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DIAGNOSA AWAL



TARIF



KODE



GROUPER



19 BRONCHITIS DEWASA



R50.9 R11 R56.8 R06.0 O42.9 O48 O46.9 O21.0 R10.4 K30 S09.9 R42 A09.9 T14.1 R40.1 J45.9 J18.0 J20.9 J40



A-4-12-I K-4-17-I G-4-22-I J-4-21-I W-4-16-I W-4-16-I W-4-16-I W-4-16-I K-4-17-I K-4-18-I G-4-24-I U-4-11-I K-4-17-I L-4-13-I G-4-21-I J-4-18-I J-4-16-I J-4-16-I J-4-21-I



3,618,800 2,027,800 3,641,500 3,837,100 2,883,800 2,883,801 2,883,802 2,883,802 2,027,800 1,791,800 3,160,800 1,891,500 2,027,800 3,268,500 2,882,700 2,960,400 3,837,100 3,837,101 3,837,100



20 ABORTION



O06



W-4-13-I



1,331,800 1,141,600



KODE



GROUPER



O02.1 O02.0 N18.9 E11.9 I10 R73.9 E16.2 I50.0 R51 M54.5



W-4-13-I W-4-16-I N-4-10-I E-4-10-I I-4-17-I E-4-10-I



NO 1 FEBRIS



2 VOMITUS 3 KEJANG 4 DYSPNEU 5 KPD (Ketuban Pecah Dini) 6 SEROTINUS 7 APH (Antepartum Hemmorrage) 8 HEG (Hyperemesis Gravidum) 9 KOLIK ABDOMEN 10 DYSPEPSI 11 CKR (Cedera Kepala) 12 VERTIGO 13 GEA 14 VL 15 STUPOR (Penurunan Kesadaran) 16 ASMA 17 BRPN (BRONCOPNEUMONIA) 18 BRONCHITIS ANAK



NO



DIAGNOSA AWAL



21 MISSED ABORTION 22 BO (BLIGHTED OVUM) 23 CKD 24 DM 25 HT (HYPERTENSI) 26 HYPERGLIKEMIA 27 HYPOGLIKEMIA 28 CHF 29 CEPHALGIA 30 LBP (LOW BACK PAIN)



E-4-10-I I-4-12-I G-4-23-I M-4-17-I



1



2 3,101,800 1,738,100 3,121,300 3,289,000 2,471,800 2,471,801 2,471,802 2,471,802 1,738,100 1,535,900 2,709,300 1,621,300 1,738,100 2,801,600 2,470,900 2,537,500 3,289,000 3,289,001 3,289,000



TARIF 1 1,331,801 2,883,800 3,548,500 4,802,700 2,535,900 4,802,700 4,802,700 3,714,100 2,837,800 3,948,900



2 1,141,601 2,471,800 3,041,500 4,116,600 2,173,600 4,116,600 4,116,600 3,183,500 2,432,400 3,384,800



31 ANEMIA



38 SNH



D64.9 R07.4 I21.1 A16.2 I21.4 I20.9 I61.9 I63.9



D-4-13-I I-4-20-I I-4-10-I J-4-15-I I-4-10-I I-4-20-I G-4-13-I G-4-14-I



3,198,500 4,365,200 4,199,400 5,767,500 4,199,400 4,365,200 3,164,400 5,368,100



39 IKTERUS / JAUNDICE



R17



B-4-13-I



4,502,000 3,858,900



KODE



GROUPER



S52.6 S72.9 S42.3 S42.7 S82.2 S52.4 S92.5 S62.6 A05.9 A01.0 S39.9 O20.0 K12.1 G81.9 G82.2 K92.1 K92.0 K92.8 R59.0



M-4-12-I M-4-10-I M-4-12-I



KODE



GROUPER



N93.9 G82.5 R13



W-4-12-I G-4-10-I K-4-18-I



32 CHEST PAIN 33 STEMI 34 TB PARU 35 NSTEMI 36 ANGINA PECTORIS 37 ICH



NO



DIAGNOSA AWAL



FRAKTUR RADIUS FRAKTUR FEMUR FRAKTUR HUMERUS FRAKTUR CLAVICULA FRAKTUR TIBIA FRAKTUR ULNA FRAKTUR DIGITI / TOE / JARI KAKI FRAKTUR PHALANX FINGER KERACUNAN MAKANAN TYPOID FEVER TRAUMA ABDOMEN ABORTUS IMINIENT STOMATITIS HEMIPARESIS PARAPARASE / PARAPLEGIA MELENA HEMATEMESIS HEMATOCHEZIA 58 LYMPHADENOPATI 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57



NO



DIAGNOSA AWAL



59 AUB 60 TETRAPLEGIA 61 DYSPHAGIA



M-4-12-I M-4-12-I M-4-12-I M-4-12-I M-4-12-I K-4-18-I A-4-14-I S-4-10-I W-4-14-I U-4-14-I G-4-26-I G-4-10-I K-4-18-I K-4-18-I K-4-18-I D-4-14-I



2,741,500 3,741,600 3,599,500 4,943,600 3,599,500 3,741,600 2,712,400 4,601,200



TARIF 1 3,156,000 3,173,000 3,156,000 3,156,001 3,156,002 3,156,003 3,156,004 3,156,005 1,791,800 3,017,400 2,905,200 1,779,900 3,949,400 4,268,100 4,535,900 1,791,800 1,791,800 1,791,800 3,430,500



2 2,705,200 2,719,700 2,705,200 2,705,201 2,705,202 2,705,203 2,705,204 2,705,205 1,535,900 2,586,400 2,490,100 1,525,600 3,385,200 3,658,400 3,887,900 1,535,900 1,535,900 1,535,900 2,940,400



TARIF 1 3,852,000 4,535,900 1,791,800



2 3,301,700 3,887,900 1,535,900



KOLIK RENAK / COLIC RENAL HERNIA INGUINAL / SCROTAL TROMBOCYTOPENI OA GENU 66 HEMAPTOE / HAEMOPTYSIS 67 EPISTAXSIS 62 63 64 65



68 69 70 71 72 73 74 75 76 77



N23 K40.9 D69.3 M17.9 R04.2 R04.0



N-4-13-I K-4-18-I D-4-11-I M-4-18-I



4,686,000 1,791,800 4,329,100 2,984,800



J-4-21-I



3,837,100 3,289,000 3,475,000 2,978,600



U-4-12-I



4,016,600 1,535,900 3,710,600 2,558,400



TARIF 3 2,584,900 1,448,400 2,601,100 2,740,800 2,059,800 2,059,801 2,059,802 2,059,802 1,448,400 1,279,900 2,257,700 1,351,100 1,448,400 2,334,600 2,059,100 2,114,600 2,740,800 2,740,801 2,740,800 951,300



TARIF 3 951,301 2,059,800 2,534,600 3,430,500 1,811,400 3,430,500 3,430,500 2,652,900 2,027,000 2,820,700



2,284,600 3,118,000 2,999,600 4,119,700 2,999,600 3,118,000 2,260,300 3,834,300 3,215,700



TARIF 3 2,254,300 2,266,400 2,254,300 2,254,301 2,254,302 2,254,303 2,254,304 2,254,305 1,279,900 2,155,300 2,075,100 1,271,300 2,821,000 3,048,700 3,239,900 1,279,900 1,279,900 1,279,900 2,450,400



TARIF 3 2,751,400 3,239,900 1,279,900



3,347,100 1,279,900 3,092,200 2,132,000



2,740,800 2,482,200