Laporan Diagnosa Pasien per Dokter

Periode 01/08/2017 s.d. 31/08/2017

NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

1
1 A WAHYU RADITYANTO .TN 12707 ASKES 28/08/17 10:26:13
2 ASEP MAS HERAWAN, TN 349834 ASKES 21/08/17 09:43:58
3 SALEH, TN 470180 KARTU INDONESIA 21/08/17 10:44:19
4 TITA NU ARI 477693 SEHAT
BPJS 21/08/17 10:51:02
2 Anie Besari, drg
1 SRI NURMALA 8988 KARTU INDONESIA 1/8/2017 10:27 K04.7 Periapical abscess without sinus
2 ARMUNAH 64594 SEHAT
ASKES 24/08/17 08:06:34 K04.1 Necrosis of pulp
3 DEWI FRIDAWATI 78022 BPJS 2/8/2017 10:49 K04.1 Necrosis of pulp
4 ENOK SAENAH 93079 BPJS 8/8/2017 9:01 K05.3 Chronic periodontitis
5 NANO KARNO 99776 BPJS 12/8/2017 10:00 K05.3 Chronic periodontitis
6 WATI KONAWATI 102025 BPJS 24/08/17 08:13:08 K05.3 Chronic periodontitis
7 WATI KONAWATI 102025 BPJS 30/08/17 08:46:46 K04.1 Necrosis of pulp
8 UYU WAHYUDIN 153078 BPJS 11/8/2017 9:11 K05.3 Chronic periodontitis
9 UYU WAHYUDIN 153078 KARTU INDONESIA 25/08/17 08:01:25 K05.3 Chronic periodontitis
10 EHA JULAEHA 240692 SEHAT
ASKES 31/08/17 08:51:14 K04.1 Necrosis of pulp
11 YAYAH KODARIAH 299518 BPJS 22/08/17 09:48:20 K04.1 Necrosis of pulp
12 MUTIA RATNA RAHMAWATI 305990 BPJS 8/8/2017 10:28 K04.1 Necrosis of pulp
13 MUTIA RATNA RAHMAWATI 305990 BPJS 15/08/17 11:07:55 K04.1 Necrosis of pulp
14 MUTIA RATNA RAHMAWATI 305990 BPJS 23/08/17 09:35:04 K04.1 Necrosis of pulp
15 ETI GARTINI 309407 KARTU INDONESIA 26/08/17 07:48:57 K04.7 Periapical abscess without sinus
16 PATIMAH 320913 SEHAT
ASKES 2/8/2017 9:02 K02.1 Caries of dentine
17 PATIMAH 320913 ASKES 14/08/17 10:43:07 K02.1 Caries of dentine
18 PATIMAH 320913 ASKES 23/08/17 10:07:36 K02.1 Caries of dentine
19 IIS 330291 UMUM 3/8/2017 9:48 K05.3 Chronic periodontitis
20 KARNO 334153 BPJS 23/08/17 08:39:07 K02.1 Caries of dentine
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NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

21 IRENA NURMALASARI 350314 ASKES 10/8/2017 10:23 K04.1 Necrosis of pulp

22 DASMAT ISMAYA 351098 BPJS 14/08/17 10:20:28 K04.1 Necrosis of pulp
23 DADANG HERDIANTO 352676 BPJS 15/08/17 10:51:48 K07.3 Anomalies of tooth position
24 DADANG HERDIANTO 352676 BPJS 22/08/17 09:58:14 K04.1 Necrosis of pulp
25 SISWATI 354748 BPJS 21/08/17 10:28:04 K04.1 Necrosis of pulp
26 ISZA OCTHA WICAKSONO 361997 BPJS 23/08/17 10:27:01 K02.1 Caries of dentine
3 Anie Besari, drg
1 EDOH.NY 363662 BPJS 2/8/2017 9:00 K05.3 Chronic periodontitis
4 Anie Besari, drg
1 ENTIN HARTINI 364692 BPJS 15/08/17 10:42:58 K04.1 Necrosis of pulp
2 DINA YULIAN 369361 KARTU INDONESIA 9/8/2017 10:30 K02.1 Caries of dentine
3 DINA YULIAN 369361 SEHAT
KARTU INDONESIA 16/08/17 11:06:13 K02.1 Caries of dentine
4 RIPIANI 370028 SEHAT
BPJS 31/08/17 09:23:37 K04.7 Periapical abscess without sinus
5 MUTIA RAHMAWATI 373500 BPJS 30/08/17 10:36:22 K02.1 Caries of dentine
6 MAMAH NY 375663 KARTU INDONESIA 10/8/2017 10:06 K02.1 Caries of dentine
7 DIAN RAMDANSYAH, TN 384185 SEHAT
BPJS 15/08/17 11:04:10 K02.1 Caries of dentine
5 Anie Besari, drg
1 KURNIA 385006 UMUM 21/08/17 09:04:33 K03.6 Deposits [accretions] on teeth
6 Anie Besari, drg
1 ENDUT SUMIYASIH 386554 BPJS 14/08/17 09:59:27 K05.3 Chronic periodontitis
2 ENDUT SUMIYASIH 386554 KARTU INDONESIA 21/08/17 09:28:16 K04.1 Necrosis of pulp
3 SRI NURNANINGSIH 387937 SEHAT
BPJS 8/8/2017 9:47 K05.1 Chronic gingivitis
4 DEDE DARYATI 394629 BPJS 24/08/17 10:41:59 K04.7 Periapical abscess without sinus
5 DEDE DARYATI 394629 BPJS 29/08/17 09:35:48 K08.3 Retained dental root
6 EVI LAELATUL MUSFIDAH 396277 BPJS 15/08/17 11:01:30 K04.7 Periapical abscess without sinus
7 TIA RESTIANI 402653 BPJS 21/08/17 10:19:29 K06.1 Gingival enlargement
8 INDRIAWAN SAPUTRA 405953 UMUM 21/08/17 10:34:34 K02.1 Caries of dentine
9 INDRIAWAN SAPUTRA 405953 UMUM 24/08/17 10:52:02 K02.1 Caries of dentine
10 HENI NURAENI 406378 BPJS 8/8/2017 10:00 K03.6 Deposits [accretions] on teeth
11 RICO ALPIAN 422667 UMUM 8/8/2017 8:23 K04.7 Periapical abscess without sinus
12 DEWI MULIA SILMIE 428371 ASKES 1/8/2017 8:45 K02.1 Caries of dentine
13 AAM AMINAH 430551 BPJS 16/08/17 10:51:18 K04.0 Pulpitis
14 DADANG HERMAWAN 432180 KARTU INDONESIA 15/08/17 08:45:31 K04.1 Necrosis of pulp
15 DADANG HERMAWAN 432180 SEHAT
KARTU INDONESIA 22/08/17 07:43:38 K04.1 Necrosis of pulp
16 R USYE KUSWANDANI HJ 433102 SEHAT
ASKES 1/8/2017 11:02 K04.7 Periapical abscess without sinus
17 R USYE KUSWANDANI HJ 433102 ASKES 8/8/2017 10:16 K04.1 Necrosis of pulp
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NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

18 CEPI HENDRA 436147 BPJS 21/08/17 10:47:33 K05.1 Chronic gingivitis

19 RIDWAN GUNAWAN 437677 ASKES 24/08/17 10:33:48 K03.6 Deposits [accretions] on teeth
20 EROS ROSMAYANTI 437769 BPJS 9/8/2017 8:33 K04.1 Necrosis of pulp
21 OOM ROMANAH 441695 UMUM 8/8/2017 8:49 K04.7 Periapical abscess without sinus
22 YAYAH 441724 BPJS 2/8/2017 8:47 K05.3 Chronic periodontitis
23 YAYAH 441724 KARTU INDONESIA 9/8/2017 8:20 K08.3 Retained dental root
24 DEDEH NURHASANAH 457901 SEHAT
BPJS 25/08/17 08:31:07 K07.3 Anomalies of tooth position
25 DEDEH NURHASANAH 457901 BPJS 31/08/17 08:47:32 K04.1 Necrosis of pulp
26 RESTI LISTIANI ANTA,NN 465550 BPJS 21/08/17 09:43:03 K07.3 Anomalies of tooth position
27 ATENG YUSUP 465905 BPJS 15/08/17 10:20:33 K04.1 Necrosis of pulp
28 MUHAROM 466414 KARTU INDONESIA 15/08/17 07:43:42 K04.7 Periapical abscess without sinus
29 AI NONOH 466509 SEHAT
BPJS 15/08/17 07:22:20 K05.3 Chronic periodontitis
30 ARDIANTO 472609 BPJS 16/08/17 08:35:33 K02.1 Caries of dentine
31 ERWIN EKA PUTRA KOSWANDA 475533 BPJS 16/08/17 10:45:27 K04.1 Necrosis of pulp
32 ABD. ROHIM 476453 BPJS 4/8/2017 9:41 K05.3 Chronic periodontitis
33 ENOK DIDIH 476564 BPJS 15/08/17 08:13:43 K04.7 Periapical abscess without sinus
34 HERMAN 476566 KARTU INDONESIA 21/08/17 09:14:44 K04.1 Necrosis of pulp
35 MEGAN GUMILAR HIDAYAT 476593 SEHAT
KARTU INDONESIA 15/08/17 09:53:04 K02.1 Caries of dentine
36 HERI HERIANTO 476763 SEHAT
BPJS 10/8/2017 9:30 K03.6 Deposits [accretions] on teeth
37 NOERANISA ADHADIANTY 477084 KARTU INDONESIA 11/8/2017 9:45 K04.1 Necrosis of pulp
GUNAWAN SEHAT
38 NOERANISA ADHADIANTY 477084 BPJS 24/08/17 10:18:59 K02.1 Caries of dentine
GUNAWAN
39 JUJU 477218 BPJS 1/8/2017 9:26 K04.0 Pulpitis
7 Anie Besari, drg
1 IDI,TN 477380 ASKES 22/08/17 07:57:37 K05.3 Chronic periodontitis
8 Anie Besari, drg
1 LISNA NOVITA 477388 BPJS 3/8/2017 11:02 K03.6 Deposits [accretions] on teeth
9 Anie Besari, drg
1 ISKA NALURI NOER 477399 KARTU INDONESIA 3/8/2017 10:38 K02.1 Caries of dentine
SEHAT
10 Anie Besari, drg
1 ANI HERYANI 477551 BPJS 11/8/2017 8:32 K05.3 Chronic periodontitis
2 ISTI INSANI AMALIA 477776 BPJS 1/8/2017 8:23 K04.7 Periapical abscess without sinus
3 UUN SUHARTINI 478101 KARTU INDONESIA 4/8/2017 9:01 K03.6 Deposits [accretions] on teeth
4 AI MUSTIKA NURJANAH 478436 SEHAT
UMUM 8/8/2017 9:50 K05.3 Chronic periodontitis
5 APIP SEPTIAN 478750 BPJS 11/8/2017 9:44 K04.1 Necrosis of pulp
6 RAHMAT HIDAYAT 478802 BPJS 16/08/17 09:12:08 K04.1 Necrosis of pulp
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NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

7 LIA DAHLIA 479062 KARTU INDONESIA 15/08/17 10:00:51 K02.1 Caries of dentine
8 LIA DAHLIA 479062 SEHAT
KARTU INDONESIA 22/08/17 09:00:33 K04.1 Necrosis of pulp
9 NANI SRIJANTINY 479361 SEHAT
BPJS 26/08/17 08:56:30 K02.1 Caries of dentine
10 WASJA 479505 BPJS 21/08/17 09:04:17 K04.7 Periapical abscess without sinus
11 ODID PARYADI 479759 UMUM 23/08/17 08:49:32 K04.7 Periapical abscess without sinus
12 LIA ANDRIANI 479853 BPJS 24/08/17 09:30:37 K08.3 Retained dental root
13 ANI SURYANI 479872 UMUM 24/08/17 10:42:35 K04.7 Periapical abscess without sinus
14 DUROTUL FARIDAH 479940 UMUM 25/08/17 08:58:23 K04.7 Periapical abscess without sinus
15 DUROTUL FARIDAH 479940 UMUM 25/08/17 08:58:23 K05.3 Chronic periodontitis
16 SUTINI 480005 UMUM 26/08/17 08:41:09 K04.7 Periapical abscess without sinus
17 HERAWATI 480276 BPJS 29/08/17 09:29:17 K05.3 Chronic periodontitis
18 NOVILA ANGGRAENY RISHYADI 480355 KARTU INDONESIA 30/08/17 08:07:44 K05.3 Chronic periodontitis
19 MIMIN 480463 SEHAT
UMUM 31/08/17 09:14:14 K04.1 Necrosis of pulp
11 H. Herdiana, dr, Sp. THT
1 SOLEHUDIN 355670 KARTU INDONESIA 22/08/17 09:49:32 J01.0 Acute maxillary sinusitis
SEHAT
12 H. Herdiana, dr, Sp. THT
1 HENDRA 479263 UMUM 22/08/17 07:35:41 C09.9 Tonsil, unspecified
13 drg. Asep Kemal Pasha,Sp.KGA.MM
1 BENI YANUAR AHMAD W 478111 BPJS 23/08/17 08:36:38 K00.6 Disturbances in tooth eruption
2 TAUFIK 479374 BPJS 19/08/17 08:54:38 K04.7 Periapical abscess without sinus
14 Aldi Rinaldi,dr,SpOT
1 UJU ABDUR ROZAK 424048 BPJS 30/08/17 11:13:27 Z47.9 Orthopaedic follow-up care, unspecified
15 Drg. Hj. Rinia Mulyasari
1 AMARULOH 3786 BPJS 12/8/2017 8:40 K04.0 Pulpitis
2 ELIYANTI 16878 ASKES 2/8/2017 8:26 K02.1 Caries of dentine
3 NURYATI 62562 KARTU INDONESIA 10/8/2017 10:46 K03.6 Deposits [accretions] on teeth
4 NURYATI 62562 SEHAT
KARTU INDONESIA 18/08/17 09:20:39 K04.1 Necrosis of pulp
5 ARMUNAH 64594 SEHAT
ASKES 11/8/2017 9:43 K04.7 Periapical abscess without sinus
6 NANO KARNO 99776 BPJS 22/08/17 10:43:53 K05.3 Chronic periodontitis
7 UYU WAHYUDIN 153078 BPJS 18/08/17 08:10:37 K04.7 Periapical abscess without sinus
8 YUSTI ASTYARINI 167187 ASKES 3/8/2017 10:46 K03.6 Deposits [accretions] on teeth
16 Drg. Hj. Rinia Mulyasari
1 IRMA AGUSTIEN 201024 UMUM 11/8/2017 9:12 K02.1 Caries of dentine
17 Drg. Hj. Rinia Mulyasari
1 SRI MULYATI 230316 BPJS 19/08/17 09:27:57 K03.6 Deposits [accretions] on teeth
2 IKA MUSTIKAWATI 242591 ASKES 19/08/17 09:23:49 K03.6 Deposits [accretions] on teeth
SimRS - 27/08/2018 20:38:34 4 of 10
NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

3 IKA MUSTIKAWATI 242591 ASKES 26/08/17 07:45:10 K02.1 Caries of dentine

4 REDHANI SANI 246695 BPJS 1/8/2017 10:10 K04.1 Necrosis of pulp
5 NURLAELA BADRIAH 273115 ASKES 16/08/17 09:44:36 K04.7 Periapical abscess without sinus
6 ETI GARTINI 309407 BPJS 3/8/2017 9:34 K04.7 Periapical abscess without sinus
7 INDRA 324811 UMUM 4/8/2017 8:26 K04.1 Necrosis of pulp
8 KARNO 334153 BPJS 2/8/2017 10:04 K04.7 Periapical abscess without sinus
9 KARNO 334153 BPJS 9/8/2017 8:20 K04.7 Periapical abscess without sinus
10 KARNO 334153 BPJS 16/08/17 08:48:35 K04.7 Periapical abscess without sinus
11 HETI HENDRAWATI NY 337491 BPJS 1/8/2017 11:08 K04.7 Periapical abscess without sinus
12 DASMAT ISMAYA 351098 BPJS 22/08/17 08:33:42 K04.1 Necrosis of pulp
13 SOLEHUDIN 355670 KARTU INDONESIA 22/08/17 09:49:32 K05.3 Chronic periodontitis
14 NDINDING SUPRIATININGSIH 358129 SEHAT
BPJS 3/8/2017 9:51 K04.7 Periapical abscess without sinus
15 NDINDING SUPRIATININGSIH 358129 BPJS 10/8/2017 9:58 K04.1 Necrosis of pulp
16 ANI ROHAENI 362248 BPJS 1/8/2017 9:24 K04.0 Pulpitis
17 FAUZIAH SRI LESTARI 366997 BPJS 4/8/2017 9:58 K04.1 Necrosis of pulp
18 NINING PERMASIH 368496 KARTU INDONESIA 23/08/17 10:44:37 K04.7 Periapical abscess without sinus
19 DINA YULIAN 369361 SEHAT
KARTU INDONESIA 23/08/17 10:35:45 K02.1 Caries of dentine
20 DINA YULIAN 369361 SEHAT
KARTU INDONESIA 29/08/17 10:52:05 K02.1 Caries of dentine
21 DETI SEPTIANI 373164 SEHAT
UMUM 1/8/2017 9:39 K04.1 Necrosis of pulp
22 TEJA YEPI SOFIANINGSIH 374595 BPJS 21/08/17 10:43:47 K04.7 Periapical abscess without sinus
23 AAN ASIAH 375437 BPJS 31/08/17 09:51:36 K05.3 Chronic periodontitis
24 ROHANAH 378824 ASKES 15/08/17 08:42:15 K04.7 Periapical abscess without sinus
25 TITA AMALIA.NY 392408 BPJS 16/08/17 08:18:08 K05.3 Chronic periodontitis
26 RIFKI MIFTAHUL ARIFIN 392685 BPJS 12/8/2017 10:10 K03.6 Deposits [accretions] on teeth
27 CARSIH 396066 BPJS 23/08/17 07:29:17 K04.7 Periapical abscess without sinus
28 EVI LAELATUL MUSFIDAH 396277 BPJS 30/08/17 10:30:10 K04.1 Necrosis of pulp
29 NURSAMSIAH 397827 BPJS 19/08/17 08:31:56 K02.1 Caries of dentine
18 Drg. Hj. Rinia Mulyasari
1 AGUS SUTORO 402656 UMUM 23/08/17 08:51:37 K02.1 Caries of dentine
19 Drg. Hj. Rinia Mulyasari
1 ASIH SUMIASIH 403663 BPJS 14/08/17 09:15:24 K04.1 Necrosis of pulp
2 ASIH SUMIASIH 403663 BPJS 21/08/17 10:36:20 K04.1 Necrosis of pulp
3 ASIH SUMIASIH 403663 BPJS 28/08/17 08:48:32 K02.1 Caries of dentine
4 YADI,TN 407489 BPJS 4/8/2017 8:27 K04.0 Pulpitis
5 R YENY RACHMAT 419655 KARTU INDONESIA 21/08/17 09:17:50 K04.7 Periapical abscess without sinus
6 TITIS MASPUPAH 420609 SEHAT
BPJS 22/08/17 08:02:46 K02.1 Caries of dentine
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NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

7 ERNA RIZKI ARDIANTI 424744 ASKES 24/08/17 09:14:51 K07.3 Anomalies of tooth position
8 DIAN RAHDIANI 427254 ASKES 14/08/17 10:40:22 K04.1 Necrosis of pulp
9 OTONG KARMANA 427657 BPJS 1/8/2017 9:20 K04.1 Necrosis of pulp
10 ARIP ARIPIN 427694 KARTU INDONESIA 3/8/2017 9:44 K04.1 Necrosis of pulp
11 AAM AMINAH 430551 SEHAT
BPJS 9/8/2017 10:10 K04.7 Periapical abscess without sinus
20 Drg. Hj. Rinia Mulyasari
1 EROS ROSMAYANTI 437769 BPJS 3/8/2017 9:00 K04.7 Periapical abscess without sinus
21 Drg. Hj. Rinia Mulyasari
1 EMPAT PATIMAH 440872 ASKES 1/8/2017 8:49 K04.1 Necrosis of pulp
2 YANI ROYANI 445303 BPJS 19/08/17 09:07:07 K08.3 Retained dental root
22 Drg. Hj. Rinia Mulyasari
1 ENUNG 445443 ASKES 14/08/17 10:01:12 K04.1 Necrosis of pulp
23 Drg. Hj. Rinia Mulyasari
1 MAYA 446565 ASKES 16/08/17 08:06:15 K04.0 Pulpitis
2 ANDA SENJAYA 447942 UMUM 1/8/2017 10:45 K05.3 Chronic periodontitis
3 DEDEH NURHASANAH 457901 BPJS 18/08/17 08:51:05 K01.1 Impacted teeth
4 DEDE WAWAT HERAWATI 458080 BPJS 10/8/2017 9:53 K08.3 Retained dental root
5 RESTI LISTIANI ANTA,NN 465550 BPJS 14/08/17 09:53:26 K03.6 Deposits [accretions] on teeth
6 YUNI WAHYUNI,NN 467156 KARTU INDONESIA 14/08/17 11:02:00 S02.6
7 SITI HAJAH 475344 SEHAT
KARTU INDONESIA 1/8/2017 8:39 K04.1 Necrosis of pulp
8 ENOK DIDIH 476564 SEHAT
BPJS 1/8/2017 8:20 K04.1 Necrosis of pulp
9 MEGAN GUMILAR HIDAYAT 476593 BPJS 1/8/2017 10:20 K02.1 Caries of dentine
10 HERI HERIANTO 476763 KARTU INDONESIA 3/8/2017 9:42 K12.2 Cellulitis and abscess of mouth
11 SUSI SUSYANTI 476799 SEHAT
KARTU INDONESIA 2/8/2017 10:04 K02.1 Caries of dentine
12 NOERANISA ADHADIANTY 477084 SEHAT
BPJS 16/08/17 10:34:35 K02.1 Caries of dentine
GUNAWAN
13 IDI,TN 477380 ASKES 29/08/17 08:11:29 K04.1 Necrosis of pulp
14 RENI HANDAYANI 477417 UMUM 1/8/2017 8:44 K04.1 Necrosis of pulp
15 AYUDIA RAHMA MAULIDA 477686 BPJS 16/08/17 11:02:33 K02.1 Caries of dentine
16 NENI NURAENI S.IP 478020 ASKES 3/8/2017 10:56 K04.7 Periapical abscess without sinus
17 SRIMULYATI SYAPUTRI 478184 UMUM 5/8/2017 9:07 K02.1 Caries of dentine
24 Drg. Hj. Rinia Mulyasari
1 SRIMULYATI SYAPUTRI 478184 UMUM 8/8/2017 9:38 K02.1 Caries of dentine
25 Drg. Hj. Rinia Mulyasari
1 NENI SURYANI ,NY 478482 KARTU INDONESIA 21/08/17 10:01:40 K04.7 Periapical abscess without sinus
2 TEPI MEILANI 478507 SEHAT
UMUM 10/8/2017 9:53 K04.1 Necrosis of pulp
3 AJAT SUDRAJAT 478522 UMUM 9/8/2017 8:53 K01.1 Impacted teeth
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NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

4 SUGIARTI 478531 UMUM 9/8/2017 9:25 K04.7 Periapical abscess without sinus
5 DEDE LIA MULIAWATI 478555 UMUM 9/8/2017 11:07 K04.0 Pulpitis
6 IYON 478804 BPJS 12/8/2017 8:26 K04.7 Periapical abscess without sinus
7 RIAN APRIANSAH 479029 BPJS 28/08/17 09:57:53 K04.1 Necrosis of pulp
8 ACAH 479031 UMUM 15/08/17 08:31:02 K04.1 Necrosis of pulp
9 SURYANA 479256 UMUM 18/08/17 08:07:43 K04.7 Periapical abscess without sinus
26 Drg. Hj. Rinia Mulyasari
1 SURYANA 479256 UMUM 25/08/17 08:25:20 K05.3 Chronic periodontitis
27 Drg. Hj. Rinia Mulyasari
1 SURYANA 479256 UMUM 31/08/17 08:28:01 K04.1 Necrosis of pulp
2 HENDRA 479263 BPJS 18/08/17 08:35:11 K02.1 Caries of dentine
3 UUS SANDILANI 479284 UMUM 18/08/17 09:31:05 K04.0 Pulpitis
4 NANI SRIJANTINY 479361 BPJS 19/08/17 08:09:53 K03.6 Deposits [accretions] on teeth
5 WASJA 479505 BPJS 28/08/17 09:38:57 K04.7 Periapical abscess without sinus
6 JUJU JULIA 479745 BPJS 23/08/17 08:18:38 K04.1 Necrosis of pulp
28 Drg. Hj. Rinia Mulyasari
1 LUGU ILHAMI 479852 BPJS 24/08/17 09:24:39 K02.1 Caries of dentine
29 Drg. Hj. Rinia Mulyasari
1 ANI SURYANI 479872 UMUM 30/08/17 09:22:09 K05.3 Chronic periodontitis
2 MUDRIKAH 479931 BPJS 25/08/17 08:14:48 K04.7 Periapical abscess without sinus
3 AISYAH 480142 UMUM 28/08/17 09:18:53 K04.0 Pulpitis
4 BELLA SAPARINA 480184 UMUM 28/08/17 10:31:08 K04.1 Necrosis of pulp
5 ROHMAH AGHNIA SUPRIADI 480296 UMUM 29/08/17 10:23:12 K04.7 Periapical abscess without sinus
6 NENENG SITI NAFISAH 480402 KARTU INDONESIA 30/08/17 10:18:49 K04.1 Necrosis of pulp
7 TRI HARYANI 480468 SEHAT
KARTU INDONESIA 31/08/17 09:44:10 K08.3 Retained dental root
8 RISMA LESTARI 480470 SEHAT
ASKES 31/08/17 09:47:52 K02.1 Caries of dentine
30 Rita Dewi Handayani,drg.Sp KG
1 DEDE ROHAYATI 32447 BPJS 1/8/2017 9:22 K04.0 Pulpitis
2 YAYAH KODARIAH 299518 BPJS 29/08/17 09:11:15 K04.0 Pulpitis
3 NENI HERYANI 353696 KARTU INDONESIA 1/8/2017 9:59 K04.1 Necrosis of pulp
4 NURHAYANI 380841 SEHAT
BPJS 1/8/2017 9:22 K02.1 Caries of dentine
5 LUSIYANA KOSIM,NY 403891 BPJS 8/8/2017 8:11 K04.0 Pulpitis
6 LUSIYANA KOSIM,NY 403891 BPJS 15/08/17 08:08:45 K04.1 Necrosis of pulp
31 Rita Dewi Handayani,drg.Sp KG
1 NENENG NIDA FARIDA 406721 KARTU INDONESIA 15/08/17 09:52:10 K04.1 Necrosis of pulp
SEHAT
32 Rita Dewi Handayani,drg.Sp KG
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NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

1 LILIS SUSANTI 433081 ASKES 25/08/17 09:12:43 K04.1 Necrosis of pulp

33 Rita Dewi Handayani,drg.Sp KG
1 EMPAT PATIMAH 440872 ASKES 25/08/17 08:26:18 K04.1 Necrosis of pulp
2 ZEERIN TASTBITA 447367 ASKES 1/8/2017 9:58 K04.1 Necrosis of pulp
3 ATENG YUSUP 465905 BPJS 23/08/17 08:42:53 K04.0 Pulpitis
4 DIDIK UTOMO 466342 BPJS 3/8/2017 7:50 K04.0 Pulpitis
5 ERWIN EKA PUTRA KOSWANDA 475533 BPJS 29/08/17 10:00:47 K04.0 Pulpitis
6 ABD. ROHIM 476453 BPJS 18/08/17 08:46:54 K04.0 Pulpitis
7 IIN HINDASAH 478416 BPJS 8/8/2017 8:57 K04.1 Necrosis of pulp
8 SUHAJI JUHANA 479871 BPJS 24/08/17 10:37:05 K02.1 Caries of dentine
34 Rita Dewi Handayani,drg.Sp KG
1 HERDIANA 479916 BPJS 25/08/17 07:26:21 K04.0 Pulpitis
35 H.Dendy R.Sukarjo,Drg.MM
1 ARMUNAH 64594 ASKES 16/08/17 08:24:06 K04.7 Periapical abscess without sinus
2 ARMUNAH 64594 ASKES 30/08/17 08:04:09 K04.1 Necrosis of pulp
3 SRI MULYATI 230316 BPJS 26/08/17 08:00:42 K04.7 Periapical abscess without sinus
4 RUSONI TN 230403 ASKES 14/08/17 10:23:35 K04.7 Periapical abscess without sinus
5 RAHAYU FARIDA ARIYANI 242397 KARTU INDONESIA 26/08/17 09:24:39 K03.6 Deposits [accretions] on teeth
6 NUNUNG NURAIDAH 263278 SEHAT
BPJS 7/8/2017 10:27 K02.1 Caries of dentine
7 NUNUNG NURAIDAH 263278 BPJS 14/08/17 10:42:20 K02.1 Caries of dentine
8 NUNUNG 304095 KARTU INDONESIA 11/8/2017 9:44 K04.0 Pulpitis
9 ETI GARTINI 309407 SEHAT
BPJS 10/8/2017 9:19 K04.7 Periapical abscess without sinus
10 ETI GARTINI 309407 KARTU INDONESIA 18/08/17 09:17:23 K04.1 Necrosis of pulp
11 IIS 330291 SEHAT
UMUM 8/8/2017 9:29 K04.7 Periapical abscess without sinus
12 ANAH 348629 BPJS 23/08/17 08:11:51 K04.7 Periapical abscess without sinus
13 ANAH 348629 BPJS 30/08/17 08:05:00 K04.7 Periapical abscess without sinus
14 AHMAD FARHANI 349879 BPJS 7/8/2017 9:10 K04.1 Necrosis of pulp
15 IRENA NURMALASARI 350314 ASKES 3/8/2017 10:21 K04.7 Periapical abscess without sinus
16 ETIN PARTINI 355484 BPJS 18/08/17 09:42:25 S03.0 Dislocation of jaw
17 ENTIN HARTINI 364692 BPJS 7/8/2017 9:39 K04.1 Necrosis of pulp
18 ENTIN HARTINI 364692 BPJS 21/08/17 10:10:18 K02.1 Caries of dentine
19 DINA YULIAN 369361 KARTU INDONESIA 2/8/2017 8:24 K02.1 Caries of dentine
20 ROHANAH 378824 SEHAT
ASKES 23/08/17 08:24:05 K04.7 Periapical abscess without sinus
36 H.Dendy R.Sukarjo,Drg.MM
1 TITIN NURIAH 381006 UMUM 7/8/2017 10:35 K04.0 Pulpitis
37 H.Dendy R.Sukarjo,Drg.MM
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NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

1 DIAN RAMDANSYAH, TN 384185 BPJS 23/08/17 08:43:13 K04.1 Necrosis of pulp

2 EEM SUHAEMAH 385141 BPJS 4/8/2017 8:33 K04.7 Periapical abscess without sinus
3 CARSIH 396066 BPJS 15/08/17 08:05:25 K04.7 Periapical abscess without sinus
4 RENI NURONIAH 396076 BPJS 10/8/2017 10:40 K04.1 Necrosis of pulp
5 EVI LAELATUL MUSFIDAH 396277 BPJS 23/08/17 10:34:52 K04.7 Periapical abscess without sinus
6 NURSAMSIAH 397827 BPJS 26/08/17 08:49:20 K02.1 Caries of dentine
7 TIA RESTIANI 402653 BPJS 14/08/17 09:34:20 K03.6 Deposits [accretions] on teeth
8 ASIH SUMIASIH 403663 BPJS 7/8/2017 8:58 K04.1 Necrosis of pulp
9 NENENG NIDA FARIDA 406721 KARTU INDONESIA 5/8/2017 9:05 K04.1 Necrosis of pulp
10 YADI,TN 407489 SEHAT
BPJS 10/8/2017 8:05 K02.1 Caries of dentine
11 YADI,TN 407489 BPJS 16/08/17 07:54:12 K02.1 Caries of dentine
12 AAN NURHASANAH 412344 KARTU INDONESIA 23/08/17 10:02:19 K02.0 Caries limited to enamel
13 R YENY RACHMAT 419655 SEHAT
KARTU INDONESIA 28/08/17 08:56:28 K04.7 Periapical abscess without sinus
14 TITIS MASPUPAH 420609 SEHAT
BPJS 29/08/17 08:01:33 K04.1 Necrosis of pulp
15 ARIP ARIPIN 427694 KARTU INDONESIA 10/8/2017 10:04 K04.1 Necrosis of pulp
16 DEWI MULIA SILMIE 428371 SEHAT
ASKES 11/8/2017 9:12 K04.0 Pulpitis
17 NIA KARIN 431449 KARTU INDONESIA 28/08/17 09:58:57 K04.7 Periapical abscess without sinus
18 DADANG HERMAWAN 432180 SEHAT
KARTU INDONESIA 30/08/17 07:56:04 K04.1 Necrosis of pulp
19 ANDANG 433734 SEHAT
UMUM 22/08/17 09:27:18 K04.7 Periapical abscess without sinus
20 DEDI SUHENDAR 435766 BPJS 7/8/2017 10:33 K03.6 Deposits [accretions] on teeth
21 RIDWAN GUNAWAN 437677 ASKES 31/08/17 10:03:44 K02.1 Caries of dentine
22 YAYAH 441724 KARTU INDONESIA 16/08/17 08:49:35 K04.1 Necrosis of pulp
SEHAT
38 H.Dendy R.Sukarjo,Drg.MM
1 ENUNG 445443 ASKES 7/8/2017 11:02 K04.7 Periapical abscess without sinus
39 H.Dendy R.Sukarjo,Drg.MM
1 RATNA HIDAYANTI 463867 BPJS 3/8/2017 9:46 K04.7 Periapical abscess without sinus
2 MANSYUR 464094 BPJS 16/08/17 10:45:29 K08.3 Retained dental root
3 MUHAROM 466414 KARTU INDONESIA 8/8/2017 7:51 K04.7 Periapical abscess without sinus
4 AI NONOH 466509 SEHAT
BPJS 22/08/17 09:12:58 K08.3 Retained dental root
5 ARDIANTO 472609 BPJS 23/08/17 08:29:25 K02.1 Caries of dentine
6 ENTIN ,NY 473412 UMUM 30/08/17 08:31:55 K04.7 Periapical abscess without sinus
7 ENOK DIDIH 476564 BPJS 8/8/2017 8:15 K04.1 Necrosis of pulp
8 IDI,TN 477380 ASKES 15/08/17 08:44:36 K04.7 Periapical abscess without sinus
9 ISKA NALURI NOER 477399 KARTU INDONESIA 30/08/17 10:29:42 K02.1 Caries of dentine
10 ANI HERYANI 477551 SEHAT
BPJS 4/8/2017 9:06 K04.7 Periapical abscess without sinus
11 AYUDIA RAHMA MAULIDA 477686 BPJS 7/8/2017 9:56 K02.1 Caries of dentine
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NO. NAMA DOKTER - NAMA PASIEN NO. PASIEN DEBITUR Tanggal NO DTD DIAGNOSA

12 TITA NU ARI 477693 BPJS 7/8/2017 10:08 K06.8 Other specified disorders of gingiva and edentulous
alveolar ridge
13 TITA NU ARI 477693 BPJS 14/08/17 10:16:44 K06.8 Other specified disorders of gingiva and edentulous
alveolar ridge
14 DARSALAM 477909 KARTU INDONESIA 2/8/2017 9:56 K08.3 Retained dental root
15 JAJANG 478183 SEHAT
KARTU INDONESIA 5/8/2017 9:03 K04.7 Periapical abscess without sinus
16 JAJANG 478183 SEHAT
KARTU INDONESIA 12/8/2017 9:38 K04.7 Periapical abscess without sinus
17 AGIS SUPRIATIN 478325 SEHAT
UMUM 7/8/2017 10:00 K02.1 Caries of dentine
18 IIS ISMAYANTI 478395 UMUM 8/8/2017 8:05 K04.7 Periapical abscess without sinus
19 AGUS PRIYATNA 478439 ASKES 8/8/2017 9:53 K03.6 Deposits [accretions] on teeth
20 NENI SURYANI ,NY 478482 KARTU INDONESIA 15/08/17 08:03:18 K04.7 Periapical abscess without sinus
21 UYU YUHANA 478746 SEHAT
UMUM 11/8/2017 9:31 K02.1 Caries of dentine
22 APIP SEPTIAN 478750 BPJS 18/08/17 09:31:18 K02.1 Caries of dentine
23 RAHMAT HIDAYAT 478802 BPJS 12/8/2017 7:42 K03.6 Deposits [accretions] on teeth
24 IYON 478804 BPJS 19/08/17 08:47:53 K04.7 Periapical abscess without sinus
25 IYON 478804 BPJS 26/08/17 08:25:19 K04.7 Periapical abscess without sinus
26 TITI 478936 UMUM 14/08/17 09:28:17 K05.3 Chronic periodontitis
27 RIAN APRIANSAH 479029 UMUM 15/08/17 08:29:10 K04.1 Necrosis of pulp
28 HENDRA 479263 UMUM 22/08/17 07:35:41 K02.1 Caries of dentine
29 ADE DARSONO S.PD.M, M.PD 479357 KARTU INDONESIA 19/08/17 07:48:43 K04.1 Necrosis of pulp
30 AANG SUNANDI 479370 SEHAT
BPJS 19/08/17 08:45:33 K04.7 Periapical abscess without sinus
31 AANG SUNANDI 479370 BPJS 25/08/17 08:27:44 K04.7 Periapical abscess without sinus
32 PAUZI MAULANA YUSUF 479675 UMUM 22/08/17 10:43:43 K03.6 Deposits [accretions] on teeth
33 NURHAYATI 479849 UMUM 24/08/17 09:06:56 K04.7 Periapical abscess without sinus
34 NURHAYATI 479849 UMUM 30/08/17 07:31:22 K04.7 Periapical abscess without sinus
35 OTONG SONJAYA 479992 KARTU INDONESIA 26/08/17 07:33:50 K04.7 Periapical abscess without sinus
36 SELVI WARDATI RAHIMA 480093 SEHAT
UMUM 28/08/17 07:51:20 K03.6 Deposits [accretions] on teeth
37 INTAN KHAIRUNNISA 480096 UMUM 28/08/17 07:53:02 K03.6 Deposits [accretions] on teeth
38 SAEPULAH 480284 KARTU INDONESIA 29/08/17 09:50:14 K02.1 Caries of dentine
SEHAT
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NO NAMA DOKTER NAMA DIAGNOSA PENJAMIN JUMLAH