5 6179350412907249756

KODE_RS KELAS_RS KELAS_RAWAT KODE_TARIF PTD ADMISSION_DATE
DISCHARGE_DATE BIRTH_DATE BIRTH_WEIGHT SEX DISCHARGE_STATUS

DIAGLIST PROCLIST ADL1 ADL2 IN_SP IN_SR IN_SI IN_SD INACBG
SUBACUTE CHRONIC SP SR SI SD DESKRIPSI_INACBG TARIF_INACBG
TARIF_SUBACUTE TARIF_CHRONIC DESKRIPSI_SP TARIF_SP DESKRIPSI_SR
TARIF_SR DESKRIPSI_SI TARIF_SI DESKRIPSI_SD TARIF_SD
TOTAL_TARIF TARIF_RS TARIF_POLI_EKS LOS ICU_INDIKATOR ICU_LOS
VENT_HOUR NAMA_PASIEN MRN UMUR_TAHUN UMUR_HARI DPJP SEP NOKARTU
PAYOR_ID CODER_ID VERSI_INACBG VERSI_GROUPER C1 C2 C3
C4
7322003 D 3 DS 1 29/09/2018 01/10/2018 01/08/1999 0 1
1 K30 - 0 0 None None None None K-4-18-I None None
None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
1130000 0 0 - 0 - 0 - 0 - 0
1130000 275000 0 3 0 0 0 EKING 026192 19
6999 dr. MUSMIANI MUIS, Sp.PD 0341R0040918V002588 0000942766042
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48165 1#0##0
0 b4bc335ebca13766c4639cfd18362dee
7322003 D 3 DS 1 28/09/2018 01/10/2018 01/01/1948 0 2
1 J40;K30 - 0 0 None None None None J-4-21-I None
None None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM PERNAFASAN
LAIN-LAIN (RINGAN) 2635000 0 0 - 0 - 0 - 0
- 0 2635000 525000 0 4 0 0 0 KUNTA 010767
70 25838 dr. MUSMIANI MUIS, Sp.PD 0341R0040918V002586
0000941882308 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48166 1#0##0 0 8c8d674577900e473c0db3a417f28d5a
7322003 D 1 DS 1 27/09/2018 01/10/2018 23/09/1980 0 2
1 O14.1;O82.8;Z37.0;O42.9 74.4 0 0 None None None None O-6-
10-II None None None None None None OPERASI PEMBEDAHAN CAESAR (SEDANG)
6628500 0 0 - 0 - 0 - 0 - 0
6628500 5860500 0 5 0 0 0 HASRIANI 018436
38 13883 DR.ASRIYANTI AMSIR,SP.OG,M.KES. 0341R0040918V002564
0000132430162 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48167 1#0##0 0 d3b9d5493f7ae8d6ea2573495844e457
7322003 D 3 DS 1 28/09/2018 01/10/2018 28/09/2018 2025 1
1 P07.1 - 0 0 None None None None P-8-13-I None None
None None None None NEONATAL, BBL 2000 - 2499 GR TANPA PROSEDUR MAYOR
(RINGAN) 4728100 0 0 - 0 - 0 - 0 - 0
4728100 2175000 0 4 0 0 0 BAYI NY. ERNAWATI GII
026186 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0040918V002639 0002483515179 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48168 1#0##0 0
dcec4905a9b266a2df1a36c965eb3c20
7322003 D 3 DS 1 28/09/2018 01/10/2018 28/09/2018 2320 2
(RINGAN) 4728100 0 0 - 0 - 0 - 0 - 0
4728100 2175000 0 4 0 0 0 BAYI NY. ERNAWATI GI
0341R0040918V002640 0002479190501 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48169 1#0##0 0
bc6211f473e2c882740cb3ae7f7fb7a4
7322003 D 3 DS 1 27/09/2018 01/10/2018 22/12/2015 0 2
1 J18.0 - 0 0 None None None None J-4-16-I None None
None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (RINGAN)
3300100 0 0 - 0 - 0 - 0 - 0
3300100 735500 0 5 0 0 0 MIFTAHUL KHAIR 026158
2 1010 DR. MULYANI KADIR, SP.A,.M.KES. 0341R0040918V002578
0001963889392 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48170 1#0##0 0 dd1968204afe457953a91e35e67cae9b
7322003 D 3 DS 1 28/09/2018 01/10/2018 04/06/1992 0 2
1 N73.9 - 0 0 None None None None W-4-11-I None None
None None None None INFEKSI SISTEM REPRODUKSI WANITA (RINGAN) 2134700
0 0 - 0 - 0 - 0 - 0 2134700 375000
0 4 0 0 0 SELVYANI, S.PD.H 019540 26 9612
DR.ASRIYANTI AMSIR,SP.OG,M.KES. 0341R0040918V002575 0002328457904
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48171 1#0##0
0 9306f573b6c6187f44e4fba3950cdf7b
7322003 D 3 DS 1 27/09/2018 01/10/2018 01/08/1979 0 2
1 O21.0 - 0 0 None None None None W-4-16-I None None
None None None None GANGGUAN ANTEPARTUM (RINGAN) 1980300 0 0
- 0 - 0 - 0 - 0 1980300 535000 0
5 0 0 0 ALIMRA 026159 39 14302 DR.ASRIYANTI
AMSIR,SP.OG,M.KES. 0341R0040918V002505 0000942474363 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48172 1#0##0 0
44c246a0ea58fe567fe7911a82cdceff
7322003 D 3 DS 1 28/09/2018 01/10/2018 28/11/1991 0 2
1 O84.2;Z37.0 74.4 0 0 None None None None O-6-10-I None
None None None None None OPERASI PEMBEDAHAN CAESAR (RINGAN) 4475400
0 0 - 0 - 0 - 0 - 0 4475400
4670500 0 4 0 0 0 ERNAWATI 026127 26 9801
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48173 1#0##0
0 f85f7dff7012ae48f316e9f572c2e76a
7322003 D 2 DS 1 29/09/2018 01/10/2018 15/03/1982 0 2
1 L98.9 86.74 0 0 None None None None L-1-30-I None None
None None None None PEMINDAHAN KULIT TANPA LUKA BAKAR (RINGAN)
7198500 0 0 - 0 - 0 - 0 - 0
7198500 4520500 0 3 0 0 0 ANITAWATI,S. PD 026149
36 13347 dr. SUWANTO, Sp.B.,FICSSpB.,FKS 0341R0040918V002642
0001903485701 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48174 1#0##0 0 d6682fdd28fda4b20087c209aabd7bef
7322003 D 3 DS 1 28/09/2018 01/10/2018 01/12/1950 0 1
1 S89.9;M19.96 81.47 0 0 None None None None M-1-70-I
None None None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN
KAKI (RINGAN) 9992400 0 0 - 0 - 0 - 0 -
0 9992400 4375000 0 4 0 0 0 SUPU DG. PARELLE
026189 67 24773 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
0341R0040918V002585 0000941996182 3;JKN ANDI RAHMAT;7322112311880004
5.2.5.201812201302 4 48175 1#0##0 0
a8eed16a218fb12259e6cc1be0db65b6
7322003 D 3 DS 1 29/09/2018 01/10/2018 15/12/1979 0 2
1 S86.9;S09.9 83.64 0 0 None None None None M-1-50-II None
None None None None None PROSEDUR JARINGAN LUNAK (SEDANG) 5795400
0 0 - 0 - 0 - 0 - 0 5795400
4345000 0 3 0 0 0 Nurjani 009911 38 14168
dr. SUWANTO, Sp.B.,FICSSpB.,FKS 0341R0040918V002629 0001604665732
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48176 1#0##0
0 5e8cdcb4dba47fb15f42b11eb1de074f
7322003 D 3 DS 1 29/09/2018 01/10/2018 17/07/1951 0 1
1 T81.4 86.59 0 0 None None None None A-4-11-I None None
None None None None INFEKSI SESUDAH OPERASI & TRAUMA (RINGAN) 2222200
0 0 - 0 - 0 - 0 - 0 2222200
4420500 0 3 0 0 0 M. SAID. DG. SIKKI 025592
0001964532486 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48177 1#0##0 0 7b84412e5ce44f8366fe174121b490cf
7322003 D 3 DS 1 29/09/2018 01/10/2018 01/12/1942 0 2
1 D18.0 86.4 0 0 None None None None M-1-50-I None None
None None None None PROSEDUR JARINGAN LUNAK (RINGAN) 3492200 0
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 HJ PANYAURI 026196 75 27696 dr. SUWANTO,
Sp.B.,FICSSpB.,FKS 0341R0040918V002631 0000942492868 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48178 1#0##0 0
57c9c6ab09fa36b89e1bbd15a19b4a80
7322003 D 3 DS 1 29/09/2018 01/10/2018 16/07/1999 0 2
1 O68.0;O82.8;Z37.0 74.4 0 0 None None None None O-6-10-I
None None None None None None OPERASI PEMBEDAHAN CAESAR (RINGAN)
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4522500 0 3 0 0 0 MARYUNI 026191
0001071126887 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48179 1#0##0 0 de1f6230d6543fa1ddd2d9fff0bf963c
7322003 D 3 DS 1 28/09/2018 01/10/2018 30/06/1977 0 2
1 O33.5;O42.9;O82.8;Z37.0 74.4 0 0 None None None None O-6-
10-I None None None None None None OPERASI PEMBEDAHAN CAESAR (RINGAN)
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4520500 0 4 0 0 0 PURWATI 023614
0002016445678 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48180 1#0##0 0 3e6504eec71fd7869cfa70a572a6cdc1
7322003 D 2 DS 1 28/09/2018 01/10/2018 16/01/2014 0 1
None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM PERNAFASAN LAIN-
LAIN (RINGAN) 3162000 0 0 - 0 - 0 - 0 -
0 3162000 635500 0 4 0 0 0 INRI BELA 019893
0001875541746 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48181 1#0##0 0 f39ef4c136f66fd5623812c422cf23e7
7322003 D 3 DS 1 29/09/2018 01/10/2018 01/02/2000 0 2
1 K21.9 - 0 0 None None None None K-4-12-I None None
None None None None GANGGUAN ESOFAGUS (RINGAN) 1995300 0 0
- 0 - 0 - 0 - 0 1995300 375000 0
3 0 0 0 LASTRI 001503 18 6815 dr. MUSMIANI MUIS,
Sp.PD 0341R0040918V002628 0000941134713 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48182 1#0##0 0
0da99cf73b44ebb59781c5bfd526eec3
7322003 D 3 DS 1 28/09/2018 01/10/2018 01/01/2001 0 2
1 A90 - 0 0 None None None None A-4-13-I None None
None None None None INFEKSI VIRAL & NON-BAKTERIAL LAIN (RINGAN)
1091500 0 0 - 0 - 0 - 0 - 0
1091500 806500 0 4 0 0 0 SERLIN 026154
0000942591453 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48183 1#0##0 0 8ab87ad7bb124e6353f224928ed27b6e
7322003 D 3 DS 1 29/09/2018 02/10/2018 15/10/2017 0 2
LAIN (RINGAN) 2635000 0 0 - 0 - 0 - 0 -
0 2635000 485500 0 4 0 0 0 MITHA OCKVIANI
0341R0040918V002644 0002495918632 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48184 1#0##0 0
ce5da31b9915f64261d06d010dd5b810
7322003 D 2 DS 1 29/09/2018 02/10/2018 05/10/1982 0 2
1356000 0 0 - 0 - 0 - 0 - 0
1356000 875000 0 4 0 0 0 NURJAYANA 025699
35 13143 dr. AWALUDDIN H., Sp.PD 0341R0040918V002607 0001628644847
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48185 1#0##0
0 261f10d56935226c3304b60a2e61e912
7322003 D 3 DS 1 29/09/2018 02/10/2018 29/09/2018 3115 2
None None None None NEONATAL, BBL > 2499 GR TANPA PROSEDUR MAYOR (RINGAN)
3152100 0 0 - 0 - 0 - 0 - 0
3152100 2175000 0 4 0 0 0 BAYI NY MARIAM 026193
0002495497375 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48186 1#0##0 0 8c3630f8f98cec2ece60c99fc56d198f
7322003 D 3 DS 1 30/09/2018 02/10/2018 09/03/2004 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 385500 0 3 0 0 0 LIRA YANA 026210
0001556882166 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48187 1#0##0 0 448f85cb44829b168dfbba246d3477df
7322003 D 3 DS 1 01/10/2018 02/10/2018 01/07/1964 0 2
1 N18.5;D64.9;E11.9 - 0 0 None None None None N-4-10-II
None None None None None None TUMOR GINJAL & SALURAN URIN & GAGAL
GINJAL (SEDANG) 2706600 0 0 - 0 - 0 - 0 -
0 2706600 1114000 0 2 0 0 0 ODA 026214
0000943045986 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48188 1#0##0 0 e8f5e0b30be2f6661fe8fce17e80d5ba
7322003 D 3 DS 1 30/09/2018 02/10/2018 17/07/1980 0 1
1 S01.0 83.65 0 0 None None None None M-1-50-I None None
0 - 0 - 0 - 0 - 0 3492200 4310000
0 3 0 0 0 HARNO 026208 38 13954 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48189 1#0##0 0
8c40d351034d30edc0861cb613d75f84
7322003 D 3 DS 1 26/09/2018 02/10/2018 01/06/1999 0 2
1 R50.9 - 0 0 None None None None A-4-12-I None None
None None None None DEMAM YANG TIDAK DITENTUKAN (RINGAN) 2485100
0 0 - 0 - 0 - 0 - 0 2485100 785500
0 7 0 0 0 HARIATI RANDAN 014600 19 7057 dr.
MUSMIANI MUIS, Sp.PD 0341R0040918V002579 0000941591237 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48190 1#0##0 0
6cf0d4847cf6067aca092de748397a9c
7322003 D 1 DS 1 30/09/2018 02/10/2018 15/04/2009 0 1
1 J02.9;K30 - 0 0 None None None None U-4-13-I None
None None None None None PERADANGAN EPIGLOTIS, TELINGA TENGAH, ISPA DAN
LARINGOTRAKEITIS (RINGAN) 2531900 0 0 - 0 - 0 -
0 - 0 2531900 885500 0 3 0 0 0 FAIZAH
5.2.5.201812201302 4 48191 1#0##0 0
bbcc3cb4dd1c0aed90b52b9831606374
7322003 D 3 DS 1 28/09/2018 02/10/2018 01/12/1958 0 2
1 N30.0 - 0 0 None None None None N-4-12-I None None
None None None None INFEKSI GINJAL DAN SALURAN URIN (RINGAN) 2022000
0 0 - 0 - 0 - 0 - 0 2022000 820500
0 5 0 0 0 DAYA 026167 59 21851 dr. MUSMIANI MUIS,
5.2.5.201812201302 4 48192 1#0##0 0
320621fcbe9d88393ba955c4a5000cab
7322003 D 3 DS 1 01/10/2018 03/10/2018 01/12/1980 0 2
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4420500 0 3 0 0 0 SINDANG 025852
0000941594051 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48193 1#0##0 0 640aa0202cf6db2caf503bd9b84a7dbd
7322003 D 3 DS 1 01/10/2018 03/10/2018 08/01/1987 0 2
0 - 0 - 0 - 0 - 0 3492200 4385500
0 3 0 0 0 UCI KAPIYARSIH 019444 31 11589 dr.
SUWANTO, Sp.B.,FICSSpB.,FKS 0341R0041018V000149 0000942036974 3;JKN
INACBG;123123123123 5.2.2.201806040537 4 48194 1#0##0 0
4cc17a7807ae0fefd13bed708576620c
7322003 D 3 DS 1 01/10/2018 03/10/2018 01/07/1930 0 1
1 D36.7 86.3 0 0 None None None None L-1-40-I None None
None None None None PROSEDUR PADA KULIT, JA(RINGAN) BAWAH KULIT DAN
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 385500 0 3 0 0 0 BADIRI 006943
0001556914702 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48195 1#0##0 0 a9b7a9af793cdd62977967e6db488a29
7322003 D 3 DS 1 01/10/2018 03/10/2018 01/07/1968 0 1
1 N35.9 58.49 0 0 None None None None N-1-40-I None None
None None None None PROSEDUR PADA URETRA DAN TRANSURETRA (RINGAN)
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4275000 0 3 0 0 0 SUTOPO 013543
0001973118363 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48196 1#0##0 0 b5859ac72aff597a06c05a7850cbb997
7322003 D 3 DS 1 01/10/2018 03/10/2018 13/05/2007 0 2
1 J02.9 - 0 0 None None None None U-4-13-I None None
None None None None PERADANGAN EPIGLOTIS, TELINGA TENGAH, ISPA DAN
0 - 0 1808500 445500 0 3 0 0 0 SARIPA
SALWA HILAL 026232 11 4159 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V000125 0001557211948 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48197 1#0##0 0
93206e844c72379c6ee2972289621a4b
7322003 D 3 DS 1 01/10/2018 03/10/2018 01/11/2002 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4420500 0 3 0 0 0 ARDIAN 026240
0000942392902 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48198 1#0##0 0 61206d3421672dcd456092a6061d0d01
7322003 D 3 DS 1 01/10/2018 03/10/2018 01/07/1969 0 2
1 D12.6;K56.6 46.10 0 0 None None None None K-1-20-II None
None None None None None PROSEDUR INTESTINAL KOMPLEKS (SEDANG)
11138600 0 0 - 0 - 0 - 0 - 0
11138600 4385500 0 3 0 0 0 JAHRA 025349 49
17989 dr. SUWANTO, Sp.B.,FICSSpB.,FKS 0341R0041018V000151
0000940703275 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48199 1#0##0 0 e806fcdf839845a6f4bfb10ab9cf47b4
7322003 D 1 DS 1 01/10/2018 03/10/2018 27/06/1984 0 2
8398300 0 0 - 0 - 0 - 0 - 0
8398300 4955500 0 3 0 0 0 YUNIAN PRIHATINI 023897
0002041885563 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48200 1#0##0 0 c6fca20f41bd9beb6913f2205addd57b
7322003 D 1 DS 1 01/10/2018 03/10/2018 14/05/2002 0 2
PAYUDARA (RINGAN) 4706600 0 0 - 0 - 0 - 0 -
0 4706600 4885500 0 3 0 0 0 NANDA MEILANI
JUFRI 026220 16 5984 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
5.2.5.201812201302 4 48201 1#0##0 0
fbbda1911424ad936529b16451a9acdc
7322003 D 1 DS 1 01/10/2018 03/10/2018 07/01/1976 0 1
1 L50.8;K30 - 0 0 None None None None L-4-14-I None
None None None None None GANGGUAN PADA KULIT & PAYUDARA LAIN-LAIN
(RINGAN) 2783200 0 0 - 0 - 0 - 0 - 0
2783200 1125000 0 3 0 0 0 LUKMAN 003700
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48202 1#0##0
0 0d990c58ea739c072123724c05b2679a
7322003 D 2 DS 1 01/10/2018 03/10/2018 31/12/1952 0 1
6320400 0 0 - 0 - 0 - 0 - 0
6320400 4485500 0 3 0 0 0 RUSLAN 024533
0000132569357 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48203 1#0##0 0 0311f5e6e1434d6426607ee352e0bdb5
7322003 D 3 DS 1 29/09/2018 03/10/2018 09/06/2001 0 1
0 - 0 - 0 - 0 - 0 3492200 4655500
0 5 0 0 0 MUH. ABDUL MUSBAH 026204 17 6321
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48204 1#0##0
0 8eb0b1b4c9e12c95f0ac2cddb7a9272d
7322003 D 3 DS 1 01/10/2018 03/10/2018 16/06/1974 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 NURLAELA 026225 44 16178 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48205 1#0##0 0
90fa2afd91d742471f9f76fb28e10c2e
7322003 D 3 DS 1 01/10/2018 03/10/2018 01/04/1997 0 2
1 D24 85.21 0 0 None None None None L-1-50-I None None
None None None None PROSEDUR PADA PAYUDARA (RINGAN) 4413400 0
0 - 0 - 0 - 0 - 0 4413400 4385500
0 3 0 0 0 NUR ASMI 008840 21 7853 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48206 1#0##0 0
f22a26396ab4fc2559fa479eeba1efe0
7322003 D 3 DS 1 29/09/2018 03/10/2018 01/07/1940 0 1
None None None None PROSEDUR ANGGOTA TUBUH ATAS (RINGAN) 5680300
0 0 - 0 - 0 - 0 - 0 5680300
4510000 0 5 0 0 0 DULA 026201 78 28579 dr.
SUWANTO, Sp.B.,FICSSpB.,FKS 0341R0040918V002630 0000943109583 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48207 1#0##0 0
a7cdf47b213e7d87c20744d145e6126b
7322003 D 3 DS 1 27/09/2018 03/10/2018 20/10/1986 0 2
1 O03.4 69.02 0 0 None None None None W-1-11-I None None
None None None None PROSEDUR DILATASI, KURET, INTRAUTERIN & SERVIK
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4675000 0 7 0 0 0 YULIANTI 026151
0001560235026 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48208 1#0##0 0 3ac7c26e967b282dab00615687c493b0
7322003 D 3 DS 1 29/09/2018 03/10/2018 03/10/1997 0 2
1 O99.8;R50.9 - 0 0 None None None None W-4-16-I None
None None None None None GANGGUAN ANTEPARTUM (RINGAN) 1980300 0
0 - 0 - 0 - 0 - 0 1980300 645500
0 5 0 0 0 IKA ROSANTI 011579 20 7666 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48209 1#0##0 0
168c6197f1a587627e52d926529f3b5c
7322003 D 1 DS 1 29/09/2018 03/10/2018 09/09/1997 0 2
1582000 0 0 - 0 - 0 - 0 - 0
1582000 1075000 0 5 0 0 0 NURHASANAH RAHMAN 026205
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48210 1#0##0
0 f603c515d2207439eb8280945b85e2cd
7322003 D 3 DS 1 01/10/2018 03/10/2018 01/06/1972 0 2
None None None None BATU URIN (RINGAN) 3217900 0 0 -
0 - 0 - 0 - 0 3217900 945000 0 3
0 0 0 IRAWATI 026231 46 16923 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48211 1#0##0 0
8e5ee168ca60c180a7ce8048c360b35f
7322003 D 3 DS 1 01/10/2018 03/10/2018 01/03/1970 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4520500 0 3 0 0 0 LAMAMMI 025740
0001825942195 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48212 1#0##0 0 6b612759e73f74f3c47b29edcef9f9e0
7322003 D 3 DS 1 03/10/2018 04/10/2018 12/12/1977 0 2
1 A01.0;E11.9 - 0 0 None None None None A-4-14-I None
None None None None None PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN
(RINGAN) 2181200 0 0 - 0 - 0 - 0 - 0
2181200 625000 0 2 0 0 0 JAYATI 010638
0002206363612 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48213 1#0##0 0 cb00ccbbf8b99ed74ef737b79b7717ce
7322003 D 3 DS 1 02/10/2018 04/10/2018 11/03/1972 0 2
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4385500 0 3 0 0 0 ERNY 026262 46
17006 DR.LILA NASIKHAH 0341R0041018V000239 0000941589437 3;JKN
INACBG;123123123123 5.2.2.201806040537 4 48214 1#0##0 0
b14661e8f6a4544f9eefdf6057788e36
7322003 D 3 DS 1 02/10/2018 04/10/2018 01/12/1997 0 1
1 R07.3 - 0 0 None None None None I-4-20-I None None
None None None None ANGINA PEKTORIS DAN NYERI DADA (RINGAN) 2752800
0 0 - 0 - 0 - 0 - 0 2752800 784500
0 3 0 0 0 ZULKIFLI 026256 20 7610 dr.
AWALUDDIN H., Sp.PD 0341R0041018V000267 0000943144694 3;JKN
INACBG;123123123123 5.2.2.201806040537 4 48215 1#0##0 0
44cf8851edb0f948fb820d6cfc0215c7
7322003 D 3 DS 1 02/10/2018 04/10/2018 31/12/1955 0 1
1 K80.2;M86.99 - 0 0 None None None None B-4-14-I
None None None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN
(RINGAN) 2836000 0 0 - 0 - 0 - 0 - 0
2836000 445000 0 3 0 0 0 PARLAN 009680
0002087132387 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48216 1#0##0 0 8a85c32504a88643d43f1136eb4ce2d8
7322003 D 3 DS 1 02/10/2018 04/10/2018 01/05/2004 0 2
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4385500 0 3 0 0 0 JESYCA ALVI KARUNI
0341R0041018V000250 0001072722442 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48217 1#0##0 0
7cdca3e4a3eb7d80d0a7d81a881ee024
7322003 D 3 DS 1 02/10/2018 04/10/2018 19/09/1996 0 2
None None None None None PERSALINAN VAGINAL (RINGAN) 1529800 0
0 - 0 - 0 - 0 - 0 1529800 1775000
0 3 0 0 0 MAYANG SARI 026272 22 8048 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48218 1#0##0 0
8be47da8b40db9ee93420eacae436515
7322003 D 1 DS 1 02/10/2018 04/10/2018 31/12/1952 0 2
1 I11.9;K30 - 0 0 None None None None I-4-17-I None
None None None None None HIPERTENSI (RINGAN) 2438000 0 0
- 0 - 0 - 0 - 0 2438000 975000 0
3 0 0 0 NY.JUMALLAH 026260 65 24016 dr. AWALUDDIN H.,
Sp.PD 0341R0041018V000234 0000132579832 3;JKN ANDI RAHMAT;7322112311880004
5.2.5.201812201302 4 48219 1#0##0 0
a46c1a25aac34d3e9c02217eb66d03b9
7322003 D 1 DS 1 01/10/2018 04/10/2018 01/10/2018 3015 2
4412900 0 0 - 0 - 0 - 0 - 0
4412900 1425000 0 4 0 0 0 BAYI NY NURHIDAYAH
5.2.5.201812201302 4 48220 1#0##0 0
7fad2677ad735c967d79dfd20bba20df
7322003 D 1 DS 1 01/10/2018 04/10/2018 26/03/2015 0 1
1 K40.9 53.00 0 0 None None None None K-1-14-I None None
None None None None PROSEDUR HERNIA INGUINAL DAN FEMORAL (RINGAN)
5765700 0 0 - 0 - 0 - 0 - 0
5765700 5305500 0 4 0 0 0 MUHAMMAD ZAHRAN PRATAMA
0341R0041018V000143 0002248998783 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48221 1#0##0 0
9d6846b67461d3b07ec090cc53b61dca
7322003 D 1 DS 1 01/10/2018 04/10/2018 23/06/1980 0 2
6265600 0 0 - 0 - 0 - 0 - 0
6265600 4922500 0 4 0 0 0 NURHIDAYAH 023716
0000194270949 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48222 1#0##0 0 5ca491b02affb31990c214df5b675f9b
7322003 D 3 DS 1 02/10/2018 04/10/2018 01/07/1976 0 2
1 N35.9;N30.0 58.49 0 0 None None None None N-1-40-II None
None None None None None PROSEDUR PADA URETRA DAN TRANSURETRA (SEDANG)
7152500 0 0 - 0 - 0 - 0 - 0
7152500 4385500 0 3 0 0 0 BUNGA 004663 42
0001840959764 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48223 1#0##0 0 ba2a301171696ffe4d9b6681e9f41596
7322003 D 3 DS 1 02/10/2018 04/10/2018 03/06/1987 0 1
1 S01.0;S20.2 83.65 0 0 None None None None M-1-50-I None
None None None None None PROSEDUR JARINGAN LUNAK (RINGAN) 3492200
0 0 - 0 - 0 - 0 - 0 3492200
4310000 0 3 0 0 0 SUPRIADI 026294 31 11444
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48224 1#0##0
0 4a960dd3f3c47ee65e60ec192b44e3c6
7322003 D 1 DS 1 02/10/2018 04/10/2018 17/01/1978 0 2
- 0 - 0 - 0 - 0 2772500 535500 0
3 0 0 0 ASDA EVIANI MUSLIMIN 022426 40 14868
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48225 1#0##0
0 4e2a549c51375d1f842f8a6675f21b59
7322003 D 3 DS 1 19/09/2018 04/10/2018 01/07/1943 0 1
1 D30.3;N35.9;D64.9 57.59;58.49;99.03 0 0 None None None None
N-1-30-II None None None None None None PROSEDUR KANDUNG KEMIH DAN
SALURAN URIN BAWAH (SEDANG) 8872300 0 0 - 0 - 0 -
0 - 0 8872300 9572500 0 16 0 0 0 MANDA
5.2.5.201812201302 4 48226 1#0##0 0
9ecb4868a5e0d49253119404761ed327
7322003 D 3 DS 1 02/10/2018 04/10/2018 07/05/1974 0 2
0 - 0 - 0 - 0 - 0 3492200 4310000
0 3 0 0 0 RAMINA 023329 44 16219 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48227 1#0##0 0
d13c27b285eb7b3214413fc4c954ef2e
7322003 D 3 DS 1 02/10/2018 04/10/2018 19/05/1992 0 1
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4385500 0 3 0 0 0 YEHESKIEL 009809
0002093419427 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48228 1#0##0 0 86149e904bdbd1f0b8f7cc7ee16be071
7322003 D 3 DS 1 03/10/2018 04/10/2018 23/11/1987 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4175000 0 2 0 0 0 NATALIA 026311
0001604709707 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48229 1#0##0 0 d32884e15a1576ba88412f01dbf75ebb
7322003 D 3 DS 1 02/10/2018 04/10/2018 08/12/1983 0 1
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4385500 0 3 0 0 0 jainuddin 023474
0001885336334 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48230 1#0##0 0 0f70f95527027c75baf66615cd7ca62d
7322003 D 3 DS 1 03/10/2018 04/10/2018 31/12/1959 0 2
None None None None GANGGUAN POSTPARTUM (RINGAN) 1461300 0 0
- 0 - 0 - 0 - 0 1461300 4210000 0
2 0 0 0 ACHDIA 025650 58 21461 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48231 1#0##0 0
16d5398a05db2c3dad01656d73b8305d
7322003 D 1 DS 1 02/10/2018 04/10/2018 12/10/1970 0 2
1 K30;I10 - 0 0 None None None None K-4-18-I None
None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
1582000 0 0 - 0 - 0 - 0 - 0
1582000 1085500 0 3 0 0 0 SAHRUNI KINDONG 011263
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48232 1#0##0
0 8685d646f998ad0b784a723535b43c59
7322003 D 3 DS 1 02/10/2018 04/10/2018 24/12/1988 0 2
- 0 - 0 - 0 - 0 1980300 275000 0
3 0 0 0 REZKY 021921 29 10874 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48233 1#0##0 0
aebf11fa73922a1223a85c1f07e2373f
7322003 D 3 DS 1 01/10/2018 04/10/2018 30/04/2001 0 2
0 0 - 0 - 0 - 0 - 0 2485100 785500
0 4 0 0 0 DIAN ANUGRA 026242 17 6363 dr. MUSMIANI
MUIS, Sp.PD 0341R0041018V000137 0002480140271 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48234 1#0##0 0
9353f34174b75db3176a203759cf72a0
7322003 D 3 DS 1 02/10/2018 05/10/2018 02/10/2018 2970 2
3152100 0 0 - 0 - 0 - 0 - 0
3152100 675000 0 4 0 0 0 BY NY MADE EVI SUASTINI
0341R0041018V000227 0002489231452 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48235 1#0##0 0
6ef984f394265e2746f371f5a1c3becc
7322003 D 3 DS 1 03/10/2018 05/10/2018 04/01/2002 0 1
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 JEKI RIWI 026316 16 6116 dr. SUWANTO,
Sp.B.,FICSSpB.,FKS 0341R0041018V000308 0001939423667 3;JKN
INACBG;123123123123 5.2.5.201812201302 4 48236 1#0##0 0
e681cb91107c84f008d4fb10157d4d7f
7322003 D 3 DS 1 02/10/2018 05/10/2018 05/03/2009 0 1
1130000 0 0 - 0 - 0 - 0 - 0
1130000 745000 0 4 0 0 0 MUHFADLI M ISRAIL 026254
0002013791319 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48237 1#0##0 0 f0a6cd4301c98231ea861c0ba6d43552
7322003 D 3 DS 1 04/10/2018 05/10/2018 02/07/1986 0 2
- 0 - 0 - 0 - 0 1980300 175000 0
2 0 0 0 FITRIANI 022422 32 11782 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48238 1#0##0 0
b3e4a390d6bc554911c5a632e284ee6f
7322003 D 3 DS 1 02/10/2018 05/10/2018 01/08/2004 0 2
1 M79.16 - 0 0 None None None None M-4-20-I None
None None None None None TANDA, GEJALA & PERADANGAN MUSKULOSKELETAL
(RINGAN) 1980000 0 0 - 0 - 0 - 0 - 0
1980000 375000 0 4 0 0 0 RUFIAT ILMA DARAJAT
026293 14 5175 dr. INDRAHAYU, Sp.S 0341R0041018V000232
0000942635169 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48239 1#0##0 0 395ed68e1ec567c4e6e4fde32d327262
7322003 D 3 DS 1 03/10/2018 05/10/2018 01/07/1967 0 1
1 I10;K30 - 0 0 None None None None I-4-17-I None
- 0 - 0 - 0 - 0 1741400 385500 0
3 0 0 0 DASENG 010756 51 18722 dr. MUSMIANI MUIS,
5.2.5.201812201302 4 48240 1#0##0 0
a26e80d14e30980d36f86ca1abfc95c1
7322003 D 1 DS 1 01/10/2018 05/10/2018 14/04/1945 0 1
1 E11.9;J18.9;I11.0 - 0 0 None None None None E-4-10-III
None None None None None None PENYAKIT KENCING MANIS & GANGGUAN
NUTRISI/ METABOLIK (BERAT) 8008100 0 0 - 0 - 0 -
0 - 0 8008100 1954500 0 5 0 0 0 H.
MADING 026248 73 26833 dr. AWALUDDIN H., Sp.PD 0341R0041018V000222
0001827692548 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48241 1#0##0 0 921c50dc179dd267472a2bc3e91f84f9
7322003 D 2 DS 1 27/09/2018 05/10/2018 16/09/1970 0 1
1 E11.1;M10.06;K30 - 0 0 None None None None E-4-10-I
None None None None None None PENYAKIT KENCING MANIS & GANGGUAN
NUTRISI/ METABOLIK (RINGAN) 3957700 0 0 - 0 - 0 -
0 - 0 3957700 3283000 0 9 0 0 0 YAKUB
PALIRA 025462 48 17543 dr. AWALUDDIN H., Sp.PD 0341R0040918V002473
0000132502555 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48242 1#0##0 0 651891ea88af21e29fe8eaee50d19894
7322003 D 3 DS 1 01/10/2018 05/10/2018 22/03/1991 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 5620500 0 5 0 0 0 TIFANI EUNIKE MAKASSAR
025726 27 10055 DR.ASRIYANTI AMSIR,SP.OG,M.KES.
5.2.5.201812201302 4 48243 1#0##0 0
d5b0b5fef5cf1a6a752d3afde528a144
7322003 D 3 DS 1 04/10/2018 05/10/2018 31/12/1967 0 2
1 K76.8 - 0 0 None None None None B-4-13-I None None
None None None None GANGGUAN HATI LAIN-LAIN (RINGAN) 2839100 0
0 - 0 - 0 - 0 - 0 2839100 485500
0 2 0 0 0 NUR SAMSIA 026361 50 18540 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48244 1#0##0 0
b89efab42546159502b79a795c8554e5
7322003 D 3 DS 1 03/10/2018 05/10/2018 01/12/1950 0 1
None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN KAKI (RINGAN)
9992400 0 0 - 0 - 0 - 0 - 0
9992400 4385500 0 3 0 0 0 SUPU DG. PARELLE 026189
0000941996182 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48245 1#0##0 0 dd5f83a6feb7dfa316d324ef1bd84807
7322003 D 3 DS 1 03/10/2018 05/10/2018 25/01/2001 0 1
0 - 0 - 0 - 0 - 0 3492200 4310000
0 3 0 0 0 WAWAN SUGIANTO LAU TANETE 026317 17
0002170261888 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48246 1#0##0 0 0295f623c99ffd75baf91744671442be
7322003 D 1 DS 1 01/10/2018 05/10/2018 31/12/1935 0 2
1 K27.9;M19.96;D64.9 99.03 0 0 None None None None K-4-
11-II None None None None None None GASTRITIS & ULKUS PEPTIKUM (SEDANG)
4215000 0 0 - 0 - 0 - 0 - 0
4215000 2085500 0 5 0 0 0 SINANGA 017754
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48247 1#0##0
0 ccb0f8fff1c951c336c781c6c4d21008
7322003 D 3 DS 1 01/10/2018 05/10/2018 22/12/1994 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4620500 0 5 0 0 0 MADE EVI SUASTINI 024955
0001735226155 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48248 1#0##0 0 062fcd449904c2cbf1e97ea1ccd09e1a
7322003 D 1 DS 1 02/10/2018 06/10/2018 27/07/1972 0 2
1 S09.9;S20.2 - 0 0 None None None None G-4-24-I None
None None None None None TRAUMA KEPALA (RINGAN) 2790600 0 0
- 0 - 0 - 0 - 0 2790600 1825000 0
5 0 0 0 SUMIATI 026290 46 16868 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48249 1#0##0 0
f40d75c60993e0d2a2dea65ee368417e
7322003 D 2 DS 1 04/10/2018 06/10/2018 06/07/1972 0 1
0 0 - 0 - 0 - 0 - 0 2426400
1085500 0 3 0 0 0 HAERUL AFIUDDIN 026375 46
16891 dr. AWALUDDIN H., Sp.PD 0341R0041018V000417 0000132592961 3;JKN
INACBG;123123123123 5.2.2.201806040537 4 48250 1#0##0 0
4c15912e5d2c8c1b8114db96a71c59d3
7322003 D 3 DS 1 04/10/2018 06/10/2018 01/07/1962 0 2
1 N39.0;I10 - 0 0 None None None None N-4-12-I None
None None None None None INFEKSI GINJAL DAN SALURAN URIN (RINGAN)
2022000 0 0 - 0 - 0 - 0 - 0
2022000 445000 0 3 0 0 0 MANELI 026370
0001604716503 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48251 1#0##0 0 1d520a67f765325fa25a8d233febae7a
7322003 D 3 DS 1 04/10/2018 06/10/2018 01/07/1957 0 1
- 0 - 0 - 0 - 0 1993300 425000 0
3 0 0 0 H. ANDI SELLE 026344 61 22375 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48252 1#0##0 0
1825637b7ee1c3157d7bdd664817c72d
7322003 D 3 DS 1 04/10/2018 06/10/2018 01/11/1980 0 1
1 N23 - 0 0 None None None None N-4-13-I None None
0 - 0 - 0 - 0 3217900 585500 0 3
0 0 0 SUYONO 026366 37 13851 dr. MUSMIANI MUIS, Sp.PD
0341R0041018V000390 0000942543786 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48253 1#0##0 0
ab0e9fdb9d58f50527eb72ead3f3fa4f
7322003 D 3 DS 1 03/10/2018 06/10/2018 01/09/1966 0 2
1 I12.9 - 0 0 None None None None N-4-16-I None None
None None None None PENYAKIT GINJAL DAN SALURAN URIN LAIN-LAIN (RINGAN)
2495700 0 0 - 0 - 0 - 0 - 0
2495700 864000 0 4 0 0 0 SIRA 026296 52
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48254 1#0##0
0 83a3ba98c0c69594d4087ca05038f183
7322003 D 3 DS 1 04/10/2018 06/10/2018 01/08/1999 0 2
0 - 0 - 0 - 0 - 0 3492200 4345000
0 3 0 0 0 EKA 026336 19 7004 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48255 1#0##0 0
9c2a296454c556c779c81e267044575a
7322003 D 3 DS 1 03/10/2018 06/10/2018 01/07/1940 0 1
1 J18.9;I11.9 - 0 0 None None None None J-4-16-I None
None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (RINGAN)
3300100 0 0 - 0 - 0 - 0 - 0
3300100 525000 0 4 0 0 0 ADDA 012052 78
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48256 1#0##0
0 acb403834cc051666ac4b10a4448fd36
7322003 D 1 DS 1 02/10/2018 06/10/2018 21/08/2003 0 1
1 I20.9;A09.9 - 0 0 None None None None I-4-20-I None
None None None None None ANGINA PEKTORIS DAN NYERI DADA (RINGAN)
3853900 0 0 - 0 - 0 - 0 - 0
3853900 996000 0 5 0 0 0 MUH. FARAS FALIH FAHMI
0341R0041018V000229 0001078332737 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48257 1#0##0 0
73f1a1c49b3c0e2a5097bd9c4a4c2866
7322003 D 1 DS 1 01/10/2018 06/10/2018 24/06/1936 0 1
7373800 0 0 - 0 - 0 - 0 - 0
7373800 6255500 0 6 0 0 0 RABANG 026245
0000132580405 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48258 1#0##0 0 7251f446233e82ec493233f79c175557
7322003 D 2 DS 1 03/10/2018 06/10/2018 23/04/1982 0 1
1 D12.6 49.6 0 0 None None None None K-1-50-I None None
None None None None PROSEDUR ANAL (RINGAN) 4824900 0 0 -
0 - 0 - 0 - 0 4824900 5270500 0 4
0 0 0 SUDIRMAN 026318 36 13312 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48259 1#0##0 0
36a67b1edc3283510a6e6fcec223a8f9
7322003 D 1 DS 1 03/10/2018 06/10/2018 22/10/1968 0 1
None None None None ASTHMA & BRONKIOLITIS (RINGAN) 2846200 0
0 - 0 - 0 - 0 - 0 2846200 1385500
0 4 0 0 0 ASBIR 026319 49 18243 dr. AWALUDDIN H.,
5.2.5.201812201302 4 48260 1#0##0 0
7ff2dbe3127563c27c7a49652998391a
7322003 D 2 DS 1 05/10/2018 06/10/2018 25/04/1984 0 2
(RINGAN) 1808300 0 0 - 0 - 0 - 0 - 0
1808300 4425000 0 2 0 0 0 HARYANI HAFID 026346
0001653961757 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48261 1#0##0 0 a358f493f89a7672727d7d4863cabdd5
7322003 D 1 DS 1 03/10/2018 06/10/2018 13/12/1992 0 2
6265600 0 0 - 0 - 0 - 0 - 0
6265600 5372500 0 4 0 0 0 WIWIK 024059 25
9425 DR.ASRIYANTI AMSIR,SP.OG,M.KES. 0341R0041018V000416
0001814054319 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48262 1#0##0 0 77e614d866cdd906c8bd51be496207f3
7322003 D 1 DS 1 02/10/2018 06/10/2018 27/06/1987 0 2
- 0 - 0 - 0 - 0 2772500 1475000 0
5 0 0 0 ERNAWATI 008328 31 11420 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48263 1#0##0 0
9c355429857ed650779054ce9fe42eef
7322003 D 2 DS 1 02/10/2018 06/10/2018 31/07/1990 0 2
5370500 0 0 - 0 - 0 - 0 - 0
5370500 4820500 0 5 0 0 0 DARNA 026230 28
0002477915853 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48264 1#0##0 0 af130c8e73b5abc2b307288f2b22d35a
7322003 D 2 DS 1 11/09/2018 06/10/2018 19/04/1975 0 2
1 G81.9;N17.9 - 0 0 None None None None G-4-26-III None
None None None None None GANGGUAN - PENYAKIT SISTEM SARAF LAIN-LAIN
(BERAT) 5618400 0 0 - 0 - 0 - 0 - 0
5618400 13820500 0 26 0 0 0 BECCE MERIEM ANDI BASO
025708 43 15851 dr. INDRAHAYU, Sp.S 0341R0040918V001093
0002094182739 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48265 1#0##0 0 089295c50dfb21f468bf3135702e4c6e
7322003 D 3 DS 1 04/10/2018 06/10/2018 12/03/2014 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 ULFA SARI 024084 4 1667 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48266 1#0##0 0
6a8eedd3cfc2cf08a0c1f40e000edcc1
7322003 D 3 DS 1 04/10/2018 06/10/2018 01/10/1995 0 2
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4490500 0 3 0 0 0 RIANTI 026323
0001072689096 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48267 1#0##0 0 0a0762ce5ea649d72b12c84ade0d5c61
7322003 D 3 DS 1 04/10/2018 06/10/2018 03/05/2017 0 1
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 MUH. FATHIR AL GAZALI 026322 1 519
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48268 1#0##0
0 d35e151f7dab3e0796df6978e96da7df
7322003 D 3 DS 1 04/10/2018 06/10/2018 25/06/2003 0 2
1 R10.4 - 0 0 None None None None K-4-17-I None None
None None None None NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN (RINGAN)
1125300 0 0 - 0 - 0 - 0 - 0
1125300 575000 0 3 0 0 0 DEWI RATNA SARI 025730
0000940863688 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48269 1#0##0 0 93949578136d10e1901743d8e1d22f1e
7322003 D 3 DS 1 04/10/2018 06/10/2018 31/12/1963 0 2
0 - 0 - 0 - 0 - 0 3492200 4620500
0 3 0 0 0 H. SITTI 026345 54 20001 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48270 1#0##0 0
b92931725e5304849438a52e91100bae
7322003 D 3 DS 1 17/09/2018 06/10/2018 17/09/2018 1450 1
1 P07.1;P36.9;P59.9 - 0 0 None None None None P-8-11-II
None None None None None None NEONATAL, BBL 1000 - 1499 GR TANPA
PROSEDUR MAYOR (SEDANG) 8190700 0 0 - 0 - 0 - 0
- 0 8190700 13855000 0 20 0 0 0 ARKAN GIFARI
0341R0040918V001606 0002491580046 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48271 1#0##0 0
7e8b9bd24b3078d940495f2fc49bf012
7322003 D 3 DS 1 05/10/2018 07/10/2018 09/10/1990 0 2
1 A09.9 - 0 0 None None None None K-4-17-I None None
1125300 0 0 - 0 - 0 - 0 - 0
1125300 275000 0 3 0 0 0 BUDIA 007084 27
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48272 1#0##0
0 7ad75e468d09613929648a63907988ef
7322003 D 3 DS 1 05/10/2018 07/10/2018 01/10/2010 0 2
LAIN (RINGAN) 2635000 0 0 - 0 - 0 - 0 -
0 2635000 485500 0 3 0 0 0 NOVITA SARI 026414
0002297542858 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48273 1#0##0 0 1612504c5854309c5ab43f1d773c8522
7322003 D 3 DS 1 04/10/2018 07/10/2018 23/06/1988 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 5270500 0 4 0 0 0 ASTUTI 005602
0001885288476 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48274 1#0##0 0 cb85fab6f896d9f1e4395cfc6b19fa70
7322003 D 3 DS 1 04/10/2018 07/10/2018 01/07/1962 0 1
1 K72.0;I10 - 0 0 None None None None B-4-13-I None
None None None None None GANGGUAN HATI LAIN-LAIN (RINGAN) 2839100
0 0 - 0 - 0 - 0 - 0 2839100 575000
0 4 0 0 0 TOMO ARSYAD 022367 56 20549 dr. MUSMIANI
5.2.5.201812201302 4 48275 1#0##0 0
75bf4c84e969a19a0055ed102149fdfa
7322003 D 3 DS 1 04/10/2018 07/10/2018 04/10/2018 2635 2
None None None None NEONATAL, BBL > 2499 GR DENGAN KONGENITAL/INFEKSI
PERINATAL (RINGAN) 1624900 0 0 - 0 - 0 - 0
- 0 1624900 2235000 0 4 0 0 0 BAYI NY
YULIS 026374 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V000488 0002497112234 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48276 1#0##0 0
2d1183f921e7d1634a39ca015d690f94
7322003 D 3 DS 1 04/10/2018 07/10/2018 18/12/2011 0 1
1 S01.0 86.59 0 0 None None None None L-4-13-I None None
None None None None TRAUMA PADA KULIT, JARINGAN BAWAH KULIT DAN PAYUDARA
(RINGAN) 2244500 0 0 - 0 - 0 - 0 - 0
2244500 4555500 0 4 0 0 0 MUH.SALMAN 026353
0001604666002 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48277 1#0##0 0 9d00e642955b03a7b3575ab75d3f2429
7322003 D 1 DS 1 05/10/2018 07/10/2018 25/11/2004 0 2
1575500 0 0 - 0 - 0 - 0 - 0
1575500 885500 0 3 0 0 0 RIFAATUL MAHMUDAH IQBAL
0341R0041018V000645 0001311805091 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48278 1#0##0 0
171fb0217aad98088ee45ce81a6920bc
7322003 D 1 DS 1 05/10/2018 07/10/2018 12/10/2011 0 1
1575500 0 0 - 0 - 0 - 0 - 0
1575500 885500 0 3 0 0 0 FADHIL AHLAN 026380
0000207365984 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48279 1#0##0 0 a6a44286cda8495a55c7718825e7d8a8
7322003 D 3 DS 1 03/10/2018 07/10/2018 25/08/1997 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4680500 0 5 0 0 0 YULIS 026320 21
0000941858109 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48280 1#0##0 0 07ca418bd7540b1db036e653b14428e8
7322003 D 3 DS 1 04/10/2018 07/10/2018 16/03/1990 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4682500 0 4 0 0 0 SELVI 026337 28
0002460343364 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48281 1#0##0 0 df272860cc56f84ff58be9ecb20cb09b
7322003 D 3 DS 1 05/10/2018 07/10/2018 01/07/1985 0 2
None None None None GANGGUAN MENSTRUASI & SISTEM REPRODUKSI WANITA LAIN-
LAIN (RINGAN) 2645200 0 0 - 0 - 0 - 0 -
0 2645200 275000 0 3 0 0 0 ROSNAENI 022509
0000942080321 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48282 1#0##0 0 49ae7203042aada0ba1b495af7571dba
7322003 D 3 DS 1 06/10/2018 07/10/2018 01/09/1975 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4175000 0 2 0 0 0 SIANA 026455 43
0000941583069 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48283 1#0##0 0 c62924dc200f78e2dfb9515914e63fcb
7322003 D 1 DS 1 04/10/2018 07/10/2018 04/10/2018 3005 1
4412900 0 0 - 0 - 0 - 0 - 0
4412900 1325000 0 4 0 0 0 BAYI NY. WIWIK 026362
0002487907541 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48284 1#0##0 0 fefb246df5d6fa1e13cee52416412c32
7322003 D 3 DS 1 04/10/2018 08/10/2018 06/04/1942 0 2
1 R53 - 0 0 None None None None Z-4-11-I None None
None None None None GEJALA-GEJALA DAN TANDA-TANDA (RINGAN) 1689600
0 0 - 0 - 0 - 0 - 0 1689600 734500
0 5 0 0 0 HJ. SUBAEDAH 026364 76 27940 dr.
MUSMIANI MUIS, Sp.PD 0341R0041018V000402 0002024960692 3;JKN
INACBG;123123123123 5.2.5.201812201302 4 48285 1#0##0 0
8b1206762dcb297665e44d36ec842ccd
7322003 D 3 DS 1 05/10/2018 08/10/2018 01/07/1948 0 2
1 Z98.2 54.63 0 0 None None None None K-1-40-I None None
None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
5262000 0 0 - 0 - 0 - 0 - 0
5262000 4620500 0 4 0 0 0 NURJAENI 026410
0000941552785 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48286 1#0##0 0 00f6a51835098f3d410480c7a19e7ca7
7322003 D 3 DS 1 06/10/2018 08/10/2018 23/08/1945 0 1
1 I10 - 0 0 None None None None I-4-17-I None None
None None None None HIPERTENSI (RINGAN) 1741400 0 0 -
0 - 0 - 0 - 0 1741400 645500 0 3
0 0 0 CODDING 026422 73 26707 dr. MUSMIANI MUIS, Sp.PD
0341R0041018V000540 0001556923994 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48287 1#0##0 0
c7b07b0affe75b7f8249e86bc91659da
7322003 D 1 DS 1 06/10/2018 08/10/2018 07/11/1983 0 1
- 0 - 0 - 0 - 0 2793500 975000 0
3 0 0 0 MAHYOMI, SH 026456 34 12752 dr. AWALUDDIN H.,
5.2.5.201812201302 4 48288 1#0##0 0
ed13ee2f4e26160b474706973518ceb6
7322003 D 1 DS 1 04/10/2018 08/10/2018 06/11/1977 0 2
1 K21.9;I10 - 0 0 None None None None K-4-12-I None
None None None None None GANGGUAN ESOFAGUS (RINGAN) 2793500 0
0 - 0 - 0 - 0 - 0 2793500 975000
0 5 0 0 0 YENNI GIANITA, S.HI 026373 40 14942
dr. AWALUDDIN H., Sp.PD 0341R0041018V000394 0000200056724 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48289 1#0##0 0
5867d75383db6a0b686ddf90f5ae3e4a
7322003 D 3 DS 1 06/10/2018 08/10/2018 11/05/1990 0 1
1 A16.2 - 0 0 None None None None J-4-15-I None None
None None None None PERADANGAN DAN INFEKSI PERNAFASAN (RINGAN)
3960700 0 0 - 0 - 0 - 0 - 0
3960700 425000 0 3 0 0 0 ANTON 026423 28
ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48290 1#0##0
0 005d6ce07b88f28eee7d53b2f68b5f5a
7322003 D 1 DS 1 05/10/2018 08/10/2018 25/04/1986 0 2
0 - 0 - 0 - 0 - 0 2846200 775000
0 4 0 0 0 MINAYANTI, S.PD 019429 32 11851 dr.
INACBG;123123123123 5.2.5.201812201302 4 48291 1#0##0 0
d7c2da1a352af1ad825ef6b5cc3d6362
7322003 D 1 DS 1 06/10/2018 08/10/2018 06/07/1974 0 2
LAIN (RINGAN) 3703300 0 0 - 0 - 0 - 0 -
0 3703300 475000 0 3 0 0 0 MULIANA 014213
0000132477096 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48292 1#0##0 0 9f0e78060696acd209e1407b688c4eca
7322003 D 1 DS 1 04/10/2018 08/10/2018 05/09/1990 0 2
1 O62.4;Z34.9 - 0 0 None None None None W-4-16-I None
0 - 0 - 0 - 0 - 0 2772500 1475000
0 5 0 0 0 HUSAEFAH 025415 28 10256 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48293 1#0##0 0
95ae58a84083487197999b00b5b88e6e
7322003 D 3 DS 1 06/10/2018 08/10/2018 11/03/1990 0 2
1 O42.9;O10.0 - 0 0 None None None None W-4-16-I None
0 - 0 - 0 - 0 - 0 1980300 275000
0 3 0 0 0 MARTA 026457 28 10436 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48294 1#0##0 0
97ca247e941aa482282be8d02cb47acc
7322003 D 3 DS 1 04/10/2018 08/10/2018 31/12/1963 0 2
1 S09.9;S20.2;S96.9 83.64 0 0 None None None None M-1-50-I
None None None None None None PROSEDUR JARINGAN LUNAK (RINGAN)
3492200 0 0 - 0 - 0 - 0 - 0
3492200 5030000 0 5 0 0 0 ASNI 026321 54
0001557313323 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48295 1#0##0 0 d328e409a239fa339223bb5c0a4c4953
7322003 D 3 DS 1 05/10/2018 08/10/2018 01/07/1959 0 2
0 0 - 0 - 0 - 0 - 0 2222200
4590500 0 4 0 0 0 SARTIYEM 026392 59 21646
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48296 1#0##0
0 d7950c804fd33540e1fb5184a83477bf
7322003 D 3 DS 1 07/10/2018 08/10/2018 01/08/1992 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 MELYANI R 025679 26 9563 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48297 1#0##0 0
dda0a51dad802c4c9a9264de90f1660f
7322003 D 3 DS 1 07/10/2018 08/10/2018 12/11/1995 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 AYU LESTARI 026468 22 8365 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48298 1#0##0 0
ff5492911569c0bf8ba0a8c8b798e335
7322003 D 1 DS 1 03/10/2018 08/10/2018 24/05/2000 0 1
None None None None None PROSEDUR JARINGAN LUNAK (SEDANG) 8113500
0 0 - 0 - 0 - 0 - 0 8113500
5895000 0 6 0 0 0 GERALD STEVEN TANNING 036312
0000135139566 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48299 1#0##0 0 92738d26960f18e18b8da8df9ce7364a
7322003 D 3 DS 1 05/10/2018 08/10/2018 19/10/1993 0 2
- 0 - 0 - 0 - 0 1980300 375000 0
4 0 0 0 RASNITA 025714 24 9117 DR.ASRIYANTI
AMSIR,SP.OG,M.KES. 0341R0041018V000678 0001935184206 3;JKN
INACBG;123123123123 5.2.5.201812201302 4 48300 1#0##0 0
be1bab810f9d5f140b7175d946fd8dd6
7322003 D 3 DS 1 05/10/2018 08/10/2018 01/07/1981 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 MUSNI 022276 37
0001072738383 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48301 1#0##0 0 27819a4fe9768301cff72fb5584707d8
7322003 D 3 DS 1 05/10/2018 08/10/2018 01/01/2001 0 2
1 O32.1;O82.8;Z37.0;O10.0 74.4 0 0 None None None None O-6-
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4682500 0 4 0 0 0 EFA SAHAFIAH 025200
0000942789159 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48302 1#0##0 0 58de0576ab8c70a911d437ee915f60fd
7322003 D 3 DS 1 08/10/2018 09/10/2018 25/07/1945 0 1
1125300 0 0 - 0 - 0 - 0 - 0
1125300 175000 0 2 0 0 0 MARINUS SITUPA 026519
0002290463357 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48303 1#0##0 0 ae24c53c91e3493abec6c44ecbeee2b3
7322003 D 3 DS 1 08/10/2018 09/10/2018 02/04/1955 0 2
1 A16.5;I10 - 0 0 None None None None J-4-15-I None
None None None None None PERADANGAN DAN INFEKSI PERNAFASAN (RINGAN)
3960700 0 0 - 0 - 0 - 0 - 0
3960700 285500 0 2 0 0 0 IDASARI 010668
0002005334111 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48304 1#0##0 0 edb168ef8aa321dcbf2d6309c3ad610f
7322003 D 3 DS 1 05/10/2018 09/10/2018 25/05/1936 0 1
1 E11.9;I10 - 0 0 None None None None E-4-10-I None
None None None None None PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/
METABOLIK (RINGAN) 3298100 0 0 - 0 - 0 - 0
- 0 3298100 704500 0 5 0 0 0 JASRIN
026411 82 30083 dr. MUSMIANI MUIS, Sp.PD 0341R0041018V000525
0002205343653 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48305 1#0##0 0 b4287b88fe2da7215e84a0786ea53a04
7322003 D 3 DS 1 07/10/2018 09/10/2018 07/10/2018 2530 1
1 P21.9;P12.8 - 0 0 None None None None P-8-08-I None
None None None None None NEONATAL, BERAT BADAN LAHIR GROUP-5 DENGAN
SINDROMA DISTRES PERNAFASAN (RINGAN) 3640200 0 0 - 0 -
0 - 0 - 0 3640200 2075000 0 3 0 0
0 BAYI NY MELI KABE RURU 026466 0 0 DR. MULYANI KADIR,
SP.A,.M.KES. 0341R0041018V000649 0002497355526 3;JKN
INACBG;123123123123 5.2.5.201812201302 4 48306 1#0##0 0
8fdb10dd54e722245447adca8fae7766
7322003 D 3 DS 1 07/10/2018 09/10/2018 02/10/1994 0 2
0 0 - 0 - 0 - 0 - 0 2485100 385500
0 3 0 0 0 PIPIN GREIS RIWI 026462 24 8771 dr.
INACBG;123123123123 5.2.5.201812201302 4 48307 1#0##0 0
59955f3bf3218daf18a45d6a497bc238
7322003 D 3 DS 1 06/10/2018 09/10/2018 01/07/1960 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 575000 0 4 0 0 0 RASIA 026441 58
0000942025702 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48308 1#0##0 0 9c1f028a90fa0fa19dbd6de49eb75627
7322003 D 3 DS 1 04/10/2018 09/10/2018 01/09/1982 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 575000 0 6 0 0 0 MASNAINI 024989
0000941873782 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48309 1#0##0 0 61b7743d4e1ae5078165d7d8467a3d98
7322003 D 2 DS 1 06/10/2018 09/10/2018 22/12/1995 0 2
1356000 0 0 - 0 - 0 - 0 - 0
1356000 1125000 0 4 0 0 0 HASNI WATI 016950
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48310 1#0##0
0 77571cbc09660568bda42c4025cde9f8
7322003 D 1 DS 1 06/10/2018 09/10/2018 06/07/1984 0 2
None None None None ABORTUS MENGANCAM (RINGAN) 1571400 0 0
- 0 - 0 - 0 - 0 1571400 1125000 0
4 0 0 0 MASITA, A.MD KEP 019916 34 12510 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48311 1#0##0 0
faab4f0581c08753be8ed63efc742097
7322003 D 1 DS 1 04/10/2018 09/10/2018 21/03/1952 0 1
- 0 4617300 2717500 0 6 0 0 0 H. MANSUR
SUYADI,A.MA.PD. 026376 66 24303 dr. AWALUDDIN H., Sp.PD
0341R0041018V000393 0000132471101 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48312 1#0##0 0
69c5f93dc76025ed4a98342a6ec49568
7322003 D 2 DS 1 06/10/2018 09/10/2018 07/12/1989 0 2
1356000 0 0 - 0 - 0 - 0 - 0
1356000 1325000 0 4 0 0 0 RIRIN INDRAYANI 026458
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48313 1#0##0
0 314534f7aa819c0029fae37e385e5b6f
7322003 D 1 DS 1 06/10/2018 09/10/2018 24/07/1992 0 2
6265600 0 0 - 0 - 0 - 0 - 0
6265600 4922500 0 4 0 0 0 SUTRAYANI 011194
0000132571394 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48314 1#0##0 0 5df63c991feacfbb11f34b9c441a16d7
7322003 D 2 DS 1 08/10/2018 09/10/2018 28/08/1988 0 1
1356000 0 0 - 0 - 0 - 0 - 0
1356000 425000 0 2 0 0 0 I MADE ARYONO SUKA
WIJAYA 004008 30 10998 dr. AWALUDDIN H., Sp.PD 0341R0041018V000588
0001094609643 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48315 1#0##0 0 2da261bda9f6ab3ec24738b1a062439e
7322003 D 3 DS 1 04/10/2018 09/10/2018 12/03/1955 0 2
1 K30;I10;J06.9 - 0 0 None None None None K-4-18-I
None None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN
(RINGAN) 1130000 0 0 - 0 - 0 - 0 - 0
1130000 1135500 0 6 0 0 0 ST. NURIA 017433
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48316 1#0##0
0 4031b18b3d985eced02e1490260cfeb7
7322003 D 2 DS 1 06/10/2018 09/10/2018 25/11/1983 0 2
0 - 0 - 0 - 0 - 0 2376400 1125000
0 4 0 0 0 MASNAENI 025752 34 12734 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48317 1#0##0 0
0e96f3eb9f1f43047033e6b7d8a6d7d4
7322003 D 3 DS 1 07/10/2018 09/10/2018 10/11/2012 0 1
1 N47 - 0 0 None None None None V-4-11-I None None
None None None None PENYAKIT SISTEM REPRODUKSI LAKI-LAKI SELAIN TUMOR
(RINGAN) 2493700 0 0 - 0 - 0 - 0 - 0
2493700 275000 0 3 0 0 0 RAMAYANA AZIS 026463
0002023093833 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48318 1#0##0 0 634b93a23ef2fe281cba9b34070cdcbe
7322003 D 3 DS 1 05/10/2018 09/10/2018 14/06/2004 0 2
0 0 - 0 - 0 - 0 - 0 2134700 595000
0 5 0 0 0 REINA KADIR 025444 14 5226 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48319 1#0##0 0
0b6549211bf6c9e3d2f93c16f25d271e
7322003 D 3 DS 1 08/10/2018 09/10/2018 01/04/1989 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 RIRIN SARI 024196 29 10782 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48320 1#0##0 0
9de9e76edd34e970039f8c09e8bd1eda
7322003 D 3 DS 1 06/10/2018 09/10/2018 01/01/1988 0 2
0 - 0 - 0 - 0 - 0 1529800 1875000
0 4 0 0 0 ELIS RUMPANG 025888 30 11236
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48321 1#0##0
0 14576e4b784eaeb5605a2930fcfef3c5
7322003 D 3 DS 1 08/10/2018 09/10/2018 01/11/1982 0 2
1 O42.9;O82.8;Z37.0 73.59 0 0 None None None None W-4-16-I
None None None None None None GANGGUAN ANTEPARTUM (RINGAN) 1980300
0 0 - 0 - 0 - 0 - 0 1980300
1675000 0 2 0 0 0 MARHUMA 026506 35 13125
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48322 1#0##0
0 54855efb4cc7d8a29964e4017f277cc0
7322003 D 3 DS 1 06/10/2018 09/10/2018 11/10/1969 0 1
0 - 0 - 0 - 0 3217900 985500 0 4
0 0 0 SUYITNO ADI 025124 48 17892 dr. AWALUDDIN H., Sp.PD
5.2.5.201812201302 4 48323 1#0##0 0
18a3c4c8db2bbb361e9199fd3afb6e2f
7322003 D 2 DS 1 04/10/2018 09/10/2018 25/07/1942 0 1
1 I11.9;A16.2 - 0 0 None None None None I-4-17-II None
None None None None None HIPERTENSI (SEDANG) 2432800 0 0
- 0 - 0 - 0 - 0 2432800 1325000 0
6 0 0 0 YK. SAMPE BAMBA 011244 76 27830 dr.
AWALUDDIN H., Sp.PD 0341R0041018V000469 0002085683848 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48324 1#0##0 0
5037302d4bce8a57a52edd073d79fdb0
7322003 D 3 DS 1 04/10/2018 09/10/2018 01/12/1966 0 2
1 I20.9;I11.9 - 0 0 None None None None I-4-20-I None
2752800 0 0 - 0 - 0 - 0 - 0
2752800 1155000 0 6 0 0 0 ANDI HASNAWATI ANDI NUR
0001072702809 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48325 1#0##0 0 9418eaf4f8f1ddd2399d952b988040c2
7322003 D 3 DS 1 08/10/2018 10/10/2018 31/12/1964 0 1
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 MARADDI 019731 53 19639 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48326 1#0##0 0
04c6de532fef1b63a26a33eb41a34fb5
7322003 D 3 DS 1 08/10/2018 10/10/2018 14/08/2004 0 2
1 R55 - 0 0 None None None None I-4-21-I None None
None None None None SYNCOPE & COLLAPSE (RINGAN) 2059900 0 0
- 0 - 0 - 0 - 0 2059900 775000 0
3 0 0 0 EKI PUSPITA 026020 14 5168 dr. INDRAHAYU,
Sp.S 0341R0041018V000735 0001941102009 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48327 1#0##0 0
9b3275b1b16cebeffdaa12c5da966710
7322003 D 3 DS 1 08/10/2018 10/10/2018 01/03/1973 0 1
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4385500 0 3 0 0 0 SURYA RAMA GAU
0341R0041018V000716 0001072594664 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48328 1#0##0 0
1628465b04ffc2df964d8055dba283db
7322003 D 3 DS 1 05/10/2018 10/10/2018 05/10/2018 2550 2
None None None None None NEONATAL, BBL > 2499 GR DENGAN
KONGENITAL/INFEKSI PERINATAL (RINGAN) 1624900 0 0 - 0 -
0 - 0 - 0 1624900 2235000 0 6 0 0
0 BAYI NY EFA SAHAFIAH 026381 0 0 DR. MULYANI KADIR,
SP.A,.M.KES. 0341R0041018V000468 0002497022831 3;JKN
INACBG;123123123123 5.2.5.201812201302 4 48329 1#0##0 0
95fe71d87c240adfe493d201307f95ba
7322003 D 3 DS 1 08/10/2018 10/10/2018 01/08/1948 0 2
11138600 0 0 - 0 - 0 - 0 - 0
11138600 4385500 0 3 0 0 0 MARSINAH 140146
0001072674977 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48330 1#0##0 0 fbcee6c15ad0d135d35af1e72bdbbedb
7322003 D 3 DS 1 06/10/2018 10/10/2018 10/05/2016 0 1
0 - 0 1808500 585500 0 5 0 0 0
CHRISTIAN ANUGRAH SULU 026453 2 879 DR. MULYANI KADIR,
SP.A,.M.KES. 0341R0041018V000697 0002224107189 3;JKN
INACBG;123123123123 5.2.5.201812201302 4 48331 1#0##0 0
eefa4d346eefadf8a8a036c6f5349286
7322003 D 3 DS 1 08/10/2018 10/10/2018 01/07/1979 0 1
0 0 - 0 - 0 - 0 - 0 3492200
4385500 0 3 0 0 0 HAWALUDDIN 026354 39 14344
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48332 1#0##0
0 0b07ba27bd2cbd23b87526071df952a4
7322003 D 3 DS 1 08/10/2018 10/10/2018 26/08/1982 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4420500 0 3 0 0 0 STEPANUS TIMBULA 026504
0001604698402 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48333 1#0##0 0 de116e4826fd3ec0a7b1c71f5a513e07
7322003 D 2 DS 1 08/10/2018 10/10/2018 17/03/1988 0 2
1 O99.5;J45.9 - 0 0 None None None None W-4-16-I None
0 - 0 - 0 - 0 - 0 2376400 775000
0 3 0 0 0 ANEU ROSMAYANTI 019556 30 11162
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48334 1#0##0
0 aca9879a8b221f3c0c7c7f995c87b81d
7322003 D 2 DS 1 10/10/2018 10/10/2018 07/03/1989 0 2
1 O32.1;O80.8;Z37.0 73.59 0 0 None None None None O-6-13-II
None None None None None None PERSALINAN VAGINAL (SEDANG) 2172700
0 0 - 0 - 0 - 0 - 0 2172700
1725000 0 1 0 0 0 MULTASAM 023989 29 10809
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48335 1#0##0
0 59c264d08d5465185f453388ca927d60
7322003 D 3 DS 1 08/10/2018 10/10/2018 01/12/1978 0 2
11138600 0 0 - 0 - 0 - 0 - 0
11138600 4310000 0 3 0 0 0 HASRIPAH 025732
0000941986247 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48336 1#0##0 0 01e8d28a2e964cd43e3690d7ba705948
7322003 D 3 DS 1 08/10/2018 10/10/2018 31/12/1949 0 1
9992400 0 0 - 0 - 0 - 0 - 0
9992400 4485500 0 3 0 0 0 SINDING 022784
0001556890773 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48337 1#0##0 0 8b97328c02a036f6a568ece4372330db
7322003 D 3 DS 1 09/10/2018 10/10/2018 16/07/1999 0 2
- 0 - 0 - 0 - 0 1461300 4210000 0
2 0 0 0 MARYUNI 026191 19 7025 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48338 1#0##0 0
4776079db45f83552ddabbf57f2bdbe7
7322003 D 1 DS 1 08/10/2018 10/10/2018 22/02/1957 0 2
1 D26.1 69.09 0 0 None None None None W-1-11-I None None
(RINGAN) 2109700 0 0 - 0 - 0 - 0 - 0
2109700 4775000 0 3 0 0 0 SITTI RAHMATIAH 024977
0001312921113 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48339 1#0##0 0 6a7f7b3f7c3b20051ed21a2f1d44ae2c
7322003 D 3 DS 1 08/10/2018 10/10/2018 01/12/1972 0 2
- 0 - 0 - 0 - 0 1980300 275000 0
3 0 0 0 ANI 024079 45 16747 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48340 1#0##0 0
6058a5c70b42c8d7458a68df9d00191c
7322003 D 3 DS 1 08/10/2018 10/10/2018 12/01/1993 0 2
0 0 - 0 - 0 - 0 - 0 1810600
1775000 0 3 0 0 0 HARIANTI 026529 25 9400
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48341 1#0##0
0 b5c36ae79ca41297198d292f633a3860
7322003 D 3 DS 1 07/10/2018 10/10/2018 01/07/1975 0 2
1 G44.1 - 0 0 None None None None G-4-23-I None None
None None None None MIGREN DAN SAKIT KEPALA LAIN (RINGAN) 1789600
0 0 - 0 - 0 - 0 - 0 1789600 375000
0 4 0 0 0 RUSNI 026465 43 15804 dr. INDRAHAYU,
Sp.S 0341R0041018V000584 0000942704739 3;JKN ANDI RAHMAT;7322112311880004
5.2.5.201812201302 4 48342 1#0##0 0
3f04375aa16f80151a8b49a546195847
7322003 D 3 DS 1 09/10/2018 10/10/2018 13/02/1998 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 SRI WAHYUNI 024490 20 7543 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48343 1#0##0 0
ba27be73ca050762f488b00e3a198c92
7322003 D 3 DS 1 08/10/2018 11/10/2018 01/07/1960 0 2
1 I10;M19.96 - 0 0 None None None None I-4-17-I None
- 0 - 0 - 0 - 0 1741400 504500 0
4 0 0 0 NURJANNA 026531 58 21283 dr. MUSMIANI MUIS,
5.2.2.201806040537 4 48344 1#0##0 0
27e8a883600d326ac5c04fb1edb7319c
7322003 D 3 DS 1 08/10/2018 11/10/2018 21/12/1992 0 2
5262000 0 0 - 0 - 0 - 0 - 0
5262000 4670500 0 4 0 0 0 ATTA 026386 25
0002279786319 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48345 1#0##0 0 5d326d48c383f77b5ea7d7a7ec4ded6f
7322003 D 3 DS 1 09/10/2018 11/10/2018 01/12/1950 0 1
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4385500 0 3 0 0 0 SUPU DG. PARELLE
0341R0041018V000817 0000941996182 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48346 1#0##0 0
e96acd5ac4e8ee1a5e478d893cc4bc06
7322003 D 3 DS 1 09/10/2018 11/10/2018 01/11/1985 0 2
1 K21.9;D07.3 - 0 0 None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 1995300 475000
0 3 0 0 0 HERLIN BABAO 026569 32 12030 dr.
INACBG;123123123123 5.2.5.201812201302 4 48347 1#0##0 0
a1237824a518644167cd6b36f067665d
7322003 D 3 DS 1 06/10/2018 11/10/2018 01/09/2001 0 2
1 K52.9;K92.1 - 0 0 None None None None K-4-17-I None
None None None None None NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN
(RINGAN) 1125300 0 0 - 0 - 0 - 0 - 0
1125300 685500 0 6 0 0 0 NINIS PURWATI 011706
0000942473193 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48348 1#0##0 0 20501218cd48d4dbad1c7d9ea4ffc832
7322003 D 3 DS 1 08/10/2018 11/10/2018 01/07/1940 0 2
1 M86.96;E11.5;D64.9 84.10;99.03 0 0 None None None None
M-1-02-II None None None None None None AMPUTASI (SEDANG) 10217600
0 0 - 0 - 0 - 0 - 0 10217600
6358000 0 4 0 0 0 MADE BUKTI 025774 78 28588
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48349 1#0##0
0 272e2b266561a046ddd0babff6bc8ea7
7322003 D 3 DS 1 09/10/2018 11/10/2018 12/11/2012 0 2
1 J02.9;A09.9 - 0 0 None None None None U-4-13-I None
0 - 0 1808500 385500 0 3 0 0 0
NATASYA NURUL AZAZIL 026576 5 2157 DR. MULYANI KADIR,
SP.A,.M.KES. 0341R0041018V000821 0001935215875 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48350 1#0##0 0
4d6fffd546cbb9067f4b355f23f8d517
7322003 D 3 DS 1 08/10/2018 11/10/2018 17/05/2005 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 485500 0 4 0 0 0 SERMILA RAMME 026527
0000943071939 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48351 1#0##0 0 dd939be911ae32a424579b449c487be0
7322003 D 1 DS 1 08/10/2018 11/10/2018 09/08/1985 0 2
0 - 0 - 0 - 0 - 0 6178800 5270500
0 4 0 0 0 JUWITA 026486 33 12113 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48352 1#0##0 0
7055891b8ff6176a01e968f54e197e50
7322003 D 2 DS 1 08/10/2018 11/10/2018 11/04/1985 0 2
1 O34.0;O82.8 74.4 0 0 None None None None O-6-10-I None
0 0 - 0 - 0 - 0 - 0 5370500
5372500 0 4 0 0 0 ALIBAITUL LESTARI.N 013111
0001283273831 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48353 1#0##0 0 209ac0cbfe5de982dc4676727bbab9cb
7322003 D 3 DS 1 07/10/2018 11/10/2018 06/08/1964 0 1
1 M86.96 77.09 0 0 None None None None M-1-60-I None
None None None None None PROSEDUR SISTEM MUSKULOSKLETAL & JARINGAN
PENGHUBUNG LAIN-LAIN (RINGAN) 5393500 0 0 - 0 - 0 -
0 - 0 5393500 5809500 0 5 0 0 0 ABBAS
0341R0041018V000590 0002233173464 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48354 1#0##0 0
dcf3d1e0c781dbbd001fe5fa636157f7
7322003 D 2 DS 1 09/10/2018 11/10/2018 01/07/1959 0 2
- 0 - 0 - 0 - 0 2089700 575000 0
3 0 0 0 NURDIA 026572 59 21650 dr. AWALUDDIN H.,
5.2.5.201812201302 4 48355 1#0##0 0
729b9f2d7c6c3f59516338286672f298
7322003 D 1 DS 1 09/10/2018 11/10/2018 25/03/1974 0 2
1 R55 - 0 0 None None None None I-4-21-I None None
None None None None SYNCOPE & COLLAPSE (RINGAN) 2883800 0 0
- 0 - 0 - 0 - 0 2883800 934500 0
3 0 0 0 GRESY SANGGOLA 024623 44 16269 dr.
INACBG;123123123123 5.2.5.201812201302 4 48356 1#0##0 0
dabd6411f1ad8d68c59f354271ddbece
7322003 D 2 DS 1 08/10/2018 11/10/2018 12/07/2003 0 2
1 I84.1 - 0 0 None None None None K-4-18-I None None
1356000 0 0 - 0 - 0 - 0 - 0
1356000 870500 0 4 0 0 0 JESIKA JULIA. S 025893
0001438239712 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48357 1#0##0 0 53f263b474c7f13d507066a5e7d5c98f
7322003 D 2 DS 1 08/10/2018 11/10/2018 01/07/1947 0 2
1350400 0 0 - 0 - 0 - 0 - 0
1350400 1325000 0 4 0 0 0 ISA HAMID 016607
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48358 1#0##0
0 a6aa197c226fcd1c589a77241384c47d
7322003 D 2 DS 1 08/10/2018 11/10/2018 04/12/1993 0 2
0 - 0 - 0 - 0 - 0 2376400 525000
0 4 0 0 0 ASMARA 024664 24 9074 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48359 1#0##0 0
984db2be610124a769d33367f317cea6
7322003 D 2 DS 1 09/10/2018 11/10/2018 08/10/2018 3030 2
3782500 0 0 - 0 - 0 - 0 - 0
3782500 1425000 0 3 0 0 0 BAYI NY ALIBAITUL
LESTARI.N 026518 0 1 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48360 1#0##0 0
b664ec3d0ce7ae4c883eb0c77dd46563
7322003 D 3 DS 1 08/10/2018 11/10/2018 27/11/1987 0 2
5262000 0 0 - 0 - 0 - 0 - 0
5262000 4555500 0 4 0 0 0 NASTI 026494 30
0001556867766 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48361 1#0##0 0 3d3cb588c03db181fce2fd1ab903ce99
7322003 D 3 DS 1 06/10/2018 11/10/2018 27/05/2000 0 2
0 0 - 0 - 0 - 0 - 0 2134700 775000
0 6 0 0 0 RAHMA AULYA J. 026459 18 6706
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48362 1#0##0
0 5fd9526db1fda94504d9f9d55fd6de91
7322003 D 2 DS 1 10/10/2018 12/10/2018 05/08/1965 0 2
0 - 0 - 0 - 0 - 0 4190700 4480000
0 3 0 0 0 SADARIA 026582 53 19424 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48363 1#0##0 0
732102d63736ba124c7ff26c69b4f70b
7322003 D 3 DS 1 10/10/2018 12/10/2018 05/11/1950 0 1
4118400 0 0 - 0 - 0 - 0 - 0
4118400 4420500 0 3 0 0 0 WAJI BANNE 026625
0001831502316 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48364 1#0##0 0 47f56e0ff02ea5afb2682bc5222bc5a5
7322003 D 3 DS 1 10/10/2018 12/10/2018 01/01/1986 0 2
0 - 0 - 0 - 0 - 0 4413400 4420500
0 3 0 0 0 DARMAWATI 025521 32 11970 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48365 1#0##0 0
7fa75786d8880ae0f9841f3c278f8ecd
7322003 D 3 DS 1 10/10/2018 12/10/2018 01/12/1984 0 1
None None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN KAKI
(RINGAN) 9992400 0 0 - 0 - 0 - 0 - 0
9992400 4420500 0 3 0 0 0 BAMBANG 026617
0000943669361 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48366 1#0##0 0 52c47cd6c985fa0f856e7e7c2b7c481d
7322003 D 3 DS 1 11/10/2018 12/10/2018 01/07/1946 0 2
0 - 0 - 0 - 0 1741400 334500 0 2
0 0 0 RUMASIA 026644 72 26400 dr. MUSMIANI MUIS, Sp.PD
0341R0041018V000969 0001560238738 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48367 1#0##0 0
766e88db41e39ed25913c127f873d98a
7322003 D 3 DS 1 08/10/2018 12/10/2018 01/12/1969 0 2
1 E15 - 0 0 None None None None E-4-10-I None None
None None None None PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/ METABOLIK
(RINGAN) 3298100 0 0 - 0 - 0 - 0 - 0
3298100 913000 0 5 0 0 0 SUTRA 026517 48
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48368 1#0##0
0 1732e068692c00462630aedff379c3ce
7322003 D 3 DS 1 09/10/2018 12/10/2018 01/10/1981 0 2
3960700 0 0 - 0 - 0 - 0 - 0
3960700 635500 0 4 0 0 0 DINDO 026570 37
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48369 1#0##0
0 6eb26e69afae771f80cab274469a064d
7322003 D 3 DS 1 09/10/2018 12/10/2018 01/05/2005 0 1
0 - 0 - 0 - 0 - 0 3492200 4555500
0 4 0 0 0 NASRUN 026568 13 4909 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48370 1#0##0 0
3b88334d02d48bd9c39e5390d080576f
7322003 D 3 DS 1 10/10/2018 12/10/2018 18/12/2011 0 1
1 S06.81 39.31 0 0 None None None None I-1-20-I None
None None None None None PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN
(RINGAN) 10063600 0 0 - 0 - 0 - 0 - 0
10063600 4310000 0 3 0 0 0 MUH.SALMAN 026353
0001604666002 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48371 1#0##0 0 354741550b9d76114f82eac12f2f9d03
7322003 D 3 DS 1 12/10/2018 12/10/2018 12/10/2018 2870 1
- 0 1624900 2175000 0 1 0 0 0 BAYI NY
NURSANA 026663 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V001153 0002499160228 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48372 1#0##0 0
af36dbe0420900198b287697ed13d51d
7322003 D 3 DS 1 11/10/2018 12/10/2018 05/07/1971 0 2
0 - 0 - 0 - 0 - 0 4413400 4420500
0 2 0 0 0 SUTINAH 010486 47 17265 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48373 1#0##0 0
5bde9e2ea72169722a444014c809971a
7322003 D 3 DS 1 10/10/2018 12/10/2018 12/02/2018 0 1
1 Q43.9 46.10 0 0 None None None None K-1-20-I None None
None None None None PROSEDUR INTESTINAL KOMPLEKS (RINGAN) 7974500
0 0 - 0 - 0 - 0 - 0 7974500
4275000 0 3 0 0 0 KEVIN SYAHPUTRA 022891 0
0002430395019 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48374 1#0##0 0 9f7ae597f8765da7897f282cf3c2dab5
7322003 D 3 DS 1 10/10/2018 12/10/2018 01/10/1955 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4420500 0 3 0 0 0 JANNA LAKASO 011339
0000941526268 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48375 1#0##0 0 82606249ae089e16211609240393d2ed
7322003 D 3 DS 1 10/10/2018 12/10/2018 01/07/1943 0 1
None None None None PROSEDUR KANDUNG KEMIH KOMPLEK (RINGAN) 5750900
0 0 - 0 - 0 - 0 - 0 5750900
4420500 0 3 0 0 0 MANDA 025468 75 27495 dr.
RAHMAT;7322112311880004 5.2.5.201812201302 4 48376 1#0##0 0
c902fa59684889984cd1000200923b08
7322003 D 2 DS 1 10/10/2018 12/10/2018 28/10/1984 0 2
0 - 0 - 0 - 0 - 0 4190700 4655500
0 3 0 0 0 ST NURHAYATI 026616 33 12400 dr.
INACBG;123123123123 5.2.5.201812201302 4 48377 1#0##0 0
e7d484386be8ad32c2edad062d0c5573
7322003 D 3 DS 1 10/10/2018 12/10/2018 16/10/2015 0 1
1 J20.9 93.94 0 0 None None None None J-4-21-I None None
LAIN (RINGAN) 2635000 0 0 - 0 - 0 - 0 -
0 2635000 885500 0 3 0 0 0 RAFIQI REYHAN
ARKANANTA 026628 2 1090 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48378 1#0##0 0
e8ffd4cf57899a72e40c5434a7aa95de
7322003 D 3 DS 1 08/10/2018 12/10/2018 11/02/1932 0 1
4118400 0 0 - 0 - 0 - 0 - 0
4118400 4955500 0 5 0 0 0 SAELAN 026482
0001557338624 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48379 1#0##0 0 3e0c0dc4edb695c2521941c3c7132f07
7322003 D 3 DS 1 10/10/2018 12/10/2018 23/12/2009 0 2
0 - 0 - 0 - 0 - 0 3492200 4385500
0 3 0 0 0 INGRID CANTIKA FRISYLIA 026623 8 3213
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48380 1#0##0
0 5943e680c6031346c0fa62d92114f7a4
7322003 D 3 DS 1 10/10/2018 12/10/2018 01/12/1974 0 2
0 - 0 5393500 4385500 0 3 0 0 0
MARLIN, NY 019031 43 16019 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
0341R0041018V000901 0000943117637 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48381 1#0##0 0
c98bfe8e3e28bb833f7e801b25623572
7322003 D 1 DS 1 10/10/2018 12/10/2018 31/07/1983 0 2
0 0 - 0 - 0 - 0 - 0 3479100 535500
0 3 0 0 0 ANITA YULIANTI SETIAWAN 017425 35 12855
dr. AWALUDDIN H., Sp.PD 0341R0041018V000920 0001101391323 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48382 1#0##0 0
a059d3fc234624b9c9de4335b6ceeb57
7322003 D 1 DS 1 11/10/2018 12/10/2018 04/04/2001 0 2
1582000 0 0 - 0 - 0 - 0 - 0
1582000 775000 0 2 0 0 0 Tirta Ayu Lestari Akbar
009422 17 6399 dr. AWALUDDIN H., Sp.PD 0341R0041018V000993
0000132420058 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48383 1#0##0 0 1cb7a95b511678efb088420922a9db3e
7322003 D 3 DS 1 08/10/2018 12/10/2018 05/03/1994 0 1
- 0 - 0 - 0 - 0 1993300 510000 0
5 0 0 0 ARDI 026528 24 8983 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48384 1#0##0 0
6554012467d46ef9d73e062db562640e
7322003 D 3 DS 1 08/10/2018 12/10/2018 12/12/1959 0 1
2495700 0 0 - 0 - 0 - 0 - 0
2495700 680500 0 5 0 0 0 SAMSUR 026525
0001935530109 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48385 1#0##0 0 8d9ead297d3e487258ef66e9c47e4846
7322003 D 3 DS 1 10/10/2018 12/10/2018 01/10/1997 0 1
0 - 0 5393500 4420500 0 3 0 0 0 CANDRA
5.2.5.201812201302 4 48386 1#0##0 0
62bf67e9b9981c671eb583d3d9eebab1
7322003 D 3 DS 1 10/10/2018 12/10/2018 01/11/2000 0 2
- 0 - 0 - 0 - 0 1980300 275000 0
3 0 0 0 SERI MURNI 026629 17 6552 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48387 1#0##0 0
5addd3d250faf46462295c1ba0e97c88
7322003 D 3 DS 1 12/10/2018 12/10/2018 18/08/1986 0 2
0 - 0 - 0 - 0 - 0 1529800 1500000
0 1 0 0 0 MAYAH 026648 32 11743 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48388 1#0##0 0
65a8610dde26a3529ae0ddf2a33877b6
7322003 D 3 DS 1 09/10/2018 12/10/2018 11/06/1977 0 2
LAIN (RINGAN) 2645200 0 0 - 0 - 0 - 0 -
0 2645200 525000 0 4 0 0 0 JUMSIA .P 008717
0001891346005 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48389 1#0##0 0 e1fc698d3367e11d6cd9c6b73fcdc28a
7322003 D 3 DS 1 08/10/2018 12/10/2018 09/10/1992 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 5122500 0 5 0 0 0 SARLIATI 025513
0002464540198 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48390 1#0##0 0 867d2fcd14ca127e2999ccd1ffe12e9f
7322003 D 1 DS 1 10/10/2018 12/10/2018 07/09/2001 0 2
1575500 0 0 - 0 - 0 - 0 - 0
1575500 1145000 0 3 0 0 0 SITI AFRIYANI 003334
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48391 1#0##0
0 5194d021778085cb9dfae8a7364eee69
7322003 D 3 DS 1 09/10/2018 12/10/2018 04/02/1998 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4972500 0 4 0 0 0 RESTIKA 026574
0001072629527 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48392 1#0##0 0 8f115f97135b00f71e95c75f7388c50a
7322003 D 2 DS 1 10/10/2018 12/10/2018 31/12/1918 0 1
6320400 0 0 - 0 - 0 - 0 - 0
6320400 4775000 0 3 0 0 0 BALLAO DAMO' 021123
0002287051007 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48393 1#0##0 0 abe142be97dd65cfdeae68569a0098fa
7322003 D 3 DS 1 09/10/2018 13/10/2018 01/07/1952 0 1
0 - 0 - 0 - 0 4020700 4545000 0 5
0 0 0 MABBE 026541 66 24206 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48394 1#0##0 0
67262073fbfd707c39f25fbb8e97192e
7322003 D 3 DS 1 10/10/2018 13/10/2018 30/05/1982 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 WELNI 026579 36
0000942117704 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48395 1#0##0 0 c2100bb2b9ae51e7d65b32a1202fc5f0
7322003 D 3 DS 1 08/10/2018 13/10/2018 01/07/1957 0 1
1 M25.46 - 0 0 None None None None M-4-21-I None
None None None None None GANGGUAN SISTEM MUSKULOSKELETAL & JA(RINGAN)
0 - 0 1993700 685500 0 6 0 0 0
LONTONG 002073 61 22379 dr. MUSMIANI MUIS, Sp.PD
0341R0041018V000712 0000943012067 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48396 1#0##0 0
3ba72b35163626dfbcfe667e068c7405
7322003 D 3 DS 1 10/10/2018 13/10/2018 22/02/1979 0 2
1 R42 - 0 0 None None None None U-4-11-I None None
None None None None DYSEQUILIBRIUM (RINGAN) 1192800 0 0 -
0 - 0 - 0 - 0 1192800 375000 0 4
0 0 0 IRFAN 026626 39 14475 dr. MUSMIANI MUIS, Sp.PD
0341R0041018V000900 0001941103798 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48397 1#0##0 0
3b09eae14f82e23505d77b4d6eff0783
7322003 D 2 DS 1 10/10/2018 13/10/2018 27/03/1981 0 2
5370500 0 0 - 0 - 0 - 0 - 0
5370500 5372500 0 4 0 0 0 YARSIA 026025
0001849107789 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48398 1#0##0 0 7592f53e2055f7b3ff281d6fed5d47c5
7322003 D 1 DS 1 12/10/2018 13/10/2018 21/05/1975 0 1
1582000 0 0 - 0 - 0 - 0 - 0
1582000 425000 0 2 0 0 0 ALFIAN 026673
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48399 1#0##0
0 8546197320b570f4b1f082fe01538fac
7322003 D 3 DS 1 10/10/2018 13/10/2018 10/10/2018 3060 2
1 P12.8;P36.9 - 0 0 None None None None P-8-17-II None
None None None None None NEONATAL, BBL > 2499 GR TANPA PROSEDUR MAYOR
(SEDANG) 5673800 0 0 - 0 - 0 - 0 - 0
5673800 2175000 0 4 0 0 0 BAYI NY HERNITA 026620
0002498847039 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48400 1#0##0 0 d7c507d82e46734b2cf0d2fb98a339d0
7322003 D 3 DS 1 09/10/2018 13/10/2018 09/10/2018 3050 2
3152100 0 0 - 0 - 0 - 0 - 0
3152100 2775000 0 5 0 0 0 BAYI NY RESTIKA 026575
0002498171534 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48401 1#0##0 0 7c0ef1e5b1b0ded44bfb0300023ddc90
7322003 D 3 DS 1 10/10/2018 13/10/2018 10/10/2018 2950 2
3152100 0 0 - 0 - 0 - 0 - 0
3152100 675000 0 4 0 0 0 BAYI NY WELNI 026580
0002498200097 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48402 1#0##0 0 a05ddcf7b3a8ee7a08e357fcf604816d
7322003 D 3 DS 1 02/10/2018 13/10/2018 02/02/2010 0 1
1 A01.0;A16.2 - 0 0 None None None None A-4-14-II None
None None None None None PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN
(SEDANG) 2647600 0 0 - 0 - 0 - 0 - 0
2647600 2346500 0 12 0 0 0 MUH. MARWANSYAH 026292
0002271757948 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48403 1#0##0 0 621fb0816e48d1be1f0905023a38a197
7322003 D 1 DS 1 11/10/2018 13/10/2018 17/08/1987 0 2
- 0 - 0 - 0 - 0 2772500 775000 0
3 0 0 0 LILIANA S 018434 31 11378 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48404 1#0##0 0
538e552025a7ae1a13e6edff0c023445
7322003 D 2 DS 1 10/10/2018 13/10/2018 10/10/2018 2790 1
3782500 0 0 - 0 - 0 - 0 - 0
3782500 1425000 0 4 0 0 0 BAYI NY RENI IRMAWATI
0341R0041018V000991 0002498624199 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48405 1#0##0 0
45a417afee5d44f40794713497b933c6
7322003 D 2 DS 1 10/10/2018 13/10/2018 16/04/1987 0 2
5370500 0 0 - 0 - 0 - 0 - 0
5370500 5932500 0 4 0 0 0 RENI IRMAWATI 012544
0000208039239 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48406 1#0##0 0 ed060fda0611e9b9befd83df70ea6e84
7322003 D 2 DS 1 10/10/2018 13/10/2018 10/10/2018 2750 2
3782500 0 0 - 0 - 0 - 0 - 0
3782500 1425000 0 4 0 0 0 BAYI NY YARSIA 026584
0002498464629 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48407 1#0##0 0 7bb442a3bccf4d1881bfa2167d87fb31
7322003 D 2 DS 1 10/10/2018 13/10/2018 23/10/1976 0 1
0 - 0 - 0 - 0 - 0 4190700 5305500
0 4 0 0 0 ANNAS 026587 41 15327 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48408 1#0##0 0
cd0210236ab2b8ea8141a00dcc470703
7322003 D 3 DS 1 10/10/2018 13/10/2018 16/11/2017 0 1
4118400 0 0 - 0 - 0 - 0 - 0
4118400 4520500 0 4 0 0 0 MUH. SYAFI ASSYAUQI
5.2.5.201812201302 4 48409 1#0##0 0
7f487676f9f3599817ff4eb77f6f6d89
7322003 D 3 DS 1 10/10/2018 13/10/2018 01/07/1983 0 2
1 O33.0;Z37.0;O82.8 74.4 0 0 None None None None O-6-10-I
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4717500 0 4 0 0 0 HERNITA 024733
0001072585912 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48410 1#0##0 0 6d9233e37f437cc0b5aab2de875f44b3
7322003 D 3 DS 1 12/10/2018 13/10/2018 12/08/1992 0 2
None None None None None None PERSALINAN VAGINAL (RINGAN) 1529800
0 0 - 0 - 0 - 0 - 0 1529800
1675000 0 2 0 0 0 SUNARTI 026224 26 9557
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48411 1#0##0
0 cd140a8d399e3e09c3b3edef37a80048
7322003 D 3 DS 1 12/10/2018 13/10/2018 25/08/1998 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 BAIQ RIRIN JAYANTI 024587 20 7353
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48412 1#0##0
0 9ac4cc8576a070ef35036d81eb5a2682
7322003 D 3 DS 1 11/10/2018 13/10/2018 01/10/2002 0 1
3300100 0 0 - 0 - 0 - 0 - 0
3300100 535500 0 3 0 0 0 AISAH 026640 16
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48413 1#0##0
0 fd93250722a762c6b6b4214b003ce7f9
7322003 D 3 DS 1 12/10/2018 13/10/2018 29/04/1993 0 2
0 0 - 0 - 0 - 0 - 0 1810600
1675000 0 2 0 0 0 MULIYANI 022497 25 9297
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48414 1#0##0
0 03c96a92d5423d19383e26b7ea81e063
7322003 D 1 DS 1 09/10/2018 13/10/2018 01/02/1958 0 1
5544900 0 0 - 0 - 0 - 0 - 0
5544900 2145500 0 5 0 0 0 GUSTI MADE PATRA 023958
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48415 1#0##0
0 9a15f54cd86d33b9c4c6c59f5b5efbed
7322003 D 3 DS 1 25/09/2018 13/10/2018 30/05/2018 0 2
1 E46;Q21.0;P37.5;P23.9 - 0 0 None None None None E-4-
10-III None None None None None None PENYAKIT KENCING MANIS & GANGGUAN
NUTRISI/ METABOLIK (BERAT) 5720100 0 0 - 0 - 0 -
0 - 0 5720100 2615000 0 19 0 0 0 BAYI
NY HAPSIAH 022932 0 118 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0040918V002495 0002463182436 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48416 1#0##0 0
8653077cd9777f7d9b3e8283b60ef375
7322003 D 3 DS 1 12/10/2018 14/10/2018 06/06/1966 0 2
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4520500 0 3 0 0 0 RATNA 026042 52
0002494813803 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48417 1#0##0 0 2b41064d69ecbbd09e73ce13ee54ab4e
7322003 D 3 DS 1 08/10/2018 14/10/2018 20/12/2016 0 1
1125300 0 0 - 0 - 0 - 0 - 0
1125300 585500 0 7 0 0 0 cristian pagiling 024539
0002211552922 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48418 1#0##0 0 a57f0a053d3cd6d6aafef61dbebbc04a
7322003 D 1 DS 1 12/10/2018 14/10/2018 15/12/1966 0 1
0 - 0 7550900 4680000 0 3 0 0 0
ARIANTO SAERAN 003062 51 18929 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
0341R0041018V001059 0001555480708 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48419 1#0##0 0
1782676499c7c45d2eb594dbedd7553a
7322003 D 2 DS 1 12/10/2018 14/10/2018 12/11/1983 0 2
0 0 - 0 - 0 - 0 - 0 2172700 775000
0 3 0 0 0 AGUSTINA YERMIN 021415 34 12753
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48420 1#0##0
0 257851f68492aee1beedea4d1cf36ddd
7322003 D 3 DS 1 11/10/2018 14/10/2018 11/03/1990 0 2
None None None None None None OPERASI PEMBEDAHAN CAESAR (SEDANG)
4734600 0 0 - 0 - 0 - 0 - 0
4734600 4622500 0 4 0 0 0 MARTA 026457 28
0002492759924 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48421 1#0##0 0 5c9994ced5debbcb274d6173eaecad0f
7322003 D 3 DS 1 12/10/2018 14/10/2018 27/07/1972 0 2
(SEDANG) 10991700 0 0 - 0 - 0 - 0 - 0
10991700 4275000 0 3 0 0 0 SRI RITA LOPI WATI
5.2.5.201812201302 4 48422 1#0##0 0
4c191071c1e6633ecc0f49e3ae3970df
7322003 D 3 DS 1 12/10/2018 14/10/2018 31/12/1950 0 1
(RINGAN) 9992400 0 0 - 0 - 0 - 0 - 0
9992400 4275000 0 3 0 0 0 PETRUS ANGIN 025598
0002487111906 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48423 1#0##0 0 5eb56b975f3397fc14522b4516d39105
7322003 D 3 DS 1 12/10/2018 14/10/2018 12/10/2018 2820 1
- 0 1624900 1535000 0 3 0 0 0 BAYI NY
SISKA DEVI 026646 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V001035 0002498885313 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48424 1#0##0 0
a47ee38fb5f56f38c3e90fdefb3bee55
7322003 D 3 DS 1 11/10/2018 14/10/2018 11/10/2018 2190 1
(RINGAN) 4728100 0 0 - 0 - 0 - 0 - 0
4728100 2175000 0 4 0 0 0 BAYI NY IRMA 026642
0002498863757 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48425 1#0##0 0 efa583968c21f61ea104f5dfc9ae4c19
7322003 D 3 DS 1 12/10/2018 14/10/2018 08/09/1987 0 2
(RINGAN) 9992400 0 0 - 0 - 0 - 0 - 0
9992400 4275000 0 3 0 0 0 IRTAWATI ICHA 025992
0001557301509 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48426 1#0##0 0 d77334ef9141466db1d9c9691803a5cc
7322003 D 3 DS 1 11/10/2018 14/10/2018 28/10/1993 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 IRMA 026031 24
0002170264487 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48427 1#0##0 0 6d3fd44e5969def321085532282fef87
7322003 D 3 DS 1 13/10/2018 14/10/2018 01/06/1999 0 2
- 0 - 0 - 0 - 0 1980300 1675000 0
2 0 0 0 HARMAYANTI 026682 19 7074 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48428 1#0##0 0
c0d64df984541df2c81598ada357419e
7322003 D 3 DS 1 12/10/2018 14/10/2018 08/09/1993 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4522500 0 3 0 0 0 SISKA DEVI 026645
0001558158603 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48429 1#0##0 0 e36bd8b9acc64ce393f32b57405c356c
7322003 D 1 DS 1 07/10/2018 14/10/2018 05/08/1963 0 1
PAYUDARA (RINGAN) 4706600 0 0 - 0 - 0 - 0 -
0 4706600 7819500 0 8 0 0 0 SELAMAT IRWAN
0341R0041018V000579 0000207663401 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48430 1#0##0 0
2503965466d96c48521fea60d62f9cdd
7322003 D 1 DS 1 15/10/2018 15/10/2018 30/06/2001 0 1
1 K30;F41.9 - 0 0 None None None None K-4-18-I None
1582000 0 0 - 0 - 0 - 0 - 0
1582000 425000 0 1 0 0 0 MOH. TAUFIK NUGRAHA
0000135120251 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48431 1#0##0 0 b0f4d217a9f75c78a23793210678bba1
7322003 D 3 DS 1 14/10/2018 15/10/2018 06/07/1977 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 175000 0 2 0 0 0 Nasrah 009881
0001557179335 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48432 1#0##0 0 58a1eb99d7b5ab6f088bed821a8f5802
7322003 D 3 DS 1 13/10/2018 15/10/2018 01/07/1967 0 2
0 - 0 - 0 - 0 - 0 3492200 4480000
0 3 0 0 0 DAHLIA 026681 51 18732 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48433 1#0##0 0
f0bce07d85d20a78e121073e23bc4cf8
7322003 D 3 DS 1 13/10/2018 15/10/2018 07/01/1990 0 2
0 0 - 0 - 0 - 0 - 0 3492200
4420500 0 3 0 0 0 EDI SURIAWAN 026683 28
0001556913442 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48434 1#0##0 0 8c5c8a40468059fb76cb11040bdd2f0f
7322003 D 3 DS 1 11/10/2018 15/10/2018 11/10/2018 1870 1
(RINGAN) 5449300 0 0 - 0 - 0 - 0 - 0
5449300 2775000 0 5 0 0 0 BAYI NY MARTA 026633
0002492761454 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48435 1#0##0 0 98a01e07c2fd73c0c34541640c2a97ac
7322003 D 3 DS 1 15/10/2018 15/10/2018 01/06/1979 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 585500 0 1 0 0 0 LISMA 026733 39
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48436 1#0##0
0 032509f7959278ad6ded59f491a36d40
7322003 D 2 DS 1 09/10/2018 15/10/2018 14/05/1972 0 1
1 T81.4;D64.9 86.59;99.03 0 0 None None None None A-4-11-II
None None None None None None INFEKSI SESUDAH OPERASI & TRAUMA (SEDANG)
3795300 0 0 - 0 - 0 - 0 - 0
3795300 5560500 0 7 0 0 0 MUH. DIRHAM 025690
0001281986076 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48437 1#0##0 0 fdc2ebb125c6c173b1197a0d8834392d
7322003 D 3 DS 1 13/10/2018 15/10/2018 17/08/1987 0 2
- 0 - 0 - 0 - 0 1980300 375000 0
3 0 0 0 HASBIANA 006867 31 11380 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48438 1#0##0 0
93e73fc5b9c58813767186a00696037d
7322003 D 3 DS 1 09/10/2018 15/10/2018 10/04/1973 0 1
1 M86.96;E11.9 77.09 0 0 None None None None M-1-60-I
None None None None None None PROSEDUR SISTEM MUSKULOSKLETAL & JARINGAN
0 - 0 5393500 6055000 0 7 0 0 0
TUKIMIN 026573 45 16618 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
0341R0041018V000876 0002378625355 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48439 1#0##0 0
07a1889da9870bcc96bfb8a8dfbf9679
7322003 D 1 DS 1 13/10/2018 15/10/2018 06/07/1984 0 2
(RINGAN) 2109700 0 0 - 0 - 0 - 0 - 0
2109700 4775000 0 3 0 0 0 MASITA, A.MD KEP 019916
0000195367781 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48440 1#0##0 0 4ab2eda1fcfec1801203422a0a938381
7322003 D 1 DS 1 14/10/2018 15/10/2018 07/09/1984 0 2
0 - 0 - 0 - 0 - 0 2141700 1925000
0 2 0 0 0 IDHAENI, A.MA 021195 34 12455
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48441 1#0##0
0 6454f9b9282e2c1bc26431d2f25f4767
7322003 D 1 DS 1 12/10/2018 15/10/2018 12/01/2002 0 2
1575500 0 0 - 0 - 0 - 0 - 0
1575500 525000 0 4 0 0 0 Lilis Sintia 009748
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48442 1#0##0
0 626a649bef7ab3504dc6cc55e290213f
7322003 D 1 DS 1 13/10/2018 15/10/2018 26/11/1978 0 2
1582000 0 0 - 0 - 0 - 0 - 0
1582000 885500 0 3 0 0 0 NURNIAH, SPT 013857
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48443 1#0##0
0 1db3c00e1192e48686537b4b38b4d434
7322003 D 3 DS 1 12/10/2018 15/10/2018 05/10/2003 0 1
0 0 - 0 - 0 - 0 - 0 3492200
4575000 0 4 0 0 0 SYAHRIL HUSSEN 026670 15
0001941150982 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48444 1#0##0 0 0c66c438ad930a98d2a6af95fe061656
7322003 D 3 DS 1 11/10/2018 15/10/2018 25/06/2003 0 2
7152500 0 0 - 0 - 0 - 0 - 0
7152500 4675000 0 5 0 0 0 DEWI RATNA SARI 025730
0000940863688 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48445 1#0##0 0 fb60c4b9d4093a932accfb70525a9fee
7322003 D 3 DS 1 14/10/2018 15/10/2018 01/12/1985 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 RINA 026695 32 12005 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48446 1#0##0 0
189592ab71ef84ce3e940e8509c689d4
7322003 D 3 DS 1 06/10/2018 15/10/2018 19/10/1987 0 1
1 A16.2;J02.9;E84.9 - 0 0 None None None None J-4-15-II
None None None None None None PERADANGAN DAN INFEKSI PERNAFASAN
(SEDANG) 4731900 0 0 - 0 - 0 - 0 - 0
4731900 1740500 0 10 0 0 0 MARKUS DEDI 026442
0001941478885 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48447 1#0##0 0 ac64848540c49d052d4af08b6ad98722
7322003 D 3 DS 1 12/10/2018 15/10/2018 07/02/1984 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 NURSANA 016847
0001556873943 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48448 1#0##0 0 421d27fcc3aff6d9f7960e7e76c99567
7322003 D 3 DS 1 14/10/2018 15/10/2018 21/05/1991 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4175000 0 2 0 0 0 ARNILA SUARDI 026701
0002070940555 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48449 1#0##0 0 7cf4de495ce923a67f25fbcd811a1d4a
7322003 D 1 DS 1 11/10/2018 15/10/2018 31/12/1962 0 1
1 E11.9 - 0 0 None None None None E-4-10-I None None
None None None None PENYAKIT KENCING MANIS & GANGGUAN NUTRISI/ METABOLIK
(RINGAN) 4617300 0 0 - 0 - 0 - 0 - 0
4617300 994000 0 5 0 0 0 MANDULEWAN 026643
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48450 1#0##0
0 c4f38a8de03a51ecb284f424e260bc43
7322003 D 3 DS 1 12/10/2018 15/10/2018 28/12/1992 0 2
1 K35.2;N30.0 54.11 0 0 None None None None K-1-40-II None
None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (SEDANG)
5801600 0 0 - 0 - 0 - 0 - 0
5801600 4755500 0 4 0 0 0 MATAN SE'DAN
5.2.5.201812201302 4 48451 1#0##0 0
19a9b845661941acdead7062d5aa47e4
7322003 D 3 DS 1 14/10/2018 16/10/2018 10/09/1998 0 2
0 - 0 1808500 625000 0 3 0 0 0
HASRIANI 026694 20 7339 dr. AWALUDDIN H., Sp.PD
0341R0041018V001125 0002458839418 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48452 1#0##0 0
61fcdd151b00707b82aae1ef9445c5cf
7322003 D 3 DS 1 13/10/2018 16/10/2018 06/02/2001 0 2
1 A09.9;K21.9 - 0 0 None None None None K-4-17-I None
None None None None None NYERI ABDOMEN & GASTROENTERITIS LAIN-LAIN
(RINGAN) 1125300 0 0 - 0 - 0 - 0 - 0
1125300 375000 0 4 0 0 0 NURLATIFAH HALIDA 026688
0000942636701 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48453 1#0##0 0 be8476c837bc15a7af0a4d8090120fe8
7322003 D 2 DS 1 15/10/2018 16/10/2018 29/05/1987 0 2
(RINGAN) 1808300 0 0 - 0 - 0 - 0 - 0
1808300 4425000 0 2 0 0 0 FITRIANI DEWI JURADI
0341R0041018V001348 0001643551604 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48454 1#0##0 0
233a3032bc5a5ef6156c56da914e3f6a
7322003 D 3 DS 1 14/10/2018 16/10/2018 01/05/1975 0 1
1125300 0 0 - 0 - 0 - 0 - 0
1125300 835500 0 3 0 0 0 IRSAM 026700 43
INACBG;123123123123 5.2.5.201812201302 4 48455 1#0##0 0
5584410bb351438b148c4bc396feea34
7322003 D 3 DS 1 13/10/2018 16/10/2018 01/12/1975 0 2
- 0 - 0 - 0 - 0 1995300 585500 0
4 0 0 0 MIRNAWATI 026674 42 15657 dr. MUSMIANI MUIS,
5.2.5.201812201302 4 48456 1#0##0 0
b190dafacf5838b7d17372cb47deca76
7322003 D 2 DS 1 14/10/2018 16/10/2018 25/08/2017 0 2
LAIN (RINGAN) 3162000 0 0 - 0 - 0 - 0 -
0 3162000 1085500 0 3 0 0 0 A. CAHAYA ADIBA
ALWAHYU 016068 1 415 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48457 1#0##0 0
d14b3b0419ba9cc0973a18dc556ef6c2
7322003 D 1 DS 1 15/10/2018 16/10/2018 22/02/1957 0 2
LAIN (RINGAN) 3703300 0 0 - 0 - 0 - 0 -
0 3703300 425000 0 2 0 0 0 SITTI RAHMATIAH
5.2.5.201812201302 4 48458 1#0##0 0
e1b686ca6b937ff311452cdd91aa29a7
7322003 D 1 DS 1 10/10/2018 16/10/2018 31/12/1935 0 2
1 K27.9;I11.9;D64.9 99.03 0 0 None None None None K-4-11-II
None None None None None None GASTRITIS & ULKUS PEPTIKUM (SEDANG)
4215000 0 0 - 0 - 0 - 0 - 0
4215000 2206500 0 7 0 0 0 SINANGA 017754
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48459 1#0##0
0 91902dcd7410e9c6f0c9115381df4150
7322003 D 1 DS 1 10/10/2018 16/10/2018 17/01/1972 0 2
None None None None None PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (SEDANG)
8122200 0 0 - 0 - 0 - 0 - 0
8122200 6855500 0 7 0 0 0 BETI LUBIS 026614
0000132496064 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48460 1#0##0 0 d86c3467d652ebea2f3834efd1da65b9
7322003 D 2 DS 1 14/10/2018 16/10/2018 08/02/1993 0 1
1 K35.8;N20.0 - 0 0 None None None None K-4-18-II None
None None None None None GANGGUAN SISTEM PENCERNAAN LAIN-LAIN (SEDANG)
1926900 0 0 - 0 - 0 - 0 - 0
1926900 785500 0 3 0 0 0 RISMAN 026691
0001276072762 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48461 1#0##0 0 bbaad0645cfbf5c4cbdc3c7e3bb40552
7322003 D 2 DS 1 12/10/2018 16/10/2018 17/03/2014 0 2
1350400 0 0 - 0 - 0 - 0 - 0
1350400 985500 0 5 0 0 0 ELIRA CANTIKA PANDE
5.2.5.201812201302 4 48462 1#0##0 0
f2ba41d3ec9dd712e435fe4d32ff7eaa
7322003 D 3 DS 1 14/10/2018 17/10/2018 01/01/1958 0 1
1 A16.2;D64.9;K27.9 99.03 0 0 None None None None J-4-15-II
(SEDANG) 4731900 0 0 - 0 - 0 - 0 - 0
4731900 1395000 0 4 0 0 0 LOBO 026692 60
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48463 1#0##0
0 a0d0101e3fe912d1004a149ec687dedf
7322003 D 3 DS 1 13/10/2018 17/10/2018 15/08/1954 0 1
1 I63.9 - 0 0 None None None None G-4-14-I None None
None None None None KECEDERAAN PEMBULUH DARAH OTAK DENGAN INFARK (RINGAN)
3385200 0 0 - 0 - 0 - 0 - 0
3385200 654500 0 5 0 0 0 M. SUAIB DM 026685
64 23435 dr. INDRAHAYU, Sp.S 0341R0041018V001143 0001935184443
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48464 1#0##0
0 fc4459f9b4319fb805b4f6c77929b781
7322003 D 3 DS 1 15/10/2018 17/10/2018 01/07/1950 0 1
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4420500 0 3 0 0 0 SAHARUDDIN DG. NABA
0341R0041018V001261 0001475649369 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48465 1#0##0 0
4c0e350202434f7372c54724519e4435
7322003 D 3 DS 1 15/10/2018 17/10/2018 01/07/1996 0 1
0 - 0 - 0 - 0 - 0 4413400 4515000
0 3 0 0 0 ERNA 026729 22 8141 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48466 1#0##0 0
5ca1fe8901e349948743fd102a6ef742
7322003 D 2 DS 1 14/10/2018 17/10/2018 03/07/1996 0 2
1 S09.9 - 0 0 None None None None G-4-24-I None None
None None None None TRAUMA KEPALA (RINGAN) 2392000 0 0 -
0 - 0 - 0 - 0 2392000 525000 0 4
0 0 0 MURNIATI 026703 22 8138 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48467 1#0##0 0
7e17c43f858aeb86e1533f351bc78604
7322003 D 3 DS 1 14/10/2018 17/10/2018 10/02/1969 0 2
1 I11.0 - 0 0 None None None None I-4-12-I None None
None None None None KEGAGALAN JANTUNG (RINGAN) 2342200 0 0
- 0 - 0 - 0 - 0 2342200 1475000 0
4 0 0 0 NUR RAHIM 026693 49 18143 dr. AWALUDDIN H.,
5.2.2.201806040537 4 48468 1#0##0 0
a72b544a2db6b4ba6a05cc05f5cf906a
7322003 D 3 DS 1 15/10/2018 17/10/2018 01/07/1962 0 1
0 - 0 - 0 - 0 - 0 1995300 375000
0 3 0 0 0 ISMAIL BIN CAI 026737 56 20560 dr.
INACBG;123123123123 5.2.2.201806040537 4 48469 1#0##0 0
e3e278d840aa333bba85889bd5491e22
7322003 D 3 DS 1 14/10/2018 17/10/2018 01/12/1978 0 2
- 0 - 0 - 0 - 0 1993300 410000 0
4 0 0 0 IDA 026699 39 14562 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48470 1#0##0 0
c82d328d8f36d62891d004e49ba2aaa3
7322003 D 3 DS 1 15/10/2018 17/10/2018 01/12/1963 0 2
1 S89.9;M19.96 81.47 0 0 None None None None M-1-70-I
None None None None None None PROSEDUR LUTUT DAN TUNGKAI BAWAH SELAIN
KAKI (RINGAN) 9992400 0 0 - 0 - 0 - 0 -
0 9992400 4445000 0 3 0 0 0 DORKAS. R 024379
0000943157823 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48471 1#0##0 0 81e5d34b81dab7c8dd3981de3c1d6f21
7322003 D 3 DS 1 15/10/2018 17/10/2018 01/08/2000 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4275000 0 3 0 0 0 MERLI 026657 18
0001072660476 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48472 1#0##0 0 fee56c5a387d211d267e19d5b7fe2176
7322003 D 3 DS 1 16/10/2018 17/10/2018 01/12/1991 0 1
1125300 0 0 - 0 - 0 - 0 - 0
1125300 375000 0 2 0 0 0 ARIF 014186 26
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48473 1#0##0
0 aeb87428bfe017fbd003faab6a80054d
7322003 D 3 DS 1 15/10/2018 17/10/2018 22/10/2001 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 585500 0 3 0 0 0 SILFI HAERUL 025668
0001604696578 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48474 1#0##0 0 18937767962e0284be9b743476248295
7322003 D 3 DS 1 15/10/2018 17/10/2018 22/12/1992 0 2
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4385500 0 3 0 0 0 NIKE SASMITHA
5.2.5.201812201302 4 48475 1#0##0 0
a34f8c2593f38a27f8821d08dee32e42
7322003 D 3 DS 1 14/10/2018 17/10/2018 01/07/1972 0 2
0 0 - 0 - 0 - 0 - 0 3492200
4480000 0 4 0 0 0 LIA 018676 46 16906 dr.
RAHMAT;7322112311880004 5.2.5.201812201302 4 48476 1#0##0 0
fae1061744f7c7eb37683fd7df77de02
7322003 D 3 DS 1 15/10/2018 17/10/2018 01/07/1996 0 1
0 0 - 0 - 0 - 0 - 0 3492200
4310000 0 3 0 0 0 OBED 026735 22 8141 dr.
RAHMAT;7322112311880004 5.2.5.201812201302 4 48477 1#0##0 0
77f7d5f2e7993a2a8e4e00df77f6b837
7322003 D 3 DS 1 16/10/2018 17/10/2018 31/12/1963 0 2
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4690500 0 2 0 0 0 H. SITTI 026345
0002047247662 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48478 1#0##0 0 cd6bc8fab6ee8d5d0b435dfef91545ad
7322003 D 3 DS 1 14/10/2018 17/10/2018 05/02/1996 0 1
0 0 - 0 - 0 - 0 - 0 5680300
4470000 0 4 0 0 0 SUKAIMAN 026697 22 8287
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48479 1#0##0
0 d1f243a7bf98fd9d7300da9888b2ad41
7322003 D 3 DS 1 15/10/2018 17/10/2018 01/08/1988 0 1
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 ASBAR 026730 30 11032 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48480 1#0##0 0
a40e6bdd96bf54cc0b4f1836a730b350
7322003 D 2 DS 1 15/10/2018 17/10/2018 04/06/2008 0 1
0 - 0 - 0 - 0 - 0 4190700 4920500
0 3 0 0 0 GALANG PUTRA BHAYANGKARA 026714 10
0001822584767 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48481 1#0##0 0 3c2f95ca64c60e5ba2c1bb2d596d5e2f
7322003 D 3 DS 1 15/10/2018 17/10/2018 20/06/1991 0 2
0 0 - 0 - 0 - 0 - 0 2134700 394500
0 3 0 0 0 UNI PRATAMI 010966 27 9979 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48482 1#0##0 0
069bc16cf0626e6b36d8d8822f51f570
7322003 D 3 DS 1 16/10/2018 17/10/2018 05/01/2012 0 1
0 - 0 1808500 885500 0 2 0 0 0 FARHAN
FAHREZI 026742 6 2476 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48483 1#0##0 0
e9b1c8a5328f13d5a3772a0c23a3ed94
7322003 D 2 DS 1 14/10/2018 17/10/2018 22/12/2017 0 1
1350400 0 0 - 0 - 0 - 0 - 0
1350400 1295500 0 4 0 0 0 MUH. AGHAM 000661
0002499217288 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48484 1#0##0 0 7a91fdb3af2bb3db87a5d2f3cd0c89cc
7322003 D 1 DS 1 15/10/2018 17/10/2018 05/05/1963 0 2
None None None None None PROSEDUR ANAL (SEDANG) 7310000 0 0
- 0 - 0 - 0 - 0 7310000 4885500 0
3 0 0 0 ALFRIDA 021844 55 20252 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48485 1#0##0 0
afc6ba9a853037da362f078a64e53e11
7322003 D 1 DS 1 24/09/2018 17/10/2018 31/12/1938 0 2
7366900 0 0 - 0 - 0 - 0 - 0
7366900 11375000 0 24 0 0 0 DJUHERAH 026000
0001078803808 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48486 1#0##0 0 401d1853731b739cd5c8e1746bf0b9ee
7322003 D 2 DS 1 15/10/2018 17/10/2018 20/11/1959 0 2
- 0 3957700 945000 0 3 0 0 0 ISEHANG
0001288846732 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48487 1#0##0 0 a879f12c5399581d7069f6fc983eee01
7322003 D 3 DS 1 16/10/2018 17/10/2018 01/07/1942 0 1
1 S89.9 - 0 0 None None None None M-4-21-I None None
None None None None GANGGUAN SISTEM MUSKULOSKELETAL & JA(RINGAN)
0 - 0 1993700 885500 0 2 0 0 0 YUSUF
MINGGU 026736 76 27866 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
5.2.5.201812201302 4 48488 1#0##0 0
30a443962be023867f3fb7be24f18160
7322003 D 3 DS 1 15/10/2018 17/10/2018 01/05/2003 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 475000 0 3 0 0 0 RAHMI 026706 15
0001072735727 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48489 1#0##0 0 0e5848c4d0584e6be300617865afe77f
7322003 D 2 DS 1 16/10/2018 17/10/2018 15/03/1999 0 2
0 0 - 0 - 0 - 0 - 0 1835700
1925000 0 2 0 0 0 RUKAYYAH ARIF 026613 19
0002464856627 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48490 1#0##0 0 aa80f5da3e783a198be21bf3c46636f8
7322003 D 3 DS 1 14/10/2018 17/10/2018 07/10/1955 0 1
1 D30.3 - 0 0 None None None None N-4-16-I None None
2495700 0 0 - 0 - 0 - 0 - 0
2495700 964000 0 4 0 0 0 EDDY PRIBADI 022488
0002419580531 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48491 1#0##0 0 119d01228e74fab356d8f8032fe23f01
7322003 D 3 DS 1 16/10/2018 17/10/2018 01/07/1996 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 FEBRIANI 026751 22 8142 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48492 1#0##0 0
c7ba3fc9086e1f2a8931e14bb5cf1561
7322003 D 3 DS 1 16/10/2018 18/10/2018 01/06/2006 0 1
0 - 0 - 0 - 0 4020700 4385500 0 3
0 0 0 ARAFIK 015316 12 4520 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48493 1#0##0 0
7bf23fcc09351b7269cc4b981ad85c79
7322003 D 3 DS 1 16/10/2018 18/10/2018 01/12/1953 0 1
1 I10;A16.2 - 0 0 None None None None I-4-17-II None
None None None None None HIPERTENSI (SEDANG) 2027400 0 0
- 0 - 0 - 0 - 0 2027400 485500 0
3 0 0 0 SIMON ANTIRU 022379 64 23695 dr. MUSMIANI
5.2.2.201806040537 4 48494 1#0##0 0
d4ba47bd5541c40e4a500570385df537
7322003 D 3 DS 1 17/10/2018 18/10/2018 05/08/1998 0 1
1 D36.7 - 0 0 None None None None C-4-14-I None None
None None None None TUMOR MYELOPROLIFERATIF LAIN-LAIN (RINGAN)
2486800 0 0 - 0 - 0 - 0 - 0
2486800 285500 0 2 0 0 0 ASBAR 025142 20
0001556917299 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48495 1#0##0 0 e7a003708516834fc058f2607f192e27
7322003 D 3 DS 1 15/10/2018 18/10/2018 01/10/1997 0 2
1 O40;O10.0;O82.8;Z37.0 74.4 0 0 None None None None O-6-
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4682500 0 4 0 0 0 SULHERA YANTI 023370
0000941909387 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48496 1#0##0 0 c7625fa1ccffb7355e6e3159095be900
7322003 D 1 DS 1 16/10/2018 18/10/2018 26/07/1974 0 2
0 0 - 0 - 0 - 0 - 0 2505400 775000
0 3 0 0 0 WISMAWATI 012543 44 16153 dr.
INDRAHAYU, Sp.S 0341R0041018V001362 0000132506886 3;JKN
INACBG;123123123123 5.2.2.201806040537 4 48497 1#0##0 0
d32ef8fd4215e29ab2a9bfd15cfd18d5
7322003 D 2 DS 1 17/10/2018 18/10/2018 20/02/1984 0 2
0 - 0 - 0 - 0 - 0 1835700 1775000
0 2 0 0 0 ROSITA 026767 34 12658 DR.ASRIYANTI
INACBG;123123123123 5.2.2.201806040537 4 48498 1#0##0 0
39039d62051578be8f043c92524fbfc7
7322003 D 3 DS 1 15/10/2018 18/10/2018 01/05/1987 0 2
5262000 0 0 - 0 - 0 - 0 - 0
5262000 4555500 0 4 0 0 0 IRMA 026727 31
0000942385634 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48499 1#0##0 0 0ce9b6d40dc8c389909b44a62303b687
7322003 D 3 DS 1 12/10/2018 18/10/2018 05/02/1942 0 1
4118400 0 0 - 0 - 0 - 0 - 0
4118400 4890500 0 7 0 0 0 SAJI 003426 76
0001867799744 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48500 1#0##0 0 be733b5b5936c2d9526f22b463dcbf16
7322003 D 3 DS 1 15/10/2018 18/10/2018 15/10/2018 3280 2
3152100 0 0 - 0 - 0 - 0 - 0
3152100 675000 0 4 0 0 0 BAYI NY SULHERIANTI
0341R0041018V001324 0002499659998 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48501 1#0##0 0
3b8f4bdcc4f7cfd4df935d6ffec23cb3
7322003 D 3 DS 1 15/10/2018 18/10/2018 15/10/2018 3640 1
None None None None NEONATAL, BERAT BADAN LAHIR GROUP-5 DENGAN SINDROMA
DISTRES PERNAFASAN (RINGAN) 3640200 0 0 - 0 - 0 -
0 - 0 3640200 675000 0 4 0 0 0 BAYI
NY YETTI KUSMAN 126705 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V001137 0002499153052 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48502 1#0##0 0
0d0649fa751d73004d0230b843e4b30c
7322003 D 3 DS 1 16/10/2018 18/10/2018 01/12/1952 0 1
9992400 0 0 - 0 - 0 - 0 - 0
9992400 4385500 0 3 0 0 0 KETUT SENTER 026383
0001072861108 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48503 1#0##0 0 b65308e6cefcc00b84b397cd3915aebe
7322003 D 3 DS 1 16/10/2018 18/10/2018 01/09/1938 0 1
0 - 0 - 0 - 0 - 0 3492200 4520500
0 3 0 0 0 KADEMEN 006010 80 29265 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48504 1#0##0 0
4d00cda699f2a5975bf1693fa0519c4f
7322003 D 3 DS 1 16/10/2018 18/10/2018 31/12/1973 0 1
0 0 - 0 - 0 - 0 - 0 5680300
4570500 0 3 0 0 0 SUDIRMAN 026743 44 16360
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48505 1#0##0
0 5e701ad4c7f10df79bb0991d3c635af2
7322003 D 3 DS 1 17/10/2018 18/10/2018 03/04/1992 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4175000 0 2 0 0 0 SURIANI 026797
0002122486222 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48506 1#0##0 0 d6398885c23318d3bd235a720c14fbc8
7322003 D 3 DS 1 16/10/2018 18/10/2018 17/10/2000 0 1
0 - 0 - 0 - 0 - 0 4413400 4520500
0 3 0 0 0 SAHRIAMIS MARADANA 023838 17 6573
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48507 1#0##0
0 8e3e81aea7137982390c96b27c46bca4
7322003 D 3 DS 1 15/10/2018 18/10/2018 01/12/1976 0 2
0 0 - 0 - 0 - 0 - 0 2485100 685500
0 4 0 0 0 JUMRANA 026740 41 15293 dr. MUSMIANI
5.2.5.201812201302 4 48508 1#0##0 0
1e9a0449a5eb073e05d7f62ad9f36f71
7322003 D 3 DS 1 15/10/2018 18/10/2018 01/01/1998 0 2
- 0 - 0 - 0 - 0 1122400 435000 0
4 0 0 0 NOVA PEBRIANTI 000940 20 7592 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48509 1#0##0 0
1b00b258e8e87ed55318861afc968211
7322003 D 1 DS 1 14/10/2018 18/10/2018 31/01/2013 0 2
1 J02.9;K30 - 0 0 None None None None U-4-13-I None
0 - 0 2531900 1585500 0 5 0 0 0 AIRA
KARTANEGARA 008645 5 2082 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48510 1#0##0 0
cd7ed3b8f63da15b2630ec9c5c6450e4
7322003 D 2 DS 1 15/10/2018 18/10/2018 05/04/2017 0 2
1350400 0 0 - 0 - 0 - 0 - 0
1350400 1235500 0 4 0 0 0 WAHDANIA HUMAIRAH
MAWADDAH 026738 1 558 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48511 1#0##0 0
9b2f7bb5e22110520ca692bdf0d09194
7322003 D 2 DS 1 12/10/2018 18/10/2018 07/07/2017 0 2
1350400 0 0 - 0 - 0 - 0 - 0
1350400 2285500 0 7 0 0 0 BAYI NY. RATIH PUSPITA
0341R0041018V001242 0002263001848 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48512 1#0##0 0
bc84dd082c8e222f0a6eb8e75f3a1ce5
7322003 D 2 DS 1 16/10/2018 18/10/2018 16/06/1982 0 1
0 - 0 - 0 - 0 - 0 4190700 4375000
0 3 0 0 0 METHUSELAH DATULINGGI, ST 026766 36
0001825371448 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48513 1#0##0 0 71206ae681ad31b8c92cd79f9dd93d5d
7322003 D 2 DS 1 16/10/2018 18/10/2018 09/08/1978 0 2
0 - 0 - 0 - 0 - 0 4190700 4520500
0 3 0 0 0 DARMAWATI 024923 40 14678 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48514 1#0##0 0
309e178294301614df4f3ce36e4477c3
7322003 D 3 DS 1 16/10/2018 18/10/2018 01/09/1981 0 2
None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-LAIN (RINGAN)
2496600 0 0 - 0 - 0 - 0 - 0
2496600 385500 0 3 0 0 0 HADANA 012300
0000941878675 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48515 1#0##0 0 29451781f6d59c5bb7a1c154147519af
7322003 D 2 DS 1 15/10/2018 18/10/2018 05/05/1976 0 2
0 0 - 0 - 0 - 0 - 0 2147500
1125000 0 4 0 0 0 ANDI TENRI NGILE 026732 42
0002139761812 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48516 1#0##0 0 7537b83f287c9b72d82dd61ec48950d2
7322003 D 3 DS 1 15/10/2018 18/10/2018 12/06/2008 0 1
(RINGAN) 9992400 0 0 - 0 - 0 - 0 - 0
9992400 5305500 0 4 0 0 0 MUH. BILAL PASYA 026720
0002071284366 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48517 1#0##0 0 e6763a78145452f6e6da05e691f3eff1
7322003 D 3 DS 1 15/10/2018 18/10/2018 02/03/1987 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 YETTI KUSMAN 026704
0001557336532 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48518 1#0##0 0 176f6b5874d8b978a7ef33c89328b090
7322003 D 3 DS 1 17/10/2018 18/10/2018 08/08/1987 0 2
0 0 - 0 - 0 - 0 - 0 1529800
1675000 0 2 0 0 0 YUNI PRIYATNA 026630 31
0001556894068 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48519 1#0##0 0 8eb43912eb0ffbadbe3ad94026c8278e
7322003 D 2 DS 1 16/10/2018 18/10/2018 06/12/1999 0 2
- 0 - 0 - 0 - 0 2376400 775000 0
3 0 0 0 SUCI CITRA ANUGRAH 026765 18 6889
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48520 1#0##0
0 54b78f8e4f363b0e56a2904903b1f379
7322003 D 2 DS 1 16/10/2018 18/10/2018 20/04/2003 0 2
PAYUDARA (RINGAN) 4034200 0 0 - 0 - 0 - 0 -
0 4034200 4520500 0 3 0 0 0 NOLA AFRIELA
5.2.5.201812201302 4 48521 1#0##0 0
ff82a05bbed73e652a376d98fecec4d0
7322003 D 2 DS 1 17/10/2018 18/10/2018 02/08/1993 0 2
1350400 0 0 - 0 - 0 - 0 - 0
1350400 625000 0 2 0 0 0 SUBAEDA 024894
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48522 1#0##0
0 8821c101c6c7a6ea02be080897922105
7322003 D 2 DS 1 16/10/2018 18/10/2018 31/12/1952 0 1
6320400 0 0 - 0 - 0 - 0 - 0
6320400 4375000 0 3 0 0 0 RUSLAN 024533
0000132569357 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48523 1#0##0 0 11f0bff6626f7b3fc0a8b7a0b129be8a
7322003 D 3 DS 1 16/10/2018 18/10/2018 21/12/1995 0 2
0 0 - 0 - 0 - 0 - 0 2485100 585500
0 3 0 0 0 DELVINA GEROSI 026746 22 8335 dr.
MUSMIANI MUIS, Sp.PD 0341R0041018V001393 0001557222862 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48524 1#0##0 0
d0d93f52b6c02a6fae95afdee052afd6
7322003 D 3 DS 1 19/10/2018 19/10/2018 08/09/1993 0 2
- 0 - 0 - 0 - 0 1461300 4175000 0
1 0 0 0 SISKA DEVI 026645 25 9172 DR.ASRIYANTI
INACBG;123123123123 5.2.2.201806040537 4 48525 1#0##0 0
6df2e751b95b8ff469641f1cd1046867
7322003 D 3 DS 1 17/10/2018 19/10/2018 01/10/2002 0 1
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 EGI 026770 16 5860 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48526 1#0##0 0
2d6fcb85127b21cb86faf034e197cca0
7322003 D 1 DS 1 17/10/2018 19/10/2018 16/09/1980 0 2
PAYUDARA (RINGAN) 4706600 0 0 - 0 - 0 - 0 -
0 4706600 4920500 0 3 0 0 0 DEWITA YUNUS
0341R0041018V001464 0000132434133 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48527 1#0##0 0
b987bcf662775a1629536a15a3a315e1
7322003 D 1 DS 1 17/10/2018 19/10/2018 20/06/1983 0 2
- 0 - 0 - 0 - 0 2772500 475000 0
3 0 0 0 MASRAWATI 012988 35 12903 DR.ASRIYANTI
INACBG;123123123123 5.2.2.201806040537 4 48528 1#0##0 0
d9566fa620d4bb0a729f9222f3f8eac2
7322003 D 3 DS 1 18/10/2018 19/10/2018 09/10/1992 0 2
- 0 - 0 - 0 - 0 1461300 4260000 0
2 0 0 0 SARLIATI 025513 26 9505 DR.ASRIYANTI
INACBG;123123123123 5.2.2.201806040537 4 48529 1#0##0 0
f49777845f98a2e7c69040764cf7f0d5
7322003 D 3 DS 1 16/10/2018 19/10/2018 01/12/1949 0 1
1 K27.9;D64.9 99.03 0 0 None None None None K-4-11-II None
None None None None None GASTRITIS & ULKUS PEPTIKUM (SEDANG) 3010700
0 0 - 0 - 0 - 0 - 0 3010700 955000
0 4 0 0 0 SAMSUDDIN 026747 68 25156 dr. MUSMIANI
5.2.2.201806040537 4 48530 1#0##0 0
6377b88a8bee12365045b57a30fc6a21
7322003 D 3 DS 1 16/10/2018 19/10/2018 01/12/1942 0 1
3300100 0 0 - 0 - 0 - 0 - 0
3300100 585000 0 4 0 0 0 KELLE 026659 75
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48531 1#0##0
0 dd4e77a35558685cddfa202ba3c511de
7322003 D 3 DS 1 13/10/2018 19/10/2018 30/06/1995 0 1
1091500 0 0 - 0 - 0 - 0 - 0
1091500 2897000 0 7 0 0 0 MUHAMMAD MUHARRANG RASID
0001831295417 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48532 1#0##0 0 c9e345b0da0674dad1d256aefcdca740
7322003 D 3 DS 1 16/10/2018 19/10/2018 26/09/1985 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4282500 0 4 0 0 0 SURYANI 026762
0001557316247 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48533 1#0##0 0 a972ff9dadc36faf572c4763df4af2ab
7322003 D 3 DS 1 16/10/2018 19/10/2018 16/10/2018 3580 1
3152100 0 0 - 0 - 0 - 0 - 0
3152100 1275000 0 4 0 0 0 BAYI NY SURYANI 026763
0002500054773 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48534 1#0##0 0 03e3c16fb4d6613c242a60d6aac4c6ad
7322003 D 3 DS 1 17/10/2018 19/10/2018 01/11/1980 0 2
7152500 0 0 - 0 - 0 - 0 - 0
7152500 4585500 0 3 0 0 0 IRA 010614 37
0000942528914 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48535 1#0##0 0 366beb175444a1e1f2ae0cd144a95996
7322003 D 3 DS 1 17/10/2018 19/10/2018 01/05/2005 0 1
1 T81.0 39.31 0 0 None None None None I-1-20-I None None
None None None None PROSEDUR SISTIM PEREDARAN DARAH LAIN-LAIN (RINGAN)
10063600 0 0 - 0 - 0 - 0 - 0
10063600 4420500 0 3 0 0 0 NASRUN 026568
0001072670387 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48536 1#0##0 0 2a8527f1dcdf71d4ebea63d1aaf15dd4
7322003 D 3 DS 1 16/10/2018 19/10/2018 16/10/2018 2860 2
3152100 0 0 - 0 - 0 - 0 - 0
3152100 575000 0 4 0 0 0 BAYI NY ELISABET 026759
0002500149464 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48537 1#0##0 0 6feacaa86650824d4717ea0c47f62988
7322003 D 3 DS 1 17/10/2018 19/10/2018 01/12/1963 0 2
1 T79.6 81.91 0 0 None None None None M-4-21-I None None
None None None None GANGGUAN SISTEM MUSKULOSKELETAL & JA(RINGAN)
0 - 0 1993700 4445000 0 3 0 0 0
DORKAS. R 024379 54 20044 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
5.2.5.201812201302 4 48538 1#0##0 0
9858d77def4c84e713879bff754f3908
7322003 D 3 DS 1 16/10/2018 19/10/2018 16/10/2018 2340 2
(RINGAN) 4728100 0 0 - 0 - 0 - 0 - 0
4728100 2175000 0 4 0 0 0 BAYI NY ANI 026764
0002500008502 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48539 1#0##0 0 f37c1cbb321d4edfe56e1c6279768cd4
7322003 D 3 DS 1 16/10/2018 19/10/2018 01/07/1972 0 2
1 I11.0;K76.1 - 0 0 None None None None I-4-12-II None
None None None None None KEGAGALAN JANTUNG (SEDANG) 2714800 0
0 - 0 - 0 - 0 - 0 2714800 3340000
0 4 0 0 0 NURSAINI 026745 46 16908 dr. MUSMIANI
MUIS, Sp.PD 0341R0041018V001373 0002293803551 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48540 1#0##0 0
fd862c2090a31e6da5173dffd88f42e1
7322003 D 2 DS 1 17/10/2018 19/10/2018 31/12/1918 0 1
6320400 0 0 - 0 - 0 - 0 - 0
6320400 4775000 0 3 0 0 0 BALLAO DAMO' 021123
0002287051007 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48541 1#0##0 0 23ccb9c3d8fdbbaaa7e3e50dc9a315bf
7322003 D 3 DS 1 17/10/2018 19/10/2018 31/12/1950 0 1
2495700 0 0 - 0 - 0 - 0 - 0
2495700 275000 0 3 0 0 0 PETRUS ANGIN 025598
0002487111906 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48542 1#0##0 0 5aa8c312f28c904884fefdf01d4d4f03
7322003 D 1 DS 1 16/10/2018 19/10/2018 01/07/1959 0 2
1582000 0 0 - 0 - 0 - 0 - 0
1582000 775000 0 4 0 0 0 MASTIA 025626
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48543 1#0##0
0 5f8d505654b2424abde39902ca75d8cd
7322003 D 1 DS 1 16/10/2018 19/10/2018 31/12/1965 0 2
1 E04.1 06.2 0 0 None None None None E-1-20-I None None
None None None None PROSEDUR PADA TIROID, PARATIROID DAN SALURAN
TIROGLOSAL (RINGAN) 7105900 0 0 - 0 - 0 - 0
- 0 7105900 5099000 0 4 0 0 0 SERIHARTI
5.2.5.201812201302 4 48544 1#0##0 0
5c9640e02914134b8de33863c2af279b
7322003 D 2 DS 1 19/10/2018 19/10/2018 29/12/1986 0 2
1356000 0 0 - 0 - 0 - 0 - 0
1356000 425000 0 1 0 0 0 NURMIATI 011326
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48545 1#0##0
0 40e7e29eb842ef87ec023da87a7081ee
7322003 D 2 DS 1 16/10/2018 19/10/2018 16/10/2018 4220 1
None None None None None NEONATAL, BBL > 2499 GR TANPA PROSEDUR MAYOR
(RINGAN) 3782500 0 0 - 0 - 0 - 0 - 0
3782500 1425000 0 4 0 0 0 BAYI NY RUTH SA'BI
5.2.5.201812201302 4 48546 1#0##0 0
395cce9a5a1f8a3a5d92222d14000840
7322003 D 2 DS 1 16/10/2018 19/10/2018 05/06/1986 0 2
0 0 - 0 - 0 - 0 - 0 5370500
5372500 0 4 0 0 0 RUTH SA'BI 026632 32 11821
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48547 1#0##0
0 f84f79e231cbd58ed16a59590208d1f3
7322003 D 2 DS 1 18/10/2018 19/10/2018 17/06/1982 0 1
1356000 0 0 - 0 - 0 - 0 - 0
1356000 425000 0 2 0 0 0 RAIS 017725 36
INACBG;123123123123 5.2.5.201812201302 4 48548 1#0##0 0
5d9962f85f18d3cb7467e707efde8ab5
7322003 D 3 DS 1 15/10/2018 19/10/2018 01/12/1972 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4842000 0 5 0 0 0 ANI 024079 45
0001072661139 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48549 1#0##0 0 d1a529b910a0ce79c12cdb2a526248b5
7322003 D 3 DS 1 18/10/2018 19/10/2018 21/07/1994 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 SARWANA 026404 24 8855 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48550 1#0##0 0
6dbd975a5d7c1309d0f633e25e19adf6
7322003 D 1 DS 1 16/10/2018 19/10/2018 01/07/1950 0 2
1575500 0 0 - 0 - 0 - 0 - 0
1575500 1125000 0 4 0 0 0 SITTI BAEDA 023070
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48551 1#0##0
0 3a1c0ebcad5407ba8c104297a5ece424
7322003 D 3 DS 1 15/10/2018 19/10/2018 01/04/1984 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4722500 0 5 0 0 0 ELISABET 024710
0000941930921 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48552 1#0##0 0 bc4e89b540a86f487e2a841dacc57856
7322003 D 3 DS 1 18/10/2018 20/10/2018 01/07/1942 0 1
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4275000 0 3 0 0 0 Nengah Kantin 006795
0001845456838 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48553 1#0##0 0 1b68da14c82ad7eb9a455db15e49f227
7322003 D 3 DS 1 18/10/2018 20/10/2018 05/07/1988 0 2
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4420500 0 3 0 0 0 MEGAWATI 026814
0002495974421 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48554 1#0##0 0 0a721198d0c3264aa45d814abce0c3cb
7322003 D 3 DS 1 19/10/2018 20/10/2018 01/07/1983 0 2
- 0 - 0 - 0 - 0 1461300 4210000 0
2 0 0 0 HERNITA 024733 35 12894 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48555 1#0##0 0
f8dd60922cb4972003570f99c6807306
7322003 D 3 DS 1 17/10/2018 20/10/2018 10/11/1988 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4772500 0 4 0 0 0 RESTYANI 026789
0002487952001 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48556 1#0##0 0 74b5f77da323fe65ab1030a2c9568d75
7322003 D 3 DS 1 17/10/2018 20/10/2018 01/12/1996 0 1
0 - 0 - 0 - 0 - 0 3492200 4555500
0 4 0 0 0 RAIS 026795 21 7990 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48557 1#0##0 0
b8767f005201fc986e431d2fee2ef6c5
7322003 D 3 DS 1 18/10/2018 20/10/2018 01/01/1982 0 2
- 0 - 0 - 0 - 0 1980300 275000 0
3 0 0 0 RASNI 019553 36 13439 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48558 1#0##0 0
15e502c33dab84dadfc3bbc933b6fd08
7322003 D 1 DS 1 18/10/2018 20/10/2018 28/10/1975 0 2
1582000 0 0 - 0 - 0 - 0 - 0
1582000 475000 0 3 0 0 0 MURNI JAYA 011494
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48559 1#0##0
0 446ad4203d1f13e898883e2c4ad03503
7322003 D 3 DS 1 18/10/2018 20/10/2018 01/05/1994 0 1
0 0 - 0 - 0 - 0 - 0 2485100 385500
0 3 0 0 0 DIRMAN 026828 24 8936 dr. MUSMIANI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48560 1#0##0 0
4eeb5e61976e959d08154fb0c89b19ea
7322003 D 3 DS 1 17/10/2018 20/10/2018 01/12/1930 0 1
1 I20.9;I11.9 - 0 0 None None None None I-4-20-I None
2752800 0 0 - 0 - 0 - 0 - 0
2752800 735500 0 4 0 0 0 RUSMIN 026796
0000941527168 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48561 1#0##0 0 0722e91484a5338e9783e678235f5f3c
7322003 D 1 DS 1 18/10/2018 20/10/2018 01/07/1930 0 2
- 0 4617300 1004500 0 3 0 0 0 WARI 026825
0001820284705 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48562 1#0##0 0 89fc7e2a8cee90dfd86ce8c5cca5bdd5
7322003 D 1 DS 1 19/10/2018 20/10/2018 22/07/2010 0 2
0 - 0 2531900 585500 0 2 0 0 0 AQILAH
FAUZIYAH RIFAI 023311 8 3011 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48563 1#0##0 0
2d4a1c38300dfef5b877866849ea3198
7322003 D 3 DS 1 18/10/2018 20/10/2018 05/12/1994 0 2
- 0 - 0 - 0 - 0 1980300 275000 0
3 0 0 0 IRMAWATI 026824 23 8718 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48564 1#0##0 0
3ce2001792fe67f7bc8d435eba0b00e6
7322003 D 3 DS 1 18/10/2018 20/10/2018 03/05/1992 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4275000 0 3 0 0 0 MASRIANI 026787
0000938074408 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48565 1#0##0 0 8434500c6a2b7c2cfffb9c2a9c8e6879
7322003 D 3 DS 1 13/10/2018 20/10/2018 03/01/2000 0 2
LAIN (RINGAN) 2645200 0 0 - 0 - 0 - 0 -
0 2645200 1205500 0 8 0 0 0 NUR AISYA 026689
0000941854972 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48566 1#0##0 0 6f69c956b4e905c9a184c42abbf6edfe
7322003 D 3 DS 1 17/10/2018 21/10/2018 31/12/1968 0 1
4118400 0 0 - 0 - 0 - 0 - 0
4118400 4855500 0 5 0 0 0 ROHMAN 026786
0001935191913 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48567 1#0##0 0 0a0ffb52972283bf5c7da400b17d1e97
7322003 D 2 DS 1 19/10/2018 21/10/2018 24/03/1976 0 1
0 - 0 - 0 - 0 1431400 375000 0 3
0 0 0 RUDY ABSALON 023515 42 15549 DR.LILA NASIKHAH
5.2.5.201812201302 4 48568 1#0##0 0
5cf7635b4258476317c92a7cd88e897e
7322003 D 2 DS 1 17/10/2018 21/10/2018 16/07/1987 0 2
1 O33.0;O82.8;Z37.0;O99.0 74.4;99.03 0 0 None None None None
O-6-10-II None None None None None None OPERASI PEMBEDAHAN CAESAR
(SEDANG) 5681500 0 0 - 0 - 0 - 0 - 0
5681500 5722500 0 5 0 0 0 SILVAH 026799
0001259045638 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48569 1#0##0 0 ac15e29a200af524ac67ae23f53d9f25
7322003 D 1 DS 1 20/10/2018 21/10/2018 15/11/1988 0 2
0 - 0 - 0 - 0 - 0 2141700 1675000
0 2 0 0 0 KARTINI 026860 29 10931 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48570 1#0##0 0
359e50b1014ce0a9039c73600a74d08f
7322003 D 3 DS 1 19/10/2018 22/10/2018 28/07/1984 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 MARHANI 026841
0001090592728 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48571 1#0##0 0 be793273a3d553621fc9d70458246f27
7322003 D 3 DS 1 20/10/2018 22/10/2018 26/12/2002 0 2
0 - 0 1808500 275000 0 3 0 0 0
NURHAFIDAH JAMA'ANG 026864 15 5777 dr. MUSMIANI MUIS, Sp.PD
0341R0041018V001690 0001560241293 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48572 1#0##0 0
535870bc531be20b0341a03771b4f177
7322003 D 3 DS 1 19/10/2018 22/10/2018 18/10/2018 2080 1
(RINGAN) 4728100 0 0 - 0 - 0 - 0 - 0
4728100 2775000 0 4 0 0 0 BAYI NY NURLAELA 026821
0002500697586 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48573 1#0##0 0 eeeda3700efe456b9fe5715fc01854ff
7322003 D 3 DS 1 17/10/2018 22/10/2018 01/12/1960 0 1
- 0 - 0 - 0 - 0 2342200 1395500 0
6 0 0 0 SIRAT 026804 57 21139 dr. MUSMIANI MUIS, Sp.PD
5.2.5.201812201302 4 48574 1#0##0 0
f206eb394e95a76ff934da8d649ef77c
7322003 D 3 DS 1 19/10/2018 22/10/2018 19/10/2018 2940 2
0 - 0 - 0 1624900 2235000 0 4 0 0
0 BAYI NY RISNA 026829 0 0 DR. MULYANI KADIR,
SP.A,.M.KES. 0341R0041018V001594 0002500694741 3;JKN
INACBG;123123123123 5.2.5.201812201302 4 48575 1#0##0 0
f38c9f37d0dcbc987ee352646455cbc0
7322003 D 3 DS 1 19/10/2018 22/10/2018 03/07/1945 0 1
1 I12.9 - 0 0 None None None None N-4-16-I None None
2495700 0 0 - 0 - 0 - 0 - 0
2495700 754500 0 4 0 0 0 TAHIR 005257 73
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48576 1#0##0
0 c0ebd204ea87e4950f3f3c5be2f523aa
7322003 D 3 DS 1 18/10/2018 22/10/2018 17/05/1995 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4717500 0 5 0 0 0 RISNA 026047 23
0000942446349 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48577 1#0##0 0 2362f605c365a2adf87e27f246707291
7322003 D 1 DS 1 20/10/2018 22/10/2018 17/05/1948 0 1
0 - 0 - 0 - 0 2438000 475000 0 3
0 0 0 KAISSANAN PASABAK 026854 70 25723 dr. AWALUDDIN H.,
5.2.5.201812201302 4 48578 1#0##0 0
e82d05dc9a002bc640a163f57f7f348e
7322003 D 3 DS 1 07/10/2018 22/10/2018 07/12/1992 0 2
1 O21.0;A01.0 - 0 0 None None None None W-4-16-III None
None None None None None GANGGUAN ANTEPARTUM (BERAT) 3589200 0
0 - 0 - 0 - 0 - 0 3589200 2335000
0 16 0 0 0 MULIATI 005017 25 9435 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48579 1#0##0 0
a8874431867045d243df5215ac2d49f2
7322003 D 3 DS 1 21/10/2018 22/10/2018 31/12/1955 0 2
1 S42.01 - 0 0 None None None None M-4-12-I None
None None None None None FRAKTUR/DISLOKASI SELAIN FEMUR DAN PELVIS
(RINGAN) 1990300 0 0 - 0 - 0 - 0 - 0
1990300 325000 0 2 0 0 0 HJ. NURHAYATI 025130
0002471991333 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48580 1#0##0 0 cf60cd364712f209b0593d8ad298e7ba
7322003 D 3 DS 1 20/10/2018 22/10/2018 12/05/1997 0 2
0 - 0 - 0 - 0 3217900 585500 0 3
0 0 0 WAYAN LISTIAWATI 022993 21 7831 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48581 1#0##0 0
ccaeeaf8dfc60151dcc2c287629998c8
7322003 D 3 DS 1 17/10/2018 22/10/2018 01/07/1966 0 1
3960700 0 0 - 0 - 0 - 0 - 0
3960700 845000 0 6 0 0 0 MUSA 014170 52
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48582 1#0##0
0 ef5fa7ced8303635478faacbafc99de4
7322003 D 3 DS 1 18/10/2018 22/10/2018 01/07/1986 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4722500 0 5 0 0 0 NURLELA 024245
0002076811525 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48583 1#0##0 0 3d44e8ee34576d8f93a74be4c3295b02
7322003 D 3 DS 1 19/10/2018 22/10/2018 19/10/2018 2730 1
3152100 0 0 - 0 - 0 - 0 - 0
3152100 475000 0 4 0 0 0 BAYI NY. MARHANI 026846
0002501090019 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48584 1#0##0 0 023c2307892b639a0c2c442c81878d41
7322003 D 1 DS 1 18/10/2018 22/10/2018 31/12/1950 0 1
1 E11.2;D64.9 99.03 0 0 None None None None N-4-16-II None
None None None None None PENYAKIT GINJAL DAN SALURAN URIN LAIN-LAIN
(SEDANG) 4987100 0 0 - 0 - 0 - 0 - 0
4987100 1934000 0 5 0 0 0 B A K R I 021812
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48585 1#0##0
0 9d42ee2b92d6eafa40167c81cc76d376
7322003 D 3 DS 1 20/10/2018 22/10/2018 03/03/1940 0 1
- 0 - 0 - 0 - 0 1741400 575000 0
3 0 0 0 DANIEL NARI 014658 78 28720 dr. AWALUDDIN H.,
5.2.5.201812201302 4 48586 1#0##0 0
337588b252341f949ccf0a1f7e32c325
7322003 D 3 DS 1 18/10/2018 22/10/2018 31/12/1964 0 1
1 K30;J06.9 - 0 0 None None None None K-4-18-I None
1130000 0 0 - 0 - 0 - 0 - 0
1130000 1775000 0 5 0 0 0 SINTO 012630 53
ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48587 1#0##0
0 5e8e12236bb3501186f0dae502449c93
7322003 D 3 DS 1 20/10/2018 23/10/2018 01/07/1964 0 2
1 S20.2;S49.9 - 0 0 None None None None L-4-13-I None
None None None None None TRAUMA PADA KULIT, JARINGAN BAWAH KULIT DAN
PAYUDARA (RINGAN) 2244500 0 0 - 0 - 0 - 0 -
0 2244500 703500 0 4 0 0 0 HASIRA 013100
0002023414108 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48588 1#0##0 0 2be71f0fa4ae0a0c3adf0073443d0144
7322003 D 2 DS 1 20/10/2018 23/10/2018 22/12/1991 0 1
0 0 - 0 - 0 - 0 - 0 2982100
1115500 0 4 0 0 0 FRANS ARIS PAELO 025788 26
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48589 1#0##0
0 dc724033ef7d74209147db86207b4d12
7322003 D 3 DS 1 17/10/2018 23/10/2018 01/05/1998 0 2
1 Z54.0;C85.9;Z54.2;K30 - 0 0 None None None None Z-4-
12-II None None None None None None FAKTOR-FAKTOR YANG MEMPENGARUHI STATUS
KESEHATAN LAIN-LAIN (SEDANG) 1914500 0 0 - 0 - 0 -
0 - 0 1914500 2206500 0 7 0 0 0 SUKMA
WANTI 014227 20 7474 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
0341R0041018V001483 0001879656783 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48590 1#0##0 0
bd7fff08e2e5ce2dcf7bafb4a45aae9e
7322003 D 3 DS 1 21/10/2018 23/10/2018 01/06/1986 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 275000 0 3 0 0 0 SRI HANDAYANI 026869
0000942763691 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48591 1#0##0 0 7d29f0bb495ad1093e6e912849e58dc3
7322003 D 3 DS 1 21/10/2018 23/10/2018 01/12/1967 0 2
0 - 0 - 0 - 0 1741400 585500 0 3
0 0 0 ADOLVINA 026874 50 18587 dr. MUSMIANI MUIS, Sp.PD
0341R0041018V001708 0000941344424 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48592 1#0##0 0
bc7a70a7afd66eeb841d80771f5456fe
7322003 D 3 DS 1 17/10/2018 23/10/2018 01/06/1978 0 1
1 A16.2;B37.0 - 0 0 None None None None J-4-15-II None
None None None None None PERADANGAN DAN INFEKSI PERNAFASAN (SEDANG)
4731900 0 0 - 0 - 0 - 0 - 0
4731900 995500 0 7 0 0 0 ANTONIUS PASAPAN 026800
0000940981869 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48593 1#0##0 0 6bd19452fcb8fcbc631be6ea0e1de2ab
7322003 D 3 DS 1 12/10/2018 23/10/2018 31/07/1950 0 1
1 S72.91;S72.9;S20.2 - 0 0 None None None None M-4-
10-I None None None None None None FRAKTUR FEMUR (RINGAN) 2001000 0
0 - 0 - 0 - 0 - 0 2001000 4135500
0 12 0 0 0 M. ASNGARI 026671 68 24910 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48594 1#0##0 0
66bf1378f542d9003d7828c5d7cbf3af
7322003 D 3 DS 1 16/10/2018 23/10/2018 17/12/1988 0 2
1 D34 06.4 0 0 None None None None E-1-20-I None None
- 0 5075600 7115500 0 8 0 0 0 MEGAWATI
0341R0041018V001371 0000941686874 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48595 1#0##0 0
259bce5c9213be184e01c4246cdb59df
7322003 D 3 DS 1 21/10/2018 23/10/2018 01/10/2001 0 2
1 K21.9;J06.9 - 0 0 None None None None K-4-12-I None
0 - 0 - 0 - 0 - 0 1995300 385500
0 3 0 0 0 ALDA 019999 17 6229 dr. MUSMIANI MUIS,
5.2.5.201812201302 4 48596 1#0##0 0
9a3550564985279b0bcc4cf912e6a2fa
7322003 D 1 DS 1 21/10/2018 23/10/2018 31/12/1952 0 2
1 I11.0;E11.9 - 0 0 None None None None I-4-12-I None
None None None None None KEGAGALAN JANTUNG (RINGAN) 3279000 0
0 - 0 - 0 - 0 - 0 3279000 1245000
0 3 0 0 0 NY.JUMALLAH 026260 65 24035 dr.
RAHMAT;7322112311880004 5.2.5.201812201302 4 48597 1#0##0 0
89f1733c852a5b2d0032bdb763533f13
7322003 D 3 DS 1 21/10/2018 23/10/2018 01/10/2002 0 1
- 0 - 0 - 0 - 0 1993300 275000 0
3 0 0 0 ARIF 026872 16 5864 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48598 1#0##0 0
71e795d988068383445e20f88202c4e0
7322003 D 3 DS 1 17/10/2018 23/10/2018 09/02/2000 0 2
1 E04.9 06.39 0 0 None None None None E-1-20-I None None
- 0 5075600 7885500 0 7 0 0 0 YULFIANI
0341R0041018V001505 0001604634557 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48599 1#0##0 0
2a3f35a5dc43a02ef08650f88aadf9ec
7322003 D 1 DS 1 21/10/2018 23/10/2018 04/07/1978 0 2
1582000 0 0 - 0 - 0 - 0 - 0
1582000 475000 0 3 0 0 0 JUMLIANA, S.PD.SD 026871
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48600 1#0##0
0 71481338aede93e4b9679c73090f7032
7322003 D 3 DS 1 22/10/2018 24/10/2018 10/02/2002 0 1
0 - 0 - 0 - 0 - 0 3492200 4520500
0 3 0 0 0 ALFONS VEBRIAN 026900 16 6098 dr.
INACBG;123123123123 5.2.2.201806040537 4 48601 1#0##0 0
334acc4b3d879bd1e321e04aa695a5f9
7322003 D 2 DS 1 22/10/2018 24/10/2018 05/08/1965 0 2
7198500 0 0 - 0 - 0 - 0 - 0
7198500 4555500 0 3 0 0 0 SADARIA 026582
0001560245321 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48602 1#0##0 0 397ebf4f122bc24ba2fe4002f7884470
7322003 D 3 DS 1 21/10/2018 24/10/2018 01/07/1987 0 2
0 - 0 5393500 4580000 0 4 0 0 0 RAENA
0341R0041018V001689 0000936288459 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48603 1#0##0 0
bb1b18c56881642162dba8958c488131
7322003 D 3 DS 1 22/10/2018 24/10/2018 29/04/2003 0 2
7152500 0 0 - 0 - 0 - 0 - 0
7152500 4385500 0 3 0 0 0 MITA 026895 15
0002496446493 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48604 1#0##0 0 2df89de50996d652a62074f1740adbda
7322003 D 3 DS 1 22/10/2018 24/10/2018 23/03/2013 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 DZAQIA QURROTUN A'YUN 026896 5 2039
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48605 1#0##0
0 735d52d54ca27c1d58ca1c2a18f33ec7
7322003 D 3 DS 1 22/10/2018 24/10/2018 01/04/1997 0 2
0 - 0 - 0 - 0 - 0 4413400 4385500
0 3 0 0 0 NUR ASMI 008840 21 7874 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48606 1#0##0 0
a38cc2cc0e3e3f36d4711286c7f46591
7322003 D 3 DS 1 22/10/2018 24/10/2018 01/12/1978 0 2
11138600 0 0 - 0 - 0 - 0 - 0
11138600 4385500 0 3 0 0 0 HASRIPAH 025732
0000941986247 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48607 1#0##0 0 a31729764ee90b478298f39ac478cac7
7322003 D 3 DS 1 24/10/2018 24/10/2018 22/07/1984 0 1
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4420500 0 1 0 0 0 JONI SAMOLI 026958
0001557303625 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48608 1#0##0 0 8d2dc00cbf52fc4a6b4c5348c4e2a488
7322003 D 1 DS 1 22/10/2018 24/10/2018 14/05/2002 0 2
PAYUDARA (RINGAN) 4706600 0 0 - 0 - 0 - 0 -
0 4706600 4920500 0 3 0 0 0 NANDA MEILANI
JUFRI 026220 16 6005 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
0341R0041018V001925 0001099701843 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48609 1#0##0 0
8217656d7a18aacbd61d8d1fcfac881c
7322003 D 3 DS 1 22/10/2018 24/10/2018 01/07/1969 0 2
None None None None PROSEDUR INTESTINAL KOMPLEKS (RINGAN) 7974500
0 0 - 0 - 0 - 0 - 0 7974500
4420500 0 3 0 0 0 JAHRA 025349 49 18010 dr.
RAHMAT;7322112311880004 5.2.5.201812201302 4 48610 1#0##0 0
1d0ec8d399cd08e11a97442a778ff5a3
7322003 D 3 DS 1 22/10/2018 24/10/2018 25/01/1995 0 1
0 - 0 - 0 - 0 - 0 3492200 4480000
0 3 0 0 0 MUH. YUSANDY 026883 23 8671 dr.
RAHMAT;7322112311880004 5.2.5.201812201302 4 48611 1#0##0 0
5ed64e07a303aca88596dabcfdb6895d
7322003 D 3 DS 1 22/10/2018 24/10/2018 01/12/1999 0 1
0 0 - 0 - 0 - 0 - 0 3492200
4420500 0 3 0 0 0 ASRUL 026884 18 6900 dr.
RAHMAT;7322112311880004 5.2.5.201812201302 4 48612 1#0##0 0
f70b136b3bd623bbe3ff3ca854416a3f
7322003 D 3 DS 1 22/10/2018 24/10/2018 01/07/1968 0 1
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4555500 0 3 0 0 0 SATIA 026897
0001941452662 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48613 1#0##0 0 08a913556d93a21d5a78aaaceca93c82
7322003 D 3 DS 1 22/10/2018 24/10/2018 01/07/1952 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4420500 0 3 0 0 0 MABBE 026541 66
0001604791844 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48614 1#0##0 0 48effac23c97cd8b03f6218628dcf6f8
7322003 D 1 DS 1 24/10/2018 24/10/2018 24/10/2018 3000 2
None None None None None NEONATAL, BERAT BADAN LAHIR GROUP-5 DENGAN
SINDROMA DISTRES PERNAFASAN (RINGAN) 5096300 0 0 - 0 -
0 - 0 - 0 5096300 675000 0 1 0 0
0 BAYI NY SILVIAH 026939 0 0 DR. MULYANI KADIR,
SP.A,.M.KES. 0341R0041018V002109 0002502575684 3;JKN ANDI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48615 1#0##0 0
f1975862e7a5424f58a37557bf5ccbb1
7322003 D 3 DS 1 23/10/2018 24/10/2018 01/09/1995 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4175000 0 2 0 0 0 SUCI 012100 23
0000941700622 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48616 1#0##0 0 85e7926d12ad1b65d149a70d3264b79e
7322003 D 2 DS 1 24/10/2018 24/10/2018 01/07/1975 0 2
0 - 0 - 0 - 0 - 0 1835700 1725000
0 1 0 0 0 SUYATI 026934 43 15821 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48617 1#0##0 0
f37ca4d0c6f6581d66cdcbdcb603f607
7322003 D 3 DS 1 22/10/2018 24/10/2018 01/05/1952 0 2
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4445000 0 3 0 0 0 KAMINI 026885
0000942987262 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48618 1#0##0 0 7e4c78bf97fc3f6f488f1f46783889e4
7322003 D 3 DS 1 23/10/2018 24/10/2018 01/12/1970 0 1
None None None None INFARK MYOKARD AKUT (RINGAN) 2648200 0 0
- 0 - 0 - 0 - 0 2648200 2485500 0
2 0 0 0 MULLAR 026862 47 17493 dr. MUSMIANI MUIS,
5.2.5.201812201302 4 48619 1#0##0 0
ee885d58055080d82027bce0eb03c227
7322003 D 3 DS 1 22/10/2018 24/10/2018 07/07/1993 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 275000 0 3 0 0 0 PUSPITA AYU LESTARI
0002240760205 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48620 1#0##0 0 85b3e954391bb239920301973a1d7362
7322003 D 1 DS 1 17/10/2018 24/10/2018 01/07/1943 0 2
1 B90.9;I11.9 - 0 0 None None None None J-4-19-I None
None None None None None PENYAKIT PARU INTERSTITIAL (RINGAN) 4912000
0 0 - 0 - 0 - 0 - 0 4912000
2904500 0 8 0 0 0 MAIDA 026803 75 27502 dr.
INACBG;123123123123 5.2.5.201812201302 4 48621 1#0##0 0
ca16ce272509f9a3ad20e232157ddcde
7322003 D 1 DS 1 20/10/2018 24/10/2018 10/01/1960 0 2
1 J18.0;K30 - 0 0 None None None None J-4-16-I None
None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (RINGAN)
4620100 0 0 - 0 - 0 - 0 - 0
4620100 1515000 0 5 0 0 0 SITTI SUHERAH 026855
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48622 1#0##0
0 5a938d56ecccd8b9aca99874582fcb23
7322003 D 1 DS 1 22/10/2018 24/10/2018 07/06/1955 0 1
0 - 0 7550900 4715000 0 3 0 0 0 EFRAIN
PADINDIK,SH 026898 63 23148 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
5.2.5.201812201302 4 48623 1#0##0 0
b71be2d14709965e73eaef436125a998
7322003 D 3 DS 1 22/10/2018 24/10/2018 14/04/2004 0 2
None None None None GANGGUAN SALURAN EMPEDU LAIN-LAIN (RINGAN)
2836000 0 0 - 0 - 0 - 0 - 0
2836000 585500 0 3 0 0 0 JOVITA 026772
0000943011639 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48624 1#0##0 0 d2664b9c30b008b81adb6e944a95283c
7322003 D 1 DS 1 22/10/2018 24/10/2018 15/03/1950 0 1
8398300 0 0 - 0 - 0 - 0 - 0
8398300 4620500 0 3 0 0 0 DRS. RUSDIN ISMAIL
5.2.5.201812201302 4 48625 1#0##0 0
6826a1cd1742c597b0817718ea939177
7322003 D 3 DS 1 23/10/2018 25/10/2018 22/10/2018 2570 1
3152100 0 0 - 0 - 0 - 0 - 0
3152100 675000 0 3 0 0 0 BAYI NY. FIRLI 026891
0002501580789 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48626 1#0##0 0 8efae50aa683e5802b422d1df4fe2574
7322003 D 3 DS 1 23/10/2018 25/10/2018 01/07/1942 0 1
1 K27.9;D64.9;I10 99.03 0 0 None None None None K-4-11-II
None None None None None None GASTRITIS & ULKUS PEPTIKUM (SEDANG)
3010700 0 0 - 0 - 0 - 0 - 0
3010700 835500 0 3 0 0 0 GARITING 010471
0000942693322 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48627 1#0##0 0 5f6e3d5e9acad6f47322d449f16e30ea
7322003 D 3 DS 1 23/10/2018 25/10/2018 01/09/1984 0 2
0 - 0 - 0 - 0 4020700 4385500 0 3
0 0 0 ETI 026929 34 12470 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48628 1#0##0 0
319223a9c39819e27afbc3c1752fb734
7322003 D 3 DS 1 22/10/2018 25/10/2018 31/12/1962 0 1
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4615000 0 4 0 0 0 BASRI 026905
0001875990317 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48629 1#0##0 0 c7ad83b6402837dbb68c6eabf84ed4bd
7322003 D 3 DS 1 22/10/2018 25/10/2018 23/06/2013 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 1035500 0 4 0 0 0 AISYAH 026902
0001834008513 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48630 1#0##0 0 7c7531d08c8a4e8c2e19ad55e1070e62
7322003 D 3 DS 1 24/10/2018 25/10/2018 25/04/1999 0 1
1 T65.9;K21.9 - 0 0 None None None None S-4-12-I None
None None None None None KERACUNAN TERMASUK KERACUNAN OBAT (RINGAN)
1346900 0 0 - 0 - 0 - 0 - 0
1346900 504500 0 2 0 0 0 IWAN ASRIAN 009225
0002081718549 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48631 1#0##0 0 3bb148539cdb9409a8298097a41393c7
7322003 D 2 DS 1 21/10/2018 25/10/2018 28/12/1985 0 2
1 O00.9;O99.0 65.49;99.03 0 0 None None None None W-1-20-II
None None None None None None PROSEDUR PADA RAHIM & ADNEKSA (SEDANG)
8367600 0 0 - 0 - 0 - 0 - 0
8367600 6335500 0 5 0 0 0 RATNAWATI DESI, SE
0341R0041018V001713 0001440178345 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48632 1#0##0 0
9deb5be519562715fa65ce33dc579271
7322003 D 3 DS 1 22/10/2018 25/10/2018 01/05/1975 0 1
0 - 0 - 0 - 0 - 0 3492200 765000
0 4 0 0 0 IRSAM 026700 43 15880 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48633 1#0##0 0
c44bb637257f617c836855f65194f0ad
7322003 D 3 DS 1 24/10/2018 25/10/2018 01/01/1992 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4175000 0 2 0 0 0 SITI FATIMAH 026951
0001090590726 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48634 1#0##0 0 d6867b623317314bb1a05948d653dbc5
7322003 D 3 DS 1 21/10/2018 25/10/2018 01/04/1925 0 1
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4735000 0 5 0 0 0 GUNNA 012585 93
0000941754262 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48635 1#0##0 0 1368e2420da32b615116d70f099568f9
7322003 D 3 DS 1 22/10/2018 25/10/2018 01/08/1963 0 2
(RINGAN) 9992400 0 0 - 0 - 0 - 0 - 0
9992400 4555500 0 4 0 0 0 MUNA ROSADI 000490
0000941750998 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48636 1#0##0 0 34324be3913f25352ff8fa53846986ba
7322003 D 3 DS 1 23/10/2018 25/10/2018 01/12/1958 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 YUSPINA ROMBE 026914 59 21876 dr.
INACBG;123123123123 5.2.5.201812201302 4 48637 1#0##0 0
33e1c85fa1c7cfd36f9f785d022a5a84
7322003 D 3 DS 1 22/10/2018 25/10/2018 31/12/1955 0 2
0 - 0 - 0 - 0 - 0 3492200 4670500
0 4 0 0 0 ITEJA 026882 62 22941 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48638 1#0##0 0
bc212d283b937d0ce199ebe2371037af
7322003 D 3 DS 1 22/10/2018 25/10/2018 24/05/2011 0 2
0 0 - 0 - 0 - 0 - 0 2022000 575000
0 4 0 0 0 MAWARIDATUS SOFIYAH 026877 7 2708
DR. MULYANI KADIR, SP.A,.M.KES. 0341R0041018V001736 0001846832084
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48639 1#0##0
0 f9e5bb8f4998a204c899a3aa15c43e4a
7322003 D 3 DS 1 22/10/2018 25/10/2018 31/12/1954 0 2
0 - 0 - 0 - 0 - 0 4413400 5440500
0 4 0 0 0 INAWATI 026901 63 23306 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48640 1#0##0 0
7263ad96fb4cce24f74d2922e80cfd51
7322003 D 3 DS 1 20/10/2018 25/10/2018 23/07/1983 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 5072500 0 6 0 0 0 NURHASNIATI 026865
0002490444742 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48641 1#0##0 0 d19f6ac14e57459055cc883fab36f554
7322003 D 3 DS 1 23/10/2018 25/10/2018 12/03/2014 0 2
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4420500 0 3 0 0 0 ULFA SARI 024084
0002023027391 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48642 1#0##0 0 b317fd570c52fe903613b5694c7967dc
7322003 D 1 DS 1 21/10/2018 25/10/2018 02/10/1970 0 2
1 D34;A09.9 - 0 0 None None None None E-4-13-I None
None None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-LAIN (RINGAN)
3495200 0 0 - 0 - 0 - 0 - 0
3495200 1755500 0 5 0 0 0 SAMARIA 005010
0000164288597 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48643 1#0##0 0 79846f42659ba099624a20ad86da3c81
7322003 D 3 DS 1 23/10/2018 25/10/2018 12/04/1978 0 1
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4485500 0 3 0 0 0 MUHLASON PRIYANTO 026908
0001730474357 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48644 1#0##0 0 5cd25af5749f4606025c612ed667300e
7322003 D 3 DS 1 23/10/2018 25/10/2018 19/05/1992 0 1
PAYUDARA (RINGAN) 3361800 0 0 - 0 - 0 - 0 -
0 3361800 4385500 0 3 0 0 0 YEHESKIEL 009809
0002093419427 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48645 1#0##0 0 944fa15a56576c000566f77dace80078
7322003 D 3 DS 1 22/10/2018 25/10/2018 28/04/1992 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 FIRLI 026890 26
0001072596892 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48646 1#0##0 0 d6670e6ced6ad1573b8c72a18155bdd9
7322003 D 2 DS 1 24/10/2018 25/10/2018 21/10/1994 0 2
0 0 - 0 - 0 - 0 - 0 2172700
1925000 0 2 0 0 0 NURPILDA 023653 24 8769
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48647 1#0##0
0 74c647f0c68c7ac239f61f435e2a5ed4
7322003 D 3 DS 1 23/10/2018 25/10/2018 06/08/1964 0 1
0 - 0 5393500 4680000 0 3 0 0 0 ABBAS
0341R0041018V001973 0002233173464 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48648 1#0##0 0
c5914ef702e0257bcdab48f6d51eead0
7322003 D 3 DS 1 22/10/2018 25/10/2018 21/12/1986 0 1
0 - 0 - 0 - 0 - 0 2033000 375000
0 4 0 0 0 LUKMAN TAHIR 019951 31 11628 dr.
INACBG;123123123123 5.2.5.201812201302 4 48649 1#0##0 0
81eab0b3ff780e3bf1c319101ca0380c
7322003 D 3 DS 1 23/10/2018 25/10/2018 10/10/1983 0 2
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4920500 0 3 0 0 0 LASIAH 026819
0002433904705 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48650 1#0##0 0 9c9e1a156c6642d7d8d81bf4b47b6e0a
7322003 D 1 DS 1 24/10/2018 25/10/2018 24/11/1976 0 1
1 R51;I10 - 0 0 None None None None G-4-23-I None
None None None None None MIGREN DAN SAKIT KEPALA LAIN (RINGAN)
2505400 0 0 - 0 - 0 - 0 - 0
2505400 425000 0 2 0 0 0 MUNAWAR KHALID S.TH.I
025817 41 15309 dr. WIDY ASTUTI 0341R0041018V002055
0000976735247 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48651 1#0##0 0 7ef8fa670cc4c70e72487f08ac9486ad
7322003 D 2 DS 1 23/10/2018 25/10/2018 31/12/1947 0 2
None None None None PROSEDUR SISTEM MUSKULOSKLETAL & JARINGAN PENGHUBUNG
LAIN-LAIN (RINGAN) 6472200 0 0 - 0 - 0 - 0
- 0 6472200 4885500 0 3 0 0 0 NURHAEDAH
5.2.5.201812201302 4 48652 1#0##0 0
f5d1c73e0ebc123bd9c5e8487ec8ffdf
7322003 D 3 DS 1 23/10/2018 25/10/2018 22/10/2018 3180 2
3152100 0 0 - 0 - 0 - 0 - 0
3152100 1075000 0 3 0 0 0 BAYI NY. SALJU 026247
0002501591411 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48653 1#0##0 0 ba904556dc3c53bc60d11160e29c7c9a
7322003 D 3 DS 1 23/10/2018 25/10/2018 01/07/2005 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4972500 0 3 0 0 0 SALJU 013502 13
0000942745386 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48654 1#0##0 0 ac03d2ca75b0d8e2a887d544163ebb19
7322003 D 3 DS 1 23/10/2018 25/10/2018 01/12/1982 0 2
- 0 - 0 - 0 - 0 1122400 235000 0
3 0 0 0 EMI SARIANTO 026936 35 13110 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48655 1#0##0 0
f0c890afa782f679c244e12529b13537
7322003 D 3 DS 1 24/10/2018 25/10/2018 01/12/1983 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4175000 0 2 0 0 0 NURIANA 026940
0000942828232 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48656 1#0##0 0 ae33f25798cc42e81347e12e0596bf88
7322003 D 3 DS 1 20/10/2018 25/10/2018 01/10/1994 0 2
- 0 - 0 - 0 - 0 1980300 635000 0
6 0 0 0 DORCE 026863 24 8785 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48657 1#0##0 0
69b211b159a68651e6fbd6cad0fb8e53
7322003 D 2 DS 1 24/10/2018 25/10/2018 22/10/2016 0 1
1350400 0 0 - 0 - 0 - 0 - 0
1350400 285500 0 2 0 0 0 OKTIANI SINTIKHE LEPPARA
5.2.5.201812201302 4 48658 1#0##0 0
56f215bde1706e685d33ae8b585cd3f1
7322003 D 2 DS 1 22/10/2018 25/10/2018 23/10/1976 0 1
7198500 0 0 - 0 - 0 - 0 - 0
7198500 4980000 0 4 0 0 0 ANNAS 026587 41
0001093282356 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48659 1#0##0 0 2107708f9724a3e4bbda704ae7e0a911
7322003 D 3 DS 1 19/10/2018 25/10/2018 01/01/1990 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4922500 0 7 0 0 0 LINDA 001001 28
0001072309015 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48660 1#0##0 0 c9eb6ec065c85c440bd0532a0b31a70a
7322003 D 3 DS 1 24/10/2018 26/10/2018 01/04/1986 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 HARDIANI 036970 32 11894 dr. SUWANTO,
INACBG;123123123123 5.2.2.201806040537 4 48661 1#0##0 0
a4170c10c11d9b61ad917fea421a8f3d
7322003 D 3 DS 1 24/10/2018 26/10/2018 02/09/2000 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 SURIYANTI BAKRI 026949 18 6626 dr.
INACBG;123123123123 5.2.2.201806040537 4 48662 1#0##0 0
04aa5607640faec0939c9b5c83024851
7322003 D 3 DS 1 24/10/2018 26/10/2018 01/10/2005 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 AMILAH MAHARANI 036957 13 4771 dr.
INACBG;123123123123 5.2.2.201806040537 4 48663 1#0##0 0
abd6384baa7ce96969d874ad14395db1
7322003 D 3 DS 1 24/10/2018 26/10/2018 01/07/1968 0 1
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4275000 0 3 0 0 0 SUTOPO 013543
0001973118363 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48664 1#0##0 0 9b9cbe1a2391effd6bc80abcfb3b35f0
7322003 D 3 DS 1 24/10/2018 26/10/2018 17/08/1987 0 2
- 0 - 0 - 0 - 0 1980300 525000 0
3 0 0 0 HASBIANA 006867 31 11391 DR.ASRIYANTI
INACBG;123123123123 5.2.2.201806040537 4 48665 1#0##0 0
2c9f38825223d85e4c6e257a563d95de
7322003 D 3 DS 1 23/10/2018 26/10/2018 01/01/2004 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 435000 0 4 0 0 0 MAWAR DAHLIA 026933
0000942611962 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48666 1#0##0 0 7e8c0727e53ec33731a2bea32ce92577
7322003 D 3 DS 1 22/10/2018 26/10/2018 01/07/1958 0 1
3960700 0 0 - 0 - 0 - 0 - 0
3960700 795500 0 5 0 0 0 JAMAL 013664 60
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48667 1#0##0
0 b145f7494a23e358828a42f032124b72
7322003 D 3 DS 1 26/10/2018 26/10/2018 14/04/2004 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 1 0 0 0 JOVITA 026772 14 5308 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48668 1#0##0 0
fbb6f86a06e36f27de60492af7815ab4
7322003 D 3 DS 1 24/10/2018 26/10/2018 01/12/1955 0 2
0 0 - 0 - 0 - 0 - 0 2022000 585500
0 3 0 0 0 DEBORA MENDILE 026965 62 22973 dr.
INACBG;123123123123 5.2.5.201812201302 4 48669 1#0##0 0
7824eee4ea8431864da9e885a8d3378a
7322003 D 3 DS 1 24/10/2018 26/10/2018 01/12/1945 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4420500 0 3 0 0 0 DASI 025718 72
0000941024812 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48670 1#0##0 0 ffabadc3aa9aa75a0d26830099a26124
7322003 D 1 DS 1 24/10/2018 26/10/2018 10/03/1975 0 1
3494000 0 0 - 0 - 0 - 0 - 0
3494000 775000 0 3 0 0 0 ALBERT PARASIUNG 003847
0001437048898 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48671 1#0##0 0 06faadaf44dfea287638ab36dcf0c42f
7322003 D 3 DS 1 24/10/2018 26/10/2018 01/12/1984 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4385500 0 3 0 0 0 BAMBANG 026617
0000943669361 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48672 1#0##0 0 6c6581f33efa8095b62ee7cff69126e8
7322003 D 3 DS 1 24/10/2018 26/10/2018 20/05/1981 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 HISNAWATI 026959 37 13671 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48673 1#0##0 0
c62a942df6bdd0a1a7ec637153100190
7322003 D 3 DS 1 23/10/2018 26/10/2018 12/05/1987 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 5270500 0 4 0 0 0 NURLENSI ARISTA DEVI
5.2.5.201812201302 4 48674 1#0##0 0
76542cb3fa6b1cb3c01d4bd00a1a225c
7322003 D 3 DS 1 23/10/2018 26/10/2018 10/09/1990 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4682500 0 4 0 0 0 MASNIA 025929
0001073925189 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48675 1#0##0 0 dad3d1a82b52dd181784473969eb283d
7322003 D 3 DS 1 24/10/2018 26/10/2018 01/12/1980 0 2
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4385500 0 3 0 0 0 SINDANG 025852
0000941594051 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48676 1#0##0 0 c4bc60bf987affed872fe46a502d200c
7322003 D 3 DS 1 23/10/2018 26/10/2018 23/10/2018 3800 2
3152100 0 0 - 0 - 0 - 0 - 0
3152100 1425000 0 4 0 0 0 BAYI NY NURLENSI ARISTA
DEVI 026937 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48677 1#0##0 0
0317aa41ca1bc7b2267d3c384be39dce
7322003 D 3 DS 1 24/10/2018 26/10/2018 01/08/1982 0 2
1 O41.0;O68.0 - 0 0 None None None None W-4-16-I None
0 - 0 - 0 - 0 - 0 1980300 275000
0 3 0 0 0 JUBAEDA, S.PD 026768 36 13233
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48678 1#0##0
0 d3248435c67e3caabd1899e83ce95c21
7322003 D 3 DS 1 25/10/2018 26/10/2018 06/03/1999 0 2
0 0 - 0 - 0 - 0 - 0 1529800
1675000 0 2 0 0 0 HASTUTI 025920 19 7173
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48679 1#0##0
0 b5221feb72fcdbcfb70b50d307b473a6
7322003 D 3 DS 1 24/10/2018 26/10/2018 29/04/1985 0 1
1125300 0 0 - 0 - 0 - 0 - 0
1125300 475000 0 3 0 0 0 NASRUL BIN ERWIN 026962
0002473879037 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48680 1#0##0 0 1eed1c6c6af40bf6b6cfcb37b0a8e2b0
7322003 D 3 DS 1 20/10/2018 26/10/2018 31/12/1957 0 1
1 J18.9;I11.0 - 0 0 None None None None J-4-16-III None
None None None None None SIMPLE PNEUMONIA & WHOOPING COUGH (BERAT)
5863300 0 0 - 0 - 0 - 0 - 0
5863300 1534500 0 7 0 0 0 SUDDING 026859
0001072607512 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48681 1#0##0 0 ed177151fd142fbbd77e439b3f5fe4d7
7322003 D 3 DS 1 25/10/2018 27/10/2018 01/05/2002 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4275000 0 3 0 0 0 SITTI AIZA 020307
0000940956985 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48682 1#0##0 0 5d5b755bfcd704703ac30a79ea5b2b29
7322003 D 2 DS 1 25/10/2018 27/10/2018 23/05/2016 0 2
1350400 0 0 - 0 - 0 - 0 - 0
1350400 585500 0 3 0 0 0 NAJWA ASHALINA YUMNA
0341R0041018V002212 0002293966361 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48683 1#0##0 0
199a8905bc8723ef2709e0b3d443405a
7322003 D 1 DS 1 25/10/2018 27/10/2018 16/05/2014 0 2
0 - 0 2531900 885500 0 3 0 0 0 FAIQAH
AININDITA IRFAN 002139 4 1623 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V002205 0001311401092 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48684 1#0##0 0
a49d29e997f913f5f0daa33672ede0e3
7322003 D 3 DS 1 26/10/2018 27/10/2018 06/01/2005 0 1
1130000 0 0 - 0 - 0 - 0 - 0
1130000 225000 0 2 0 0 0 M AS`AD YUNUS 027022
0002068194925 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48685 1#0##0 0 b6761036958ce96998a9075f0fb658e3
7322003 D 3 DS 1 24/10/2018 27/10/2018 01/06/1965 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 664000 0 4 0 0 0 MANNAWIAH 005175
0000941180409 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48686 1#0##0 0 865e29a91ad053ccf2e91b6779b1d732
7322003 D 3 DS 1 24/10/2018 27/10/2018 01/07/1958 0 2
0 - 0 - 0 - 0 1741400 545000 0 4
0 0 0 JUNAYA 026968 60 22030 dr. INDRAHAYU, Sp.S
0341R0041018V002045 0000941742011 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48687 1#0##0 0
73b1124686a69c4ba00a4f972e5ba394
7322003 D 3 DS 1 25/10/2018 27/10/2018 01/09/1990 0 2
9992400 0 0 - 0 - 0 - 0 - 0
9992400 4385500 0 3 0 0 0 HELDA 026979 28
0000941704986 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48688 1#0##0 0 bfee00aa17a199782678de5ad40ae35e
7322003 D 3 DS 1 24/10/2018 27/10/2018 18/08/1994 0 2
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4785500 0 4 0 0 0 LIS SATRI HARIANTI
5.2.5.201812201302 4 48689 1#0##0 0
d7fbff794f85272fcd6ce6c46079641b
7322003 D 3 DS 1 25/10/2018 27/10/2018 01/07/1952 0 1
5267000 0 0 - 0 - 0 - 0 - 0
5267000 4385500 0 3 0 0 0 SUTRISNO 024475
0000943565049 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48690 1#0##0 0 073dda8fca4127679df42ec75c6691ef
7322003 D 3 DS 1 25/10/2018 27/10/2018 01/02/1981 0 2
0 - 0 - 0 - 0 - 0 3492200 4385500
0 3 0 0 0 LILIK SUHARTATI 026978 37 13780 dr.
INACBG;123123123123 5.2.5.201812201302 4 48691 1#0##0 0
54cb343dba3b1bb6df79728a3ef7e40d
7322003 D 1 DS 1 25/10/2018 27/10/2018 02/07/1951 0 2
3970400 0 0 - 0 - 0 - 0 - 0
3970400 885500 0 3 0 0 0 NAISA 026984 67
0000208050759 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48692 1#0##0 0 1db1b178bdc9ab79454aeb7464a7142c
7322003 D 3 DS 1 24/10/2018 27/10/2018 01/12/1974 0 2
1 E05.9;I43.8;I48 - 0 0 None None None None E-4-13-II
None None None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-LAIN
(SEDANG) 3657000 0 0 - 0 - 0 - 0 - 0
3657000 785500 0 4 0 0 0 SANTI EVINSARI 026944
0000942520105 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48693 1#0##0 0 cd7a7fb7b329158b00ac3972bac3e0cf
7322003 D 3 DS 1 22/10/2018 27/10/2018 01/08/1973 0 2
1 N13.2;I10 - 0 0 None None None None N-4-13-I None
None None None None None BATU URIN (RINGAN) 3217900 0 0
- 0 - 0 - 0 - 0 3217900 775000 0
6 0 0 0 DARMIATI 015390 45 16518 dr. MUSMIANI MUIS,
5.2.5.201812201302 4 48694 1#0##0 0
d8bdcb53bed95864af78d7980aad5828
7322003 D 3 DS 1 23/10/2018 27/10/2018 01/12/1960 0 1
1 N13.3;I11.0 - 0 0 None None None None N-4-13-III None
None None None None None BATU URIN (BERAT) 5947700 0 0 -
0 - 0 - 0 - 0 5947700 675000 0 5
0 0 0 SIRAT 026804 57 21145 dr. MUSMIANI MUIS, Sp.PD
5.2.5.201812201302 4 48695 1#0##0 0
42834778150c99fc2fd72df46586b1a0
7322003 D 1 DS 1 25/10/2018 27/10/2018 09/03/2017 0 1
1 S09.9;S01.5 27.52 0 0 None None None None G-4-24-I None
- 0 - 0 - 0 - 0 2790600 4775000 0
3 0 0 0 ALRAFAEYZA ARIFIN SOFYAN 026998 1 595
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48696 1#0##0
0 60b0d1bcdfd7934ff0c90e92a7777113
7322003 D 2 DS 1 24/10/2018 27/10/2018 10/12/1958 0 1
0 0 - 0 - 0 - 0 - 0 6816300
5270500 0 4 0 0 0 KUSMADI 026966 59 21868
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48697 1#0##0
0 78f6eb8979642ce34f07e6fa64a7ce62
7322003 D 3 DS 1 24/10/2018 27/10/2018 27/09/1973 0 2
2836000 0 0 - 0 - 0 - 0 - 0
2836000 985500 0 4 0 0 0 MISWA 026960 45
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48698 1#0##0
0 12233e8f0fb798e9719d64b10f18ad0d
7322003 D 3 DS 1 23/10/2018 27/10/2018 05/08/1985 0 1
1 E11.5 - 0 0 None None None None I-4-15-I None None
None None None None PENYAKIT PEMBULUH DARAH PERIFER DAN LAIN-LAIN
(RINGAN) 4220500 0 0 - 0 - 0 - 0 - 0
4220500 604500 0 5 0 0 0 HARMAN 025229
0002213253134 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48699 1#0##0 0 dc44561d74bb471f1d8f0bf822e388bc
7322003 D 3 DS 1 25/10/2018 27/10/2018 25/10/2018 2750 2
3152100 0 0 - 0 - 0 - 0 - 0
3152100 1075000 0 3 0 0 0 BAYI NY YULIANA 026964
0002502409724 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48700 1#0##0 0 b62d2c72d72b4faa40231256814d13d0
7322003 D 3 DS 1 24/10/2018 27/10/2018 09/07/1991 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4717500 0 4 0 0 0 YULIANA A.MD.KEB 024801
0002038387511 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48701 1#0##0 0 2c9c33e6d129835917c1bf54c6c53a3a
7322003 D 3 DS 1 23/10/2018 27/10/2018 23/10/2018 3660 1
3152100 0 0 - 0 - 0 - 0 - 0
3152100 975000 0 5 0 0 0 BAYI NY. MASNIA 026938
0002501975733 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48702 1#0##0 0 dc95d2882a47e663c7a8cbdf543a1f68
7322003 D 2 DS 1 25/10/2018 27/10/2018 07/12/2001 0 2
- 0 - 0 - 0 - 0 2394400 775000 0
3 0 0 0 HELPIANA 026999 16 6166 dr. MUSMIANI MUIS,
5.2.5.201812201302 4 48703 1#0##0 0
f327e698fe782a3b47b42e250077a06a
7322003 D 3 DS 1 22/10/2018 27/10/2018 05/02/1962 0 1
4118400 0 0 - 0 - 0 - 0 - 0
4118400 6301000 0 6 0 0 0 SUNYOTO 026903
0002055478509 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48704 1#0##0 0 58983956d652a8ae718e247c5da9f469
7322003 D 3 DS 1 25/10/2018 27/10/2018 10/09/1953 0 1
1 D30.3 57.82 0 0 None None None None N-1-30-I None None
None None None None PROSEDUR KANDUNG KEMIH DAN SALURAN URIN BAWAH
(RINGAN) 5864800 0 0 - 0 - 0 - 0 - 0
5864800 4485500 0 3 0 0 0 I NYOMAN SUWANDI 026977
0001838499546 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48705 1#0##0 0 46eec541d60ac8d04da2164207ca7882
7322003 D 2 DS 1 25/10/2018 27/10/2018 01/07/1966 0 2
0 - 0 - 0 - 0 - 0 5296100 4620500
0 3 0 0 0 HJ. SUARNI 026981 52 19109 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48706 1#0##0 0
efd3efa7d3253bcdee2ba30239222c96
7322003 D 2 DS 1 26/10/2018 27/10/2018 12/11/1977 0 2
0 - 0 - 0 - 0 - 0 1835700 1735000
0 2 0 0 0 HAMDANA PARMAN 015879 40 14958
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48707 1#0##0
0 69e732ece1f083bec28f3c8b81eee9e6
7322003 D 3 DS 1 21/10/2018 27/10/2018 22/05/1987 0 2
- 0 - 0 - 0 - 0 1980300 735000 0
7 0 0 0 ANHI 026870 31 11475 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48708 1#0##0 0
8f78be8088bb73d116168a7c28a57ef3
7322003 D 3 DS 1 24/10/2018 27/10/2018 31/12/1950 0 2
1 B90.9 - 0 0 None None None None J-4-19-I None None
None None None None PENYAKIT PARU INTERSTITIAL (RINGAN) 3508600 0
0 - 0 - 0 - 0 - 0 3508600 1185000
0 4 0 0 0 YETI 013134 67 24769 dr. AWALUDDIN H.,
5.2.5.201812201302 4 48709 1#0##0 0
c3b815b7efb37858d8cbeb59ce304c6a
7322003 D 3 DS 1 26/10/2018 27/10/2018 01/07/2001 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 285500 0 2 0 0 0 SINTA 001236 17
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48710 1#0##0
0 4537df8d45978145b04098236fc1d40e
7322003 D 3 DS 1 26/10/2018 27/10/2018 01/06/1997 0 2
0 - 0 - 0 - 0 - 0 1529800 1675000
0 2 0 0 0 KRISTINA 024304 21 7817 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48711 1#0##0 0
bda5120770dc00d7731f44d714d0dcc1
7322003 D 3 DS 1 24/10/2018 28/10/2018 01/07/1984 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4722500 0 5 0 0 0 MULIANTI 024358
0000941716754 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48712 1#0##0 0 65cebad9e62d8c0ee1c051821760a951
7322003 D 3 DS 1 25/10/2018 28/10/2018 25/10/2018 2080 1
1 P07.1;P36.9;P59.9 - 0 0 None None None None P-8-13-II
None None None None None None NEONATAL, BBL 2000 - 2499 GR TANPA
- 0 6241200 2235000 0 4 0 0 0 BAYI NY.
SULARMI 027002 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V002154 0002502779218 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48713 1#0##0 0
ba30a97aab1106177b83dcd3f1f8e914
7322003 D 1 DS 1 25/10/2018 28/10/2018 25/10/2018 3490 2
0 - 0 - 0 2274900 2235000 0 4 0 0
0 BY NY ESPIN 026980 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V002112 0002494313155 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48714 1#0##0 0
439df1ec197bf7df0bcd7b07f36214ed
7322003 D 3 DS 1 26/10/2018 28/10/2018 08/12/1983 0 1
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 jainuddin 023474 34 12741 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48715 1#0##0 0
500021dfe5c8f4c8af1be2187e03440c
7322003 D 3 DS 1 26/10/2018 28/10/2018 01/10/2002 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4420500 0 3 0 0 0 EGI 026770 16
0000941834586 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48716 1#0##0 0 51ed8b0fb570e87773eab0c51737ea47
7322003 D 2 DS 1 26/10/2018 28/10/2018 22/09/1996 0 1
1 T81.4 86.89 0 0 None None None None L-1-40-I None None
PAYUDARA (RINGAN) 4034200 0 0 - 0 - 0 - 0 -
0 4034200 555500 0 3 0 0 0 SAIFUL BAKHRI
5.2.5.201812201302 4 48717 1#0##0 0
268a9784fba93d70af0424b9a38ae159
7322003 D 1 DS 1 25/10/2018 28/10/2018 15/07/1988 0 2
6265600 0 0 - 0 - 0 - 0 - 0
6265600 5372500 0 4 0 0 0 ESPIN KAWA 025135
0002453733369 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48718 1#0##0 0 431f42e9ab28e1eb049322b8bea32d49
7322003 D 3 DS 1 24/10/2018 28/10/2018 13/06/1982 0 2
0 - 0 - 0 - 0 1192800 675000 0 5
0 0 0 LENNI 026948 36 13282 dr. INDRAHAYU, Sp.S
5.2.5.201812201302 4 48719 1#0##0 0
7a0dc1c80a3f2cc6f73edcf0f9c82670
7322003 D 3 DS 1 24/10/2018 28/10/2018 24/10/2018 2950 1
3152100 0 0 - 0 - 0 - 0 - 0
3152100 575000 0 5 0 0 0 BAYI NY. MULIANTI 036972
0002502571061 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48720 1#0##0 0 cb6c718096b84d703dce37e6784c7621
7322003 D 3 DS 1 25/10/2018 28/10/2018 05/06/1970 0 1
- 0 - 0 - 0 - 0 2342200 1485500 0
4 0 0 0 M SYAMSIR 015352 48 17674 dr. MUSMIANI MUIS,
5.2.5.201812201302 4 48721 1#0##0 0
a35dcf0ba62e8e5432694f0f73437dd5
7322003 D 1 DS 1 26/10/2018 28/10/2018 01/05/2001 0 2
0 - 0 2531900 885500 0 3 0 0 0 SINTA
0000132521051 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48722 1#0##0 0 ef486f9f096188a6410bf679b29a2bda
7322003 D 1 DS 1 26/10/2018 28/10/2018 01/01/1968 0 1
1 K04.7 - 0 0 None None None None U-4-14-I None None
None None None None PENYAKIT MULUT DAN GIGI (RINGAN) 3486800 0
0 - 0 - 0 - 0 - 0 3486800 945000
0 3 0 0 0 ZAKARIAH 027004 50 18561 dr. MUSMIANI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48723 1#0##0 0
a3a783ec09c73d58cf0a4e87294a0dbf
7322003 D 3 DS 1 25/10/2018 28/10/2018 12/02/1979 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 SULARMI 027000
0001935211026 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48724 1#0##0 0 a14d57a41fd406e73a67c58a6cb7ff47
7322003 D 3 DS 1 25/10/2018 28/10/2018 01/07/1948 0 1
1 M86.96;E11.9 77.09 0 0 None None None None M-1-60-I
None None None None None None PROSEDUR SISTEM MUSKULOSKLETAL & JARINGAN
0 - 0 5393500 5330000 0 4 0 0 0 SAIM
0341R0041018V002202 0002477672662 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48725 1#0##0 0
094e7cf1d102b3b0b9ab0835dc3fa041
7322003 D 3 DS 1 27/10/2018 28/10/2018 01/06/1990 0 2
(RINGAN) 1506900 0 0 - 0 - 0 - 0 - 0
1506900 4175000 0 2 0 0 0 JUNARTI Y 016888
0000942156551 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48726 1#0##0 0 4ff2e63b785beab5b15c209e6bc35065
7322003 D 3 DS 1 27/10/2018 28/10/2018 26/09/1985 0 2
- 0 - 0 - 0 - 0 1461300 4210000 0
2 0 0 0 SURYANI 026762 33 12084 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48727 1#0##0 0
9c83ca6eb530feac670007b787e7bdef
7322003 D 3 DS 1 26/10/2018 28/10/2018 31/12/1949 0 1
0 0 - 0 - 0 - 0 - 0 3492200
4385500 0 3 0 0 0 SINDING 022784 68 25136
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48728 1#0##0
0 46510fe4129bec98832a2049ecf458db
7322003 D 3 DS 1 28/10/2018 29/10/2018 14/07/1999 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 175000 0 2 0 0 0 ALFRIDA KEMBONG 020242
0001604632869 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48729 1#0##0 0 05ad765e5fa21a8ab2c7f4283f02d521
7322003 D 3 DS 1 24/10/2018 29/10/2018 17/11/1986 0 2
1 A16.2;E11.9;B37.0 - 0 0 None None None None J-4-15-II
(SEDANG) 4731900 0 0 - 0 - 0 - 0 - 0
4731900 1423000 0 6 0 0 0 IRAWATI 026953
0000942303543 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48730 1#0##0 0 8c77ab9037be255048aa3305edbca20b
7322003 D 3 DS 1 26/10/2018 29/10/2018 01/03/1961 0 1
0 0 - 0 - 0 - 0 - 0 2485100 485500
0 4 0 0 0 JANONG 027026 57 21058 dr. MUSMIANI
5.2.2.201806040537 4 48731 1#0##0 0
3eb97e921f39f98dc6fee048d8308f79
7322003 D 2 DS 1 26/10/2018 29/10/2018 07/09/1984 0 2
LAIN (RINGAN) 3174300 0 0 - 0 - 0 - 0 -
0 3174300 585000 0 4 0 0 0 RAHMAWATI 027003
0001434174052 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48732 1#0##0 0 a8b79b5b99e44eae24c4423a45457b05
7322003 D 3 DS 1 26/10/2018 29/10/2018 10/07/2002 0 1
5262000 0 0 - 0 - 0 - 0 - 0
5262000 4555500 0 4 0 0 0 AHMAD FAUZI.S.P 027006
0002366257781 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48733 1#0##0 0 d56645ce7bcd50a72241163adb7ecc7b
7322003 D 2 DS 1 22/10/2018 29/10/2018 22/10/2018 1685 2
None None None None None NEONATAL, BBL 1500 - 1999 GR TANPA PROSEDUR
MAYOR (RINGAN) 6539200 0 0 - 0 - 0 - 0 -
0 6539200 4975000 0 8 0 0 0 BAYI WINDA SARI
HALIDU 026887 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V001862 0002501555411 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48734 1#0##0 0
82f23b56a4d56ceb6ed429d7aab4c3cf
7322003 D 3 DS 1 23/10/2018 29/10/2018 13/12/1936 0 1
1 N18.5;J02.9 - 0 0 None None None None N-4-10-I None
None None None None None TUMOR GINJAL & SALURAN URIN & GAGAL GINJAL
(RINGAN) 2237700 0 0 - 0 - 0 - 0 - 0
2237700 1474000 0 7 0 0 0 WAYAN KALER 026911
0001604795073 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48735 1#0##0 0 935b01ab80b53195ab2c23c960882fa6
7322003 D 3 DS 1 23/10/2018 29/10/2018 01/07/1958 0 1
1 S89.9;I10 81.47 0 0 None None None None M-1-70-I None
(RINGAN) 9992400 0 0 - 0 - 0 - 0 - 0
9992400 4515000 0 7 0 0 0 PANTING 026907
0001604720452 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48736 1#0##0 0 2c86ea30fa9b65622d234e4042fda999
7322003 D 3 DS 1 21/10/2018 29/10/2018 01/01/1986 0 2
1 L27.0 - 0 0 None None None None L-4-14-I None None
None None None None GANGGUAN PADA KULIT & PAYUDARA LAIN-LAIN (RINGAN)
1988000 0 0 - 0 - 0 - 0 - 0
1988000 970000 0 9 0 0 0 DARMAWATI 025521
0000941292191 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48737 1#0##0 0 b805a6d7fd2d2035186685a7be6ad2b8
7322003 D 2 DS 1 26/10/2018 29/10/2018 26/10/2018 2835 1
3782500 0 0 - 0 - 0 - 0 - 0
3782500 875000 0 4 0 0 0 BAYI NY MURNIATI KURNIA
0341R0041018V002380 0002503285187 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48738 1#0##0 0
2d7760068f62b43d38529291a184d4fc
7322003 D 2 DS 1 26/10/2018 29/10/2018 02/04/1986 0 2
5370500 0 0 - 0 - 0 - 0 - 0
5370500 4922500 0 4 0 0 0 MURNIATI KURNIA 022728
0000203917972 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48739 1#0##0 0 96df9b4babc5009cb5b5c9e8eef6a9db
7322003 D 3 DS 1 28/10/2018 29/10/2018 20/03/2000 0 2
- 0 - 0 - 0 - 0 1461300 1735000 0
2 0 0 0 DEWI AMINAH 024951 18 6796 DR.ASRIYANTI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48740 1#0##0 0
6bbce92e419e655f840f9be53ae898d9
7322003 D 3 DS 1 26/10/2018 29/10/2018 20/10/1967 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 485500 0 4 0 0 0 NURI 027005 51
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48741 1#0##0
0 5aac1e1bda81b6db054976659f1f8eb3
7322003 D 3 DS 1 25/10/2018 29/10/2018 01/07/1963 0 2
1 I10;A09.9 - 0 0 None None None None I-4-17-I None
- 0 - 0 - 0 - 0 1741400 475000 0
5 0 0 0 TIMA 026993 55 20205 dr. MUSMIANI MUIS, Sp.PD
5.2.5.201812201302 4 48742 1#0##0 0
19dc3189e3785a2488bfee0d637255d6
7322003 D 3 DS 1 27/10/2018 29/10/2018 27/08/2018 0 2
LAIN (RINGAN) 2635000 0 0 - 0 - 0 - 0 -
0 2635000 385500 0 3 0 0 0 IVANI 027033
0002485944066 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48743 1#0##0 0 943a11a18d99ce50aeb537f627ed7aa8
7322003 D 2 DS 1 24/10/2018 29/10/2018 15/01/1988 0 2
5370500 0 0 - 0 - 0 - 0 - 0
5370500 1585500 0 6 0 0 0 MASNA RUPA 026941
0000976410933 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48744 1#0##0 0 8d09bf8805121484ae9363588f79c9b5
7322003 D 2 DS 1 26/10/2018 29/10/2018 01/01/2001 0 2
- 0 - 0 - 0 - 0 2394400 1125000 0
4 0 0 0 KARUNIA FITRI LESTARI 007438 17 6507 dr.
INACBG;123123123123 5.2.5.201812201302 4 48745 1#0##0 0
5faed93e552566ab76189f8d02c077a3
7322003 D 1 DS 1 26/10/2018 29/10/2018 28/02/1983 0 2
LAIN (RINGAN) 3703300 0 0 - 0 - 0 - 0 -
0 3703300 1555000 0 4 0 0 0 ASRIYANI RAHMAN
0341R0041018V002241 0000202690901 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48746 1#0##0 0
3412188e4da47435c74a4e5df4e784dc
7322003 D 3 DS 1 26/10/2018 29/10/2018 02/12/1956 0 2
1 L02.4 - 0 0 None None None None L-4-12-I None None
None None None None PERADANGAN KULIT/CELLULITIS (RINGAN) 1148000
0 0 - 0 - 0 - 0 - 0 1148000
1354500 0 4 0 0 0 HJ. KAMA 027023 61 22608
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48747 1#0##0
0 11239d9f8dd2a46ee066dc7b14df8480
7322003 D 1 DS 1 23/10/2018 29/10/2018 25/09/1970 0 2
1575500 0 0 - 0 - 0 - 0 - 0
1575500 1645500 0 7 0 0 0 NURSIA 025435
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48748 1#0##0
0 07de398057413bc1e3cb5d4f89b3b800
7322003 D 2 DS 1 23/10/2018 29/10/2018 15/09/1966 0 1
0 - 0 6472200 6749500 0 7 0 0 0
IGNATIUS SURAHMAN 018814 52 19031 dr. SUWANTO, Sp.B.,FICSSpB.,FKS
5.2.5.201812201302 4 48749 1#0##0 0
5b94443d98d9615e8f80587d8d0c8652
7322003 D 1 DS 1 26/10/2018 29/10/2018 28/10/1975 0 2
0 - 0 - 0 - 0 - 0 2793500 1325000
0 4 0 0 0 MURNI JAYA 011494 42 15704 dr. MUSMIANI
RAHMAT;7322112311880004 5.2.5.201812201302 4 48750 1#0##0 0
e38ae3aef14db14d918bad094809add4
7322003 D 2 DS 1 26/10/2018 29/10/2018 20/03/1936 0 1
1350400 0 0 - 0 - 0 - 0 - 0
1350400 1295000 0 4 0 0 0 DJIBU 027017 82
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48751 1#0##0
0 2f764034fbe9bfa931017cceef0a0616
7322003 D 3 DS 1 27/10/2018 29/10/2018 01/07/1999 0 2
- 0 - 0 - 0 - 0 1980300 335000 0
3 0 0 0 YURNI 016999 19 7058 DR.ASRIYANTI
INACBG;123123123123 5.2.5.201812201302 4 48752 1#0##0 0
724d36e546fda19afaa0e7476e42395f
7322003 D 3 DS 1 29/10/2018 29/10/2018 23/03/1998 0 2
0 - 0 - 0 - 0 - 0 1529800 1735000
0 1 0 0 0 MILA KARMILA 027056 20 7525
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48753 1#0##0
0 c2aa60461b75cdc0c0a8c2bf1380a0d0
7322003 D 3 DS 1 27/10/2018 30/10/2018 27/10/2018 3685 1
3152100 0 0 - 0 - 0 - 0 - 0
3152100 575000 0 4 0 0 0 BAYI NY HARBIA 027032
0002503429211 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48754 1#0##0 0 95fd8e9e5650a360ffc2204f7feb34d9
7322003 D 3 DS 1 29/10/2018 30/10/2018 29/10/2018 2300 2
(RINGAN) 4728100 0 0 - 0 - 0 - 0 - 0
4728100 775000 0 2 0 0 0 BY NY MILA KARMILA
0341R0041018V002428 0002503357997 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48755 1#0##0 0
70d0f919a9fe2a2dccfd44c58ef845d2
7322003 D 3 DS 1 25/10/2018 30/10/2018 01/05/1997 0 2
None None None None None PROSEDUR ANGGOTA TUBUH ATAS (RINGAN)
5680300 0 0 - 0 - 0 - 0 - 0
5680300 4635000 0 6 0 0 0 NURUL ULFI 025265
0000941873567 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48756 1#0##0 0 f6d3a91bf8b2589a7f1080a189c18b49
7322003 D 3 DS 1 26/10/2018 30/10/2018 01/07/1975 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 785500 0 5 0 0 0 ASMA 013085 43
0001557313514 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48757 1#0##0 0 42ed9207d08c537d3d7d1e01c8cd8c3e
7322003 D 3 DS 1 20/10/2018 30/10/2018 24/08/1993 0 1
1 C85.9 - 0 0 None None None None C-4-11-I None None
None None None None LIMFOMA & LEUKEMIA NON AKUT (RINGAN) 2990000
0 0 - 0 - 0 - 0 - 0 2990000
2834000 0 11 0 0 0 EDI SUDARSO 026857 25 9188
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48758 1#0##0
0 600845ae18a77441952cccceaedb4973
7322003 D 3 DS 1 27/10/2018 30/10/2018 01/11/1975 0 2
None None None None GANGGUAN KELENJAR ENDOKRIN LAIN-LAIN (RINGAN)
2496600 0 0 - 0 - 0 - 0 - 0
2496600 585500 0 4 0 0 0 FEBEZENDHY MAGDALENA
5.2.5.201812201302 4 48759 1#0##0 0
c6b8bfd82169542e9e0221c9aafabc75
7322003 D 2 DS 1 28/10/2018 30/10/2018 28/05/1976 0 2
1350400 0 0 - 0 - 0 - 0 - 0
1350400 475000 0 3 0 0 0 NURSANTI 019292
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48760 1#0##0
0 1c41166f53982bcad4ec171a91881ed5
7322003 D 2 DS 1 29/10/2018 30/10/2018 07/08/1997 0 2
1350400 0 0 - 0 - 0 - 0 - 0
1350400 375000 0 2 0 0 0 ALCE 027053 21
INACBG;123123123123 5.2.5.201812201302 4 48761 1#0##0 0
5789b39e1636466f1a114472aa4c087c
7322003 D 1 DS 1 29/10/2018 30/10/2018 10/10/1940 0 1
1 I64 - 0 0 None None None None G-4-15-I None None
None None None None KECEDERAAN PEMBULUH DARAH OTAK NON SPESIFIK &
PENYUMBATAN PRE-CEREBRAL TANPA INFARK (RINGAN) 3872400 0 0 - 0
- 0 - 0 - 0 3872400 845000 0 2 0
0 0 H.ISMAIL DG LOLO 027091 78 28508 DR. ISMAWATI IRWAN,SP.AN
0341R0041018V002461 0000132577042 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48762 1#0##0 0
bca56388fa226a9f2bf3eb1b86cd84f3
7322003 D 3 DS 1 27/10/2018 30/10/2018 28/03/1991 0 2
- 0 - 0 - 0 - 0 1122400 475000 0
4 0 0 0 Ervina Savitri Solikin 010008 27 10075
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48763 1#0##0
0 fe2c1ba2c7f149c864a1c9841d7570c3
7322003 D 1 DS 1 29/10/2018 30/10/2018 09/05/1967 0 2
- 0 - 0 - 0 - 0 2793500 525000 0
2 0 0 0 SURYANI 027059 51 18801 dr. AWALUDDIN H.,
5.2.5.201812201302 4 48764 1#0##0 0
cc54ffca8bffc313da6a132dd514bed5
7322003 D 3 DS 1 27/10/2018 30/10/2018 01/05/1953 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 485500 0 4 0 0 0 RUT 027035 65
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48765 1#0##0
0 9aa5b17fc00e76749fc48e53f9beef3f
7322003 D 3 DS 1 27/10/2018 30/10/2018 01/07/1979 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 4622500 0 4 0 0 0 HARBIA 026756
0000943012945 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48766 1#0##0 0 42c7d4919fd24b68f0488de784a5ba40
7322003 D 3 DS 1 29/10/2018 30/10/2018 31/12/1971 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 575000 0 2 0 0 0 HARTIANA 027043
0001557217899 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48767 1#0##0 0 6f182ed2ed7edf55b2cea1949092f84c
7322003 D 3 DS 1 26/10/2018 30/10/2018 27/05/1980 0 2
4475400 0 0 - 0 - 0 - 0 - 0
4475400 5722500 0 5 0 0 0 ALMAIDA 027009
0001836107291 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48768 1#0##0 0 0d59ed5d4906cd5a79439c0c7e0c6c19
7322003 D 1 DS 1 26/10/2018 30/10/2018 04/09/1946 0 2
1575500 0 0 - 0 - 0 - 0 - 0
1575500 1475000 0 5 0 0 0 BUDIAH 024323
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48769 1#0##0
0 491158ed5863f6d1a3ce767fb6d0c33d
7322003 D 1 DS 1 25/10/2018 30/10/2018 17/01/1972 0 2
0 0 - 0 - 0 - 0 - 0 3111000
6075500 0 6 0 0 0 BETI LUBIS 026614 46 17083
3;JKN INACBG;123123123123 5.2.5.201812201302 4 48770 1#0##0
0 2bc43a85841549542bc2c1f93d514b90
7322003 D 1 DS 1 27/10/2018 30/10/2018 12/12/1969 0 2
1 R07.3 - 0 0 None None None None I-4-20-I None None
None None None None ANGINA PEKTORIS DAN NYERI DADA (RINGAN) 3853900
0 0 - 0 - 0 - 0 - 0 3853900
1344500 0 4 0 0 0 NURMA 027030 48 17851 dr.
INACBG;123123123123 5.2.5.201812201302 4 48771 1#0##0 0
8227d0691206d3e4a8ba4f72f42a02f6
7322003 D 3 DS 1 28/10/2018 30/10/2018 06/04/1990 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 775000 0 3 0 0 0 Fharamita 009860
0001422707477 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48772 1#0##0 0 9b2710cead42cbb09288c011cc38f146
7322003 D 2 DS 1 29/10/2018 30/10/2018 03/11/2000 0 1
1309800 0 0 - 0 - 0 - 0 - 0
1309800 846000 0 2 0 0 0 ZULFIKAR 027057
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48773 1#0##0
0 24a5de116485717e398bf09743963a05
7322003 D 3 DS 1 26/10/2018 30/10/2018 10/04/1973 0 1
1 M86.96;E11.9 - 0 0 None None None None M-4-14-I
None None None None None None OSTEOMIELITIS (RINGAN) 3779500 0
0 - 0 - 0 - 0 - 0 3779500 1044500
0 5 0 0 0 TUKIMIN 026573 45 16635 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48774 1#0##0 0
8e2e059c9c19ffeca89dcddf01167263
7322003 D 2 DS 1 29/10/2018 31/10/2018 31/12/1952 0 1
1 N39.0;N35.9 58.49 0 0 None None None None N-1-40-I None
None None None None None PROSEDUR PADA URETRA DAN TRANSURETRA (RINGAN)
6320400 0 0 - 0 - 0 - 0 - 0
6320400 4375000 0 3 0 0 0 RUSLAN 024533
0000132569357 3;JKN INACBG;123123123123 5.2.2.201806040537 4
48775 1#0##0 0 d7730813311552a403f410fe74dcf6e8
7322003 D 2 DS 1 29/10/2018 31/10/2018 14/05/1972 0 1
0 0 - 0 - 0 - 0 - 0 2666600
4620500 0 3 0 0 0 MUH. DIRHAM 025690 46 16969
3;JKN INACBG;123123123123 5.2.2.201806040537 4 48776 1#0##0
0 2436098daeaaeeb3e745d629017bd4ed
7322003 D 2 DS 1 28/10/2018 31/10/2018 28/10/2018 2665 1
3782500 0 0 - 0 - 0 - 0 - 0
3782500 1225000 0 4 0 0 0 BAYI NY MASNAENI GII
0341R0041018V002415 0002503314955 3;JKN INACBG;123123123123
5.2.2.201806040537 4 48777 1#0##0 0
49ed368bc136b4ed0114bfd61047519b
7322003 D 3 DS 1 27/10/2018 31/10/2018 01/07/1979 0 1
1125300 0 0 - 0 - 0 - 0 - 0
1125300 785500 0 5 0 0 0 EPENDI 027029
0000942769359 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48778 1#0##0 0 f823afc9120f65a3a89be5cf22cf4a4f
7322003 D 3 DS 1 29/10/2018 31/10/2018 01/07/1942 0 2
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 SAIRAH 027070 76 27879 dr. SUWANTO,
RAHMAT;7322112311880004 5.2.5.201812201302 4 48779 1#0##0 0
c37e15f247e7cd87d8517cd236c7b82e
7322003 D 2 DS 1 28/10/2018 31/10/2018 28/10/2018 2395 2
None None None None None NEONATAL, BBL 2000 - 2499 GR TANPA PROSEDUR
MAYOR (RINGAN) 5673800 0 0 - 0 - 0 - 0 -
0 5673800 2175000 0 4 0 0 0 BAYI NY MASNAENI
GI 027047 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
0341R0041018V002416 0002503312233 3;JKN INACBG;123123123123
5.2.5.201812201302 4 48780 1#0##0 0
c46d5de6ccd3efc7592efd8bb6f19320
7322003 D 3 DS 1 29/10/2018 31/10/2018 01/12/1975 0 1
0 - 0 - 0 - 0 - 0 3492200 4420500
0 3 0 0 0 ACO 027077 42 15673 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48781 1#0##0 0
408428c1f892d52ca28f020a937335fd
7322003 D 1 DS 1 29/10/2018 31/10/2018 25/06/1963 0 2
0 0 - 0 - 0 - 0 - 0 3111000
4680000 0 3 0 0 0 ENDANG YUNIATI 007621 55
0000132518687 3;JKN INACBG;123123123123 5.2.5.201812201302 4
48782 1#0##0 0 86438c0e4bebe8d4dcd67a4df4b992b2
7322003 D 3 DS 1 29/10/2018 31/10/2018 01/07/1996 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4420500 0 3 0 0 0 ERNA 026729 22
0001941102202 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48783 1#0##0 0 1eb8f12936563fdcffe08e88f434d9f2
7322003 D 3 DS 1 29/10/2018 31/10/2018 31/12/1964 0 1
5998800 0 0 - 0 - 0 - 0 - 0
5998800 4480000 0 3 0 0 0 MARADDI 019731
0000941553707 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48784 1#0##0 0 53f37363356ed4c737616ce0d721d365
7322003 D 3 DS 1 29/10/2018 31/10/2018 02/02/2016 0 1
1 J20.9;Q90.9 - 0 0 None None None None J-4-21-I None
None None None None None GEJALA, TANDA DAN DIAGNOSIS SISTEM PERNAFASAN
LAIN-LAIN (RINGAN) 2635000 0 0 - 0 - 0 - 0
- 0 2635000 385500 0 3 0 0 0 MUH RUHIL
5.2.5.201812201302 4 48785 1#0##0 0
b323455fc61d8c21523629b1ea9b82e0
7322003 D 3 DS 1 29/10/2018 31/10/2018 01/12/1963 0 2
1 T81.4 83.64 0 0 None None None None M-1-50-I None None
0 - 0 - 0 - 0 - 0 3492200 4385500
0 3 0 0 0 DORKAS. R 024379 54 20056 dr. SUWANTO,
INACBG;123123123123 5.2.5.201812201302 4 48786 1#0##0 0
5be11bbbbce4c63db46052868d326729
7322003 D 3 DS 1 29/10/2018 31/10/2018 01/07/1943 0 1
1 D30.3 57.84 0 0 None None None None N-1-11-I None None
None None None None PROSEDUR KANDUNG KEMIH KOMPLEK (RINGAN) 5750900
0 0 - 0 - 0 - 0 - 0 5750900
4385500 0 3 0 0 0 MANDA 025468 75 27514 dr.
INACBG;123123123123 5.2.5.201812201302 4 48787 1#0##0 0
4157c9bd120ee425700e6e72f7146358
7322003 D 3 DS 1 29/10/2018 31/10/2018 01/12/2003 0 2
1130000 0 0 - 0 - 0 - 0 - 0
1130000 485500 0 3 0 0 0 PUTRI WULANDARI 027089
0000942549513 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48788 1#0##0 0 fceecd382747fe28f603bec30f0c2209
7322003 D 2 DS 1 30/10/2018 31/10/2018 17/06/1982 0 1
1 T14.1 - 0 0 None None None None L-4-13-I None None
None None None None TRAUMA PADA KULIT, JARINGAN BAWAH KULIT DAN PAYUDARA
(RINGAN) 2693400 0 0 - 0 - 0 - 0 - 0
2693400 625000 0 2 0 0 0 RAIS 017725 36
INACBG;123123123123 5.2.5.201812201302 4 48789 1#0##0 0
69bd4d9f75a664125d08ae4630699ad7
7322003 D 2 DS 1 28/10/2018 31/10/2018 25/11/1983 0 2
None None None None None None OPERASI PEMBEDAHAN CAESAR (SEDANG)
5681500 0 0 - 0 - 0 - 0 - 0
5681500 5432500 0 4 0 0 0 MASNAENI 025752
0000942251804 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48790 1#0##0 0 6c3b11c1d75f3648d0a3dbc77036dd3b
7322003 D 2 DS 1 29/10/2018 31/10/2018 10/12/1969 0 1
1 S09.9 86.89 0 0 None None None None L-1-40-I None None
PAYUDARA (RINGAN) 4034200 0 0 - 0 - 0 - 0 -
0 4034200 4810000 0 3 0 0 0 AHMADI 027078
0000132428068 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48791 1#0##0 0 f54036278e8b48938cfc30c5a00648a5
7322003 D 3 DS 1 29/10/2018 31/10/2018 27/08/1999 0 2
1125300 0 0 - 0 - 0 - 0 - 0
1125300 675000 0 3 0 0 0 RINI LESTARI 027092
0002314650622 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48792 1#0##0 0 b7be14fb78018ed0cd9bfdfad18accaa
7322003 D 1 DS 1 22/10/2018 31/10/2018 31/12/1958 0 2
1 D36.7;E11.5 86.3 0 0 None None None None L-1-40-II None
None None None None None PROSEDUR PADA KULIT, JA(RINGAN) BAWAH KULIT DAN
PAYUDARA (SEDANG) 9440300 0 0 - 0 - 0 - 0 -
0 9440300 8238500 0 10 0 0 0 NURHAYANI 001852
0001794283312 3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302
4 48793 1#0##0 0 b4077b1ee3050a4dab5eafc2866827aa
7322003 D 3 DS 1 26/10/2018 31/10/2018 26/10/2018 1700 1
1 P07.1;P22.8;P36.9;P59.9 - 0 0 None None None None P-8-
12-II None None None None None None NEONATAL, BBL 1500 - 1999 GR TANPA
- 0 7748100 2235000 0 6 0 0 0 BAYI NY.
NURHALISA 027052 0 0 DR. MULYANI KADIR, SP.A,.M.KES.
5.2.5.201812201302 4 48794 1#0##0 0
b73de2522a32a924c30c45eb35350051
7322003 D 2 DS 1 27/10/2018 31/10/2018 31/12/1930 0 1
None None None None ATHEROSKLEROSIS (RINGAN) 1704600 0 0
- 0 - 0 - 0 - 0 1704600 675000 0
5 0 0 0 ALPAUT DG. SITINGGI 027042 87 32077 dr.
RAHMAT;7322112311880004 5.2.5.201812201302 4 48795 1#0##0 0
53eadeacfb49709b0f5e71c1c2332dc5
7322003 D 3 DS 1 27/10/2018 31/10/2018 04/05/2004 0 2
0 0 - 0 - 0 - 0 - 0 4475400
6422500 0 5 0 0 0 NURHALISA 025257 14 5289
3;JKN ANDI RAHMAT;7322112311880004 5.2.5.201812201302 4 48796 1#0##0
0 39afdc10da0c12eba362aef54733ca08

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