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NAMA BIAYASEP BIAYARS iur pasien selisih

januari LALU WINARAN PUTRANGGA 3,985,372 6,560,600 763,100 (1,812,128)
3,985,372 6,560,600
februari DRS.G.HENDARTO,BE. 5,069,339 9,240,800 (4,171,461)
DAMIRI 9,643,483 5,516,400 4,127,083
DULADI 5,682,544 4,103,000 1,579,544
SYAMSU ARIF M. SH 2,957,939 3,235,500 1,001,800 724,239
23,353,305 22,095,700
maret PUDJIATI SYARIF 7,600,859 6,970,300 630,559
SUDIMAN 2,712,841 3,472,300 1,079,000 319,541
10,313,700 10,442,600
april SUDI RAHAYU 7,272,515 11,003,800 6,503,800 2,772,515
LAELA MIMI SAETA 7,137,848 4,906,500 2,231,348
NUR KHASANAH 15,128,688 6,991,200 8,137,488
SITI BAIK 5,084,946 9,862,700 (4,777,754)
34,623,997 32,764,200
mei DIMAS RIZQI ADINATA 3,985,372 7,174,200 1,246,300 (1,942,528)
3,985,372 7,174,200
juni ANTONIUS EFFENDI SUKASNO 5,837,039 3,687,900 2,149,139
DRS. BAMBANG SUTRIMO 12,967,447 13,470,600 7,065,500 6,562,347
BUDIMAN HERRY WIBOWO 7,561,414 8,907,100 (1,345,686)
MUHAMMAD WILDAN 3,569,933 3,033,800 536,133
ASYFI RAHMA NAFSIYANI 5,003,177 1,007,400 3,995,777
34,939,010 30,106,800
juli

Agustus THOMAS NOACH PEEA.MM 8,209,555 16,188,100
INDRO SURIANTO 6,095,917 8,241,900
LILIEK AHMALIA 6,095,917 6,140,400
MONIKA IRMA SANTI 7,137,848 6,108,900
raidah 7,137,848 4,712,700
SUPARTININGSIH 6,705,851 7,688,300
HANDAYANI WIBOWO 7,272,515 4,323,900
raidah 4,433,129 4,779,300
53,088,580 58,183,500
september LIANA FEBRIANTY YUWONO 6,938,400 6,308,200
SAMROH NUSROTUN VAUZIAH 5,837,000 2,407,100
HANDAYANI WIBOWO 7,272,500 4,675,000
SUDARMAWAN 18,283,400 9,081,700
KARNOTO 6,316,100 3,505,700
AMIRUDIN 9,560,800 17,204,900
54,208,200 43,182,600
okt LINTANG NITI SEKAR 12,907,300 6,576,500
sim tjoe tjeng 4,997,900 6,271,600
SUDARmi 6,095,900 6,334,800

andi mahendra udoy isoga 3,416,000 6,966,000
HONGGO WONGSO 3,236,300 3,758,100
EKA NOVIANTI 6,515,000 6,000,900
FAJAR SUPRAPTO 7,540,800 7,540,800
44,709,200 43,448,700
nov ARDI FIRMAN RAMADANI 5,845,600 5,845,600
DEWI SORAYA AINIYAH 11,171,600 5,328,300
KARNOTO 9,697,300 2,700,300
SEPTIAN BUDI PRABOWO 8,797,700 7,289,300
M SAIFULLAH 5,194,700 5,131,800
S WASPANI 1,550,400 2,857,800
OEY PING AN 3,929,100 4,279,000
46,186,400 33,432,100
des CRISTINA PURWIYANTININGSIH 7,272,500 9,663,000
DANIL MUHAMMAD ROSYID 7,272,500 7,001,100
MUHAMMAD DAFA IMANNIAR 4,997,900 4,997,900
LINTANG NITI SEKAR 7,137,800 6,196,900
DIMAS PRAKOSO 7,272,500 7,412,200
SRI MURDININGSIH 2,956,700 6,099,300
SRI REJEKI 5,194,700 4,826,400
SAMROH NUSROTUN VAUZIAH 6,819,800 6,625,600
PRIYATNO SANTOSO 3,569,900 4,373,100
52,494,300 57,195,500

361,887,436 344,586,500

kls yg HAK LOS KdCBGS NmCbgs
utama 1 3 K-1-13-I APPENDIX OPERATION

1 1 10 B-4-14-III OTHER BILIARY TRACT DISEASES
1 1 3 L-1-30-I SKIN GRAFT EXCUDING BURNS
1 1 7 J-4-13-I CHEST TRAUMA
utama 2 2 N-4-13-II URINARY CALCULI

3 1 4 M-1-40-II LOCAL EXCISION & REMOVAL OF INTERNAL FIXATERS
vip 1 4 K-4-15-I GASTROINTESTINAL OBSTRUCTION

utama 1 5 M-1-80-I OPERATIONS OF UPPER LIMB
1 1 2 L-1-50-I BREAST OPERATIONS
1 1 3 K-1-40-III OTHER OPERATION OF DIGESTIVE SYSTEM
3 3 7 M-1-20-I HIP & FEMUR OPERATION EXCLUDING JOINTS

utama 1 5 K-1-13-I APPENDIX OPERATION

1 1 5 K-4-18-II OTHER DIGESTIVE SYSTEM DISORDERS
utama 2 7 K-1-40-III OTHER OPERATION OF DIGESTIVE SYSTEM
1 1 8 B-1-12-I CHOLECYSTECTOMY (NON LAPAROSCOPIC)
3 3 2 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR
2 2 2 K-4-18-II OTHER DIGESTIVE SYSTEM DISORDERS

9 1 K-1-50-II ANAL OPERATION
3 1 K-1-50-I ANAL OPERATION
3 1 K-1-50-I ANAL OPERATION
2 1 L-1-50-I BREAST OPERATIONS
2 1 L-1-50-I BREAST OPERATIONS
4 1 E-1-20-I OPERATION OF THYROID PARATHYROID & THYROGLOSSAL DUCT
2 1 M-1-80-I OPERATIONS OF UPPER LIMB
8 1 Z-4-12-II OTHER FACTORS INFLUENCING HEALTH STATUS

3 1 K-1-14-II INGUINAL & FEMORAL HERNIA REPAIR
3 1 K-4-18-II OTHER DIGESTIVE SYSTEM DISORDERS
2 1 M-1-80-I OPERATIONS OF UPPER LIMB
5 1 M-1-20-II HIP & FEMUR OPERATION EXCLUDING JOINTS
6 3 U-4-10-II EAR NOSE MOUTH & THROAT NEOPLASMS
12 1 M-1-80-II OPERATIONS OF UPPER LIMB

3 1 L-1-50-II BREAST OPERATIONS
3 1 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR
4 1 K-1-50-I ANAL OPERATION

7 2 K-1-13-I APPENDIX OPERATION 5 3 N-4-10-II RENAL & URINARY TRACT NEOPLASM & KIDNEY FAILURE 4 2 M-1-40-II LOCAL EXCISION & REMOVAL OF INTERNAL FIXATERS 3 2 M-1-60-I OTHER OPERATIONS OF MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE 5 2 M-1-50-I OPERATION OF SOFT TISSUES 3 2 M-1-20-I HIP & FEMUR OPERATION EXCLUDING JOINTS 3 3 U-4-10-III EAR NOSE MOUTH & THROAT NEOPLASMS 4 1 M-1-60-I OTHER OPERATIONS OF MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE 3 3 M-1-80-I OPERATIONS OF UPPER LIMB 2 3 M-4-12-I FRACTURE OR DISLOCATION EXCLUDING FEMUR & PELVIS 2 2 L-1-40-I OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS 4 1 M-1-80-I OPERATIONS OF UPPER LIMB 5 1 M-1-80-I OPERATIONS OF UPPER LIMB 6 1 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 2 1 L-1-50-I BREAST OPERATIONS 4 1 M-1-80-I OPERATIONS OF UPPER LIMB 4 3 M-1-40-I LOCAL EXCISION & REMOVAL OF INTERNAL FIXATERS 4 3 M-1-80-I OPERATIONS OF UPPER LIMB 4 1 M-1-50-I OPERATION OF SOFT TISSUES 3 3 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR .

L FIXATERS HYROGLOSSAL DUCT .

DNEY FAILURE L FIXATERS EL SYSTEM & CONNECTIVE TISSUE EL SYSTEM & CONNECTIVE TISSUE EMUR & PELVIS EAST OPERATIONS L FIXATERS .

823.698.135.304.023.444.790.244.100 SOEPRAPTO 3.600 Juli SUNARTO 8.914.577.360 agustus SUNARTO 3.228.700 MUHAMAD FURQON 3.390.500 AHMAD FARID 2.427.405.088.598.126.000 WELAS WALUYO.525 6.400 SUKARNO 10.370.784 8.200 CHUZARI 8.121.700 1.900 5.748 16.996 17.361.394.129 4.252.335 12.698.128 ENDANG KARYAWATI LESTARI 11.409.657 30.252.700 28.415.099 909.600 juni KUNTJORO 10.665.200 760.626 64.500 M YUSUF 2.433.638. BA 8.169.897.000 KARTONO 18.568 5.129 5.800 .367 9.665.141.300 CHUZARI 5.300 SUYANTA 2.348.053.109.800 BAIR GINTING 2.100 2.623 18.285.400 5.700 27.000 maret YUSTINUS SOEMANTRI 2.038 2.019.999 35.519 5.276 84.361.900 6.281.760 ARI SRI HARYANI 2.201 3.820 28.094.534.915 2.628.742.450.194.307.201 1.053.665.100 MUHAMAD FURQON 15.458 1.500 M YUSUF 3.992.562.450.733 3.700 MUHAMMAD ISMAUWIIL 5.335 13.282.321 47.822.173.873.400 77.571 9.731.748 970.597.347 18.332.400 DEWI EKOWATI 3.889.095. NAMA BIAYASEP BIAYARS IUR januari SOEPARDI 12.200 WIDO KUSTANTO 3.748 13.000 ANDREAS PRASETYA P 2.534.779.335 10.524.030.226.500 SLAMET 11.600 mei CHUZARI 8.100 SLAMET ABUBAKAR 1.665.648 15.800 10.900 SUSJANTO 4.335 11.038 1.200 KHAMID WINOTO 9.900 6.900 KUNTJORO 5.568 3.100 M YUSUF 8.003.915 1.495.485.750 3.000 47.200 SISWADI 8.767 8.170.778.929 2.996 9.929 4.300 SUNARTO 2.632.100 45.100 4.000 2.361.100 SUKIR 3.598 2.411.739.214.189.111.722.875.632.665.569.600 RASYID 6.100 479.361.486.568 5.722.600 15.598 609.100 BUDI SETYOTOMO 5.856.722.029.408.800 936.875.595.641.568 4.335 13.861.850 april SUSJANTO 14.600 TRIMANTO 3.

464.500 1.100 ARIF BUDIHARJO 2.273.600 2.616.108.313.740.200 4.523.SD 3.200 MOCH TAMIM 10.996 9.300 BAHARUDIN 6.534.300 1.S.538.058.367 8.200 2.700 11.658.700 2.289.108.600 nov KANAWIE 15.400 .053.600 BAMBANG SANTOSO 10.390.650.300 95.300 EKO LISTYO BINTORO 7.348.746.318 55.367 8.616.400 9.100 NUR CHASANY 2.700 KUNARSO 8.821.529.400 8.989.172.900 2.200 RAESAH 2.464.100 RATNA ERIKA PUSPITASARI 2.641.860.641.683.800 sep SUNARTO 3.450.500 SUHARJO 14.800 ZULAIKHIYAH 11.046.256.500 ISTIQOMARGIFIN 3.427.400 HERI SETIAWAN 2.464.487.000 LANNY SYLVIAWATI 4.500 SUHARJO 3.700 DENY SAPUTRA 1.632.682.748 10.900 10.342.200 6.525 7.800 10.300 SRI MULJATI 3.423 118.800 LANNY SYLVIAWATI 3.038 3.800 SUTRISNO 12.632.700 6.126.408. MUSDALIFAH.108.632.600 1.PD.725.858.170.632.900 ISTICHAROH 2.100.900 SRI ANNA 8.800 8.318 3.600 ABDUL RAHMAN YAHYA 1.900 CHANDRA DJAJA KUSUMA 7.992.500 SLAMET SISWANDI 2.550.246.524.700 38.170.700 9.886 6.700 ALFRED MARIANTO KARUNA 2.406.748 8.256.600 MOHAMMAD AZAM 2.641.050.464.080.141.400 2.875.900 AKHMAD ROIS 13.200 68.090.785.530.221.189.400 73.600 1.300 4.893.342.705.200 3.600 TRI SUSANTI 1.000 5.400 10.400 SUTRISNO 2.722.187.609.511.100 3.400 10.300 okt FAIZAL 2.048.875.875.600 DEWI HESTININGRUM 8.673.382.300 10.900 AMAT 6.437.300 SLAMET EFENDI 10.400 5.800 TITIN LUTIARSO 12.041.641.100 GATOT HARKANANTO GUNAWAN 12.534.300 SUTOMO 10.048.929.582.000 MUFID 4.439.641.484 14.000 12.053.200 ISTIQOMARGIFIN 8.399.482.648 2.600 1.767 20.500 7.345.200 SAPARI 7.

437.200 WINDAYATI 11.784.627.599. PUJI UTAMI 14.600 7.900 KASMURAH 11.900 4.600 CASUMI 11.500 I MADE PARWATA 7.400 SRI ANNA 7.800 132.464.300 MURIYAH 3.245.257.977.427.489.000 9.464.300 5.989.875.700 723.900 6.200 3.853.053.400 8.600 4.800 8.406.569.379.500 146.000 1.073.427.100 11.406.396.427.723.400 7.126.600 SUTIJAH 2.579.689.200 faiz harinda pratama 5.300 MOHAMMAD AZAM 14.794.126.400 9.418.200 LANNY SYLVIAWATI 4.464.126.455.600 AFIF SAEFUDIN 15.300 145.957.800 des KANAWIE 2.816.700.421.464.632.000 6.632.000 12.319.900 110.388 777.200 SRI RAHAYU 2.100 murpatono 2.000 21.100 SUGIMAN 14.400 DILIANA KUSUMAWATI 2.300 4.641.800 10.245.900 2.200 MUHAMMAD NAILUL MAFAZ 7.400 13.300 BAMBANG SANTOSO 2.113.530.633.082.236.032.400 7.400 SRI MANAH 2.300 2.300 1.300 2.600 3.264.661.900 SUJAK BARDJAK 7.957.800 10.800 11.198.380.300 2.957.400 KUSWONO 8.210 .392.000 TRI MEI PUJIASTUTI 2.641.600 DIARTI 18.421.500 ISTIQOMARGIFIN 3.053.119.800 SOEDIONO 3.700 tarlina 13.700 HANIFAH 8.361.641.

849.665) utama 1 7 V-1-1TRANSURETHRAL PROSTATE OPERATION ### utama 1 9 N-1-2UPPER URINARY TRACT OPERATION (95.625.271 2 2 10 N-1-2UPPER URINARY TRACT OPERATION 299.069 vip 2 4 V-4-1DISEASES OF MALE REPRODUCTIVE SYSTEM EXCLUDING NEOPLAS 470.516.230.935 utama 1 6 V-1-1TRANSURETHRAL PROSTATE OPERATION 637.568 2 1 2 V-1-1COMPLEX PROSTATE & SCROTAL OPERATION (88.124.971) 2 2 7 N-4-1OTHER RENAL & URINARY TRACT DISEASES 6.103.929 utama 1 3 N-4-1URINARY CALCULI 2.166.329 utama 1 2 Z-4-1OTHER FACTORS INFLUENCING HEALTH STATUS 1.387.619.567 1 1 6 N-1-2UPPER URINARY TRACT OPERATION (5. KLS RWT HAK LOS KdCBNmCbgs 4.246.002) 3 3 4 N-4-1URINARY CALCULI 5.VAGINA CERVIX & VULVA OPERATION J-4-1 RESPIRATORY INFECTIONS & INFLAMMATIONS J-4-1 RESPIRATORY NEOPLASMS U-4-1DYSEQUILIBRIUM 2 1 N-4-1OTHER RENAL & URINARY TRACT DISEASES 9 1 N-4-1RENAL & URINARY TRACT SIGNS & SYMPTOMS .338 1 1 2 N-4-1URINARY CALCULI 966.171) utama 1 5 N-4-1URINARY CALCULI 1.648 2 2 2 V-4-1DISEASES OF MALE REPRODUCTIVE SYSTEM EXCLUDING NEOPLAS (1.065) vip 1 7 V-1-1TRANSURETHRAL PROSTATE OPERATION (2.290.951 vip 1 5 V-1-1TRANSURETHRAL PROSTATE OPERATION 1.165) 1 1 5 V-1-1TRANSURETHRAL PROSTATE OPERATION 1.587.096 utama 1 8 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS (35.268 utama 1 3 V-1-1COMPLEX PROSTATE & SCROTAL OPERATION 2.496 1 1 5 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 1.900.801 1 1 3 N-4-1OTHER RENAL & URINARY TRACT DISEASES utama 1 8 V-1-1TRANSURETHRAL PROSTATE OPERATION utama 1 2 N-4-1RENAL & URINARY TRACT SIGNS & SYMPTOMS 2 2 6 V-1-1TRANSURETHRAL PROSTATE OPERATION 1 1 4 N-4-1RENAL & URINARY TRACT SIGNS & SYMPTOMS 1 1 4 N-4-1RENAL & URINARY TRACT INFECTIONS I-4-1 HYPERTENSION G-4-1CEREBROVASCULAR ACCIDENT WITH INFARCTION G-4-1CEREBROVASCULAR ACCIDENT WITH INFARCTION A-4-1OTHER BACTERIAL & PARASITIC INFECTIONS W-1.475) 3 3 6 V-1-1TRANSURETHRAL PROSTATE OPERATION 995.633 vip 1 2 N-4-1RENAL & URINARY TRACT INFECTIONS (24.

2 1 N-4-1RENAL & URINARY TRACT SIGNS & SYMPTOMS 2 2 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 10 1 N-4-1OTHER RENAL & URINARY TRACT DISEASES 4 3 V-1-1TRANSURETHRAL PROSTATE OPERATION 5 1 V-1-1TRANSURETHRAL PROSTATE OPERATION 8 1 N-1-2UPPER URINARY TRACT OPERATION 2 1 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 6 1 V-1-1TRANSURETHRAL PROSTATE OPERATION 2 1 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 4 1 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 4 1 N-4-1URINARY CALCULI 2 1 N-4-1OTHER RENAL & URINARY TRACT DISEASES 7 2 N-1-2UPPER URINARY TRACT OPERATION 5 1 N-4-1URINARY CALCULI 5 1 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 3 1 N-4-1OTHER RENAL & URINARY TRACT DISEASES 3 3 N-4-1URINARY CALCULI 8 1 N-4-1URINARY CALCULI 5 1 N-4-1URINARY CALCULI 2 2 N-4-1URINARY CALCULI 1 1 Z-4-1OTHER FACTORS INFLUENCING HEALTH STATUS 5 2 N-1-2UPPER URINARY TRACT OPERATION 7 2 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 9 1 D-4-1ANAEMIA EXCLUDING SICKLE CELL ANEMIA WITH CRISIS 3 2 N-4-1RENAL & URINARY TRACT SIGNS & SYMPTOMS 6 3 V-1-1TRANSURETHRAL PROSTATE OPERATION 3 3 N-4-1URINARY CALCULI 3 1 N-4-1RENAL & URINARY TRACT NEOPLASM & KIDNEY FAILURE 5 2 V-1-1TRANSURETHRAL PROSTATE OPERATION 2 1 N-4-1RENAL & URINARY TRACT INFECTIONS 1 2 N-4-1RENAL & URINARY TRACT INFECTIONS 1 1 N-4-1OTHER RENAL & URINARY TRACT DISEASES 2 3 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 3 3 N-4-1RENAL & URINARY TRACT INFECTIONS 4 1 N-1-2UPPER URINARY TRACT OPERATION 3 2 N-1-2UPPER URINARY TRACT OPERATION 4 3 N-4-1URINARY CALCULI 4 3 N-1-2UPPER URINARY TRACT OPERATION 1 1 N-4-1URINARY CALCULI 1 2 N-4-1URINARY CALCULI 3 2 N-1-2UPPER URINARY TRACT OPERATION 3 1 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS .

8 1 N-1-2UPPER URINARY TRACT OPERATION 3 1 N-1-2UPPER URINARY TRACT OPERATION 4 1 N-4-1OTHER RENAL & URINARY TRACT DISEASES 3 2 N-4-1URINARY CALCULI 2 3 N-4-1RENAL & URINARY TRACT NEOPLASM & KIDNEY FAILURE 6 2 V-1-1TRANSURETHRAL PROSTATE OPERATION 3 2 N-4-1URINARY CALCULI 6 2 V-1-1TRANSURETHRAL PROSTATE OPERATION 2 1 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 1 2 N-4-1URINARY CALCULI 11 1 N-1-2UPPER URINARY TRACT OPERATION 3 2 N-4-1URINARY CALCULI 2 3 N-4-1URINARY CALCULI 8 1 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 1 2 N-4-1OTHER RENAL & URINARY TRACT DISEASES 7 1 N-4-1RENAL & URINARY TRACT NEOPLASM & KIDNEY FAILURE 4 3 N-1-2UPPER URINARY TRACT OPERATION 11 3 N-1-2UPPER URINARY TRACT OPERATION 2 1 N-1-2UPPER URINARY TRACT OPERATION 1 1 N-4-1URINARY CALCULI 2 1 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 2 2 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 3 1 V-1-1COMPLEX PROSTATE & SCROTAL OPERATION 8 1 N-1-2UPPER URINARY TRACT OPERATION 2 3 N-4-1URINARY CALCULI 2 2 N-4-1URINARY CALCULI 2 2 N-1-4URETHRAL & TRANSURETHRAL OPERATIONS 7 3 N-1-2UPPER URINARY TRACT OPERATION .

M EXCLUDING NEOPLASM M EXCLUDING NEOPLASM .

WITH CRISIS DNEY FAILURE .

DNEY FAILURE DNEY FAILURE .

007 3.836.174.700 RUMAWI 8.906 5.500 DODY DWI RENDRAgraha 9.119 2.739.050 1.314 2.569.929.900 PURBANINGRUM 8.300 609.268.200 JUNAEDI 3.118.406.830 1.070.345.201.933 2.000 1.456.906 8.000 BANDIYO 5.100 SUCI SETIYANI 9.893 887.353.400 ANJI TAUHIDANI 3.169.000 maret NY.863.600 4.905.100 4.118.943 1.900 MONAH 14.266.900 CARUDI 2.569.200 FITRA RAMADANI KURNIAWAN 2.600 DIYONO 5.490.837.114.900 1.516.892.372.625.406.997.065.000 DIAH PUDJI ALRIANI 9.200 SUMARNI MM 7.779.558.059.434 2.200 EDI BASUKI 3.738.657.780.997.473.997.846.819.900 MUHAMMAD ALBANY NAABIGHAH 3.156 3.600 MANGgUS 4.100 asif rokhisyam 4.997.039 2.933.400 SRI HARTI 3.515 1.851.819.595 657.700 RIZKYANSYAH ADITYA WIBOWO 7.967.000 739.108 3.000 2.556.929.545 3.546.984 815.620.545 2.188 3.070.876.906 5.579.100 februari RINAWATI 4.956.900 KOBARYONO 3.261.958 3.708.000 LIAWATI 6.400 DEWI MURTI INDAH 4.629 9.798.283.016.415.313.400 .279.814.729 2.829.595 1. NAMA BIAYASEP BIAYARS IUR januari SUKAWATI 4.933 3.292 1.017 4.900 SRI HARTUTI 4.400 PRAMUDITO HARTADI 4.500 SUKIJANTO 5.700 KUSTANTO 3.200 PARMINEM 4.906 4.200 mei AHMAD SOFIAN 3.811 3.DR 4.779.396 1.050 2.415.567.971.664 3.LELI MARLINA MUSTHOPA 6.000 ZIDNIE KAUTSAR QUDS 3.700 BADRIYAH 4.136.700 KAMARI 7.600 ANISAH 2.574.858 1.228.595.000 AMAT KHOLIK 3.900 DYAH ISMIYATI 7.968 4.267.555.859.400 SAMALI 5.578.589.891.048.234 4.272.793.538 933.691 2.100 april JOSEPH RACHMAT.948.800 SUGIJATI 6.427 4.553 7.

335.863.800 wiwit dian antoni 2.249.003.333 4.730.700 muhamad husen yahya 13.899.646 6.919 5.400 RIDWAN 6.581.938.755.846.580.474 1.598 1.664 1.681.519 1.006.483 3.126.569 835.707.712.500 WASTIAH 6.800.262.800 ROCHMAN DJUNAEDI 6.900 juli PURWADI 7.780.452.491.320 1.347.819.233.874.318.450.245 2.474 335.048.163. RIEFKY YUNASZ FERDINAN 1.600 SUDIYONO 2.652.170.905.134.698.929 1.900 RISNOTO 2.300 EMY WIDYARTI 2.398 2.228.713.033 5.800 WASTIAH 13.585 3.600 TEGUH YUDONANTO 1.583.100 NOVITA SILVIA PANGASTIKA 4.390.624 1.521 3.164 1.988.800 FASIRUM 7.300 MEI SETYANINGRUM 3.900 DULAEMI 2.718.892 3.700 2.604 4.104.780.350 tasyani 3.600 RISKA DWI MAULITA 4.416.137.830 6.389.000 REZA RASYID FIRMANSYAH 6.800 YULIANTO NURUL FURQON 2.481.053.355.957.127 1.602.280.336.150 906.947 15.500 AGIL HASAN AL ATAS 10.300 KHOERUTUL MAWARISA 4.597 1.000 SUTRIYAH 9.283.492.068.164.330.200 MARGARETA SRI HARDANI 6.772.276 3.170.700 KHOIRIYAH 2.033 6.416.500 muhammad raif anaqie 4.781.819.900 BENNEDI 2.202 2.819.100 juni ERNI ANITA 2.255.997.700 AMIN SAPTONO 2.800 .909.320 859.728.700 NURUL HUDA 2.900 YUMNA FARIHA RAMADHANIS 2.424 5.533.070.100 RATNADI 2.216.300 MUHAMMAD WILDAN ATTABI 3.900 PRANOTO SUSILO 3.100 DURIYAH 2.656 1.300 RATNA NUZULIA NINGRUM 2.635.000 YANUARI ACHMAD 3.929.300 agustus DEWI HESTININGRUM 3.514 1.729 3.097.900 MUHAMMAD AMIRUDIN 6.312.322 1.300 SITI HALIMAH 3.830 4.000 2.694 3.250.497 2.497 1.646 7.519.830 7.681.066.858.907 DEMAS AJI PRAMUDITA 3.848 4.892.718.000 AMAT SURONO 3.372.

931.400 HADDY SUBOWO 3. MAHMUD 1.800 5.000 mc faried 5.433.000 GATOT HARKANANTO GUNAWAN 2.419.157.DARNADI 1.845.841 2.943 4.100 4.600 2.906 10.500 4.300 ANANG MAULANA 2.822.000 HJ.300 sep H.300 ELIA SHANDY KRISTANTO 6.900 FANI HIDAYAT 5.796.900 KHOTIMAH 2.100 moch ridho f 6.797.935.450.196.005.600 WAHYU PRABOWO 3.266.503.300 sarono 2.051 2.390.118.845.048.200 RATNA MARITA 5.520.100 .881.802.907.464.920.569.831.323 2.681.104.230.595 1.600 8.562.556.712.283.100 okt HARYO WIbawa 1.904.300 TATIK SURYATIK 3.000 M SINGGIH FEBRIYANTO 1.500 RETNO HENDRATI 3.920.963.032.611.997.512.652 1.568.679.700 3.500 R MARHAENDRA TS.300 3.300 SOBIRIN 2.551.779.200 3.355.300 2.800 1.755.MURA'AH 1.348.129 1.318 2.681.569.900 4.527.376.773.300 DEWI ANGGOROWATI 4. laurentius bambang samsudin 3.200 FX EKO PRIAMBODO.300 CASYODO 5.000 MOH.775.700 4.992.604.033.700 2.600 13.095.300 ERTIKAWATI 6.625 3.937.900 MARIO YONANTO 2.051 7.497.700 3.800 EKO PRANOTO 2.900 4.595 1.500 2.600 IRMA NURLIANI 2.779.800 1.900 DARGO 2.600 2.298. SH 4.000 1.779.300 JOAQUIM MOTA 2.200 SOEKARDJO 13.919 5.919.900 NOVITA SILVIA PANGASTIKA 4.779.600 10.752.245 2.085.045.048.500 CLARA MARISCA WULAN DARI 2.367.977.900 2.370 3.900 WIWIK WIDIYATMOKO 3.656 1.100 2.500 RAYHAN ABDULQODIR 2.892.900 2.819.900 DESI SARASWATI 2.098.403.489.553.100 NOVI APRILIANI 4.712.SPD 3.647. MUHAKAM 13.600 2.193.121.200 SITI DASMIRAH JD.345.400 nov KANAWIE 3.600 SUTARMO 4.000 JUNAENAH 3.500 CHRISTOPHER HENRY SETIAWAN 8.718.210.600 2.681.

361. S.173.166.300 PURNOMO ANDRIYANTO 5.100 CASTU'AH 3.098.100 14.300 TIATUN 7.500 3.800 726.042.338.902. ZWADEERY MAHARDIKA 4.455.283.569.500 2.600 IMANUEL WINDIKA ANGGORO PUT 4.500 4.700 5.681.000 NASURI 7.344.335.845.800 1.916.460.550.400 2.600 2.421.997.892.600 6.800 MOH.819.449.900 GREGORIUS ADIWIDJAYA KUSUMA 5.328.900 3.900 IRIANTI 1.400 CINTyA AYU WIJAYANTI 3.929.715.500 SENENG LINA SUSANTI SLAMET 2.800 1.100 IMMELIANA MUTIARA JUNDIA 3.470.332.500 1.900 4.300 MULYONO 3.900 KUSTIYAH 2.000 SANTOSO 3.900 4.300 MAULANA NABIL ALSITTA 3.449.345.600 2.438.166.558.100 DINA MARIANA 5.536.607 . KOM 4.800 MURDWIYANTO 13.000 J HARJANTO R 2.947 547.053.229.800 1. FAHMI LATIF. SRI HARTI 4.000 MULATINAH 6.600 2.500 1.900 6.972.500 M.548.294.342.610.500 2.537.798.137.700 des RONDIYAH 2.287.100 APRILLIA ROBIYATUN 6.400 SUDIYATI 3.235.420.765.200 4.283.000 TONADI 1.900 KASTOLANI 3.569.335.677.600 3.355.600 3.600 OEY SWIE THAY 4.891.548.800 3.500 4.459.000 NUR ALIM 11.900 4.118.800 5.170.700 SATRIO AGUS WALUYO 2.600 4.100 2.997.059.100 WILDAN PRASETYA 1.727.272.900 4.007.

306 utama 1 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR (156.137.045 1 G-4-24-III HEAD TRAUMA 46.036.271) vip 2 V-1-12-I COMPLEX PROSTATE & SCROTAL OPERATION 5.978.967) 3 3 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 1.615.015.180.584 2 2 S-4-16-I BURNS 2.906 vip 1 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 146.326.491 3 3 V-1-12-I COMPLEX PROSTATE & SCROTAL OPERATION 2 2 L-1-40-I OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS 3 3 K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS 1 1 L-4-12-I CELLULITIS 1 1 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 1 1 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 3 3 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR .727.130 vip 1 M-1-50-I OPERATION OF SOFT TISSUES 5.357.327 utama 2 S-4-16-III BURNS 1.596 1 1 K-4-10-I DIGESTIVE NEOPLASMS 4.056 2 2 L-1-50-I BREAST OPERATIONS 6.498.958 2 2 M-4-11-II FRACTURE OF PELVIS OR DISLOCATION OF HIP 4.214 3 3 K-4-18-II OTHER DIGESTIVE SYSTEM DISORDERS 2.719 3 3 M-1-50-III OPERATION OF SOFT TISSUES 2.232.738.943 1 1 I-4-15-I PERIPHERAL & OTHER VASCULAR DISEASEAS 2.426.183.910.914.180.029 1 1 I-4-15-II PERIPHERAL & OTHER VASCULAR DISEASES 2.509.695 3 3 K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS 12.358 1 1 B-4-14-I OTHER BILIARY TRACT DISEASES 2.150 2 2 L-1-40-I OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS 3.034 2 2 K-1-40-II OTHER OPERATION OF DIGESTIVE SYSTEM 603.503.544.793.268 3 3 K-1-50-II ANAL OPERATION 5.017 3 3 K-1-14-II INGUINAL & FEMORAL HERNIA REPAIR 1.092 3 2 U-4-10-II EAR NOSE MOUTH & THROAT NEOPLASMS 5.732.005.438.334 utama 1 K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS 436.446.039 1 1 K-4-18-II OTHER DIGESTIVE SYSTEM DISORDERS 4.315 1 1 M-1-80-I OPERATIONS OF UPPER LIMB 1. KLSRWT HAK KdCBGS NmCbgs 2.288 3 3 D-1-20-II OTHER PROCEDURES OF BLOOD AND BLOOD FORMING ORGANS (138.911 2 2 K-1-50-III ANAL OPERATION 1.938 3 3 K-4-18-III OTHER DIGESTIVE SYSTEM DISORDERS 1.539.990.464 1 1 G-4-24-I HEAD TRAUMA 1.245 vip 1 G-4-24-III HEAD TRAUMA 2.893 2 1 G-4-25-I CONCUSSION 1.053 2 2 W-1-20-II UTERUS & ADNEXA OPERATION 7.403.007 utama 1 W-4-12-III OTHER DISEASES OF FEMALE REPRODUCTIVE SYSTEM 7.

2 2 L-4-13-I TRAUMA TO THE SKIN SUBCUTANEOUS TISSUE & BREAST 1 1 M-1-50-I OPERATION OF SOFT TISSUES 3 3 G-4-24-I HEAD TRAUMA vip 1 M-1-50-I OPERATION OF SOFT TISSUES 1 1 M-4-12-I FRACTURE OR DISLOCATION EXCLUDING FEMUR & PELVIS 3 3 I-4-15-I PERIPHERAL & OTHER VASCULAR DISEASEAS 3 3 V-4-11-II DISEASES OF MALE REPRODUCTIVE SYSTEM EXCLUDING NEOPLASM 3 3 K-1-13-II APPENDIX OPERATION 3 3 S-4-16-I BURNS utama 2 K-1-13-I APPENDIX OPERATION 2 2 K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS 2 2 B-4-14-I OTHER BILIARY TRACT DISEASES 1 1 M-1-50-I OPERATION OF SOFT TISSUES 3 3 W-1-30-II VAGINA CERVIX & VULVA OPERATION 3 3 K-1-13-I APPENDIX OPERATION 3 3 K-4-17-I GASTROENTERITIS & ABDOMINAL PAIN D-4-11-III BLEEDING DISORDERS J-4-16-III SIMPLE PNEUMONIA & PERTUSIS K-4-17-I GASTROENTERITIS & ABDOMINAL PAIN M-1-50-III OPERATION OF SOFT TISSUES O-6-10-I CESAREAN SECTON J-4-18-III ASTHMA & BRONCHIOLITIS J-4-15-I RESPIRATORY INFECTIONS & INFLAMMATIONS I-4-17-III HYPERTENSION J-1-02-III LONG TERM MECHANICAL VENTILATION WITHOUT TRACHEOSTOMY A-4-14-I OTHER BACTERIAL & PARASITIC INFECTIONS A-4-14-II OTHER BACTERIAL & PARASITIC INFECTIONS I-4-17-II HYPERTENSION A-4-14-I OTHER BACTERIAL & PARASITIC INFECTIONS G-4-14-II CEREBROVASCULAR ACCIDENT WITH INFARCTION O-6-13-I VAGINAL DELIVERY O-6-10-I CESAREAN SECTON N-4-13-II URINARY CALCULI J-4-21-I RESPIRATORY SYSTEM SIGNS SYMPTOMS & OTHER DISORDERS M-4-12-I FRACTURE OR DISLOCATION EXCLUDING FEMUR & PELVIS K-1-13-I APPENDIX OPERATION K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR M-1-80-I OPERATIONS OF UPPER LIMB I-4-15-II PERIPHERAL & OTHER VASCULAR DISEASES V-4-11-I DISEASES OF MALE REPRODUCTIVE SYSTEM EXCLUDING NEOPLASM L-1-40-I OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS M-4-17-I MEDICAL BACK DISORDERS .

B-4-12-I OTHER PANCREAS DISORDERS EXCLUDING NEOPLASMS K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS L-4-13-I TRAUMA TO THE SKIN SUBCUTANEOUS TISSUE & BREAST K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR I-4-15-I PERIPHERAL & OTHER VASCULAR DISEASEAS I-4-15-I PERIPHERAL & OTHER VASCULAR DISEASEAS S-4-10-I TRUMA TO UNSPECIFIED OR MULTIPLE SITES K-4-15-III GASTROINTESTINAL OBSTRUCTION K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS K-4-15-I GASTROINTESTINAL OBSTRUCTION N-4-13-I URINARY CALCULI L-4-13-II TRAUMA TO THE SKIN SUBCUTANEOUS TISSUE & BREAST Z-4-12-II OTHER FACTORS INFLUENCING HEALTH STATUS M-1-50-II OPERATION OF SOFT TISSUES K-4-17-I GASTROENTERITIS & ABDOMINAL PAIN A-4-14-II OTHER BACTERIAL & PARASITIC INFECTIONS K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR G-4-25-I CONCUSSION K-4-15-I GASTROINTESTINAL OBSTRUCTION S-4-16-I BURNS L-1-50-I BREAST OPERATIONS K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR K-4-17-I GASTROENTERITIS & ABDOMINAL PAIN M-1-50-I OPERATION OF SOFT TISSUES M-1-50-I OPERATION OF SOFT TISSUES L-4-11-I NEOPLASMS OF BREAST H-1-20-I ORBITAL & EXTRAOCULAR OPERATION K-4-15-I GASTROINTESTINAL OBSTRUCTION M-1-50-I OPERATION OF SOFT TISSUES V-4-11-I DISEASES OF MALE REPRODUCTIVE SYSTEM EXCLUDING NEOPLASM I-4-15-III PERIPHERAL & OTHER VASCULAR DISEASES K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS M-1-60-I OTHER OPERATIONS OF MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE L-4-13-I TRAUMA TO THE SKIN SUBCUTANEOUS TISSUE & BREAST L-4-13-II TRAUMA TO THE SKIN SUBCUTANEOUS TISSUE & BREAST M-1-50-II OPERATION OF SOFT TISSUES V-4-11-I DISEASES OF MALE REPRODUCTIVE SYSTEM EXCLUDING NEOPLASM G-4-24-I HEAD TRAUMA N-4-15-II RENAL & URINARY TRACT SIGNS & SYMPTOMS N-4-13-II URINARY CALCULI L-1-50-I BREAST OPERATIONS .

I-4-15-I PERIPHERAL & OTHER VASCULAR DISEASEAS M-4-21-I OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DISORDERS N-4-16-II OTHER RENAL & URINARY TRACT DISEASES K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS L-1-50-I BREAST OPERATIONS M-1-80-I OPERATIONS OF UPPER LIMB N-4-12-I RENAL & URINARY TRACT INFECTIONS M-1-50-I OPERATION OF SOFT TISSUES J-4-21-I RESPIRATORY SYSTEM SIGNS SYMPTOMS & OTHER DISORDERS J-4-21-I RESPIRATORY SYSTEM SIGNS SYMPTOMS & OTHER DISORDERS L-1-40-I OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS K-4-10-I DIGESTIVE NEOPLASMS G-4-24-I HEAD TRAUMA 3 N-4-13-I URINARY CALCULI 2 M-1-50-II OPERATION OF SOFT TISSUES 3 K-4-17-I GASTROENTERITIS & ABDOMINAL PAIN 2 L-1-50-I BREAST OPERATIONS 1 M-1-50-I OPERATION OF SOFT TISSUES 1 M-1-50-II OPERATION OF SOFT TISSUES 1 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 3 B-4-13-I OTHER LIVER DISEASES 3 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 3 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 2 K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS 1 M-4-12-I FRACTURE OR DISLOCATION EXCLUDING FEMUR & PELVIS 2 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 2 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 1 V-1-12-I COMPLEX PROSTATE & SCROTAL OPERATION 1 K-4-18-I OTHER DIGESTIVE SYSTEM DISORDERS 3 L-1-50-I BREAST OPERATIONS .

FORMING ORGANS ST OPERATIONS AST OPERATIONS .

UE & BREAST MUR & PELVIS EXCLUDING NEOPLASM HOUT TRACHEOSTOMY THER DISORDERS UR & PELVIS EXCLUDING NEOPLASM ST OPERATIONS .

E & BREAST E & BREAST EXCLUDING NEOPLASM L SYSTEM & CONNECTIVE TISSUE UE & BREAST UE & BREAST EXCLUDING NEOPLASM .

ECTIVE TISSUE DISORDERS OTHER DISORDERS OTHER DISORDERS AST OPERATIONS MUR & PELVIS .

107 3.800 by.200 4.148.535.500 WINARTI P 7.155.300 HARIS RUSDIANTO L 6.100 SUKARDI L 5.372 7.500 6.555.493. riana nuvi adamdewi P 7.585 2.190.489.235.600 6.300 406.233.233.683 9.050 3.600 DESTI FIRZA MULYATI P 4.949.814.636.578 4.403.900 maret MAESI KHAERI L 1.569 2.398.700 MARCELLO JOVIAL STEVAN TUPL 1.225. NAMA JK BIAYASEP BIAYARS IUR februari BAYU ARFIANTO L 19.083 6.595.848.900 juli BAHAR DAENG MASSIKKI L 6.100 DYAH PUSPITOSARI P 5.274.917 5.038 1.354 14.100 SUCI ALLAMAH P 3.786.100 NAUFAL ARFANDI L 6.362 4.830 4.996.036.396.159.000 DWI LAKSANAWATI P 6.985.PSI P 4.530 7.783.272.951.237.987.500 2.961.300 mei KUSTANTO L 11.228.569 2.860 4. ny.700 september ABDUL NASIR L 3.018 3.115.700 .569.831.400 MUJIATI P 5.548.992.900 ROMDLON L 4.700 SUBHAN ZAENAL ABIDIN L 14.019.092.047.417 6.344.070.100.000 april ANGGA PRATAMA AP L 6.400 SUKARDI L 2.845.600 JOHN SISWANTO L 6.880.114.724.095.700 juni ARIEF SYAMSIDI L 2.900 NUR IFAWATI P 5.200 NOVI ASTUTI P 6.242.800 LIONG SHOE CHIEH P 15.800 6.418.938.387.300 LINDA RISIANA L 19.845.455.500 5.900 SOESI YULIATI.945.860.100 DYAH PUSPITOSARI P 16.181.743 1.200 2. S.115.583.575.819.395.033 4.900 4.730.400 TAN MEI LAN P 5.482 3.122 7.800 RENAMARIE p 3.247 4.675 4.783 12.025 26.900 3.225.937.218.581.300 ALFIAN TRISNA ADISURYA L 4.400 Agustus NICHOLAS ADRIEN SENTOSA L 3.114.875.300 MUHAMMAD FERDI L 3.416.910.580.462.100 5.900 DYAH PUSPITOSARI P 4.000 YUHANA FAHRUYANTI P 3.616.208 2.931.100 AGNES eka titik yulikawanti L 6.540 1.929.892 3.300 2.280.600 ANTON NURWANTO L 3.698.629 5.

997.200 4.100 8.204.000 KARYATI P 11.900 WAHYU HIMAWAN L 4.845.800 RUTH RINNA DEWATI P 5.288.440 .900 NADLROTUN FITRIANA P 4.800 SUHIRDI L 4.900 4.000 SUSANTI P 6.639.822.152.997.917.929.118.492.200 NUR AFIFAH P 18.700 2.100 SUBICHAH P 5.392.200 BAGAS WAHYU DHIYASH L 4.605.400 CATHARINA SRI SETYANINGSIHP 2.283.735.029.900 des WINARTI P 2.400 6.900 4.061 291.914.000 6.400 nov SUKIRDI L 11.118.376.983.200 ANINDIAS KEYLA RAHMANISA P 3.947.096.900 ROMJANAH P 7.600 3.534.000 HIMMATUL MUFRODAH P 6.283.069.956.100 11.114.727.900 5.okt DYAH PUSPITOSARI P 5.000 354.932.500 5.242.900 4.500 1.900 4.258.600 3.200 4.677.283.

247 2 2 2 I-1-20-II OTHER OPERATIONS OF CIRCULATORY SYSTEM 286.707 2 2 2 J-1-30-II COMPLEX RESPIRATORY SYSTEM OPERATIONS 2.669 2 2 3 M-1-50-I OPERATION OF SOFT TISSUES 1.201.228.082.908 3 3 2 L-1-40-I OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS 1.150.775 1 1 2 D-1-20-I OTHER PROCEDURES OF BLOOD AND BLOOD FORMING ORGANS 3.428) 1 1 3 K-1-13-I APPENDIX OPERATION 10.183 vip 1 5 K-1-11-I PERITONEAL ADHESIOLYSIS (40.477 utama 1 3 K-1-50-I ANAL OPERATION 2.457.650. KLSRWT HAK LOS KdCBGS NmCbgs 12.883.560 2 2 3 K-1-13-III APPENDIX OPERATION 7.255.943 3 3 4 K-4-15-I GASTROINTESTINAL OBSTRUCTION 4.029.582 3 3 2 D-1-20-I OTHER PROCEDURES OF BLOOD AND BLOOD FORMING ORGANS M-1-50-I OPERATION OF SOFT TISSUES I-4-17-III HYPERTENSION I-4-24-III OTHER CIRCULATORY SYSTEM DISORDERS 2 2 M-1-40-I LOCAL EXCISION & REMOVAL OF INTERNAL FIXATERS 2 2 D-1-20-I OTHER PROCEDURES OF BLOOD AND BLOOD FORMING ORGANS 8 3 K-1-11-III PERITONEAL ADHESIOLYSIS 5 3 Z-4-12-III OTHER FACTORS INFLUENCING HEALTH STATUS 3 3 M-1-10-I CRANIAL & FACIAL BONE RECONSTRUCTION 2 2 M-1-80-I OPERATIONS OF UPPER LIMB 10 2 K-1-11-III PERITONEAL ADHESIOLYSIS 4 3 L-1-40-II OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS 3 3 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 3 3 I-1-20-III OTHER OPERATIONS OF CIRCULATORY SYSTEM 3 2 M-1-80-I OPERATIONS OF UPPER LIMB 2 2 V-1-15-I CIRCUMCISION 7 2 K-1-50-I ANAL OPERATION 14 3 K-4-18-III OTHER DIGESTIVE SYSTEM DISORDERS 3 1 M-1-80-I OPERATIONS OF UPPER LIMB 2 3 Z-4-12-II OTHER FACTORS INFLUENCING HEALTH STATUS .783 vip 1 13 P-8-14-II NEONATE BIRTHWT >2499 GRAMS WITH COMPLEX CONGENITAL A 2.192 utama 1 2 L-1-40-I OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS 207.438 1 1 2 N-4-13-I URINARY CALCULI 833.755.003.174.429 utama 2 2 V-1-12-I COMPLEX PROSTATE & SCROTAL OPERATION 353.969 2 2 2 M-1-50-I OPERATION OF SOFT TISSUES (3.222 3 1 5 M-1-20-III HIP & FEMUR OPERATION EXCLUDING JOINTS 836.170) 1 1 6 K-1-13-II APPENDIX OPERATION 1.

8 3 K-1-40-I OTHER OPERATION OF DIGESTIVE SYSTEM 2 2 L-1-50-I BREAST OPERATIONS 2 1 W-1-30-I VAGINA CERVIX & VULVA OPERATION 4 1 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 6 3 K-1-10-II SIMPLE SMALL & LARGE BOWEL OPERATION 8 2 M-1-50-II OPERATION OF SOFT TISSUES 5 1 W-4-12-II OTHER DISEASES OF FEMALE REPRODUCTIVE SYSTEM 2 3 K-4-18-III OTHER DIGESTIVE SYSTEM DISORDERS 2 2 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 3 2 K-1-14-I INGUINAL & FEMORAL HERNIA REPAIR 3 2 K-1-20-I COMPLEX INTESTINAL OPERATION 5 1 K-1-20-II COMPLEX INTESTINAL OPERATION 2 2 M-1-50-I OPERATION OF SOFT TISSUES 2 3 M-1-40-I LOCAL EXCISION & REMOVAL OF INTERNAL FIXATERS 2 2 D-1-20-I OTHER PROCEDURES OF BLOOD AND BLOOD FORMING ORGANS 2 2 L-1-50-I BREAST OPERATIONS .

OMPLEX CONGENITAL ABNORMALITIES EAST OPERATIONS OD FORMING ORGANS EAST OPERATIONS OD FORMING ORGANS D FORMING ORGANS AST OPERATIONS .

VE SYSTEM L FIXATERS OD FORMING ORGANS .

233.813.585 DR HARI SUKO SP OT FICS MNKES RIBUT SANTOSO 7/24/2014 ### 8.770 DR HARI SUKO SP OT FICS MNKES sep SARIMAH P ### RITL 8/26/2014 alex felino L ### RITL 8/31/2014 TITIS WIDIATMO L ### RITL 9/11/2014 MUHAMMAD HADI L ### RITL 9/11/2014 kurniawan adi sepL ### RITL 9/11/2014 okt ADVENTINA WIDYP ### RITL 10/3/2014 18:16 WAHYUNI P ### RITL 9/26/2014 RIBUT ACHWANDL ### RITL 10/15/2014 9:07 FARAH ANISSA R P ### RITL 10/28/2014 nov SUKAR L ### RITL 11/2/2014 13:00 ELIA SRI SUNDARP ### RITL 10/30/2014 21:37 SOETOLO BOEDI L ### RITL 11/13/2014 13:37 SANTOSA L ### RITL 11/4/2014 10:32 mutmainah P ### RITL 11/10/2014 15:31 NUR HIDAYAH P ### RITL 11/1/2014 11:59 des mutmainah P ### RITL 11/28/2014 10:07 sugianto L ### RITL 12/11/2014 12:49 DADANG SUYATNL ### RITL 12/19/2014 14:21 HARTONO L ### RITL 12/23/2014 13:20 . NOKAPST NAMA JK TGLLHR JNSPEL maret 0000078279309 MULYONO L 10/12/1981 RITL 0000080445532 DIAN KURNIASIH P 7/16/1977 RITL 0000162874462 NABILA APRILIANI P 4/19/2009 RITL april 0000078015104 WAROYAH P 3/9/1965 RITL 0000166689641 PURWOTO L 7/4/1949 RITL mei 0001298494034 NUR JANAH P 2/19/1960 RITL 0001271683361 KHOTIJAH P 7/2/1972 RITL juni 0000077943947 SAILAH P 4/13/1945 RITL 0000078129685 SOEMENTINAH P 10/10/1940 RITL 0000080286096 SUBANDI L 7/9/1959 RITL juli FARAH ANISSA R 7/18/2014 ### 6.

233.178.076) 1 1 3 5/1/2014 5/9/2014 4.118.291.400 (519.800 (3.358.100 3.396.331.342.000 (898.700 (785.400 71 1 2 9 6/2/2014 6/9/2014 13.312.900 F-4-16-II DEMENTIA AND OTHER ORGANIC BRAIN DISTURBANCES INCLUDING MENTAL RETARDATION 9/1/2014 12133515 2 DR HARI SUKO 18343800 7 M-1-04-II LOWER LIMB JOINT OPERATIO 9/5/2014 13724015 2 DR HARI SUKO 18268300 6 M-1-70-II OPERATION OF KNEE & LEG P 9/15/2014 4052300 1 DR HARI SUKO 4052300 5 J-1-30-I COMPLEX RESPIRATORY SYST 9/17/2014 9772600 3 DR HARI SUKO 11654900 7 M-1-50-II OPERATION OF SOFT TISSUES 9/13/2014 6515000 2 DR HARI SUKO 4494700 3 M-1-40-II LOCAL EXCISION & REMOVAL 10/6/2014 3.097 7.900 13.836.586.271.797.369 12.384.729 vip 1 8 6/1/2014 6/5/2014 35.971.502.169.153) 1 2 1 3/13/2014 3/16/2014 4.300 7 M-1-20-II HIP & FEMUR OPERATION EXC 10/21/2014 ### 1 DR HARI SUKO 8.892 11.442.200 4 M-1-40-I LOCAL EXCISION & REMOVAL 10/2/2014 ### 3 DR HARI SUKO 5.571.285 3 2 3 4/14/2014 4/23/2014 18.871 17.100 5.802.585 3.136.734.122 vip 1 10 4/7/2014 4/9/2014 4.300 2.200 10.878.000 4.300 28.902.000 K-4-17-I GASTROENTERITIS & ABDOMINAL PAIN 10.648 1.052.391.208) vip 1 4 3/27/2014 3/29/2014 6.451.500.291.480.100 10.393.372.200 3.548.000 2 DR HARI SUKO 6.048 3 3 2 6/19/2014 6/27/2014 6.TGLDATANG TGLPULANG BIAYASEP BIAYARS IUR KLS RWT HAK LOS 3/6/2014 3/11/2014 3.797 2 1 5 5.583.122 24.439.700 7 M-1-60-II OTHER OPERATIONS OF MUS 10/30/2014 3.347 7.629 22.502.900 3 M-1-40-I LOCAL EXCISION & REMOVAL 11/6/2014 2712300 1 DR HARI SUKO 2711800 5 M-4-17-I MEDICAL BACK DISORDERS 11/3/2014 10590400 1 DR HARI SUKO 11195700 5 M-1-60-II OTHER OPERATIONS OF MUS 11/19/2014 32230300 2 DR HARI SUKO 13154500 7 M-1-04-II LOWER LIMB JOINT OPERATIO 11/7/2014 2172800 1 DR HARI SUKO 2803000 4 M-4-10-I FRACTURES OF FEMUR 11/11/2014 1550400 3 DR HARI SUKO 1379700 2 M-4-12-I FRACTURE OR DISLOCATION 11/4/2014 9119300 3 DR HARI SUKO 6577000 4 M-1-70-I OPERATION OF KNEE & LEG P 12/2/2014 6284000 3 DR HARI SUKO 6215800 5 M-1-60-I OTHER OPERATIONS OF MUS 12/18/2014 5841900 1 DR HARI SUKO 5842500 8 L-4-12-II CELLULITIS 12/19/2014 43935100 1 DR HARI SUKO 23768300 1 M-1-04-II LOWER LIMB JOINT OPERATIO 12/27/2014 3548000 2 DR HARI SUKO 6543200 5 M-1-40-I LOCAL EXCISION & REMOVAL .931) vip 1 9 5/28/2014 5/29/2014 3.600 2.844.100 4.000 2 DR HARI SUKO 4.909.548.324 4.446.

KdCBGS NmCbgs M-4-18-II OTHER DISORDER OF BONES & JOINTS L-1-40-I OTHER SKIN SUBCUTANEOUS TISSUE & BREAST OPERATIONS M-1-80-I OPERATIONS OF UPPER LIMB I-1-20-II OTHER OPERATIONS OF CIRCULATORY SYSTEM J-1-30-I COMPLEX RESPIRATORY SYSTEM OPERATIONS C-4-11-II LYMPHOMA & CHRONIC LEUKEMIA M-4-13-I NEOPLASMS OF MUSCULOSKELETAL & CONNECTIVE TISSUE & PATHOLOGICAL FRACTURES M-1-20-II HIP & FEMUR OPERATION EXCLUDING JOINTS M-1-04-II LOWER LIMB JOINT OPERATION J-1-30-III COMPLEX RESPIRATORY SYSTEM PROCEDURES MENTAL RETARDATION WER LIMB JOINT OPERATION ERATION OF KNEE & LEG PROCEDURES EXCLUDING FOOT MPLEX RESPIRATORY SYSTEM OPERATIONS ERATION OF SOFT TISSUES CAL EXCISION & REMOVAL OF INTERNAL FIXATERS CAL EXCISION & REMOVAL OF INTERNAL FIXATERS P & FEMUR OPERATION EXCLUDING JOINTS HER OPERATIONS OF MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE CAL EXCISION & REMOVAL OF INTERNAL FIXATERS DICAL BACK DISORDERS HER OPERATIONS OF MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE WER LIMB JOINT OPERATION ACTURES OF FEMUR ACTURE OR DISLOCATION EXCLUDING FEMUR & PELVIS ERATION OF KNEE & LEG PROCEDURES EXCLUDING FOOT HER OPERATIONS OF MUSCULOSKELETEL SYSTEM & CONNECTIVE TISSUE WER LIMB JOINT OPERATION CAL EXCISION & REMOVAL OF INTERNAL FIXATERS .