PEMERINTAH KOTA BANDUNG

DINAS KESEHATAN
PUSKESMAS UPT PASIR KALIKI
Jl. Pasir Kalilki No. 188, Kec. Cicendo

LAPORAN RUJUKAN PASIEN

Periode Laporan: Oktober 2018

Kode Puskesmas: P3273190201 Kelurahan : PASIRKALIKI

Puskesmas : UPT PASIR KALIKI Kecamatan : CICENDO

Jaminan/Cara Bayar
No. Kode Nama Diagnosa
PBI NON PBI Umum Gratis Sktm

1 H52.7 Disorder of refraction, unspecified 11 28 1 0 0

2 H25.9 Senile cataract, unspecified 8 20 0 0 0

3 I64 Stroke, not specified as haemorrhage or infarction 7 20 0 0 0

4 I50.0 Congestive heart failure 6 12 0 0 0

5 H52.1 Myopia 5 9 0 0 0

6 J44.9 Chronic obstructive pulmonary disease, unspecified 5 6 0 0 0

7 N18.0 End-stage renal disease 5 6 0 0 0

8 I11.9 Hypertensive heart disease without (congestive) heart failure 4 15 0 0 0

9 N40 Hyperplasia of prostate 4 11 0 0 0

10 H52.4 Presbyopia 4 5 0 0 0

11 K08.3 Retained dental root 3 5 0 0 0

12 R50.9 Fever, unspecified 3 4 0 0 0

13 K30 Dyspepsia 3 3 0 0 0

14 I25.0 Atherosclerotic cardiovascular disease, so described 2 19 0 0 0

15 I11.0 Hypertensive heart disease with (congestive) heart failure 2 15 0 0 0

16 M13.0 Polyarthritis, unspecified 2 10 0 0 0

17 J45.8 Mixed asthma 2 7 0 0 0

18 L98.9 Disorder of skin and subcutaneous tissue, unspecified 2 7 0 0 0

19 M54.5 Low back pain 2 7 0 0 0

20 E05.9 Thyrotoxicosis, unspecified 2 6 0 0 0

21 E14.9 Unspecified diabetes mellitus without complications 1 31 1 0 0

22 I15.9 Secondary hypertension, unspecified 1 11 0 0 0

23 M54.1 Radiculopathy 1 11 0 0 0

24 K04.1 Necrosis of pulp 1 7 0 0 0

25 R07.4 Chest pain, unspecified 1 4 0 0 0

26 K08.1 Loss of teeth due to accident, extraction or local periodontal disease 0 16 0 0 0

27 I25.1 Atherosclerotic heart disease 0 11 0 0 0

28 E10.9 Insulin-dependent diabetes mellitus without complications 0 9 0 0 0

29 K01.1 Impacted teeth 0 7 0 0 0

30 H40.9 Glaucoma, unspecified 0 5 0 0 0