DAFTAR PENYAKIT TERSERING BPJS NO 1 2 3 4 5
DIAGNOSIS HEG keton (-) GEA Thypoid fever Viral infection + ISPA + Dyspepsia BPPV + LBP + myalgia
6
Pneumonia + HT
7
UAP +AMI + IDDM
8
BP + Bacterial infection + cardiomegaly + enteritis viral Kista ginjal + bacterial infection Dyspepsia + hipokalemi + ISPA Kolik renal + HT + Dyspepsia BPPV + Dyspepsia + HT
9 10 11 12 13 14 15
16 17
AB inkomplit HEG keton (-) + GEA Kolik renal + nefrolitiasis + cholelitiasis + dyspepsia + intake kurang + HT + AKI + Fatty liver DHF Arhytmia cordis + HT + VES
18 19
Menometroraghia Vertigo perifer
KODE ICD 10 O21.0 A09.9 A01.0 B34.9 + J06.9 + K30 H81.1 + M54.59 + M79.1 J18.9 + I10
I20.0 + I21.4 + E10.6 J18.0 + A49.9 + I51.7 + A08.3 Q61.9 + A49.9 K30 + E87.6 + J06.9 N23 + I10 +K30 H81.1 + K30 + I10 O05.4 O21.0 + A09.9 N23 + N20.0 + K80.5 + K30 + Z59.4 + I10 + N17.8 + K76.0 A91 I49.9 + I10 + 149.3 N92.1 H81.3
Tindakan IVFD, Inj. Obat, lab IVFD, lab IVFD, Inj. Obat, lab IVFD, lab
IGD
POLI
KELAS 1 2.883.800 2.027.800
KELAS 2
KELAS 3
1.738.100
1.448.400 2.155.300
2.176.200
IVFD, Inj. Obat
1.351.100
O2, nebul, IVFD, Inj. Steroid, inj. Antibiotic, lab darah, EKG, X foto thorax, AGD Lab, EKG, UL, IVFD, inj. Antikoagulan, inj. insulin IVFD, inj. Obat, inj. Antibiotic, nebul, EKG, lab darah, X foto thorax, sputum IVFD, inj. Antibiotic, inj. Obat, cek darah, UL IVFD, inj. Obat, cek darah
3.432.600
5.384.600 4.823.600 2.826.800 2.182.500
IVFD, inj. Obat, cek darah, UL IVFD, inj. Obat, EKG, cek darah Kuret DC, IVFD, cek darah, O2 IVFD, inj. obat IVFD, inj. Obat, cek darah, UL, USG abdomen, EKG
IVFD, inj. Obat, cek darah, UL IVFD, O2, X foto thorax, x foto pedis, x foto lumbosacral, cek darah, EKG Kuret AC, IVFD, inj. Obat, cek darah IVFD, inj. Obat, cek darah
3.347.100 1.351.100 2.048.200
1.706.800 2.059.800
8.661.100
1.554.400 2.994.300 2.751.400 1.621.300
20 21
GEA + Kejang demam KDS + ISPA + Leukositosis
22
Dyspepsia + abdominal pain + intake kurang Dyspepsia + ISPA IDDM + CKD + HHD dengan CHF Kolik renal
A09.9 + R56.0 R56.0 + J06.9 + D72.8 K30 + R10.4 + Z59.4 K30 + J06.9 E10.7 + N18.9 + I11.0 N23
26
Pleuritis + cardiomegali + bronchiektasis + HT
J94.9 + I51.7 + J47 + I10
27 28
Mioma uteri GEA + hipokalemi + hamil
29
32
Pneumonia + TB + Bacterial infection FA + intake kurang + exantema subitum + dermatomikosis ISK + dyspepsia + akut abdomen Thypoid fever + epilepsi
D25.9 A09.9 + E87.6 + Z32.1 J18.9 + A16.0 + A49.9 J02.8 + Z59.4 + B08.2 + B36.9
33 34 35 36
Vertigo perifer + dyspepsia Bacterial infection GEA + intake kurang Bronchitis + asma
H81.3 + K30 A49.9 A09.9 + Z59.4 J40 + J45.9
37
GEA + Hipokalemi
A09.9 + E87.6
38
Hepatitis A tanpa koma hepatik + hiperbilirubinemia + peningkatan enzim transaminase +
23 24 25
30
31
N39.0 + K30 + R10.0 A01.0 + G40.9
B15.9 + E80.7 + R74.0 + D69.6
IVFD, inj. Antibiotik, cek darah, UL, FL IVFD, inj. antibiotik
1.981.100 3.323.400
IVFD, inj. Obat, cek darah, UL, IVFD, inj. Obat, cek darah UL, EKG, X foto thorax, cek darah, AGD, inj. Obat, inj. Insulin, O2, USG ginjal IVFD, inj. Obat, cek darah, UL, USG abdomen, EKG Cek darah, EKG, AGD, O2, nebul, x foto thorax, IVFD, inj. Obat, inj. Steroid, inj. antibiotik IVFD, inj. Obat, cek darah IVFD, inj. Obat, USG hamil, cek darah
1.535.900 1.279.900 8.329.600 4.686.000 4.415.400
2.751.400 2.377.300
IVFD, inj. Antibiotik, inj. Obat, nebul, sputum, x foto thorax, cek darah IVFD, inj. Antibiotik, cek darah
IVFD, inj. Obat, cek darah, UL, USG abdomen IVFD, inj. Antibiotik, inj. Steroid, cek darah, UL IVFD, inj. obat IVFD, inj. Antibiotik, cek darah, UL IVFD, inj. Antibiotik, cek darah IVFD, inj. Antibiotik, nebul, inj. Obat, cek darah, x foto thorax IVFD, inj. Obat, FL, Cek darah, inj. antibiotik IVFD, inj. Antibiotik, inj. Obat, cek darah
4.119.100 2.661.200
2.220.000 3.139.400 1.351.100 3.017.400 1.448.400 3.289.000 2.377.300 4.495.400
1.981.100
39
trombositopenia Dyspepsia + melena + susp. keganasan HT + Chest pain + dyspepsia
46
SNH + hipokalemi + palpitasi + cardiomegaly + HT
47
Kolik renal + hydronefrosis + ISK + dyspepsia Cholelitiasis + dyspepsia
K30 + K29.1 + Z03.1 I10 + R07.4 + K30 A49.9 + A09.9 O20.0 K30 + B34.9 + K92.1 K30 E10.7 + N39.0 + A49.9 + I10 + E87.6 I64 + E87.6 + R00.2 + I51.7 + I10 N23 + N13.2 + N39.0 + K30 K80.2 + K30
49
TB paru + bacterial infection + dyspepsia
A15.2 + A49.9 + K30
50
Thypoid fever + hipokalemi
A01.0 + E87.6
51 52 53 54 55
BP Dyspepsia + BPPV STT punggung Bacterial infection + dyspepsia Tumor Ovarium
56 57
STT abdomen Appendicitis akut
58
CHF + HT + cardiomegaly
40 41 42 43 44 45
48
Bacterial infection + GEA Ab imminens Dyspepsia + viral infection + melena Dyspepsia IDDM + ISK + bacterial infection + HT + hipokalemi
J18.0 K30 + H81.1 D23.6 A49.9 + K30 D27 D21.4 K35.3 I50.0 + I10 +
IVFD, Inj. Obat, cek darah
1.791.800
IVFD + inj. Obat + cek darah + EKG + x foto thorax IVFD, inj. Antibiotik, UL IVFD, inj. Obat, USG hamil, cek darah IVFD, inj. Obat, cek darah, UL, FL
1.811.400 2.586.400 1.525.600 1.535.900
IVFD, inj. Obat, cek darah IVFD, inj. Obat, inj. Insulin, inj. Antibiotik, cek darah, UL, EKG
1.279.900 4.793.500
Cek darah, x foto thorax, CT scan kepala, EKG, IVFD, inj. obat IVFD, inj. Obat, inj. Antibiotik, cek darah, UL, USG abdomen IVFD, cek darah, USG abdomen, inj. Antibiotik, inj. obat IVFD, inj. Obat, inj. Antibiotik, nebul, AGD, x foto thorax, sputum, cek darah, O2 IVFD, Inj. Obat, inj. Antibiotik, cek darah, FL IVFD + cek darah + x foto thorax IVFD, inj. OBAT, cek darah IVFD, inj. Obat, eksisi lesi IVFD, inj. Obat, cek darah, UL, X foto thorax Salpingo oophorostomy, IVFD, inj. Obat, spinal analgetik, DC urin, inj. antibiotik IVFD, inj. Obat, eksisi lesi Appendectomy, IVFD, inj. Obat, inj. Antibiotik, cek darah IVFD, inj. Obat, inj. Antibiotik, cek darah,
4.486.900
5.651.800 3.212.300 4.119.700
2.616.200 4.119.100 5.537.800
3.432.600 1.279.900
4.746.700 2.155.300 7.585.200 4.746.700 2.874.500 2.652.900
59
DHF + IDDM + ISPA + HT + Phlebitis
60
SC karena BSC
I51.7 A91 + E10.8 + J06.9 + I10 + I80.9 034.2
61
63
Asma + pneumoni + dyspepsia + ISK + bacterial infection Kolik renal + hematuri + batu ginjal + dyspepsia Pneumonia + bronchiektasis
J45.9 + J18.9 + K30 + N39.0 + A49.9 N23 + R31 + N20.0 + K30 J18.9 + J47
64
Mioma uteri
65
IDDM + dyspepsia + HT
66 67
IDDM + ULKUS DM + dyspepsia + HT SC + steril
68
KAD + GEA + hipokalemi
62
D26.1 E10.6 + K30 + I10 E10.6 + L98.4 + K30 + I10 O34.2 + Z30.2 E10.1 + A09.9 + E87.6
UL, x foto thorax IVFD, cek darah, x foto thorax, EKG, inj. Antibiotik, inj. Obat, inj. Insulin,
3.278.400
SC, IVFD, inj. Obat, spinal anestesi, DC urin, USG abdomen IVFD, inj. Obat, inj. Antibiotik, nebul, cek darah, UL, x foto thorax
6.965.200
IVFD + inj. Obat + cek darah + UL + USG abdomen IVFD + inj. Obat + inj. Antibiotik + nebul + cek darah + sputum + chest fisioterapi + inj. steroid Laparatomi, IVFD, inj. Antibiotik, tranfusi PRC, inj. Obat, cek darah IVFD, inj. insulin, cek darah, UL, AGD, EKG IVFD, inj. insulin, inj. Obat, inj. Antibiotik, cek darah, x foto thorax, EKG SC, IVFD, inj. Obat, spinal anestesi, DC urin, USG abdomen + 66.99 IVFD, inj. Antibiotik, inj. Insulin, inj. Obat, x foto thorax, cek darah, AGD
4.686.000
4.975.200 3.673.800
4.016.600 4.823.600
6.571.300 4.116.600 5.752.200 8.849.400 4793.500