KLINIK UMUM PRATAMA JAYA HUSADA
JL. MARDITOMO RT 1 RW 2
SIDOREJO KIDUL, TINGKIR
PASIEN BPJS YANG DIRUJUK PERIODE JANUARI – AGUSTUS 2018
BULAN NO NAMA PASIEN
JANUARI 1 Oppy Triastiti S.
2 Yesia Candra Dewi
3 Maya Nurhayati Aini
4 Hinggawati Irwanto
5. Maya Nurhayati Aini
6 Hidayah
7. Slamet Widodo
8 Oppy Triastiti S.
FEBRUARI 1 Siti Asiyah
2 Musyarofah
3 Rini
MARET 1 Ngatini
2 Dewi Choirunnisa
3 Musyarofah
4 Witri Asih
5 Ika Roudhotus Syarifah
6 Wiyono
SALATIGA
TELP : 085950365888
NO ID BPJS DIAGNOSA
0002318867605 Necrosis of pulp
0001834026041 Impacted Teeth
0002221113172 Tuberculosis of lung, confirmed
by culture only
0001810766079 Gastroenteritis and colitis due
to radiation
0002221113172 Simple chronic bronchitis
0001802841175 Congetive Heart Failure
0002308577139 Keratitis and
keratoconjunctivitis in other
diseases classified
elsewhere
0002318867605 Caries of dentine
0001267357094 Periapical abscess without sinus
0002032817499 Cerebral infarction, unspecified
0002421479272 Maternal care for poor fetal
growth
0002285447218 Simple chronic bronchitis
0002308577591 Astigmatism
0002032817499 Cerebral infarction,
unspecified
0001199585024 Supervision of other normal
pregnancy
0001691723788 Supervision of pregnancy
with history of abortive
outcome
0002326556687 Hyperplasia of prostate
 KLINIK UMUM PRATAMA JAYA HUSADA
JL. MARDITOMO RT 1 RW 2
SIDOREJO KIDUL, TINGKIR
7 Siti Asiyah
APRIL 1 Atina Wulandari
2 Hery Anjas Wahyu
Setiawan
3 Slamet Widodo
4 Aurel Nadine Kiranasya
5 F. Endang Yuni
Wahyuningsih
6 Indrarini
7 Yona Agustina
8 Ngateman
9 Marmi Budiarti
MEI 1 Rika Utami
2 Ahada Aufara Amitabha
3 Fika Agustin
4 Restuti Dhian Pangesti
Prasetya Ning Tyas
5 Herry Saputro S
6 Pawiro Djayus
7 Sujarwo
8 H. Djunedi
9 Wartini
10 Evariantini
SALATIGA
TELP : 085950365888
0001267357094 Periapical abscess without sinus
0001802843199 Supervision of normal
pregnancy, unspecified
0002447165428 Chronic kidney disease
0002308577139 Pulpitis
0001532653119 Dengue haemorrhagic fever
0002444616663 Other carcinoma in situ of
breast
0001849387498 Trigger finger
0002429439287 Supervision of normal
pregnancy
0001735027132 Chronic obstructive pulmonary
disease, unspecified
0002439430615 Non-insulin-dependent
diabetes mellitus with
peripheral circulatory
complications
0001908194758 Pulpitis
0002304438761 Necrosis of pulp
0001799358287 Myopia
0002268646209 Impacted Teeth
0001528674221 Impacted Teeth
0000088406818 Presbyopia
0000601556196 Other benign neoplasm of
connective and other soft tissue of
lower limb, including hip
0001834385455 Suppurative otitis media,
unspecified
0002308582001 Mechanical complication of
intrauterine contraceptive
device
0000076109927 Other hypertrophic disorders of
 KLINIK UMUM PRATAMA JAYA HUSADA
JL. MARDITOMO RT 1 RW 2
SIDOREJO KIDUL, TINGKIR
SALATIGA
TELP : 085950365888

skin
11 Hidayah 0001802841175 Congestive heart failure
12 Sri Sukapti 0001463125667 Other vitreous opacities
13 Budi Suprihatin Lutfi 0000088287963 Tuberculosis of lung, confirmed
by unspecified means
14 Fitria Ningsih 0001639558754 Supervision of normal pregnancy,
unspecified

JUNI 1 Pawiro Djayus 0000088406818 Trigeminal neuralgia

2. Devi Maharani Apriyanti 0001081252293 Myopia
3 Nurul Maida 0002425535908 Supervision of normal first
pregnancy
4 Faiz Ahmad 0001178019202 Pulpitis
5 Sri Yanah 0001790493693 Pulpitis
6 Dina Kurnianingsih 0002448131578 Supervision of normal pregnancy

JULI 1 Siti Muslikhatun 0002273075864 Necrosis of pulp

2 Tjindrajani
3 Aaron Steven Falim
4 Adriele Seanvictoria
Falim
5 Yosia Deny Kristanto
6 Agnesia Caroline
7 Rafasya Caesar
Alkhaliki
8 Husna Kurniawati
9 Faiz Ahmad
10 Mugiman
11 Putut Bayu Prakosa
0002375450381 Hypermetropia
0002375450392 Myopia
0002375450414 Myopia
0002462669098 Myopia
0002462669144 Myopia
0001632267562 Chronic diseases of tonsils and
adenoids
0000088280482 Retained dental root
0001178019202 Pulpitis
0001442878525 Paraplegia, unspecified
0001834025117 Myopia
 KLINIK UMUM PRATAMA JAYA HUSADA
JL. MARDITOMO RT 1 RW 2
SIDOREJO KIDUL, TINGKIR
SALATIGA
TELP : 085950365888

12 Adonis Kana Mahardika 0002424526244 Necrosis of pulp

13 Angelina Wilma Adhitya 0001810767521 Myopia
14 Budi Suprihatin Lutfi 0000088287963 Hypertmetropia

AGUSTUS 1 Ika Roudhotus Syarifah 0001691723788 Supervision of pregnancy with

history of abortive outcome
2 Adonis Kana Mahardika 0002424526244 Necrosis of pulp
3 Nur Aini 0001838287866 Pulpitis
4 Siti Zubaidah 0001032737635 Sequelae of stroke, not
specified as haemorrhage or
infarction
5 Haryanto 0001127886467 Non-insulin-dependent
diabetes mellitus with
unspecified complications
6 Siti Muslikhatun 0002273075864 Necrosis of pulp
7 Tjondro Djatmiko 0001275890433 Low back pain
8 Ngateman 0001735027132 Chronic obstructive pulmonary
disease, unspecified
9 Sugiyem 0001844324379 Postmastectomy lymphoedema
syndrome
10 Bhima Wahana 0002290755216 Carpal tunnel syndrome
Kurniawan
11 Hj. Warsiti 0001834385916 Pain localized to other parts of
lower abdomen
12 Yuni Astuti 0000074598502 Myopia
13 Tukul Purwanto 0002274037975 Idiopathic gout, ankle and foot
14 Nila Adila 0001183866298 Chest pain, unspecified
15 Supriyono 0001285816882 Periapical abscess without
sinus
 KLINIK UMUM PRATAMA JAYA HUSADA
JL. MARDITOMO RT 1 RW 2
SIDOREJO KIDUL, TINGKIR
SALATIGA
TELP : 085950365888

DATA RUJUKAN PASIEN BPJS TAHUN

2018
16
14
12
10
8
6
4
2
0