TERA

BPJS DIAGNOSA TANDA & GEJALA

DEWASA

T81.2 ACCIDENT Vulnus, avulsi, ekstraksi pritamox 500mg 3x1, molasic 3x1,kaditic 2x1 Pritamox syr 3

BRONCHOPNEUM panas batuk pilek dan provamed 500mg 3x1, sanmol 3x1, dextral Provamed 200
J180 ONIA sesak 3x1,lexcomet 2x1 3x1
batuk batuk yang lama provamed 500mg 3x1, sanmol 3x1, dextral Provamed 200
J219 BRONCITIS ACUT dan dada sakit 3x1,lexcomet 2x1 3x1

K021 CARIES DENTIS sakit gigi dan bengkak pritamox 500mg 3x1, molasic 3x1,kaditic 2x1 Pritamox syr 3

sakit kepala dan leher

G442 CEPHALGIA pritagesic 3x1, dananeuron 1x1, vitazym 3x1
kaku
CERUMEN PROP
CERVICAL ROOT meloxicam 7,5 mg 1x1, lescomet 2x1,
G54.2 leher sulit di gerakan
DISORDER dananeuron 1x1

J00 COMMON COLD Panas, batuk, pilek pritamox 500mg 3x1, sanmol 3x1, dextral 3x1 pritamox syr 3

CONJUNCTIVITIS Pritamox 3x1, loratadin 1x1, lexcomet 2x1,

H103 ACUT mata merah dan gatal alletrol ED 3x3 gt pritamox syr 3

CORPUS ALIENUM Benda asing di wound toilet, simptomatis ( sanmol 3x1,

T16 pritamox syr 3
telinga/mata/hidung pritamox 3x1, lescomet 2x1)
DERMATITIS/SKABI gatal gatal di badan Pulv (loratadin
L209 loratadin 1x1, lexcomet 2x1, bevalex cream
ES cr/ketokonazo
GDS tinggi, baal, Amaril 1x1, metformin 300mg 1x1, dananeuron
E119 DIABETES kesemutan 1x1
nyeri pada saat
N946 DYSMENORHOE buscopan 3x1, dananeuron 1x1
mentruasi

K30 DYSPEPSIA kembung dan mual Actal 3x1, famos 20mg 2x1, vitazym 3x1 infatrim syr 2x

A09 ENTERITIS diare dan muntah infatrim forte 2x1, molagit 3x1, actal 3x1 infatrim syr 2x

Actal 3x1, famos 20mg 2x1, vitazym 3x1

nyeri ulu hati dan mual
K291 GASTRITIS ACUT ,buscopan 3x1 dateng 2x ga sembuh kasih
serta kembung lansoprazole 1x1
ada benjolan di anus dan dianicol 500mg 3x1,molasic 3x1/2,kaditic
I84.4 HAEMORRHOID berdarah 3x1/2,asamex 500mg 3x1

Post varicella, lesi acyclovir 200 mg 5x1, loratadin 1x1,acifar cream,

B029 HERPES ZOSTER unilateral sesuai corovit 1x1
dermatom, pegal-pegal

HYPERCHOLESTER sering pusing dan badan simvastatin 5mg 1x1, pritagesic 3x1,dananeuron
E780 OL pada sakit (cek lab) 1x1

sering sakit leher dan amlodipin 10mg 1x1, pritagesic 3x1,

I10 HYPERTENSION kepala dananneuron 1x1
pusing dan kunang
I959 HYPOTENSION pritagesic 3x1, feromex 1x1, lybrozym 3x1
kunang
 P
r
nyeri kaki , kesemutan Voltadex 50mg 2x1,lexcomet 2x1, dananeuron i
M7916 ISCHIALGIA dan kram 1x1 p
t
ra
ofloxacin 200mg 2x1, buscopan 3x1, im
N390 ISK/UTI nyeri kencing dan panas dananeuron 1x1 to
ax
KOCH Sesak nafas, berdebar- BULAN I-II: rifampicin 1x450mg ,beneazid forte m
A153 PULMONUM /TBC debar, rhonki (+) 1x1, pirazinamid 3x500, dananeuron 1x1 o
s
xy
BULAN III-VI: rifampicin 1x600mg ,beneazid r
forte 1x1, dananeuron 1x1, foto thorax 1
2
3
FOTO THORAX (+) lanjut sampe IX: rifampicin 5
x
1x600mg ,beneazid forte 1x1, dananeuron 1x1, B
foto thorax m
B
g,
FOTO THORAX (+) lanjut XII: rifampicin 1x600mg 3 p
,beneazid forte 1x1, dananeuron 1x1, STOP ixu
B
n
l
Nyeri pinggang menjalar Voltadex 50mg 2x1,lexcomet 2x1, dananeuron fB v
M545 LOW BACK PAIN ,a
ke kaki 1x1
t(
rp
s
Benjolan di kelenjar iu
I889 LYMPHADENITIS Pritamox 3x1, molasic 3x1, kaditic 2x1 a
cervical, mammae, axilla ym
n
em
p
Payudara bengkak dan rsro
N61 MASTITIS Pritamox 3x1, molasic 3x1, kaditic 2x1
merah, nyeri (iyl
str,p
MENOMETRORAG haid tidak lancar dan ofloxcain 200mg 2x1, asamex 500mg 3x1, ara
N926 HIA banyak dananeuron 1x1 n
2
li
m
Pegal-pegal seluruh xm
et
o
M791 MYALGIA pritagesic 3x1,molacort 3x1, dananeuron 1x1 o
xsB
badan a
lce
B
m
,o
sn
o
panas badannya dan lm
yd
B059 MORLBILLI x
biontik merah di badan o
rip
e
rtsc
u
la,y
o
3
p
nyeri pinggang dan ofloxacin 200mg 2x1, buscopan 3x1,nepromex xlvtr
N219 NEFROLITHIASIS aB
kencing agak keruh, mual 3x1,dananeuron 1x1 i(d
c3
1
B
tlit
,2
xan
tidak bisa BAB dan Actal 3x1, famos 20mg 2x1, vitazym 3x1 ia5
B
K590 OBSTIPASI m
,b
kembung ,kompolak syr 3x1 lp
B
o
ra),u
m
xc
ofloxacin 200mg 2x1, lexcomet 2x1,reyco ED 3x3 lgo
H609 OTITIS EXTERNA Nyeri telinga,serumen +/- ts telinga vzt3
p
sayx
(su
ylm
OTITIS MEDIA keluar cairan dari telinga Pritamox 3x1, lexcomet 2x1,reyco ED 3x3 ts 1
lsyr)
H669 ACUT dan bau telinga ar,v
l(
n
3
3
o
3
m
xsrx
PAROTITIS/MUMPS Bengkak di leher Ciprofloxacin 2x1, sanmol 3x1, dextral 3x1, xB
B269 ao
(gondongan) dananeuron 1x1 a1
lB
n
B
t,,B
m
panas batuk pilek dan pritamox 500mg 3x1, sanmol 3x1, dextral ,ga
J029 PHARINGITIS ,o
G
sakit menelan 3x1,lexcomet 2x1 rlG
d
p
io
,p
,u
PREGNENCY/HAMI Kehamilan normal, USG tau
n
Z321 Dananeuron 1x1, calcifar 1x1 G
la,
L jika 8 bulan lG
m
vav
v
,b
rcia
to
m
xab
slro
l)yo
r,x
3
p
o
x1
r
 xtl
1
v,
2
1
(
5
xl
b
1
ye
m
b
pritamox 3x1, loratadin 1x1, lescomet 2x1, vagr
L282 PRURIGO gatal gatal di kaki bevalex cr aco
slyz
e
icyy
Mata seperti mengganjal, Pritamox 3x1, loratadin 1x1, lexcomet 2x1, xn
H110 PTYRIGIUM bayangan di depan mata alletrol ED 3x3 gt lrm
fo
,c
a3
v
Nyeri pinggang, nyeri rtixP
N700 SALPINGITIS Ofloxacin 2x1, buscopan 3x1, dananeuron 1x1 le
tekan uterus B
ru
ea
B
ilx
bibir pecah pecah dan pritamox 3xBB, lybrozym 3x1, lexcomet m
,2
m
vc
K121 STOMATITIS 0
lidah luka 2x1,bufacomb (oles mulut) o
ks0
(p
m
au
yle
panas tinggi terutama
A01.0 THYPOID malam hari *hari ke 5 cek ofloxacin 200mg 2x1, sanmol 3x1, actal 3x1, rylm
et
dananeuron 1x1 o
ges,
widal
cra
2
b
(x5
o
batuk, sesak, tonsil pritamox 500mg 3x1, sanmol 3x1, dextral 3x1, ce
J039 TONSILITIS sxm
B
tr
membesar lescomet 2x1 aea
B
1
Bruntus-bruntus a,tn
l
L50.0 URTICARIA Lescomet 2x1, winatin 3x1 t,)
m
kemerahan
o
p
l
timbul bintik dan gatal di ku
lw
o
3
B018 VARICELLA alri,x
badan
asvn
1
cita
H813 VERTIGO Pusing berputar Pritagesic 3x1, merislon 3x1, dananeuron 1x1 (att,
kld
iab
muntah muntah dan lin
u
R11 VOMITUS actal 3x1,lexapram 3x1,lybrozym 3x1 ,o
pusing b
n
)f
d
rla
e
yc
o
1
3
rzxo
b
yrm
1
m
am
,o
b
,az
yclc(
ro
m
io
/rf)l
kae
e
3
trs
tax
o
c1
dm
kiru
o
n
el
,n
au
aam
tz
c,)
o
t
alc
lo
c)r
ro
3
v
xi
1
t

1
x
1
 TERAPI
ANAK **

Pritamox syr 3xBB, sanmol syr 3xBB KETERANGAN

Acifar : kalsium
Provamed 200mg 3xBB, pulv (sanmol,GG,ambroxol,dextamin,salbutamol) Actal : ranitidin
3x1 Alletrol : dexa + polymicinB
Amaril : glimepirid
Provamed 200mg 3xBB, pulv (sanmol,GG,ambroxol,pritacort,salbutamol) Asamex : as tranexamat
3x1 Beneazid Fr : isoniazid 400 mg
Bevalex Cr : beta + neomisin
Pritamox syr 3xBB, sanmol syr 3xBB Buscopan : anti spasmodik
Calcifar : kalsium
Corovit : multivitamin
Dananeuron : neuroprotector
Dextral : DMP
Dextamin : loratadin + CTM
Dianicol : thiampenicol
Famos : famotidin
Grotavit : vitamin nafsu makan
Infantrim Forte : kotrimoksazole
pritamox syr 3xBB, pulv(sanmol,GG,ambroxol,pritacort) 3x1 Kaditic : Kalium diklofenak
Kompolak : laxadin
Lexapram : metokloperamid HC
pritamox syr 3xBB, pulv (winatin,lexcomet) 3x1,alletrol tetes mata 2x2 gt Lexcomet : metilprednisolon
Merislon : betahistin
pritamox syr 3xBB, pulv (winatin,lexcomet) 3x1,alletrol tetes mata 3x3 gt Molagit : atapulgit
Molasic : as mefenamat
Nepromex : orthosipon fol
Pulv (loratadin,lexcomet) 3x1, bevalex cream kalo berat kasi kloderma Pritacort : loratadin + CTM
cr/ketokonazol cr Pritagesic : metampiron
Pritamox: amoxicilin
Provamed : spiramicin
Reyco : kloramfenikol
Sendicol : thiampenicol
Vitazym : enzym
Veromex : Fe
Voltadex : Na-diklofenak
infatrim syr 2xBB, pulv (librozym,loratadin,actal) 3x1 Winatin : loratadin

infatrim syr 2xBB, pulv (molagit,loratadin,actal) 3x1

acyclovir 100 mg 4xBB ,pulv(loratadin,calcifar) 3x1, acifar cream,grotavit

1x1
BULAN I-II: (rifampicin BBx10mg ,beneazid forte BBx15mg, pirazinamid
BBx10mg) 1x1, dananeuron 1x1

BULAN III-VI: (rifampicin BBx10mg ,beneazid forte BBx15mg,) 1x1,

dananeuron 1x1, foto thorax

FOTO THORAX (+) lanjut IX: (rifampicin BBx10mg ,beneazid forte

BBx15mg,) 1x1, dananeuron 1x1, foto thorax

FOTO THORAX (+) lanjut XII: (rifampicin BBx10mg ,beneazid forte

BBx15mg,) 1x1, dananeuron 1x1, STOP

sendicol 3x1, pulv (lescomet,sanmol,winatin) 3x1

pritamox 3xBB,pulv (sanmol,librozym,winatin,lescomet) 3x1, grootavit 1x1

Cefixim 2xBB, pulv (sanmol,GG,ambroxol,pritacort) 3x1

pritamox 3xBB, pulv (sanmol,GG,ambroxol,lescomet) 3x1

pritamox 125 mg syr 3x2, puyer(loratadin,lexcomet,calcifar), bevalex
cream

infatrim 2xBB / dianicol 3xBB, pulv (lybrozym, lexcomet, actal)

3x1,bufacomb (oles mulut)

dianicol 3xBB, pulv (sanmol,actal,pritacort) 3x1

pritamox syr 3xBB, pulv(sanmol,GG,ambroxol,lescomet) 3x1

pulv (lescomet,winatin) 3x1

acyclovir 100 mg 4x1,puyer(loratadin,calcifar) 3x1, acifar cream

GAN **DOSIS ANAK
kalsium
ranitidin ANTIBIOTIK (Kg)
dexa + polymicinB 1 = ¼ 11 = 1
glimepirid
as tranexamat 2 =¼ 12 = 1 ¼
Fr : isoniazid 400 mg 3 =½ 13 = 1 ¼
r : beta + neomisin
: anti spasmodik 4 =½ 14 = 1 ½
kalsium
multivitamin 5 =½ 15 = 1 ½
on : neuroprotector 6 =½ 16 = 1 ½
DMP
: loratadin + CTM 7 =¾ 17 = 1 ¾
thiampenicol 8 =¾ 18 = 1 ¾
famotidin 9 =1 19 = 2
vitamin nafsu makan 10= 1 20 = 2
Forte : kotrimoksazole
Kalium diklofenak
: laxadin
: metokloperamid HCl
: metilprednisolon
betahistin
atapulgit
as mefenamat
x : orthosipon fol
loratadin + CTM
: metampiron
amoxicilin
: spiramicin ** DOSIS ANAK
kloramfenikol
thiampenicol PULV (Kg)
enzym 1 = ½ 11 = 2 ¼ >20 = 4 ½
Fe
Na-diklofenak 2 =½ 12 = 2 ¼
loratadin 3 =½ 13 = 2 ¼
4 =1 14 = 3
5 =1 15 = 3
6 =1 16 = 3
7 = 1 ¾ 17 = 3 ½
8 = 1 ¾ 18 = 3 ½
9 =2 19 = 4
10= 2 20 = 4