DX

NO NAMA UMUR ALAMAT TB BB LP TD THERAPY

SP2TP BPJS
11
 DX
NO NAMA UMUR ALAMAT
SP2TP BPJS
1 Cik Ima 59 2 1200 i10
2 Hamdani 65 1 2201 k29.7
3 asril 58 1
4 mulyadi 68 2
5 yohir 55 4 2201 k29.7
6 iskandar 60 2 ispa r05
7 khairil anwar 65 5 ispa ro5
8 yulianis 63 1
9 Ramlan 62 1
2/2/2019
1 Stepanus 62 4 2215+1200 e11.9+10
2 mardeonito 56 4 2215+1200 e11.9+10
3 Andika 62 3 2100+2201 m79.1
4 A.Pahlef 56 5 102 a09
5 iswandi 60 4 2001
6 Kausar 62 4 ispa r05
7 Ernawat 64 4
8 Ruslan 68 1 2201 k29.7
9 Ariyah 63 3 404

2/4/2019
1 Rosda 60 1 1200 i10
2 Hamdani 65 1 2201 K29.7
3 Sahidin 70 5 1200 i10
4 Ardini 67 2 2100 m79.1
5 Nizmakursila 57 1
6 Salma 64 3 2101
7 Azwar 75 3 ispa j02.6
8 Yutanis 63 5 2201 k29.7
9 Widrayudin 57 4 h10.9
10 Mihainah 56 5 2201 k29.7
11 Ernawat 62 1 2201 k29.7

2/6/2019
1 rugayatul 57 5 ispa r05
2 darusa 90 3 ispa +2101 r05+m79.1
3 nuraini 64 4
4 p.anton suyono 69 3 dm+ht+p.jantung
5 alimin 70 5 ispa r05
 6 syaiful syahril 66 5 ispa r05
7 nudiah 61 5 1604
8 sulaiaman 62 2 2003
9 samsul 67 5 ispa+2201 r05+k29.7
10 hariyani 62 5 konstpasi+isk

11 kausar 62 5 ispa
12 budiono 56 5 2002 l50.0
13 M.lazim pulungan 65 1 2216+2215+1200 i50.9+e11.9+i10

14 yusniat 62 4 2101 m06.9

15 Nurdjani 79 3 2216+i10+ispa
16 Syaripudin 57 2 2201 k29.7
17 kamil 56 5 2101 m05.7
18 zalika 65 1
19 Nazarudin 62 4
20 Sukandi 59 2
21 Sit 56 2

2/7/2019
1 Dodik Bambang 66 1 ispa r05
2 M.Arfan 60 1 1200 i10
3 Eliza Martn 57 04 ispa r05
4 Dahlan 79 1 2100 m79.1
5 Nurjasmi 75 1 2101 m06.9
6 Z.Abidin 59 3 2002 l50.0
7 Warnaini 62 3 2216+1200 i50.9+i10
8 Marwi 66 4 2216+1200 i50.9+i10
9 robinson 56 1 2216+1200 i50.9+i10
10 Nungcik 57 2 2219
11 Zulhijani 73 2 ispa r05
12 Zainal 70 1 ispa r05
13 moriana 73 1
14 ratna zuraini 75 3
15 Asrul 62 2
16 Musrizal 55 2
17 M.Nasir Sinapa 71 3
18 robinson 56 1

2/8/2019
1 Elva 58 1 2100 m79.1
2 Asropi 64 1 2215 e11.9
3 samsidar 66 5 ispa r05

2/10/2019
 2/11/2019
1 Rohana 78 1 2101 m06.9
2 Ardini 67 2 ispa r05
3 Edizal 61 2 PPOK j44.9
4 M.Arfan 60 1 1200 i10
5 Syafrudin 63 2 2101 r06.9
6 ahmad rain 67 5 1200 i10
7 Fatmawat 64 5 1200+2201 i10+k29.7
8 Kausar 62 3 ispa ro5
9 Syafrudin 63 2 2101 m06.9
10 Hariani 56 3
11 Zahara 64 4 2201
12 Sri Hastut 55 5 ispa r05
13 Asmarania 64 3 ispa r05
14 Nudiah 60 5 isk
15 Nurmilisiswat 63 5 gigit semut insect bith
16 Janat 62 2 2201 k29.7
17 Roland 71 4 2101 m06.9
18 yasmin 67 3 1200+2201 i10
19 masita 56 2 2201+2101 k29.7+m06.9
20 Nursyah 60 1 ispa R05
21 Sukandi 61 2 2201 k29.7
22 yusna 60 2
23 Bakhtar 80 3
24 Machlizar 59 2
25 Badri 65 1 2101 m06.9

Feb-19
1 ridwan 68 3 2101 m06.9
2 Noni 60 1
3 Hasnah 66 1 2100 + 1200 m79.1 + i10
4 Mardewa 56 1 ispa r05
5 Rosda 60 2 1200+2201 i10
 6 A.Minhadi 67 3 ispa r05
7 Maryat 71 3 KLL
8 Nursidah 74 1
9 Zulhayat 57 4
10 Nuraisyah 60 3
11 Mutara rozali 78 1
12 Fatmawat 59 2 2201 k29.7
13 Rahuna 65 3 2100 m79.1
14 Maderf 64 2 2215 + 1200 e11.9+ 1200
15 Hamdani 65 1 2201+m06.9
16 Ramanie 64 1 2100 m79.1
17 Ratsiba 60 5 2201 k29.7
18 Syahbudin 65 5 KLL
19 Rostna 60 4

13-Feb-19
1 Muklis 58 1 2201 m06.9
2 Nur aza 74 4 ispa+2002 r05+L50.0
3 Gustana 65 2 2215 e11.9
4 Edi subagio 61 2 2201 k29.7
5 Nurbait 60 4 1200 i10
6 Dodik 66 1 ispa r05
7 Aspuri 64 4 1200 i10
8 Sabil 57 2 ispa r05
9 Gusnawat 57 4 ispa r05
10 Saiful Amri 55 3 ispa+abses r05+L02.2

2/14/2019
1 asril 58 1 ispa r05
2 ardini 67 2 febris
3 mulyadi 68 2 ispa r05
4 edison 62 4 2100 k29.7
5 safti 66 5 ispa+2101 m06.9
6 darmawat 66 1 2215+2101 e11.9+m06.9
7 arhanudin 58 3 2215+1200 e11.9+i10
8 nurjanah 63 3 2215 e11.9
9 maryono 65 1 2101 m06.9

2/15/2019
1 suharsono 61 3 2215 e11.9
2 Kencana wat 60 1 2101+2215 m06.9+e11.9
3 Hayat 57 2 2101 m06.9
4 Rustam 68 1 2101 m06.9
5 Herman 62 5 1604 n39.0
6 Rugaiyatul 57 5 ispa+k29.7 r05+2201
 2/16/2019
1 Henny indriani 61 2 ispa ro5
2 Hetty linggawat 67 3 ispa + 2100 r05+m79.1
3 Sahidin 70 4 ispa + 1200 r05+1200
4 Inardi 56 5 kaki bengkak
5 Syahbudin 65 5 KLL l02.0
6 Syafrida 62 3 2101+2201 m06.9+k29.7
7 Budiyono 56 5
8 gunarto 58 5 2002 l50.0
9 sofyan 63 1 2215 e11.9
10 Zul Afnan 58 1 2002 2002
11 Nirmala Dewi 57 1 flu

2/18/2019
1 m arfan 61 1 1200 i10
2 jelita 57 2
3 dahlan 79 1
4 aina 56 4 2101 m06.9
5 hanifah 73 3 2101 m06.9
6 syahrul 63 3 2201+ispa k29.7+r05
7 marwi 65 4 2002 L50.0
8 hasbi 81 3 d17.9
9 yarman 57 5 2101 e11.9
10 m ali 88 4 1200 i10
11 fatmawat 69 1 ispa r05
12 nuraini 74 2 2201 k29.7+r05
13 suryat 69 1 1200 i10
14 ridwan 70 3 2101 mo6.9
15syahbudin 65 5 abses

2/19/2019
1 Ardini 67 2 ispa r05
2 Nazirin 75 2 ispa R05
3 Saparudin 70 4 ispa r05
4 Syarifudin 57 2 2201 + 2225 k29.7 h81.3
5 madsani 70 2 ispa R05
6 Aspuri yana 64 4 1200 i10
7 nurdjani 79 3 2101 m06.9
8 budiant 62 1 1200 i10
9 safti 66 5 1200+ispa i10+r05

2/20/2019
1 Subianto 66 5 2101 e11.9
2 Hasna 66 4 2100 m79.1
 3 Jhon kenedi 55 2 2101 e11.9
4 Nurmiat 58 1
5 Busnan 60 4 ispa r05
6 Dodik 65 1 102 a09
7 Nurhayani 56 5
8 Sabil 57 2 ispa r05
9 Nourma 70 2
10 Edizal 61 5 ispa r05
11 Rustam 68 1 1200+2101 i10+m06.9
12 Zahara 64 4 2215 e11.9
TB BB LP TD THERAPY

amlo,b.com
ranitdin,antasid,omz
b.com,melocixam,amlo
pct, b.comomz
omz,antasid,ranitdin
dexa,ctm,vit.c,,ambroxol
amox,ibu,ctm,ambroxol
p.mata-RSTS-ggn.Refraksi
p.mata-RSTS-ggn.Refraksi

metformin,simvas,amlo
130/80 metformin,simvas,amlo
melocixam, antasid,omz,ranitdin
168 80 120/70 B6,antasid,omz,diatab
110/70 amox,ctm,dexa,vit.c
Amox,dexa,vitC,ambrox,ctm
RSJ-Skizoprenia
110/60 antasid,pct,B6,omz,ranitdin
130/80 Var4, asmet, Vit.c

130/90 amlodipine
110/80 antasid,ranitdin,omz,pct,piroxicam
130/80 amlodipine,bcomp
120/70 na.dic,pred,cetrizin,ranitdin,ctm
110/70 bcomp
110/80 allupurinol,prednison,dexa, omz
110/80 amox,dea,ctm,ambroxol,pred
120/80 antasid,ranitdin,omz,b6,pct
130/80 bcomp,ctm
120/80 antasid,ranitdin,omz,b6,pct
110/80 antasid,ranitdin,omz,b6

76 130/70 amox,pct,ctm,pred,amb,omz
140/80 ctm,dexa,ambro,melox,b com
130/70 ctm,ketokonazem,vit b com,kalk
120/70 simuastatn,caudesartan,aspilet,bisopiolo
130/70 ctm,dexa,ambrox,b.com
 140/70 ctm, dexa,ambrox,b.comp
110/80 cotri,pct,pred,b.comp
140/100 ctm,dexa,pct,b.comp,ketokonazol sk
120/80 amox,ctm,ambrox,antasid,omz
120/80 antasid,b.6,pct

130/70 amok,pct,ctm,ambrox
130/80 meloxicam,b.com,dexa,amox,oxytetra sk
100/70 candesartan,bisoprolol,amlodipin,simvastatn,metformin,gli
mepirid
110/70 melocixam,b.comp,ctm,dexa
130/80 candesartan,herbeser,ambrox,b.com,ctm
110/70 antasid,ranitn,pct,omz,b.com
120/90 allu,pirox,omz,neurodex,simvas
p.jantung-rsmy-heart failure
p.paru-rsmy-ppok
p.mata-rsts-gang.refraksi
p.gastro-rsmy-serocis hepats

120/80 Amox,ctm,dexa,ambroxol
140/90 Amlodipin,B.Comp
90/70 amox,pct,ambroxol
110/70 melox,pred,B.comp
58 130/80 melox,B.com,kalk
110/70 kalk,ctm,dexa,betametson zalf
cpg,bisoprolol,simvastatn,candesartan,amlo
cpg,bisoprolol,cande,gliquidon
Aspilet,cande,nitrokaf,bisoprolol,simvastatn
pct,pred,b.comp,antasid
130/70 pct,ctm,pred,ambroxol
60 120/80 Amox,pct,ctm,pred,ambroxol
Konsul rujukan jiwa
p.dalam-RS.Kota-DM Complikasi
P.Paru-RSTS-PPOK
P.dalam-RS.Bhayangkara-DM
P.THT-RS.Kota-Othalgia
P.Mata-RSTS-Ggn.Reffraksi

120/80 melox,b.comp,pct
130/80 metformin,glimepirid
110/70 pct,ctm,ambroxol,b.comp
 120/80 Melox, alupurinol,b.com,kalk
65 150/90 PCT,CTM,Pred,Ambrox,amox
120/80 Symbicort
130/80 Amlodipin,B.comp
130/90 alupurinol,melocixam,b.comp
130/80 Amlo,B.com
120/70 Amlo,B.comp,antasid,ranitdin,pirox,omz,neurodek
Amox,pct,ctm,dexa,ambrox
77 130/90 Alupurinol,melocixam,b.comp
konsul rujukan orthopedi
140/90 gliben,b.com,pct
amox,pct,ambrox,ctm
130/90 amox,pct,ambrox,ctm
PCT
100/70 ctm,dexa,kalk,betametason SK
110/70 antasid,ranitdin,B6,pct,omz
140/90 alupurinol,pirox,omz,neurodex
amlo.antasid,omz,ranitdin,b.com
alupurinol,pirox,b.6,antasid
110/70 Simvastatn,pct,neurodek,ctm
150/90 antasi,ranitdin,omz,b.6,ctm
Rujuk p.dalam-RS.Kota-DM
Rujuk.P.saraf-RSTS-Stroke
Rujuk P.dalam-RSTS-GGK
110/70 eloxicam,pred,b.com

120/80 Mlocixam,dexa,b.comp
120/80 Amlodipin,candesartan
160/100 melocixam,amlo,b.com
120/80 pct,ctm,pred,amox
Amlo,antasid,B6,pct
 pct,ctm,dexa,ambroxol
Melocixam,dexa,b.comp
Amlo,amox,ambrox,dexa,ctm,pct
Melo,dexa,b.comp,kalk
Obh syrup,dexa,ctm,ibuprofen,amlo
PCT,B.comp
120/80 OMZ,Ranitdin,B.comp
140/90 Melocixam,b.com
140/90 amlo.gliben,b,com
120/80 Melocixam,antasid,omz,ranitdin
120/80 melocixam,b.comp.antasid
120/80 ranitdin,omz,b.comp
110/70 Asmet,amox,dexa,Vit.c
130/80 neurodex

150/90 melox,b.comp,pred
130/80 ctm,dexa,ambroxol,metro salp
130/80 gliben,metformin,b.comp
120/80 pct,antasid,omz,ranitdin
150/90 amlo,pct,b.comp
130/70 amox,ctm,dexa,ambroxol
160/100 amlo,neurodex
120/80 amox,pct,ctm,ambroxol
130/80 amox,pct,ambroxol,dexa,ctm
130/90 amox,ctm,dexa,ambroxol

150/100 amlo,pct,ctm,ambroxol,amox
130/90 pct,kalk,b.comp
130/80 melox,b.comp,kalk,ambroxol,amox
110/70 melox,b.comp,kalk,ambroxol,amox
140/80 allup,amlo,pirox,omz,neurodex,antasid,ctm
120/80 allup,piox,omz,neurodex,b.comp
140/90 amlo,mertgo,antasid,ranitdin,b6
120/80 gliben,melox
130/80 metformin,melox,allup,b.comp,ambrox,keto salp

120/70 metformin,glimepirid
100/70 metformin,dexa,amox,oxitetra SK
90/70 melocixam,dexa,b.comp,kalk
120/80 alu,melocixam,dexa,b.comp
110/70 Kotri,pct,dexa,b.comp
140/90 amox,pct,pred,ambrox,antasid,dmp
120/80 Cipro, ambroxol,dexa,ctm
110/70 Amox,ambrox,ctm,dexa,melocixam
160/100 Amox,ambrox,ctm,pred,amlo
140/80 Kotri,pct,dexa,b.comp
110/70 ibuprofen,amox,dexa,vit.c
120/80 melox,alupurinol,omz,antasid,pct
120/80 pct,ctm,dexa,ketoko sk,b.comp
130/80 ctm,dexa,b.com
glimepirid,metformin,amlo,cande,biso,spironolol
140/80 ctm,dexa,ibuprofen,betametason SK
100/70 ibuprofen,ctm,dexa,omz

120/90 amlodipin,b.comp
130/80 amlo,allup,b.comp,pred,antasid
120/80 ctm,dexa,kalk,salisilk talk
140/90 melox,allup,kalk,b.comp,
120/90 melox,b.comp,pct,dexa
120/80 amox,pct,ctm,ambroxol,antasid,0mz
130/80 ctm,[red,kalk,keto salp
100/70 amox,dexa,vit c
110/70 metformin,glimepirid,acarbase,melox
140/90 amlo,b.comp
110/70 melox,pred,obh,antasid
140/90 antasid,omz,vertgo,b.comp
120/80 amlodipin
130/80 melox,dexa,b.comp
120/80 amox,dexa,ctm

120/80 Amox,Pred,ctm,ambrox,pct,ambrox,pct,melocixam
110/70 amox,ctm,dexa,ambroxol
120/80 Pct,ctm,dexa,ambrox,Bcom
110/80 pct,antasid,omz,metgo
120/80 Pct,ctm,dexa,ambrox
150/100 amlo,b.comp
130/80 amox,ctm,pred,b.comp
amlo,miniasf
120/80 allup,amlo,pirox,omz,neurodex,ctm

cek gds
120/80 melox,dexa,b.comp
 glimepirid,metformin,adalat,aspilet
konsul rujukan
100/70 pct,pred,ambroxol,b.comp
100/70 cotri,antasid,diaform,oralit
konsul rujukan
110/70 amox,ctm,pred,ambroxol
konsul rujukan
90/70 amox,pct,ctm,pred,ambroxol
160/100 amlo,allup.dexa,melox,b.comp
130/80 glimepirid,b.comp
 REKAPITULASI
NAMA BPJS NAMA SP2TP
i10 15 1200 13
k29.7 15 2201 16
r05 28 ispa 33
e11.9+10 2 2215+1200 3
m79.1 0 102 2
a09 2 404 1
h10.9 1 0
j02.6 1 0
 DX
NO NAMA UMUR ALAMAT TB BB LP TD
SP2TP BPJS
 REKAPITULASI
NAMA BPJS
THERAPY
aa 0
contoh 1
0
0
0
0
REKAPITULASI
NAMA SP2TP
0
0
0
0
0
0