RL 2a Dan RL 2a1 TW 2010 Total

DATA KEADAAN MORBIDITAS PASIEN RAWAT INAP RUMAH SAKIT
TRIWULAN : I ( Januari S.D Maret) TAHUN 2010

Formulir RL 2a
RUMAH SAKIT UMUM DAERAH SUMBAWA
No.
No. DTD
Urut
1
01
02
03
04
05
No. DAFTAR TERPERINCI
2
001
002
003
004.0
004.9
GOLONGAN SEBAB-SEBAB SAKIT
A 00
A 01
A 03
A 06.4
A 06.0-3, 5-9
Cholera
Demam tifoid dan paratifoid
Shigellosis
Abses hati amuba
Amebiasis lainnya
06 005
A 09
Diare & gastroenteritis oleh penyebab

infeksi tertentu (kolitis infeksi)
07 006
A 02, A 04, A 05. A 07, A 08
Penyakit infeksi usus lainnya
08 007.0
A 15.0
09 007.1
10 007.9
11 008.0
A 15.1 - A 16.2
A 16.3-9
A 17.0
12 008.1
A 17.1-9
13
14
15
16
17
18
19
20
21
22
23
24
25
26
A 18.0
A 18.2
A 19
A 18.1, 3-8
A 20
A 23
A 30
A 33
A 34, A 35
A 36
A 37
A 39
A 40, A 41
A 22
A 21, A 24-28, A 31-32, A 38,
A 42-49
A 50
A 51
A 52, A 53
A 54
008.2
008.3
008.4
008.9
009
010
011
012
013
014
015
016
017
018.0
27 018.9
28
29
30
31
019
020
021
022
32 023
A 55, A 56
33 024
A 57- A 64
34
35
36
37
38
39
40
41
42
43
44
A 68
A 71
A 75
A 80
A 82
A 83 - A 86
A 95
A 90
A 91
A 92.0
A 92.1, A 92
025
026
027
028
029
030
031
032.0
032.1
032.2
032.3
45 032.9
A 93 - A 94, A 96 - A 99
46 033
B 00
47 034
B 01 - B 02
48
49
50
51
52
53
54
B 05
B 06
B 16
B 15
B 17.1
B 17.2
B 17.08, B 18, B19
035
036
037
038.0
038.1
038.2
038.9
Tuberkulosis (TB) pari BTA (+)

dengan/ tanpa biakan kuman TB
Tuberkulosis paru lainnya
Tuberkulosis alat napas lainnya
Meningitis tuberkulosa
Tuberkulosis susunan saraf pusat
lainnya
Tuberkulosis tulang dan sendi
Limfadenitis tuberkulosa
Tuberkulosis milier
Tuberkulosis lainnya
Sampar / Pes
Bruselosis
Lepra / Kusta
Tetanus neonatorum
Tetanus lainnya
Difteria
Pertusis / Batuk rejan
Infeksi meningokok
Septisemia
Anthraks
Penyakit bakteri lainnya
Sifilis bawaan
Sifilis dini
Sifilis lainnya
Infeksi gonokok
Penyakit klamidia yg ditularkan melalui
hubungan seksual
Infeksi lainnya yang terutama
ditularkan melalui hubungan seksual
Demam bolaik-balik
Trakoma
Demam tifus
Poliomielitis akut
Rabies
Ensefalitis virus
Demam kuning
Demam dengue
Demam berdarah dengue
Chikungunya
Demam virus tular nyamuk
Demam virus dan demam berdarah
virus tular serangga lainnya
Infeksi herpesvirus (Herpes simpleks)
Varisela (cacar air) dan zoster (herpes
zoster)
Campak
Rubella
Hepatitis B akut
Hepatitis A akut
Hepatitis C akut
Hepatitis E akut
Hepatitis virus lainnya
Penyakit virus gannguan defisiensi
imun pada manusia (HIV)
Gondong
55 039
B 20 - B 24
56 040
B 26
57 041
A 81, A 87- A 89, B 03 - B 04,

Penyakit virus lainnya
B 07- B 09, B 25, B 27- B 34
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
B 35 - B 49
B 50 - B 54
B 55
B 56 - B 57
B 65
B 66
B 67
B 72
B 73
B 74
B 76
B 68 - 71, B 75, B 77 - 83
B 90.91
B 90.92
B 90.0-8
B 91
B 92
A 66
042
043
044
045
046
047
048
049
050
051
052
053
054.0
054.1
054.9
055
056
057.0
Mikosis
Malaria (included all malaria)
Lesmaniasis
Tripanosomiasis
Skistosomiasis (Bilharziasis)
Infeksi trematoda lainnya
Ekinokokosis
Drakunkuliasis
Onkosersiasis
Filariasis
Penyakit cacing tambang
Helmintiasis lainnya
Paru/lobus luluh akibat TB
Sindrom obstruksi pasca TB
Sukuele (gejala sisa) TB lainnya
Sukuele (gejala sisa) poliomielitis
Sukuele (gejala sisa) lepra
Patek (Frambusia)
PASIEN KELUAR (HIDUP & MATI) MENURUT

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
1
11
35
4
3
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
1
0
0
0
0
32
0
0
0
0
24
0
0
0
0
56
0
0
0
0
0
0
0
0
61
61
13
11
35
39
15
128
107
235
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
4
9
4
0
6
17
13
0
2
6
5
0
10
15
17
0
3
18
5
0
13
33
22
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
1
0
1
0
0
0
9
0
0
0
0
0
0
0
0
0
0
2
0
0
0
8
0
0
0
0
0
0
0
0
0
0
1
0
0
0
4
0
0
0
0
0
0
0
0
0
0
4
0
0
0
23
0
0
0
0
0
1
0
0
1
0
1
0
0
0
18
0
0
0
0
0
1
0
0
1
0
5
0
0
0
41
0
0
0
0
0
0
0
0
0
0
1
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
32
0
0
0
0
0
0
0
0
0
0
0
87
0
0
0
0
0
0
0
0
0
0
3
22
0
0
0
0
0
0
0
0
0
0
2
8
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
3
84
0
0
0
0
0
0
0
0
0
0
2
71
0
0
0
0
0
0
0
0
0
0
5
155
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
0
0
0
2
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
3
1
0
0
1
1
0
0
1
0
0
0
0
1
0
0
4
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
23
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
40
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
65
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
51
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
116
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
76 057.1
77 057.2
78 057.9
79 058.0
80 058.1
81 058.9
82 059
83 060
84 061
85 062
86 063
87 064
88 065
89
90
91
92
066
067.0
067.9
068.0
93 068.9
94 069
95 070
96 071
97 072.0
98 072.9
99 073
100 074
101 075.0
102 075.9
103 076.0
104 076.1
105 076.9
106 077
107 078.0
108 078.1
109 078.9
110 079
A 70
Infeksi Klamedia
B 58
Toksoplasmosis
A 65, A 67, A 69, A 74, A 77 A79, B 56 - B 64, B 85 - B 89, Penyakit infeksi dan parasit lainnya
B 94 - B99
Neoplasma ganas bibir, rongga mulut,
C 00 - C 10
kelenjar liur, faring, tonsil
C 11
Neoplasma ganas nasofaring
C 12 - C 14
faring, lainnya & YTT
C 15
Neoplasma ganas esofagus
C 16
Neoplasma ganas lambung
C 18
Neoplasma ganas kolon
Neoplasma ganas daerah
C 19 - C 21
rektosigmoid, rektum dan anus
Neoplasma ganas hati dan saluran
C 22
empedu intrahepatik
C 25
Neoplasma ganas pankreas
Neoplasma ganas usus halus dan alat
C 17, C 23-C 24, C 26
cerna lainnya
C 32
Neoplasma ganas laring
C 33
Neoplasma ganas trakea
C 34
Neoplasma ganas bronkus dan paru
C 38.1-8
Neoplasma ganas mediastinum
C 30, C 31, C 37, C 38.0, C
Neoplasma ganas sistem napas dan
39
alat rongga dada lainnya
Neoplasma ganas tulang dan tulang
C 40 - C 41
rawan sendi
C 43
Neoplasma ganas kulit
C 44
Neoplasma ganas kulit lainnya
C 45
Mesotelioma
Neoplasma ganas jaringan ikat dan
C 46 - C 49
jaringan lunak
C 50
Neoplasma ganas payudara
C 53
Neoplasma ganas serviks uterus
C 54
Neoplasma ganas korpus uteri
Neoplasma ganas bagian uterus
C 55
lainnya dan YTT
Neoplasma ganas ovarium (indung
C 56
telur)
C 58
Neoplasma ganas plasenta (uri)
Neoplasma ganas alat kelamin
C 51-C 52, C 57
perempuan lainnya
C 61
Neoplasma ganas prostat
C 60
Neoplasma ganas penis
C 62
Neoplasma ganas testis
Neoplasma ganas alat kelamin pria
C 63
lainnya
Neoplasma ganas kandung kemih
C 67
(buli-buli)
111 080.0
C 64 - C 65
Neoplasma ganas ginjal, pelvis ginjal
112 080.9
C 66, C 68
Neoplasma ganas alat kemih lainnya
113 081
C 69
Neoplasma ganas mata dan adneksa
114 082
C 71
115 083
C 70, C 72
116 084.0
C 73
117 084.1
C 74 - C 75
118 084.2
C 76
119 084.3
C 77 - C 80
120 084.9
C 97
121 085
122 086
123 087
C 81
C 82 - C 85
C 91 - C 95
124 088
C 88 - C 90, C 96
125
126
127
128
D 06
D 22 - D 23
D 24
D 25
Neoplasma ganas otak

Neoplasma ganas bagian susunan
saraf pusat
Neoplasma ganas kelenjar tiroid
Neoplasma ganas kelenjar endokrin
lain dan struktur terkait
Neoplasma ganas tempat lain dan
yang tidak jelas batasannya
Neoplasma ganas sekunder dan
neoplasma ganas kelenjar getah
bening YTT
Neoplasma ganas primer tempat
multipel
Penyakit Hadgkin
Limfoma non Hodgkin
Leukemia
Neoplasma ganas dari limfoid,
hematopoetik dan jaringan terkait
lainnya
Karsinoma in situ serviks uterus
Neoplasma jinak kulit
Neoplasma jinak payudara
Leiomioma uterus
Neoplasma jinak ovarium (indung
telur)
Neoplasma jinak alat kemih
Neoplasma jinak otak dan susunan
saraf pusat lainnya
Karsinoma in situ kulit
Karsinoma in situ payudara
Karsinoma in situ lainnya
Polip gastrointestinal
089
090
091
092
129 093
D 27
130 094
D 30
131 095
D 33
132
133
134
135
D 04
D 05
D 00-D 03, D 07-D 09
D 12.6
096.0
096.1
096.2
096.3

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
1
0
0
0
1
1
1
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
0
2
1
2
0
4
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
4
3
0
0
10
0
0
0
3
0
0
0
0
0
0
0
2
0
0
0
15
4
0
0
17
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
4
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
1
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
4
0
0
2
8
0
0
1
3
0
0
1
2
0
0
5
7
0
0
1
10
0
0
6
17
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
6
3
0
0
0
4
8
0
0
0
0
0
0
0
0
2
0
0
0
0
9
11
0
0
0
11
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
136 096.4
D 14.1 - 4
Neoplasma jinak sistem napas lainnya
137 096.5
D 15.2
D10 - D12.0-5, 7-9, D13 D14.0, D15.0-1, D15.7-9D20, D21, D26, D28 - D29,
D31 - D32, D34 - D 36
Neoplasma jinak mediastinum
138 096.6
139 096.9
D 37 - D 48
140
141
142
143
144
145
D 50
D 59
D 61
D51 - D58, D60, D62, D64
D 70
D 74
146 099.9
D65 - D69, D71- D73, D75 D77
Kondisi hemoragik dan penyakit darah

dan organ pembuat darah lainnya
147 100
D80 - D89
148 101
149
150
151
152
153
154
102
103.0
103.1
103.2
103.9
104.0
155 104.1
156 104.2
157
158
159
160
161
104.3
104.9
105
106
107
162 108
163 109
164 110
165 111
166 112
167 113
168 114.0
169 114.1
Penyakit tertentu yang menyangkut

mekanisme imun
Gangguan tiroid berhubungan dengan
E00 - E 02
defisiensi iodium
E 05
Tirotoksikosis (hipertiroidisme)
E 03
Hipotiroidisme lainnya
E 04
Penyakit gondok nontoksik lain
E 06
Tiroiditis
E 07
Gangguan kelenjar tiroid lainnya
E 10
Diabetes melitus bergantung insulin
Diabetes melitus tidak bergantung
E 11
insulin
Diabetes melitus berhubungan
E 12
malnutrisi
E 13
Diabetes melitus YDT lainnya
E 14
diabetes melitus YTT
E 40 - E 46
Malnutrisi
E 50
Defisiensi vitamin A
E 51 - E 56
Defisiensi vitamin lainnya
Gejala sisa malnutrisi dan defisiensi
E 64
gizi lainnya
E 66
Obesitas
E 86
Deplesi volume (dehidrasi)
E15-35, E58, E63, E65, E67- Gangguan endokrin, nutrisi dan
E85, E87 -E90
metabolik lainnya
F 00 - F 03
Demensia
Gangguan mental dan perilaku akibat
F 10
pengunaan Alkohol
F 11
pengunaan Opioda
F 12
pengunaan Kanabinoida
170 114.2
F 13
171 114.3
F 14
172 114.4
F 15
173 114.5
F 16
174 114.6
F 17
175 114.9
F 18, F 19
176 115.0
F 20, F21, F 23
177 115.1
F 22, F 24
178 115.2
F 25
179 115.9
F 28 - F 29
180 116.0
F 30, F31
181 116.9
F 32 - F 39
182 117.0
F 40, F 41
183 117.1
184 117.2
F 42
F 43.1
185 117.3
F 43.0, F 43.2-9, F 45, F48
186 117.9
F 44
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
4
0
0
2
0
0
0
7
0
0
6
0
0
0
9
0
0
9
0
0
4
5
0
0
14
0
0
7
7
0
0
14
0
0
2
4
0
0
3
0
0
2
4
0
0
22
0
0
7
28
0
0
26
0
0
8
12
0
0
48
0
0
15
40
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
5
0
0
0
0
0
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
7
0
0
0
0
0
3
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
20
0
0
0
0
0
4
0
0
0
0
0
10
1
0
0
0
0
21
1
0
0
0
0
31
2
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Neoplasma jinak lainnya

Neoplasma yang tak menentu
perangainya dan yang tak diketahui
sifatnya
Anemia defisiensi zat besi
Anemia Hemolitik
Anemia aplastik lainnya
Anemia lainnya
Agranulositosis
Metahaemoglobinema
097
098.0
098.1
098.9
099.0
099.1

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

pengunaan Sedativa dan Hipnotika
pengunaan Kokain
pengunaan Stimulansia
pengunaan Halusinogenika
pengunaan Tembakau
zat pelarut yang mudah menguap atau
zat multipel dan zat psikoaktif lainnya
Skizofrenia, gannguan skizotipal,
psikotik akut dan sementara
Gangguan waham nemetap dan
induksi
Gangguan skizoafektif
Gangguan psikotik nonorganik lainnya
atau YTT
Episode manik dan gangguan afektif
bipolar
Episode depresif, gangguan depresif
berulang, gangguan suasana
perasaan (mood afektif) menetap,
lainnya atau YTT
Gangguan Anxietas fobik, gangguan
anxietas lainnya
Gangguan obsesi - kompulsif
Gangguan stres pasca trauma
Reaksi terhadap stres berat dan
gangguan penyesuaian, gangguan
somatoform, gangguan neurotik
lainnya
Gangguan disosiatif (konversi)

Formulir RL 2a
No.
No. DTD
Urut
1
2
187 118
3
F70 - F79
188 119.0
F04, F07, F09
189 119.1
F 50 - F59
4
Retardasi mental
Sindrom amnesik dan gangguan
mental organik
Sindrom makan, gangguan tidur,
disfungsi seksual, gangguan perilaku
lainnya
Gangguan kepribadian, gangguan
kebiasaan dan impuls, gangguan
identitas, gangguan prevensi seksual
190 119.2
F 60 - F69
191 119.3
F 80 - F89
192 119.4
F 05 - F06, F90 - F98
193 119.9
F 99
Gangguan perkembangan psikologis

Gangguan hiperkinetik, perilaku,
emosional atau fungsi sosial khas,
gangguan "tic", dan gangguan mental
dan emotional lainnya
Gangguan jiwa YTT
194 120
G 00 - G 09
Penyakit radang susunan saraf pusat
195
196
197
198
121
122
123
124
G 20
G 30
G 35
G 40 - G41
199 125
G 43 - G44
Penyakit Parkinson
Penyakit Alzheimer
Sklerosis multiple
Epilepsi
Migrain dan sindrom nyeri kepala
lainnya
200 126
G 45
201 127.0
202 127.1
203 127.2
G 56.0
G 56.2
G 56.3
204 127.3
205 127.9
206
207
208
209
128.0
128.9
129.0
129.1
210 129.9
211 130
212 131
213 132
214
215
216
217
218
219
220
133
134
135
136
137
138
139.0
Gangguan serangan perdarahan otak

sepintas dan sindrom yang terkait
Sindroma carpal tunnel

Lesi saraf ulnaris
Lesi saraf radialis
Mononeuropati anggota tubuh bagian
G 56.8
atas lainnya
G 50 - G 55, G 56.1,4,9, G57 - Gangguan saraf radiks, dan pleksus
G59
saraf
G 80
Infantil cerebral palsy
G 81- G83
Sindrom paralitik lainnya
G 21
Parkinson sekunder
G 92
Toksik ensefalopati
G10 - G13, G22 - G26, G31 G32, G36 - G37, G46 - G47,
Penyakit susunan saraf lainnya
G60 - G73, G90 - G91, G93 G99
H 00 - H 01
Radang kelopak mata
Konjungtivitis dan gangguan lain
H 10 - H 13
konjungtiva
Keratitis dan gangguan lain sklera dan
H 15 - H 19
kornea
H 25 - H 28
Katarak dan gangguan lain lensa
H 33
Ablasi dan kerusakan retina
H 40 - H 42
Glaukoma
H 49 - H 50
Strabismus
H 52
Gangguan refraksi dan akomodasi
H 54
Buta dan rabun
H 02 - H 03
Gangguan lain kelopak mata
221 139.1
H 04 - H 06
222 139.2
H 20 - H 22
223 139.3
224 139.4
225 139.5
H 30 - H 32
H 34
H 35 - H 36
Iridosiklitis dan gangguan lain iris dan

badan silier
Gangguan koroid dan korioretina
Sumbatan vaskuler retina
Gangguan lain retina
226 139.6
H 43 - H 45
Gangguan badan kaca dan bola mata
227 139.7
H 46 - H48
Gangguan saraf optik dan saraf

penglihatan
228 139.8
H 51
Gangguan lain gerakan mata binokuler
229 139.9
H 53
230 139.10
H 55
231 139.11
H 57 - H 59
232 140
H 65 - H 75
233 141
234 142.0
H 90 - H 91
H 61.8
Gangguan daya lihat

Nistagmus & pergerakan mata yang
tidak teratur lainnya
Penyakit mata dan adneksa
Otitis media dan gangguan mastoid
dan telingah tengah
Gangguan daya dengar
Fistula / kista preaurikel
235 142.1
H 83.3
Efek kebisingan telinga bagian dalam
236 142.9
H 60 - H 61.0-3
Penyakit telinga dan prosesus mastoid
237
238
239
240
241
242
243
I 00 - I 02
I 05 - I 09
I 10
I 11 - I 15
I 21 - I 22
I 20, I 23 - I 25
I 26
Demam reumatik akut

Penyakit jantung reumatik kronik
Hipertensi esensial (primer)
Penyakit hipertensi lainnya
Infark miokard akut
Penyakit jantung iskemik lainnya
Emboli paru
Gangguan hantaran dan aritmia
jantung
Gagal jantung
Kardiomiopati
Penyakit jantung lainnya
143
144
145
146
147
148
149
244 150
I 44 - I 49
245 151
246 152.0
247 152.9
I 50
I 42 - I 43
I 27 - I 41, I 51 - I 52
Gangguan sistem lakrimal dan orbita

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
5
0
0
0
0
1
0
0
0
3
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
4
0
0
0
2
4
0
0
0
1
8
0
0
0
4
1
0
0
0
0
11
13
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
1
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
13
2
0
2
0
0
0
0
44
5
1
1
0
0
0
0
28
2
0
1
0
0
0
0
42
6
0
2
0
0
0
0
44
3
1
3
0
0
0
0
86
9
1
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
1
0
13
0
5
0
8
0
9
0
10
0
5
0
12
0
12
0
20
0
9
0
32
0
21
0
1
0
2

Formulir RL 2a
No.
No. DTD
Urut
1
2
248 153
249 154
I 60 - I 62
I 63
250 155
I 64
251 156
252 157
253 158.0
I 65 - I 69
I 70
I 75.0
254 158.9
I 73.1 - 9
255 159
I 74
256 160
I 71 - I 72, I 77 - I 79
257 161
I 80 - I 82
258
259
260
261
262
263
264
I 83
I 84
I 85
I 86 - I 99
J 02
J 03
J 04
162
163
164.0
164.9
165.0
165.9
166
265 167
J 00 - J 01, J 05 - J 06
266
267
268
269
270
J 10 - J 11
J 12 - J 18
J 20 - J 21
J 32
J 30.3
168
169
170
171
172.0
271 172.1
J 34.8
273 173
J30.0 - J30.2, J30.4 - J31,

J33, J34.0-3
J 35
274 174
J 36 - J39
275 175
J 40 - J 44
276
277
278
279
280
281
282
283
284
J 45
J 46
J 47
J 60 - J 65
J 85.1, 2
J 93
J 86
J 90 - J 91
J 66.0
272 172.9
176.0
176.9
177
178
179.0
179.1
179.2
179.3
179.4
285 179.5
J 67
286 179.6
J 68
287 179.7
289 180
J 92
J 22, J66.1-2, J66.8, J69 J84, J85.0,3, J 94 - J99
K 02
290 181.0
K 00 - K 01
291 181.1
292 181.2
K 03
K 04
293 181.3
K 05 - K 06
294 181.9
K 07 - K 08
295 182.0
K 09 - K 10
296 182.1
K 11
297 182.2
K 12
298 182.9
K 13 - K 14
299 183
300 184
301 185.0
K 25 - K 27
K 29
K 30
302 185.9
K 20 - K 23, K 28, K 31
303
304
305
306
K 35 - K 38
K 40
K 41 - K 46
K 50 - K 51
288 179.9
186
187
188
189
4
Perdarahan intrakranial
Infark serebral
Strok tak menyebut perdarahan atau
infark
Penyakit serebrovaskular lainnya
Aterosklerosis
Sindroma Raynaud's
Penyakit pembuluh darah perifer
lainnya
Emboli dan trombosis arteri
Penyakit arteri, arteriol dan kapiler
lainnya
Flebitis, tromboflebitis, emboli dan
trombosis vena
Varises vena ekstremitas bawah
Hemoroid / Wasir
Varises esofagus
Penyakit sistem sirkulasi lainnya
Faringitis akut
Tonsilitis akut
Laringitis dan trakeitis akut
Infeksi saluran napas bagian atas akut
lainnya
Influensa
Pneumonia
Bronkitis akut dan bronkiolitis akut
Sinusitis kronik
Alergi rhinitis akibat kerja
Ulcus mucosa hidung & perforasi
septum nasi
Penyakit hidung dan sinus hidung
lainnya
Penyakit tonsil dan adenoid kronik
Penyakit saluran napas bagian atas
lainnya
Bronkhitis, emphisema dan penyakit
paru obstruktif kronik lainnya
Asma akibat kerja
Status asmatikius
Bronkiektasis
Pneumokoniosis
Abses paru
Pneumotoraks
Piotorak (empiema)
Efusi pleura (empiema)
Bisinosis
Pnemonitis Hipersensitivity akibat abu
organik
Gangguan pernapasan akibat
menghirup zat kimia, gas, asap dan
uap
Plak pleural
Penyakit sistem napas lainnya
Karies gigi
Gangguan perkembangan dan erupsi
gigi termasuk impaksi
Penyakit jaringan keras gigi lainnya
Penyakit pulpa dan periapikal
Penyakit gusi, jaringan periodontal dan
tulang alveolar
Kelainan dentofasial termasuk
maloklusi
Kista rongga mulut dan penyakit pada
rahang
Penyakit kelenjar liur
Penyakit jaringan lunak mulut
(Stomatitis) dan lesi yang berkaitan
Penyakit bibir, mukosa mulut lainnya
dan lidah
Tukak lambung dan duodenum
Gastritis dan duodenitis
Dispepsia
Penyakit esofagus, lambung dan
duodenum lainnya
Penyakit apendiks
Hernia enguinal
Hernia lainnya
Penyakit Crohn dan tukak kolitis
Ileus paralitik dan obstruksi usus
tanpa Hernia
Penyakit Divertikel usus
Sindrom usus ringkih (Irritable bowel
syndrome)
307 190
K 56
308 191
K 57
309 192.0
K 58
310 192.9
K 52 - K 55, K 59 - K 67
Penyakit usus dan peritoneum lainnya
311
312
313
314
K 70
K 72
K 73
K 74.6
Penyakit hati alkohol

Koma hepatikum hepatitis fulminan
Hepatitis kronik
Sirosis hati
193
194.0
194.1
194.2

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
7
7
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
6
0
11
0
9
0
20
0
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
11
0
0
0
17
0
0
0
22
0
0
0
31
0
0
0
20
0
0
0
51
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
2
0
0
0
3
0
0
0
2
0
1
1
1
0
0
1
1
0
1
2
1
0
0
0
2
0
0
0
0
0
0
0
4
0
1
2
2
0
0
1
3
0
1
1
4
0
0
1
7
0
2
3
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
58
0
1
0
0
0
33
0
0
0
0
0
6
0
0
0
0
0
1
0
0
0
0
0
1
0
7
0
0
0
0
0
2
0
0
0
0
0
1
0
0
0
62
0
5
0
0
0
37
0
6
0
0
0
99
0
11
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
6
0
0
0
0
0
0
3
0
0
6
0
0
0
0
0
0
1
0
0
4
0
0
0
0
0
0
0
0
0
13
0
0
0
0
0
0
1
0
1
14
0
0
0
0
0
0
3
0
1
27
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
3
19
0
0
3
42
0
0
5
26
2
0
5
6
0
0
8
48
0
0
8
48
2
0
16
96
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
7
0
2
0
0
10
0
1
0
0
28
0
6
0
0
19
0
13
0
0
2
0
5
0
0
36
0
28
0
0
30
0
0
0
0
66
0
28
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
1
0
0
0
4
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
2
0
4
0
0
1
3
13
0
0
3
3
23
0
1
3
5
3
0
0
0
2
31
0
1
7
11
16
0
0
2
2
47
0
1
9
13
1
0
1
0
1

Formulir RL 2a
No.
No. DTD
Urut
1
2
315 194.3
316 194.4
317 194.5
3
K 76.0
K 76.6
K 76.7
318 194.6
K 71
4
Perlemakan hati
Hipertensi portal
Sindrom hepatorenal
Penyakit hati akibat bahan beracun di
tempat kerja
346 207.9
K 74.0-5, K 75, K 76.1-5, 8, 9,

Penyakit hati lainnya
K 77
K 80
Kolelitiasis
K 81
Kolesistitis
Pankreatitis akut dan penyakit
K 85 - K 86
pankreas lainnya
K 82 - K 83, K 87 - K 93
Penyakit sistem cerna lainnya
L 00 - L 08
Infeksi kulit dan jaringan subkutan
L 23 - L 24
Dermatosis akibat kerja
Penyakit kulit dan jaringan subkutan
L 10 - L 22, L 25 - L 99
lainnya
M 05 - M 06
Artritis rematoid
M 07
Psoriasis dan artropati enteropati
M 08 - M 09
Artritis belia
M 10 - M 11
Psoriasis dan artropati lainnya
M 12 - M 14
Artropati dan artritis
M 15 - M 19
Artrosis
M 20 - M 21
Deformitas tungkai didapat
Artritis piogenik dan artritis pada
M 00 - M 01
penyakit infeksi dan parasit YDK di
tempat lain
M 02 - M 03
Artropati reaksi
M 22 - M 25
Kelainan sendi lainnya
M 32
Lupus eritemateus sistemik
Gangguan jaringan ikat sistemik
M 30 - M 31, M 33 - M36
lainnya
Gangguan diskus servikal dan
M 50 - M 51
intervertebral lainnya
M 45 - M 49
Spondiloartropati seronegatif
M 54.5
Nyeri punggung bawah
M 40 - M 44, M 53 - M 54.4, M
Dorsopati lainnya
54.6, 8, 9
M 60 - M 64, M 65.0 - M65.3,
Miopati dan reumatisme
8, 9, M 66 - M 68
M 65.4
Penyakit de Quervain
Gangguan jaringan lunak akibat yang
M 70
berhubungan dengan penggunaan
tekanan berlebihan
M 71 - M 79
Gangguan jaringan lunak lainnya
347 208
M 80 - M 85
Gangguan struktur dan densitas tulang
348 209
M 86
349 210
M 87 - M 99
350 211
N 00 - N 01
351 212.0
352 212.2
N 04
N 02.8
Osteomielitis
Penyakit sistem muskuloskeletal dan
jaringan ikat lainnya
Sindrom nefritik progesif cepat dan
akut
Sindrom nefritik
Nefropati Imunoglobulin A (Ig A)
353 212.9
N 02.0-7, 9, N 03, N 05 - N 08 Penyakit glomerulus lainnya
319 194.9
320 195.0
321 195.9
322 196
323 197
324 198
325 199.0
326 199.9
327
328
329
330
331
332
333
200.0
200.1
200.2
200.3
200.9
201
202
334 203.0
335 203.1
336 203.9
337 204.0
338 204.9
339 205
340 206.0
341 206.1
342 206.9
343 207.0
344 207.1
345 207.2
354 213.0
N 12
355 213.1
N 14.3
356 213.9
N 10 - N 11, N 13, N 14.0-2,

4, N 15 - N 16
Nefritis tubulo - intersitial, tidak

ditemukan akut atau kronik/
pielonefritis
Nefropati disebabkan oleh logam
logam berat
Penyakit tubulo interstitial ginjal
lainnya
357 214.0
N 17.8
Gagal ginjal akut akibat asam jengkol
358
359
360
361
362
363
364
N 17.0-2, 9 - N 19
N 20 - N 23
N 30
N 25 - N 29, N 31 - N 39
N 40
N 41 - N 42
N 43
Gagal ginjal lainnya

Urolitiasis
Sistitis
Penyakit sistem kemih lainnya
Hiperplasia prostat
Gangguan prostat lainnya
Hidrokel dan spermatokel
Prepusium berlebih, fimosis dan
parafimosis
Penyakit alat kelamin laki lainnya
Gangguan pada payudara
Salpingitis dan ooforitis
Radang serviks
Radang panggul perempuan lainnya
Kista dan abses kelenjar Bartholin
Radang alat dalam panggul
perempuan lainnya (Adneksitis)
Endometriosis
Prolaps alat kelamin perempuan
Gangguan bukan radang pada indung
telur, saluran telur dan ligamentum
latum
Amenore
Menoragi atau metroragi
Gangguan haid lainnya
214.9
215
216
217
218
219
220
365 221
N 47
366
367
368
369
370
371
222
223
224
225
226.0
226.1
N 44 - N 46, N 48 - N 51
N 60 - N 64
N 70
N 72
N 73
N 75.0.1
372 226.9
N 71, N 74, N 75.8 - N77
373 227
374 228
N 80
N 81
375 229
N 83
376 230.0
377 230.1
378 230.9
N 91.0, 1, 2
N 92.0, 1
N 91.3-5, N 92.2-6

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
1
2
0
2
0
2
2
0
1
1
2
3
3
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
2
0
0
0
2
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
5
0
0
0
0
1
0
0
11
0
0
0
0
1
2
0
4
0
0
0
0
0
1
0
1
0
0
0
1
0
0
0
12
0
0
0
1
2
2
0
10
0
0
0
0
2
1
0
22
0
0
0
1
4
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
2
1
0
2
0
0
1
0
0
2
0
0
0
0
0
5
0
0
3
1
0
8
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
0
0
0
0
1
3
0
5
0
0
0
0
0
0
0
4
0
0
0
0
9
6
0
21
1
0
0
0
6
0
0
6
8
0
0
0
10
1
0
6
14
0
0
0
17
9
0
29
23
0
0
0
9
2
0
17
0
0
0
0
26
11
0
45
23
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
13
0
0
3
0
0
0
5
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
4
0
0
0
19
0
1
4
0
0
0
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
0
7
0
0
0
2
0
0
0
0
0
0
0
0
0
1
0
11
0
1
0
11
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
379 231
380 232
381 233
382
383
384
385
386
234
235
236.0
236.1
236.2
387 236.9
388 237.0
389 237.1
390 237.9
391 238.0
392 238.1
393 283.9
394
395
396
397
239.0
239.1
239.2
239.3
398 239.9
399
400
401
402
240
241
242.0
242.1
403 242.2
404 242.3
4
Gannguan dalam masa menopause
N 95
dan perimenopause lainnya
N 97
Infertilitas perempuan
N 82, N 84 - N 90, N 93 - N
Gangguan sistem kemih kelamin
94, N 96, N 98 - N 99
lainnya
O 03
Abortus spontan
O 04
Abortus medik
O 00
Kehamilan ektopik
O 01
Mola hidatidosa
O 05
Abortus lainnya
Kehamilan lain yang berakhir dengan
O 02, O 06, O 08
abortus
Hipertensi gestasional (akibat
O 14
kehamilan) dengan proteinuria yang
nyata/ Preeklampsia
O 15
Eklampsia
Edema, proteinuria dan gangguan
O 10 - O 13, O 16
hipertensi dalam kehamilan,
persalinan dan masa nifas
O 44
Plasenta previa
O 45
Solusio plasenta
Perdarahan antepartum YTK di
O 46
tempat lain
O 30
Kehamilan multipel
O 40
Hidramnion
O 42
Ketuban pecah dini
O 48
Kehamilan lewat waktu
Perawatan ibu yang berkaitan dengan
O 31 - O 39, 0 41, 0 43, O 47 janin dan ketuban dan masalah
persalinan
O 64 - O 66
Persalinan macet
O 72
Pendarahan pasca persalinan
O 24
Diabetes melitus dalam kehamilan
O 60
Persalinan prematur
Persalinan dengan penyulit gawat
O 68
janin
O 84
Persalinan multipel
405 242.9
O 20 - O 23, O 25 - O 29, O
Penyulit kehamilan dan persalinan
61 - O 63, O 67, O 69 - 71, O
lainnya
73 - O 75, O 81 - -O 83
406 243
O 80
407 244
O 85 - O 99
409 246
P 05 - P 07
410 247
P 10 - P15
Persalinan tunggal spontan

Penyulit yang lebih banyak
berhubungan dengan masa nifas
kondisi obstetrik lainnya, YTK
ditempat lain
Janin dan bayi baru lahir yang
dipengaruhi oleh faktor dan penyulit
kehamilan persalinan dan kelahiran
Pertumbuhan janin lamban, malnutrisi
janin dan gangguan yang
berhubungan dengan kehamilan
pendek dan berat badan lahir rendah
Cedera lahir
411 248
P 20 - P 21
Hipoksia intrauterus dan asfiksia lahir
412 249
P 22 - P 28
Gangguan napas lainnya yang

berhubungan dengan masa perinatal
413 250
P 35 - P 37
Penyakit infeksi dan parasit kongenital
414 251
P 38 - P 39
408 245
415 252
416 253.0
417 253.9
418 254
419 255.0
420 255.9
421 256
422 257
423 258
424 259
425 260
426 261.0
P 00 - P 04
Infeksi khusus lainnya pada masa

perinatal
Penyakit hemolitik pada janin & bayi
P 55
baru lahir
P 95
Lahir mati
P 08, P 29, P 50 - P 54, P 56 - Kondisi lain yang bermula pada masa
P 94, P 96
perinatal
Q 05
Spina bifida
Q 03
Hidrosefalus kongenital
Q 00 - Q 02, Q 04, Q 06, Q
Malformasi kongenital susunan saraf
07
lain
Malformasi kongenital sistem
Q 20 - Q 28
peredaran darah
Q 35 - Q 37
Bibir celah dan langit-langit celah
Tidak ada, atresia dan stenosis usus
Q 41
halus
Malformasi kongenital sistem cerna
Q 38 - Q 40, Q 42 - Q 45
lainnya
Q 53
Testis tidak turun
Malformasi kongenital alat kelamin
Q 50 - Q 52
wanita
427 261.1
Q 54 - Q 56
428 261.9
Q 60 - Q 64
429 262
430 263
Q 65
Q 66
431 264
Q 67 - Q 79
Malformasi kongenital alat kelamin laki

Malformasi kongenital sistem kemih
lainnya
Deformasi kongenital sendi panggul
Deformasi kongenital kaki
Malformasi dan deformasi kongenital
sistem muskulo skleletal lain

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
2
0
0
0
0
8
2
0
0
0
0
0
0
0
36
81
119
119
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
15
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
0
0
0
0
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
0
3
0
0
50
0
12
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
64
0
15
0
0
64
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
19
89
54
179
1
3
0
0
0
0
74
273
74
273
0
1
19
12
19
10
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
14
0
26
0
8
0
10
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
Malformasi kongenital lainnya
433 266.0
3
Q 10 - Q 18, Q 30 - Q34, Q
80 - Q 89
Q 90
434 266.9
Q 91 - Q 99
Kelainan kromosom YTK ditempat lain
435 267
R 10
Nyeri perut dan panggul
436 268
R 50
Demam yang sebabnya tidak ketahui
437
438
439
440
441
442
443
R 54
R 00 - R 01
R 09.2
R 33
R 56
R 75
R 95
R 02 - R 09.0,1,3,8, R 11 - R
32, R 34 - R 49, R 51 - R 52,
R 55, R 57 - R 74, R 76 - R
94, R 96 - R 99
S 02
S 12, S 22, S 32, T 08
S 72
S 42, S 52, S 62, S 82, S 92,
T 10, T 12
Senilitis
Gejala pada jantung
Gagal napas
Retensi urin
Kejang YTT
Hasil laboratorium positif HIV
Sindrom mati mendadak pada bayi
432 265
269
270.0
270.1
270.2
270.3
270.4
270.5
444 270.9
445 271
446 272
447 273
448 274
449 275
450 276
451 277
452 278
453 279
454 280
T 02
S 03, 13, 23, 43, 53, 63, 73,
83, 93, T 03
S 05
S 06
S 26 - S 27
Sindrom Down
Gejala, tanda dan penemuan klinik

dan laboratorium tidak normal lainnya,
YTK ditempat lain
Fraktur tengkorak dan tulang muka
Fraktur leher, toraks atau panggul
Fraktur paha
Fraktur tulang anggota gerak lainnya
Fraktur meliputi daerah badan
multiplel
Dislokasi, terkilir, teregang YDT dan
daerah badan multipel
Cedera mata dan orbita
Cedera intrakranial
Cedera alat dalam lainnya
S36-S37, S07-S08, S17-S18,

S28, S38, S47-S48, S57-S58, Cedera remuk dan trauma amputasi
S67-S68, S77-S78, S87-S88, YDT dan daerah badan multipel
S97-S98, T04-T05
455 281
S00-S01, S04, S09-S11, S14S16, S19-S21, S24-25, S29S31, S34-S35, S39-S41, S44S46, S49-S51, S54-S56, S59- Cedera YDT lainnya, YTT dan daerah
S61, S64-S66, S69-S71, S74- badan multipel
S76, S79-S81, S84-S86, S89S91, S94-S96, S99, T00-T01,
T06-T07, T09-T11, T13-T14
456 282.0
T 16
457 282.9
T 15, T 17 - T 19
458 283
T 20 - T 32
Benda asing pada telinga

Akibat dari kemasukan benda asing
melalui lubang tubuh
Luka bakar dan korosi
459 284
T 36 T 50
Keracunan obat dan preparat biologik
460
461
462
463
T 52
T 56
T 59
T 60
T51, T53 - T55, T57 - T58,
T61 - T65
T 74
T 66
T 67
T 70
Keracunan pelarut organik

Keracunan logam
Keracunan gas, asap dan uap lain
Keracunan pestisida
Efek toksik bahan non medisinal
lainnya
Sindrom salah perlakuan
Efek radiasi YTT
Efek panas dan pencahayaan
Efek tekanan udara dan tekanan air
Efek sebab luar lainnya dan YTT
pembedahan dan perawatan YTK di
tempat lain
Penyulit awal trauma tertentu dan
penyulit pembedahan dan perawatan
YTK di tempat lain
Gejala sisa cedera, keracunan dan
akibat lanjut sebab luar
Pemeriksaan kesehatan umum
Pemeriksaan kesehatan bayi dan anak
secara rutin
285.0
285.1
285.2
285.3
464 285.9
465
466
467
468
286
287.0
287.1
287.2
469 287.9
T33-T35, T68-T69, T71-T73,

T75-T78
470 288
T 79 - T 88
471 289
T 90 - T 98
472 290.0
Z 00.0
473 290.1
Z 00.1
Orang yang mendapatkan pelayanan

kesehatan untuk pemeriksaan khusus
dan investigasi lainnya
474 290.9
Z 00.2 - Z 13
475
476
477
478
479
480
481
291
292.0
292.1
292.2
292.3
292.4
292.6
Z 21
Z 23.2
Z 23.5
Z 24.0
Z 24.2
Z 24.4
Z 24.6
482 292.7
Z 27.1
483 292.8
Z 23.0,1,3,4,6,7,8, Z 24.1,3,5, Imunisasi dan kemoterapi pencegahan

Z 25 - Z 27.0, Z 272.2 - Z 29 lainnya
Keadaan infeksi HIV asimtomatik

Imunisasi BCG
Imunisasi Tetanus
Iminusasi Poliomielitis
Imunisasi Rabies
Imunisasi Campak
Imunisasi Hepatitis virus
Imunisasi gabungan DPT (difteri,
pertusis, tetanus)

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
2
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
2
2
2
2
0
0
0
0
1
0
0
0
0
1
0
2
0
2
0
1
0
0
1
5
0
1
1
6
1
0
0
0
0
0
0
0
0
0
17
0
0
5
0
17
0
0
41
0
0
0
0
27
0
0
58
0
0
0
0
9
0
0
35
0
0
0
0
0
0
0
39
0
0
0
1
0
0
0
18
0
0
2
2
2
0
0
12
0
0
1
2
0
0
0
125
0
0
5
4
34
0
0
95
0
0
3
1
21
0
0
220
0
0
8
5
55
0
0
0
0
0
4
0
5
0
0
0
0
0
0
5
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
20
0
0
0
4
0
0
0
2
0
0
0
9
0
0
0
26
0
0
0
35
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
7
0
0
0
5
0
0
0
0
0
0
0
18
0
0
0
1
0
0
0
19
0
0
0
10
0
0
0
0
0
4
0
29
0
37
0
51
0
33
0
7
0
103
0
58
0
161
0
2
0
0
0
0
0
0
2
1
0
0
2
0
3
0
0
0
0
1
4
0
3
1
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
2
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
1
2
0
0
0
4
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
484 292.9
Z 20, Z 22
485 293
486 294.0
Z 30
Z 34
487 294.1
Z 35
488 294.9
489 295
Z 36
Z 38
490 296
Z 39
491 297.0
Z 46.0
492 297.1
Z 41.2
493 297.2
Z 46.3
494 297.3
Z 50
495 297.9
Z 40 - Z 41.0,1,3, Z 45, Z
46.1,2,4-9, Z 49, Z 51 - Z 54
496 298
4
Orang lain dengan risiko gangguan
kesehatan yang berkaitan dengan
penyakit menular
Pengelolaan kontrasepsi
Pengawasan kehamilan normal
Pengawasan kehamilan dengan risiko
tinggi
Seleksi antenatal
Bayi lahir hidup sesuai tempat lahir
Perawatan dan pemeriksaan pasca
persalinan
Pemasangan dan penyesuaian
kacamata dan lensa kontak
Khitanan menurut agama dan adat
kebiasaan
Pemasangan dan penyesuaian gigi
palsu
Pelayanan yang melibatkan gangguan
prosedur prosedur rehabilitasi
Orang yang mengunjungi pelayanan

kesehatan untuk tindakan perawatan
khusus lainnya
Penunjang sarana kesehatan untuk
Z 31 - Z 33, Z 37, Z 55 - Z 99
alasan lainnya
JUMLAH

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
28
0
246
0
258
0
329
0
417
0
1000
0
522
0
227
0
1342
0
1686
0
3027
0
95
PENYEBAB KECELAKAAN
No.
No. DTD
Urut
01 299.0
02 299.1
V 01 - V 89
V 90 - V 94
03 299.2
V 95 - V 97
04 299.9
05 300
V 98 - V 99
W 00 - W 19
Kecelakaan angkutan darat

Kecelakaan angkutan air
Kecelakaan angkutan udara dan ruang
angkasa
Kecelakaan angkutan lain
Jatuh
06 301
W 65 - W 74
Kecelakaan tenggelam dan terbenam
07 302
X 00 - X 09
Terdedah asap, api dan uap
08 303.0
X 45
Keracunan akibat pemaparan alkohol
09 303.1
X 46
Keracunan akibat pemaparan pelarut

organik & hidrokarbon serta uapnya
10 303.2
X 47
11 303.3
X 48
12 303.4
X 49
13 303.9
X 40 - X 44
14 304..0
X 60 - X 69
15 304.9
16 305
17 306.0
X 70 - X 84
X 85 - Y 09
X 10 - X 19
18 306.1
X 20 - X 29
19 306.2
X 30 - X 39
20 306.3
Y 40 - Y 59
21 306.4
Y 60 - Y 84
22 306.5
23 306.6
24 306.7
W 42
W 43
W 88
25 306.8
W 89
26 306.9
27 306.10
W 90
W 91
28 306.11
X 50
29 306.12
Y 96
30 306.13
Keracunan akibat pemaparan gas-gas

& uap-uap lainnya
Keracunan akibat pemaparan
pestisida
Keracuran akibat pemaparan bahan
beracun berbahaya lainnya
Kecelakaan keracunan dan terdedah
oleh bahan beracun lainnya
Sengaja mencederai diri dengan
bahan beracun
Sengaja mencederai diri lainnya
Dicederai
Kontak dengan bahan panas
Kontak dengan binatang & tumbuhan
beracun
Terdedah faktor alam
Efek samping pengguna obat, bahan
obat dan bahan biologik
Kesalahan pada pasien selama
perawatan medis non bedah
Pemaparan bising
Pemaparan getaran
Pemaparan radiasi pengion
Pemaparan sinar ultraviolet dan
manmade visible
Pemaparan radiasi pengion lain
Pemaparan radiasi YTT
Gangguan gerakan berulang-ulang
dengan kekuatan berlebih
Gangguan kesehatan yang
berhubungan dengan pekerjaan
W20-W41, W44-W64, W75W87, W92-W99, X51-X59,

Sebab luar lainnya
Y10-Y39, Y85-Y95, Y97-Y98
JUMLAH
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
0
0
0
0
0
0
0
0
0
0
0
0
0
0
>65
TH
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
PR
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
2
0
0
0
2
0
2
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
3
0
2
0
0
0
5
0
2
0
7
0
0
Sumbawa, 1 April 2010

Direktur RSUD Sumbawa
dr. A.A.G KOSALA PUTRA

NIP.19560114 198301 1 002

TRIWULAN : II ( April S.D Juni) TAHUN 2010
Formulir RL 2a
No.
No. DTD
Urut
1
01
02
03
04
05
2
001
002
003
004.0
004.9
A 00
A 01
A 03
A 06.4
A 06.0-3, 5-9
Cholera
Shigellosis
Abses hati amuba
Amebiasis lainnya
06 005
A 09

07 006
A 02, A 04, A 05. A 07, A 08
08 007.0
A 15.0
09 007.1
10 007.9
11 008.0
A 15.1 - A 16.2
A 16.3-9
A 17.0
12 008.1
A 17.1-9
13
14
15
16
17
18
19
20
21
22
23
24
25
26
A 18.0
A 18.2
A 19
A 18.1, 3-8
A 20
A 23
A 30
A 33
A 34, A 35
A 36
A 37
A 39
A 40, A 41
A 22
A 21, A 24-28, A 31-32, A 38,
A 42-49
A 50
A 51
A 52, A 53
A 54
008.2
008.3
008.4
008.9
009
010
011
012
013
014
015
016
017
018.0
27 018.9
28
29
30
31
019
020
021
022
32 023
A 55, A 56
33 024
A 57- A 64
34
35
36
37
38
39
40
41
42
43
44
A 68
A 71
A 75
A 80
A 82
A 83 - A 86
A 95
A 90
A 91
A 92.0
A 92.1, A 92
025
026
027
028
029
030
031
032.0
032.1
032.2
032.3
45 032.9
A 93 - A 94, A 96 - A 99
46 033
B 00
47 034
B 01 - B 02
48
49
50
51
52
53
54
B 05
B 06
B 16
B 15
B 17.1
B 17.2
B 17.08, B 18, B19
035
036
037
038.0
038.1
038.2
038.9

lainnya
Tuberkulosis milier
Sampar / Pes
Bruselosis
Lepra / Kusta
Tetanus neonatorum
Tetanus lainnya
Difteria
Infeksi meningokok
Septisemia
Anthraks
Sifilis bawaan
Sifilis dini
Sifilis lainnya
Infeksi gonokok
hubungan seksual
Demam bolaik-balik
Trakoma
Demam tifus
Poliomielitis akut
Rabies
Ensefalitis virus
Demam kuning
Demam dengue
Chikungunya
zoster)
Campak
Rubella
Hepatitis B akut
Hepatitis A akut
Hepatitis C akut
Hepatitis E akut
Gondong
55 039
B 20 - B 24
56 040
B 26
57 041
A 81, A 87- A 89, B 03 - B 04,

B 07- B 09, B 25, B 27- B 34
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
B 35 - B 49
B 50 - B 54
B 55
B 56 - B 57
B 65
B 66
B 67
B 72
B 73
B 74
B 76
B 68 - 71, B 75, B 77 - 83
B 90.91
B 90.92
B 90.0-8
B 91
B 92
A 66
042
043
044
045
046
047
048
049
050
051
052
053
054.0
054.1
054.9
055
056
057.0
Mikosis
Lesmaniasis
Tripanosomiasis
Ekinokokosis
Drakunkuliasis
Onkosersiasis
Filariasis
Patek (Frambusia)

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
3
12
44
3
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
0
0
0
0
0
45
0
0
0
0
20
0
0
0
0
65
0
0
0
0
0
0
0
0
83
121
25
12
37
24
168
140
308
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
0
0
1
9
2
0
4
10
4
0
2
1
1
0
6
18
6
0
1
4
2
0
7
22
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
1
0
0
0
0
1
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
1
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
2
0
0
0
0
1
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
2
0
0
0
0
1
0
0
0
37
0
0
0
0
0
0
0
0
0
0
1
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
18
0
0
0
0
0
0
0
0
0
0
0
44
0
0
0
0
0
0
0
0
0
0
4
12
0
0
0
0
0
0
0
0
0
0
2
6
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
43
0
0
0
0
0
0
0
0
0
0
5
40
0
0
0
0
0
0
0
0
0
0
8
83
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
39
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
73
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
53
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
126
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
76 057.1
77 057.2
111 080.0
112 080.9
A 70
Infeksi Klamedia
B 58
Toksoplasmosis
B 94 - B99
C 00 - C 10
C 11
C 12 - C 14
C 15
C 16
C 18
C 19 - C 21
C 22
empedu intrahepatik
C 25
C 17, C 23-C 24, C 26
cerna lainnya
C 32
C 33
C 34
C 38.1-8
C 30, C 31, C 37, C 38.0, C
39
C 40 - C 41
rawan sendi
C 43
C 44
C 45
Mesotelioma
C 46 - C 49
jaringan lunak
C 50
C 53
C 54
C 55
lainnya dan YTT
C 56
telur)
C 58
C 51-C 52, C 57
perempuan lainnya
C 61
C 60
C 62
C 63
lainnya
Neoplasma ganas kandung kemih (buliC 67
buli)
C 64 - C 65
C 66, C 68
113 081
C 69
114 082
C 71
115 083
C 70, C 72
116 084.0
C 73
117 084.1
C 74 - C 75
118 084.2
C 76
119 084.3
C 77 - C 80
120 084.9
C 97
121 085
122 086
123 087
C 81
C 82 - C 85
C 91 - C 95
124 088
C 88 - C 90, C 96
125
126
127
128
D 06
D 22 - D 23
D 24
D 25

saraf pusat
bening YTT
multipel
Penyakit Hadgkin
Limfoma non Hodgkin
Leukemia
lainnya
Leiomioma uterus
129 093
D 27
Neoplasma jinak ovarium (indung telur)
130 094
D 30
131 095
D 33
132
133
134
135
D 04
D 05
D 00-D 03, D 07-D 09
D 12.6

saraf pusat lainnya
78 057.9
79 058.0
80 058.1
81 058.9
82 059
83 060
84 061
85 062
86 063
87 064
88 065
89
90
91
92
066
067.0
067.9
068.0
93 068.9
94 069
95 070
96 071
97 072.0
98 072.9
99 073
100 074
101 075.0
102 075.9
103 076.0
104 076.1
105 076.9
106 077
107 078.0
108 078.1
109 078.9
110 079
089
090
091
092
096.0
096.1
096.2
096.3

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
3
2
1
0
0
2
3
0
0
0
0
0
2
0
0
0
1
5
4
0
3
5
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
1
1
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
10
7
0
0
0
3
8
0
0
0
1
0
0
0
0
2
0
0
0
0
13
15
0
0
0
15
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
136 096.4
D 14.1 - 4
137 096.5
D 15.2
D10 - D12.0-5, 7-9, D13 D14.0, D15.0-1, D15.7-9D20, D21, D26, D28 - D29,
D31 - D32, D34 - D 36
138 096.6
139 096.9
D 37 - D 48
140
141
142
143
144
145
D 50
D 59
D 61
D51 - D58, D60, D62, D64
D 70
D 74
146 099.9
D65 - D69, D71- D73, D75 D77

147 100
D80 - D89
148 101
149
150
151
152
153
154
102
103.0
103.1
103.2
103.9
104.0
155 104.1
156 104.2
157
158
159
160
161
104.3
104.9
105
106
107
162 108
163 109
164 110
165 111
166 112
167 113
168 114.0
169 114.1

mekanisme imun
E00 - E 02
defisiensi iodium
E 05
E 03
E 04
E 06
Tiroiditis
E 07
E 10
E 11
insulin
E 12
malnutrisi
E 13
E 14
E 40 - E 46
Malnutrisi
E 50
E 51 - E 56
E 64
gizi lainnya
E 66
Obesitas
E 86
E85, E87 -E90
metabolik lainnya
F 00 - F 03
Demensia
F 10
pengunaan Alkohol
F 11
pengunaan Opioda
F 12
170 114.2
F 13
171 114.3
F 14
172 114.4
F 15
173 114.5
F 16
174 114.6
F 17
175 114.9
F 18, F 19
176 115.0
F 20, F21, F 23
177 115.1
F 22, F 24
178 115.2
F 25
179 115.9
F 28 - F 29
180 116.0
F 30, F31
181 116.9
F 32 - F 39
182 117.0
F 40, F 41
183 117.1
184 117.2
F 42
F 43.1
185 117.3
F 43.0, F 43.2-9, F 45, F48
186 117.9
F 44
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
21
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
4
0
0
1
0
0
1
12
0
0
0
2
0
0
3
0
0
3
0
0
0
10
0
0
7
2
0
0
14
0
0
4
1
0
0
12
0
0
9
2
1
0
27
0
0
6
3
0
1
29
0
0
15
5
1
1
56
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
4
0
0
0
0
0
0
1
0
0
0
0
0
0
2
0
0
0
0
0
0
6
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
6
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
18
0
0
0
0
0
11
0
0
0
0
0
13
5
0
0
0
0
18
5
0
0
0
0
31
10
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
1
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
3
0
0
0
3
0
3
0
6
0
0
0

sifatnya
Anemia Hemolitik
Anemia lainnya
Agranulositosis
Metahaemoglobinema
097
098.0
098.1
098.9
099.0
099.1

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

pengunaan Kokain
pengunaan Tembakau
induksi
atau YTT
bipolar
berulang, gangguan suasana perasaan
(mood afektif) menetap, lainnya atau
YTT
anxietas lainnya
lainnya

Formulir RL 2a
No.
No. DTD
Urut
1
2
187 118
3
F70 - F79
188 119.0
F04, F07, F09
189 119.1
F 50 - F59
190 119.2
F 60 - F69
191 119.3
F 80 - F89
192 119.4
F 05 - F06, F90 - F98
193 119.9
F 99
Retardasi mental
mental organik
lainnya
Gangguan jiwa YTT
194 120
G 00 - G 09
195
196
197
198
G 20
G 30
G 35
G 40 - G41
121
122
123
124
223 139.3
224 139.4
225 139.5
Penyakit Parkinson
Penyakit Alzheimer
Sklerosis multiple
Epilepsi
G 43 - G44
lainnya
G 45
G 56.0
G 56.2
Lesi saraf ulnaris
G 56.3
Lesi saraf radialis
G 56.8
atas lainnya
G59
saraf
G 80
G 81- G83
G 21
Parkinson sekunder
G 92
Toksik ensefalopati
G10 - G13, G22 - G26, G31 G32, G36 - G37, G46 - G47,
G60 - G73, G90 - G91, G93 G99
H 00 - H 01
Radang kelopak mata
H 10 - H 13
konjungtiva
H 15 - H 19
kornea
H 25 - H 28
H 33
H 40 - H 42
Glaukoma
H 49 - H 50
Strabismus
H 52
H 54
Buta dan rabun
H 02 - H 03
H 04 - H 06
H 20 - H 22
badan silier
H 30 - H 32
H 34
H 35 - H 36
226 139.6
H 43 - H 45
227 139.7
H 46 - H48

penglihatan
228 139.8
H 51
229 139.9
H 53
230 139.10
H 55
231 139.11
H 57 - H 59
232 140
H 65 - H 75
233 141
234 142.0
H 90 - H 91
H 61.8
Gangguan daya lihat

dan telingah tengah
235 142.1
H 83.3
236 142.9
H 60 - H 61.0-3
237
238
239
240
241
242
243
I 00 - I 02
I 05 - I 09
I 10
I 11 - I 15
I 21 - I 22
I 20, I 23 - I 25
I 26
Demam reumatik akut

Infark miokard akut
Emboli paru
jantung
Gagal jantung
Kardiomiopati
199 125
200 126
201 127.0
202 127.1
203 127.2
204 127.3
205 127.9
206
207
208
209
128.0
128.9
129.0
129.1
210 129.9
211 130
212 131
213 132
214
215
216
217
218
219
220
221
133
134
135
136
137
138
139.0
139.1
222 139.2
143
144
145
146
147
148
149
244 150
I 44 - I 49
245 151
246 152.0
247 152.9
I 50
I 42 - I 43
I 27 - I 41, I 51 - I 52

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
3
3
0
0
0
5
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
6
1
0
0
6
1
0
0
0
2
7
1
0
0
8
1
0
0
0
0
11
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
1
0
0
0
2
0
1
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
2
0
1
0
0
0
0
37
3
0
6
0
0
0
0
32
2
0
2
0
0
0
0
41
1
0
6
0
0
0
0
41
6
0
3
0
0
0
0
82
7
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
6
0
2
0
4
0
5
0
4
0
3
0
5
0
4
0
9
0
8
0
14
0
12
0
1
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
248 153
249 154
I 60 - I 62
I 63
250 155
I 64
251 156
252 157
253 158.0
I 65 - I 69
I 70
I 75.0
254 158.9
I 73.1 - 9
255 159
I 74
256 160
I 71 - I 72, I 77 - I 79
257 161
I 80 - I 82
258
259
260
261
262
263
264
I 83
I 84
I 85
I 86 - I 99
J 02
J 03
J 04
162
163
164.0
164.9
165.0
165.9
166
265 167
J 00 - J 01, J 05 - J 06
266
267
268
269
270
J 10 - J 11
J 12 - J 18
J 20 - J 21
J 32
J 30.3
168
169
170
171
172.0
271 172.1
J 34.8
273 173
J30.0 - J30.2, J30.4 - J31,

J33, J34.0-3
J 35
274 174
J 36 - J39
275 175
J 40 - J 44
276
277
278
279
280
281
282
283
284
J 45
J 46
J 47
J 60 - J 65
J 85.1, 2
J 93
J 86
J 90 - J 91
J 66.0
272 172.9
176.0
176.9
177
178
179.0
179.1
179.2
179.3
179.4
285 179.5
J 67
286 179.6
J 68
287 179.7
289 180
J 92
J 22, J66.1-2, J66.8, J69 J84, J85.0,3, J 94 - J99
K 02
290 181.0
K 00 - K 01
291 181.1
292 181.2
K 03
K 04
293 181.3
K 05 - K 06
294 181.9
K 07 - K 08
295 182.0
K 09 - K 10
296 182.1
K 11
297 182.2
K 12
298 182.9
K 13 - K 14
299 183
300 184
301 185.0
K 25 - K 27
K 29
K 30
302 185.9
K 20 - K 23, K 28, K 31
303
304
305
306
K 35 - K 38
K 40
K 41 - K 46
K 50 - K 51
288 179.9
186
187
188
189
4
Infark serebral
infark
Aterosklerosis
Sindroma Raynaud's
lainnya
lainnya
trombosis vena
Hemoroid / Wasir
Varises esofagus
Faringitis akut
Tonsilitis akut
lainnya
Influensa
Pneumonia
Sinusitis kronik
septum nasi
lainnya
lainnya
Asma akibat kerja
Status asmatikius
Bronkiektasis
Pneumokoniosis
Abses paru
Pneumotoraks
Piotorak (empiema)
Bisinosis
organik
uap
Plak pleural
Karies gigi
tulang alveolar
maloklusi
rahang
dan lidah
Dispepsia
duodenum lainnya
Penyakit apendiks
Hernia enguinal
Hernia lainnya
Ileus paralitik dan obstruksi usus tanpa
Hernia
syndrome)
307 190
K 56
308 191
K 57
309 192.0
K 58
310 192.9
K 52 - K 55, K 59 - K 67
311
312
313
314
K 70
K 72
K 73
K 74.6

Hepatitis kronik
Sirosis hati
193
194.0
194.1
194.2

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
1
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
1
0
1
0
1
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
17
0
0
0
12
0
0
0
17
0
0
0
17
0
0
0
34
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
3
0
0
1
0
0
0
0
1
0
0
1
0
0
0
0
5
0
0
2
1
0
0
0
0
0
0
0
0
0
0
0
7
0
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
28
0
0
0
1
0
11
0
0
0
2
0
2
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
0
0
1
0
25
0
0
1
3
0
18
0
0
0
4
0
43
0
0
1
0
0
5
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
0
1
5
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
5
7
0
0
0
0
0
0
1
0
8
10
0
0
0
0
0
0
0
0
6
3
0
0
0
0
0
0
0
0
16
16
0
0
0
0
0
0
0
0
5
16
0
0
0
0
0
0
1
0
25
32
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
25
1
0
1
72
4
0
0
42
2
0
0
17
2
0
1
66
2
0
0
91
7
0
1
157
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
2
0
0
17
0
0
0
0
38
0
10
0
0
10
0
16
0
0
1
0
11
0
0
30
0
38
0
0
41
0
1
0
0
71
0
39
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
1
0
0
1
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
5
0
0
0
1
16
0
1
6
0
12
0
2
3
7
3
0
0
1
0
28
0
3
9
5
10
0
0
1
3
38
0
3
10
8
2
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
315 194.3
316 194.4
317 194.5
3
K 76.0
K 76.6
K 76.7
318 194.6
K 71
4
Perlemakan hati
Hipertensi portal
Sindrom hepatorenal
tempat kerja
346 207.9
K 74.0-5, K 75, K 76.1-5, 8, 9,

K 77
K 80
Kolelitiasis
K 81
Kolesistitis
K 85 - K 86
pankreas lainnya
K 82 - K 83, K 87 - K 93
L 00 - L 08
L 23 - L 24
L 10 - L 22, L 25 - L 99
lainnya
M 05 - M 06
Artritis rematoid
M 07
M 08 - M 09
Artritis belia
M 10 - M 11
M 12 - M 14
M 15 - M 19
Artrosis
M 20 - M 21
M 00 - M 01
tempat lain
M 02 - M 03
Artropati reaksi
M 22 - M 25
M 32
M 30 - M 31, M 33 - M36
lainnya
M 50 - M 51
M 45 - M 49
M 54.5
M 40 - M 44, M 53 - M 54.4, M
Dorsopati lainnya
54.6, 8, 9
M 60 - M 64, M 65.0 - M65.3,
8, 9, M 66 - M 68
M 65.4
M 70
tekanan berlebihan
M 71 - M 79
347 208
M 80 - M 85
348 209
M 86
349 210
M 87 - M 99
350 211
N 00 - N 01
351 212.0
352 212.2
N 04
N 02.8
Osteomielitis
akut
Sindrom nefritik
353 212.9
319 194.9
320 195.0
321 195.9
322 196
323 197
324 198
325 199.0
326 199.9
327
328
329
330
331
332
333
200.0
200.1
200.2
200.3
200.9
201
202
334 203.0
335 203.1
336 203.9
337 204.0
338 204.9
339 205
340 206.0
341 206.1
342 206.9
343 207.0
344 207.1
345 207.2

pielonefritis
logam berat
354 213.0
N 12
355 213.1
N 14.3
356 213.9
N 10 - N 11, N 13, N 14.0-2,

4, N 15 - N 16
Penyakit tubulo interstitial ginjal lainnya
357 214.0
N 17.8
358
359
360
361
362
363
364
N 17.0-2, 9 - N 19
N 20 - N 23
N 30
N 25 - N 29, N 31 - N 39
N 40
N 41 - N 42
N 43

Urolitiasis
Sistitis
Hiperplasia prostat
parafimosis
Radang serviks
Endometriosis
latum
Amenore
214.9
215
216
217
218
219
220
365 221
N 47
366
367
368
369
370
371
222
223
224
225
226.0
226.1
N 44 - N 46, N 48 - N 51
N 60 - N 64
N 70
N 72
N 73
N 75.0.1
372 226.9
N 71, N 74, N 75.8 - N77
373 227
374 228
N 80
N 81
375 229
N 83
376 230.0
377 230.1
378 230.9
N 91.0, 1, 2
N 92.0, 1
N 91.3-5, N 92.2-6

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
1
0
0
0
0
0
3
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
1
0
0
0
2
0
0
0
3
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
1
0
0
0
0
0
0
4
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
14
1
0
0
0
0
0
0
9
0
0
0
0
0
0
0
23
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
2
0
0
10
0
0
0
0
1
0
0
2
0
0
0
0
7
6
0
18
0
0
0
0
13
1
0
21
11
0
1
0
5
0
0
2
17
0
0
0
12
5
0
39
28
0
1
0
16
2
0
19
0
0
0
0
28
7
0
58
28
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
8
0
2
0
0
0
0
3
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
1
1
0
0
0
11
0
3
1
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
3
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
9
0
0
0
9
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
379 231
380 232
381 233
382
383
384
385
386
234
235
236.0
236.1
236.2
387 236.9
388 237.0
389 237.1
390 237.9
391 238.0
392 238.1
393 283.9
394
395
396
397
239.0
239.1
239.2
239.3
398 239.9
399
400
401
402
240
241
242.0
242.1
4
N 95
N 97
N 82, N 84 - N 90, N 93 - N
94, N 96, N 98 - N 99
lainnya
O 03
Abortus spontan
O 04
Abortus medik
O 00
Kehamilan ektopik
O 01
Mola hidatidosa
O 05
Abortus lainnya
O 02, O 06, O 08
abortus
O 14
nyata/ Preeklampsia
O 15
Eklampsia
O 10 - O 13, O 16
hipertensi dalam kehamilan, persalinan
dan masa nifas
O 44
Plasenta previa
O 45
Solusio plasenta
Perdarahan antepartum YTK di tempat
O 46
lain
O 30
Kehamilan multipel
O 40
Hidramnion
O 42
Ketuban pecah dini
O 48
persalinan
O 64 - O 66
Persalinan macet
O 72
O 24
O 60
Persalinan prematur
403 242.2
O 68
Persalinan dengan penyulit gawat janin
404 242.3
O 84
Persalinan multipel
405 242.9
O 20 - O 23, O 25 - O 29, O
61 - O 63, O 67, O 69 - 71, O
lainnya
73 - O 75, O 81 - -O 83
406 243
O 80
407 244
O 85 - O 99
409 246
P 05 - P 07
410 247
P 10 - P15

kondisi obstetrik lainnya, YTK ditempat
lain
janin dan gangguan yang berhubungan
dengan kehamilan pendek dan berat
badan lahir rendah
Cedera lahir
411 248
P 20 - P 21
412 249
P 22 - P 28

413 250
P 35 - P 37
414 251
P 38 - P 39
408 245
415 252
416 253.0
417 253.9
418 254
419 255.0
420 255.9
421 256
422 257
423 258
424 259
425 260
426 261.0
P 00 - P 04

perinatal
P 55
baru lahir
P 95
Lahir mati
P 94, P 96
perinatal
Q 05
Spina bifida
Q 03
Q 00 - Q 02, Q 04, Q 06, Q
07
lain
Q 20 - Q 28
peredaran darah
Q 35 - Q 37
Q 41
halus
Q 38 - Q 40, Q 42 - Q 45
lainnya
Q 53
Testis tidak turun
Q 50 - Q 52
wanita
427 261.1
Q 54 - Q 56
428 261.9
Q 60 - Q 64
429 262
430 263
Q 65
Q 66
431 264
Q 67 - Q 79

lainnya

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
11
5
8
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
7
8
0
0
0
12
7
8
0
0
0
0
0
0
14
86
103
103
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
38
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
46
0
9
0
0
46
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
63
50
251
0
1
0
0
0
0
55
299
55
315
0
1
12
12
23
16
23
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
8
0
14
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
1
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
433 266.0
3
Q 10 - Q 18, Q 30 - Q34, Q
80 - Q 89
Q 90
434 266.9
Q 91 - Q 99
435 267
R 10
436 268
R 50
437
438
439
440
441
442
443
R 54
R 00 - R 01
R 09.2
R 33
R 56
R 75
R 95
R 02 - R 09.0,1,3,8, R 11 - R
32, R 34 - R 49, R 51 - R 52,
R 55, R 57 - R 74, R 76 - R
94, R 96 - R 99
S 02
S 12, S 22, S 32, T 08
S 72
S 42, S 52, S 62, S 82, S 92,
T 10, T 12
Senilitis
Gejala pada jantung
Gagal napas
Retensi urin
Kejang YTT
T 02
Fraktur meliputi daerah badan multiplel
S 03, 13, 23, 43, 53, 63, 73,

83, 93, T 03
S 05
S 06
S 26 - S 27

Cedera intrakranial
432 265
269
270.0
270.1
270.2
270.3
270.4
270.5
444 270.9
445 271
446 272
447 273
448 274
449 275
450 276
451 277
452 278
453 279
454 280
Sindrom Down
Gejala, tanda dan penemuan klinik dan

laboratorium tidak normal lainnya, YTK
ditempat lain
Fraktur paha
S36-S37, S07-S08, S17-S18,

S97-S98, T04-T05
455 281
S76, S79-S81, S84-S86, S89S91, S94-S96, S99, T00-T01,
T06-T07, T09-T11, T13-T14
456 282.0
T 16
457 282.9
T 15, T 17 - T 19
458 283
T 20 - T 32

459 284
T 36 T 50
460
461
462
463
T 52
T 56
T 59
T 60
T51, T53 - T55, T57 - T58,
T61 - T65
T 74
T 66
T 67
T 70

Keracunan logam
Keracunan pestisida
lainnya
Efek radiasi YTT
tempat lain
YTK di tempat lain
secara rutin
Imunisasi BCG
Imunisasi Tetanus
Imunisasi Rabies
Imunisasi Campak
pertusis, tetanus)
285.0
285.1
285.2
285.3
464 285.9
465
466
467
468
286
287.0
287.1
287.2
469 287.9
T33-T35, T68-T69, T71-T73,

T75-T78
470 288
T 79 - T 88
471 289
T 90 - T 98
472 290.0
Z 00.0
473 290.1
Z 00.1
474 290.9
Z 00.2 - Z 13
475
476
477
478
479
480
481
291
292.0
292.1
292.2
292.3
292.4
292.6
Z 21
Z 23.2
Z 23.5
Z 24.0
Z 24.2
Z 24.4
Z 24.6
482 292.7
Z 27.1
483 292.8

Z 25 - Z 27.0, Z 272.2 - Z 29 lainnya

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
2
0
3
0
4
0
3
0
6
0
7
0
13
0
0
0
0
0
0
0
0
0
0
12
0
0
6
0
6
0
0
37
0
0
1
0
31
0
0
60
0
0
0
1
4
0
0
12
0
0
0
0
0
0
0
24
0
0
1
1
0
0
0
15
0
0
1
2
0
0
0
5
0
0
0
0
0
0
0
85
0
0
3
2
31
0
0
80
0
0
6
2
10
0
0
165
0
0
9
4
41
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
5
0
0
0
3
0
0
0
5
0
0
0
14
0
0
0
6
0
0
0
3
0
0
0
11
0
0
0
26
0
0
0
37
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
3
0
0
0
3
0
0
0
0
0
0
0
9
0
0
0
1
0
0
0
10
0
0
0
4
0
0
0
0
0
5
0
27
0
61
0
68
0
21
0
5
0
135
0
55
0
187
0
2
0
0
0
0
0
0
0
0
1
0
2
1
0
0
0
0
0
1
3
0
0
1
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
2
0
0
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
484 292.9
Z 20, Z 22
485 293
486 294.0
Z 30
Z 34
487 294.1
Z 35
488 294.9
489 295
Z 36
Z 38
490 296
Z 39
491 297.0
Z 46.0
492 297.1
Z 41.2
493 297.2
Z 46.3
494 297.3
Z 50
495 297.9
Z 40 - Z 41.0,1,3, Z 45, Z
46.1,2,4-9, Z 49, Z 51 - Z 54
496 298
4
penyakit menular
tinggi
Seleksi antenatal
persalinan
kebiasaan
palsu

khusus lainnya
Z 31 - Z 33, Z 37, Z 55 - Z 99
alasan lainnya
JUMLAH

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
65
0
154
0
296
0
316
0
315
0
1007
0
448
0
200
0
1235
0
1551
0
2801
0
42
PENYEBAB KECELAKAAN
No.
No. DTD
Urut
01 299.0
02 299.1
V 01 - V 89
V 90 - V 94
03 299.2
V 95 - V 97
04 299.9
05 300
V 98 - V 99
W 00 - W 19

angkasa
Jatuh
06 301
W 65 - W 74
07 302
08 303.0
X 00 - X 09
X 45
09 303.1
X 46
10 303.2
X 47

& uap-uap lainnya
11 303.3
X 48
12 303.4
X 49
13 303.9
X 40 - X 44
14 304..0
X 60 - X 69
15 304.9
16 305
17 306.0
X 70 - X 84
X 85 - Y 09
X 10 - X 19
18 306.1
X 20 - X 29
19 306.2
X 30 - X 39
20 306.3
Y 40 - Y 59
21 306.4
Y 60 - Y 84
22 306.5
23 306.6
24 306.7
W 42
W 43
W 88
25 306.8
W 89
26 306.9
27 306.10
W 90
W 91
28 306.11
X 50
29 306.12
Y 96
30 306.13
Keracunan akibat pemaparan pestisida

Sengaja mencederai diri dengan bahan
beracun
Dicederai
beracun
Pemaparan bising
Pemaparan getaran
manmade visible
W20-W41, W44-W64, W75W87, W92-W99, X51-X59,

Sebab luar lainnya
Y10-Y39, Y85-Y95, Y97-Y98
JUMLAH
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
0
0
0
0
0
0
0
0
0
0
0
0
0
0
>65
TH
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
PR
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
1
0
0
0
2
0
2
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
5
0
1
0
0
0
5
0
4
0
9
0
0
Sumbawa, 1 Juli 2010


NIP.19560114 198301 1 002

TRIWULAN : III ( Juli S.D Sept) TAHUN 2010
Formulir RL 2a
No.
No. DTD
Urut
1
01
02
03
04
05
2
001
002
003
004.0
004.9
A 00
A 01
A 03
A 06.4
A 06.0-3, 5-9
Cholera
Shigellosis
Abses hati amuba
Amebiasis lainnya
06 005
A 09

07 006
A 02, A 04, A 05. A 07, A 08
08 007.0
A 15.0
09 007.1
10 007.9
11 008.0
A 15.1 - A 16.2
A 16.3-9
A 17.0
12 008.1
A 17.1-9
13
14
15
16
17
18
19
20
21
22
23
24
25
26
A 18.0
A 18.2
A 19
A 18.1, 3-8
A 20
A 23
A 30
A 33
A 34, A 35
A 36
A 37
A 39
A 40, A 41
A 22
A 21, A 24-28, A 31-32, A 38,
A 42-49
A 50
A 51
A 52, A 53
A 54
008.2
008.3
008.4
008.9
009
010
011
012
013
014
015
016
017
018.0
27 018.9
28
29
30
31
019
020
021
022
32 023
A 55, A 56
33 024
A 57- A 64
34
35
36
37
38
39
40
41
42
43
44
A 68
A 71
A 75
A 80
A 82
A 83 - A 86
A 95
A 90
A 91
A 92.0
A 92.1, A 92
025
026
027
028
029
030
031
032.0
032.1
032.2
032.3
45 032.9
A 93 - A 94, A 96 - A 99
46 033
B 00
47 034
B 01 - B 02
48
49
50
51
52
53
54
B 05
B 06
B 16
B 15
B 17.1
B 17.2
B 17.08, B 18, B19
035
036
037
038.0
038.1
038.2
038.9

lainnya
Tuberkulosis milier
Sampar / Pes
Bruselosis
Lepra / Kusta
Tetanus neonatorum
Tetanus lainnya
Difteria
Infeksi meningokok
Septisemia
Anthraks
Sifilis bawaan
Sifilis dini
Sifilis lainnya
Infeksi gonokok
hubungan seksual
Demam bolaik-balik
Trakoma
Demam tifus
Poliomielitis akut
Rabies
Ensefalitis virus
Demam kuning
Demam dengue
Chikungunya
zoster)
Campak
Rubella
Hepatitis B akut
Hepatitis A akut
Hepatitis C akut
Hepatitis E akut
Gondong
55 039
B 20 - B 24
56 040
B 26
57 041
A 81, A 87- A 89, B 03 - B 04,

B 07- B 09, B 25, B 27- B 34
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
B 35 - B 49
B 50 - B 54
B 55
B 56 - B 57
B 65
B 66
B 67
B 72
B 73
B 74
B 76
B 68 - 71, B 75, B 77 - 83
B 90.91
B 90.92
B 90.0-8
B 91
B 92
A 66
042
043
044
045
046
047
048
049
050
051
052
053
054.0
054.1
054.9
055
056
057.0
Mikosis
Lesmaniasis
Tripanosomiasis
Ekinokokosis
Drakunkuliasis
Onkosersiasis
Filariasis
Patek (Frambusia)

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
13
26
1
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
0
0
0
0
0
24
0
0
0
0
19
0
0
0
0
43
0
0
0
0
1
0
0
0
99
147
21
40
45
15
205
171
376
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
2
0
0
0
9
0
7
0
7
0
9
0
3
0
5
0
15
1
16
0
7
0
5
0
22
1
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
1
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
1
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
28
0
0
0
0
0
0
0
0
0
0
2
11
0
0
0
0
0
0
0
0
0
0
3
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
3
24
0
0
0
0
0
0
0
0
0
0
3
25
0
0
0
0
0
0
0
0
0
0
6
49
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
2
0
0
0
0
0
0
1
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
38
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
58
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
45
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
103
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
76 057.1
77 057.2
78 057.9
79 058.0
80 058.1
81 058.9
82 059
83 060
84 061
85 062
86 063
87 064
88 065
89
90
91
92
066
067.0
067.9
068.0
93 068.9
94 069
95 070
96 071
97 072.0
98 072.9
99 073
100 074
101 075.0
102 075.9
103 076.0
104 076.1
105 076.9
106 077
107 078.0
108 078.1
109 078.9
110 079
A 70
Infeksi Klamedia
B 58
Toksoplasmosis
B 94 - B99
C 00 - C 10
C 11
C 12 - C 14
C 15
C 16
C 18
C 19 - C 21
C 22
empedu intrahepatik
C 25
C 17, C 23-C 24, C 26
cerna lainnya
C 32
C 33
C 34
C 38.1-8
C 30, C 31, C 37, C 38.0, C
39
C 40 - C 41
rawan sendi
C 43
C 44
C 45
Mesotelioma
C 46 - C 49
jaringan lunak
C 50
C 53
C 54
C 55
lainnya dan YTT
C 56
telur)
C 58
C 51-C 52, C 57
perempuan lainnya
C 61
C 60
C 62
C 63
lainnya
C 67
(buli-buli)
111 080.0
C 64 - C 65
112 080.9
C 66, C 68
113 081
C 69
114 082
C 71
115 083
C 70, C 72
116 084.0
C 73
117 084.1
C 74 - C 75
118 084.2
C 76
119 084.3
C 77 - C 80
120 084.9
C 97
121 085
122 086
123 087
C 81
C 82 - C 85
C 91 - C 95
124 088
C 88 - C 90, C 96
125
126
127
128
D 06
D 22 - D 23
D 24
D 25

saraf pusat
bening YTT
multipel
Penyakit Hadgkin
Limfoma non Hodgkin
Leukemia
lainnya
Leiomioma uterus
telur)
saraf pusat lainnya
089
090
091
092
129 093
D 27
130 094
D 30
131 095
D 33
132
133
134
135
D 04
D 05
D 00-D 03, D 07-D 09
D 12.6
096.0
096.1
096.2
096.3

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
1
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
1
0
1
0
0
3
1
0
0
0
0
1
0
1
0
0
1
3
2
1
1
4
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
3
3
0
0
1
5
0
0
1
2
0
0
1
0
0
0
5
6
0
0
2
4
0
0
7
10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
7
0
0
0
0
1
3
0
0
0
1
0
0
0
0
0
0
0
0
0
11
3
0
0
0
11
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
136 096.4
D 14.1 - 4
137 096.5
D 15.2
D10 - D12.0-5, 7-9, D13 D14.0, D15.0-1, D15.7-9D20, D21, D26, D28 - D29,
D31 - D32, D34 - D 36
138 096.6
139 096.9
D 37 - D 48
140
141
142
143
144
145
D 50
D 59
D 61
D51 - D58, D60, D62, D64
D 70
D 74
146 099.9
D65 - D69, D71- D73, D75 D77

147 100
D80 - D89
148 101
149
150
151
152
153
154
102
103.0
103.1
103.2
103.9
104.0
155 104.1
156 104.2
157
158
159
160
161
104.3
104.9
105
106
107
162 108
163 109
164 110
165 111
166 112
167 113
168 114.0
169 114.1

mekanisme imun
E00 - E 02
defisiensi iodium
E 05
E 03
E 04
E 06
Tiroiditis
E 07
E 10
E 11
insulin
E 12
malnutrisi
E 13
E 14
E 40 - E 46
Malnutrisi
E 50
E 51 - E 56
E 64
gizi lainnya
E 66
Obesitas
E 86
E85, E87 -E90
metabolik lainnya
F 00 - F 03
Demensia
F 10
pengunaan Alkohol
F 11
pengunaan Opioda
F 12
170 114.2
F 13
171 114.3
F 14
172 114.4
F 15
173 114.5
F 16
174 114.6
F 17
175 114.9
F 18, F 19
176 115.0
F 20, F21, F 23
177 115.1
F 22, F 24
178 115.2
F 25
179 115.9
F 28 - F 29
180 116.0
F 30, F31
181 116.9
F 32 - F 39
182 117.0
F 40, F 41
183 117.1
184 117.2
F 42
F 43.1
185 117.3
F 43.0, F 43.2-9, F 45, F48
186 117.9
F 44
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
0
0
0
0
0
0
0
0
0
0
0
10
0
0
1
0
0
0
15
0
0
3
0
0
0
14
0
0
0
0
0
0
3
0
0
3
0
0
0
13
0
0
7
0
0
0
19
0
0
1
0
0
0
9
0
0
7
0
0
0
42
0
0
8
0
0
0
41
0
0
15
0
0
0
83
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
5
0
0
0
0
2
1
4
1
0
0
0
1
0
1
0
0
0
0
0
1
3
0
0
0
0
3
0
7
2
0
0
0
3
1
10
2
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
3
0
0
0
0
1
0
0
0
0
0
4
0
0
0
0
0
18
0
0
0
0
2
5
0
0
0
0
2
11
3
0
0
0
0
17
2
0
0
0
2
28
5
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
1
0
1
0
2
0
0
0

sifatnya
Anemia Hemolitik
Anemia lainnya
Agranulositosis
Metahaemoglobinema
097
098.0
098.1
098.9
099.0
099.1

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

pengunaan Kokain
pengunaan Tembakau
induksi
atau YTT
bipolar
lainnya atau YTT
anxietas lainnya
lainnya

Formulir RL 2a
No.
No. DTD
Urut
1
2
187 118
3
F70 - F79
188 119.0
F04, F07, F09
189 119.1
F 50 - F59
4
Retardasi mental
mental organik
lainnya
190 119.2
F 60 - F69
191 119.3
F 80 - F89
192 119.4
F 05 - F06, F90 - F98
193 119.9
F 99

Gangguan jiwa YTT
194 120
G 00 - G 09
195
196
197
198
121
122
123
124
G 20
G 30
G 35
G 40 - G41
199 125
G 43 - G44
Penyakit Parkinson
Penyakit Alzheimer
Sklerosis multiple
Epilepsi
lainnya
200 126
G 45
201 127.0
202 127.1
203 127.2
G 56.0
G 56.2
G 56.3
204 127.3
205 127.9
206
207
208
209
128.0
128.9
129.0
129.1
210 129.9
211 130
212 131
213 132
214
215
216
217
218
219
220
133
134
135
136
137
138
139.0


Lesi saraf ulnaris
Lesi saraf radialis
G 56.8
atas lainnya
G59
saraf
G 80
G 81- G83
G 21
Parkinson sekunder
G 92
Toksik ensefalopati
G10 - G13, G22 - G26, G31 G32, G36 - G37, G46 - G47,
G60 - G73, G90 - G91, G93 G99
H 00 - H 01
Radang kelopak mata
H 10 - H 13
konjungtiva
H 15 - H 19
kornea
H 25 - H 28
H 33
H 40 - H 42
Glaukoma
H 49 - H 50
Strabismus
H 52
H 54
Buta dan rabun
H 02 - H 03
221 139.1
H 04 - H 06
222 139.2
H 20 - H 22
223 139.3
224 139.4
225 139.5
H 30 - H 32
H 34
H 35 - H 36

badan silier
226 139.6
H 43 - H 45
227 139.7
H 46 - H48

penglihatan
228 139.8
H 51
229 139.9
H 53
230 139.10
H 55
231 139.11
H 57 - H 59
232 140
H 65 - H 75
233 141
234 142.0
H 90 - H 91
H 61.8
Gangguan daya lihat

dan telingah tengah
235 142.1
H 83.3
236 142.9
H 60 - H 61.0-3
237
238
239
240
241
242
243
I 00 - I 02
I 05 - I 09
I 10
I 11 - I 15
I 21 - I 22
I 20, I 23 - I 25
I 26
Demam reumatik akut

Infark miokard akut
Emboli paru
jantung
Gagal jantung
Kardiomiopati
143
144
145
146
147
148
149
244 150
I 44 - I 49
245 151
246 152.0
247 152.9
I 50
I 42 - I 43
I 27 - I 41, I 51 - I 52

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
0
0
2
0
0
0
3
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
3
2
0
0
0
2
7
0
0
0
5
2
0
0
0
0
10
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
15
0
1
3
0
0
0
0
47
0
1
0
0
0
0
0
19
1
0
2
0
0
0
1
37
0
1
1
0
0
0
2
44
1
1
5
0
0
0
3
81
1
2
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
13
0
4
0
18
0
2
0
8
0
5
0
14
0
9
0
25
0
3
0
39
0
12
0
2
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
248 153
249 154
I 60 - I 62
I 63
250 155
I 64
251 156
252 157
253 158.0
I 65 - I 69
I 70
I 75.0
254 158.9
I 73.1 - 9
255 159
I 74
256 160
I 71 - I 72, I 77 - I 79
257 161
I 80 - I 82
258
259
260
261
262
263
264
I 83
I 84
I 85
I 86 - I 99
J 02
J 03
J 04
162
163
164.0
164.9
165.0
165.9
166
265 167
J 00 - J 01, J 05 - J 06
266
267
268
269
270
J 10 - J 11
J 12 - J 18
J 20 - J 21
J 32
J 30.3
168
169
170
171
172.0
271 172.1
J 34.8
273 173
J30.0 - J30.2, J30.4 - J31,

J33, J34.0-3
J 35
274 174
J 36 - J39
275 175
J 40 - J 44
276
277
278
279
280
281
282
283
284
J 45
J 46
J 47
J 60 - J 65
J 85.1, 2
J 93
J 86
J 90 - J 91
J 66.0
272 172.9
176.0
176.9
177
178
179.0
179.1
179.2
179.3
179.4
285 179.5
J 67
286 179.6
J 68
287 179.7
289 180
J 92
J 22, J66.1-2, J66.8, J69 J84, J85.0,3, J 94 - J99
K 02
290 181.0
K 00 - K 01
291 181.1
292 181.2
K 03
K 04
293 181.3
K 05 - K 06
294 181.9
K 07 - K 08
295 182.0
K 09 - K 10
296 182.1
K 11
297 182.2
K 12
298 182.9
K 13 - K 14
299 183
300 184
301 185.0
K 25 - K 27
K 29
K 30
302 185.9
K 20 - K 23, K 28, K 31
303
304
305
306
K 35 - K 38
K 40
K 41 - K 46
K 50 - K 51
288 179.9
186
187
188
189
4
Infark serebral
infark
Aterosklerosis
Sindroma Raynaud's
lainnya
lainnya
trombosis vena
Hemoroid / Wasir
Varises esofagus
Faringitis akut
Tonsilitis akut
lainnya
Influensa
Pneumonia
Sinusitis kronik
septum nasi
lainnya
lainnya
Asma akibat kerja
Status asmatikius
Bronkiektasis
Pneumokoniosis
Abses paru
Pneumotoraks
Piotorak (empiema)
Bisinosis
organik
uap
Plak pleural
Karies gigi
tulang alveolar
maloklusi
rahang
dan lidah
Dispepsia
duodenum lainnya
Penyakit apendiks
Hernia enguinal
Hernia lainnya
tanpa Hernia
syndrome)
307 190
K 56
308 191
K 57
309 192.0
K 58
310 192.9
K 52 - K 55, K 59 - K 67
311
312
313
314
K 70
K 72
K 73
K 74.6

Hepatitis kronik
Sirosis hati
193
194.0
194.1
194.2

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
1
3
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
3
0
4
0
3
0
7
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
25
0
0
0
21
0
0
0
22
0
0
0
27
0
0
0
49
0
0
0
8
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
1
0
0
0
0
2
0
0
0
2
0
0
0
2
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
4
0
1
1
0
1
0
0
0
0
0
2
4
0
0
0
4
0
1
3
4
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
16
0
0
0
0
0
19
0
0
0
2
0
0
0
0
0
0
0
1
0
0
0
1
0
1
0
0
0
1
0
3
0
0
0
0
0
3
0
0
0
4
0
20
0
0
0
1
0
23
0
0
0
5
0
43
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
5
9
0
0
0
0
0
0
0
0
3
7
0
0
0
0
0
0
0
0
8
16
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
8
28
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
2
27
0
0
2
65
0
0
1
56
0
0
0
17
0
0
1
76
0
0
4
90
0
0
5
166
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
4
0
0
4
0
1
0
0
14
0
2
0
0
19
0
5
0
0
8
0
16
0
0
2
0
8
0
0
28
0
33
0
0
21
0
3
0
0
49
0
36
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
8
0
1
0
0
0
4
0
7
0
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
1
0
4
0
0
3
4
9
0
1
4
6
11
0
2
0
2
12
0
1
5
9
16
0
2
3
3
28
0
3
8
12
2
0
2
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
315 194.3
316 194.4
317 194.5
3
K 76.0
K 76.6
K 76.7
318 194.6
K 71
4
Perlemakan hati
Hipertensi portal
Sindrom hepatorenal
tempat kerja
346 207.9
K 74.0-5, K 75, K 76.1-5, 8, 9,

K 77
K 80
Kolelitiasis
K 81
Kolesistitis
K 85 - K 86
pankreas lainnya
K 82 - K 83, K 87 - K 93
L 00 - L 08
L 23 - L 24
L 10 - L 22, L 25 - L 99
lainnya
M 05 - M 06
Artritis rematoid
M 07
M 08 - M 09
Artritis belia
M 10 - M 11
M 12 - M 14
M 15 - M 19
Artrosis
M 20 - M 21
M 00 - M 01
tempat lain
M 02 - M 03
Artropati reaksi
M 22 - M 25
M 32
M 30 - M 31, M 33 - M36
lainnya
M 50 - M 51
M 45 - M 49
M 54.5
M 40 - M 44, M 53 - M 54.4, M
Dorsopati lainnya
54.6, 8, 9
M 60 - M 64, M 65.0 - M65.3,
8, 9, M 66 - M 68
M 65.4
M 70
tekanan berlebihan
M 71 - M 79
347 208
M 80 - M 85
348 209
M 86
349 210
M 87 - M 99
350 211
N 00 - N 01
351 212.0
352 212.2
N 04
N 02.8
Osteomielitis
akut
Sindrom nefritik
353 212.9
319 194.9
320 195.0
321 195.9
322 196
323 197
324 198
325 199.0
326 199.9
327
328
329
330
331
332
333
200.0
200.1
200.2
200.3
200.9
201
202
334 203.0
335 203.1
336 203.9
337 204.0
338 204.9
339 205
340 206.0
341 206.1
342 206.9
343 207.0
344 207.1
345 207.2
354 213.0
N 12
355 213.1
N 14.3
356 213.9
N 10 - N 11, N 13, N 14.0-2,

4, N 15 - N 16

pielonefritis
logam berat
lainnya
357 214.0
N 17.8
358
359
360
361
362
363
364
N 17.0-2, 9 - N 19
N 20 - N 23
N 30
N 25 - N 29, N 31 - N 39
N 40
N 41 - N 42
N 43

Urolitiasis
Sistitis
Hiperplasia prostat
parafimosis
Radang serviks
Endometriosis
latum
Amenore
214.9
215
216
217
218
219
220
365 221
N 47
366
367
368
369
370
371
222
223
224
225
226.0
226.1
N 44 - N 46, N 48 - N 51
N 60 - N 64
N 70
N 72
N 73
N 75.0.1
372 226.9
N 71, N 74, N 75.8 - N77
373 227
374 228
N 80
N 81
375 229
N 83
376 230.0
377 230.1
378 230.9
N 91.0, 1, 2
N 92.0, 1
N 91.3-5, N 92.2-6

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
2
0
0
0
1
0
0
0
2
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
4
0
0
0
0
2
0
0
1
0
0
0
0
0
0
0
9
0
0
0
0
2
0
0
6
0
0
0
0
0
0
0
15
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
1
1
0
1
1
0
0
0
0
0
0
0
0
0
5
0
0
2
0
0
3
0
0
0
0
0
3
0
0
0
0
0
1
0
0
12
0
0
13
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
5
0
0
0
0
1
0
0
2
0
0
0
0
3
1
0
23
0
0
0
1
6
2
0
14
6
0
0
0
4
1
0
3
17
0
0
1
8
2
0
34
23
0
0
0
6
2
0
19
0
0
0
1
14
4
0
53
23
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
2
0
0
0
9
0
2
0
0
0
0
6
0
0
0
0
0
0
0
0
3
0
0
0
0
1
0
0
2
0
0
0
15
0
3
2
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
5
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
8
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
379 231
380 232
381 233
382
383
384
385
386
234
235
236.0
236.1
236.2
387 236.9
388 237.0
389 237.1
390 237.9
391 238.0
392 238.1
393 283.9
394
395
396
397
239.0
239.1
239.2
239.3
398 239.9
399
400
401
402
240
241
242.0
242.1
403 242.2
404 242.3
4
N 95
N 97
N 82, N 84 - N 90, N 93 - N
94, N 96, N 98 - N 99
lainnya
O 03
Abortus spontan
O 04
Abortus medik
O 00
Kehamilan ektopik
O 01
Mola hidatidosa
O 05
Abortus lainnya
O 02, O 06, O 08
abortus
O 14
nyata/ Preeklampsia
O 15
Eklampsia
O 10 - O 13, O 16
O 44
Plasenta previa
O 45
Solusio plasenta
O 46
tempat lain
O 30
Kehamilan multipel
O 40
Hidramnion
O 42
Ketuban pecah dini
O 48
persalinan
O 64 - O 66
Persalinan macet
O 72
O 24
O 60
Persalinan prematur
O 68
janin
O 84
Persalinan multipel
405 242.9
O 20 - O 23, O 25 - O 29, O
61 - O 63, O 67, O 69 - 71, O
lainnya
73 - O 75, O 81 - -O 83
406 243
O 80
407 244
O 85 - O 99
409 246
P 05 - P 07
410 247
P 10 - P15

ditempat lain
Cedera lahir
411 248
P 20 - P 21
412 249
P 22 - P 28

413 250
P 35 - P 37
414 251
P 38 - P 39
408 245
415 252
416 253.0
417 253.9
418 254
419 255.0
420 255.9
421 256
422 257
423 258
424 259
425 260
426 261.0
P 00 - P 04

perinatal
P 55
baru lahir
P 95
Lahir mati
P 94, P 96
perinatal
Q 05
Spina bifida
Q 03
Q 00 - Q 02, Q 04, Q 06, Q
07
lain
Q 20 - Q 28
peredaran darah
Q 35 - Q 37
Q 41
halus
Q 38 - Q 40, Q 42 - Q 45
lainnya
Q 53
Testis tidak turun
Q 50 - Q 52
wanita
427 261.1
Q 54 - Q 56
428 261.9
Q 60 - Q 64
429 262
430 263
Q 65
Q 66
431 264
Q 67 - Q 79

lainnya

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
0
1
0
0
2
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
3
5
0
1
0
0
3
5
0
0
0
0
0
0
0
18
74
92
92
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
0
0
0
0
39
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
52
0
3
0
0
52
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
58
49
226
1
2
0
0
0
0
57
286
57
286
0
0
14
21
22
18
14
18
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
5
0
12
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
2
0
1
3
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
433 266.0
3
Q 10 - Q 18, Q 30 - Q34, Q
80 - Q 89
Q 90
434 266.9
Q 91 - Q 99
435 267
R 10
436 268
R 50
437
438
439
440
441
442
443
R 54
R 00 - R 01
R 09.2
R 33
R 56
R 75
R 95
R 02 - R 09.0,1,3,8, R 11 - R
32, R 34 - R 49, R 51 - R 52,
R 55, R 57 - R 74, R 76 - R
94, R 96 - R 99
S 02
S 12, S 22, S 32, T 08
S 72
S 42, S 52, S 62, S 82, S 92,
T 10, T 12
Senilitis
Gejala pada jantung
Gagal napas
Retensi urin
Kejang YTT
432 265
269
270.0
270.1
270.2
270.3
270.4
270.5
444 270.9
445 271
446 272
447 273
448 274
449 275
450 276
451 277
452 278
453 279
454 280
T 02
S 03, 13, 23, 43, 53, 63, 73,
83, 93, T 03
S 05
S 06
S 26 - S 27
Sindrom Down

YTK ditempat lain
Fraktur paha
multiplel
Cedera intrakranial
S36-S37, S07-S08, S17-S18,

S97-S98, T04-T05
455 281
S76, S79-S81, S84-S86, S89S91, S94-S96, S99, T00-T01,
T06-T07, T09-T11, T13-T14
456 282.0
T 16
457 282.9
T 15, T 17 - T 19
458 283
T 20 - T 32

459 284
T 36 T 50
460
461
462
463
T 52
T 56
T 59
T 60
T51, T53 - T55, T57 - T58,
T61 - T65
T 74
T 66
T 67
T 70

Keracunan logam
Keracunan pestisida
lainnya
Efek radiasi YTT
tempat lain
YTK di tempat lain
secara rutin
285.0
285.1
285.2
285.3
464 285.9
465
466
467
468
286
287.0
287.1
287.2
469 287.9
T33-T35, T68-T69, T71-T73,

T75-T78
470 288
T 79 - T 88
471 289
T 90 - T 98
472 290.0
Z 00.0
473 290.1
Z 00.1

474 290.9
Z 00.2 - Z 13
475
476
477
478
479
480
481
291
292.0
292.1
292.2
292.3
292.4
292.6
Z 21
Z 23.2
Z 23.5
Z 24.0
Z 24.2
Z 24.4
Z 24.6
482 292.7
Z 27.1
483 292.8

Z 25 - Z 27.0, Z 272.2 - Z 29 lainnya

Imunisasi BCG
Imunisasi Tetanus
Imunisasi Rabies
Imunisasi Campak
pertusis, tetanus)

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
1
0
0
1
2
0
0
1
0
0
0
0
0
0
0
0
2
1
1
1
3
2
1
1
0
0
0
0
0
0
0
0
0
3
0
6
0
7
0
3
0
11
0
7
0
19
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
9
0
0
30
0
0
0
0
19
0
0
35
0
0
0
0
6
0
0
19
0
0
0
0
0
0
0
24
0
0
1
0
0
0
0
11
0
0
3
0
0
0
0
4
0
0
1
0
0
0
0
75
0
0
2
0
23
0
0
52
0
0
4
0
11
0
0
127
0
0
6
0
34
0
0
0
0
0
0
0
1
0
0
0
0
0
0
3
0
0
0
6
0
0
0
3
0
0
0
2
0
0
0
15
0
0
0
15
0
0
0
6
0
0
0
19
0
0
0
31
0
0
0
50
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
12
0
0
0
9
0
0
0
4
0
0
0
0
0
0
0
21
0
0
0
6
0
0
0
27
0
0
0
13
0
0
0
0
0
7
0
33
0
54
0
77
0
40
0
12
0
165
0
58
0
223
0
1
0
0
0
0
0
0
2
1
0
0
1
0
1
0
2
0
0
1
5
0
1
1
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
484 292.9
Z 20, Z 22
485 293
486 294.0
Z 30
Z 34
487 294.1
Z 35
488 294.9
489 295
Z 36
Z 38
490 296
Z 39
491 297.0
Z 46.0
492 297.1
Z 41.2
493 297.2
Z 46.3
494 297.3
Z 50
495 297.9
Z 40 - Z 41.0,1,3, Z 45, Z
46.1,2,4-9, Z 49, Z 51 - Z 54
496 298
4
penyakit menular
tinggi
Seleksi antenatal
persalinan
kebiasaan
palsu

khusus lainnya
Z 31 - Z 33, Z 37, Z 55 - Z 99
alasan lainnya
JUMLAH

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
152
0
308
0
234
0
326
0
918
0
522
0
230
0
1233
0
1510
0
2740
0
58
PENYEBAB KECELAKAAN
No.
No. DTD
Urut
01 299.0
02 299.1
V 01 - V 89
V 90 - V 94
03 299.2
V 95 - V 97
04 299.9
05 300
V 98 - V 99
W 00 - W 19

angkasa
Jatuh
06 301
W 65 - W 74
07 302
X 00 - X 09
08 303.0
X 45
09 303.1
X 46

10 303.2
X 47
11 303.3
X 48
12 303.4
X 49
13 303.9
X 40 - X 44
14 304..0
X 60 - X 69
15 304.9
16 305
17 306.0
X 70 - X 84
X 85 - Y 09
X 10 - X 19
18 306.1
X 20 - X 29
19 306.2
X 30 - X 39
20 306.3
Y 40 - Y 59
21 306.4
Y 60 - Y 84
22 306.5
23 306.6
24 306.7
W 42
W 43
W 88
25 306.8
W 89
26 306.9
27 306.10
W 90
W 91
28 306.11
X 50
29 306.12
Y 96
30 306.13

& uap-uap lainnya
pestisida
bahan beracun
Dicederai
beracun
Pemaparan bising
Pemaparan getaran
manmade visible
W20-W41, W44-W64, W75W87, W92-W99, X51-X59,

Sebab luar lainnya
Y10-Y39, Y85-Y95, Y97-Y98
JUMLAH
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
0
0
0
0
0
0
0
0
0
0
0
0
0
0
>65
TH
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
PR
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
1
0
1
0
0
0
4
0
1
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
2
0
3
0
2
0
1
0
0
0
6
0
4
0
10
0
0
Sumbawa, 1 April 2009


NIP.19560114 198301 1 002

TRIWULAN : IV( oktober S.D desember) TAHUN 2010
Formulir RL 2a
No.
No. DTD
Urut
1
01
02
03
04
05
2
001
002
003
004.0
004.9
A 00
A 01
A 03
A 06.4
A 06.0-3, 5-9
Cholera
Shigellosis
Abses hati amuba
Amebiasis lainnya
06 005
A 09

07 006
A 02, A 04, A 05. A 07, A 08
08 007.0
A 15.0
09 007.1
10 007.9
11 008.0
A 15.1 - A 16.2
A 16.3-9
A 17.0
12 008.1
A 17.1-9
13
14
15
16
17
18
19
20
21
22
23
24
25
26
A 18.0
A 18.2
A 19
A 18.1, 3-8
A 20
A 23
A 30
A 33
A 34, A 35
A 36
A 37
A 39
A 40, A 41
A 22
A 21, A 24-28, A 31-32, A 38,
A 42-49
A 50
A 51
A 52, A 53
A 54
008.2
008.3
008.4
008.9
009
010
011
012
013
014
015
016
017
018.0
27 018.9
28
29
30
31
019
020
021
022
32 023
A 55, A 56
33 024
A 57- A 64
34
35
36
37
38
39
40
41
42
43
44
A 68
A 71
A 75
A 80
A 82
A 83 - A 86
A 95
A 90
A 91
A 92.0
A 92.1, A 92
025
026
027
028
029
030
031
032.0
032.1
032.2
032.3
45 032.9
A 93 - A 94, A 96 - A 99
46 033
B 00
47 034
B 01 - B 02
48
49
50
51
52
53
54
B 05
B 06
B 16
B 15
B 17.1
B 17.2
B 17.08, B 18, B19
035
036
037
038.0
038.1
038.2
038.9

lainnya
Tuberkulosis milier
Sampar / Pes
Bruselosis
Lepra / Kusta
Tetanus neonatorum
Tetanus lainnya
Difteria
Infeksi meningokok
Septisemia
Anthraks
Sifilis bawaan
Sifilis dini
Sifilis lainnya
Infeksi gonokok
hubungan seksual
Demam bolaik-balik
Trakoma
Demam tifus
Poliomielitis akut
Rabies
Ensefalitis virus
Demam kuning
Demam dengue
Chikungunya
zoster)
Campak
Rubella
Hepatitis B akut
Hepatitis A akut
Hepatitis C akut
Hepatitis E akut
Gondong
55 039
B 20 - B 24
56 040
B 26
57 041
A 81, A 87- A 89, B 03 - B 04,

B 07- B 09, B 25, B 27- B 34
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
B 35 - B 49
B 50 - B 54
B 55
B 56 - B 57
B 65
B 66
B 67
B 72
B 73
B 74
B 76
B 68 - 71, B 75, B 77 - 83
B 90.91
B 90.92
B 90.0-8
B 91
B 92
A 66
042
043
044
045
046
047
048
049
050
051
052
053
054.0
054.1
054.9
055
056
057.0
Mikosis
Lesmaniasis
Tripanosomiasis
Ekinokokosis
Drakunkuliasis
Onkosersiasis
Filariasis
Patek (Frambusia)

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
3
17
52
3
4
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
1
0
0
0
0
40
0
0
0
0
41
0
0
0
0
81
0
0
0
0
1
0
0
0
56
88
59
33
38
24
155
152
307
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
5
0
2
0
16
0
0
0
3
0
0
0
23
0
2
0
6
0
0
0
29
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
1
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
1
0
1
0
0
0
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
0
0
0
0
0
0
1
0
1
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
23
0
0
0
0
0
0
0
0
0
0
4
3
0
0
0
0
0
2
0
0
0
0
5
1
0
0
0
0
0
1
0
0
0
0
3
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
7
15
0
0
0
0
0
2
0
0
0
0
6
20
0
0
0
0
0
3
0
0
0
0
13
35
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
7
0
0
0
0
0
0
0
15
0
0
0
0
0
0
1
22
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
25
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
26
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
37
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
29
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
75
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
67
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
142
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
76 057.1
77 057.2
78 057.9
79 058.0
80 058.1
81 058.9
82 059
83 060
84 061
85 062
86 063
87 064
88 065
89
90
91
92
066
067.0
067.9
068.0
93 068.9
94 069
95 070
96 071
97 072.0
98 072.9
99 073
100 074
101 075.0
102 075.9
103 076.0
104 076.1
105 076.9
106 077
107 078.0
108 078.1
109 078.9
110 079
A 70
Infeksi Klamedia
B 58
Toksoplasmosis
B 94 - B99
C 00 - C 10
C 11
C 12 - C 14
C 15
C 16
C 18
C 19 - C 21
C 22
empedu intrahepatik
C 25
C 17, C 23-C 24, C 26
cerna lainnya
C 32
C 33
C 34
C 38.1-8
C 30, C 31, C 37, C 38.0, C
39
C 40 - C 41
rawan sendi
C 43
C 44
C 45
Mesotelioma
C 46 - C 49
jaringan lunak
C 50
C 53
C 54
C 55
lainnya dan YTT
C 56
telur)
C 58
C 51-C 52, C 57
perempuan lainnya
C 61
C 60
C 62
C 63
lainnya
C 67
(buli-buli)
111 080.0
C 64 - C 65
112 080.9
C 66, C 68
113 081
C 69
114 082
C 71
115 083
C 70, C 72
116 084.0
C 73
117 084.1
C 74 - C 75
118 084.2
C 76
119 084.3
C 77 - C 80
120 084.9
C 97
121 085
122 086
123 087
C 81
C 82 - C 85
C 91 - C 95
124 088
C 88 - C 90, C 96
125
126
127
128
D 06
D 22 - D 23
D 24
D 25

saraf pusat
bening YTT
multipel
Penyakit Hadgkin
Limfoma non Hodgkin
Leukemia
lainnya
Leiomioma uterus
telur)
saraf pusat lainnya
089
090
091
092
129 093
D 27
130 094
D 30
131 095
D 33
132
133
134
135
D 04
D 05
D 00-D 03, D 07-D 09
D 12.6
096.0
096.1
096.2
096.3

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
0
0
2
0
1
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
2
0
0
0
0
2
0
0
0
0
2
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
2
3
0
2
1
0
0
1
1
2
0
0
0
3
0
3
4
5
0
3
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
3
0
0
1
0
0
0
0
0
0
0
1
1
0
0
0
3
0
0
1
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
4
0
0
0
0
6
0
0
0
0
3
0
0
0
0
2
0
0
0
0
14
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
136 096.4
D 14.1 - 4
137 096.5
D 15.2
D10 - D12.0-5, 7-9, D13 D14.0, D15.0-1, D15.7-9D20, D21, D26, D28 - D29,
D31 - D32, D34 - D 36
138 096.6
139 096.9
D 37 - D 48
140
141
142
143
144
145
D 50
D 59
D 61
D51 - D58, D60, D62, D64
D 70
D 74
146 099.9
D65 - D69, D71- D73, D75 D77

147 100
D80 - D89
148 101
149
150
151
152
153
154
102
103.0
103.1
103.2
103.9
104.0
155 104.1
156 104.2
157
158
159
160
161
104.3
104.9
105
106
107
162 108
163 109
164 110
165 111
166 112
167 113
168 114.0
169 114.1

mekanisme imun
E00 - E 02
defisiensi iodium
E 05
E 03
E 04
E 06
Tiroiditis
E 07
E 10
E 11
insulin
E 12
malnutrisi
E 13
E 14
E 40 - E 46
Malnutrisi
E 50
E 51 - E 56
E 64
gizi lainnya
E 66
Obesitas
E 86
E85, E87 -E90
metabolik lainnya
F 00 - F 03
Demensia
F 10
pengunaan Alkohol
F 11
pengunaan Opioda
F 12
170 114.2
F 13
171 114.3
F 14
172 114.4
F 15
173 114.5
F 16
174 114.6
F 17
175 114.9
F 18, F 19
176 115.0
F 20, F21, F 23
177 115.1
F 22, F 24
178 115.2
F 25
179 115.9
F 28 - F 29
180 116.0
F 30, F31
181 116.9
F 32 - F 39
182 117.0
F 40, F 41
183 117.1
184 117.2
F 42
F 43.1
185 117.3
F 43.0, F 43.2-9, F 45, F48
186 117.9
F 44
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
4
0
0
4
0
0
0
15
0
0
6
0
0
0
16
0
0
3
0
0
0
7
0
0
10
0
0
0
16
0
0
10
0
0
0
14
0
0
5
0
0
0
13
0
0
22
0
0
0
43
0
0
16
0
0
0
42
0
0
38
0
0
0
85
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
6
0
0
0
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
0
0
7
0
0
0
0
0
0
5
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
2
0
0
0
0
1
0
0
0
0
5
8
0
0
0
0
5
14
0
0
0
0
1
5
0
0
0
0
6
11
1
0
0
0
5
19
2
0
0
0
11
28
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
1
0
0
0
2
0
2
0
4
0
0
0

sifatnya
Anemia Hemolitik
Anemia lainnya
Agranulositosis
Metahaemoglobinema
097
098.0
098.1
098.9
099.0
099.1

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

pengunaan Kokain
pengunaan Tembakau
induksi
atau YTT
bipolar
lainnya atau YTT
anxietas lainnya
lainnya

Formulir RL 2a
No.
No. DTD
Urut
1
2
187 118
3
F70 - F79
188 119.0
F04, F07, F09
189 119.1
F 50 - F59
4
Retardasi mental
mental organik
lainnya
190 119.2
F 60 - F69
191 119.3
F 80 - F89
192 119.4
F 05 - F06, F90 - F98
193 119.9
F 99

Gangguan jiwa YTT
194 120
G 00 - G 09
195
196
197
198
121
122
123
124
G 20
G 30
G 35
G 40 - G41
199 125
G 43 - G44
Penyakit Parkinson
Penyakit Alzheimer
Sklerosis multiple
Epilepsi
lainnya
200 126
G 45
201 127.0
202 127.1
203 127.2
G 56.0
G 56.2
G 56.3
204 127.3
205 127.9
206
207
208
209
128.0
128.9
129.0
129.1
210 129.9
211 130
212 131
213 132
214
215
216
217
218
219
220
133
134
135
136
137
138
139.0


Lesi saraf ulnaris
Lesi saraf radialis
G 56.8
atas lainnya
G59
saraf
G 80
G 81- G83
G 21
Parkinson sekunder
G 92
Toksik ensefalopati
G10 - G13, G22 - G26, G31 G32, G36 - G37, G46 - G47,
G60 - G73, G90 - G91, G93 G99
H 00 - H 01
Radang kelopak mata
H 10 - H 13
konjungtiva
H 15 - H 19
kornea
H 25 - H 28
H 33
H 40 - H 42
Glaukoma
H 49 - H 50
Strabismus
H 52
H 54
Buta dan rabun
H 02 - H 03
221 139.1
H 04 - H 06
222 139.2
H 20 - H 22
223 139.3
224 139.4
225 139.5
H 30 - H 32
H 34
H 35 - H 36

badan silier
226 139.6
H 43 - H 45
227 139.7
H 46 - H48

penglihatan
228 139.8
H 51
229 139.9
H 53
230 139.10
H 55
231 139.11
H 57 - H 59
232 140
H 65 - H 75
233 141
234 142.0
H 90 - H 91
H 61.8
Gangguan daya lihat

dan telingah tengah
235 142.1
H 83.3
236 142.9
H 60 - H 61.0-3
237
238
239
240
241
242
243
I 00 - I 02
I 05 - I 09
I 10
I 11 - I 15
I 21 - I 22
I 20, I 23 - I 25
I 26
Demam reumatik akut

Infark miokard akut
Emboli paru
jantung
Gagal jantung
Kardiomiopati
143
144
145
146
147
148
149
244 150
I 44 - I 49
245 151
246 152.0
247 152.9
I 50
I 42 - I 43
I 27 - I 41, I 51 - I 52

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
2
0
0
0
0
6
2
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
5
1
0
0
0
4
3
0
0
0
9
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
2
0
0
0
0
1
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
13
0
0
1
0
0
0
0
60
0
0
4
0
0
0
0
25
0
0
1
0
0
0
0
35
0
0
3
0
0
0
0
64
0
0
3
0
0
0
0
99
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
1
0
2
10
4
0
3
5
5
0
3
9
5
0
3
10
5
0
5
19
10
0
8
1
0
0
1

Formulir RL 2a
No.
No. DTD
Urut
1
2
248 153
249 154
I 60 - I 62
I 63
250 155
I 64
251 156
252 157
253 158.0
I 65 - I 69
I 70
I 75.0
254 158.9
I 73.1 - 9
255 159
I 74
256 160
I 71 - I 72, I 77 - I 79
257 161
I 80 - I 82
258
259
260
261
262
263
264
I 83
I 84
I 85
I 86 - I 99
J 02
J 03
J 04
162
163
164.0
164.9
165.0
165.9
166
265 167
J 00 - J 01, J 05 - J 06
266
267
268
269
270
J 10 - J 11
J 12 - J 18
J 20 - J 21
J 32
J 30.3
168
169
170
171
172.0
271 172.1
J 34.8
273 173
J30.0 - J30.2, J30.4 - J31,

J33, J34.0-3
J 35
274 174
J 36 - J39
275 175
J 40 - J 44
276
277
278
279
280
281
282
283
284
J 45
J 46
J 47
J 60 - J 65
J 85.1, 2
J 93
J 86
J 90 - J 91
J 66.0
272 172.9
176.0
176.9
177
178
179.0
179.1
179.2
179.3
179.4
285 179.5
J 67
286 179.6
J 68
287 179.7
289 180
J 92
J 22, J66.1-2, J66.8, J69 J84, J85.0,3, J 94 - J99
K 02
290 181.0
K 00 - K 01
291 181.1
292 181.2
K 03
K 04
293 181.3
K 05 - K 06
294 181.9
K 07 - K 08
295 182.0
K 09 - K 10
296 182.1
K 11
297 182.2
K 12
298 182.9
K 13 - K 14
299 183
300 184
301 185.0
K 25 - K 27
K 29
K 30
302 185.9
K 20 - K 23, K 28, K 31
303
304
305
306
K 35 - K 38
K 40
K 41 - K 46
K 50 - K 51
288 179.9
186
187
188
189
4
Infark serebral
infark
Aterosklerosis
Sindroma Raynaud's
lainnya
lainnya
trombosis vena
Hemoroid / Wasir
Varises esofagus
Faringitis akut
Tonsilitis akut
lainnya
Influensa
Pneumonia
Sinusitis kronik
septum nasi
lainnya
lainnya
Asma akibat kerja
Status asmatikius
Bronkiektasis
Pneumokoniosis
Abses paru
Pneumotoraks
Piotorak (empiema)
Bisinosis
organik
uap
Plak pleural
Karies gigi
tulang alveolar
maloklusi
rahang
dan lidah
Dispepsia
duodenum lainnya
Penyakit apendiks
Hernia enguinal
Hernia lainnya
tanpa Hernia
syndrome)
307 190
K 56
308 191
K 57
309 192.0
K 58
310 192.9
K 52 - K 55, K 59 - K 67
311
312
313
314
K 70
K 72
K 73
K 74.6

Hepatitis kronik
Sirosis hati
193
194.0
194.1
194.2

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
5
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
1
0
2
0
4
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
21
0
0
0
15
0
0
0
17
0
0
0
25
0
0
0
42
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
3
4
0
0
0
0
0
0
2
0
0
0
2
0
0
2
2
0
0
0
3
0
0
2
0
0
0
0
2
0
0
1
0
0
0
0
4
0
0
0
3
4
0
0
3
0
0
5
4
1
0
0
7
0
0
5
7
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
18
0
0
0
0
0
24
0
0
0
0
0
8
0
0
0
0
0
0
0
0
0
3
0
1
0
0
0
1
0
2
0
0
0
0
0
0
0
0
0
4
0
26
0
0
0
0
0
27
0
0
0
4
0
53
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
1
2
0
0
0
0
0
0
0
0
3
6
0
0
0
0
0
0
1
0
11
14
0
0
0
0
0
0
0
0
9
8
0
0
0
0
0
0
1
0
15
18
0
0
0
0
0
0
2
0
9
15
0
0
0
0
0
0
0
0
24
33
0
0
0
0
0
0
2
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
0
3
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
41
0
0
1
89
2
0
2
57
2
0
2
21
0
0
4
81
4
0
1
128
0
0
5
209
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
1
0
0
3
0
3
0
0
16
0
2
0
0
18
4
3
0
1
5
0
10
0
0
1
2
5
0
0
19
8
27
0
1
24
0
13
0
1
43
8
24
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
0
1
0
5
0
1
0
4
0
7
0
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
3
0
1
0
0
7
0
15
0
1
13
1
15
0
0
9
3
6
0
0
3
0
23
0
1
18
3
15
0
0
17
1
38
0
1
35
4
0
0
1
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
315 194.3
316 194.4
317 194.5
3
K 76.0
K 76.6
K 76.7
318 194.6
K 71
4
Perlemakan hati
Hipertensi portal
Sindrom hepatorenal
tempat kerja
346 207.9
K 74.0-5, K 75, K 76.1-5, 8, 9,

K 77
K 80
Kolelitiasis
K 81
Kolesistitis
K 85 - K 86
pankreas lainnya
K 82 - K 83, K 87 - K 93
L 00 - L 08
L 23 - L 24
L 10 - L 22, L 25 - L 99
lainnya
M 05 - M 06
Artritis rematoid
M 07
M 08 - M 09
Artritis belia
M 10 - M 11
M 12 - M 14
M 15 - M 19
Artrosis
M 20 - M 21
M 00 - M 01
tempat lain
M 02 - M 03
Artropati reaksi
M 22 - M 25
M 32
M 30 - M 31, M 33 - M36
lainnya
M 50 - M 51
M 45 - M 49
M 54.5
M 40 - M 44, M 53 - M 54.4, M
Dorsopati lainnya
54.6, 8, 9
M 60 - M 64, M 65.0 - M65.3,
8, 9, M 66 - M 68
M 65.4
M 70
tekanan berlebihan
M 71 - M 79
347 208
M 80 - M 85
348 209
M 86
349 210
M 87 - M 99
350 211
N 00 - N 01
351 212.0
352 212.2
N 04
N 02.8
Osteomielitis
akut
Sindrom nefritik
353 212.9
319 194.9
320 195.0
321 195.9
322 196
323 197
324 198
325 199.0
326 199.9
327
328
329
330
331
332
333
200.0
200.1
200.2
200.3
200.9
201
202
334 203.0
335 203.1
336 203.9
337 204.0
338 204.9
339 205
340 206.0
341 206.1
342 206.9
343 207.0
344 207.1
345 207.2
354 213.0
N 12
355 213.1
N 14.3
356 213.9
N 10 - N 11, N 13, N 14.0-2,

4, N 15 - N 16

pielonefritis
logam berat
lainnya
357 214.0
N 17.8
358
359
360
361
362
363
364
N 17.0-2, 9 - N 19
N 20 - N 23
N 30
N 25 - N 29, N 31 - N 39
N 40
N 41 - N 42
N 43

Urolitiasis
Sistitis
Hiperplasia prostat
parafimosis
Radang serviks
Endometriosis
latum
Amenore
214.9
215
216
217
218
219
220
365 221
N 47
366
367
368
369
370
371
222
223
224
225
226.0
226.1
N 44 - N 46, N 48 - N 51
N 60 - N 64
N 70
N 72
N 73
N 75.0.1
372 226.9
N 71, N 74, N 75.8 - N77
373 227
374 228
N 80
N 81
375 229
N 83
376 230.0
377 230.1
378 230.9
N 91.0, 1, 2
N 92.0, 1
N 91.3-5, N 92.2-6

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
1
0
0
0
0
0
0
2
0
0
0
0
1
0
0
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
8
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
10
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
5
0
4
1
0
1
4
2
6
0
10
2
0
0
0
0
0
0
0
0
2
0
0
0
0
1
0
0
0
0
2
1
0
0
2
1
0
0
0
0
0
0
0
0
0
1
0
0
2
0
0
1
0
0
3
0
0
1
0
0
1
0
0
2
0
0
7
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
16
0
0
0
0
0
1
0
4
0
0
0
0
8
1
0
18
1
0
0
0
7
1
0
16
4
0
0
0
5
1
0
4
8
0
0
0
11
2
0
29
10
0
0
0
10
2
0
29
3
0
0
0
18
4
0
58
13
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
2
0
3
0
0
0
0
8
0
0
0
0
0
0
2
0
0
0
0
0
0
0
1
4
0
0
0
0
3
0
0
0
0
0
0
9
1
4
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
1
0
0
0
0
0
0
0
1
2
0
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
14
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
18
0
0
0
18
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
379 231
380 232
381 233
382
383
384
385
386
234
235
236.0
236.1
236.2
387 236.9
388 237.0
389 237.1
390 237.9
391 238.0
392 238.1
393 283.9
394
395
396
397
239.0
239.1
239.2
239.3
398 239.9
399
400
401
402
240
241
242.0
242.1
403 242.2
404 242.3
4
N 95
N 97
N 82, N 84 - N 90, N 93 - N
94, N 96, N 98 - N 99
lainnya
O 03
Abortus spontan
O 04
Abortus medik
O 00
Kehamilan ektopik
O 01
Mola hidatidosa
O 05
Abortus lainnya
O 02, O 06, O 08
abortus
O 14
nyata/ Preeklampsia
O 15
Eklampsia
O 10 - O 13, O 16
O 44
Plasenta previa
O 45
Solusio plasenta
O 46
tempat lain
O 30
Kehamilan multipel
O 40
Hidramnion
O 42
Ketuban pecah dini
O 48
persalinan
O 64 - O 66
Persalinan macet
O 72
O 24
O 60
Persalinan prematur
O 68
janin
O 84
Persalinan multipel
405 242.9
O 20 - O 23, O 25 - O 29, O
61 - O 63, O 67, O 69 - 71, O
lainnya
73 - O 75, O 81 - -O 83
406 243
O 80
407 244
O 85 - O 99
409 246
P 05 - P 07
410 247
P 10 - P15

ditempat lain
Cedera lahir
411 248
P 20 - P 21
412 249
P 22 - P 28

413 250
P 35 - P 37
414 251
P 38 - P 39
408 245
415 252
416 253.0
417 253.9
418 254
419 255.0
420 255.9
421 256
422 257
423 258
424 259
425 260
426 261.0
P 00 - P 04

perinatal
P 55
baru lahir
P 95
Lahir mati
P 94, P 96
perinatal
Q 05
Spina bifida
Q 03
Q 00 - Q 02, Q 04, Q 06, Q
07
lain
Q 20 - Q 28
peredaran darah
Q 35 - Q 37
Q 41
halus
Q 38 - Q 40, Q 42 - Q 45
lainnya
Q 53
Testis tidak turun
Q 50 - Q 52
wanita
427 261.1
Q 54 - Q 56
428 261.9
Q 60 - Q 64
429 262
430 263
Q 65
Q 66
431 264
Q 67 - Q 79

lainnya

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
12
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
13
3
0
0
0
0
13
3
0
0
0
0
0
0
29
85
115
115
0
0
0
0
0
0
0
0
0
0
2
2
0
0
0
0
0
0
2
2
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
39
0
0
0
0
4
0
0
0
0
0
0
0
0
0
20
0
0
0
0
55
0
0
0
0
55
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
76
40
214
0
4
0
0
0
0
45
294
45
294
0
0
28
34
34
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
4
0
6
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
1
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
433 266.0
3
Q 10 - Q 18, Q 30 - Q34, Q
80 - Q 89
Q 90
434 266.9
Q 91 - Q 99
435 267
R 10
436 268
R 50
437
438
439
440
441
442
443
R 54
R 00 - R 01
R 09.2
R 33
R 56
R 75
R 95
R 02 - R 09.0,1,3,8, R 11 - R
32, R 34 - R 49, R 51 - R 52,
R 55, R 57 - R 74, R 76 - R
94, R 96 - R 99
S 02
S 12, S 22, S 32, T 08
S 72
S 42, S 52, S 62, S 82, S 92,
T 10, T 12
Senilitis
Gejala pada jantung
Gagal napas
Retensi urin
Kejang YTT
432 265
269
270.0
270.1
270.2
270.3
270.4
270.5
444 270.9
445 271
446 272
447 273
448 274
449 275
450 276
451 277
452 278
453 279
454 280
T 02
S 03, 13, 23, 43, 53, 63, 73,
83, 93, T 03
S 05
S 06
S 26 - S 27
Sindrom Down

YTK ditempat lain
Fraktur paha
multiplel
Cedera intrakranial
S36-S37, S07-S08, S17-S18,

S97-S98, T04-T05
455 281
S76, S79-S81, S84-S86, S89S91, S94-S96, S99, T00-T01,
T06-T07, T09-T11, T13-T14
456 282.0
T 16
457 282.9
T 15, T 17 - T 19
458 283
T 20 - T 32

459 284
T 36 T 50
460
461
462
463
T 52
T 56
T 59
T 60
T51, T53 - T55, T57 - T58,
T61 - T65
T 74
T 66
T 67
T 70

Keracunan logam
Keracunan pestisida
lainnya
Efek radiasi YTT
tempat lain
YTK di tempat lain
secara rutin
285.0
285.1
285.2
285.3
464 285.9
465
466
467
468
286
287.0
287.1
287.2
469 287.9
T33-T35, T68-T69, T71-T73,

T75-T78
470 288
T 79 - T 88
471 289
T 90 - T 98
472 290.0
Z 00.0
473 290.1
Z 00.1

474 290.9
Z 00.2 - Z 13
475
476
477
478
479
480
481
291
292.0
292.1
292.2
292.3
292.4
292.6
Z 21
Z 23.2
Z 23.5
Z 24.0
Z 24.2
Z 24.4
Z 24.6
482 292.7
Z 27.1
483 292.8

Z 25 - Z 27.0, Z 272.2 - Z 29 lainnya

Imunisasi BCG
Imunisasi Tetanus
Imunisasi Rabies
Imunisasi Campak
pertusis, tetanus)

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
2
0
0
0
0
0
0
0
0
0
0
0
0
1
0
7
0
3
0
0
0
4
0
7
0
11
0
0
0
0
0
7
0
0
0
0
14
0
0
10
0
6
0
0
39
0
0
0
0
72
0
0
56
0
0
0
0
10
0
0
29
0
0
0
0
0
0
0
55
0
0
1
0
0
0
0
29
0
0
0
0
0
0
0
10
0
0
2
0
0
0
0
125
0
0
13
0
59
0
0
107
0
0
7
0
29
0
0
232
0
0
20
0
88
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
4
0
0
0
14
0
0
0
4
0
0
0
1
0
0
0
8
0
0
0
17
0
0
0
25
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
3
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
11
0
0
0
0
0
0
0
11
0
0
0
3
0
0
0
0
0
2
0
36
0
71
0
71
0
31
0
10
0
146
0
75
0
221
0
1
0
0
0
0
0
0
1
1
2
1
0
0
1
0
0
0
0
2
1
0
3
2
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
484 292.9
Z 20, Z 22
485 293
486 294.0
Z 30
Z 34
487 294.1
Z 35
488 294.9
489 295
Z 36
Z 38
490 296
Z 39
491 297.0
Z 46.0
492 297.1
Z 41.2
493 297.2
Z 46.3
494 297.3
Z 50
495 297.9
Z 40 - Z 41.0,1,3, Z 45, Z
46.1,2,4-9, Z 49, Z 51 - Z 54
496 298
4
penyakit menular
tinggi
Seleksi antenatal
persalinan
kebiasaan
palsu

khusus lainnya
Z 31 - Z 33, Z 37, Z 55 - Z 99
alasan lainnya
JUMLAH

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
46
0
120
0
313
0
374
0
399
0
1009
0
529
0
239
0
1300
0
1765
0
3029
0
38
PENYEBAB KECELAKAAN
No.
No. DTD
Urut
01 299.0
02 299.1
V 01 - V 89
V 90 - V 94
03 299.2
V 95 - V 97
04 299.9
05 300
V 98 - V 99
W 00 - W 19

angkasa
Jatuh
06 301
W 65 - W 74
07 302
X 00 - X 09
08 303.0
X 45
09 303.1
X 46

10 303.2
X 47
11 303.3
X 48
12 303.4
X 49
13 303.9
X 40 - X 44
14 304..0
X 60 - X 69
15 304.9
16 305
17 306.0
X 70 - X 84
X 85 - Y 09
X 10 - X 19
18 306.1
X 20 - X 29
19 306.2
X 30 - X 39
20 306.3
Y 40 - Y 59
21 306.4
Y 60 - Y 84
22 306.5
23 306.6
24 306.7
W 42
W 43
W 88
25 306.8
W 89
26 306.9
27 306.10
W 90
W 91
28 306.11
X 50
29 306.12
Y 96
30 306.13

& uap-uap lainnya
pestisida
bahan beracun
Dicederai
beracun
Pemaparan bising
Pemaparan getaran
manmade visible
W20-W41, W44-W64, W75W87, W92-W99, X51-X59,

Sebab luar lainnya
Y10-Y39, Y85-Y95, Y97-Y98
JUMLAH
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
0
0
0
0
0
0
0
0
0
0
0
0
0
0
>65
TH
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
PR
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
0
0
0
0
0
0
0
0
0
3
0
1
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
3
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
4
0
0
0
7
0
0
0
0
0
8
0
4
0
12
0
0
Sumbawa,1 Januari 2011


NIP.19560114 198301 1 002

TRIWULAN : TAHUN 2010
Formulir RL 2a
No.
No. DTD
Urut
1
01
02
03
04
05
2
001
002
003
004.0
004.9
A 00
A 01
A 03
A 06.4
A 06.0-3, 5-9
Cholera
Shigellosis
Abses hati amuba
Amebiasis lainnya
06 005
A 09

07 006
A 02, A 04, A 05. A 07, A 08
08 007.0
A 15.0
09 007.1
10 007.9
11 008.0
A 15.1 - A 16.2
A 16.3-9
A 17.0
12 008.1
A 17.1-9
13
14
15
16
17
18
19
20
21
22
23
24
25
26
A 18.0
A 18.2
A 19
A 18.1, 3-8
A 20
A 23
A 30
A 33
A 34, A 35
A 36
A 37
A 39
A 40, A 41
A 22
A 21, A 24-28, A 31-32, A 38,
A 42-49
A 50
A 51
A 52, A 53
A 54
008.2
008.3
008.4
008.9
009
010
011
012
013
014
015
016
017
018.0
27 018.9
28
29
30
31
019
020
021
022
32 023
A 55, A 56
33 024
A 57- A 64
34
35
36
37
38
39
40
41
42
43
44
A 68
A 71
A 75
A 80
A 82
A 83 - A 86
A 95
A 90
A 91
A 92.0
A 92.1, A 92
025
026
027
028
029
030
031
032.0
032.1
032.2
032.3
45 032.9
A 93 - A 94, A 96 - A 99
46 033
B 00
47 034
B 01 - B 02
48
49
50
51
52
53
54
B 05
B 06
B 16
B 15
B 17.1
B 17.2
B 17.08, B 18, B19
035
036
037
038.0
038.1
038.2
038.9

lainnya
Tuberkulosis milier
Sampar / Pes
Bruselosis
Lepra / Kusta
Tetanus neonatorum
Tetanus lainnya
Difteria
Infeksi meningokok
Septisemia
Anthraks
Sifilis bawaan
Sifilis dini
Sifilis lainnya
Infeksi gonokok
hubungan seksual
Demam bolaik-balik
Trakoma
Demam tifus
Poliomielitis akut
Rabies
Ensefalitis virus
Demam kuning
Demam dengue
Chikungunya
zoster)
Campak
Rubella
Hepatitis B akut
Hepatitis A akut
Hepatitis C akut
Hepatitis E akut
Gondong
55 039
B 20 - B 24
56 040
B 26
57 041
A 81, A 87- A 89, B 03 - B 04,

B 07- B 09, B 25, B 27- B 34
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
B 35 - B 49
B 50 - B 54
B 55
B 56 - B 57
B 65
B 66
B 67
B 72
B 73
B 74
B 76
B 68 - 71, B 75, B 77 - 83
B 90.91
B 90.92
B 90.0-8
B 91
B 92
A 66
042
043
044
045
046
047
048
049
050
051
052
053
054.0
054.1
054.9
055
056
057.0
Mikosis
Lesmaniasis
Tripanosomiasis
Ekinokokosis
Drakunkuliasis
Onkosersiasis
Filariasis
Patek (Frambusia)

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
7
53
157
11
12
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
2
0
0
0
0
141
0
0
0
0
104
0
0
0
0
245
0
0
0
0
2
0
0
0
299
417
118
40
145
146
60
656
570
1226
15
0
0
0
0
0
0
0
0
0
1
0
0
1
1
1
0
8
2
0
0
19
18
15
0
33
27
26
0
10
7
11
0
54
34
41
0
17
22
12
0
71
56
53
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
40
0
0
0
0
0
0
0
0
0
0
0
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
1
0
0
0
0
2
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
2
0
0
2
0
1
0
0
0
24
0
0
0
0
0
0
0
0
0
0
4
0
0
0
17
0
0
0
0
0
0
0
0
0
0
1
0
0
0
10
0
0
0
0
0
2
0
0
1
0
7
0
0
0
64
0
0
0
0
0
1
0
0
1
0
1
0
0
0
56
0
0
0
0
0
3
0
0
2
0
8
0
0
0
120
0
0
0
0
0
0
0
0
0
0
2
0
0
0
25
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
62
0
0
0
0
0
0
0
0
0
0
0
182
0
0
0
0
0
0
0
0
0
0
13
48
0
0
0
0
0
2
0
0
0
0
12
18
0
0
0
0
0
1
0
0
0
0
5
3
0
0
0
0
0
0
0
0
0
0
2
1
0
0
0
0
0
1
0
0
0
0
16
166
0
0
0
0
0
2
0
0
0
0
16
156
0
0
0
0
0
3
0
0
0
0
32
322
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
6
0
0
0
0
0
0
1
17
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
1
0
2
1
0
0
0
0
0
0
2
0
0
0
1
1
0
0
0
0
0
0
0
1
8
0
3
1
0
0
1
2
17
0
1
0
0
0
0
3
25
0
4
1
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
23
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
77
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
92
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
55
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
154
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
67
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
19
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
271
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
216
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
487
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
1
2
76 057.1
77 057.2
78 057.9
79 058.0
80 058.1
81 058.9
82 059
83 060
84 061
85 062
86 063
87 064
88 065
89
90
91
92
066
067.0
067.9
068.0
93 068.9
94 069
95 070
96 071
97 072.0
98 072.9
99 073
100 074
101 075.0
102 075.9
103 076.0
104 076.1
105 076.9
106 077
107 078.0
108 078.1
109 078.9
110 079
A 70
Infeksi Klamedia
B 58
Toksoplasmosis
B 94 - B99
C 00 - C 10
C 11
C 12 - C 14
C 15
C 16
C 18
C 19 - C 21
C 22
empedu intrahepatik
C 25
C 17, C 23-C 24, C 26
cerna lainnya
C 32
C 33
C 34
C 38.1-8
C 30, C 31, C 37, C 38.0, C
39
C 40 - C 41
rawan sendi
C 43
C 44
C 45
Mesotelioma
C 46 - C 49
jaringan lunak
C 50
C 53
C 54
C 55
lainnya dan YTT
C 56
telur)
C 58
C 51-C 52, C 57
perempuan lainnya
C 61
C 60
C 62
C 63
lainnya
C 67
(buli-buli)
111 080.0
C 64 - C 65
112 080.9
C 66, C 68
113 081
C 69
114 082
C 71
115 083
C 70, C 72
116 084.0
C 73
117 084.1
C 74 - C 75
118 084.2
C 76
119 084.3
C 77 - C 80
120 084.9
C 97
121 085
122 086
123 087
C 81
C 82 - C 85
C 91 - C 95
124 088
C 88 - C 90, C 96
125
126
127
128
D 06
D 22 - D 23
D 24
D 25

saraf pusat
bening YTT
multipel
Penyakit Hadgkin
Limfoma non Hodgkin
Leukemia
lainnya
Leiomioma uterus
telur)
saraf pusat lainnya
089
090
091
092
129 093
D 27
130 094
D 30
131 095
D 33
132
133
134
135
D 04
D 05
D 00-D 03, D 07-D 09
D 12.6
096.0
096.1
096.2
096.3

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
1
0
1
1
0
0
1
2
1
0
2
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
3
0
0
0
1
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
4
1
0
0
5
1
4
0
9
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
1
0
0
1
0
0
0
0
2
0
3
0
0
3
0
0
0
0
2
0
3
0
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
3
0
0
0
1
0
0
0
9
0
0
0
0
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
5
4
0
5
13
1
3
3
5
8
2
0
0
1
1
5
2
1
0
4
21
14
6
9
23
15
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
0
4
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
3
0
3
0
2
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
4
8
0
0
3
16
0
0
3
6
0
0
3
2
0
0
12
15
0
0
3
17
0
0
15
32
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
7
0
0
0
0
27
10
0
0
0
14
19
0
0
0
5
0
0
0
0
6
0
0
0
0
47
29
0
0
0
53
29
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
136 096.4
D 14.1 - 4
137 096.5
D 15.2
D10 - D12.0-5, 7-9, D13 D14.0, D15.0-1, D15.7-9D20, D21, D26, D28 - D29,
D31 - D32, D34 - D 36
138 096.6
139 096.9
D 37 - D 48
140
141
142
143
144
145
D 50
D 59
D 61
D51 - D58, D60, D62, D64
D 70
D 74
146 099.9
D65 - D69, D71- D73, D75 D77

147 100
D80 - D89
148 101
149
150
151
152
153
154
102
103.0
103.1
103.2
103.9
104.0
155 104.1
156 104.2
157
158
159
160
161
104.3
104.9
105
106
107
162 108
163 109
164 110
165 111
166 112
167 113
168 114.0
169 114.1

mekanisme imun
E00 - E 02
defisiensi iodium
E 05
E 03
E 04
E 06
Tiroiditis
E 07
E 10
E 11
insulin
E 12
malnutrisi
E 13
E 14
E 40 - E 46
Malnutrisi
E 50
E 51 - E 56
E 64
gizi lainnya
E 66
Obesitas
E 86
E85, E87 -E90
metabolik lainnya
F 00 - F 03
Demensia
F 10
pengunaan Alkohol
F 11
pengunaan Opioda
F 12
170 114.2
F 13
171 114.3
F 14
172 114.4
F 15
173 114.5
F 16
174 114.6
F 17
175 114.9
F 18, F 19
176 115.0
F 20, F21, F 23
177 115.1
F 22, F 24
178 115.2
F 25
179 115.9
F 28 - F 29
180 116.0
F 30, F31
181 116.9
F 32 - F 39
182 117.0
F 40, F 41
183 117.1
184 117.2
F 42
F 43.1
185 117.3
F 43.0, F 43.2-9, F 45, F48
186 117.9
F 44
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
20
18
31
31
62
0
0
0
0
0
0
0
0
0
1
0
19
0
0
7
0
0
0
41
0
0
16
0
0
1
51
0
0
12
2
0
4
18
0
0
30
0
0
7
46
0
0
38
2
0
2
51
0
0
13
1
0
2
38
0
0
60
2
1
7
140
0
0
56
3
0
9
124
0
0
116
5
1
16
264
0
0
0
0
0
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
2
1
0
0
0
0
1
19
0
0
0
0
2
2
11
2
0
0
0
1
0
2
0
0
0
0
0
1
7
1
0
0
0
3
3
27
2
0
0
0
3
4
30
3
0
0
0
1
0
2
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
11
0
0
0
0
0
7
0
0
0
0
2
0
0
0
0
5
21
0
0
0
0
5
70
0
0
0
0
3
25
0
0
0
0
8
45
10
0
0
0
5
75
10
0
0
0
13
118
20
0
0
0
0
3
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
1
0
2
0
1
0
4
0
5
0
0
0
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
5
0
6
0
0
0
6
0
6
0
12
0
0
0

sifatnya
Anemia Hemolitik
Anemia lainnya
Agranulositosis
Metahaemoglobinema
097
098.0
098.1
098.9
099.0
099.1

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

pengunaan Kokain
pengunaan Tembakau
induksi
atau YTT
bipolar
lainnya atau YTT
anxietas lainnya
lainnya

Formulir RL 2a
No.
No. DTD
Urut
1
2
187 118
3
F70 - F79
188 119.0
F04, F07, F09
189 119.1
F 50 - F59
4
Retardasi mental
mental organik
lainnya
190 119.2
F 60 - F69
191 119.3
F 80 - F89
192 119.4
F 05 - F06, F90 - F98
193 119.9
F 99

Gangguan jiwa YTT
194 120
G 00 - G 09
195
196
197
198
121
122
123
124
G 20
G 30
G 35
G 40 - G41
199 125
G 43 - G44
Penyakit Parkinson
Penyakit Alzheimer
Sklerosis multiple
Epilepsi
lainnya
200 126
G 45
201 127.0
202 127.1
203 127.2
G 56.0
G 56.2
G 56.3
204 127.3
205 127.9
206
207
208
209
128.0
128.9
129.0
129.1
210 129.9
211 130
212 131
213 132
214
215
216
217
218
219
220
133
134
135
136
137
138
139.0


Lesi saraf ulnaris
Lesi saraf radialis
G 56.8
atas lainnya
G59
saraf
G 80
G 81- G83
G 21
Parkinson sekunder
G 92
Toksik ensefalopati
G10 - G13, G22 - G26, G31 G32, G36 - G37, G46 - G47,
G60 - G73, G90 - G91, G93 G99
H 00 - H 01
Radang kelopak mata
H 10 - H 13
konjungtiva
H 15 - H 19
kornea
H 25 - H 28
H 33
H 40 - H 42
Glaukoma
H 49 - H 50
Strabismus
H 52
H 54
Buta dan rabun
H 02 - H 03
221 139.1
H 04 - H 06
222 139.2
H 20 - H 22
223 139.3
224 139.4
225 139.5
H 30 - H 32
H 34
H 35 - H 36

badan silier
226 139.6
H 43 - H 45
227 139.7
H 46 - H48

penglihatan
228 139.8
H 51
229 139.9
H 53
230 139.10
H 55
231 139.11
H 57 - H 59
232 140
H 65 - H 75
233 141
234 142.0
H 90 - H 91
H 61.8
Gangguan daya lihat

dan telingah tengah
235 142.1
H 83.3
236 142.9
H 60 - H 61.0-3
237
238
239
240
241
242
243
I 00 - I 02
I 05 - I 09
I 10
I 11 - I 15
I 21 - I 22
I 20, I 23 - I 25
I 26
Demam reumatik akut

Infark miokard akut
Emboli paru
jantung
Gagal jantung
Kardiomiopati
143
144
145
146
147
148
149
244 150
I 44 - I 49
245 151
246 152.0
247 152.9
I 50
I 42 - I 43
I 27 - I 41, I 51 - I 52

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
0
0
3
0
0
0
0
12
0
0
0
5
6
0
0
0
17
3
0
0
0
3
0
1
0
0
1
1
0
0
0
0
0
0
0
0
0
17
1
0
0
16
8
0
0
0
9
25
1
0
0
26
5
0
0
0
0
20
19
15
34
49
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
1
0
0
0
0
1
0
0
0
0
0
0
0
0
0
2
0
0
0
0
1
0
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
2
0
1
0
0
0
3
0
2
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
0
0
0
0
0
1
0
1
0
0
0
1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
54
4
1
7
0
0
0
0
188
8
2
11
0
0
0
0
104
5
0
6
0
0
0
1
155
7
1
12
0
0
0
2
193
10
2
14
0
0
0
3
348
17
3
25
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
1
0
3
4
33
0
13
10
34
0
19
5
27
0
16
9
36
0
28
10
59
0
25
19
95
0
53
1
4
0
3

Formulir RL 2a
No.
No. DTD
Urut
1
2
248 153
249 154
I 60 - I 62
I 63
250 155
I 64
251 156
252 157
253 158.0
I 65 - I 69
I 70
I 75.0
254 158.9
I 73.1 - 9
255 159
I 74
256 160
I 71 - I 72, I 77 - I 79
257 161
I 80 - I 82
258
259
260
261
262
263
264
I 83
I 84
I 85
I 86 - I 99
J 02
J 03
J 04
162
163
164.0
164.9
165.0
165.9
166
265 167
J 00 - J 01, J 05 - J 06
266
267
268
269
270
J 10 - J 11
J 12 - J 18
J 20 - J 21
J 32
J 30.3
168
169
170
171
172.0
271 172.1
J 34.8
273 173
J30.0 - J30.2, J30.4 - J31,

J33, J34.0-3
J 35
274 174
J 36 - J39
275 175
J 40 - J 44
276
277
278
279
280
281
282
283
284
J 45
J 46
J 47
J 60 - J 65
J 85.1, 2
J 93
J 86
J 90 - J 91
J 66.0
272 172.9
176.0
176.9
177
178
179.0
179.1
179.2
179.3
179.4
285 179.5
J 67
286 179.6
J 68
287 179.7
289 180
J 92
J 22, J66.1-2, J66.8, J69 J84, J85.0,3, J 94 - J99
K 02
290 181.0
K 00 - K 01
291 181.1
292 181.2
K 03
K 04
293 181.3
K 05 - K 06
294 181.9
K 07 - K 08
295 182.0
K 09 - K 10
296 182.1
K 11
297 182.2
K 12
298 182.9
K 13 - K 14
299 183
300 184
301 185.0
K 25 - K 27
K 29
K 30
302 185.9
K 20 - K 23, K 28, K 31
303
304
305
306
K 35 - K 38
K 40
K 41 - K 46
K 50 - K 51
288 179.9
186
187
188
189
4
Infark serebral
infark
Aterosklerosis
Sindroma Raynaud's
lainnya
lainnya
trombosis vena
Hemoroid / Wasir
Varises esofagus
Faringitis akut
Tonsilitis akut
lainnya
Influensa
Pneumonia
Sinusitis kronik
septum nasi
lainnya
lainnya
Asma akibat kerja
Status asmatikius
Bronkiektasis
Pneumokoniosis
Abses paru
Pneumotoraks
Piotorak (empiema)
Bisinosis
organik
uap
Plak pleural
Karies gigi
tulang alveolar
maloklusi
rahang
dan lidah
Dispepsia
duodenum lainnya
Penyakit apendiks
Hernia enguinal
Hernia lainnya
tanpa Hernia
syndrome)
307 190
K 56
308 191
K 57
309 192.0
K 58
310 192.9
K 52 - K 55, K 59 - K 67
311
312
313
314
K 70
K 72
K 73
K 74.6

Hepatitis kronik
Sirosis hati
193
194.0
194.1
194.2

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
9
15
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
11
0
18
0
17
0
35
0
17
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
25
0
0
0
80
0
0
0
70
0
0
0
87
0
0
0
89
0
0
0
176
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
1
7
4
0
0
2
0
0
1
5
0
0
0
9
0
1
3
5
0
0
1
9
0
2
6
1
0
0
0
5
0
0
2
0
0
0
0
17
0
2
5
6
5
0
1
6
0
1
8
12
1
0
1
25
0
3
13
18
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
59
0
63
0
0
0
34
0
54
0
0
0
10
0
10
0
0
1
2
0
1
0
0
0
5
0
9
0
0
0
2
0
8
0
0
0
0
0
5
0
0
0
71
0
76
0
0
1
41
0
74
0
0
0
112
0
150
0
0
1
5
0
9
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
1
0
0
0
1
0
0
2
1
2
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
1
4
0
0
0
0
0
0
0
0
1
15
0
0
0
0
0
0
0
0
1
11
0
0
0
0
0
0
0
0
9
24
0
0
0
0
0
0
5
0
24
39
0
0
0
0
0
0
1
0
18
22
0
0
0
0
0
0
1
0
39
63
0
0
0
0
0
0
3
0
15
57
0
0
0
0
0
0
4
0
58
120
0
0
0
0
0
0
7
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
1
0
1
0
0
0
3
0
0
0
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5
0
0
0
0
0
0
0
0
0
4
0
1
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
5
112
1
0
7
268
6
0
8
181
6
0
7
61
2
0
14
271
6
0
13
357
9
0
27
628
15
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
6
0
0
19
0
8
0
0
57
0
5
0
0
103
4
24
0
1
42
0
55
0
0
6
2
29
0
0
113
8
126
0
1
116
0
17
0
1
229
8
127
0
0
0
0
0
0
0
0
2
0
1
0
1
0
4
0
11
1
7
0
1
0
13
0
14
1
27
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
0
5
0
12
0
0
9
4
48
0
2
25
8
59
0
4
19
21
23
0
2
4
4
94
0
6
39
28
57
0
2
23
9
151
0
8
62
37
5
0
4
0
1

Formulir RL 2a
No.
No. DTD
Urut
1
2
315 194.3
316 194.4
317 194.5
3
K 76.0
K 76.6
K 76.7
318 194.6
K 71
4
Perlemakan hati
Hipertensi portal
Sindrom hepatorenal
tempat kerja
346 207.9
K 74.0-5, K 75, K 76.1-5, 8, 9,

K 77
K 80
Kolelitiasis
K 81
Kolesistitis
K 85 - K 86
pankreas lainnya
K 82 - K 83, K 87 - K 93
L 00 - L 08
L 23 - L 24
L 10 - L 22, L 25 - L 99
lainnya
M 05 - M 06
Artritis rematoid
M 07
M 08 - M 09
Artritis belia
M 10 - M 11
M 12 - M 14
M 15 - M 19
Artrosis
M 20 - M 21
M 00 - M 01
tempat lain
M 02 - M 03
Artropati reaksi
M 22 - M 25
M 32
M 30 - M 31, M 33 - M36
lainnya
M 50 - M 51
M 45 - M 49
M 54.5
M 40 - M 44, M 53 - M 54.4, M
Dorsopati lainnya
54.6, 8, 9
M 60 - M 64, M 65.0 - M65.3,
8, 9, M 66 - M 68
M 65.4
M 70
tekanan berlebihan
M 71 - M 79
347 208
M 80 - M 85
348 209
M 86
349 210
M 87 - M 99
350 211
N 00 - N 01
351 212.0
352 212.2
N 04
N 02.8
Osteomielitis
akut
Sindrom nefritik
353 212.9
319 194.9
320 195.0
321 195.9
322 196
323 197
324 198
325 199.0
326 199.9
327
328
329
330
331
332
333
200.0
200.1
200.2
200.3
200.9
201
202
334 203.0
335 203.1
336 203.9
337 204.0
338 204.9
339 205
340 206.0
341 206.1
342 206.9
343 207.0
344 207.1
345 207.2
354 213.0
N 12
355 213.1
N 14.3
356 213.9
N 10 - N 11, N 13, N 14.0-2,

4, N 15 - N 16

pielonefritis
logam berat
lainnya
357 214.0
N 17.8
358
359
360
361
362
363
364
N 17.0-2, 9 - N 19
N 20 - N 23
N 30
N 25 - N 29, N 31 - N 39
N 40
N 41 - N 42
N 43

Urolitiasis
Sistitis
Hiperplasia prostat
parafimosis
Radang serviks
Endometriosis
latum
Amenore
214.9
215
216
217
218
219
220
365 221
N 47
366
367
368
369
370
371
222
223
224
225
226.0
226.1
N 44 - N 46, N 48 - N 51
N 60 - N 64
N 70
N 72
N 73
N 75.0.1
372 226.9
N 71, N 74, N 75.8 - N77
373 227
374 228
N 80
N 81
375 229
N 83
376 230.0
377 230.1
378 230.9
N 91.0, 1, 2
N 92.0, 1
N 91.3-5, N 92.2-6

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
5
6
7
8
9
10
11
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
3
0
0
0
2
2
0
2
0
2
5
0
1
1
2
3
6
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
2
0
0
0
7
1
0
0
2
0
0
0
6
0
0
0
6
1
0
0
12
1
0
0
1
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
7
0
0
0
0
2
0
0
8
0
0
0
0
1
0
0
35
1
0
0
0
1
2
0
14
0
0
0
0
2
1
0
8
0
0
0
1
0
0
0
45
1
0
0
1
4
2
0
31
0
0
0
0
2
1
0
76
1
0
0
1
6
3
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
1
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
1
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
5
1
4
1
0
2
4
2
6
2
10
4
0
0
0
0
0
0
0
0
2
1
0
0
0
1
0
0
1
0
2
2
1
0
3
2
0
0
0
0
0
0
0
0
0
7
0
0
7
1
0
7
0
0
4
0
0
6
0
0
1
0
0
9
0
0
23
1
0
32
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
14
0
0
0
0
4
3
0
36
0
0
0
0
2
1
0
12
0
0
0
0
27
14
0
80
2
0
0
1
32
4
0
57
29
0
1
0
24
3
0
15
56
0
0
1
48
18
0
131
84
0
1
0
41
8
0
84
3
0
0
1
86
26
0
214
87
0
1
0
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
2
0
0
0
0
4
0
4
4
0
0
0
38
0
4
3
0
0
0
16
0
0
0
0
0
0
0
1
10
0
0
0
0
4
0
1
7
0
0
0
54
1
11
7
0
0
0
58
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
1
0
1
2
0
0
1
0
0
0
0
1
5
0
1
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
9
0
1
0
29
0
0
0
8
0
0
0
0
0
0
0
0
0
1
0
46
0
1
0
46
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
379 231
380 232
381 233
382
383
384
385
386
234
235
236.0
236.1
236.2
387 236.9
388 237.0
389 237.1
390 237.9
391 238.0
392 238.1
393 283.9
394
395
396
397
239.0
239.1
239.2
239.3
398 239.9
399
400
401
402
240
241
242.0
242.1
403 242.2
404 242.3
4
N 95
N 97
N 82, N 84 - N 90, N 93 - N
94, N 96, N 98 - N 99
lainnya
O 03
Abortus spontan
O 04
Abortus medik
O 00
Kehamilan ektopik
O 01
Mola hidatidosa
O 05
Abortus lainnya
O 02, O 06, O 08
abortus
O 14
nyata/ Preeklampsia
O 15
Eklampsia
O 10 - O 13, O 16
O 44
Plasenta previa
O 45
Solusio plasenta
O 46
tempat lain
O 30
Kehamilan multipel
O 40
Hidramnion
O 42
Ketuban pecah dini
O 48
persalinan
O 64 - O 66
Persalinan macet
O 72
O 24
O 60
Persalinan prematur
O 68
janin
O 84
Persalinan multipel
405 242.9
O 20 - O 23, O 25 - O 29, O
61 - O 63, O 67, O 69 - 71, O
lainnya
73 - O 75, O 81 - -O 83
406 243
O 80
407 244
O 85 - O 99
409 246
P 05 - P 07
410 247
P 10 - P15

ditempat lain
Cedera lahir
411 248
P 20 - P 21
412 249
P 22 - P 28

413 250
P 35 - P 37
414 251
P 38 - P 39
408 245
415 252
416 253.0
417 253.9
418 254
419 255.0
420 255.9
421 256
422 257
423 258
424 259
425 260
426 261.0
P 00 - P 04

perinatal
P 55
baru lahir
P 95
Lahir mati
P 94, P 96
perinatal
Q 05
Spina bifida
Q 03
Q 00 - Q 02, Q 04, Q 06, Q
07
lain
Q 20 - Q 28
peredaran darah
Q 35 - Q 37
Q 41
halus
Q 38 - Q 40, Q 42 - Q 45
lainnya
Q 53
Testis tidak turun
Q 50 - Q 52
wanita
427 261.1
Q 54 - Q 56
428 261.9
Q 60 - Q 64
429 262
430 263
Q 65
Q 66
431 264
Q 67 - Q 79

lainnya

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
5
0
1
0
0
21
20
11
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
23
27
11
1
0
0
23
27
11
0
0
0
0
0
0
97
326
429
429
0
0
0
0
0
0
0
0
0
0
2
3
0
3
0
0
0
0
2
6
2
6
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
3
0
0
0
0
18
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
22
0
0
0
0
22
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
46
0
3
0
0
166
0
24
0
0
5
0
0
0
0
0
0
0
0
0
20
0
0
0
0
217
0
27
0
0
217
0
27
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
36
286
193
870
2
10
0
0
0
0
231
1152
231
1168
0
2
15
50
67
68
47
19
33
35
66
42
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
27
0
31
0
58
0
13
0
14
13
21
14
14
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14
0
1
1
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
10
0
0
5
1
1
15
1
1
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
2
0
2
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
433 266.0
3
Q 10 - Q 18, Q 30 - Q34, Q
80 - Q 89
Q 90
434 266.9
Q 91 - Q 99
435 267
R 10
436 268
R 50
437
438
439
440
441
442
443
R 54
R 00 - R 01
R 09.2
R 33
R 56
R 75
R 95
R 02 - R 09.0,1,3,8, R 11 - R
32, R 34 - R 49, R 51 - R 52,
R 55, R 57 - R 74, R 76 - R
94, R 96 - R 99
S 02
S 12, S 22, S 32, T 08
S 72
S 42, S 52, S 62, S 82, S 92,
T 10, T 12
Senilitis
Gejala pada jantung
Gagal napas
Retensi urin
Kejang YTT
432 265
269
270.0
270.1
270.2
270.3
270.4
270.5
444 270.9
445 271
446 272
447 273
448 274
449 275
450 276
451 277
452 278
453 279
454 280
T 02
S 03, 13, 23, 43, 53, 63, 73,
83, 93, T 03
S 05
S 06
S 26 - S 27
Sindrom Down

YTK ditempat lain
Fraktur paha
multiplel
Cedera intrakranial
S36-S37, S07-S08, S17-S18,

S97-S98, T04-T05
455 281
S76, S79-S81, S84-S86, S89S91, S94-S96, S99, T00-T01,
T06-T07, T09-T11, T13-T14
456 282.0
T 16
457 282.9
T 15, T 17 - T 19
458 283
T 20 - T 32

459 284
T 36 T 50
460
461
462
463
T 52
T 56
T 59
T 60
T51, T53 - T55, T57 - T58,
T61 - T65
T 74
T 66
T 67
T 70

Keracunan logam
Keracunan pestisida
lainnya
Efek radiasi YTT
tempat lain
YTK di tempat lain
secara rutin
285.0
285.1
285.2
285.3
464 285.9
465
466
467
468
286
287.0
287.1
287.2
469 287.9
T33-T35, T68-T69, T71-T73,

T75-T78
470 288
T 79 - T 88
471 289
T 90 - T 98
472 290.0
Z 00.0
473 290.1
Z 00.1

474 290.9
Z 00.2 - Z 13
475
476
477
478
479
480
481
291
292.0
292.1
292.2
292.3
292.4
292.6
Z 21
Z 23.2
Z 23.5
Z 24.0
Z 24.2
Z 24.4
Z 24.6
482 292.7
Z 27.1
483 292.8

Z 25 - Z 27.0, Z 272.2 - Z 29 lainnya

Imunisasi BCG
Imunisasi Tetanus
Imunisasi Rabies
Imunisasi Campak
pertusis, tetanus)

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
PR
13
14
3
0
3
2
2
0
0
2
0
0
0
0
0
0
0
0
3
1
5
3
8
4
1
1
0
0
1
0
0
0
0
2
0
8
0
18
0
15
0
6
1
26
0
22
1
49
1
0
0
0
0
7
0
0
0
0
47
0
0
21
0
38
0
0
147
0
0
1
0
149
0
0
209
0
0
0
1
29
0
0
95
0
0
0
0
0
0
0
142
0
0
3
2
0
0
0
73
0
0
6
4
2
0
0
31
0
0
4
2
0
0
0
410
0
0
23
6
147
0
0
334
0
0
20
3
71
0
0
744
0
0
43
9
218
0
0
0
0
0
5
0
7
0
0
0
0
0
0
9
0
0
0
13
0
0
0
8
0
0
0
13
0
0
0
63
0
0
0
29
0
0
0
12
0
0
0
47
0
0
0
100
0
0
0
147
0
0
0
9
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
6
0
0
0
26
0
0
0
21
0
0
0
14
0
0
0
0
0
0
0
59
0
0
0
8
0
0
0
67
0
0
0
30
0
0
0
0
0
18
0
125
0
223
0
267
0
125
0
34
0
549
0
246
0
792
0
6
0
0
0
0
0
0
5
3
3
1
5
1
5
0
2
0
0
5
13
0
7
5
20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
2
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
1
4
0
0
0
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
4
0
0
0
0
2
4
0
0
0
6
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Formulir RL 2a
No.
No. DTD
Urut
484 292.9
Z 20, Z 22
485 293
486 294.0
Z 30
Z 34
487 294.1
Z 35
488 294.9
489 295
Z 36
Z 38
490 296
Z 39
491 297.0
Z 46.0
492 297.1
Z 41.2
493 297.2
Z 46.3
494 297.3
Z 50
495 297.9
Z 40 - Z 41.0,1,3, Z 45, Z
46.1,2,4-9, Z 49, Z 51 - Z 54
496 298
4
penyakit menular
tinggi
Seleksi antenatal
persalinan
kebiasaan
palsu

khusus lainnya
Z 31 - Z 33, Z 37, Z 55 - Z 99
alasan lainnya
JUMLAH

GOLONGAN UMUR
0-28 29 HR- 1-4
HR <1 TH TH
5
6
7
5-14
TH
8
15-24 25-44 45-64

TH
TH
TH
9
10
11
5 2 0 4 0 1 3
No. Kode RS :
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX
>65
TH
12
LK
PR
13
14
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
15
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
189
0
672
0
1175
0
1253
0
1457
0
3934
0
2021
0
896
0
5110
0
6512
0
11597
0
233
PENYEBAB KECELAKAAN
No.
No. DTD
Urut
01 299.0
02 299.1
V 01 - V 89
V 90 - V 94
03 299.2
V 95 - V 97
04 299.9
05 300
V 98 - V 99
W 00 - W 19

angkasa
Jatuh
06 301
W 65 - W 74
07 302
X 00 - X 09
08 303.0
X 45
09 303.1
X 46

10 303.2
X 47
11 303.3
X 48
12 303.4
X 49
13 303.9
X 40 - X 44
14 304..0
X 60 - X 69
15 304.9
16 305
17 306.0
X 70 - X 84
X 85 - Y 09
X 10 - X 19
18 306.1
X 20 - X 29
19 306.2
X 30 - X 39
20 306.3
Y 40 - Y 59
21 306.4
Y 60 - Y 84
22 306.5
23 306.6
24 306.7
W 42
W 43
W 88
25 306.8
W 89
26 306.9
27 306.10
W 90
W 91
28 306.11
X 50
29 306.12
Y 96
30 306.13

& uap-uap lainnya
pestisida
bahan beracun
Dicederai
beracun
Pemaparan bising
Pemaparan getaran
manmade visible
W20-W41, W44-W64, W75W87, W92-W99, X51-X59,

Sebab luar lainnya
Y10-Y39, Y85-Y95, Y97-Y98
JUMLAH
PASIEN
KELUAR
(hidup&mati)
MENURUT
SEX

GOLONGAN UMUR
0-28 29 HR- 1-4
5-14 15-24 25-44 45-64
HR <1 TH TH
TH
TH
TH
TH
0
0
0
0
0
0
0
0
0
0
0
0
0
0
>65
TH
LK
JUMLAH
PASIEN
KELUAR
JUMLAH
PASIEN
KELUAR
MATI
PR
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
3
0
0
0
0
0
0
0
0
0
3
0
2
0
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
1
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
1
0
2
0
9
0
4
0
0
0
11
0
5
0
16
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
3
0
7
0
6
0
17
0
4
0
0
0
24
0
14
0
38
0
0
Sumbawa,1 Januari 2011


NIP.19560114 198301 1 002

RL 2a Dan RL 2a1 TW 2010 Total

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RL 2a Dan RL 2a1 TW 2010 Total

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DATA KEADAAN MORBIDITAS PASIEN RAWAT INAP RUMAH SAKIT

TRIWULAN : I ( Januari S.D Maret) TAHUN 2010

No. DAFTAR TERPERINCI

GOLONGAN SEBAB-SEBAB SAKIT

Diare & gastroenteritis oleh penyebab

A 02, A 04, A 05. A 07, A 08

Penyakit infeksi usus lainnya

Tuberkulosis (TB) pari BTA (+)

A 81, A 87- A 89, B 03 - B 04,

PASIEN KELUAR (HIDUP & MATI) MENURUT

DATA KEADAAN MORBIDITAS PASIEN RAWAT INAP RUMAH SAKIT

No. DAFTAR TERPERINCI

GOLONGAN SEBAB-SEBAB SAKIT

Neoplasma ganas ginjal, pelvis ginjal

Neoplasma ganas alat kemih lainnya

Neoplasma ganas mata dan adneksa

Neoplasma ganas otak

PASIEN KELUAR (HIDUP & MATI) MENURUT

DATA KEADAAN MORBIDITAS PASIEN RAWAT INAP RUMAH SAKIT

No. DAFTAR TERPERINCI

GOLONGAN SEBAB-SEBAB SAKIT

Neoplasma jinak sistem napas lainnya

Neoplasma jinak mediastinum

D65 - D69, D71- D73, D75 D77

Kondisi hemoragik dan penyakit darah

Penyakit tertentu yang menyangkut

F 43.0, F 43.2-9, F 45, F48

15-24 25-44 45-64

Neoplasma jinak lainnya

PASIEN KELUAR (HIDUP & MATI) MENURUT

Gangguan mental dan perilaku akibat

DATA KEADAAN MORBIDITAS PASIEN RAWAT INAP RUMAH SAKIT

No. DAFTAR TERPERINCI

F04, F07, F09

GOLONGAN SEBAB-SEBAB SAKIT

F 05 - F06, F90 - F98

Gangguan perkembangan psikologis

Penyakit radang susunan saraf pusat

Gangguan serangan perdarahan otak

Sindroma carpal tunnel

Iridosiklitis dan gangguan lain iris dan

Gangguan badan kaca dan bola mata

Gangguan saraf optik dan saraf

Gangguan lain gerakan mata binokuler

Gangguan daya lihat

Efek kebisingan telinga bagian dalam

Penyakit telinga dan prosesus mastoid

Demam reumatik akut

Gangguan sistem lakrimal dan orbita

PASIEN KELUAR (HIDUP & MATI) MENURUT

DATA KEADAAN MORBIDITAS PASIEN RAWAT INAP RUMAH SAKIT

No. DAFTAR TERPERINCI

J30.0 - J30.2, J30.4 - J31,

GOLONGAN SEBAB-SEBAB SAKIT

Penyakit usus dan peritoneum lainnya

Penyakit hati alkohol

PASIEN KELUAR (HIDUP & MATI) MENURUT

DATA KEADAAN MORBIDITAS PASIEN RAWAT INAP RUMAH SAKIT

No. DAFTAR TERPERINCI

GOLONGAN SEBAB-SEBAB SAKIT

K 74.0-5, K 75, K 76.1-5, 8, 9,

Gangguan struktur dan densitas tulang

N 02.0-7, 9, N 03, N 05 - N 08 Penyakit glomerulus lainnya

N 10 - N 11, N 13, N 14.0-2,