KLAIM COVID dr.

LIA

PENJAMIN : KEMENKES

Tanggal Hasil Swab Pemeriksaan Fisik Tindakan

6 November Positif (CT 22,93) TD 160/100 DR

N 40 Diff count
R 28 OT/PT
S 38,4 UR/CR
Saturasi 89 AGD
Thorax foto
GDS
EKG

7 November TD 150/100 GDP

N 55 GD2JPP
R 28 Profil lipid
S 37,7
Saturasi 89

8 November TD 150/90 AGD

N 55 EKG
R 28
S 38,1
Saturasi 89
9 November TD 160/100 AGD
N 58 GDP
R 28 GD2JPP
S 37,8 Swab
Saturasi 89

10 November TD 150/100 AGD

N 58 EKG
R 28
S 37,4
Saturasi 89

11 November TD 160/100 AGD

N 55 EKG
R 26
S 37,5
Saturasi 89
12 November Positif TD 160/100 AGD
RdRp 15,65 N 40 GDP
N gene 15,74 R 28 GD2JPP
S 38,4
Saturasi 85
 Terapi

Infus RL 1500/24jam
O2 5 lt NC
Azitromicin 1x500
Oseltamivir 2x75mg
Cavit D 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
OMZ 1x40mg
Sucralfat 3x1 C
Sanmol Forte 3x1
Tensinop 1x10mg
Novorapid 3-3-3
Lantus 0-0-10
Atorvastatin 1x20mg

Infus RL 1500/24jam
O2 10 lt NRM
Azitromicin 1x500
Oseltamivir 2x75mg
Cavit D 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
OMZ 1x40mg
Sucralfat 3x1 C
Sanmol Forte 3x1
Tensinop 1x10mg
Novorapid 3-3-3
Atorvastatin 1x20mg
Lantus 0-0-10
Dexametason 1x5mg iv

Infus RL 1500/24jam
O2 10 lt NRM
Azitromicin 1x500
Oseltamivir 2x75mg
Cavit D 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
OMZ 1x40mg
Sucralfat 3x1 C
Sanmol Forte 3x1
Tensinop 1x10mg
Novorapid 3-3-3
Atorvastatin 1x20mg
Lantus 0-0-10
Dexametason 1x5mg iv

Infus RL 1500/24jam
O2 10 lt NRM
Azitromicin 1x500
Oseltamivir 2x75mg
Cavit D 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
OMZ 1x40mg
Sucralfat 3x1 C
Sanmol Forte 3x1
Tensinop 1x10mg
Novorapid 6-6-6
Atorvastatin 1x20mg
Lantus 0-0-10
Dexametason 1x5mg iv

Infus RL 1500/24jam
O2 10 lt NRM
Azitromicin 1x500
Oseltamivir 2x75mg
Cavit D 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
OMZ 1x40mg
Sucralfat 3x1 C
Sanmol Forte 3x1
Tensinop 1x10mg
Lantus 0-0-10
Novorapid 6-6-6
Atorvastatin 1x20mg
Dexametason 1x5mg iv

Infus RL 1500/24jam
O2 10 lt NRM
Azitromicin 1x500
Oseltamivir 2x75mg
Cavit D 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
OMZ 1x40mg
Sucralfat 3x1 C
Sanmol Forte 3x1
Tensinop 1x10mg
Novorapid 6-6-6
Lantus 0-0-10
Atorvastatin 1x20mg
Dexametason 1x5mg iv
Meropenem 3x1 gr /iv

Infus RL 1500/24jam
O2 10 lt NRM
Azitromicin 1x500
Oseltamivir 2x75mg
Cavit D 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
OMZ 1x40mg
Sucralfat 3x1 C
Sanmol Forte 3x1
Tensinop 1x10mg
Novorapid 6-6-6
Lantus 0-0-10
Atorvastatin 1x20mg
Dexametason 1x5mg iv
Meropenem 3x1 gr /iv
Pindah ruangan ICU COVID
KLAIM COVID Nugraha

PENJAMIN : ASURANSI PRUDENTIAL

18 November Positif TD 120/80 AGD Infus RL 1500/24jam

N 80 Darah rutin O2 6lt/menit simple mask
R 23 Esola 1x40mg/iv
S 38,4 Avigan 2x600 mg/po
Saturasi 92 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Episan 3x1 C
Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv

19 November TD 110/70 AGD Infus RL 1500/24jam

N 80 Thorax foto O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 95 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv

20 November TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 95 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv
21 November Negatif TD 110/70 Infus RL 1500/24jam
N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 93 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv

22 November TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 93 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv

23 November NEGATIF TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 93 Cavit D3 1x1000
 NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv

24 November TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 93 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv
Lovenox 1x4000 IU
Dexametason 1x5mg po

25 November TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 93 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
 Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv
Lovenox 1x4000 IU
Dexametason 1x5mg po

26 November TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 93 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Zibramax 1x500mg
Sanmol 3x500 po
Baquinor-inf 2x400mg/iv
Lovenox 1x4000 IU
Dexametason 1x5mg po

27 November TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 93 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
Lovenox 1x4000 IU
Dexametason 1x5mg po
28 November TD 110/70 Infus RL 1500/24jam
N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 93 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
Lovenox 1x4000 IU
Dexametason 1x5mg po

29 November TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 94 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
Lovenox 1x4000 IU
Dexametason 1x5mg po

30 November TD 110/70 Infus RL 1500/24jam

N 80 O2 6lt/menit simple mask
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 96 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
 Lovenox 1x4000 IU
Dexametason 1x5mg po

1-Dec TD 110/70 Infus RL 1500/24jam

N 80 O2 3lt nc
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 95 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
Lovenox 1x4000 IU

2-Dec TD 110/70 Infus RL 1500/24jam

N 80 O2 3lt nc
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 95 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
Lovenox 1x4000 IU

3-Dec TD 110/70 Infus RL 1500/24jam

N 80 O2 3lt nc
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 95 Cavit D3 1x1000
 NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
Lovenox 1x4000 IU

4-Dec TD 110/70 Infus RL 1500/24jam

N 80 O2 3lt nc
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 97 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
Lovenox 1x4000 IU

5-Dec TD 110/70 Infus RL 1500/24jam

N 80 O2 3lt nc
R 20 Esola 1x40mg/iv
S 36,5 Avigan 2x600 mg/po
Saturasi 98 Cavit D3 1x1000
NAC 3x500
Sarcorbin 3x400mg/iv
Esola 1x40mg
Episan 3x1 C
Sanmol 3x500 po
Lovenox 1x4000 IU

Obat pulang :
Cavit D 1x1000
Zegavit 2x1