INACBGS

NO ICD 10 DIAGNOSA
KELAS 3
1 O82.9/O82.1 SC/SC CITO 4.975.200
4 O82.9/66.39 SC + TINDAKAN STERIL 4.975.200
3 O06.9/69.02 Dilation and curettage following delivery or abortion 1,706,800
Dilation and curettage for termination of pregnancy 1,633,000
5 68.3 Other and unspecified total abdominal hysterectomy 6.321.000
6 N83.2/65.29 KISTA OVARIUM + CYSTECTOMY 6.321.000
7 O21.1 2.883.800

PROSEDUR
1 90.59 LAB DL
2 99.21 INJ AB
3 99.29 INFUS & INJ. TERAPI
4 93.94 NEBULIZER
5 93.96 O2
6 89.52 EKG
7 88.78 USG KEHAMILAN
8 73.59 PERSALINAN NORMAL
9 99.17 INJECTION INSULIN
10 87.44 FOTO THORAX
11 88.76 USG ABDOMEN
12 88.73 USG BREAST

INACBGS
NO ICD 10 DIAGNOSA
KELAS 3
1 A91 DHF/DSS/VIRAL INFECTION Rp1,554,400
2 K30 DYSPEPSIA Rp1,279,900
3 A01.0 TYPHOID FEVER Rp2,155,300
4 A09/R10.4 GEA/GE/ENTERITIS/COLIC ABD. Rp1,448,400
5 A49.9 BACTERIAL INFECTION Rp2,155,300
6 N39.0 ISK' Rp2,220,000
7 K29.7/K29.1 GASTRITIS / GASTERITIS AKUT Rp2,203,700
8 E11.9/E14.9 NIDDM/DM Rp3,430,500
9 II0 HYPERTENSION Rp2,535,900
10 I50.0 CHF Rp2,652,900

INACBGS
NO ICD 10 DIAGNOSA
KELAS 3
1 J06.9 / J06.8 ISPA / TONSFAR / FARINGITIS Rp1,881,100
 2 B34.9 / A90 VIRAL INFECTION / D.DENGUE Rp1,554,400
3 R56.0 KEJANG DEMAM Rp2,601,100
4 A49.9 BACTERIAL INFECTION Rp2,155,300
5 R50.9 FEBRIS / FEVER / HIPERPIREKSIA Rp2,584,900
6 E86 DEHIDRASI Rp2,260,000
7 D69.6 TROMBOSITOPENIA Rp3,092,200
8 P59.9 HIPERBILIRUBIN Rp3,215,700
9 P03.4 / P03.3 NCBSMK SC/NCBSMK VE Rp3,426,200
10 R11 VOMITUS Rp1,448,400
11 J18.0 BRONKOPNEUMONIA Rp3,432,600

INACBGS
NO ICD 10 DIAGNOSA
KELAS 3
1 K37/47.01/47.09 APPENDICITIS + APENDICTOMY Rp2,874,500
2 D24/85.21 FAM + EKSISI FAM Rp4,998,900
3 K40.9/53.05 HIL + HERNIOTOMY Rp4,664,800
4 D48.1/83.39 SOFT TISSUE TUMOR + EKSISI STT Rp3,955,600
5 D48.1/86.3 SOFT TISSUE TUMOR + EKSISI STT Rp3,807,800
6 I84.9/49.46 HAEMOROID + HAEMOROIDECTOMY Rp4,554,100
7
8
9
10
11
GS
KELAS 2 KELAS 1
5.970.200 6.965.200
5.970.200 6.965.200
2.048.200 2.389.600
1,959,600 2,286,200
7.585.200 8.849.400
7.585.200 8.849.400
2.471.800 2.059.800

GS
KELAS 2 KELAS 1
Rp1,865,300 Rp2,176,200
Rp1,535,900 Rp1,791,800
Rp2,586,400 Rp3,017,400
Rp1,738,100 Rp2,027,800
Rp2,586,400 Rp3,017,400
Rp2,664,000 Rp3,108,100
Rp2,644,400 Rp3,085,200
Rp4,116,600 Rp4,802,700
Rp2,173,600 Rp2,535,900
Rp3,183,500 Rp3,714,100

GS
KELAS 2 KELAS 1
Rp2,257,400 Rp2,633,600
 Rp1,865,300 Rp2,176,200
Rp3,121,300 Rp3,641,500
Rp2,586,400 Rp3,017,400
Rp3,101,800 Rp3,618,800
Rp2,712,100 Rp3,164,100
Rp3,710,600 Rp4,329,100
Rp3,858,900 Rp4,502,000
Rp4,111,400 Rp4,796,700
Rp1,738,100 Rp2,027,800
Rp4,119,100 Rp4,805,600

GS
KELAS 2 KELAS 1
Rp3,449,400 Rp4,024,300
Rp5,998,700 Rp6,998,500
Rp5,597,700 Rp6,530,700
Rp4,746,700 Rp5,537,800
Rp4,569,400 Rp5,331,000
Rp5,465,000 Rp6,375,800