001980 M HUSNI TAsLIM 59 L L CHF, CAD, HT
18 171185 0407R00404170001943 MGS AHMAD NAZI 47 L L CHF, CAD, AF
19 60091 0407R00404170001847 MOH SUHERMAN 44 L L PPM EC TAVB (BRADIARITMIA)
20 148025 0407R00404170002074 MUSTAPA BARA 50 L L CHF,CAD, HHD
21 137724 0407R00404170001770 NURTINI 48 P L CHF, HHD
22 68431 0407R00404170001917 OSTARIA GULTOM 44 P L CHF, HHD, GASTRITIS
23 100900 0407R00404170001875 PATURRAHMAN 54 L L CHF, HHD, AF, MSI
24 147300 0407R00404170001828 RAZALI KIDAM 69 L L CAD
25 174726 0407R00404170002006 RIKO ADOLF MARA 34 L L SYNCOPE + GASTRITIS
26 17587 0407R00404170001982 Salmida. Hj 61 P L CHF, CAD, HHD
27 158858 0407R00404170001923 SRI ASIH 39 P L HHD, VES
 28 163995 0407R00404170001989 SRI HARIYANI 45 P L CHF, RHD MR, TR, HHD
29 97697 0407R00404170001817 SULARMAN 49 L L CHF, CM, HHD, DM 2
30 168991 0407R00404170002024 SUTINI 46 P L CAD
31 126938 0407R00404170001806 SYAMSUARMI 57 P L CHF, CAD, HHD EKG
32 116366 0407R00404170002081 SYAMSURIZAL 63 L L CHF, ICM
33 167214 0407R00404170001976 TIPAK HUTAPEA 45 L L CAD
34 94653 0407R00404170002067 TUKIMAN 60 L L CHF, AF, MR VALVULAR
35 165730 0407R00404170001884 YESSI HERNAWATI 42 P L CHF, DISFUNGSI DIATOLIK
36 171597 0407R00404170001921 ZUCHRI 43 L L CAD
JUMLAH 36
 POLI JANTUNG
TGL : 11-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMURL/P B/LPENUNJANGKONSULTAN DIAGNOSA KELENGKAPAN BERKASTINDA KET
U L BPJS / NO SEP KLAIM PERAWAT KAN
1 46518 0407R00404170002184 MURNI 59 P L CHF, CAD, HHD
2 43370 0407R00404170002229 YASMAINI 66 P L HHD
3 159146 0407R00404170002151 MASLINI SITOMPU 77 P L CAD, HT
JUMLAH 3

POLI JANTUNG
TGL : 11-4-2017
NAMA DOKTER : dr. Afdalun A. H, Sp.JP.FIHA.FAsCC

NO RM JENIS PEMBAYARAN NAMA PASIEN UMURL/P B/LPENUNJANGKONSULTAN DIAGNOSA KELENGKAPAN BERKASTINDA KET
U L BPJS / NO SEP KLAIM PERAWAT KAN
1 149952 0407R00404170002146 YUSRAL GANI 57 L L CAD
2 58698 0407R00404170005127 Maman Suherman 49 L L CAD
3 174869 1 MAZLAN 76 L B CAD EKG DARI PARU
4 166529 0407R00404170002252 SUNARTI 52 P L CAD, HHD EKG
5 174904 0407R00404170002296 BUKHARI ST SAMP 80 L B CAD,HHD, RBBB EKG
6 174911 0407R00404170002308 NORMI 32 P B GERD, VES EKG
7 174386 0407R00404170002373 SITI KALIMATUS S 39 P L CHF, HHD
8 152431 0407R00404170002448 MARPOAH 73 P L CHF, MR, AR
9 168145 0407R00404170002429 LILI 61 P L CHF, CAD, AR, DM 2
10 174946 0407R00404170002452 PATIMAH 57 P B CHF, CAD, HHD EKG
JUMLAH 10
 POLI JANTUNG
TGL : 12-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANG KONSULTAN DIAGNOSA KELENGKAPAN BERK TIND KET
U L BPJS / NO SEP KLAIM PERAWAT AKAN
1 93790 0407R00404170002595 NURAYA MANIK 71 P L dr. Handedi, CAD, HHD OK
Sp.S, M.Kes
2 79693 0407R00404170002130 ISWADI 34 L L dr. Yuliana CHF, HHD, DISLIPIDEMIA SEP 11-4
Sarly, S.SpPK

3 156238 0407R00404170002489 WARNELIS 57 P L CAD ISKEMIK

4 66505 0407R00404170002516 RAFWAN 37 L L MR VALVULAR, CHF
5 152663 0407R00404170002526 TIOLINA S 75 P L CHF + ICM + AR
6 133373 0407R00404170002539 ERLINA NABABAN 39 P L dr. Hj. CHF, MVR
Hilmiyah,
SpPK
7 155949 0407R00404170002550 PAHAM GINTING 61 L L CHF, ICM
8 134971 0407R00404170002557 ZAHARAH 68 P L CHF, HHD, VES
9 171222 0407R00404170002570 MUSLIM 43 L L CHF, HHD
10 2784 0407R00404170002575 DIAH widiatI 47 P L CAD, HHD EKG
11 159150 0407R00404170002577 NURSIMA LUBIS 55 P L CHF, TIROID CM
12 159161 0407R00404170002586 KHAIDIR 50 L L CHF, DCM
13 170371 0407R00404170002609 ALI JASMAN 51 L L CAD
14 163432 0407R00404170002612 PITUA MAGDALENA 40 P L CAD
15 84280 0407R00404170002614 NURMIDA SILITONG 59 P L CHF, HHD
16 160085 0407R00404170002615 SYIHABUDIN 54 L L CAD
17 1923 0407R00404170002618 JOEL TAHAN 52 L L CAD
18 122852 0407R00404170002641 SIMON BENI 45 L L CAD, HT, DM 2
19 6567 0407R00404170002648 WIWIK KUSWITAWISA 41 P L dr. Acholder CHF, PPCM
TP Sirait
Sp.OG, M.Kes

20 8209 0407R00404170002650 SITI ROHANIAH 35 P L CHF, PPCM

21 37748 0407R00404170002662 UMI SANGIDAH 38 P L ASD
22 161487 0407R00404170002664 JUPENSIUS SINAMU 55 L L CAD, CPC
23 87590 0407R00404170002668 HARIS 56 L L CHF, CAD
24 110822 0407R00404170002681 SUPARTINI 50 P L CHF, ICM
 25 159429 0407R00404170002683 PAIMAN 48 L L CHF, ICM, HT
26 152110 0407R00404170002684 PENDI LUBIS 61 L L CPC + PHT
27 32761 0407R00404170002688 LAMTIUR SITINJAK 43 P L CPC, PHT
28 14846 0407R00404170002693 MEDIANA S PARDED 41 P L HHD, CHF
29 154599 0407R00404170002705 MAHARANI 64 P L CHF, ICM, DM 2
30 158729 0407R00404170002708 SYAIFULLAH 48 L L CHF, CAD
31 175045 1 OSCAR LUIS 0 L B VSD ECHO
32 145792 1 YULVITA 47 P L POST MVR
JUMLAH 2 30
 POLI JANTUNG
TGL : 13-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANG KONSUL DIAGNOSA KELENGKAPAN BER TINDAKA KET
TAN N
U L BPJS / NO SEP KLAIM PERAWAT
1 75479 1 DIKIE FRANZ PAULU 32 L L RANAP
2 104862 0407R00404170002792 ROCHIMAH 52 P L POST MVR + AF + CHF
3 168494 0407R00404170002807 dea hayati 46 P L dr. Yani Christina, CAD TREADMI
Sp.KFR L
4 165414 0407R00404170002816 ZULFIKAR AZMI 0 L L VSD + ASD
5 158728 0407R00404170002911 JUNINTAN DEBORA 46 P L VES + TIROID HEART
6 80425 0407R00404170002920 HADIJAH 62 P L CAD, AR
7 14876 0407R00404170002923 SAMSUDDIN 71 L L CHF, AS GASTRITIS , AP
JUMLAH 7

POLI JANTUNG
TGL : 13-4-2017
NAMA DOKTER : dr. Afdalun A. H, Sp.JP.FIHA.FAsCC

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANG KONSUL DIAGNOSA KELENGKAPAN BER TINDAKA KET
U L BPJS / NO SEP TAN KLAIM PERAWAT N
1 40092 1 EMRIN SIMATUPAN 44 P L CAD EKG DARI PARU
2 84877 0407R00404170002766 RESMI WULANDARI 32 P L KU NORMAL EKG &
ECHO
3 33869 0407R00404170002845 RENY NOVIANTI 32 P L TAVB + PSVT
4 175109 0407R00404170002846 YUNI RESNOWATI 51 P L HHD, HT EKG
5 175151 0407R00404170002965 MARIDUK TAMPUB 56 L L CHF, CAD, AR EKG
6 9897 0407R00404170002967 MARIAM 56 P L HHD, AR
7 298 0407R00404170002972 SUMINI 51 P L CHF + HHD + CAD
8 175175 0407R00404170003036 FETRIYENI 47 P L PSVT + ATYPICAL CHEST EKG
PAIN
9 175142 1 ROY SILABAN 29 L L ATYPICAL CHEST PAIN EKG
JUMLAH 1 8
 POLI JANTUNG
TGL : 17-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANG KONSU DIAGNOSA KELENGKAPAN BERKAS TIND KET
LTAN
U L BPJS / NO SEP KLAIM PERAWAT AKAN
1 135376 0407R00404170003294 ALIF HANAN MAU 3 L L dr. MurfTOF
2 175352 0407R00404170003584 EDY KUSNANTO 60 L B CHF, ICM, DM 2 EKG EROR
3 151947 0407R00404170003214 jumaidi 42 L L CAD
4 13668 0407R00404170003223 NAFSIA 64 P L CAD
5 920 0407R00404170003227 HERLIN MARTHA 52 P L CAD, HHD, PPOK
6 169102 0407R00404170003239 DAVID KALE LUDJI 64 L L CHF, ICM, DM 2
7 75479 0407R00404170003245 DIKIE FRANZ PAU 32 L L dr. Yani Christina, HHD,
Sp.KFR HIPERURESEMIA
8 166695 0407R00404170003252 RANTONY HUTAH 51 L L CAD, HHD
9 68189 0407R00404170003343 GILBERT HUTABA 63 L L CAD, SND, TAVB
10 2417 0407R00404170003351 TRI WURYANTI 57 P L CAD
11 30905 0407R00404170003356 Muharnis 48 P L HHD
12 51106 0407R00404170003381 Mazlan 49 L L CPC
13 157985 0407R00404170003392 ASNEKER UMARLI 44 L L CAD, CHF, HT
14 172138 0407R00404170003394 ROSMINAR S 41 P L ARITMIA, SVT
15 13557 0407R00404170003398 SYAFRUDDIN 57 L L CAD, CHF EKG
16 23708 0407R00404170003422 CUKUP TARIGAN 49 L L CHF, ICM, VES
17 117361 0407R00404170003426 ZAILANI 43 L L CAD
18 171838 0407R00404170003438 DARMANSYAH 43 L L CAD
19 135806 0407R00404170003449 INNEK PURBA 45 P L CAD
20 69128 0407R00404170003458 MUH SULHAN 63 L L CAD, CHF
21 168464 0407R00404170003461 MUNYARTINI 52 P L RHD MS + AF
22 168620 0407R00404170003478 EGENIUS RONKAL 46 L L CAD, HHD
23 174662 0407R00404170003484 NELSON SIANIPAR 52 L L AF, TIROID
CARDIOMIOPATI
24 7639 0407R00404170003490 DORA RUMITA SIH 65 P L dr. Eri Siti, POST MVR
Sp.PK.,M.Kes
25 99897 0407R00404170003499 KAMIYAH 52 P L CAD
26 174363 0407R00404170003522 NURIL HIDAYATI 30 P L CHF, PPCM
27 123697 0407R00404170003544 ERNIE DETTY SE 61 P L CHF, CAD, HHD
28 68431 0407R00404170003572 OSTARIA GULTOM 44 P L ATYPICAL CHEST PAIN

29 175286 1 ATMO SUPARTO A 72 P B POSIBLE CPC EKG

 30 173204 1 PELIPUS PAO 57 L L CAD + CHF

JUMLAH 2 28
 POLI JANTUNG
TGL : 18-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/LPENUNJANG KONSULTAN DIAGNOSA KELENGKAPAN BERKASTINDAKAN KET
U L BPJS / NO SEP KLAIM PERAWAT
1 154083 0407R00404170003556 SARDIMAN S 68 L L CHF, ICM, DM 2 SEP 17-4
2 174709 0407R00404170003576 TUMIRAH 64 P L CAD, DM 2 SEP 17-4
3 167533 0407R00404170003730 HOIRIL 50 L L CAD, CPC TREADMIL
4 55045 0407R00404170003817 Benediktus Leng 44 L L CHF, CAD, AS MILD +
DISLIPIDEMIA
5 162595 0407R00404170003853 KANDANCE A 48 P L CHF, HHD EKG SEP 17-4
6 167471 0407R00404170003855 YUHANENGSIH 38 P L dr. H. Ganda HT, HHD
Hidayat, Msc.,
Sp.PD
JUMLAH 6
 POLI JANTUNG
TGL : 19-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANG KONSULTA DIAGNOSA KELENGKAPAN BERKAS TIND KET
N
U L BPJS / NO SEP KLAIM PERAWAT AKAN
1 102284 0407R00404170003658 RINALDI 53 L L HHD, CPC, AP SEP 18-4
2 1404 0407R00404170003975 MISNAH 67 P L HHD, VES
3 84435 0407R00404170003976 M TASIR 58 L L CHF, HHD
4 145795 0407R00404170003990 AMIRUDIN 59 L L dr. Hj. Hilmiyah, CHF, ICM
SpPK
5 12808 0407R00404170003997 SUDARTI 69 P L CHF, HHD, CPC, ARITMIA
6 175519 0407R00404170004016 RIKI ISKANDAR 25 L B ARITMIA, HT EKG
7 148963 0407R00404170004025 WA AMILA 52 P L HHD, VES
8 64799 0407R00404170004030 NURHAYATI 45 P L CAD, HHD, CHF
9 57139 0407R00404170004043 JARIAH 61 P L CPC
10 15903 0407R004041700040554 SULASMI 49 P L CHF, RHD MS. AR SEKUNDER
11 52844 0407R00404170004080 eunike loius 10 P L VSD + AR SEVERE
12 82823 0407R00404170004109 SUDUNG SIMANJ 48 L L CHF, ICM
13 174773 0407R00404170004118 HENDRIC GULTO 37 L L TIROID CM, AF
14 115321 0407R00404170004129 LIDIA ARDENI 43 P L VES + AML PHIL
15 87351 0407R00404170004144 NASIP ASLINA 52 P L CHF, HHD
16 106477 0407R00404170004144 MARTINAH 53 P L dr. Yani Christina, CHF, HHD
Sp.KFR
17 150404 0407R00404170004156 HUI LANG 83 P L CHF, ICM
18 48407 0407R00404170004164 M Achir 64 L L CHF, CAD, HHD
19 170525 0407R00404170004186 RAJAB 53 L L CHF, ICM, HHD
20 140909 0407R00404170004202 HARTINI 44 P L CHF, ICM, CKD
21 164568 0407R00404170004218 MANGURUS NAI 44 L L CHF, CAD
22 161207 0407R00404170004223 DAMASUS F F 2 L L VSD
23 168812 0407R00404170004229 KURNIAWATI 37 P L VES, PAC EKG
JUMLAH 23
 POLI JANTUNG
TGL : 25-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIENUMUR L/P B/L PENUNJANG KONSULTAN DIAGNOSA KELENGKAPAN BERKAS TINDAKAN KET
U L BPJS / NO SEP KLAIM PERAWAT
1 38522 0407R00404170004944 RABIYAH 65 P L dr. Dessy Sp.Rad CAD
2 163374 0407R00404170004987 ADARA TEVRIA 1 P L VSD echo
3 125599 0407R00404170005004 HABIDI 69 L L CAD
4 162304 0407R00404170005114 INDRA 56 L L CHF, ICM, HT
5 112719 0407R00404170005180 MAIZEN SIHOB 48 L L HHD
6 133228 0407R00404170005190 M.YASIN SALEH 68 L L CHF, ICM
7 175242 0407R00404170005199 SYAMSU 48 L L CAD
8 175861 0407R00404170005204 ARMIATI 43 P B CHF, RBBB, DD ekg
9 139591 0407R00404170005207 SAKIRMAN 63 L L ANGINA PECTORIS
10 159095 0407R00404170005221 NURSITA SINA 49 P L CAD
11 175823 1 SARI OKTAVIA 36 L B KONSULTASI MCU treadmill
12 175813 SERI 38 L B PRO ECHO
1 MARLIANA
13 165714 1 BEDDU 67 L L CHF, ICM, AF
JUMLAH 3 10
 POLI JANTUNG
TGL : 26-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANGKONSULTAN DIAGNOSA KELENGKAPAN BERKASTIND KET
AKA
U L BPJS / NO SEP KLAIM PERAWAT N
1 174916 1 RICKY ANDAVI 34 L L ACC OP EKG DARI URO
2 15858 0407R0040417000 NAHAR BIN UMAR 65 L L ACS, CHF RANAP
3 120953 0407R00404170005481 ALIFA NUR SAHFITRI 2 P L dr. Retno, S PAD
4 123411 0407R00404170004447 SRI HARTI WIDYASAR 42 P L CHF + MR
SEKUNDER + AF +
CPC
5 31775 0407R00404170005302 UMI PAWIRO UTOM 65 P L CAD, HHD
6 175894 0407R00404170005304 RENDI M 27 L B VES
7 102167 0407R00404170005306 MAS NUR BAITI 51 P L CAD+VES
8 150698 0407R00404170005311 pLAFIANUS SIBEON 49 L L CAD, HHD
9 14783 0407R00404170005316 ZAINUN 52 L L CAD
10 167258 0407R00404170005317 JOKO WAHYUDIONO 43 L L CAD
11 104800 0407R00404170005326 RISTONI JAMES PARU 48 L L CAD, HHD
12 78680 0407R00404170005327 NIKSON SIREGAR 45 L L CHF, CAD, HT
13 168764 0407R00404170005337 SUTRINI 66 P L CAD, HHD
14 116849 0407R00404170005347 RUMANAH 76 P L CHF, CAD, HHD
15 124960 0407R00404170005348 HELPI EDISON 43 L L CHF, CAD, HHD
16 8334 0407R00404170005353 Muhammad nur 64 L L CHF, ICM, CPC
17 145558 0407R00404170005361 REMIKA SIMAMORA 35 P L CHF, RHD MS, AR
18 49507 0407R00404170005362 pui ng moi 84 P L CHF, DCM, AAA
19 72859 0407R00404170005369 ANDRIAS ADI 57 L L CAD, HHD
20 107750 0407R00404170005370 CUT INDAH SARI 15 P L TOF
21 168727 0407R00404170005373 GAFNA DELITA 40 P L CAD, HHD
22 151107 0407R00404170005375 BILTER SIHOMBING 51 L L CAD, HHD
23 171440 0407R00404170005389 DARIYANTO 79 L L CHF, CAD, HHD
24 153299 0407R00404170005397 SARIPAH 49 P L CPC, MAG
25 136630 0407R00404170005406 DARYANA 53 P L CPC, TR, AAA
26 163194 0407R00404170005411 WAHAB 56 L L CAD, HHD
27 96958 0407R00404170005422 NURJANAH 56 P L dr. Yuliana dr. Yani CHF, HHD, DM 2
Sarly, SpPK Christina,
Sp.KFR

28 135032 0407R00404170005423 NUR BAYAH 56 P L CHF, CPC

29 135706 0407R00404170005430 YUSMAWATI 55 P L HHD, AP
30 136941 0407R00404170005432 SYAKDAN 43 L L CHF, ICM, DM 2
31 126836 0407R00404170005439 TETTY ELFRIDA M 39 P L CHF + RHD MSI
32 153436 0407R00404170005440 ALISTER SIMAMORA 39 L L CHF, ICM, HHD
33 161214 0407R00404170005446 PURWATI 67 P L VES
34 165855 0407R00404170005459 ENTIN MARYATIN 57 P L HHD, DISPEPSIA
35 151085 0407R00404170005463 HERI PURWANTO 39 L L CAD, VES
36 166866 0407R00404170005475 RUTH CLAUDINE 1 P L PJB, PDA
37 142603 0407R00404170005476 HANIBAH 43 P L CHF, CAD, HT, DM 2

38 9359 0407R00404170005494 RIANI SIHOTANG 60 P L CHF, HHD, AP EKG

39 122720 0407R00404170005498 TJONG KIE MIN 52 L L CAD, AF
40 166529 0407R00404170005518 SUNARTI 52 P L CHF, HHD
41 175934 0407R00404170005520 MAHMUD 52 L B CAD EKG
42 141683 0407R00404170005521 MAWE BINTI TOTOK 74 P L CHF, VALVULAR AR
43 138444 0407R00404170005523 MAR 52 P L HHD, VES
44 167876 0407R00404170005533 HASANUDDIN 59 L L CHF, ICM
45 152764 0407R00404170005541 DIAN SHAKIRA S 7 P L AML
46 144017 0407R00404170005549 ROSLINA 66 P L CAD
47 93195 0407R00404170005561 RUSLAN 62 L L CHF, ICM, HHD
48 58735 0407R00404170005577 HELMI 55 L L CHF, ICM, NHS
49 159215 0407R00404170005581 NANUNG AMIR 63 L L CHF, RHD MS
50 127506 0407R00404170005588 hIDAYAH 28 P L CHF, RHD MS
51 175207 0407R00404170005600 HAMIDANI 50 P L HHD, DISPEPSIA
52 142649 0407R00404170005604 MUHAMMAD 63 L L CAD
53 127921 0407R00404170005628 JAMIL 67 L L CHF, CPC, ICM
 54 148543 1 SUHARTINI 37 P L AP + CAD
JUMLAH 1 53
 POLI JANTUNG
TGL : 27-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASI UMUR L/P B/L PENUNJANG

U L BPJS / NO SEP
1 49377 0407R0040 BENNY SE 40 L L
JUMLAH 1
KONSULTAN DIAGNOS KELENGKAPAN BERKASTINDAKAN KET
A KLAIM PERAWAT
CAD, HT TREADMILL
 POLI JANTUNG
TGL : 28-4-2017
NAMA DOKTER : dr. Nanang Rudy U, Sp.JP.FIHA

NO RM JENIS PEMBAYARAN NAMA PASIEN UMUR L/P B/L PENUNJANG KONSULTAN DIAGNOSA KELENGKAPAN BERKAS TIND KET
U L BPJS / NO SEP KLAIM PERAWAT AKAN
1 79419 0407R0040417000 SUHENDRA 43 L L KE KULIT
2 36915 0407R00404170006016 Joko Purwanto 54 L L dr. MVR (MSI) AF
Lindayanti,
Sp.Pk
3 95637 0407R00404170006017 HARIYANTO 38 L L CHF, CAD, HT
4 149053 0407R00404170006018 NUR BADIAH 54 L L dr. Ade CHF, CM
Senorita
Sp.Pd
5 82503 0407R00404170006030 SUPOYO 69 L L dr. Yani CHF, CAD, AF
Christina,
Sp.KFR
6 75975 0407R00404170006048 SYAMSUDIN UM 59 L L CHF, CAD, HHD, ASI
7 139032 0407R00404170006091 KOMSATUN 46 P L CHF + TIROID CM + AF +
HHD
8 168159 0407R00404170006096 BASARNAWATI 63 P L CHF, CAD, HHD, MAG
9 105714 0407R00404170006097 MELA VEBRIANT 33 P L HHD
10 150141 0407R00404170006099 KHINANTI ARA Y 1 P L VSD
11 165848 0407R00404170006120 MARSYOVA ARE 46 P L CHF, TIROID CM EKG
12 81142 0407R00404170006122 AGUSMAN LUBIS 49 L L dr. CHF, HHD
Lindayanti,
Sp.Pk
13 111717 0407R00404170006131 NURSYAMSINAR 83 P L CAD, HT, PAD
14 32816 0407R00404170006139 EPELINA HOTMA 61 P L CAD
15 92120 0407R00404170006152 YUYU 64 L L CHF, ICM, HT
16 87520 0407R00404170006167 ARIFIN 53 L L CAD, HT
17 149294 0407R00404170006179 SATIMAN 68 L L CHF,, ICM, HT
18 162990 0407R00404170006181 TRIMO 57 L L CPC + PHT
19 79401 0407R00404170006186 KASMAH KHAIRA 40 P L ARITMIA
20 154287 0407R00404170006193 MUSTAN GUAN 45 L L ANGINA PECTORIS EKG
21 95325 0407R00404170006202 ALIMAR T 77 P L CAD
22 94980 0407R00404170006206 MARZUKI 64 L L CHF, ICM
23 88884 0407R00404170006210 KAMET 53 L L CAD EKG
24 146118 0407R00404170006224 JULY 35 L L CPC
25 150534 0407R00404170006234 IGNASIUS OLA 45 L L CHF, ICM
 26 156163 0407R00404170006254 SAKINI 63 P L CHF, ICM, VES
27 176120 1 WASIS WATI 60 P B CHF + HHD + ARITMIA
JUMLAH 1 26