Ceklist Kelengkapan Rekam Medsi Lansia 2023

CEKLIST KELENGKAPAN PENGISIAN REKAM MEDIS POLI LANSIA
Puskesmas : KARANGBINANGUN
Tanggal : : 01-01-2023 s/d 31-01-2023
INDIKATOR KELENGKAPAN PENGISIAN
No Tanggal No Reg Jenis Pasien No BPJS NIK Nama Pasien L/P Alamat Usia Diagnosa Pemeriks Anamnes
aan Fisik a
1 02-01-2023 0001101 BPJS 0000103499482 SUKAERI,DRS L SAMBO 002/002

60 Thn 7 Bln Acute hepatitis B with delta-agent (coinfection) without hepatic coma √ √
2 02-01-2023 0006781 BPJS 0000758434994 3524244101590028 RUQOYAH P BR. WUNGU
Hypertensive heart disease without (congestive) heart failure; Myalgia;
64 Thn 0 Bln Non-insulin-dependent diabetes mellitus without complications √ √
3 02-01-2023 0034365 BPJS 0002866148908 3524244101580011 ARTI P BAKALAN 65 Thn 0 Bln Other specified cataract √ √
4 02-01-2023 0007480 BPJS 0000103767208 3524241505440001 MACHFUD L PUPUS 001/006 78 Thn 7 Bln Dementia in Alzheimer's disease, unspecified √ √
5 02-01-2023 0013472 BPJS 0003134739442 3524244101610069 SUPARMI P MAYONG TENGAH 004/003 62 Thn 0 Bln Senile cataract, unspecified √ √
6 02-01-2023 0002597 BPJS 0000758463129 3524246106570001 MUAYAH P SAMBO 001/002 65 Thn 5 Bln Myalgia √ √
7 02-01-2023 0037890 BPJS 0000763918569 3525015706620001 RIATI P PETISSARI 003/002 60 Thn 6 Bln Diarrhoea and gastroenteritis of presumed infectious origin √ √
8 02-01-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004 68 Thn 6 Bln Cough; Myalgia √ √
9 02-01-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 68 Thn 4 Bln Myalgia √ √
10 02-01-2023 0023446 BPJS 0000103590437 3524241508560001 BUDI UTOMO L KURO 003/001 66 Thn 4 Bln Hypertensive heart disease without (congestive) heart failure √ √
11 02-01-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 70 Thn 0 Bln Myalgia √ √
12 02-01-2023 0011396 BPJS 0002771159376 3524243001570001 KASTO L BANJARANYAR 003/002 65 Thn 11 Bln Typhoid fever √ √
13 02-01-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004 63 Thn 4 Bln Myalgia √ √
14 02-01-2023 0012642 BPJS 0001961118516 3524244105570006 MASRIAH P WEDENG 002/003
65 Thn 8 Bln Lumbar and other intervertebral disc disorders with radiculopathy √ √
15 02-01-2023 0031937 BPJS 0002597958235 3524241001540001 SYAEAN L WARUK 002/001 Myalgia; Non-insulin-dependent diabetes mellitus without
68 Thn 11 Bln complications √ √
16 02-01-2023 0013036 BPJS 0001961115423 3524240510530003 MOH. THOHA L WEDENG 002/003 69 Thn 2 Bln Myalgia √ √
17 02-01-2023 0018521 BPJS 0000758671885 3524246101410001 SRIPAH P KETAPANG 001/002 Dementia in Alzheimer's disease, unspecified; Moderate depressive
81 Thn 11 Bln episode √ √
18 02-01-2023 0033879 BPJS 0002455205545 3524240508540001 SARI L PUTATREJO 001/003
Cerebral infarction due to thrombosis of precerebral arteries;
Localization-related (focal) (partial) symptomatic epilepsy and epileptic
68 Thn 4 Bln syndromes with complex partial seizures √ √
19 02-01-2023 0036410 BPJS 0002845119442 3524245101400010 SUMINTEN P NGAJARAN 04/04 82 Thn 11 Bln Congestive heart failure √ √
20 02-01-2023 0013983 BPJS 0001047282513 3524242101600002 SUTARNO L BAKALAN 62 Thn 11 Bln Pterygium √ √
21 03-01-2023 0008117 BPJS 0000103695412 3524246209600002 MACHRUSAH P SAMBO 002/004 Hypertensive heart disease without (congestive) heart failure;
62 Thn 3 Bln Rheumatoid arthritis, unspecified √ √
22 03-01-2023 0037264 BPJS 0002773002475 3524244101620027 MARIYAH P PUPUK 001/003 61 Thn 0 Bln Primary open-angle glaucoma; Senile cataract, morgagnian type √ √
23 03-01-2023 0010489 BPJS 0002162609829 3524244101560016 SAMSUNI P BAKALAN 002/002 67 Thn 0 Bln Gastritis, unspecified √ √
24 03-01-2023 0003965 BPJS 0002889710188 3524244101630048 HJ. MUNTIYAH P BLAWI SELATAN 002/004 60 Thn 0 Bln Conjunctivitis, unspecified √ √
25 03-01-2023 0024099 BPJS 0000759057017 3524240101630015 SEKAR L BAKALAN 001/001 60 Thn 0 Bln Old myocardial infarction √ √
26 04-01-2023 0036174 BPJS 0000103766635 3524244811520001 RUFIÀH P NGAJARAN 001/003
70 Thn 1 Bln Cough; Hypertensive heart disease without (congestive) heart failure √ √
27 04-01-2023 0021140 BPJS 0000758431923 3524244101580058 YATNAH P BLAWI 001/004
65 Thn 0 Bln Cough; Hypertensive heart disease without (congestive) heart failure √ √
28 04-01-2023 0037927 BPJS 0000758954226 3524245101540002 NEMU P PUPUK 002/003 Hypertensive heart disease without (congestive) heart failure; Spinal
68 Thn 11 Bln stenosis, lumbar region √ √
29 04-01-2023 0002817 BPJS 0000759941368 SENATRI P PRIYOSO WETAN 60 Thn 6 Bln Senile cataract, unspecified √ √
30 04-01-2023 0005294 BPJS 0000758801766 MUSLIKIN L PULOKERTO 001/001 62 Thn 5 Bln Benign neoplasm of bronchus and lung √ √
31 04-01-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 Allergic rhinitis, unspecified; Hypertensive heart disease without
64 Thn 2 Bln (congestive) heart failure; Myalgia √ √
32 04-01-2023 0008730 BPJS 0000758680964 3524247006580007 SITI MUJENAH P WINDU 64 Thn 6 Bln Allergic contact dermatitis due to adhesives √ √
33 05-01-2023 0017187 BPJS 0000751120435 ACHYAR L DSN.PELUK
69 Thn 0 Bln Hypertensive heart disease without (congestive) heart failure; Myalgia √ √
34 05-01-2023 0036452 BPJS 0000759709427 3524245001400001 TENI P WATANGAN 001/002 82 Thn 11 Bln Scoliosis, unspecified, sacral and sacrococcygeal region √ √
35 05-01-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002 Acute nasopharyngitis [common cold]; Non-insulin-dependent diabetes
66 Thn 0 Bln mellitus without complications √ √
36 05-01-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004
68 Thn 6 Bln Dyspepsia; Hypertensive heart disease without (congestive) heart failure √ √
37 05-01-2023 0025066 BPJS 0001388131806 3524245104380001 KARSANI P BLAWI UTARA 001/004 Acute upper respiratory infection, unspecified; Hypertensive heart
84 Thn 8 Bln disease without (congestive) heart failure √ √
38 05-01-2023 0020660 BPJS 0000103500382 SHOLIKIN L KETAPANG 001/002 73 Thn 4 Bln Congestive heart failure √ √
39 05-01-2023 0009146 UMUM NAHNU L PENCARAN Hypertensive heart disease without (congestive) heart failure; Myalgia;
65 Thn 9 Bln Tinea corporis √ √
40 05-01-2023 0016038 BPJS 0000759820511 3524245503610001 SURIATI P KURIPAN 001/008 Candidal stomatitis; Diarrhoea and gastroenteritis of presumed
61 Thn 9 Bln infectious origin √ √
41 05-01-2023 0037936 UMUM 3524241101540003 SOKRAN L SUKLEN 001/004
42 06-01-2023 0010385 BPJS 0000758404012 ACHROM L KARANGBINANGUN 001/001 Diarrhoea and gastroenteritis of presumed infectious origin; Necrosis of
70 Thn 0 Bln pulp √ √
43 06-01-2023 0021140 BPJS 0000758431923 3524244101580058 YATNAH P BLAWI 001/004 65 Thn 0 Bln Myalgia √ √
44 06-01-2023 0021977 BPJS 0000758731678 3524244102610004 KASTONAH P SUMBERJO 61 Thn 11 Bln Benign neoplasm of breast √ √
45 06-01-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 61 Thn 9 Bln Myalgia √ √
46 06-01-2023 0016427 BPJS 0000758913074 3524244101550008 MUNAMAH P KLECO 001/003 68 Thn 0 Bln General counselling and advice on contraception √ √
47 06-01-2023 0010777 BPJS 0001047277181 3524240407550001 WIYADI L WINDU 001/002 Allergic rhinitis, unspecified; Hypertensive heart disease without
67 Thn 6 Bln (congestive) heart failure √ √
48 06-01-2023 0019964 BPJS 0002066070363 MATOKAN L PULOKERTO 002/001 69 Thn 3 Bln Chronic renal failure, unspecified √ √
49 09-01-2023 0006776 BPJS 0000758316262 3524240101470002 SUEP KARTOWIYONO L MAGOK 001/002
76 Thn 0 Bln Insulin-dependent diabetes mellitus with multiple complications √ √
50 09-01-2023 0034936 BPJS 0002876182492 3524244201570013 DAIYAH P PUPUS 002/006
51 09-01-2023 0034935 BPJS 0002876182468 3524240101510050 ABD. KARIM L PUPUS 002/006 72 Thn 0 Bln Myalgia √ √
52 09-01-2023 0033839 BPJS 0000759370263 3524244210570001 HARMINI P WATES 001/002 Pleural effusion, not elsewhere classified; Primary respiratory
65 Thn 3 Bln tuberculosis, confirmed bacteriologically and histologically √ √
53 09-01-2023 0019172 BPJS 0001543283706 3524245203620001 SITI MUKHAYAH P BR. BOTOH 006/002 60 Thn 9 Bln Intraductal carcinoma in situ √ √
54 09-01-2023 0033622 BPJS 0001047273232 3524245909610001 MARHAMAH P PENCARAN 001/005 61 Thn 3 Bln Myalgia √ √
55 09-01-2023 0028642 BPJS 0001047281455 SAKUR L BONRINGIN 001/004 61 Thn 0 Bln Hypertensive heart disease with (congestive) heart failure √ √
56 09-01-2023 0014483 BPJS 0000758611563 3524246905590001 MAHMUDAH P GAYAM 006/003
Hypertensive heart disease without (congestive) heart failure; Non-
63 Thn 7 Bln insulin-dependent diabetes mellitus without complications √ √
57 09-01-2023 0030170 BPJS 0002238323207 SAMSURI L WARUK 003/001
66 Thn 8 Bln Calculus of lower urinary tract, unspecified; Unspecified renal colic √ √
58 09-01-2023 0029991 BPJS 0002741412025 3524244101610040 SUMIATUN P KETAPANG 001/001 62 Thn 0 Bln Senile cataract, unspecified √ √
59 09-01-2023 0010772 BPJS 0002926601109 3524244101560015 WIDARTI P BAKALAN 002/002
60 09-01-2023 0013095 BPJS 0003055242069 3524245208480001 SUMILAH P KEBONSARI 001/004 74 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √ √
61 09-01-2023 0031226 BPJS 0000758437457 NUR MUSTHOFA L PENCARAN BLAWI 75 Thn 8 Bln Bilateral inguinal hernia, with obstruction, without gangrene √ √
62 09-01-2023 0011437 BPJS 0000758488656 SULAIKAH P BR. PELUK
63 10-01-2023 0002670 BPJS 0000103498457 3524242504540001 DJUWONO L ALANG-ALANG 002/005 68 Thn 8 Bln Chronic renal failure, unspecified √ √
64 10-01-2023 0017442 BPJS 0001897451829 3524243006550005 MISLAN L NGIPIK 003/003 67 Thn 6 Bln Stroke, not specified as haemorrhage or infarction √ √
65 10-01-2023 0035729 BPJS 0002463188332 3524245503540001 MUNIROH P MAYONG 68 Thn 9 Bln Scoliosis, unspecified, lumbar region √ √
66 10-01-2023 0035969 BPJS 0000758682382 3524241212500003 SAMAN L MAYONG TENGAH 003/003 72 Thn 0 Bln Acute ischaemic heart disease, unspecified √ √
67 10-01-2023 0006545 UMUM 3524242305570001 ABD CHOLIQ L KARANGAJI 003/003 65 Thn 7 Bln Myalgia √ √
68 10-01-2023 0021289 BPJS 0000758798932 35242444303500002 SALEKAH P BLAWI
72 Thn 10 Bln Thromboangiitis obliterans [Buerger] √ √
69 10-01-2023 0029247 BPJS 0002443853272 3524240301590002 ABD MANAF L PUPUS 003/006 64 Thn 0 Bln Myalgia √ √
70 10-01-2023 0026047 BPJS 0002465806274 3524244101560071 RAMSEH P BANJARANYAR 001/002 67 Thn 0 Bln Dermatitis, unspecified √ √
71 10-01-2023 0022650 BPJS 0000751138402 3524241909600001 SUWIRTO L B. KADU Cutaneous abscess, furuncle and carbuncle of trunk; Hypertensive heart
72 10-01-2023 0034629 BPJS 0002733842261 3524240110590002 SUKAIRI L PUPUS 002/006 Hypertensive heart disease without (congestive) heart failure;
63 Thn 3 Bln Postzoster neuralgia √ √
73 10-01-2023 0016306 BPJS 0000759505061 3524240101520023 KANAFI L MEDIYENG 002/004 71 Thn 0 Bln Parkinson's disease √ √
74 10-01-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003
75 10-01-2023 0011752 BPJS 0000759262959 3524245706600002 ANIFAH P BLAWI 002/002 62 Thn 6 Bln Dyspepsia; Myalgia √ √
76 11-01-2023 0006103 BPJS 0000760080576 3524244301630001 ASIKAH P SUMBERJO 60 Thn 0 Bln Follow-up examination after surgery for other conditions √ √
77 11-01-2023 0000977 BPJS 0000759802779 3524247009520001 RUMINTEN P SAMBO
78 11-01-2023 0001693 BPJS 0002066720894 3524242001570002 UMAR L KR ANOM WETAN 008/004 65 Thn 11 Bln Atherosclerotic heart disease √ √
79 11-01-2023 0000374 BPJS 0000758757633 3524247112590001 SUMIATUN P SAMBO 003/002
80 11-01-2023 0028191 BPJS 0000758625625 3524244807540001 KAROMAH P BATURONO 002/002 68 Thn 6 Bln Myalgia √ √
81 12-01-2023 0009589 BPJS 0000758430617 TN. SOKRAN L SUKLEN
82 12-01-2023 0012469 BPJS 0000757393615 3524245101550005 KARMINTEN P MENGAI 001/006 68 Thn 0 Bln Acute nasopharyngitis [common cold] √ √
83 12-01-2023 0022064 BPJS 0001047279519 3524244101620084 ASTIAH P NGAJARAN 61 Thn 0 Bln Calculus in urethra; Other chronic cystitis √ √
84 12-01-2023 0000768 BPJS 0000758485089 3524244101610021 CHOLIFAH P BR. SIMAN 002/001 62 Thn 0 Bln Acute nasopharyngitis [common cold] √ √
85 12-01-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004
86 12-01-2023 0019972 BPJS 0001047284144 3524244911540001 MISTRI P PALANGAN 68 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √ √
87 12-01-2023 0011151 BPJS 0000758183242 3524244808570001 SUMAH P MAGOK 003/002
88 12-01-2023 0021572 BPJS 0002326949583 3524244101550075 SAEKAH P BLAWI 002/002 68 Thn 0 Bln Gastritis, unspecified √ √
89 13-01-2023 0020995 BPJS 0001543302235 MARDLIYAH P WARUK 63 Thn 2 Bln Acute laryngopharyngitis √ √
90 13-01-2023 0008595 BPJS 0000103767017 3303096810550001 MULYATI P KURO 001/001 67 Thn 6 Bln Osseous stenosis of neural canal, lumbar region √ √
91 13-01-2023 0014997 BPJS 0001433053271 3524242002590001 MOH. YAHYA L KARANGANOM KULON 006/003 63 Thn 10 Bln External haemorrhoids with other complications √ √
92 13-01-2023 0015303 BPJS 0000759643931 3524244701630001 MARIYAM P MONOLELO 001/002 60 Thn 0 Bln Acute nasopharyngitis [common cold] √ √
93 13-01-2023 0008215 BPJS 0000103501732 3524246404610001 INAMAH P SAMBO 001/002
94 13-01-2023 0024699 BPJS 0002162695173 3524241511530001 SARONI P SAMBO 001/003 69 Thn 1 Bln Superficial injury of ankle and foot, unspecified √ √
95 13-01-2023 0005144 BPJS 0001888188895 3524244101590044 SYAFAATUN P KAUMAN 001/002 64 Thn 0 Bln Burns involving 10-19% of body surface √ √
96 13-01-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003
97 13-01-2023 0022650 BPJS 0000751138402 3524241909600001 SUWIRTO L B. KADU Cutaneous abscess, furuncle and carbuncle of trunk; Hypertensive heart
98 13-01-2023 0027168 BPJS 0000103767006 3524242005480001 JAUMAN, S.AG. L KURO 001/001 74 Thn 7 Bln Hyperplasia of prostate √ √
99 16-01-2023 0020388 UMUM 3524244101570001 LAMIDJAH P PUTATREJO 002/003
100 16-01-2023 0037988 BPJS 0003176756403 3524240204630002 SUJOKO L PUPUK 001/003 Anxiety disorder, unspecified; Hypertensive heart disease without
101 16-01-2023 0037989 BPJS 0002162633218 3524244101540047 ALIYAH P NGAJARAN 004/004
69 Thn 0 Bln Follow-up examination after unspecified treatment for other conditions √ √
102 16-01-2023 0010772 BPJS 0002926601109 3524244101560015 WIDARTI P BAKALAN 002/002 67 Thn 0 Bln Myalgia √ √
103 16-01-2023 0019665 BPJS 0000758378957 3524244101600048 MAIMONAH P SUKLEN 001/004 63 Thn 0 Bln Myalgia; Tinea corporis √ √
104 16-01-2023 0022188 BPJS 0000758841546 3524240207550001 ABD MAJID L BADAN 002/002 69 Thn 11 Bln Candidal stomatitis; Dyspepsia √ √
105 16-01-2023 0034133 BPJS 0002439974531 3524244101580030 JAMIYAH P SIMAN 002/001
106 16-01-2023 0002429 BPJS 0000103766657 3524244101520042 SITI KHALIMAH P WEDENG 002/002 71 Thn 0 Bln Gastritis, unspecified √ √
107 16-01-2023 0011428 UMUM 3524245204620001 SUWARTIN P MAYONG WETAN 002/004 60 Thn 9 Bln Counselling, unspecified √ √
108 16-01-2023 0033600 BPJS 0002732237008 3578047112540048 KASARMU P BONRINGIN 001/004 68 Thn 0 Bln Senile cataract, unspecified √ √
109 16-01-2023 0035710 BPJS 0001704056769 3524243112450004 TARMO P SAMBO 002/002 76 Thn 0 Bln Bilateral inguinal hernia, without obstruction or gangrene √ √
110 16-01-2023 0029808 BPJS 0001861880499 3524240101480014 IDRIS L BAKALAN 001/002 75 Thn 0 Bln Primary gonarthrosis, bilateral √ √
111 16-01-2023 0010014 BPJS 0000757393547 3524241309500001 SARKUM L MENGAI 001/006 72 Thn 4 Bln Calculus in bladder √ √
112 16-01-2023 0024699 BPJS 0002162695173 3524241511530001 SARONI P SAMBO 001/003 69 Thn 2 Bln Superficial injury of ankle and foot, unspecified √ √
113 16-01-2023 0037986 BPJS 0001871476817 3524244201600012 ATUN P BLAWI TENGAH 003/003 63 Thn 0 Bln Hypertensive heart disease without (congestive) heart failure √ √
114 16-01-2023 0006781 BPJS 0000758434994 3524244101590028 RUQOYAH P BR. WUNGU
115 16-01-2023 0025453 BPJS 0002774533465 SUKATI P GUNDIK 001/004 Dyspepsia; Hypertensive heart disease without (congestive) heart
66 Thn 0 Bln failure; Myalgia √ √
116 16-01-2023 0026047 BPJS 0002465806274 3524244101560071 RAMSEH P BANJARANYAR 001/002 67 Thn 0 Bln Dermatitis, unspecified √ √
117 16-01-2023 0033239 BPJS 0000759104842 3524246101590005 FATIMAH P ALASMALANG 003/002
118 17-01-2023 0001361 BPJS 0000103767671 3524241503490001 NUR HADI L SAMBO 003/002 73 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √ √
119 17-01-2023 0025780 BPJS 0002305514351 3525163103610121 SULAIKAN L SUMBER /KEBOMAS 004/008 61 Thn 9 Bln Cerebral infarction due to thrombosis of cerebral arteries √ √
120 17-01-2023 0024744 BPJS 0000758587195 3524245707600001 SUTARTI P KURO 002/001
Fatty (change of) liver, not elsewhere classified; Non-insulin-dependent
62 Thn 6 Bln diabetes mellitus with multiple complications; Other cholelithiasis √ √
121 17-01-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 63 Thn 3 Bln Asthma, unspecified; Renovascular hypertension √ √
122 17-01-2023 0021587 BPJS 0000757162203 3524244101350067 KASMUNAH P BONSARI 88 Thn 0 Bln Congestive heart failure √ √
123 17-01-2023 0011282 UMUM 3524240101610006 MUDJI L WATANGAN 002/002 62 Thn 0 Bln Gastritis, unspecified √ √
124 17-01-2023 0005144 BPJS 0001888188895 3524244101590044 SYAFAATUN P KAUMAN 001/002 64 Thn 0 Bln Burns involving 10-19% of body surface √ √
125 17-01-2023 0024416 BPJS 0000758933291 3524243105540001 TAKRAM L BONRINGIN Abscess of liver; Non-insulin-dependent diabetes mellitus with multiple
126 17-01-2023 0015109 BPJS 0000758126709 NI`MAH P WARUK 002/002 Gastric ulcer, unspecified as acute or chronic, without haemorrhage or
60 Thn 10 Bln perforation √ √
127 18-01-2023 0025871 BPJS 0002322450404 SUKANAH P LUMBANGAN 003/001 65 Thn 0 Bln After-cataract √ √
128 18-01-2023 0036869 BPJS 0001535057739 3524241212610001 UMAR L LUWUK 006/001 61 Thn 1 Bln Sequelae of stroke, not specified as haemorrhage or infarction √ √
129 18-01-2023 0038063 BPJS 0002764871561 3524241507570002 LUKMAN L MAYONG KUOLON 001/001 65 Thn 6 Bln Calculus of lower urinary tract, unspecified √ √
130 18-01-2023 0038018 UMUM 3578061107910001 SUPRIYONO L KEPENG 61 Thn 6 Bln Gastritis, unspecified √ √
131 18-01-2023 0020463 BPJS 0002162694611 PU'AH P WINDU
132 18-01-2023 0000431 BPJS 0000103500213 3524240601550001 RUBADI L BAKALAN 002/003 68 Thn 0 Bln Hypertensive heart disease without (congestive) heart failure √ √
133 18-01-2023 0004221 BPJS 0000103501618 3524245712580001 TRINI ASTUTI P NGAJARAN 64 Thn 1 Bln Hypertensive heart disease without (congestive) heart failure √ √
134 18-01-2023 0015707 BPJS 0001265685873 3524240506600003 IMAM ROSYADI L MAYONG KULON 001/001 62 Thn 7 Bln Acute myocardial infarction, unspecified √ √
135 18-01-2023 0027775 BPJS 0001704044362 MUSRI'AH P BANDUT 002/001 Congestive heart failure; Hypertensive heart disease with (congestive)
68 Thn 5 Bln heart failure √ √
136 18-01-2023 0023446 BPJS 0000103590437 3524241508560001 BUDI UTOMO L KURO 003/001
Hypertensive heart disease without (congestive) heart failure;
Hyperuricaemia without signs of inflammatory arthritis and tophaceous
66 Thn 5 Bln disease √ √
137 19-01-2023 0012227 BPJS 0000757396462 3524244511580001 SALEKAH P WEDENG 001/003 64 Thn 2 Bln Essential (primary) hypertension; Myalgia √ √
138 19-01-2023 0027880 BPJS 0000759140796 3524244201550010 NINGSIH P BADAN 002/004 68 Thn 0 Bln Erythema nodosum √ √
139 19-01-2023 0036452 BPJS 0000759709427 3524245001400001 TENI P WATANGAN 001/002 83 Thn 0 Bln Essential (primary) hypertension √ √
140 19-01-2023 0038030 UMUM REBADI L KEBONSARI 002/004 84 Thn 9 Bln Xerosis cutis √ √
141 19-01-2023 0004221 BPJS 0000103501618 3524245712580001 TRINI ASTUTI P NGAJARAN 64 Thn 1 Bln Tinnitus √ √
142 19-01-2023 0037839 BPJS 0002216137869 3524247001530001 SUTI'AH P MONOLELO 002/002 69 Thn 11 Bln Essential (primary) hypertension √ √
143 19-01-2023 0008324 BPJS 0002874881035 3524240101610045 SAKIR L TERBIS 002/003
Chronic ischaemic heart disease, unspecified; Congestive heart failure;
62 Thn 0 Bln Non-insulin-dependent diabetes mellitus with multiple complications √ √
144 19-01-2023 0000550 BPJS 0000103768288 3524245809580002 HANNA ASTINAH P NGIPIK 64 Thn 4 Bln Myalgia, ankle and foot √ √
145 20-01-2023 0014820 BPJS 0001047269654 3524241101610004 SULKAN L LUNTAS S 003/001 62 Thn 0 Bln Acute haemorrhagic gastritis √ √
146 20-01-2023 0020995 BPJS 0001543302235 MARDLIYAH P WARUK 63 Thn 2 Bln Nodules of vocal cords √ √
147 20-01-2023 0006551 BPJS 0000758868309 MARKAN L KLECO 67 Thn 6 Bln Other miliary tuberculosis √ √
148 20-01-2023 0017197 BPJS 0000758420111 3524244101480050 FUTICHAH P MONOLELO 001/002 75 Thn 0 Bln Essential (primary) hypertension √ √
149 20-01-2023 0018002 BPJS 0002741458724 3524246611620001 SHOLUCHAH P ALANG-ALANG 002/005 Other benign neoplasm of connective and other soft tissue of head,
60 Thn 1 Bln face and neck √ √
150 20-01-2023 0031347 BPJS 0002734828593 3524244101590013 KARSITI P BAKALAN 64 Thn 0 Bln Stroke, not specified as haemorrhage or infarction √ √
151 20-01-2023 0010385 BPJS 0000758404012 ACHROM L KARANGBINANGUN 001/001 70 Thn 0 Bln Essential (primary) hypertension √ √
152 21-01-2023 0006583 BPJS 0000758869874 3524244101500028 DANIRAH P PUPUK 001/003 73 Thn 0 Bln Conjunctivitis, unspecified; Myalgia √ √
153 24-01-2023 0037986 BPJS 0001871476817 3524244201600012 ATUN P BLAWI TENGAH 003/003 Hypertensive heart disease without (congestive) heart failure;
63 Thn 0 Bln Pterygium √ √
154 24-01-2023 0016705 BPJS 0000758126643 3524242306570001 ABD. MANAN L WARUK 002/002 65 Thn 7 Bln Dermatitis, unspecified √ √
155 24-01-2023 0011624 BPJS 0000758869806 NASIKAH P MAGOK 73 Thn 10 Bln Rectal abscess √ √
156 24-01-2023 0015303 BPJS 0000759643931 3524244701630001 MARIYAM P MONOLELO 001/002 60 Thn 0 Bln Hypertensive heart disease without (congestive) heart failure √ √
157 24-01-2023 0017187 BPJS 0000751120435 ACHYAR L DSN.PELUK
158 24-01-2023 0036174 BPJS 0000103766635 3524244811520001 RUFIÀH P NGAJARAN 001/003 70 Thn 2 Bln Hypertensive heart disease without (congestive) heart failure √ √
160 24-01-2023 0002604 BPJS 0000759495172 SARSEH P NGIPIK 003/003 Hypertensive heart disease without (congestive) heart failure; Spinal
77 Thn 10 Bln stenosis, lumbar region √ √
161 24-01-2023 0011738 BPJS 0002488684645 3524244101540013 JANAH P PUPUK 002/003 69 Thn 0 Bln Spinal stenosis, lumbar region √ √
162 24-01-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 Asthma, unspecified; Hypertensive heart disease without (congestive)
163 24-01-2023 0000496 BPJS 0001047281253 3524247112480001 SITI FADILA P SAMBO 003/004
164 24-01-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 68 Thn 5 Bln Senile cataract, unspecified √ √
165 24-01-2023 0024214 BPJS 0000758973306 3524242007550001 NARIYO L MAGOK 001/002 67 Thn 6 Bln Hypertensive heart disease without (congestive) heart failure √ √
166 24-01-2023 0027880 BPJS 0000759140796 3524244201550010 NINGSIH P BADAN 002/004
68 Thn 0 Bln Congestive heart failure; Other and unspecified cirrhosis of liver √ √
167 24-01-2023 0038018 UMUM 3578061107910001 SUPRIYONO L KEPENG 61 Thn 6 Bln Acute upper respiratory infection, unspecified √ √
168 25-01-2023 0011117 BPJS 0002913182559 NAWAWI L WARUK 002/001 61 Thn 10 Bln Myalgia √ √
169 25-01-2023 0033446 BPJS 0001047286383 3524240201540003 KARMIN L MENGAI 002/006 69 Thn 0 Bln Ganglion √ √
170 25-01-2023 0014483 BPJS 0000758611563 3524246905590001 MAHMUDAH P GAYAM 006/003 Myalgia; Non-insulin-dependent diabetes mellitus with ketoacidosis;
63 Thn 7 Bln Renovascular hypertension √ √
171 25-01-2023 0038063 BPJS 0002764871561 3524241507570002 LUKMAN L MAYONG KUOLON 001/001 65 Thn 6 Bln Calculus in bladder √ √
172 25-01-2023 0025800 BPJS 0001704054971 3524240903610001 ASERI L MAGOK 001/001 61 Thn 10 Bln Congestive heart failure √ √
173 25-01-2023 0027888 BPJS 0002896469177 TIÀH P TEMBOK 002/003 Other benign neoplasm of connective and other soft tissue of head,
60 Thn 0 Bln face and neck √ √
174 25-01-2023 0035616 BPJS 0003101665138 3524244101630035 INDAHYATI P KAUMAN 001/002 Ingrowing nail; Non-insulin-dependent diabetes mellitus with
60 Thn 0 Bln ketoacidosis √ √
175 26-01-2023 0030789 BPJS 0003099436209 3524240101600035 KUSNAN L KETAPANG 002/001
Acute nasopharyngitis [common cold]; Hypertensive heart disease
without (congestive) heart failure; Non-insulin-dependent diabetes
176 26-01-2023 0006545 UMUM 3524242305570001 ABD CHOLIQ L KARANGAJI 003/003 65 Thn 8 Bln Myalgia √ √
177 26-01-2023 0021140 BPJS 0000758431923 3524244101580058 YATNAH P BLAWI 001/004 Primary respiratory tuberculosis without mention of bacteriological or
65 Thn 0 Bln histological confirmation √ √
178 26-01-2023 0022188 BPJS 0000758841546 3524240207550001 ABD MAJID L BADAN 002/002 69 Thn 11 Bln Acute nasopharyngitis [common cold] √ √
179 26-01-2023 0001410 BPJS 0000758640982 3524240101590059 ACHMAD TAM L ALASMALANG 002/002 Acute nasopharyngitis [common cold]; Hypertensive heart disease
64 Thn 0 Bln without (congestive) heart failure √ √
180 26-01-2023 0032143 BPJS 0000103500279 3524243006600011 SANTOSO EDY PURWANTO L BLAWI 002/0005 62 Thn 6 Bln Injury of other cranial nerves √ √
182 27-01-2023 0033283 BPJS 0001704089924 3524241204650003 ATEMO L BLAWI TENGAH 001/003
183 27-01-2023 0018100 BPJS 0002913269938 3524241306590001 SAMIJAN L KURIPAN 001/008 63 Thn 7 Bln Gastritis, unspecified √ √
184 27-01-2023 0028458 BPJS 0002749091602 3524241403620001 NUR KHAMIM L MENGAI 002/006 60 Thn 10 Bln Cutaneous abscess, furuncle and carbuncle, unspecified √ √
186 27-01-2023 0017197 BPJS 0000758420111 3524244101480050 FUTICHAH P MONOLELO 001/002 75 Thn 0 Bln Myalgia, ankle and foot √ √
187 27-01-2023 0002597 BPJS 0000758463129 3524246106570001 MUAYAH P SAMBO 001/002 65 Thn 5 Bln After-cataract √ √
188 30-01-2023 0009702 BPJS 0000758953541 3524245804530001 ALFIATUN P MAGOK 001/001
Acute nasopharyngitis [common cold]; Diarrhoea and gastroenteritis of
69 Thn 9 Bln presumed infectious origin; Gastritis, unspecified √ √
189 30-01-2023 0038102 BPJS 0000759538743 3524241609610002 KAYADI L PUPUS 001/006 61 Thn 4 Bln Hyperplasia of prostate √ √
190 30-01-2023 0038104 BPJS 0003176756515 3524244101490027 SAMAIYAH P BLAWI UTARA 002/004 74 Thn 0 Bln Gastritis, unspecified √ √
191 30-01-2023 0031149 BPJS 0001543303034 3524240302600002 MOH MAWARDI L LUNTAS S 002/002 62 Thn 11 Bln Examination for administrative purposes, unspecified √ √
192 30-01-2023 0007140 BPJS 0000758685396 3524245904610001 JUWATI P SAMBO 002/003 61 Thn 9 Bln Conjunctivitis, unspecified √ √
193 30-01-2023 0037339 BPJS 0003265273146 3524243012590004 ABD MUJIB L MONOLELO 002/002 63 Thn 1 Bln Senile cataract, unspecified √ √
194 30-01-2023 0037031 BPJS 0000758619044 3524244501560003 ROKIBAH P WATES 001/002 67 Thn 0 Bln Acute nasopharyngitis [common cold]; Myalgia √ √
195 30-01-2023 0014483 BPJS 0000758611563 3524246905590001 MAHMUDAH P GAYAM 006/003 Acute gingivitis; Non-insulin-dependent diabetes mellitus without
196 30-01-2023 0009850 BPJS 0002773630405 3524240101420017 KABUL L WUNGU 001/001 81 Thn 0 Bln Diarrhoea and gastroenteritis of presumed infectious origin √ √
198 30-01-2023 0014922 BPJS 0000758471095 3524244905600001 SUMIATI P KARANGANOM KULON 62 Thn 8 Bln Fracture of lower leg, part unspecified, closed √ √
199 30-01-2023 0010502 BPJS 0000759496173 3524245707360001 KUMAIYAH P PUPUS 003/006 86 Thn 4 Bln Idiopathic gout, ankle and foot √ √
200 30-01-2023 0021365 BPJS 0000757156623 PASLIKAH P KEBONSARI 62 Thn 7 Bln Open wound of wrist and hand part, part unspecified √ √
201 30-01-2023 0005948 BPJS 0002227002006 3524244204540001 TASNING P PELUK
202 30-01-2023 0003223 BPJS 0001704056771 3524246512550001 TASMINA P SAMBO 003/002
203 30-01-2023 0024737 BPJS 0000758658767 3524245303460001 SUMAIYAH P MAYONG TENGAH Gastritis, unspecified; Hypertensive heart disease without (congestive)
204 30-01-2023 0028715 BPJS 0001704092591 KASTIM L BONSARI 63 Thn 8 Bln Dyspepsia; Myalgia √ √
205 30-01-2023 0016723 BPJS 0000759612194 3524244501590004 KHOSIAH P KARANGBINANGUN 64 Thn 0 Bln Gastritis, unspecified; Myalgia √ √
206 31-01-2023 0003405 BPJS 0000103498031 3524241706590001 ACHMAD ZUBAIDI L BR KEBON 002/002
Gastritis, unspecified; Hypertensive heart disease without (congestive)
heart failure; Non-insulin-dependent diabetes mellitus without
207 31-01-2023 0038030 UMUM REBADI L KEBONSARI 002/004 84 Thn 9 Bln Xerosis cutis √ √
208 31-01-2023 0022559 BPJS 0002058535866 3524240101490017 SU'EF L PUPUK 001/003 74 Thn 0 Bln Dyspepsia; Gastric ulcer, acute with perforation √ √
209 31-01-2023 0004221 BPJS 0000103501618 3524245712580001 TRINI ASTUTI P NGAJARAN 64 Thn 1 Bln Hypertensive heart disease without (congestive) heart failure √ √
210 31-01-2023 0022070 BPJS 0000759874397 3524244101580022 MUNAH P PELUK 007/003 65 Thn 0 Bln Pterygium √ √
211 31-01-2023 0005144 BPJS 0001888188895 3524244101590044 SYAFAATUN P KAUMAN 001/002 64 Thn 0 Bln Burns involving 10-19% of body surface; Myalgia √ √
212 31-01-2023 0033518 BPJS 0001543278407 3524240509540001 SARDI L PRIYOSO WETAN 002/001
insulin-dependent diabetes mellitus without complications; Senile
68 Thn 4 Bln cataract, unspecified √ √
213 31-01-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 63 Thn 3 Bln Acute upper respiratory infection, unspecified; Myalgia √ √
214 31-01-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 61 Thn 10 Bln Gastritis, unspecified; Myalgia √ √
215 31-01-2023 0002597 BPJS 0000758463129 3524246106570001 MUAYAH P SAMBO 001/002
Gastritis, unspecified; Headache; Hypertensive heart disease without
(congestive) heart failure; Non-insulin-dependent diabetes mellitus
65 Thn 5 Bln without complications √ √
216 31-01-2023 0030015 BPJS 0002054941086 3524244910500001 ASRIFAH P NGAJARAN 004/004
72 Thn 3 Bln insulin-dependent diabetes mellitus with multiple complications √ √
INDIKATOR KELENGKAPAN PENGISIAN REKAM MEDIS
Pemeriks
Diagnosa aan
Terapi KIE
Medis penunjan
g
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
Tanggal : : 01-02-2023 s/d 28-02-2023
INDIKATOR KELENGKAPA
aan Fisik a
1 01-02-2023 0018267 BPJS 0003124940253 3524240101630048 YADI PURWONO L TERBIS 001/003 60 Thn 1 Bln Hypertensive heart disease with (congestive) heart failure √ √
2 01-02-2023 0010376 BPJS 0000759820961 3524245203600001 KUMANI P WUNGU 001/001
Acute pharyngitis, unspecified; Hypertensive heart disease without
(congestive) heart failure; Non-insulin-dependent diabetes mellitus
3 01-02-2023 0014050 BPJS 0000759820937 3524240201500004 ANIS L WUNGU 001/001 Arthrosis, unspecified; Hypertensive heart disease with (congestive)
4 01-02-2023 0017828 BPJS 0000758469699 3524241708540003 SHOLIKHIN L KARANGANOM WETAN Hypertensive heart disease without (congestive) heart failure; Senile
5 01-02-2023 0004221 BPJS 0000103501618 3524245712580001 TRINI ASTUTI P NGAJARAN
64 Thn 1 Bln Hypertensive heart disease without (congestive) heart failure; Tinnitus √ √
6 01-02-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 Hypertensive heart disease with (congestive) heart failure; Myalgia,
70 Thn 1 Bln ankle and foot √ √
7 02-02-2023 0003491 BPJS 0000169662251 3517074106500001 SALIKHAH P KURO 003/001 73 Thn 1 Bln Old myocardial infarction √ √
8 02-02-2023 0013541 BPJS 0001386491905 3524245406500001 KASRI P KLECO 002/004 72 Thn 7 Bln Hypertensive heart disease with (congestive) heart failure √ √
9 02-02-2023 0027869 BPJS 0000758380926 MOCH YUNUS JIAN MUSRIN L PALANGAN 001/001
77 Thn 8 Bln Other benign neoplasm of connective and other soft tissue, unspecified √ √
10 02-02-2023 0013481 BPJS 0000758733254 3524240101390024 ABU SU'UD L BADAN 001/004 84 Thn 1 Bln Hyperplasia of prostate √ √
11 02-02-2023 0010385 BPJS 0000758404012 ACHROM L KARANGBINANGUN 001/001 Gastritis, unspecified; Hypertensive heart disease with (congestive)
12 02-02-2023 0029335 BPJS 0000758670276 3524240106620001 MUSLAN L KETAPANG 001/002 60 Thn 8 Bln Essential (primary) hypertension √ √
13 02-02-2023 0002772 BPJS 0002908019542 3524246410570001 TUKIYAH P SAMBO 002/003
Hypertensive heart disease with (congestive) heart failure; Non-insulin-
65 Thn 3 Bln dependent diabetes mellitus with multiple complications √ √
14 02-02-2023 0010957 BPJS 0000103630858 3524240303530002 AMIN L MAYONG TENGAH 004/003 69 Thn 10 Bln Counselling, unspecified √ √
15 02-02-2023 0027641 BPJS 0000758447054 3524244101530027 SITI AMANAH P KETAPANG 001/001 70 Thn 1 Bln Umbilical hernia with obstruction, without gangrene √ √
16 03-02-2023 0024345 BPJS 0000759987382 3524243006540006 SUYATNO L MORO 68 Thn 7 Bln Fracture of lower end of humerus, closed √ √
17 03-02-2023 0019010 BPJS 0002162940827 3524240506560002 MASYKUN KHOIRI L WEDENG 001/004 66 Thn 7 Bln Acute upper respiratory infection, unspecified √ √
18 03-02-2023 0001993 BPJS 0000103766646 3524241202490002 AMIN L WEDENG 002/003 73 Thn 11 Bln Crushing injury of shoulder and upper arm √ √
19 03-02-2023 0003291 BPJS 0000758469238 3524244403560001 NINGWATI P ALANG-ALANG 001/005 66 Thn 10 Bln Acute nasopharyngitis [common cold] √ √
20 03-02-2023 0001446 UMUM KASAN L BANDUT 001/001 63 Thn 1 Bln Myalgia √ √
21 03-02-2023 0014918 BPJS 0002430467548 3524244401550003 SULASTRI P KARANGANOM KULON 002/001 68 Thn 0 Bln Glaucoma, unspecified √ √
22 03-02-2023 0015854 BPJS 0001047274154 3524241510600001 SOLIKAN L WUNGU 001/001 62 Thn 3 Bln Stroke, not specified as haemorrhage or infarction √ √
23 03-02-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 68 Thn 5 Bln Essential (primary) hypertension √ √
25 03-02-2023 0025059 BPJS 0000758703947 3524247006650006 SUMINI P WINDU 001/002 57 Thn 7 Bln Thyroid crisis or storm √ √
26 06-02-2023 0008116 BPJS 0000103695401 352424 MARKAMIN L SAMBO 69 Thn 10 Bln Cerebral infarction, unspecified √ √
27 06-02-2023 0033622 BPJS 0001047273232 3524245909610001 MARHAMAH P PENCARAN 001/005 61 Thn 4 Bln Senile cataract, unspecified √ √
28 06-02-2023 0027639 BPJS 0000759112424 3524241301550001 ASLIKAN L MAYONG TENGAH 002/003 68 Thn 0 Bln Hypertensive heart disease with (congestive) heart failure √ √
29 06-02-2023 0004573 UMUM 3524240309450001 ABDUL KAHAR L SAMBO 001/004 77 Thn 5 Bln Dermatitis, unspecified √ √
30 06-02-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002 66 Thn 1 Bln Acute upper respiratory infection, unspecified; Myalgia √ √
31 06-02-2023 0022874 BPJS 0001704050561 3624255006480002 KASENAH P WINDU 002/001 74 Thn 7 Bln Parkinson's disease √ √
32 06-02-2023 0008742 BPJS 0000759860785 3524244201600003 NAFIAH P BR.WUNGU 63 Thn 1 Bln Nontoxic multinodular goitre √ √
33 06-02-2023 0003747 BPJS 0002162693957 NAPSIYAH P NGIPIK Gastritis, unspecified; Non-insulin-dependent diabetes mellitus without
34 06-02-2023 0014606 BPJS 0001905651426 3524244304580001 MUCHLISAH P BATURONO 003/002 64 Thn 10 Bln Acute upper respiratory infection, unspecified √ √
35 06-02-2023 0004874 BPJS 0001704057513 3524242402600001 SUWADI L SAMBO 002/004 62 Thn 11 Bln Acute upper respiratory infection, unspecified √ √
36 06-02-2023 0008425 UMUM 3524240101580045 ABDUL KAHAR L BADAN 002/004 65 Thn 1 Bln √ √
38 06-02-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 Asthma, unspecified; Hypertensive heart disease without (congestive)
aan Fisik a
39 06-02-2023 0025453 BPJS 0002774533465 SUKATI P GUNDIK 001/004

40 07-02-2023 0018267 BPJS 0003124940253 3524240101630048 YADI PURWONO L TERBIS 001/003 60 Thn 1 Bln Asthma, unspecified √ √
41 07-02-2023 0038165 UMUM 3524244201490004 KASIH P KADU 002/002
42 07-02-2023 0005600 BPJS 0000758814287 3524240709590001 SAMSUL L SUMBERJO 63 Thn 5 Bln Gastric ulcer, acute with perforation √ √
43 07-02-2023 0011417 UMUM YAUB L TERBIS 001/003 80 Thn 3 Bln Acute conjunctivitis, unspecified √ √
44 07-02-2023 0038087 BPJS 0000758426218 3524240101580063 MAHIN L BALWI 03/04 65 Thn 1 Bln √ √
45 07-02-2023 0021546 BPJS 0002484356949 3524244101550060 DEWI MARYAM P BLAWI SELATAN 001/002 68 Thn 1 Bln After-cataract √ √
46 08-02-2023 0028715 BPJS 0001704092591 KASTIM L BONSARI 63 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √ √
47 08-02-2023 0010777 BPJS 0001047277181 3524240407550001 WIYADI L WINDU 001/002
48 08-02-2023 0002429 BPJS 0000103766657 3524244101520042 SITI KHALIMAH P WEDENG 002/002 Chronic gastritis, unspecified; Hypertensive heart disease without
71 Thn 1 Bln (congestive) heart failure; Myalgia √ √
49 08-02-2023 0010782 UMUM 3524244704560002 MUKANAH P KEBONSARI 004/003 66 Thn 10 Bln Acute upper respiratory infection, unspecified √ √
51 08-02-2023 0004152 BPJS 0000103501192 3524244610570001 SUMARTI, S.PD P BANJARANYAR 003/004 65 Thn 4 Bln Atrial fibrillation and flutter √ √
52 08-02-2023 0016596 BPJS 0000103501203 3524264702580001 SUMARTINI P MORO 65 Thn 0 Bln Peptic ulcer, chronic without haemorrhage or perforation √ √
53 08-02-2023 0016904 BPJS 0002422338197 3524244804620001 SUMI P MORO 001/003
54 08-02-2023 0026586 BPJS 0002422337995 KUSYAINI L MORO W 001/003
56 08-02-2023 0038194 BPJS 0000758623274 3524241209620001 MALIK L BATURONO 002/002 60 Thn 4 Bln Examination for admission to educational institution √ √
57 09-02-2023 0024611 BPJS 0001047274391 3524243006520004 ATIM L KADU 005/002 70 Thn 7 Bln Essential (primary) hypertension √ √
58 09-02-2023 0003291 BPJS 0000758469238 3524244403560001 NINGWATI P ALANG-ALANG 001/005 66 Thn 11 Bln Myalgia √ √
59 09-02-2023 0014050 BPJS 0000759820937 3524240201500004 ANIS L WUNGU 001/001 73 Thn 1 Bln Fracture of shoulder girdle, part unspecified, closed √ √
60 09-02-2023 0035616 BPJS 0003101665138 3524244101630035 INDAHYATI P KAUMAN 001/002
61 09-02-2023 0003522 BPJS 0003101663788 3524240101600033 M ACHWAN L KAUMAN 001/002 63 Thn 1 Bln Myalgia √ √
62 09-02-2023 0000431 BPJS 0000103500213 3524240601550001 RUBADI L BAKALAN 002/003 68 Thn 1 Bln Essential (primary) hypertension √ √
63 09-02-2023 0005294 BPJS 0000758801766 MUSLIKIN L PULOKERTO 001/001 62 Thn 7 Bln Malignant neoplasm of bronchus or lung, unspecified √ √
65 09-02-2023 0023282 BPJS 0000758375561 3524244101440021 SARNI P KETAPANG 79 Thn 1 Bln Urinary tract infection, site not specified √ √
66 09-02-2023 0019448 BPJS 0002746405359 3524241503550001 SUNAJI L SAMBO 002/003 67 Thn 10 Bln Myalgia √ √
67 09-02-2023 0016038 BPJS 0000759820511 3524245503610001 SURIATI P KURIPAN 001/008 61 Thn 10 Bln Acute upper respiratory infection, unspecified √ √
68 09-02-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 67 Thn 8 Bln Dermatitis, unspecified √ √
69 09-02-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 64 Thn 3 Bln Essential (primary) hypertension √ √
70 10-02-2023 0008978 BPJS 0000103885288 3524242012620001 PUJI WAHONO HARUN ALRASID L WINDU 001/001 60 Thn 1 Bln Examination for administrative purposes, unspecified √ √
72 10-02-2023 0023470 BPJS 0000759378295 3524244101600079 KARIMAH P MAYONG WETAN 002/004 63 Thn 1 Bln Dyspepsia √ √
73 10-02-2023 0000374 BPJS 0000758757633 3524247112590001 SUMIATUN P SAMBO 003/002
74 10-02-2023 0034978 BPJS 0000759348369 3524240101590034 KASBULLAH L GUNDIK 001/004 64 Thn 1 Bln Pterygium √ √
76 10-02-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 61 Thn 10 Bln Myalgia √ √
77 10-02-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 68 Thn 5 Bln Essential (primary) hypertension √ √
78 10-02-2023 0038194 BPJS 0000758623274 3524241209620001 MALIK L BATURONO 002/002 60 Thn 4 Bln Duodenal ulcer, chronic or unspecified with perforation √ √
aan Fisik a
79 10-02-2023 0004486 BPJS 0000103768547 3524144512480000 ZUMAROH P PALANGAN 74 Thn 7 Bln Myalgia √ √
80 10-02-2023 0037865 BPJS 0002732685794 3524244101630066 SUNANIK P NGAJARAN 004/004 Benign lipomatous neoplasm of skin and subcutaneous tissue of other
60 Thn 1 Bln and unspecified sites √ √
81 10-02-2023 0023446 BPJS 0000103590437 3524241508560001 BUDI UTOMO L KURO 003/001 Hyperuricaemia without signs of inflammatory arthritis and tophaceous
66 Thn 5 Bln disease √ √
82 13-02-2023 0033239 BPJS 0000759104842 3524246101590005 FATIMAH P ALASMALANG 003/002
83 13-02-2023 0023108 BPJS 0003503639507 3524241203590001 MARNO L MENGAI 002/006 63 Thn 11 Bln Tinnitus √ √
84 13-02-2023 0011752 BPJS 0000759262959 3524245706600002 ANIFAH P BLAWI 002/002 62 Thn 7 Bln Calculus of kidney √ √
85 13-02-2023 0008662 BPJS 0002888735128 UMU KULSUM P SAMBO 61 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √ √
86 13-02-2023 0019962 BPJS 0000758413135 3524243010530001 ABD KHAMID L MONOLELO
69 Thn 3 Bln Acute nephritic syndrome, focal and segmental glomerular lesions √ √
87 13-02-2023 0004573 UMUM 3524240309450001 ABDUL KAHAR L SAMBO 001/004 77 Thn 5 Bln Dermatitis, unspecified √ √
88 13-02-2023 0037620 BPJS 0003004719254 3524242501540001 AMUN L LUWUK 006/001 69 Thn 0 Bln Arthrosis, unspecified, ankle and foot √ √
89 13-02-2023 0010903 BPJS 0001890137068 MAROKAH P BLAWI 71 Thn 1 Bln Haemoptysis √ √
90 13-02-2023 0000737 BPJS 0000788682216 3524242002580001 MOCH. NADJIB L MONOLELO 002/002 Congestive heart failure; Hypertensive heart disease with (congestive)
91 13-02-2023 0018267 BPJS 0003124940253 3524240101630048 YADI PURWONO L TERBIS 001/003 60 Thn 1 Bln Asthma, unspecified √ √
92 13-02-2023 0023282 BPJS 0000758375561 3524244101440021 SARNI P KETAPANG 79 Thn 1 Bln Calculus of kidney √ √
94 13-02-2023 0038213 BPJS 0001704048805 3524240606600002 ABU CHOIRI L MENGAI 002/005
95 13-02-2023 0011891 BPJS 0002935518265 3524246008530001 MUNTAIYAH P PENCARAN 002/005 69 Thn 5 Bln Hypertensive heart disease with (congestive) heart failure √ √
96 13-02-2023 0016135 BPJS 0001299724918 3524241210540001 M CHOZIN AMIN L BR. SIMAN Essential (primary) hypertension; Non-insulin-dependent diabetes
68 Thn 4 Bln mellitus with multiple complications √ √
97 13-02-2023 0002772 BPJS 0002908019542 3524246410570001 TUKIYAH P SAMBO 002/003
Gastric ulcer, chronic without haemorrhage or perforation;

65 Thn 3 Bln dependent diabetes mellitus with multiple complications √ √
98 13-02-2023 0001920 BPJS 0000759389769 3524244102610003 SUKAYAH P KURIPAN 001/008 Atherosclerotic heart disease; Hypertensive heart disease with
99 14-02-2023 0013100 BPJS 0000759501009 3524245503600001 SUKARTI P LUNTAS B 003/007 Asthma, unspecified; Myalgia; Non-insulin-dependent diabetes mellitus
100 14-02-2023 0014052 BPJS 0003143832772 3524244101580017 SUWATIN P PELUK 001/003 65 Thn 1 Bln Other senile cataract; Pterygium √ √
101 14-02-2023 0038220 BPJS 0002811407545 3524241207540001 KARTIYO L WARUK 004/001 68 Thn 7 Bln Cellulitis of other sites √ √
102 14-02-2023 0003931 BPJS 0000759802015 3524241908480001 AWI L SAMBO 74 Thn 5 Bln Dermatitis, unspecified √ √
103 14-02-2023 0023108 BPJS 0003503639507 3524241203590001 MARNO L MENGAI 002/006 63 Thn 11 Bln Tinnitus √ √
104 15-02-2023 0018267 BPJS 0003124940253 3524240101630048 YADI PURWONO L TERBIS 001/003 60 Thn 1 Bln Abnormal results of cardiovascular function studies √ √
105 15-02-2023 0030021 BPJS 0001047283828 SULIKAN L BANJARANYAR Hypertensive heart disease with (congestive) heart failure; Other senile
66 Thn 1 Bln cataract √ √
106 15-02-2023 0038224 UMUM TRI HERMANTO L SAMBO 002/001
65 Thn 6 Bln insulin-dependent diabetes mellitus with multiple complications √ √
107 15-02-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002 66 Thn 1 Bln Acute upper respiratory infection, unspecified; Myalgia √ √
108 15-02-2023 0029463 BPJS 0000758771482 SUWONO L SAMBO 02/03 69 Thn 11 Bln Essential (primary) hypertension √ √
109 15-02-2023 0037620 BPJS 0003004719254 3524242501540001 AMUN L LUWUK 006/001 69 Thn 0 Bln Other senile cataract √ √
110 15-02-2023 0007765 BPJS 0002435810861 3524244404590001 HJ. AMATUN MUKMINATUN P PALANGAN 001/001 63 Thn 10 Bln Other heart disorders in other diseases classified elsewhere √ √
111 16-02-2023 0025724 BPJS 0001299719564 3524240309490001 MATRIPAN L KEBONSARI 73 Thn 5 Bln Allergic contact dermatitis due to other agents √ √
112 16-02-2023 0038236 BPJS 0000751167461 3524241208530002 AMIR L TEMBOK 008/003 69 Thn 6 Bln Fracture of lower end of both ulna and radius, closed √ √
113 16-02-2023 0029531 BPJS 0000758322652 KHOTIMAH P BLAWI UTARA 001/004 78 Thn 1 Bln Hypertensive heart disease with (congestive) heart failure √ √
114 16-02-2023 0010782 UMUM 3524244704560002 MUKANAH P KEBONSARI 004/003 66 Thn 10 Bln Acute bronchitis, unspecified √ √
115 16-02-2023 0002083 BPJS 0002750842416 3524240101510016 KASRUN L PELUK 001/003
72 Thn 1 Bln Disorder of kidney and ureter, unspecified; Hyperplasia of prostate √ √
116 16-02-2023 0037202 BPJS 0000759163959 3524245206530002 SAMINTEN P SINAN 003/003
117 16-02-2023 0024414 BPJS 0000758141864 3524241111560001 ABU THOLIB L WARUK 003/001 66 Thn 3 Bln Calculus of kidney √ √
aan Fisik a
118 16-02-2023 0028110 BPJS 0002499393341 AKOP L BLAWI UTARA 003/004 63 Thn 1 Bln Gastritis, unspecified √ √
119 16-02-2023 0025066 BPJS 0001388131806 3524245104380001 KARSANI P BLAWI UTARA 001/004 Acute upper respiratory infection, unspecified; Hypertensive heart
120 17-02-2023 0020388 UMUM 3524244101570001 LAMIDJAH P PUTATREJO 002/003 66 Thn 1 Bln Myalgia √ √
121 17-02-2023 0034936 BPJS 0002876182492 3524244201570013 DAIYAH P PUPUS 002/006 66 Thn 1 Bln Essential (primary) hypertension √ √
122 17-02-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004 63 Thn 6 Bln Myalgia √ √
123 17-02-2023 0028141 UMUM ABU ALI L MAYONG WETAN 78 Thn 0 Bln √ √
124 17-02-2023 0017485 BPJS 0002491021337 3524244101540005 KARNING P BAKALAN 001/001 Essential (primary) hypertension; Non-insulin-dependent diabetes
125 17-02-2023 0028642 BPJS 0001047281455 SAKUR L BONRINGIN 001/004 61 Thn 1 Bln Acute upper respiratory infection, unspecified √ √
126 17-02-2023 0024611 BPJS 0001047274391 3524243006520004 ATIM L KADU 005/002 70 Thn 7 Bln Hypertensive heart disease without (congestive) heart failure √ √
127 17-02-2023 0017045 BPJS 0000758393144 3524244201560011 SRIATUN P BR. SIMAN 67 Thn 1 Bln Other specified intervertebral disc displacement √ √
128 17-02-2023 0036612 BPJS 0003002375643 3524240201580008 SUPARTO L BLAWI 002/004 65 Thn 1 Bln Idiopathic peripheral autonomic neuropathy √ √
129 17-02-2023 0038244 UMUM SURI'AH P BANJARANYAR 62 Thn 1 Bln Open wound of unspecified body region √ √
131 17-02-2023 0034935 BPJS 0002876182468 3524240101510050 ABD. KARIM L PUPUS 002/006 72 Thn 1 Bln Atrial fibrillation and flutter √ √
132 20-02-2023 0017880 BPJS 0000758841581 SHOFA ASFAH P BADAN 002/002 60 Thn 1 Bln Erosive (osteo)arthrosis √ √
133 20-02-2023 0034133 BPJS 0002439974531 3524244101580030 JAMIYAH P SIMAN 002/001
134 20-02-2023 0003983 BPJS 0000103885007 352424 ASLIKAN ,DRS L SAMBO
135 20-02-2023 0004221 BPJS 0000103501618 3524245712580001 TRINI ASTUTI P NGAJARAN
136 20-02-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 Acute nasopharyngitis [common cold]; Hypertensive heart disease
137 20-02-2023 0038244 UMUM SURI'AH P BANJARANYAR 62 Thn 1 Bln Open wound of unspecified body region √ √
138 20-02-2023 0021152 BPJS 0000759342936 3524244103550001 TUMU`NINAH P KURO
139 20-02-2023 0037604 BPJS 0003296945542 3524240501610001 KHAMIM L PRIYOSO KULON 001/003 62 Thn 1 Bln Other glaucoma √ √
140 20-02-2023 0008945 BPJS 0002307147298 SAROPAH P BONSARI 002/004 69 Thn 1 Bln Other specified chronic obstructive pulmonary disease √ √
141 20-02-2023 0038260 BPJS 0000757924918 3524240407540001 SULAINI L BATURONO 003/002 68 Thn 7 Bln Hyperplasia of prostate √ √
142 20-02-2023 0013481 BPJS 0000758733254 3524240101390024 ABU SU'UD L BADAN 001/004 84 Thn 1 Bln Hyperplasia of prostate √ √
144 20-02-2023 0015550 BPJS 0000758933605 3524244101600006 SUPI P BONRINGIN 001/004 63 Thn 1 Bln Hypertensive heart disease without (congestive) heart failure √ √
145 20-02-2023 0010628 BPJS 0001439232309 3524240101490037 M. SOLEH L WUNGU 001/001 74 Thn 1 Bln Calculus of kidney with calculus of ureter √ √
146 21-02-2023 0038260 BPJS 0000757924918 3524240407540001 SULAINI L BATURONO 003/002 68 Thn 7 Bln Hyperplasia of prostate √ √
147 21-02-2023 0032001 BPJS 0002474678553 3524240101620015 MUSTOFA L PRIYOSO WETAN 001/002
148 21-02-2023 0022036 BPJS 0001047281297 3524246006580001 YATENI P SAMBO 002/002 64 Thn 8 Bln Hypertensive heart disease with (congestive) heart failure √ √
149 21-02-2023 0003206 BPJS 0000103501438 3524240108600001 SUPRIYANTO L SAMBO 001/002 62 Thn 6 Bln Examination for administrative purposes, unspecified √ √
150 21-02-2023 0038165 UMUM 3524244201490004 KASIH P KADU 002/002 74 Thn 1 Bln Hypertensive heart disease without (congestive) heart failure √ √
151 21-02-2023 0025005 BPJS 0000759924652 3524247006600003 NYANI P PRIYOSO WETAN 001/001
152 21-02-2023 0024433 BPJS 0001047280127 MARDHEYAH P BADAN 81 Thn 10 Bln Acute upper respiratory infection, unspecified √ √
153 21-02-2023 0015068 BPJS 0003500275364 3524241205510004 M.CHOIRI L BATURONO 002/002 71 Thn 9 Bln Acute bronchitis, unspecified √ √
154 22-02-2023 0020388 UMUM 3524244101570001 LAMIDJAH P PUTATREJO 002/003 66 Thn 1 Bln Dyspepsia; Myalgia √ √
155 22-02-2023 0015603 UMUM 3524240410570001 SATIMAN L PUTATREJO Acute upper respiratory infection, unspecified; Hypertensive heart
156 22-02-2023 0024214 BPJS 0000758973306 3524242007550001 NARIYO L MAGOK 001/002
aan Fisik a
158 22-02-2023 0038213 BPJS 0001704048805 3524240606600002 ABU CHOIRI L MENGAI 002/005 Gastritis, unspecified; Non-insulin-dependent diabetes mellitus with
62 Thn 8 Bln multiple complications √ √
159 22-02-2023 0013874 BPJS 0000751102198 3524244201580004 AMINAH P KAUMAN 004/002 Chronic cholecystitis; Hypertensive heart disease without (congestive)
160 22-02-2023 0037706 BPJS 0000758994805 3524241005530002 SANTOSO L MAYONG TENGAH 001/003 69 Thn 9 Bln Examination of blood pressure √ √
161 22-02-2023 0028110 BPJS 0002499393341 AKOP L BLAWI UTARA 003/004 63 Thn 1 Bln Gastric ulcer, acute with haemorrhage √ √
162 22-02-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 67 Thn 9 Bln Atopic dermatitis, unspecified √ √
163 23-02-2023 0034674 BPJS 0002162693946 3524243006520006 YASIR P NGIPIK 002/003 70 Thn 7 Bln Hypertensive heart disease without (congestive) heart failure √ √
164 23-02-2023 0038236 BPJS 0000751167461 3524241208530002 AMIR L TEMBOK 008/003 69 Thn 6 Bln Fracture of shaft of ulna, closed √ √
165 23-02-2023 0023139 BPJS 0000759550307 3524244410530001 KINAH P NGAJARAN 001/003 69 Thn 4 Bln Hypertensive heart disease without (congestive) heart failure √ √
166 23-02-2023 0003438 BPJS 0000103501528 3524240402540001 SUTADJI L KETAPANG 001/002 69 Thn 0 Bln Chronic ischaemic heart disease, unspecified √ √
167 23-02-2023 0024099 BPJS 0000759057017 3524240101630015 SEKAR L BAKALAN 001/001 60 Thn 1 Bln Old myocardial infarction √ √
168 23-02-2023 0023663 BPJS 0002248461101 3524244201530004 SULAMI P BLAWI
169 24-02-2023 0020211 BPJS 0000758427636 3524240708490001 SUKADI L PALANGAN 001/002 73 Thn 6 Bln Myalgia √ √
170 24-02-2023 0006976 BPJS 0001439232704 3524245606600001 NURYATI P WUNGU 001/001 62 Thn 8 Bln Congestive heart failure √ √
171 24-02-2023 0032347 BPJS 0001861883155 3524244201560009 MARNING P BAKALAN 001/002 67 Thn 1 Bln Hypertensive heart disease without (congestive) heart failure √ √
172 24-02-2023 0024345 BPJS 0000759987382 3524243006540006 SUYATNO L MORO 68 Thn 7 Bln Examination for administrative purposes, unspecified √ √
173 24-02-2023 0000338 BPJS 0000103499932 NUNUK HERONI ARUMCAHYO IRIANIGSIH P BANDUT 001/001 60 Thn 9 Bln Myalgia √ √
175 24-02-2023 0013841 BPJS 0000758389173 3524244101630034 MUNAFASAH P KAUMAN 004/002
176 24-02-2023 0035707 BPJS 0003176196816 3524240503510001 H. MUCHID L BLAWI TENGAH 003/003 71 Thn 11 Bln Myalgia √ √
177 24-02-2023 0037666 BPJS 0002199716379 H. KASEMAN L DS BLAWI 02/04 89 Thn 1 Bln Hyperplasia of prostate √ √
179 24-02-2023 0001725 BPJS 0000103753282 3524240606480002 ASIKAN L SAMBO 001/002 74 Thn 8 Bln Cystic disease of liver √ √
180 27-02-2023 0038317 BPJS 0001543367957 3524240207570001 MOH SYUKRON L KETAPANG 002/002 65 Thn 7 Bln Fracture of lower leg, part unspecified, closed √ √
181 27-02-2023 0004436 BPJS 0000759358596 3524244101620023 SENAH P KURO 61 Thn 1 Bln Dyspepsia √ √
182 27-02-2023 0037706 BPJS 0000758994805 3524241005530002 SANTOSO L MAYONG TENGAH 001/003 69 Thn 9 Bln Glaucoma, unspecified; Presence of intraocular lens √ √
183 27-02-2023 0023359 BPJS 0002811405587 3524244101500040 MUDJIYAH P KAUMAN 001/002
184 27-02-2023 0035707 BPJS 0003176196816 3524240503510001 H. MUCHID L BLAWI TENGAH 003/003 71 Thn 11 Bln Senile cataract, unspecified √ √
185 27-02-2023 0019448 BPJS 0002746405359 3524241503550001 SUNAJI L SAMBO 002/003
186 27-02-2023 0036978 BPJS 0000758182926 3524224101480043 BAWON P TUMENGGUNGAN 001/004 LAMO 75 Thn 1 Bln Rheumatoid arthritis, unspecified √ √
187 28-02-2023 0020890 BPJS 0000758241663 3524244101560003 SUKAENI P BONRINGIN 001/004
188 28-02-2023 0005144 BPJS 0001888188895 3524244101590044 SYAFAATUN P KAUMAN 001/002 64 Thn 1 Bln Burns involving 10-19% of body surface; Myalgia √ √
189 28-02-2023 0004157 BPJS 0002697610645 3524244807610001 ANIFAH P MAGOK 001/002 Acute pharyngitis, unspecified; Non-insulin-dependent diabetes
61 Thn 7 Bln mellitus without complications; Tinnitus √ √
190 28-02-2023 0010293 BPJS 0000758788571 3524240811600001 MAKSUM L Br. BUTUH
191 28-02-2023 0010376 BPJS 0000759820961 3524245203600001 KUMANI P WUNGU 001/001 62 Thn 11 Bln Dyspepsia √ √
192 28-02-2023 0019448 BPJS 0002746405359 3524241503550001 SUNAJI L SAMBO 002/003 67 Thn 11 Bln Acute amoebic dysentery √ √
193 28-02-2023 0016754 BPJS 0000758476372 3524247006620002 WARTI P KURO
194 28-02-2023 0000338 BPJS 0000103499932 NUNUK HERONI ARUMCAHYO IRIANIGSIH P BANDUT 001/001
60 Thn 9 Bln Acute upper respiratory infection, unspecified; Calculus in urethra √ √
DIKATOR KELENGKAPAN PENGISIAN REKAM MEDIS
Pemeriks
Diagnosa aan
Terapi KIE
Medis penunjan
g
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
Pemeriks
Diagnosa aan
Terapi KIE
Medis penunjan
g
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
Pemeriks
Diagnosa aan
Terapi KIE
Medis penunjan
g
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
Pemeriks
Diagnosa aan
Terapi KIE
Medis penunjan
g
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
Pemeriks
Diagnosa aan
Terapi KIE
Medis penunjan
g
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
Tanggal : : 01-03-2023 s/d 31-03-2023
INDIKATOR KELENGK
No Tanggal No Reg Jenis Pasien No BPJS NIK Nama Pasien L/P Alamat Usia Diagnosa Pemeriks
aan Fisik
1 01-03-2023 0020614 BPJS 0000758904478 3524240101620036 IKSAN L SUMBERJO 61 Thn 2 Bln Mucopurulent conjunctivitis; Senile cataract, unspecified √
2 01-03-2023 0009302 BPJS 0001704090442 3524243012580002 MISKAN L PULOKERTO 002/001 64 Thn 2 Bln Acute upper respiratory infection, unspecified √
Acute conjunctivitis, unspecified; Hypertensive heart disease without

(congestive) heart failure; Myalgia; Non-insulin-dependent diabetes
63 Thn 9 Bln mellitus without complications; Senile cataract, unspecified √
4 01-03-2023 0024611 BPJS 0001047274391 3524243006520004 ATIM L KADU 005/002
70 Thn 8 Bln Hypertensive heart disease without (congestive) heart failure; Myalgia √
5 01-03-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 63 Thn 4 Bln Asthma, unspecified √
6 01-03-2023 0018710 BPJS 0001965021434 TALKAH P KEBONSARI
84 Thn 5 Bln Dyspepsia; Malignant melanoma of other and unspecified parts of face √
7 01-03-2023 0029337 BPJS 0002503289283 3524242605590001 M.A KASTARAM L KARANGANOM KULON 001/001 63 Thn 9 Bln Nonorganic disorder of the sleep-wake schedule √
8 02-03-2023 0010376 BPJS 0000759820961 3524245203600001 KUMANI P WUNGU 001/001 62 Thn 11 Bln Other forms of stomatitis √
9 02-03-2023 0001993 BPJS 0000103766646 3524241202490002 AMIN L WEDENG 002/003 74 Thn 0 Bln Hypertensive heart disease with (congestive) heart failure √
10 02-03-2023 0008478 BPJS 0002877928334 3524245101560002 SUMIATI P PUPUK 001/003 67 Thn 1 Bln Cervicalgia, sacral and sacrococcygeal region √
11 02-03-2023 0033437 UMUM 357815300652015 SAPI'I L WINDU 70 Thn 8 Bln Hypertensive heart disease without (congestive) heart failure √
12 02-03-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002
66 Thn 2 Bln insulin-dependent diabetes mellitus without complications √
13 02-03-2023 0019982 BPJS 0000103498839 3323094106530002 SUPRAPTI P NGIPIK 70 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √
14 02-03-2023 0008954 BPJS 0001704058007 3524245011500001 SUMIANI P SAMBO 03/004 72 Thn 3 Bln √
15 03-03-2023 0038213 BPJS 0001704048805 3524240606600002 ABU CHOIRI L MENGAI 002/005
62 Thn 8 Bln Non-insulin-dependent diabetes mellitus without complications √
16 03-03-2023 0018921 BPJS 0000758506915 SUNARNO L KURO 003/001 62 Thn 0 Bln Disorder of urinary system, unspecified √
17 03-03-2023 0005055 BPJS 0002265541211 3524246204620001 RIYANAH P KEBONSARI 002/003 60 Thn 10 Bln Myalgia, ankle and foot √
18 03-03-2023 0010539 BPJS 0000758358461 3524244101530046 KAMAH P PUPUS 003/006 70 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
19 03-03-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 70 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
20 03-03-2023 0019962 BPJS 0000758413135 3524243010530001 ABD KHAMID L MONOLELO Diverticular disease of both small and large intestine without
69 Thn 4 Bln perforation or abscess √
21 04-03-2023 0036471 BPJS 0001834826264 3509014201470001 PAIJEM P WARUK 1/1 76 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
22 06-03-2023 0012776 BPJS 0002749752336 3524240705520001 H.ABDULLOH L WEDENG 001/002 70 Thn 9 Bln Erosive (osteo)arthrosis √
23 06-03-2023 0033437 UMUM 357815300652015 SAPI'I L WINDU
24 06-03-2023 0025117 BPJS 0002883093309 3524240108620001 ZAINUL IKHSAN L PUPUS 003/006 60 Thn 7 Bln Old myocardial infarction; Unstable angina √
25 06-03-2023 0037339 BPJS 0003265273146 3524243012590004 ABD MUJIB L MONOLELO 002/002 63 Thn 2 Bln Chronic ischaemic heart disease, unspecified √
26 06-03-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 61 Thn 11 Bln Myalgia √
27 06-03-2023 0000022 BPJS 0000103767816 3317135207520001 MUDRIKAH P KARANGBINANGUN 75 Thn 2 Bln Counselling, unspecified √
28 06-03-2023 0033715 BPJS 0000758845405 3524244101610044 IMRONAH P LUNTAS S 001/002 Dyspepsia; Hypertensive heart disease without (congestive) heart
62 Thn 2 Bln failure √
29 06-03-2023 0025562 BPJS 0000758441518 3524240101460043 AJI L ALANG ALANG 77 Thn 2 Bln Benign neoplasm of bronchus and lung √
30 06-03-2023 0021460 UMUM 3524241212500002 NAFIK KHUSYAIRI L GAYAM 005/003 Acute nasopharyngitis [common cold]; Hypertensive heart disease
72 Thn 2 Bln without (congestive) heart failure √
31 06-03-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004 Non-insulin-dependent diabetes mellitus without complications;
63 Thn 6 Bln Postzoster neuralgia √
32 06-03-2023 0038301 BPJS 0001704058108 3524240309440001 A. KAHAR L SAMBO 78 Thn 6 Bln Tinea pedis √
33 06-03-2023 0004436 BPJS 0000759358596 3524244101620023 SENAH P KURO 61 Thn 2 Bln Dyspepsia √
34 06-03-2023 0005731 BPJS 0000758387474 RUMEY P PELUK 007/003
35 06-03-2023 0016723 BPJS 0000759612194 3524244501590004 KHOSIAH P KARANGBINANGUN 64 Thn 2 Bln Dyspepsia √
INDIKATOR KELENGK
aan Fisik
36 06-03-2023 0021573 BPJS 0000759590098 3524240105590002 HASYIM SUSILO L NGAJARAN 002/003 Cerebral infarction due to thrombosis of cerebral arteries; Hypertensive
63 Thn 10 Bln heart disease with (congestive) heart failure √
37 06-03-2023 0008945 BPJS 0002307147298 SAROPAH P BONSARI 002/004 69 Thn 2 Bln Cervical disc disorder with radiculopathy √
38 06-03-2023 0010925 BPJS 0000763918468 3525011506580002 ROKIB L PETISSARI 003/002 64 Thn 8 Bln Dyspepsia √
39 06-03-2023 0010925 BPJS 0000763918468 3525011506580002 ROKIB L PETISSARI 003/002 64 Thn 8 Bln Dyspepsia √
40 06-03-2023 0024316 BPJS 0000103680999 3524246810580002 SITI CHODIDJAH P PENCARAN 64 Thn 4 Bln Erosive (osteo)arthrosis √
41 06-03-2023 0000749 BPJS 0002463473891 3524244101590082 JAROKAH P PULOKERTO 002/001 64 Thn 2 Bln Glaucoma, unspecified √
42 06-03-2023 0028813 UMUM 3524240406470001 AMAT L TEMBOK 002/003 Acute nasopharyngitis [common cold]; Hypertensive heart disease
44 06-03-2023 0037739 BPJS 0001473142331 3524244611610001 ILMAH P BLAWI 61 Thn 4 Bln Pterygium; Surgical follow-up care, unspecified √
45 06-03-2023 0013541 BPJS 0001386491905 3524245406500001 KASRI P KLECO 002/004 Congestive heart failure; Hypertensive heart disease with (congestive)
72 Thn 8 Bln heart failure; Other forms of angina pectoris √
46 06-03-2023 0033239 BPJS 0000759104842 3524246101590005 FATIMAH P ALASMALANG 003/002 64 Thn 1 Bln Erosive (osteo)arthrosis √
47 07-03-2023 0003437 BPJS 0001704056681 3524247006540003 KASIYATI P SAMBO 002/002 68 Thn 8 Bln Parkinson's disease √
48 07-03-2023 0010516 BPJS 0000759526547 ASMAH P BLAWI 61 Thn 2 Bln Cerebellar stroke syndrome √
49 07-03-2023 0006428 BPJS 0002257276443 3524244701500001 SITI AISYAH P PUTATREJO 002/003 73 Thn 2 Bln Gastric ulcer, acute without haemorrhage or perforation √
50 07-03-2023 0037644 BPJS 0003302774379 3524241201450002 JALI L SUMBERJO 002/003 78 Thn 1 Bln Other senile cataract √
51 07-03-2023 0010925 BPJS 0000763918468 3525011506580002 ROKIB L PETISSARI 003/002 64 Thn 8 Bln Counselling, unspecified √
52 07-03-2023 0017060 BPJS 0000103767726 RAIS RAMELI L MAYONG W 80 Thn 2 Bln Senile incipient cataract √
53 07-03-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 61 Thn 11 Bln Acute upper respiratory infection, unspecified; Myalgia √
54 07-03-2023 0002336 BPJS 0000758749948 3524244404550001 SUTIKAH P WEDENG 67 Thn 11 Bln Gastritis, unspecified √
55 07-03-2023 0035616 BPJS 0003101665138 3524244101630035 INDAHYATI P KAUMAN 001/002 Headache; Myalgia; Non-insulin-dependent diabetes mellitus without
60 Thn 2 Bln complications √
56 07-03-2023 0003522 BPJS 0003101663788 3524240101600033 M ACHWAN L KAUMAN 001/002 63 Thn 2 Bln Allergic contact dermatitis due to food in contact with skin √
57 07-03-2023 0021130 BPJS 0000758783215 KHOIRUMI L BLAWI 64 Thn 2 Bln Congestive heart failure; Old myocardial infarction √
58 07-03-2023 0038383 BPJS 0002924181268 3524240101620059 MUKMININ L PENCARAN 002/005 Headache; Non-insulin-dependent diabetes mellitus without
61 Thn 2 Bln complications; Other senile cataract √
59 07-03-2023 0019448 BPJS 0002746405359 3524241503550001 SUNAJI L SAMBO 002/003
60 07-03-2023 0024305 BPJS 0000758657305 3524240708600004 SUKIRMAN L WARUK 62 Thn 7 Bln Other senile cataract √
61 08-03-2023 0006425 BPJS 0000758161361 3524241704580001 GUFRON L LOGAWE 002/001 Chronic ischaemic heart disease, unspecified; Non-insulin-dependent
64 Thn 10 Bln diabetes mellitus without complications √
62 08-03-2023 0015847 BPJS 0000758827642 SITI CHOTIMAH P BADAN 001/002 68 Thn 8 Bln Spinal stenosis, sacral and sacrococcygeal region √
63 08-03-2023 0038414 BPJS 0003245053702 3524240101460029 SUPARJI L MAYONG WETAN 003/004 Non-insulin-dependent diabetes mellitus with neurological
64 08-03-2023 0014483 BPJS 0000758611563 3524246905590001 MAHMUDAH P GAYAM 006/003 Myalgia; Non-insulin-dependent diabetes mellitus without
65 08-03-2023 0014964 BPJS 0000757743287 3524246711600001 KHODIJAH P KARANGANOM WETAN 62 Thn 3 Bln Gastritis, unspecified √
66 08-03-2023 0003747 BPJS 0002162693957 NAPSIYAH P NGIPIK Gastritis, unspecified; Non-insulin-dependent diabetes mellitus without
67 08-03-2023 0000431 BPJS 0000103500213 3524240601550001 RUBADI L BAKALAN 002/003 68 Thn 2 Bln Hypertensive heart disease without (congestive) heart failure √
68 08-03-2023 0030777 BPJS 0000758099024 SAMUWIL L WARUK 001/002 63 Thn 0 Bln Spastic tetraplegia √
69 08-03-2023 0036451 BPJS 0000758959097 3524240101610028 DJUNAIDI L PUPUK001/003 62 Thn 2 Bln Essential (primary) hypertension √
70 08-03-2023 0029120 BPJS 0000758935146 3524241310590001 YAUDI L KEBONSARI 002/004 63 Thn 4 Bln Low vision, both eyes √
71 08-03-2023 0038391 BPJS 0000758626672 3524244404440001 BAWON P MAYONG TENGAH 003/003 78 Thn 11 Bln Hypertensive heart disease without (congestive) heart failure √
72 09-03-2023 0010604 BPJS 0002043337059 3524240101570026 ATEKAN L SUMBEREJO 001/003 66 Thn 2 Bln Atrophy of prostate √
73 09-03-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 Acute upper respiratory infection, unspecified; Hypertensive heart
64 Thn 4 Bln disease without (congestive) heart failure √
74 09-03-2023 0000308 BPJS 0000759578185 3524240101630051 MAT SHOLIHIN L BLAWI 60 Thn 2 Bln Essential (primary) hypertension √
75 09-03-2023 0016645 BPJS 0003503285831 3524244101630012 AISYATUN P WARUK 001/002 60 Thn 2 Bln Hypertensive heart disease without (congestive) heart failure √
76 09-03-2023 0008020 BPJS 0001299720183 3524244808450001 MUSAMA P KEBONSARI 002/003 77 Thn 7 Bln Arthrosis, unspecified, pelvic and thigh √
77 09-03-2023 0036451 BPJS 0000758959097 3524240101610028 DJUNAIDI L PUPUK001/003 62 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
INDIKATOR KELENGK
aan Fisik
78 09-03-2023 0033715 BPJS 0000758845405 3524244101610044 IMRONAH P LUNTAS S 001/002 62 Thn 2 Bln Gastritis, unspecified √
79 09-03-2023 0036482 BPJS 0001905647668 3524241711520001 UMAR L BATURONO 003/002 70 Thn 3 Bln Senile cataract, unspecified √
80 09-03-2023 0001672 BPJS 0001422789816 3524245204520001 SUYAMA P KLECO 001/10 70 Thn 10 Bln Examination for admission to residential institutions √
81 10-03-2023 0023574 BPJS 0001047286901 3524245112600001 WARNI P WARUK 62 Thn 2 Bln Splenomegaly, not elsewhere classified √
82 10-03-2023 0013638 BPJS 0002162613543 3524244101500050 MUNTIYANI P WINDU 002/002 73 Thn 2 Bln Other specified surgical follow-up care √
83 10-03-2023 0031926 BPJS 0002752152579 3524241207610002 MAT ARKAN L KEBONSARI 002/003 Cerebral infarction due to thrombosis of precerebral arteries; Epilepsy,
61 Thn 7 Bln unspecified; Hyperglycaemia, unspecified √
84 10-03-2023 0038383 BPJS 0002924181268 3524240101620059 MUKMININ L PENCARAN 002/005 61 Thn 2 Bln Other senile cataract √
85 10-03-2023 0031853 BPJS 0000758674326 3524244304530001 SUDARMI P BULAK 003/001 69 Thn 11 Bln √
86 10-03-2023 0011151 BPJS 0000758183242 3524244808570001 SUMAH P MAGOK 003/002 65 Thn 7 Bln √
87 10-03-2023 0027650 BPJS 0000001230041 NGATENI P DEKET 59 Thn 9 Bln Acute haemorrhagic gastritis √
88 13-03-2023 0008117 BPJS 0000103695412 3524246209600002 MACHRUSAH P SAMBO 002/004 62 Thn 5 Bln Glaucoma secondary to drugs √
89 13-03-2023 0018082 BPJS 0003176584773 3524245209590003 SUHARTI P BATURONO 002/002 Malignant neoplasm of medulla of adrenal gland; Non-Hodgkin's
63 Thn 6 Bln lymphoma, unspecified type √
91 13-03-2023 0000641 BPJS 0000103599821 3524241212480002 H. SUMARDI, DRS L BANDUT 002/001 Chronic renal failure, unspecified; Non-insulin-dependent diabetes
74 Thn 3 Bln mellitus with multiple complications √
92 13-03-2023 0000639 BPJS 0000103500437 3524244111540002 SITI ROMJATIN P BANDUT 002/001 68 Thn 4 Bln Chronic ischaemic heart disease, unspecified √
93 13-03-2023 0038414 BPJS 0003245053702 3524240101460029 SUPARJI L MAYONG WETAN 003/004
77 Thn 2 Bln Non-insulin-dependent diabetes mellitus with multiple complications √
95 13-03-2023 0033437 UMUM 357815300652015 SAPI'I L WINDU 70 Thn 8 Bln Hypertensive heart disease without (congestive) heart failure √
96 13-03-2023 0025981 UMUM 3524244101570034 RUKOIYAH P SIMAN 002/001 Hypertensive heart disease without (congestive) heart failure; Non-
65 Thn 1 Bln insulin-dependent diabetes mellitus with coma √
97 13-03-2023 0013100 BPJS 0000759501009 3524245503600001 SUKARTI P LUNTAS B 003/007
98 13-03-2023 0024704 BPJS 0002744502322 3524240101540058 SUMADI L PUPUS 002/006 69 Thn 2 Bln Tinnitus √
99 13-03-2023 0019146 BPJS 0003134588444 3524240101590041 TASLIKAN L SUMBERJO 003/003 64 Thn 2 Bln Cardiomegaly √
100 13-03-2023 0029542 BPJS 0002882538617 3524244805620001 SYAFA'AH P MAYONG TENGAH 002/003 Hypertensive heart disease with (congestive) heart failure; Other senile
60 Thn 10 Bln cataract √
101 13-03-2023 0033600 BPJS 0002732237008 3578047112540048 KASARMU P BONRINGIN 001/004
102 14-03-2023 0024611 BPJS 0001047274391 3524243006520004 ATIM L KADU 005/002 70 Thn 8 Bln Myalgia √
103 14-03-2023 0015118 BPJS 0002375087951 3524245112610001 SONATI P WARUK 002/003
Other benign neoplasm of connective and other soft tissue,
unspecified; Tuberculosis of lung, without mention of bacteriological or
histological confirmation; Unspecified diabetes mellitus without
104 14-03-2023 0038419 BPJS 0000759337806 3524243005510001 ZAKARIYAH L KURO 002/001
Hyperplasia of prostate; Urinary tract infection, site not specified;
71 Thn 9 Bln Vertiginous syndromes in diseases classified elsewhere √
105 14-03-2023 0001993 BPJS 0000103766646 3524241202490002 AMIN L WEDENG 002/003 74 Thn 1 Bln Dermatitis, unspecified √
106 14-03-2023 0002429 BPJS 0000103766657 3524244101520042 SITI KHALIMAH P WEDENG 002/002 71 Thn 2 Bln Asthma, unspecified; Gastritis, unspecified √
107 14-03-2023 0006545 UMUM 3524242305570001 ABD CHOLIQ L KARANGAJI 003/003 65 Thn 9 Bln Acute upper respiratory infection, unspecified; Myalgia √
108 14-03-2023 0033715 BPJS 0000758845405 3524244101610044 IMRONAH P LUNTAS S 001/002 62 Thn 2 Bln Senile cataract, unspecified √
109 14-03-2023 0001947 BPJS 0001543284786 3524245105570002 NGATMONAH P PUTATREJO 1/3 Chronic ischaemic heart disease, unspecified; Non-insulin-dependent
65 Thn 10 Bln diabetes mellitus without complications √
110 14-03-2023 0015548 BPJS 0000758735504 3524246501590001 SUWARTI P BONRINGIN 001/004 Atherosclerotic heart disease; Heart failure, unspecified; Hypertensive
111 15-03-2023 0038424 BPJS 0003265479382 3578104507550003 KARLIN P NGAJARAN 004/004
67 Thn 8 Bln Other benign neoplasm of connective and other soft tissue, unspecified √
112 15-03-2023 0018237 BPJS 0000759241721 3524241204550002 SARGIMAN L KLECO 67 Thn 11 Bln Tuberculosis of bones and joints √
INDIKATOR KELENGK
aan Fisik
113 15-03-2023 0023056 BPJS 0000758785522 3524246303510001 KARTI P PUTATREJO 002/003 Acute nasopharyngitis [common cold]; Hypertensive heart disease
114 15-03-2023 0016705 BPJS 0000758126643 3524242306570001 ABD. MANAN L WARUK 002/002 Acute nasopharyngitis [common cold]; Insulin-dependent diabetes
65 Thn 8 Bln mellitus without complications √
115 15-03-2023 0036204 BPJS 0000757215606 3524240101460028 NUR ROHIM L BADAN 001/002 Surgical follow-up care, unspecified; Unilateral or unspecified inguinal
77 Thn 2 Bln hernia, without obstruction or gangrene √
116 16-03-2023 0030645 BPJS 0002913088094 3524244101500052 SUKAEMI P TERBIS 001/003 73 Thn 2 Bln Myalgia √
118 16-03-2023 0038446 BPJS 0003176547794 3524240101590005 DJAYUS L WATANGAN 002/001 64 Thn 2 Bln Hypertensive heart disease without (congestive) heart failure √
119 16-03-2023 0019972 BPJS 0001047284144 3524244911540001 MISTRI P PALANGAN 68 Thn 4 Bln Blindness, one eye √
121 16-03-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 61 Thn 11 Bln Myalgia, ankle and foot √
122 16-03-2023 0031214 BPJS 0000757173756 3524245610600002 ISTIROKAH P BADAN 001/004 62 Thn 5 Bln Cellulitis of finger and toe √
123 16-03-2023 0016645 BPJS 0003503285831 3524244101630012 AISYATUN P WARUK 001/002 60 Thn 2 Bln Hypertensive heart disease without (congestive) heart failure √
124 16-03-2023 0024214 BPJS 0000758973306 3524242007550001 NARIYO L MAGOK 001/002 67 Thn 7 Bln Hypertensive heart disease without (congestive) heart failure √
125 16-03-2023 0029446 BPJS 0000759025495 KATIMAN L WARUK 002/002 68 Thn 3 Bln Otitis externa, unspecified √
126 16-03-2023 0018457 BPJS 0000099030879 3524244204620001 HJ. SYAFI'AH P PALANGAN Non-insulin-dependent diabetes mellitus with multiple complications;
70 Thn 11 Bln Senile cataract, unspecified √
127 16-03-2023 0017192 BPJS 0003174932542 SARINTEN P LUNTAS 69 Thn 2 Bln Atherosclerotic heart disease √
128 16-03-2023 0004221 BPJS 0000103501618 3524245712580001 TRINI ASTUTI P NGAJARAN Dyspepsia; Hypertensive heart disease without (congestive) heart
129 16-03-2023 0038424 BPJS 0003265479382 3578104507550003 KARLIN P NGAJARAN 004/004
130 16-03-2023 0005888 BPJS 0000758317037 3524245201570001 INEM P MAGOK 001/002 66 Thn 2 Bln Acute upper respiratory infection, unspecified √
131 17-03-2023 0011921 BPJS 0000103498705 HINDUN P BLAWI 001/003 64 Thn 8 Bln Counselling, unspecified √
132 17-03-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 Acute upper respiratory infection, unspecified; Hypertensive heart
133 17-03-2023 0010376 BPJS 0000759820961 3524245203600001 KUMANI P WUNGU 001/001 Non-insulin-dependent diabetes mellitus with unspecified
134 17-03-2023 0012776 BPJS 0002749752336 3524240705520001 H.ABDULLOH L WEDENG 001/002 70 Thn 10 Bln Atherosclerotic heart disease √
136 17-03-2023 0009702 BPJS 0000758953541 3524245804530001 ALFIATUN P MAGOK 001/001 69 Thn 10 Bln Dyspepsia; Myalgia √
138 17-03-2023 0029120 BPJS 0000758935146 3524241310590001 YAUDI L KEBONSARI 002/004 Chronic obstructive pulmonary disease with acute lower respiratory
63 Thn 5 Bln infection √
139 17-03-2023 0000180 BPJS 0000758189654 SUKANAH P BONRINGIN 001/004 68 Thn 1 Bln Hypertensive heart disease with (congestive) heart failure √
140 20-03-2023 0036466 BPJS 0001850979475 3524221506590001 SULIKAN L SAMBO 003/006 63 Thn 9 Bln Glaucoma, unspecified √
142 20-03-2023 0003544 BPJS 0000758593078 3524241204610001 KASNAWI L BATURONO 002/002 61 Thn 11 Bln Acute nasopharyngitis [common cold]; Dyspepsia √
143 20-03-2023 0018320 BPJS 0000758961189 3524240101530023 LAMIKAN L PUPUK 002/003 70 Thn 2 Bln Sequelae of stroke, not specified as haemorrhage or infarction √
144 20-03-2023 0025981 UMUM 3524244101570034 RUKOIYAH P SIMAN 002/001
145 20-03-2023 0027165 BPJS 0000759765429 3524240104540002 AMAN L BADAN 002/004 Hypertensive heart disease without (congestive) heart failure; Sequelae
68 Thn 11 Bln of open wound of upper limb √
146 20-03-2023 0036752 BPJS 0001047277146 3524243006570013 SATIMIN L WINDU 003/001 65 Thn 8 Bln Acute nasopharyngitis [common cold] √
147 20-03-2023 0010177 BPJS 0002161138858 3524240101560040 ASRON M. MUNDZIR L BLAWI 003/002 67 Thn 2 Bln Stroke, not specified as haemorrhage or infarction √
INDIKATOR KELENGK
aan Fisik
148 20-03-2023 0012143 BPJS 0000759291388 3524246505620001 RUMINAH P WEDENG 001/001

149 20-03-2023 0025089 BPJS 0002121510925 3524246010500002 H. MAIMUNAH P KARANGANOM KULON 001/001 72 Thn 5 Bln Aphakia; Presence of intraocular lens √
150 20-03-2023 0013841 BPJS 0000758389173 3524244101630034 MUNAFASAH P KAUMAN 004/002
151 20-03-2023 0020614 BPJS 0000758904478 3524240101620036 IKSAN L SUMBERJO 61 Thn 2 Bln Acute conjunctivitis, unspecified √
152 21-03-2023 0011117 BPJS 0002913182559 NAWAWI L WARUK 002/001 62 Thn 0 Bln Myalgia √
153 21-03-2023 0038419 BPJS 0000759337806 3524243005510001 ZAKARIYAH L KURO 002/001
Hyperplasia of prostate; Urinary tract infection, site not specified;
154 21-03-2023 0011944 BPJS 0002272290041 3524241008620002 SLAMET L KURO 001/001 60 Thn 7 Bln Urinary tract infection, site not specified √
155 21-03-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004 63 Thn 7 Bln Organic emotionally labile [asthenic] disorder √
156 21-03-2023 0020614 BPJS 0000758904478 3524240101620036 IKSAN L SUMBERJO 61 Thn 2 Bln Other senile cataract √
158 21-03-2023 0013472 BPJS 0003134739442 3524244101610069 SUPARMI P MAYONG TENGAH 004/003
Hypertensive heart disease with (congestive) heart failure; Insulin-

dependent diabetes mellitus with multiple complications; Pleural
62 Thn 2 Bln effusion in conditions classified elsewhere √
159 21-03-2023 0000269 BPJS 0000103500369 3524245608590002 NUR AFIFAH P MONOLELO 002/002 63 Thn 7 Bln Myalgia √
160 21-03-2023 0005126 BPJS 0002267160783 3524244101600093 JAIYAH P GOSO 001/003
63 Thn 2 Bln Dyspepsia; Hypertensive heart disease with (congestive) heart failure √
161 21-03-2023 0013957 BPJS 0001047274222 3524241510580001 MUNAWAR L KADU 005/002 Hyperglycaemia, unspecified; Hypertensive heart disease with
64 Thn 5 Bln (congestive) heart failure √
162 21-03-2023 0002429 BPJS 0000103766657 3524244101520042 SITI KHALIMAH P WEDENG 002/002 Asthma, unspecified; Hypertensive heart disease with (congestive)
71 Thn 2 Bln heart failure; Other acute gastritis √
163 21-03-2023 0025599 BPJS 0000103499144 3524241809530001 M AFNAN L KURO 002/001 69 Thn 6 Bln Myalgia √
164 21-03-2023 0030645 BPJS 0002913088094 3524244101500052 SUKAEMI P TERBIS 001/003
73 Thn 2 Bln Dyspepsia; Hypertensive heart disease with (congestive) heart failure √
165 21-03-2023 0033437 UMUM 357815300652015 SAPI'I L WINDU Acute upper respiratory infection, unspecified; Myalgia; Non-insulin-
70 Thn 8 Bln dependent diabetes mellitus without complications √
166 21-03-2023 0021828 BPJS 0000759365897 KANTUN L KURIPAN 69 Thn 1 Bln Gastritis, unspecified; Nausea and vomiting √
167 21-03-2023 0001860 UMUM 3524242710620001 SUHARTO L PELUK 007/003 60 Thn 5 Bln Dermatitis, unspecified √
168 21-03-2023 0005144 BPJS 0001888188895 3524244101590044 SYAFAATUN P KAUMAN 001/002 Acute upper respiratory infection, unspecified; Gastritis, unspecified;
64 Thn 2 Bln Myalgia √
169 21-03-2023 0023062 BPJS 0000103902399 3524242704620001 MUJIONO L SAMBO 002/002
170 24-03-2023 0037856 BPJS 0002197064428 3524241812500001 KHOIRON L PALANGAN 001/002 Recurrent atlantoaxial subluxation with myelopathy, occipito-atlanto-
72 Thn 3 Bln axial region √
171 24-03-2023 0038476 BPJS 0001917158038 3524244512510002 SAFIYAH P DS BLAWI 71 Thn 3 Bln Gastritis, unspecified √
172 24-03-2023 0001081 BPJS 0003176757055 3524240411590002 ASNAN L TERBIB 00/003 63 Thn 4 Bln Other specified pulmonary heart diseases √
173 24-03-2023 0027240 BPJS 0001704051066 3524247006550008 NENGYAH L NGIPIK 003/003
174 24-03-2023 0003544 BPJS 0000758593078 3524241204610001 KASNAWI L BATURONO 002/002 61 Thn 11 Bln Acute nasopharyngitis [common cold] √
175 24-03-2023 0020260 BPJS 0000758392716 3524244101600085 SAMANI P BLAWI 63 Thn 2 Bln Senile cataract, unspecified √
176 24-03-2023 0023317 BPJS 0003002375654 3524244101600089 FITRIYAH P BLAWI 002/004 63 Thn 2 Bln Senile cataract, unspecified √
177 24-03-2023 0029102 BPJS 0000759358563 3524240101500021 RIDUWAN L KURO 003/001 73 Thn 2 Bln Senile cataract, unspecified √
178 24-03-2023 0037753 BPJS 0000759271329 3524265710620001 SUWARNI P GMBONG TENGA 001/002 Hydronephrosis with ureteral stricture, not elsewhere classified;
60 Thn 5 Bln Unspecified renal colic √
179 24-03-2023 0038475 BPJS 0000759810519 3524244605560001 SAEKA P BOTOH 006/002 66 Thn 10 Bln Focal brain injury √
180 27-03-2023 0024214 BPJS 0000758973306 3524242007550001 NARIYO L MAGOK 001/002 Dyspepsia; Hypertensive heart disease without (congestive) heart
67 Thn 8 Bln failure; Myalgia √
INDIKATOR KELENGK
aan Fisik
181 27-03-2023 0027397 BPJS 0002243942886 3524242705600001 UMAR SYAECHAN L BATURONO 002/002 62 Thn 10 Bln Primary generalized (osteo)arthrosis √
182 27-03-2023 0003544 BPJS 0000758593078 3524241204610001 KASNAWI L BATURONO 002/002 61 Thn 11 Bln Acute nasopharyngitis [common cold]; Dyspepsia √
183 27-03-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 63 Thn 5 Bln Hypertensive heart disease with (congestive) heart failure √
184 27-03-2023 0037715 BPJS 0000759230199 3524241407620003 SUTARNO L TERBIS 002/003 60 Thn 8 Bln Malignant neoplasm of rectum √
185 27-03-2023 0024218 BPJS 0000759362231 MOCH. ANWAR L WATANGAN 001/001 Acute nasopharyngitis [common cold]; Hypertensive heart disease with
186 27-03-2023 0002336 BPJS 0000758749948 3524244404550001 SUTIKAH P WEDENG 67 Thn 11 Bln Dyspepsia √
187 27-03-2023 0027924 BPJS 0002737746483 3524244101560034 SRUÀH P LUMBANGAN 003/001 67 Thn 2 Bln Atherosclerotic heart disease √
189 27-03-2023 0035710 BPJS 0001704056769 3524243112450004 TARMO P SAMBO 002/002 76 Thn 2 Bln Dyspepsia; Myalgia √
190 27-03-2023 0027639 BPJS 0000759112424 3524241301550001 ASLIKAN L MAYONG TENGAH 002/003 68 Thn 2 Bln After-cataract √
191 27-03-2023 0038486 BPJS 0000759398286 3524241611540001 SARMADI L MENGAI 002/006 68 Thn 4 Bln Counselling, unspecified √
192 27-03-2023 0014477 BPJS 0000757931725 3524244103410002 KASTONAH P GAYAM 004/003 82 Thn 0 Bln Hypertensive heart disease without (congestive) heart failure √
193 27-03-2023 0003291 BPJS 0000758469238 3524244403560001 NINGWATI P ALANG-ALANG 001/005 67 Thn 0 Bln Dyspepsia √
195 27-03-2023 0028828 BPJS 0002236781981 3524245205600002 WAINING P MENGAI 001/006
196 28-03-2023 0027165 BPJS 0000759765429 3524240104540002 AMAN L BADAN 002/004 Attention to surgical dressings and sutures; Hypertensive heart disease
197 28-03-2023 0030594 BPJS 0001047281613 3524241706570001 SAFIK L MAGOK 001/001 65 Thn 9 Bln Hypochondriacal disorder √
198 28-03-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 62 Thn 0 Bln Myalgia √
199 28-03-2023 0006545 UMUM 3524242305570001 ABD CHOLIQ L KARANGAJI 003/003 65 Thn 10 Bln Acute upper respiratory infection, unspecified; Allergic purpura √
200 28-03-2023 0016715 BPJS 0002282330992 3524241007590001 TASKUR L MENGAI 001/008 63 Thn 8 Bln Senile cataract, unspecified √
201 28-03-2023 0024043 BPJS 0000758697625 3524245807590001 KUMAROH P MAYONG KULON 001/001
202 28-03-2023 0038486 BPJS 0000759398286 3524241611540001 SARMADI L MENGAI 002/006 68 Thn 4 Bln Hyperplasia of prostate √
203 28-03-2023 0036452 BPJS 0000759709427 3524245001400001 TENI P WATANGAN 001/002 83 Thn 2 Bln Cervical disc disorder with myelopathy √
204 28-03-2023 0033179 BPJS 0001328486635 3524242908550001 ASLIKAN L SAMBO 001/002 67 Thn 6 Bln Attention to surgical dressings and sutures √
205 28-03-2023 0006312 BPJS 0000758830498 3524240108500002 KASNAN L KADU 002/002 Acute gingivitis; Acute upper respiratory infection, unspecified;
72 Thn 7 Bln Hypertensive heart disease without (congestive) heart failure √
206 28-03-2023 0018082 BPJS 0003176584773 3524245209590003 SUHARTI P BATURONO 002/002 63 Thn 6 Bln Counselling, unspecified √
207 28-03-2023 0013323 UMUM JUMIAH P PALANGAN 68 Thn 9 Bln Myalgia √
208 28-03-2023 0000496 BPJS 0001047281253 3524247112480001 SITI FADILA P SAMBO 003/004 74 Thn 2 Bln Myalgia, hand √
209 28-03-2023 0007061 BPJS 0000758430235 3524244101380061 SITI ROICHAH P NGAJARAN 004/004 85 Thn 2 Bln Gastritis, unspecified; Myalgia √
210 29-03-2023 0027240 BPJS 0001704051066 3524247006550008 NENGYAH L NGIPIK 003/003 67 Thn 8 Bln Asthma, unspecified; Hyperglycaemia, unspecified √
211 29-03-2023 0033129 BPJS 0002876702477 SENEN GIMUN L NGIPIK 72 Thn 5 Bln Hyperglycaemia, unspecified; Myalgia √
212 29-03-2023 0004603 BPJS 0000759319176 3524240101610019 CHOIRUN L KURO 002/001 Allergic contact dermatitis, unspecified cause; Hypertensive heart
213 29-03-2023 0023108 BPJS 0003503639507 3524241203590001 MARNO L MENGAI 002/006 64 Thn 0 Bln Tinnitus √
214 29-03-2023 0033437 UMUM 357815300652015 SAPI'I L WINDU
215 29-03-2023 0029406 BPJS 0002763980436 CHODIROH P KARANGBINANGUN 003/001 Hypertensive heart disease without (congestive) heart failure; Senile
70 Thn 2 Bln cataract, unspecified √
216 29-03-2023 0031084 BPJS 0001047271825 3524240101560042 MURODIL L BLAWI SELATAN 002/003 67 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
217 30-03-2023 0020435 BPJS 0000759483786 3524245011560001 SUMIARSEH P PUPUS 003/006 66 Thn 4 Bln Hypertensive heart disease without (congestive) heart failure √
218 30-03-2023 0023186 BPJS 0001258055752 3524241808570001 TASIRIN L ALANG-ALANG 002/005 Chronic gastritis, unspecified; Hypertensive heart disease without
219 30-03-2023 0015303 BPJS 0000759643931 3524244701630001 MARIYAM P MONOLELO 001/002 Allergic contact dermatitis due to food in contact with skin;
220 31-03-2023 0027165 BPJS 0000759765429 3524240104540002 AMAN L BADAN 002/004 68 Thn 11 Bln Attention to surgical dressings and sutures √
221 31-03-2023 0020388 UMUM 3524244101570001 LAMIDJAH P PUTATREJO 002/003 Gastritis, unspecified; Hypertensive heart disease without (congestive)
66 Thn 2 Bln heart failure √
INDIKATOR KELENGK
aan Fisik
222 31-03-2023 0005611 BPJS 0001704058053 3524247112610001 MISKANA L SAMBO 003/004 61 Thn 3 Bln Caries of dentine √
224 31-03-2023 0030023 BPJS 0000758427917 3524240101630039 MUÌN L KAUMAN 004/002 Unilateral or unspecified inguinal hernia, with obstruction, without
60 Thn 2 Bln gangrene √
226 31-03-2023 0000374 BPJS 0000758757633 3524247112590001 SUMIATUN P SAMBO 003/002 Acute nasopharyngitis [common cold]; Hypertensive heart disease
227 31-03-2023 0037018 BPJS 0000103500955 3524245001600002 SUHARTATIK P ALANG2 001/005
63 Thn 2 Bln Lumbar and other intervertebral disc disorders with radiculopathy √
Pemeriks
Anamnes Diagnosa aan
a Terapi KIE Medis penunjan
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Tanggal : : 01-04-2023 s/d 30-04-2023
INDIKATOR KELENG
aan Fisik

2 03-04-2023 0003544 BPJS 0000758593078 3524241204610001 KASNAWI L BATURONO 002/002 Dyspepsia; Hypertensive heart disease without (congestive) heart
3 03-04-2023 0027165 BPJS 0000759765429 3524240104540002 AMAN L BADAN 002/004 69 Thn 0 Bln Hypertensive heart disease without (congestive) heart failure √
4 03-04-2023 0024611 BPJS 0001047274391 3524243006520004 ATIM L KADU 005/002 Acute nasopharyngitis [common cold]; Hypertensive heart disease
5 03-04-2023 0002817 BPJS 0000759941368 SENATRI P PRIYOSO WETAN 60 Thn 9 Bln Diabetic cataract √
6 03-04-2023 0003377 BPJS 0000759895424 3524245403530001 KASTUN P LUNTAS 003/007 Acute gingivitis; Hypertensive heart disease without (congestive) heart
7 03-04-2023 0023108 BPJS 0003503639507 3524241203590001 MARNO L MENGAI 002/006 64 Thn 0 Bln Tinnitus √
8 03-04-2023 0009146 UMUM NAHNU L PENCARAN
9 03-04-2023 0000269 BPJS 0000103500369 3524245608590002 NUR AFIFAH P MONOLELO 002/002 63 Thn 7 Bln Dyspepsia; Myalgia √
10 03-04-2023 0030591 BPJS 0001829062451 MUSLIMAH P GAYAM 60 Thn 4 Bln Examination for adolescent development state √
11 03-04-2023 0005882 BPJS 0001829059997 3524241010530001 NADJIECH M. NOORS L GAYAM 004/002 69 Thn 5 Bln Examination for adolescent development state √
12 03-04-2023 0028813 UMUM 3524240406470001 AMAT L TEMBOK 002/003 75 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √
13 03-04-2023 0034503 UMUM 3524244208580001 DIPI P KARANGANOM W 007/004 64 Thn 8 Bln Examination for adolescent development state √
14 03-04-2023 0034504 BPJS 0002926263058 3524244101450018 ARTI P KETAPANG 002/002 78 Thn 3 Bln Examination for adolescent development state √
15 03-04-2023 0034496 BPJS 0003143832963 SALIM L TEMBOK 002/003 64 Thn 5 Bln Examination for adolescent development state √
16 03-04-2023 0034498 UMUM 3524244101530024 YATEMI P SUMBERJO 001/002 70 Thn 3 Bln Examination for adolescent development state √
17 03-04-2023 0030450 BPJS 0002732239449 MUALIM L SIMAN 71 Thn 3 Bln Examination for adolescent development state √
18 03-04-2023 0025981 UMUM 3524244101570034 RUKOIYAH P SIMAN 002/001 65 Thn 1 Bln Examination for adolescent development state √
19 03-04-2023 0024332 BPJS 0000758661221 3524240101560020 SUBEKI L KETAPANG 67 Thn 3 Bln Examination for adolescent development state √
20 03-04-2023 0032101 UMUM SUROSO L SAMBO 001/004 66 Thn 9 Bln Examination for adolescent development state √
21 03-04-2023 0006583 BPJS 0000758869874 3524244101500028 DANIRAH P PUPUK 001/003 73 Thn 3 Bln Acute conjunctivitis, unspecified; Myalgia √
22 03-04-2023 0013541 BPJS 0001386491905 3524245406500001 KASRI P KLECO 002/004 72 Thn 9 Bln Examination for adolescent development state √
23 03-04-2023 0010189 BPJS 0001047286798 3524244307350001 YATEMI P WARUK 003/002 87 Thn 9 Bln Examination for adolescent development state √
24 03-04-2023 0009702 BPJS 0000758953541 3524245804530001 ALFIATUN P MAGOK 001/001 69 Thn 11 Bln Acute nasopharyngitis [common cold]; Dyspepsia √
27 03-04-2023 0025103 BPJS 0000759571571 3524242401590002 KHAYAT L BLAWI UTARA 001/004 64 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
28 03-04-2023 0015303 BPJS 0000759643931 3524244701630001 MARIYAM P MONOLELO 001/002 Non-insulin-dependent diabetes mellitus with other specified
29 03-04-2023 0038518 BPJS 0001047283492 3524244101520069 MARINTEN P BANJARANYAR 002/002 71 Thn 3 Bln Schizophrenia, unspecified √
30 04-04-2023 0033879 BPJS 0002455205545 3524240508540001 SARI L PUTATREJO 001/003 Cerebral infarction due to thrombosis of precerebral arteries; Other and
68 Thn 7 Bln unspecified convulsions √
31 04-04-2023 0000550 BPJS 0000103768288 3524245809580002 HANNA ASTINAH P NGIPIK 64 Thn 6 Bln Acute upper respiratory infection, unspecified √
32 04-04-2023 0036153 BPJS 0002732692724 3524244404630001 ARLIKAH P SAMBOPINGGIR 60 Thn 0 Bln Senile cataract, unspecified √
33 04-04-2023 0008020 BPJS 0001299720183 3524244808450001 MUSAMA P KEBONSARI 002/003 77 Thn 7 Bln Counselling, unspecified √
34 04-04-2023 0030724 BPJS 0002484737943 3524244101550061 CHOLIFAH P BLAWI 003/002 68 Thn 3 Bln Thyrotoxicosis, unspecified √
35 04-04-2023 0022252 BPJS 0002162609943 3524240101620011 SA'UM L BAKALAN 61 Thn 3 Bln Cerebral infarction due to thrombosis of precerebral arteries √
36 04-04-2023 0022145 BPJS 0000758265658 3524244101610029 DARMANI P LUNTAS S 003/001
62 Thn 3 Bln Chronic ischaemic heart disease, unspecified; Congestive heart failure √
37 04-04-2023 0004848 BPJS 0000103106518 3523245112620001 MAFTUCHAH P GAYAM 005/003 60 Thn 3 Bln Myalgia √
38 04-04-2023 0010957 BPJS 0000103630858 3524240303530002 AMIN L MAYONG TENGAH 004/003 70 Thn 1 Bln Old myocardial infarction √
39 04-04-2023 0018201 BPJS 0000758992678 3524247006570002 KHUZAIMAH L MAYONG WETAN 001/004 Dyspepsia; Non-insulin-dependent diabetes mellitus with multiple
65 Thn 9 Bln complications; Secondary hypertension, unspecified √
40 04-04-2023 0038523 BPJS 0003304385897 3524243006590012 RAMELI L BLAWI TENGAH 001/004 63 Thn 9 Bln Senile cataract, unspecified √
41 04-04-2023 0027184 BPJS 0000103768277 SUMIRAN L NGIPIK 002/003 75 Thn 5 Bln Acute upper respiratory infection, unspecified √
43 05-04-2023 0010385 BPJS 0000758404012 ACHROM L KARANGBINANGUN 001/001 Acute nasopharyngitis [common cold]; Dyspepsia; Hypertensive heart
44 05-04-2023 0036318 BPJS 0001704045508 3524246001440001 RUKANAH P BANJARANYAR 003/002 79 Thn 2 Bln Senile cataract, unspecified √
45 05-04-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002 66 Thn 3 Bln Abscess of prostate; Myalgia √
46 05-04-2023 0001448 BPJS 0002758761832 3524244101420014 SRIAMAH P PELUK 001/003
47 05-04-2023 0013177 BPJS 0002449100283 3524244201540006 ASTIKAH P BONSARI 002/004 69 Thn 3 Bln Headache; Other secondary hypertension √
48 05-04-2023 0030008 BPJS 0002213117717 3524242903570001 SUEB L SAMBO 001/003
49 05-04-2023 0010859 BPJS 0000759422654 3524244301540001 SUMIATI P BANJARANYAR 003/003 69 Thn 3 Bln Atrial fibrillation and flutter; Congestive heart failure √
50 06-04-2023 0012642 BPJS 0001961118516 3524244105570006 MASRIAH P WEDENG 002/003
65 Thn 11 Bln Lumbar and other intervertebral disc disorders with myelopathy √
51 06-04-2023 0018521 BPJS 0000758671885 3524246101410001 SRIPAH P KETAPANG 001/002 82 Thn 2 Bln Dementia in Alzheimer's disease, unspecified √
52 06-04-2023 0028642 BPJS 0001047281455 SAKUR L BONRINGIN 001/004 61 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √
53 06-04-2023 0038518 BPJS 0001047283492 3524244101520069 MARINTEN P BANJARANYAR 002/002 71 Thn 3 Bln Hebephrenic schizophrenia √
54 06-04-2023 0013036 BPJS 0001961115423 3524240510530003 MOH. THOHA L WEDENG 002/003 69 Thn 6 Bln Osseous stenosis of neural canal √
55 06-04-2023 0027165 BPJS 0000759765429 3524240104540002 AMAN L BADAN 002/004 69 Thn 0 Bln Hypertensive heart disease without (congestive) heart failure √
56 06-04-2023 0002794 BPJS 0002295292792 3524241305530003 SUJARI L MONOLELO 002/002 69 Thn 10 Bln Hyperplasia of prostate √
57 06-04-2023 0033437 BPJS 0000790684176 3578153006520125 SAPI'I L WINDU 002/001
58 06-04-2023 0016720 BPJS 0000159548973 3524246002530001 SRI SAJEKTI P KEPOH
59 06-04-2023 0016719 BPJS 0000103768255 3524240901510001 SUMARGONO, SE L KEPOH
60 06-04-2023 0034377 BPJS 0001262805985 3524244909560001 HJ. SALAMAH P MENGAI 001/006 66 Thn 6 Bln Other specified anaemias √
61 06-04-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 67 Thn 10 Bln Cerebral infarction, unspecified √
62 10-04-2023 0009702 BPJS 0000758953541 3524245804530001 ALFIATUN P MAGOK 001/001 69 Thn 11 Bln Acute nasopharyngitis [common cold]; Dyspepsia √
63 10-04-2023 0028828 BPJS 0002236781981 3524245205600002 WAINING P MENGAI 001/006 Dyspepsia; Non-insulin-dependent diabetes mellitus without
64 10-04-2023 0003544 BPJS 0000758593078 3524241204610001 KASNAWI L BATURONO 002/002 Bronchopneumonia, unspecified; Hypertensive heart disease without
65 10-04-2023 0035969 BPJS 0000758682382 3524241212500003 SAMAN L MAYONG TENGAH 003/003 72 Thn 3 Bln Acute ischaemic heart disease, unspecified √
66 10-04-2023 0030724 BPJS 0002484737943 3524244101550061 CHOLIFAH P BLAWI 003/002 68 Thn 3 Bln Thyrotoxicosis, unspecified √
68 10-04-2023 0027842 BPJS 0000758915155 3524245606560001 SUTI P MENGAI 002/005 65 Thn 9 Bln Gastritis, unspecified √
69 10-04-2023 0024027 BPJS 0001704043809 3524244101560072 MUFATIROH P BADAN 67 Thn 3 Bln Glaucoma, unspecified √
70 10-04-2023 0033839 BPJS 0000759370263 3524244210570001 HARMINI P WATES 001/002 65 Thn 6 Bln Pleural effusion, not elsewhere classified √
71 10-04-2023 0030591 BPJS 0001829062451 MUSLIMAH P GAYAM 60 Thn 5 Bln Hypertension secondary to endocrine disorders √
72 10-04-2023 0005882 BPJS 0001829059997 3524241010530001 NADJIECH M. NOORS L GAYAM 004/002 69 Thn 6 Bln Hypertension secondary to endocrine disorders √
74 10-04-2023 0027165 BPJS 0000759765429 3524240104540002 AMAN L BADAN 002/004 69 Thn 0 Bln Attention to surgical dressings and sutures √
75 10-04-2023 0012143 BPJS 0000759291388 3524246505620001 RUMINAH P WEDENG 001/001
76 10-04-2023 0023108 BPJS 0003503639507 3524241203590001 MARNO L MENGAI 002/006 64 Thn 0 Bln Otitis media, unspecified √
77 10-04-2023 0033437 BPJS 0000790684176 3578153006520125 SAPI'I L WINDU 002/001 70 Thn 9 Bln Bilateral inguinal hernia, without obstruction or gangrene √
78 10-04-2023 0009450 BPJS 0000758401683 3524240101560030 ROFII L KAUMAN 004/002 Cellulitis of trunk; Non-insulin-dependent diabetes mellitus without
79 10-04-2023 0005888 BPJS 0000758317037 3524245201570001 INEM P MAGOK 001/002
80 11-04-2023 0001503 BPJS 0000757542565 3524244102620002 MALIYAH P SAMBO 61 Thn 2 Bln Dyspepsia √
81 11-04-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 64 Thn 6 Bln Other acute upper respiratory infections of multiple sites √
82 11-04-2023 0016038 BPJS 0000759820511 3524245503610001 SURIATI P KURIPAN 001/008 62 Thn 0 Bln Gastritis, unspecified √
83 11-04-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004 63 Thn 8 Bln Hyperglycaemia, unspecified √
84 11-04-2023 0034503 UMUM 3524244208580001 DIPI P KARANGANOM W 007/004 64 Thn 8 Bln Examination for adolescent development state √
85 11-04-2023 0034504 BPJS 0002926263058 3524244101450018 ARTI P KETAPANG 002/002 78 Thn 3 Bln Examination for adolescent development state √
86 11-04-2023 0034496 BPJS 0003143832963 SALIM L TEMBOK 002/003 64 Thn 6 Bln Hypertension secondary to endocrine disorders √
87 11-04-2023 0034498 UMUM 3524244101530024 YATEMI P SUMBERJO 001/002 70 Thn 3 Bln Hypertension secondary to endocrine disorders √
88 11-04-2023 0005882 BPJS 0001829059997 3524241010530001 NADJIECH M. NOORS L GAYAM 004/002 69 Thn 6 Bln Hypertension secondary to endocrine disorders √
91 11-04-2023 0016772 BPJS 0001047282276 3524242009560001 SUMADI L BAKALAN 001/002 66 Thn 6 Bln Senile cataract, unspecified √
92 11-04-2023 0024332 BPJS 0000758661221 3524240101560020 SUBEKI L KETAPANG 67 Thn 3 Bln Examination for adolescent development state √
93 11-04-2023 0030591 BPJS 0001829062451 MUSLIMAH P GAYAM 60 Thn 5 Bln Hypertension secondary to other renal disorders √
94 11-04-2023 0032101 UMUM SUROSO L SAMBO 001/004 66 Thn 9 Bln Examination for adolescent development state √
95 11-04-2023 0029444 UMUM 6311022509580001 MUNDZIR MISBAH L MONOLELO 001/002 64 Thn 6 Bln Hypertension secondary to endocrine disorders √
96 11-04-2023 0013653 BPJS 0000758820284 SUPARTI P BADAN 002/004 Hyperglycaemia, unspecified; Hypertensive heart disease without
97 11-04-2023 0038446 BPJS 0003176547794 3524240101590005 DJAYUS L WATANGAN 002/001
64 Thn 3 Bln Insulin-dependent diabetes mellitus with multiple complications √
98 11-04-2023 0002181 BPJS 0000103499875 3524244203630001 NASIYATIN P KEPENG 003/002 60 Thn 1 Bln Acute ischaemic heart disease, unspecified √
99 11-04-2023 0000416 BPJS 0000103499886 3524240304630002 KHABIB L KEPENG 003/002 60 Thn 0 Bln Counselling, unspecified √
100 11-04-2023 0010189 BPJS 0001047286798 3524244307350001 YATEMI P WARUK 003/002 87 Thn 9 Bln Acute transmural myocardial infarction of inferior wall √
101 11-04-2023 0021546 BPJS 0002484356949 3524244101550060 DEWI MARYAM P BLAWI SELATAN 001/002 68 Thn 3 Bln Acute pain √
102 11-04-2023 0000346 BPJS 0000758541622 3524244506570001 WARNI P WEDENG 001/001 Vaginitis, vulvitis and vulvovaginitis in infectious and parasitic diseases
65 Thn 10 Bln classified elsewhere √
104 12-04-2023 0036513 BPJS 0002732685399 3524245805570001 SUMIATI P NGAJARAN 003/004 Gastritis, unspecified; Hypertensive heart disease without (congestive)
105 12-04-2023 0018082 BPJS 0003176584773 3524245209590003 SUHARTI P BATURONO 002/002 63 Thn 7 Bln Hypertensive heart disease with (congestive) heart failure √
106 12-04-2023 0015303 BPJS 0000759643931 3524244701630001 MARIYAM P MONOLELO 001/002
60 Thn 3 Bln Hyperglycaemia, unspecified; Other specified surgical follow-up care √
107 12-04-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 Acute upper respiratory infection, unspecified; Atopic dermatitis,
67 Thn 10 Bln unspecified √
108 12-04-2023 0026586 BPJS 0002422337995 KUSYAINI L MORO W 001/003 64 Thn 9 Bln Other and unspecified intestinal obstruction √
109 13-04-2023 0004480 BPJS 0001483865482 3524240207480001 SHODIKIN L WEDENG 002/002 74 Thn 9 Bln Primary generalized (osteo)arthrosis √
110 13-04-2023 0014603 BPJS 0000759887458 3524244209400001 SHOLIKAH P BATURONO 002/002 Hypertensive heart disease without (congestive) heart failure;
82 Thn 7 Bln Pulmonary oedema √
111 13-04-2023 0001101 BPJS 0000103499482 SUKAERI,DRS L SAMBO 002/002 60 Thn 11 Bln Acute conjunctivitis, unspecified √
112 13-04-2023 0038561 BPJS 0001787648141 3524254101590044 RUPI'AH P KUDU 002/002
64 Thn 3 Bln Unspecified diabetes mellitus with peripheral circulatory complications √
113 13-04-2023 0018191 UMUM 3524243112620004 MA'AT L SAMBOPINGGIR 60 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √
114 13-04-2023 0026509 BPJS 0000759477205 3524244101570049 SAMSIYAH P PRIYOSO WETAN 002/002
115 14-04-2023 0013638 BPJS 0002162613543 3524244101500050 MUNTIYANI P WINDU 002/002 Non-insulin-dependent diabetes mellitus with unspecified
116 14-04-2023 0027842 BPJS 0000758915155 3524245606560001 SUTI P MENGAI 002/005 65 Thn 10 Bln Gastritis, unspecified √
117 14-04-2023 0038548 BPJS 0002811410436 3524240101530044 NGATAWI L KADU 002/002 70 Thn 3 Bln Superficial injury of unspecified body region √
118 14-04-2023 0037856 BPJS 0002197064428 3524241812500001 KHOIRON L PALANGAN 001/002 72 Thn 3 Bln Torticollis, cervicothoracic region √
119 14-04-2023 0033879 BPJS 0002455205545 3524240508540001 SARI L PUTATREJO 001/003 68 Thn 8 Bln Hyperplasia of prostate √
121 14-04-2023 0022341 BPJS 0002208979091 3524241803520001 MISKAL L LUNTAS B 003/007 71 Thn 0 Bln Chronic obstructive pulmonary disease, unspecified √
122 14-04-2023 0005144 BPJS 0001888188895 3524244101590044 SYAFAATUN P KAUMAN 001/002 64 Thn 3 Bln Hypertensive heart disease without (congestive) heart failure √
123 14-04-2023 0021546 BPJS 0002484356949 3524244101550060 DEWI MARYAM P BLAWI SELATAN 001/002 68 Thn 3 Bln Hypertensive heart disease without (congestive) heart failure √
124 14-04-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 70 Thn 3 Bln Counselling, unspecified √
125 17-04-2023 0020669 BPJS 0000758793824 3524246201600001 KHOLILAH P MENGAI 002/006 Hypertensive heart disease without (congestive) heart failure; Myalgia,
63 Thn 2 Bln ankle and foot √
126 17-04-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 64 Thn 6 Bln Acute upper respiratory infection, unspecified; Myalgia √
127 17-04-2023 0005055 BPJS 0002265541211 3524246204620001 RIYANAH P KEBONSARI 002/003 Gastritis, unspecified; Hypertensive heart disease without (congestive)
128 17-04-2023 0024214 BPJS 0000758973306 3524242007550001 NARIYO L MAGOK 001/002 Gastritis, unspecified; Hypertensive heart disease with (congestive)
129 17-04-2023 0016705 BPJS 0000758126643 3524242306570001 ABD. MANAN L WARUK 002/002
130 17-04-2023 0013541 BPJS 0001386491905 3524245406500001 KASRI P KLECO 002/004 72 Thn 10 Bln Moderate depressive episode √
131 17-04-2023 0011151 BPJS 0000758183242 3524244808570001 SUMAH P MAGOK 003/002 Hyperglycaemia, unspecified; Hypertensive heart disease without
132 17-04-2023 0020211 BPJS 0000758427636 3524240708490001 SUKADI L PALANGAN 001/002 73 Thn 8 Bln Congestive heart failure √
133 17-04-2023 0019972 BPJS 0001047284144 3524244911540001 MISTRI P PALANGAN 68 Thn 5 Bln Other glaucoma √
134 17-04-2023 0038548 BPJS 0002811410436 3524240101530044 NGATAWI L KADU 002/002 70 Thn 3 Bln Surgical follow-up care, unspecified √
135 18-04-2023 0002670 BPJS 0000103498457 3524242504540001 DJUWONO L ALANG-ALANG 002/005
68 Thn 11 Bln Chronic renal failure, unspecified; Essential (primary) hypertension √
137 18-04-2023 0022874 BPJS 0001704050561 3624255006480002 KASENAH P WINDU 002/001 74 Thn 9 Bln Counselling, unspecified √
138 18-04-2023 0010385 BPJS 0000758404012 ACHROM L KARANGBINANGUN 001/001 70 Thn 3 Bln Dyspepsia; Myalgia √
139 18-04-2023 0010489 BPJS 0002162609829 3524244101560016 SAMSUNI P BAKALAN 002/002 67 Thn 3 Bln Atrial fibrillation and flutter √
140 18-04-2023 0019010 BPJS 0002162940827 3524240506560002 MASYKUN KHOIRI L WEDENG 001/004 66 Thn 10 Bln Acute nasopharyngitis [common cold] √
141 18-04-2023 0022559 BPJS 0002058535866 3524240101490017 SU'EF L PUPUK 001/003 74 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √
142 18-04-2023 0001503 BPJS 0000757542565 3524244102620002 MALIYAH P SAMBO 61 Thn 2 Bln Acute haemorrhagic gastritis; Melaena √
143 18-04-2023 0002749 BPJS 0000103767579 3524244101550062 SUKAENI P BANDUT 002/001
Anaemia due to other disorders of glutathione metabolism;

68 Thn 3 Bln dependent diabetes mellitus with multiple complications √
144 18-04-2023 0024099 BPJS 0000759057017 3524240101630015 SEKAR L BAKALAN 001/001 60 Thn 3 Bln Old myocardial infarction √
145 18-04-2023 0009146 UMUM NAHNU L PENCARAN
146 18-04-2023 0033940 BPJS 0000099183306 3525091512470001 H. SUBEKTI RAHARDJO, DRS. L JL. MANGGIS NO 20 WADENG SID 75 Thn 4 Bln Acute nasopharyngitis [common cold]; Myalgia √
147 18-04-2023 0030591 BPJS 0001829062451 MUSLIMAH P GAYAM 60 Thn 5 Bln Hypertension secondary to other renal disorders √
148 18-04-2023 0005882 BPJS 0001829059997 3524241010530001 NADJIECH M. NOORS L GAYAM 004/002 69 Thn 6 Bln Hypertensive heart disease without (congestive) heart failure √
149 18-04-2023 0038578 BPJS 0000759427817 3524241101630003 QOMARI L LUNTAS B 002/007 60 Thn 3 Bln √
150 26-04-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001
152 26-04-2023 0038024 BPJS 0002608054031 3524240411580001 DIDIK MULIADI L WATANGAN 001/002 64 Thn 5 Bln Atherosclerotic heart disease √
153 26-04-2023 0007765 BPJS 0002435810861 3524244404590001 HJ. AMATUN MUKMINATUN P PALANGAN 001/001 Congestive heart failure; Hypertensive heart disease with (congestive)
154 26-04-2023 0034377 BPJS 0001262805985 3524244909560001 HJ. SALAMAH P MENGAI 001/006 66 Thn 7 Bln Counselling, unspecified √
155 26-04-2023 0008404 BPJS 0002162696635 MUJAINAH P KEBONSARI 001/001 74 Thn 1 Bln Counselling, unspecified √
156 26-04-2023 0015068 BPJS 0003500275364 3524241205510004 M.CHOIRI L BATURONO 002/002 Asthma, unspecified; Hypertensive heart disease without (congestive)
157 26-04-2023 0026586 BPJS 0002422337995 KUSYAINI L MORO W 001/003 64 Thn 9 Bln Other and unspecified intestinal obstruction √
159 27-04-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004 63 Thn 8 Bln Myalgia, site unspecified √
160 27-04-2023 0013095 BPJS 0003055242069 3524245208480001 SUMILAH P KEBONSARI 001/004 74 Thn 8 Bln Hypertensive heart disease with (congestive) heart failure √
161 27-04-2023 0038605 BPJS 0002501347285 3524240201630007 MAHMUDI L BLAWI 001/003 60 Thn 3 Bln End-stage renal disease √
162 27-04-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002 66 Thn 3 Bln Myalgia √
163 27-04-2023 0006551 BPJS 0000758868309 MARKAN L KLECO 67 Thn 9 Bln Other miliary tuberculosis √
164 27-04-2023 0003747 BPJS 0002162693957 NAPSIYAH P NGIPIK
165 27-04-2023 0013177 BPJS 0002449100283 3524244201540006 ASTIKAH P BONSARI 002/004 69 Thn 3 Bln Hypertensive heart disease without (congestive) heart failure √
166 27-04-2023 0037927 BPJS 0000758954226 3524245101540002 NEMU P PUPUK 002/003 69 Thn 3 Bln Spinal stenosis, lumbar region √
167 27-04-2023 0024437 BPJS 0000758739486 3524247012540001 MARTIYA P SAMBO 003/004 68 Thn 3 Bln Cerebral infarction, unspecified √
168 27-04-2023 0006545 UMUM 3524242305570001 ABD CHOLIQ L KARANGAJI 003/003 65 Thn 11 Bln Acute nasopharyngitis [common cold] √
60 Thn 11 Bln Acute hepatitis B with delta-agent (coinfection) without hepatic coma √
171 28-04-2023 0036769 BPJS 0000103655575 3524245711600001 ISTIROCHAH P KARANGBINANGUN 001/001 62 Thn 5 Bln Malignant neoplasm overlapping bronchus and lung sites √
172 28-04-2023 0015303 BPJS 0000759643931 3524244701630001 MARIYAM P MONOLELO 001/002 60 Thn 3 Bln Pleural effusion, not elsewhere classified √
173 28-04-2023 0010782 UMUM 3524244704560002 MUKANAH P KEBONSARI 004/003 67 Thn 0 Bln Acute upper respiratory infection, unspecified √
Pemeriks
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
CEKLIST KELENGKAPAN PENGISIAN REKAM MEDIS POLI LANS
Tanggal : : 01-05-2023 s/d 31-05-2023
Jenis
No Tanggal No Reg No BPJS NIK
Pasien
1 02-05-2023 0020388 UMUM 3524244101570001

2 02-05-2023 0022963 UMUM 3524244105570003
3 02-05-2023 0024042 BPJS 0002419344145 3524241905550001
4 02-05-2023 0011151 BPJS 0000758183242 3524244808570001

5 02-05-2023 0029808 BPJS 0001861880499 3524240101480014
6 02-05-2023 0004848 BPJS 0000103106518 3523245112620001
7 02-05-2023 0003444 BPJS 0000758377967 3524240808550001

8 02-05-2023 0007174 UMUM 3524241205530002
9 02-05-2023 0016645 BPJS 0003503285831 3524244101630012

10 02-05-2023 0011738 BPJS 0002488684645 3524244101540013
11 02-05-2023 0024744 BPJS 0000758587195 3524245707600001
12 02-05-2023 0005888 BPJS 0000758317037 3524245201570001
13 02-05-2023 0010014 BPJS 0000757393547 3524241309500001

14 02-05-2023 0009021 BPJS 0001269227632 3524240506560001
15 02-05-2023 0018082 BPJS 0003176584773 3524245209590003
16 03-05-2023 0011981 BPJS 0002038243487 3524244101460025

17 03-05-2023 0008595 BPJS 0000103767017 3303096810550001
18 03-05-2023 0027240 BPJS 0001704051066 3524247006550008
19 03-05-2023 0000416 BPJS 0000103499886 3524240304630002

20 03-05-2023 0003444 BPJS 0000758377967 3524240808550001
21 03-05-2023 0017442 BPJS 0001897451829 3524243006550005
22 03-05-2023 0022963 UMUM 3524244105570003

23 03-05-2023 0019964 BPJS 0002066070363
24 03-05-2023 0029406 BPJS 0002763980436
25 03-05-2023 0023753 BPJS 0002245028398 3524242008540001
26 04-05-2023 0008210 BPJS 0001464136839 3524245209530001

27 04-05-2023 0027502 BPJS 0002162609919 3524240101570072
28 04-05-2023 0006411 BPJS 0003060943402 3524240101460010

29 04-05-2023 0016904 BPJS 0002422338197 3524244804620001
30 04-05-2023 0031347 BPJS 0002734828593 3524244101590013

31 04-05-2023 0003438 BPJS 0000103501528 3524240402540001
32 04-05-2023 0028828 BPJS 0002236781981 3524245205600002
33 05-05-2023 0004152 BPJS 0000103501192 3524244610570001

34 05-05-2023 0011151 BPJS 0000758183242 3524244808570001
35 05-05-2023 0004848 BPJS 0000103106518 3523245112620001

36 05-05-2023 0025981 BPJS 0003516100964 3524244101570034
37 05-05-2023 0005882 BPJS 0001829059997 3524241010530001

38 05-05-2023 0034504 BPJS 0002926263058 3524244101450018
39 05-05-2023 0021618 BPJS 0000758401637
40 05-05-2023 0033622 BPJS 0001047273232 3524245909610001
41 05-05-2023 0014488 BPJS 0003269834144 3524246103610002
42 05-05-2023 0015939 BPJS 0001047281872 3524244104630001
43 05-05-2023 0035590 BPJS 0003110245953 3524264101450087
44 05-05-2023 0035330 BPJS 0001704044362 3524246007540001
45 05-05-2023 0000261 BPJS 0000103767118
46 05-05-2023 0027880 BPJS 0000759140796 3524244201550010
47 08-05-2023 0011117 BPJS 0002913182559
48 08-05-2023 0027888 BPJS 0002896469177

49 08-05-2023 0025453 BPJS 0002774533465
50 08-05-2023 0036869 BPJS 0001535057739 3524241212610001

51 08-05-2023 0026817 BPJS 0002445619803 3524245201500001
52 08-05-2023 0022677 BPJS 0000759011398 3524241008590001
53 08-05-2023 0033230 BPJS 0000758639619

54 08-05-2023 0012469 BPJS 0000757393615 3524245101550005
55 08-05-2023 0018836 BPJS 0001704045306 3524241010580001
56 08-05-2023 0027842 BPJS 0000758915155 3524245606560001
57 08-05-2023 0027323 BPJS 0000759284717 3524244101530059
58 08-05-2023 0008116 BPJS 0000103695401 352424

59 08-05-2023 0034606 BPJS 0002912236852 3524245004410001
60 08-05-2023 0024214 BPJS 0000758973306 3524242007550001
61 08-05-2023 0026346 BPJS 0002084233713 3524244103560001

62 08-05-2023 0029991 BPJS 0002741412025 3524244101610040
63 08-05-2023 0037202 BPJS 0000759163959 3524245206530002
64 08-05-2023 0000641 BPJS 0000103599821 3524241212480002

65 08-05-2023 0018163 BPJS 0001047271623
66 08-05-2023 0023753 BPJS 0002245028398 3524242008540001
67 09-05-2023 0009021 BPJS 0001269227632 3524240506560001
68 09-05-2023 0033774 BPJS 0000758644569
69 09-05-2023 0001935 BPJS 0000103766984 3524244101550078

70 09-05-2023 0019884 BPJS 0001704046285 3524246307570001
71 09-05-2023 0037831 BPJS 0000759368125 3524247006620003

72 09-05-2023 0012501 BPJS 0000758730352 3524244912510001
73 09-05-2023 0000751 BPJS 0002088847844 3524241905620001
74 09-05-2023 0013541 BPJS 0001386491905 3524245406500001
75 09-05-2023 0012330 BPJS 0000759341856 3524240201550003
76 09-05-2023 0012143 BPJS 0000759291388 3524246505620001
77 09-05-2023 0022188 BPJS 0000758841546 3524240207550001

78 09-05-2023 0028458 BPJS 0002749091602 3524241403620001
79 10-05-2023 0027240 BPJS 0001704051066 3524247006550008
80 10-05-2023 0035616 BPJS 0003101665138 3524244101630035
81 10-05-2023 0038684 UMUM 3524240407470001
82 10-05-2023 0038680 BPJS 0000757728797 3524244803520002
83 10-05-2023 0013638 BPJS 0002162613543 3524244101500050
84 10-05-2023 0010782 UMUM 3524244704560002

85 10-05-2023 0034606 BPJS 0002912236852 3524245004410001
86 10-05-2023 0024042 BPJS 0002419344145 3524241905550001
87 10-05-2023 0037339 BPJS 0003265273146 3524243012590004

88 10-05-2023 0015118 BPJS 0002375087951 3524245112610001
89 11-05-2023 0033437 BPJS 0000790684176 3578153006520125

90 11-05-2023 0008324 BPJS 0002874881035 3524240101610045
91 11-05-2023 0019010 BPJS 0002162940827 3524240506560002
92 11-05-2023 0034764 BPJS 0003078780941 3524244201630007
93 11-05-2023 0022783 BPJS 0000758824953 3524244201620007

94 11-05-2023 0001935 BPJS 0000103766984 3524244101550078
95 11-05-2023 0004157 BPJS 0002697610645 3524244807610001
96 11-05-2023 0008730 BPJS 0000758680964 3524247006580007

97 12-05-2023 0001672 BPJS 0001422789816 3524245204520001
98 12-05-2023 0030114 BPJS 0000759770853 3524242507500003
99 12-05-2023 0037831 BPJS 0000759368125 3524247006620003
100 12-05-2023 0023753 BPJS 0002245028398 3524242008540001
101 12-05-2023 0023446 BPJS 0000103590437 3524241508560001
102 12-05-2023 0038698 BPJS 0000759592721 3524240603570001
103 12-05-2023 0004848 BPJS 0000103106518 3523245112620001

104 12-05-2023 0038699 BPJS 0000759088629 3524240101550073
105 15-05-2023 0012143 BPJS 0000759291388 3524246505620001
106 15-05-2023 0037988 BPJS 0003176756403 3524240204630002

107 15-05-2023 0000012 BPJS 0000169417719 1208236007520001
108 15-05-2023 0022677 BPJS 0000759011398 3524241008590001
109 15-05-2023 0003544 BPJS 0000758593078 3524241204610001
110 15-05-2023 0024214 BPJS 0000758973306 3524242007550001
111 15-05-2023 0003491 BPJS 0000169662251 3517074106500001

112 15-05-2023 0006213 BPJS 0002244527752
113 15-05-2023 0000502 BPJS 0000103766848 1208230112440001
114 15-05-2023 0011428 UMUM 3524245204620001
115 15-05-2023 0038708 BPJS 0000758575833 3524241805590001
116 15-05-2023 0037666 BPJS 0002199716379
117 15-05-2023 0036011 BPJS 0000758624962 3524240708590004
118 16-05-2023 0006776 BPJS 0000758316262 3524240101470002
119 16-05-2023 0033487 BPJS 0000758987357 3524245708300001

120 16-05-2023 0017323 BPJS 0000757468888
121 16-05-2023 0005677 BPJS 0000758371645 3524245101590003
122 16-05-2023 0038713 BPJS 0002162694071 3524247006480009
123 16-05-2023 0038698 BPJS 0000759592721 3524240603570001
124 16-05-2023 0002336 BPJS 0000758749948 3524244404550001

125 16-05-2023 0029728 BPJS 0002695910308
126 16-05-2023 0011752 BPJS 0000759262959 3524245706600002
127 16-05-2023 0001503 BPJS 0000757542565 3524244102620002
128 16-05-2023 0000502 BPJS 0000103766848 1208230112440001

129 17-05-2023 0027240 BPJS 0001704051066 3524247006550008
130 17-05-2023 0037238 BPJS 0003143832388 3524240108520003
131 17-05-2023 0022783 BPJS 0000758824953 3524244201620007

132 17-05-2023 0015854 BPJS 0001047274154 3524241510600001
133 17-05-2023 0024414 BPJS 0000758141864 3524241111560001
134 17-05-2023 0038293 BPJS 0000758550644 3524244101620007
135 17-05-2023 0021460 BPJS 0002488312642
136 19-05-2023 0012143 BPJS 0000759291388 3524246505620001
137 19-05-2023 0028325 BPJS 0000759155253 3524245201530001

138 19-05-2023 0002772 BPJS 0002908019542 3524246410570001
139 19-05-2023 0002159 BPJS 0000103500966 3524241103620001

140 19-05-2023 0011151 BPJS 0000758183242 3524244808570001
141 19-05-2023 0013541 BPJS 0001386491905 3524245406500001

142 19-05-2023 0027363 BPJS 0002459985535 3524240201540001
143 19-05-2023 0016596 BPJS 0000103501203 3524264702580001

144 19-05-2023 0029107 BPJS 0002765885422 3524244101610039
145 19-05-2023 0011668 BPJS 0002765884937 3524240101550053
146 19-05-2023 0025981 BPJS 0003516100964 3524244101570034
147 19-05-2023 0027750 BPJS 0001704055544
148 19-05-2023 0013177 BPJS 0002449100283 3524244201540006
149 19-05-2023 0000641 BPJS 0000103599821 3524241212480002
150 19-05-2023 0000639 BPJS 0000103500437 3524244111540002
151 19-05-2023 0001693 BPJS 0002066720894 3524242001570002
152 20-05-2023 0010189 BPJS 0001047286798 3524244307350001
153 22-05-2023 0024214 BPJS 0000758973306 3524242007550001
154 22-05-2023 0006200 BPJS 0002845117934 3524240106610002

155 22-05-2023 0001503 BPJS 0000757542565 3524244102620002
156 22-05-2023 0000639 BPJS 0000103500437 3524244111540002
157 22-05-2023 0002336 BPJS 0000758749948 3524244404550001
158 22-05-2023 0034936 BPJS 0002876182492 3524244201570013
159 22-05-2023 0034935 BPJS 0002876182468 3524240101510050
160 22-05-2023 0022677 BPJS 0000759011398 3524241008590001
161 22-05-2023 0023753 BPJS 0002245028398 3524242008540001
162 22-05-2023 0010385 BPJS 0000758404012
163 22-05-2023 0010782 UMUM 3524244704560002
164 22-05-2023 0000431 BPJS 0000103500213 3524240601550001

165 22-05-2023 0027502 BPJS 0002162609919 3524240101570072
166 22-05-2023 0001334 BPJS 0000758916022 3524244405620002

167 22-05-2023 0001000 BPJS 0000758404945 3524241211570001
168 22-05-2023 0038727 BPJS 0003520430662 3524244603600002
169 22-05-2023 0036482 BPJS 0001905647668 3524241711520001
170 22-05-2023 0000496 BPJS 0001047281253 3524247112480001
171 23-05-2023 0013472 BPJS 0003134739442 3524244101610069

172 23-05-2023 0005144 BPJS 0001888188895 3524244101590044
173 23-05-2023 0038476 BPJS 0001917158038 3524244512510002

174 23-05-2023 0034133 BPJS 0002439974531 3524244101580030
175 23-05-2023 0038727 BPJS 0003520430662 3524244603600002

176 23-05-2023 0038794 BPJS 0000758963575 3524240204620001
177 24-05-2023 0027240 BPJS 0001704051066 3524247006550008
178 24-05-2023 0017577 BPJS 0000757448291 3524245010590002
179 24-05-2023 0028160 BPJS 0000758638102 3524246907500001
180 24-05-2023 0019146 BPJS 0003134588444 3524240101590041

181 24-05-2023 0002159 BPJS 0000103500966 3524241103620001
182 24-05-2023 0004486 BPJS 0000103768547 3524144512480000
183 24-05-2023 0006428 BPJS 0002257276443 3524244701500001
184 25-05-2023 0017828 BPJS 0000758469699 3524241708540003

185 25-05-2023 0009108 BPJS 0000758427851 3524240303630003
186 25-05-2023 0025871 BPJS 0002322450404
187 25-05-2023 0024644 BPJS 0000759735088 3524244201630003
188 25-05-2023 0022070 BPJS 0000759874397 3524244101580022
189 25-05-2023 0012469 BPJS 0000757393615 3524245101550005
190 25-05-2023 0038698 BPJS 0000759592721 3524240603570001
191 25-05-2023 0036482 BPJS 0001905647668 3524241711520001
192 25-05-2023 0038748 BPJS 0000758741984 3524247012570001
193 25-05-2023 0026855 BPJS 0002424108756 3524246101580002

194 26-05-2023 0037049 BPJS 0003174198489 3524244104570001
195 26-05-2023 0011624 BPJS 0000758869806

196 26-05-2023 0006583 BPJS 0000758869874 3524244101500028
197 29-05-2023 0024214 BPJS 0000758973306 3524242007550001
198 29-05-2023 0002336 BPJS 0000758749948 3524244404550001

199 29-05-2023 0023953 BPJS 0002215173846 3524245306590001
200 29-05-2023 0031950 BPJS 0002923563249
201 29-05-2023 0038794 BPJS 0000758963575 3524240204620001
202 29-05-2023 0003747 BPJS 0002162693957

203 29-05-2023 0035441 BPJS 0003005295873 3524244104590001
204 29-05-2023 0033879 BPJS 0002455205545 3524240508540001

205 29-05-2023 0038788 UMUM 3524240304560002
206 29-05-2023 0014917 BPJS 0000758595778 3524244911550001
207 29-05-2023 0009450 BPJS 0000758401683 3524240101560030
208 29-05-2023 0010385 BPJS 0000758404012
209 30-05-2023 0013841 BPJS 0000758389173 3524244101630034

210 30-05-2023 0022783 BPJS 0000758824953 3524244201620007
211 30-05-2023 0000639 BPJS 0000103500437 3524244111540002

212 30-05-2023 0029274 BPJS 0002475134921 3524242705440001
213 30-05-2023 0038748 BPJS 0000758741984 3524247012570001

214 30-05-2023 0033239 BPJS 0000759104842 3524246101590005
215 30-05-2023 0028110 BPJS 0002499393341
216 30-05-2023 0028752 BPJS 0000758689986
217 31-05-2023 0000844 BPJS 0000103767333 3524240106510001
218 31-05-2023 0016233 BPJS 0000759161889

219 31-05-2023 0017880 BPJS 0000758841581
220 31-05-2023 0038802 BPJS 0001704090701 3524245100830001
221 31-05-2023 0014964 BPJS 0000757743287 3524246711600001
222 31-05-2023 0016705 BPJS 0000758126643 3524242306570001
223 31-05-2023 0015109 BPJS 0000758126709
224 31-05-2023 0019010 BPJS 0002162940827 3524240506560002

225 31-05-2023 0032001 BPJS 0002474678553 3524240101620015
226 31-05-2023 0008953 BPJS 0000758909441 3524244101510003

227 31-05-2023 0022677 BPJS 0000759011398 3524241008590001
PENGISIAN REKAM MEDIS POLI LANSIA
Nama Pasien L/P Alamat Usia
LAMIDJAH P PUTATREJO 002/003 66 Thn 4 Bln

MU'ADAH P BADAN 002/002 66 Thn 0 Bln
SYAFI'I L NGAJARAN 004/004
67 Thn 11 Bln
SUMAH P MAGOK 003/002 65 Thn 8 Bln
IDRIS L BAKALAN 001/002 75 Thn 4 Bln
MAFTUCHAH P GAYAM 005/003
60 Thn 4 Bln
MALIKAN L SUKLEN 001/004 67 Thn 8 Bln
HUDI ICHSAN L PENCARAN
69 Thn 11 Bln
AISYATUN P WARUK 001/002 60 Thn 4 Bln
JANAH P PUPUK 002/003 69 Thn 4 Bln
SUTARTI P KURO 002/001
62 Thn 9 Bln
INEM P MAGOK 001/002
66 Thn 3 Bln
SARKUM L MENGAI 001/006 72 Thn 7 Bln
DJUMA'IN L SAMBO
66 Thn 10 Bln
SUHARTI P BATURONO 002/002
63 Thn 7 Bln
SUARIYAH P KURO 003/001 77 Thn 4 Bln
MULYATI P KURO 001/001 67 Thn 10 Bln
NENGYAH L NGIPIK 003/003
67 Thn 10 Bln
KHABIB L KEPENG 003/002 60 Thn 1 Bln
MALIKAN L SUKLEN 001/004 67 Thn 8 Bln
MISLAN L NGIPIK 003/003
67 Thn 10 Bln
MU'ADAH P BADAN 002/002 66 Thn 0 Bln
MATOKAN L PULOKERTO 002/001 69 Thn 6 Bln
CHODIROH P KARANGBINANGUN 003/001 70 Thn 4 Bln
H.M.SARIF L PUTATREJO 001/003
68 Thn 8 Bln
SUMIATUN P KURIPAN 001/008 69 Thn 7 Bln
RUDI L BAKALAN 002/002
66 Thn 4 Bln
ASIKIN L KEPOH 004/002 77 Thn 4 Bln
SUMI P MORO 001/003
61 Thn 0 Bln
KARSITI P BAKALAN 64 Thn 4 Bln
SUTADJI L KETAPANG 001/002 69 Thn 3 Bln
WAINING P MENGAI 001/006
62 Thn 11 Bln
SUMARTI, S.PD P BANJARANYAR 003/004 65 Thn 6 Bln
SUMAH P MAGOK 003/002
65 Thn 8 Bln
MAFTUCHAH P GAYAM 005/003 60 Thn 4 Bln
RUKOIYAH P SIMAN 002/001
66 Thn 4 Bln
NADJIECH M. NOORS L GAYAM 004/002 69 Thn 6 Bln
ARTI P KETAPANG 002/002 78 Thn 4 Bln
ARTIKAH P BLAWI TENGAH 002/003 65 Thn 4 Bln
MARHAMAH P PENCARAN 001/005 61 Thn 7 Bln
HJ. MUSFIROH P GAYAM 005/003 62 Thn 1 Bln
SUMIYATI P PUTATREJO 002/003 60 Thn 1 Bln
WARSIH P KARANGANOM WETAN 008/004 78 Thn 4 Bln
MUSRI'AH P BANDUT 011/001 68 Thn 9 Bln
KASMINAH P SAMBO 002/001 70 Thn 10 Bln
NINGSIH P BADAN 002/004
68 Thn 4 Bln
NAWAWI L WARUK 002/001
44 Thn 0 Bln
TIÀH P TEMBOK 002/003 60 Thn 3 Bln
SUKATI P GUNDIK 001/004
66 Thn 3 Bln
UMAR L LUWUK 006/001 61 Thn 4 Bln
DARIYATI P KLECO 001/003
73 Thn 3 Bln
MUCHAMMAD THOEYIB L BONRINGIN 001/004
63 Thn 8 Bln
KHOIRON L WARUK 001/001 67 Thn 3 Bln
KARMINTEN P MENGAI 001/006 68 Thn 3 Bln
ABD KHANAN L KR AJI 003/006
64 Thn 6 Bln
SUTI P MENGAI 002/005 65 Thn 10 Bln
MUSOFAH P KURO 002/001
70 Thn 4 Bln
MARKAMIN L SAMBO 70 Thn 1 Bln
SRI KOPI P MAYONG KULON 001/001 82 Thn 0 Bln
NARIYO L MAGOK 001/002
67 Thn 9 Bln
KIMYATIN P PULOKERTO 002/001 67 Thn 2 Bln
SUMIATUN P KETAPANG 001/001 62 Thn 4 Bln
SAMINTEN P SINAN 003/003
69 Thn 10 Bln
H. SUMARDI, DRS L BANDUT 002/001 74 Thn 4 Bln
ACHMAD DARODJI L SUKLEN 001/004 68 Thn 10 Bln
H.M.SARIF L PUTATREJO 001/003 68 Thn 8 Bln
DJUMA'IN L SAMBO
66 Thn 11 Bln
TOYIBAH P LOGAWE
68 Thn 0 Bln
ISTIROCHA P BLAWI 002/002 68 Thn 4 Bln
SARTINA P LUNTAS B 001/007
65 Thn 9 Bln
MUAWANAH P GENTENG 005/003 60 Thn 10 Bln
TAMLIYAH P WEDENG 001/002 71 Thn 5 Bln
YASKURI L BLAWI SELATAN 003/002 60 Thn 11 Bln
KASRI P KLECO 002/004 72 Thn 10 Bln
IRPAN L LOGAWE 002/001 68 Thn 4 Bln
RUMINAH P WEDENG 001/001
60 Thn 11 Bln
ABD MAJID L BADAN 002/002 70 Thn 3 Bln
NUR KHAMIM L MENGAI 002/006 61 Thn 1 Bln
67 Thn 10 Bln
INDAHYATI P KAUMAN 001/002
60 Thn 4 Bln
H.ABDUL ROHMAN L MAYONG WETAN 001/004
75 Thn 10 Bln
MALIKA P KR ANOM WETAN 007/004
71 Thn 2 Bln
MUNTIYANI P WINDU 002/002
73 Thn 4 Bln
MUKANAH P KEBONSARI 004/003
67 Thn 1 Bln
SRI KOPI P MAYONG KULON 001/001 82 Thn 1 Bln
SYAFI'I L NGAJARAN 004/004
67 Thn 11 Bln
ABD MUJIB L MONOLELO 002/002 63 Thn 4 Bln
SONATI P WARUK 002/003
61 Thn 4 Bln
SAPI'I L WINDU 002/001 70 Thn 10 Bln
SAKIR L TERBIS 002/003 62 Thn 4 Bln
MASYKUN KHOIRI L WEDENG 001/004 66 Thn 11 Bln
ZULFAH P BLAWI UTARA 002/004
60 Thn 4 Bln
SUNARTI P BANDUT 001/001 61 Thn 4 Bln
ANIFAH P MAGOK 001/002
61 Thn 10 Bln
SITI MUJENAH P WINDU 64 Thn 10 Bln
SUYAMA P KLECO 001/10 71 Thn 1 Bln
SUKRI L KETAPANG 001/001 72 Thn 9 Bln
MUAWANAH P GENTENG 005/003 60 Thn 10 Bln
68 Thn 8 Bln
BUDI UTOMO L KURO 003/001
66 Thn 8 Bln
MUCHTAR L MONOLELO 001/002
66 Thn 2 Bln
SUKRI L MAYONG WETAN 004/004
68 Thn 4 Bln
60 Thn 11 Bln
SUJOKO L PUPUK 001/003 60 Thn 1 Bln
KAMAH P BLAWI SELATAN 002/002 71 Thn 3 Bln
MUCHAMMAD THOEYIB L BONRINGIN 001/004 63 Thn 9 Bln
KASNAWI L BATURONO 002/002
62 Thn 1 Bln
67 Thn 9 Bln
SALIKHAH P KURO 003/001 73 Thn 4 Bln
SUKARNI P WEDENG 002/003 64 Thn 8 Bln
MOH. MALIKAN L BLAWI 78 Thn 5 Bln
SUWARTIN P MAYONG WETAN 002/004 61 Thn 1 Bln
PATEMAN L SAMBO 002/003 63 Thn 11 Bln
H. KASEMAN L DS BLAWI 02/04 89 Thn 4 Bln
SAMSUL L BATURONO 002/002 63 Thn 9 Bln
SUEP KARTOWIYONO L MAGOK 001/002
76 Thn 4 Bln
MUAH P MENGAI 002/006 92 Thn 8 Bln
MUSNING P NGAJARAN 61 Thn 4 Bln
TAMINAH P SUKLEN 64 Thn 4 Bln
UMUH P WINDU 003/001 74 Thn 10 Bln
MUCHTAR L MONOLELO 001/002
66 Thn 2 Bln
SUTIKAH P WEDENG 68 Thn 1 Bln
SRI UTAMI P WATANGAN 001/001 61 Thn 4 Bln
ANIFAH P BLAWI 002/002 62 Thn 10 Bln
MALIYAH P SAMBO
61 Thn 3 Bln
MOH. MALIKAN L BLAWI 78 Thn 5 Bln
67 Thn 10 Bln
DALIL L KARANGANOMWETAN
70 Thn 9 Bln
SOLIKAN L WUNGU 001/001 62 Thn 7 Bln
ABU THOLIB L WARUK 003/001 66 Thn 6 Bln
MURTIASIH P SAMBO
61 Thn 4 Bln
NAFIK KHUSYAIRI L GAYAM 005/003
72 Thn 5 Bln
60 Thn 11 Bln
KASIATI P ALAS MALANG 70 Thn 4 Bln
TUKIYAH P SAMBO 002/003
65 Thn 6 Bln
SUKARDIONO L ALANG-ALANG 002/005 61 Thn 2 Bln
SUMAH P MAGOK 003/002
65 Thn 9 Bln
KARSAN L WATANGAN 002/002
69 Thn 4 Bln
SUMARTINI P MORO 65 Thn 3 Bln
UMI P KETAPANG 001/001 62 Thn 4 Bln
MOCHAMMAD ZEN L KETAPANG 001/001 68 Thn 4 Bln
RUKOIYAH P SIMAN 002/001
66 Thn 4 Bln
DINING L MAGOK 002/002 62 Thn 9 Bln
ASTIKAH P BONSARI 002/004 69 Thn 4 Bln
SITI ROMJATIN P BANDUT 002/001 68 Thn 6 Bln
UMAR L KR ANOM WETAN 008/004 66 Thn 3 Bln
YATEMI P WARUK 003/002 87 Thn 10 Bln
67 Thn 10 Bln
KANAN L MENGAI 001/005 61 Thn 11 Bln
MALIYAH P SAMBO 61 Thn 3 Bln
DAIYAH P PUPUS 002/006 66 Thn 4 Bln
ABD. KARIM L PUPUS 002/006 72 Thn 4 Bln
63 Thn 9 Bln
68 Thn 9 Bln
ACHROM L KARANGBINANGUN 001/001
70 Thn 4 Bln
67 Thn 1 Bln
RUBADI L BAKALAN 002/003 68 Thn 4 Bln
66 Thn 4 Bln
SUMI P BONSARI 61 Thn 0 Bln
MULYADI L KADU 005/002 65 Thn 6 Bln
SIKAH P LUWUK 001/001
63 Thn 2 Bln
UMAR L BATURONO 003/002
70 Thn 6 Bln
SITI FADILA P SAMBO 003/004
74 Thn 4 Bln
SUPARMI P MAYONG TENGAH 004/003 62 Thn 4 Bln
SYAFAATUN P KAUMAN 001/002
64 Thn 4 Bln
SAFIYAH P DS BLAWI 71 Thn 5 Bln
JAMIYAH P SIMAN 002/001
65 Thn 4 Bln
SIKAH P LUWUK 001/001 63 Thn 2 Bln
MAT JURI L WEDENG 002/003 61 Thn 1 Bln
67 Thn 10 Bln
SUPARMI P ALANG-ALANG 002/005 63 Thn 7 Bln
NIKMAH P MAYONG KULON 001/001
72 Thn 9 Bln
TASLIKAN L SUMBERJO 003/003 64 Thn 4 Bln
SUKARDIONO L ALANG-ALANG 002/005 61 Thn 2 Bln
ZUMAROH P PALANGAN 74 Thn 10 Bln
SITI AISYAH P PUTATREJO 002/003
73 Thn 4 Bln
SHOLIKHIN L KARANGANOM WETAN 68 Thn 9 Bln
TIPAN L PUPUS 001/006 60 Thn 2 Bln
SUKANAH P LUMBANGAN 003/001 65 Thn 4 Bln
SUPANI P WATANGAN 60 Thn 4 Bln
MUNAH P PELUK 007/003 65 Thn 4 Bln
MUCHTAR L MONOLELO 001/002 66 Thn 2 Bln
UMAR L BATURONO 003/002 70 Thn 6 Bln
SUWARTI P SAMBO 003/002
65 Thn 4 Bln
KASIATUN P SUMBERJO 002/003 65 Thn 4 Bln
SUWARNI P WARUK RT002/RW001
66 Thn 1 Bln
NASIKAH P MAGOK 74 Thn 2 Bln
DANIRAH P PUPUK 001/003 73 Thn 4 Bln
67 Thn 10 Bln
SUMIARTI P KLECO 002/003 63 Thn 11 Bln
NGATAJI L WARUK 003/001 62 Thn 8 Bln
MAT JURI L WEDENG 002/003
61 Thn 1 Bln
NAPSIYAH P NGIPIK 65 Thn 10 Bln
SUPIATI P KETAPANG 001/001
64 Thn 1 Bln
SARI L PUTATREJO 001/003 68 Thn 9 Bln
SUJALI L KARANGANOM KULON 002/001 67 Thn 1 Bln
SUMAIKA P KARANGANOM 67 Thn 6 Bln
ROFII L KAUMAN 004/002
67 Thn 4 Bln
ACHROM L KARANGBINANGUN 001/001
70 Thn 4 Bln
MUNAFASAH P KAUMAN 004/002
60 Thn 4 Bln
SUNARTI P BANDUT 001/001
61 Thn 4 Bln
H MAKSUM NUR L BLAWI 001/002
79 Thn 0 Bln
SUWARTI P SAMBO 003/002 65 Thn 5 Bln
FATIMAH P ALASMALANG 003/002 64 Thn 4 Bln
AKOP L BLAWI UTARA 003/004
63 Thn 4 Bln
MUYATI P SAMBO 002/001
63 Thn 11 Bln
MOCH SJOEKAIRI L WINDU 003/002
71 Thn 11 Bln
SUJONO L DUKOH 65 Thn 4 Bln
SHOFA ASFAH P BADAN 002/002 60 Thn 4 Bln
MUKAROMAH P PUPUS 003/006 64 Thn 8 Bln
KHODIJAH P KARANGANOM WETAN 62 Thn 6 Bln
ABD. MANAN L WARUK 002/002
65 Thn 11 Bln
NI`MAH P WARUK 002/002
61 Thn 2 Bln
MUSTOFA L PRIYOSO WETAN 001/002
61 Thn 4 Bln
NANIK P WATANGAN 72 Thn 4 Bln
63 Thn 9 Bln
INDIKATOR KELENGKAPAN PENGISIAN REKAM
Diagnosa Pemeriks Anamnes

Terapi
aan Fisik a
Hypertensive heart disease without (congestive) heart failure √ √ √

Senile cataract, unspecified √ √ √
Abrasion of teeth; Acute upper respiratory infection, unspecified;
Atopic dermatitis, unspecified √ √ √
Primary gonarthrosis, bilateral √ √ √
Allergic contact dermatitis due to adhesives; Hypertensive heart
disease without (congestive) heart failure; Myalgia √ √ √
Counselling, unspecified √ √ √
Allergic contact dermatitis due to drugs in contact with skin;

insulin-dependent diabetes mellitus without complications √ √ √
Erosive (osteo)arthrosis √ √ √
Spinal stenosis, lumbar region √ √ √
Non-insulin-dependent diabetes mellitus with multiple complications √ √ √

dependent diabetes mellitus with multiple complications √ √ √
Calculus in bladder √ √ √
Acute upper respiratory infection, unspecified; Hypertensive heart
disease without (congestive) heart failure √ √ √
Headache; Hypertensive heart disease with (congestive) heart failure √ √ √

Headache √ √ √
Osseous stenosis of neural canal, lumbar region √ √ √

Congestive heart failure; Neuropathic arthropathy √ √ √
Hyperplasia of prostate; Retention of urine √ √ √
Hypertensive heart disease with (congestive) heart failure; Stroke, not
specified as haemorrhage or infarction √ √ √
Peptic ulcer, acute with haemorrhage √ √ √
Myalgia, ankle and foot; Non-insulin-dependent diabetes mellitus
without complications √ √ √
Non-insulin-dependent diabetes mellitus without complications √ √ √


Stroke, not specified as haemorrhage or infarction √ √ √
Cerebral infarction, unspecified √ √ √

Atrial fibrillation and flutter √ √ √

Hypertensive heart disease with (congestive) heart failure √ √ √

√ √ √
√ √ √
Myalgia, ankle and foot √ √ √
Postzoster neuralgia √ √ √
Other carcinoma in situ of breast √ √ √
Other specified intervertebral disc degeneration √ √ √
Heart failure, unspecified; Other and unspecified cirrhosis of liver √ √ √
Lumbar and other intervertebral disc disorders with radiculopathy √ √ √

After-cataract √ √ √
Hypertensive heart disease without (congestive) heart failure; Pure
hypercholesterolaemia √ √ √
Sequelae of stroke, not specified as haemorrhage or infarction √ √ √
Hypertensive heart disease without (congestive) heart failure; Myalgia √ √ √

Dental caries, unspecified √ √ √
Myalgia √ √ √

Gastro-oesophageal reflux disease without oesophagitis √ √ √
Acute nasopharyngitis [common cold]; Hypertensive heart disease with
(congestive) heart failure √ √ √


Chronic renal failure, unspecified √ √ √
Acute upper respiratory infection, unspecified; Secondary
hypertension, unspecified √ √ √
Hypertensive heart disease with (congestive) heart failure; Senile
cataract, unspecified √ √ √
Surgical follow-up care, unspecified √ √ √
Vertiginous syndromes in diseases classified elsewhere √ √ √
Acute upper respiratory infection, unspecified √ √ √
Calculus of kidney with calculus of ureter √ √ √
Examination for adolescent development state √ √ √
Acute miliary tuberculosis, unspecified √ √ √
Acute upper respiratory infection, unspecified; Hyperglycaemia,

unspecified; Hypertensive heart disease without (congestive) heart
failure √ √ √


Hypertensive heart disease without (congestive) heart failure; Senile
Non-insulin-dependent diabetes mellitus with peripheral circulatory
complications √ √ √
Chronic obstructive pulmonary disease with acute lower respiratory
infection √ √ √
Atopic dermatitis, unspecified; Hypertensive heart disease without
Other respiratory tuberculosis, confirmed bacteriologically and
histologically √ √ √
Chronic ischaemic heart disease, unspecified √ √ √
Acute nasopharyngitis [common cold] √ √ √
Non-insulin-dependent diabetes mellitus with ophthalmic
Acute pharyngitis due to other specified organisms; Non-insulin-
dependent diabetes mellitus without complications √ √ √
Diabetic cataract √ √ √

Hyperuricaemia without signs of inflammatory arthritis and tophaceous
disease √ √ √
Dermatitis, unspecified; Hypertensive heart disease with (congestive)
heart failure √ √ √
Unilateral or unspecified inguinal hernia, with obstruction, without
gangrene √ √ √

Low vision, both eyes √ √ √
Other hypertrophic osteoarthropathy, lower leg √ √ √
Hyperglycaemia, unspecified √ √ √
Bronchopneumonia, unspecified; Hypertensive heart disease without

Old myocardial infarction √ √ √
Erosive (osteo)arthrosis; Other physical therapy √ √ √
Dyspepsia √ √ √
Chronic obstructive pulmonary disease, unspecified √ √ √
Congestive heart failure √ √ √
Other cerebral infarction √ √ √
Myalgia √ √ √
Disorder of urinary system, unspecified √ √ √
Dermatitis, unspecified; Hypertensive heart disease without
Gastritis, unspecified; Myalgia √ √ √
Calculus of kidney; Other cholelithiasis √ √ √

Pneumonia, unspecified √ √ √

disease without (congestive) heart failure; Non-insulin-dependent
diabetes mellitus without complications √ √ √
Benign neoplasm of mediastinum; Hypertensive heart disease with
Calculus of kidney √ √ √
Acute sinusitis, unspecified; Hypertensive heart disease without
Disorder of urinary system, unspecified; Hypertensive heart disease
without (congestive) heart failure; Myalgia √ √ √


Gout, unspecified √ √ √

Myalgia √ √ √


Atherosclerotic heart disease √ √ √
√ √ √
Acute pharyngitis, unspecified; Hypertensive heart disease without
Tinea manuum √ √ √
Myalgia √ √ √
Other thyrotoxicosis √ √ √
Coronary artery aneurysm √ √ √
Diarrhoea and gastroenteritis of presumed infectious origin;

Dyspepsia; Hypertensive heart disease without (congestive) heart
failure √ √ √
Moderate depressive episode √ √ √

Lumbar and other intervertebral disc disorders with myelopathy √ √ √

Headache; Hypertensive heart disease without (congestive) heart
failure √ √ √
Pleural effusion in conditions classified elsewhere √ √ √

Low back pain, lumbar region; Spondylolisthesis, lumbar region √ √ √
Asthma, unspecified √ √ √
without (congestive) heart failure √ √ √
Dyspepsia; Hypertensive heart disease without (congestive) heart
failure √ √ √
Cardiomegaly √ √ √
Myalgia √ √ √

Fever, unspecified √ √ √
Myalgia √ √ √
Crushing injury of shoulder and upper arm √ √ √
Myalgia √ √ √
Generalized pustular psoriasis √ √ √
Hyperglycaemia, unspecified; Hypertensive heart disease without

(congestive) heart failure; Surgical follow-up care, unspecified √ √ √
Myalgia √ √ √
Acute gingivitis √ √ √
failure √ √ √
Gastritis, unspecified √ √ √
Septicaemia due to Streptococcus pneumoniae √ √ √
Cerebellar stroke syndrome √ √ √
Chronic obstructive pulmonary disease with acute exacerbation,
unspecified; Congestive heart failure √ √ √
Gastritis, unspecified; Hyperglycaemia, unspecified √ √ √
Hyperplasia of prostate √ √ √
Depressive episode, unspecified √ √ √
Depressive episode, unspecified √ √ √

dependent diabetes mellitus without complications; Senile cataract,
unspecified √ √ √
failure; Myalgia √ √ √
Hypertensive heart disease with (congestive) heart failure; Unstable
angina √ √ √
Pure hypercholesterolaemia √ √ √

√ √ √
Gastric ulcer, unspecified as acute or chronic, without haemorrhage or
perforation √ √ √

Gastritis, unspecified; Routine general health check-up of armed forces √ √ √

Asthma, unspecified; Myalgia √ √ √
Hyperglycaemia, unspecified; Non-insulin-dependent diabetes mellitus
Gastric ulcer, unspecified as acute or chronic, without haemorrhage or
Myalgia √ √ √

Acute upper respiratory infection, unspecified; Myalgia √ √ √
Acute upper respiratory infection, unspecified; Hyperglycaemia,
unspecified; Myalgia √ √ √
ENGKAPAN PENGISIAN REKAM MEDIS
Pemeriks
Diagnosa aan
KIE
Medis penunjan
g
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
CEKLIST KELENGKAPAN PENGISIAN REKAM MED
Tanggal : : 01-06-2023 s/d 30-06-2023
No Tanggal No Reg Jenis Pasien No BPJS NIK
1 05-06-2023 0027502 BPJS 0002162609919 3524240101570072
2 05-06-2023 0019962 BPJS 0000758413135 3524243010530001

3 05-06-2023 0027184 BPJS 0000103768277
4 05-06-2023 0012469 BPJS 0000757393615 3524245101550005
5 05-06-2023 0025945 BPJS 0000759646001 3524240101540054
6 05-06-2023 0033239 BPJS 0000759104842 3524246101590005
7 05-06-2023 0001725 BPJS 0000103753282 3524240606480002
8 05-06-2023 0012501 BPJS 0000758730352 3524244912510001
9 05-06-2023 0030777 BPJS 0000758099024
10 05-06-2023 0015707 BPJS 0001265685873 3524240506600003
11 05-06-2023 0011891 BPJS 0002935518265 3524246008530001
12 05-06-2023 0010903 BPJS 0001890137068
13 05-06-2023 0028202 UMUM 3524241310590002
14 05-06-2023 0004848 BPJS 0000103106518 3523245112620001

15 05-06-2023 0020660 BPJS 0000103500382
16 06-06-2023 0030348 BPJS 0000758669275 3524240101630016
17 06-06-2023 0021573 BPJS 0000759590098 3524240105590002

18 06-06-2023 0008517 BPJS 0000758582976 3524244101560008
19 06-06-2023 0023753 BPJS 0002245028398 3524242008540001
20 06-06-2023 0015847 BPJS 0000758827642

21 06-06-2023 0020890 BPJS 0000758241663 3524244101560003
22 06-06-2023 0007061 BPJS 0000758430235 3524244101380061

23 06-06-2023 0002272 BPJS 0000757572412 3524245202660002
24 06-06-2023 0028856 BPJS 0002591295647
25 06-06-2023 0024214 BPJS 0000758973306 3524242007550001
26 06-06-2023 0010782 UMUM 3524244704560002
27 06-06-2023 0025005 BPJS 0000759924652 3524247006600003
28 06-06-2023 0033879 BPJS 0002455205545 3524240508540001
29 06-06-2023 0027363 BPJS 0002459985535 3524240201540001
30 06-06-2023 0016904 BPJS 0002422338197 3524244804620001
31 06-06-2023 0025117 BPJS 0002883093309 3524240108620001
32 06-06-2023 0022677 BPJS 0000759011398 3524241008590001
33 07-06-2023 0030021 BPJS 0001047283828
34 07-06-2023 0034377 BPJS 0001262805985 3524244909560001
35 07-06-2023 0005144 BPJS 0001888188895 3524244101590044
36 07-06-2023 0027323 BPJS 0000759284717 3524244101530059

37 07-06-2023 0010628 BPJS 0001439232309 3524240101490037
38 07-06-2023 0006976 BPJS 0001439232704 3524245606600001
39 07-06-2023 0005126 BPJS 0002267160783 3524244101600093
40 07-06-2023 0008662 BPJS 0002888735128

41 08-06-2023 0027240 BPJS 0001704051066 3524247006550008
42 08-06-2023 0016705 BPJS 0000758126643 3524242306570001
43 08-06-2023 0030642 BPJS 0000758532576

44 08-06-2023 0018163 BPJS 0001047271623
45 08-06-2023 0016135 BPJS 0001299724918 3524241210540001
46 08-06-2023 0029728 BPJS 0002695910308

47 09-06-2023 0006213 BPJS 0002244527752
48 09-06-2023 0000749 BPJS 0002463473891 3524244101590082
49 09-06-2023 0037757 BPJS 0001047276134 3524245704570001
50 09-06-2023 0038857 BPJS 0003273680946 3524244101600076
51 09-06-2023 0024099 BPJS 0000759057017 3524240101630015
52 12-06-2023 0027332 BPJS 0000103501135 3524242406620002
53 12-06-2023 0031910 BPJS 0001047276639
54 12-06-2023 0037339 BPJS 0003265273146 3524243012590004
55 12-06-2023 0016723 BPJS 0000759612194 3524244501590004
56 12-06-2023 0018836 BPJS 0001704045306 3524241010580001
57 12-06-2023 0028813 UMUM 3524240406470001
58 12-06-2023 0010782 UMUM 3524244704560002

59 12-06-2023 0031226 BPJS 0000758437457
60 12-06-2023 0007616 BPJS 0001704093513 3524244408540001
61 12-06-2023 0017197 BPJS 0000758420111 3524244101480050
62 12-06-2023 0033854 UMUM 3524225003630003
63 12-06-2023 0000431 BPJS 0000103500213 3524240601550001
64 13-06-2023 0030348 BPJS 0000758669275 3524240101630016
65 13-06-2023 0019172 BPJS 0001543283706 3524245203620001

66 13-06-2023 0033715 BPJS 0000758845405 3524244101610044
67 13-06-2023 0012566 BPJS 0002756614127 3524245506580001

68 13-06-2023 0012469 BPJS 0000757393615 3524245101550005
69 13-06-2023 0032347 BPJS 0001861883155 3524244201560009
70 13-06-2023 0031950 BPJS 0002923563249
71 13-06-2023 0037741 BPJS 0000759226083 3524244101620069
72 13-06-2023 0038885 BPJS 0000759124225 3524244101560069
73 13-06-2023 0010556 BPJS 0000759122706 3524240605530001
74 13-06-2023 0002181 BPJS 0000103499875 3524244203630001
75 13-06-2023 0008517 BPJS 0000758582976 3524244101560008
76 13-06-2023 0028077 BPJS 0000758633927 3524244101600075
77 14-06-2023 0027502 BPJS 0002162609919 3524240101570072
78 14-06-2023 0038446 BPJS 0003176547794 3524240101590005
79 14-06-2023 0015303 BPJS 0000759643931 3524244701630001
80 14-06-2023 0004848 BPJS 0000103106518 3523245112620001
81 14-06-2023 0027363 BPJS 0002459985535 3524240201540001

82 15-06-2023 0001993 BPJS 0000103766646 3524241202490002
83 15-06-2023 0031115 BPJS 0000758614037
84 15-06-2023 0031226 BPJS 0000758437457
85 15-06-2023 0010556 BPJS 0000759122706 3524240605530001
86 15-06-2023 0031239 BPJS 0000758782899 3524240509610002

87 15-06-2023 0005130 BPJS 0000758380375 3524245707620001
88 15-06-2023 0022677 BPJS 0000759011398 3524241008590001
89 15-06-2023 0016723 BPJS 0000759612194 3524244501590004

90 16-06-2023 0012575 BPJS 0002244526716 3524241407550002
91 16-06-2023 0008117 BPJS 0000103695412 3524246209600002

92 16-06-2023 0006823 BPJS 0000759099205 3524242910570001
93 16-06-2023 0008325 BPJS 0000759100241 3524244101590058
94 16-06-2023 0001410 BPJS 0000758640982 3524240101590059

95 16-06-2023 0010993 BPJS 0000757948948 3524241203590003
96 16-06-2023 0012776 BPJS 0002749752336 3524240705520001
97 16-06-2023 0020465 BPJS 0000759619359 3524247006490005
98 16-06-2023 0029120 BPJS 0000758935146 3524241310590001
99 19-06-2023 0029717 BPJS 0000759364569

100 19-06-2023 0009875 BPJS 0000751109319 3524244804580001
101 19-06-2023 0035774 BPJS 0002732692713
102 19-06-2023 0006545 BPJS 0000103593644

103 19-06-2023 0000374 BPJS 0000758757633 3524247112590001
104 19-06-2023 0000338 BPJS 0000103499932
105 19-06-2023 0003651 BPJS 0000103498558 3524241501570002
106 19-06-2023 0031226 BPJS 0000758437457
107 19-06-2023 0006425 BPJS 0000758161361 3524241704580001
108 19-06-2023 0010539 BPJS 0000758358461 3524244101530046
109 19-06-2023 0010485 BPJS 0000751089846

110 19-06-2023 0031239 BPJS 0000758782899 3524240509610002
111 19-06-2023 0004221 BPJS 0000103501618 3524245712580001
112 19-06-2023 0010385 BPJS 0000758404012
113 19-06-2023 0008978 BPJS 0000103885288 3524242012620001
114 20-06-2023 0036466 BPJS 0001850979475 3524221506590001

115 20-06-2023 0020720 BPJS 0000789926218 3524244502500001
116 20-06-2023 0023056 BPJS 0000758785522 3524246303510001

117 20-06-2023 0018836 BPJS 0001704045306 3524241010580001
118 20-06-2023 0038969 BPJS 0000103500393 3524245008550001
119 20-06-2023 0029728 BPJS 0002695910308

120 20-06-2023 0035616 BPJS 0003101665138 3524244101630035
121 20-06-2023 0023753 BPJS 0002245028398 3524242008540001
122 20-06-2023 0008517 BPJS 0000758582976 3524244101560008

123 20-06-2023 0028110 BPJS 0002499393341
124 20-06-2023 0020005 BPJS 0002308444255 3524240404560001

125 20-06-2023 0024407 BPJS 0000759302324 3524244101470008
126 20-06-2023 0005677 BPJS 0000758371645 3524245101590003
127 20-06-2023 0025103 BPJS 0000759571571 3524242401590002
128 20-06-2023 0010516 BPJS 0000759526547

129 20-06-2023 0035774 BPJS 0002732692713
130 20-06-2023 0038446 BPJS 0003176547794 3524240101590005
131 20-06-2023 0036742 BPJS 0000759724997 3524240101520004

132 20-06-2023 0037184 BPJS 0002738953394 3524244101570027
133 21-06-2023 0031226 BPJS 0000758437457
134 21-06-2023 0020500 BPJS 0002162612226 3524245004540001
135 21-06-2023 0031510 BPJS 0001258924779
136 21-06-2023 0007216 BPJS 0000758406486 3524241906630001
137 22-06-2023 0012566 BPJS 0002756614127 3524245506580001
138 22-06-2023 0019010 BPJS 0002162940827 3524240506560002

139 22-06-2023 0022677 BPJS 0000759011398 3524241008590001
140 22-06-2023 0010777 BPJS 0001047277181 3524240407550001
141 22-06-2023 0029337 BPJS 0002503289283 3524242605590001
142 22-06-2023 0012996 BPJS 0002611577441 3524244506630003
143 22-06-2023 0022036 BPJS 0001047281297 3524246006580001

144 22-06-2023 0038983 BPJS 0000757957869 3524255105500001
145 22-06-2023 0030645 BPJS 0002913088094 3524244101500052
146 22-06-2023 0018082 BPJS 0003176584773 3524245209590003
147 22-06-2023 0002652 BPJS 0000103766668 3524241505390001
148 22-06-2023 0017197 BPJS 0000758420111 3524244101480050
149 23-06-2023 0030348 BPJS 0000758669275 3524240101630016
150 23-06-2023 0005611 BPJS 0001704058053 3524247112610001

151 23-06-2023 0029102 BPJS 0000759358563 3524240101500021
152 23-06-2023 0038475 BPJS 0000759810519 3524244605560001
153 23-06-2023 0015548 BPJS 0000758735504 3524246501590001
154 23-06-2023 0027363 BPJS 0002459985535 3524240201540001
155 23-06-2023 0023062 BPJS 0000103902399 3524242704620001
156 23-06-2023 0022677 BPJS 0000759011398 3524241008590001

157 26-06-2023 0028813 UMUM 3524240406470001
158 26-06-2023 0037753 BPJS 0000759271329 3524265710620001

159 26-06-2023 0003651 BPJS 0000103498558 3524241501570002
160 26-06-2023 0027639 BPJS 0000759112424 3524241301550001

161 26-06-2023 0038713 BPJS 0002162694071 3524247006480009
162 26-06-2023 0038727 BPJS 0003520430662 3524244603600002
163 26-06-2023 0010858 BPJS 0000759112694 3524240101610048
164 26-06-2023 0003437 BPJS 0001704056681 3524247006540003

165 26-06-2023 0024214 BPJS 0000758973306 3524242007550001
166 26-06-2023 0020959 BPJS 0000758457551 3524244101560018
167 26-06-2023 0010993 BPJS 0000757948948 3524241203590003
168 26-06-2023 0038998 BPJS 0001047272117 3524240201610007

169 26-06-2023 0034703 BPJS 0001047274569 3524240101590019
170 26-06-2023 0030607 BPJS 0000758794241 3524240407510001
171 26-06-2023 0038446 BPJS 0003176547794 3524240101590005
172 27-06-2023 0007957 BPJS 0000103767759 3524245511550001

173 27-06-2023 0010782 UMUM 3524244704560002
174 27-06-2023 0012776 BPJS 0002749752336 3524240705520001

175 27-06-2023 0027607 BPJS 0000759293739
176 27-06-2023 0018836 BPJS 0001704045306 3524241010580001
177 27-06-2023 0028202 UMUM 3524241310590002
178 27-06-2023 0013177 UMUM 3524244201540006
179 27-06-2023 0023753 BPJS 0002245028398 3524242008540001
180 27-06-2023 0039017 BPJS 0002254579468 3524240101550070


66 Thn 5 Bln
ABD KHAMID L MONOLELO 69 Thn 7 Bln
SUMIRAN L NGIPIK 002/003 75 Thn 7 Bln
ABDUL KODIR L BADAN 69 Thn 5 Bln
FATIMAH P ALASMALANG 003/002 64 Thn 4 Bln
ASIKAN L SAMBO 001/002 74 Thn 11 Bln
TAMLIYAH P WEDENG 001/002 71 Thn 5 Bln
SAMUWIL L WARUK 001/002 63 Thn 3 Bln
IMAM ROSYADI L MAYONG KULON 001/001 63 Thn 0 Bln
MUNTAIYAH P PENCARAN 002/005 69 Thn 9 Bln
MAROKAH P BLAWI 71 Thn 5 Bln
MUNJAROH L BONSARI 002/001
63 Thn 7 Bln
SHOLIKIN L KETAPANG 001/002 73 Thn 9 Bln
SULAJI L WARUK 002/001
60 Thn 5 Bln
HASYIM SUSILO L NGAJARAN 002/003 64 Thn 1 Bln
NAÀH P SAMBO 001/004
67 Thn 5 Bln
68 Thn 9 Bln
SITI CHOTIMAH P BADAN 001/002 68 Thn 11 Bln
SUKAENI P BONRINGIN 001/004
67 Thn 5 Bln
SITI ROICHAH P NGAJARAN 004/004 85 Thn 5 Bln
IROMA P PALANGAN 002/002 57 Thn 3 Bln
KAPSAH P PALANGAN 50 Thn 8 Bln
NARIYO L MAGOK 001/002 67 Thn 10 Bln
MUKANAH P KEBONSARI 004/003 67 Thn 1 Bln
NYANI P PRIYOSO WETAN 001/001
63 Thn 0 Bln
SARI L PUTATREJO 001/003
68 Thn 10 Bln
69 Thn 5 Bln
SUMI P MORO 001/003
61 Thn 1 Bln
ZAINUL IKHSAN L PUPUS 003/006
60 Thn 10 Bln
63 Thn 9 Bln
SULIKAN L BANJARANYAR
66 Thn 5 Bln
HJ. SALAMAH P MENGAI 001/006
66 Thn 8 Bln
SYAFAATUN P KAUMAN 001/002
64 Thn 5 Bln
MUSOFAH P KURO 002/001 70 Thn 5 Bln
M. SOLEH L WUNGU 001/001 74 Thn 5 Bln
NURYATI P WUNGU 001/001 62 Thn 11 Bln
JAIYAH P GOSO 001/003
63 Thn 5 Bln
UMU KULSUM P SAMBO 61 Thn 7 Bln
67 Thn 11 Bln
65 Thn 11 Bln
YATIMAH P ALASMALANG 68 Thn 5 Bln
M CHOZIN AMIN L BR. SIMAN
68 Thn 7 Bln
JAROKAH P PULOKERTO 002/001 64 Thn 5 Bln
YATMINAH P TERBIS 001/003 66 Thn 1 Bln
NANIK P TERBIS 002/003 63 Thn 5 Bln
SEKAR L BAKALAN 001/001 60 Thn 5 Bln
H. M. SUMADI, S.PD L PUPUS 002/006 60 Thn 11 Bln
RATENI P WINDU 72 Thn 11 Bln
ABD MUJIB L MONOLELO 002/002 63 Thn 5 Bln
KHOSIAH P KARANGBINANGUN 64 Thn 5 Bln
64 Thn 8 Bln
AMAT L TEMBOK 002/003
76 Thn 0 Bln
NUR MUSTHOFA L PENCARAN BLAWI 76 Thn 1 Bln
ARTINING P BONSARI 68 Thn 10 Bln
FUTICHAH P MONOLELO 001/002 75 Thn 5 Bln
MAS'AMAH P BAKALAN 002/003 60 Thn 3 Bln
60 Thn 5 Bln
SITI MUKHAYAH P BR. BOTOH 006/002 61 Thn 3 Bln
IMRONAH P LUNTAS S 001/002
62 Thn 5 Bln
MUHARTIK P WEDENG 001/003 64 Thn 11 Bln
MARNING P BAKALAN 001/002 67 Thn 5 Bln
NGATAJI L WARUK 003/001 62 Thn 9 Bln
UMAMAH P PUPUS 001/006 61 Thn 5 Bln
SUMAIYAH P ALANG-ALANG 002/005 67 Thn 5 Bln
SUN'AN L MAYONG KULON 002/001 70 Thn 1 Bln
NASIYATIN P KEPENG 003/002 60 Thn 3 Bln
NAÀH P SAMBO 001/004 67 Thn 5 Bln
QOMARIYAH P ALASMALANG 002/002 63 Thn 5 Bln
RUDI L BAKALAN 002/002 66 Thn 5 Bln
DJAYUS L WATANGAN 002/001 64 Thn 5 Bln
MARIYAM P MONOLELO 001/002 60 Thn 5 Bln
60 Thn 6 Bln
KARSAN L WATANGAN 002/002 69 Thn 5 Bln
AMIN L WEDENG 002/003
74 Thn 4 Bln
DHOHUWA P GAYAM 005/003
59 Thn 11 Bln
NUR MUSTHOFA L PENCARAN BLAWI
76 Thn 1 Bln
SUN'AN L MAYONG KULON 002/001
70 Thn 1 Bln
YAHYA L PUTATREJO 002/003 61 Thn 9 Bln
MISNI P BR. BUTUH 006/002 60 Thn 10 Bln
63 Thn 10 Bln
KHOSIAH P KARANGBINANGUN 64 Thn 5 Bln
KHAMIM L WEDENG 002/003
67 Thn 11 Bln
MACHRUSAH P SAMBO 002/004 62 Thn 8 Bln
ASRUL SONI SIRIGAR L KEPENG 003/002 65 Thn 8 Bln
MAKHMUDA P KEPENG
64 Thn 5 Bln
ACHMAD TAM L ALASMALANG 002/002 64 Thn 5 Bln
FATHAN L BR. BATURONO 64 Thn 3 Bln
H.ABDULLOH L WEDENG 001/002 71 Thn 1 Bln
JAMILAH P WINDU 001/002 73 Thn 11 Bln
YAUDI L KEBONSARI 002/004
63 Thn 8 Bln
DULASIR L WATANGAN 001/002 70 Thn 7 Bln
MUTIKA P BR. TEMBOK 008/003 65 Thn 2 Bln
HARIONO L SAMBO 001/002
65 Thn 11 Bln
ABD. KHOLIQ L KARANGAJI 003/003 66 Thn 0 Bln
SUMIATUN P SAMBO 003/002 63 Thn 5 Bln
NUNUK HERONI ARUMCAHYO IRIANIGSIH P BANDUT 001/001 61 Thn 1 Bln
H. HAFITH, DRS L BANDUT 002/001 66 Thn 5 Bln
NUR MUSTHOFA L PENCARAN BLAWI
76 Thn 1 Bln
GUFRON L LOGAWE 002/001
65 Thn 2 Bln
KAMAH P PUPUS 003/006
70 Thn 5 Bln
SUKADI L Br. TEMBOK 67 Thn 5 Bln
YAHYA L PUTATREJO 002/003 61 Thn 9 Bln
TRINI ASTUTI P NGAJARAN 64 Thn 6 Bln
ACHROM L KARANGBINANGUN 001/001 70 Thn 5 Bln
PUJI WAHONO HARUN ALRASID L WINDU 001/001
60 Thn 5 Bln
SULIKAN L SAMBO 003/006 64 Thn 0 Bln
MUHAIYAH P LOGAWE 001/001
73 Thn 4 Bln
KARTI P PUTATREJO 002/003 72 Thn 2 Bln
64 Thn 8 Bln
UMIYANAH P KETAPANGTELU 001/002
67 Thn 10 Bln
INDAHYATI P KAUMAN 001/002
60 Thn 5 Bln
68 Thn 10 Bln
NAÀH P SAMBO 001/004
67 Thn 5 Bln
AKOP L BLAWI UTARA 003/004
63 Thn 5 Bln
SUMALI L SOMOITO 67 Thn 2 Bln
MUNIKAH P WATANGAN 76 Thn 5 Bln
TAMINAH P SUKLEN 64 Thn 5 Bln
KHAYAT L BLAWI UTARA 001/004
64 Thn 4 Bln
ASMAH P BLAWI 61 Thn 5 Bln
65 Thn 11 Bln
DJAYUS L WATANGAN 002/001
64 Thn 5 Bln
MATERJO L WATANGAN 001/001 71 Thn 5 Bln
MUFIDAH P PUPUK 002/003 66 Thn 5 Bln
NUR MUSTHOFA L PENCARAN BLAWI 76 Thn 1 Bln
SAWI P WINDU 001/001 69 Thn 2 Bln
HJ. KARTI P MAYONG NGABLAK 001/002 64 Thn 0 Bln
NADI L KARANGAJI 003/003
60 Thn 0 Bln
MUHARTIK P WEDENG 001/003
65 Thn 0 Bln
WIYADI L WINDU 001/002 67 Thn 11 Bln
M.A KASTARAM L KARANGANOM KULON 001/001 64 Thn 0 Bln
ZAINIYAH P WARUK 002/002
60 Thn 0 Bln
YATENI P SAMBO 002/002 65 Thn 0 Bln
KASBONAH P WEDENG 002/002 73 Thn 1 Bln
SUKAEMI P TERBIS 001/003 73 Thn 5 Bln
SUHARTI P BATURONO 002/002 63 Thn 9 Bln
AMIR L BAKALAN 002/003 84 Thn 1 Bln
FUTICHAH P MONOLELO 001/002 75 Thn 5 Bln
60 Thn 5 Bln
MISKANA L SAMBO 003/004 61 Thn 5 Bln
RIDUWAN L KURO 003/001 73 Thn 5 Bln
SAEKA P BOTOH 006/002 67 Thn 1 Bln
SUWARTI P BONRINGIN 001/004 64 Thn 4 Bln
69 Thn 5 Bln
MUJIONO L SAMBO 002/002
61 Thn 1 Bln
AMAT L TEMBOK 002/003
76 Thn 0 Bln
SUWARNI P GMBONG TENGA 001/002 60 Thn 8 Bln
H. HAFITH, DRS L BANDUT 002/001
66 Thn 5 Bln
ASLIKAN L MAYONG TENGAH 002/003 68 Thn 5 Bln
UMUH P WINDU 003/001 74 Thn 11 Bln
SIKAH P LUWUK 001/001
63 Thn 3 Bln
ABD ROHMAN L BANDUT
62 Thn 5 Bln
KASIYATI P SAMBO 002/002 68 Thn 11 Bln
SAINI P KETAPANGTELU 002/002 67 Thn 5 Bln
FATHAN L BR. BATURONO
64 Thn 3 Bln
SU'UD L PENCARAN 001/006 62 Thn 5 Bln
LUQMAN L PELUK 002/003 64 Thn 5 Bln
MUNIRIN L MAGOK 002/002
71 Thn 11 Bln
DJAYUS L WATANGAN 002/001
64 Thn 5 Bln
ZUHRIYAH P PALANGAN 002/001 67 Thn 7 Bln
67 Thn 2 Bln
KALIMAH P KEPOH 005/002 63 Thn 11 Bln
ABD KHANAN L KR AJI 003/006 64 Thn 8 Bln
63 Thn 8 Bln
ASTIKAH P BONSARI 002/004
69 Thn 5 Bln
68 Thn 10 Bln
KHAZIN L BADAN 002/004
68 Thn 5 Bln

Terapi
aan Fisik a

Disease of intestine, unspecified √ √ √
Benign neoplasm of prostate √ √ √
Myalgia √ √ √
Unspecified injury of trunk, level unspecified √ √ √
Cholecystitis, unspecified √ √ √
Myalgia √ √ √
Haemoptysis √ √ √
Chronic obstructive pulmonary disease, unspecified; Hypertensive heart

Cerebral infarction due to thrombosis of cerebral arteries √ √ √
failure √ √ √

Spinal stenosis, sacral and sacrococcygeal region √ √ √
Congestive heart failure; Non-insulin-dependent diabetes mellitus with
multiple complications √ √ √
Otitis media, unspecified √ √ √
Myalgia √ √ √

Cerebral infarction due to thrombosis of precerebral arteries; Other and
unspecified convulsions √ √ √

Gastritis, unspecified; Myalgia; Non-insulin-dependent diabetes mellitus
Non-insulin-dependent diabetes mellitus with multiple complications;
Myalgia; Non-insulin-dependent diabetes mellitus without
(congestive) heart failure; Senile cataract, unspecified √ √ √
Acute transmural myocardial infarction of anterior wall; Hypertensive
heart disease with (congestive) heart failure √ √ √
heart failure; Myalgia √ √ √

heart failure; Non-insulin-dependent diabetes mellitus without
Acute nasopharyngitis [common cold]; Essential (primary)

hypertension; Non-insulin-dependent diabetes mellitus without
Essential (primary) hypertension; Insulin-dependent diabetes mellitus

Angina pectoris with documented spasm √ √ √
Glaucoma, unspecified √ √ √
Other gastritis √ √ √
Asthma, unspecified; Hypertensive heart disease without (congestive)
disease with (congestive) heart failure √ √ √
Non-insulin-dependent diabetes mellitus with neurological
Intraductal carcinoma in situ √ √ √

Other disorders of vestibular function √ √ √
Myalgia √ √ √
Fracture of bone in neoplastic disease, hand √ √ √
Chest pain, unspecified √ √ √
Other senile cataract √ √ √
Other acute upper respiratory infections of multiple sites √ √ √
Other cerebral infarction √ √ √
Sciatica √ √ √

Open wound of other parts of foot √ √ √
Chronic ischaemic heart disease, unspecified; Hypertensive heart
Hypertensive heart disease without (congestive) heart failure; Open
wound of lip and oral cavity √ √ √
Tuberculosis of lung, confirmed by sputum microscopy with or without
culture √ √ √
Open wound of trunk, level unspecified √ √ √
Presence of intraocular lens √ √ √

Conjunctivitis, unspecified; Hypertensive heart disease without
Glaucoma secondary to drugs √ √ √

Malignant neoplasm of bronchus or lung, unspecified √ √ √
Myalgia √ √ √
Calculus in urethra √ √ √
Non-insulin-dependent diabetes mellitus with coma √ √ √
Hypertensive heart disease without (congestive) heart failure; Open
wound of lip and oral cavity √ √ √
Atherosclerotic heart disease; Congestive heart failure; Insulin-
dependent diabetes mellitus with multiple complications √ √ √
Heart failure, unspecified; Hypertensive heart disease with (congestive)
Cardiomegaly; Pneumonia, unspecified √ √ √
Other cholecystitis √ √ √
Hypertensive heart disease with (congestive) heart failure; Old
myocardial infarction √ √ √
(congestive) heart failure; Low vision, both eyes √ √ √
Other acute upper respiratory infections of multiple sites √ √ √
Asthma, unspecified; Hypertensive heart disease without (congestive)
Essential (primary) hypertension; Spondylosis, unspecified, lumbar
region √ √ √
(congestive) heart failure; Myalgia √ √ √
failure √ √ √
Atherosclerotic heart disease; Non-insulin-dependent diabetes mellitus
without complications; Pneumonia, unspecified √ √ √
Unstable angina √ √ √
Low back pain √ √ √
Heart failure, unspecified; Hypertensive heart disease without
Cerebellar stroke syndrome √ √ √
(congestive) heart failure; Other cerebral infarction √ √ √
Open wound of lip and oral cavity √ √ √

Myalgia √ √ √
Nonorganic sleep disorder, unspecified √ √ √

Non-Hodgkin's lymphoma, unspecified type √ √ √
Myalgia √ √ √
Myalgia √ √ √

Dermatitis, unspecified √ √ √
Focal brain injury √ √ √

Organic emotionally labile [asthenic] disorder √ √ √
without (congestive) heart failure; Myalgia √ √ √
Atherosclerotic cardiovascular disease, so described √ √ √
Cervical disc disorder with myelopathy √ √ √
Other respiratory tuberculosis, confirmed bacteriologically and
histologically √ √ √
Parkinson's disease √ √ √
Peptic ulcer, unspecified as acute or chronic, without haemorrhage or
Myalgia √ √ √
(congestive) heart failure; Other cerebral infarction √ √ √
Asthma, unspecified; Myalgia √ √ √
Chronic obstructive pulmonary disease, unspecified; Hypertensive heart

Hypertensive heart disease with (congestive) heart failure; Unstable
angina √ √ √
Pemeriks
Diagnosa aan
KIE
Medis penunjan
g
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
Tanggal : : 01-07-2023 s/d 31-07-2023
INDIKATOR KELEN
aan Fisik
1 01-07-2023 0038383 BPJS 0002924181268 3524240101620059 MUKMININ L PENCARAN 002/005

61 Thn 6 Bln Cataract in other endocrine, nutritional and metabolic diseases √
3 03-07-2023 0031926 BPJS 0002752152579 3524241207610002 MAT ARKAN L KEBONSARI 002/003
61 Thn 11 Bln Cerebral infarction due to thrombosis of cerebral arteries √
4 03-07-2023 0039045 BPJS 0000759360429 3524241602400001 KATEM L BANJARANYAR 003/001
5 03-07-2023 0004848 BPJS 0000103106518 3523245112620001 MAFTUCHAH P GAYAM 005/003
6 03-07-2023 0027335 BPJS 0002441295112 3524240801580001 SUJONO L BULAK 001/001
65 Thn 5 Bln Acute nasopharyngitis [common cold] √
7 03-07-2023 0038523 BPJS 0003304385897 3524243006590012 RAMELI L BLAWI TENGAH 001/004
64 Thn 0 Bln Senile cataract, unspecified √
8 03-07-2023 0027268 BPJS 0000759547686 3524240101620069 SUHERI L KARANGBINANGUN 003/001
61 Thn 6 Bln Open wound of other parts of forearm √
9 03-07-2023 0024316 BPJS 0000103680999 3524246810580002 SITI CHODIDJAH P PENCARAN
64 Thn 8 Bln Urticaria, unspecified √
10 03-07-2023 0039035 BPJS 0003337969353 3524242111630001 SUPANJI L WEDENG
59 Thn 7 Bln Essential (primary) hypertension √
11 03-07-2023 0010177 BPJS 0002161138858 3524240101560040 ASRON M. MUNDZIR L BLAWI 003/002
67 Thn 6 Bln Cerebral infarction, unspecified √
12 03-07-2023 0007322 BPJS 0000103768031 3524245303450001 SUMIATI P WATANGAN 002/001
78 Thn 3 Bln Tinea pedis √
66 Thn 6 Bln Myalgia √
14 03-07-2023 0003747 BPJS 0002162693957 NAPSIYAH P NGIPIK 66 Thn 0 Bln Haemorrhage of anus and rectum √
15 03-07-2023 0027607 BPJS 0000759293739 KALIMAH P KEPOH 005/002 63 Thn 11 Bln Senile cataract, unspecified √
16 03-07-2023 0020465 BPJS 0000759619359 3524247006490005 JAMILAH P WINDU 001/002
17 03-07-2023 0015303 BPJS 0000759643931 3524244701630001 MARIYAM P MONOLELO 001/002
60 Thn 5 Bln Hyperglycaemia, unspecified √
18 03-07-2023 0008020 BPJS 0001299720183 3524244808450001 MUSAMA P KEBONSARI 002/003
77 Thn 10 Bln Arthrosis, unspecified, pelvic and thigh √
19 04-07-2023 0036421 BPJS 0002845118474 3524241908620001 SUPRAPTO L BLAWI UTARA 003/004 Benign lipomatous neoplasm of skin and subcutaneous tissue of other
60 Thn 10 Bln and unspecified sites √
20 04-07-2023 0009702 BPJS 0000758953541 3524245804530001 ALFIATUN P MAGOK 001/001
70 Thn 2 Bln Acute upper respiratory infection, unspecified √
63 Thn 10 Bln Acute upper respiratory infection, unspecified √
22 04-07-2023 0021572 BPJS 0002326949583 3524244101550075 SAEKAH P BLAWI 002/002
23 04-07-2023 0010604 BPJS 0002043337059 3524240101570026 ATEKAN L SUMBEREJO 001/003 Calculus in urethra; Hypertensive heart disease without (congestive)
24 04-07-2023 0010556 BPJS 0000759122706 3524240605530001 SUN'AN L MAYONG KULON 002/001
70 Thn 1 Bln Counselling, unspecified √
25 04-07-2023 0028458 BPJS 0002749091602 3524241403620001 NUR KHAMIM L MENGAI 002/006
61 Thn 3 Bln Typhoid fever √
26 04-07-2023 0030594 BPJS 0001047281613 3524241706570001 SAFIK L MAGOK 001/001
66 Thn 0 Bln Moderate depressive episode; Somatization disorder √
27 04-07-2023 0001081 BPJS 0003176757055 3524240411590002 ASNAN L TERBIB 00/003
63 Thn 8 Bln Other specified pulmonary heart diseases √
61 Thn 2 Bln Diarrhoea and gastroenteritis of presumed infectious origin √
29 04-07-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004
68 Thn 1 Bln Cerebral infarction, unspecified √
INDIKATOR KELEN
aan Fisik
31 05-07-2023 0020260 BPJS 0000758392716 3524244101600085 SAMANI P BLAWI UTARA 002/004
63 Thn 6 Bln Presence of intraocular lens √
32 05-07-2023 0035121 BPJS 0000758886974 KARTINI P LUNTAS S 001/002 79 Thn 6 Bln Fever with chills √
33 05-07-2023 0026817 BPJS 0002445619803 3524245201500001 DARIYATI P KLECO 001/003 Hypertensive heart disease without (congestive) heart failure; Myalgia;
73 Thn 5 Bln Other acute gastritis √
34 05-07-2023 0004436 BPJS 0000759358596 3524244101620023 SENAH P KURO
61 Thn 6 Bln Duodenal ulcer, acute with haemorrhage √
35 05-07-2023 0034936 BPJS 0002876182492 3524244201570013 DAIYAH P PUPUS 002/006 Gastritis, unspecified; Hypertensive heart disease without (congestive)
36 05-07-2023 0028202 UMUM 3524241310590002 MUNJAROH L BONSARI 002/001
63 Thn 8 Bln Acute upper respiratory infection, unspecified; Asthma, unspecified √
37 05-07-2023 0011733 BPJS 0002294469077 3524245403370001 SUKAYAH P KLECO 002/003 Congestive heart failure; Hypertensive heart disease without
39 05-07-2023 0025800 BPJS 0001704054971 3524240903610001 ASERI L MAGOK 001/001 62 Thn 3 Bln Congestive heart failure √
40 05-07-2023 0033457 BPJS 0002210213687 YATMINAH P WINDU 002/001 67 Thn 11 Bln Counselling, unspecified √
41 06-07-2023 0027168 BPJS 0000103767006 3524242005480001 JAUMAN, S.AG. L KURO 001/001 75 Thn 1 Bln Hyperplasia of prostate √
43 06-07-2023 0029426 BPJS 0001047270892 PATRIYANTO L PUPUK 001/003
44 07-07-2023 0003583 BPJS 0000759749567 3524240101500031 JASMAN L PONCOL 001/005 73 Thn 6 Bln Senile cataract, unspecified √
46 07-07-2023 0023062 BPJS 0000103902399 3524242704620001 MUJIONO L SAMBO 002/002 61 Thn 2 Bln Diarrhoea and gastroenteritis of presumed infectious origin √
47 07-07-2023 0002938 BPJS 0000758413236 3524246511590003 KHANIFAH P MONOLELO 002/002 63 Thn 7 Bln Cerebral infarction due to thrombosis of cerebral arteries √
48 07-07-2023 0013177 UMUM 3524244201540006 ASTIKAH P BONSARI 002/004 69 Thn 6 Bln Counselling, unspecified √
50 07-07-2023 0022905 BPJS 0000758683629 3524245101550004 SUPIYAH P WARUK 68 Thn 5 Bln Senile cataract, unspecified √
51 07-07-2023 0016292 BPJS 0000758873237 3524244306590001 KHOIROTIN P WINDU 002/001
53 07-07-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 70 Thn 6 Bln Hypertensive heart disease with (congestive) heart failure √
54 07-07-2023 0039084 BPJS 0003012483172 3524240101510033 MAT SAI L BLAWI TENGAH 003/003 72 Thn 6 Bln Senile cataract, unspecified √
55 07-07-2023 0039085 BPJS 0003012483183 3524244101590057 KUNTIANAH P BLAWI TENGAH 003/003 64 Thn 6 Bln Senile cataract, unspecified √
56 07-07-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 64 Thn 8 Bln Asthma, unspecified; Myalgia √
57 07-07-2023 0028642 BPJS 0001047281455 SAKUR L BONRINGIN 001/004 61 Thn 6 Bln Hypertensive heart disease with (congestive) heart failure √
58 10-07-2023 0020484 BPJS 0002162610707 THOHA L PELUK 001/003 60 Thn 2 Bln Sequelae of stroke, not specified as haemorrhage or infarction √
59 10-07-2023 0039108 UMUM H. MATAJI L SAMBO 001/002 72 Thn 0 Bln Other specified surgical follow-up care √
60 10-07-2023 0039109 BPJS 0003523133024 3524240204500001 IMAM L WARUK 001/001 73 Thn 3 Bln Diarrhoea and gastroenteritis of presumed infectious origin √
62 10-07-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 68 Thn 10 Bln Dermatitis, unspecified √
63 10-07-2023 0017197 BPJS 0000758420111 3524244101480050 FUTICHAH P MONOLELO 001/002 75 Thn 6 Bln Hypertensive heart disease with (congestive) heart failure √
64 10-07-2023 0019010 BPJS 0002162940827 3524240506560002 MASYKUN KHOIRI L WEDENG 001/004 67 Thn 1 Bln √
65 10-07-2023 0039112 BPJS 0000759610517 3524244101490032 AMAT P PENCARAN 001/005 74 Thn 6 Bln √
67 10-07-2023 0027703 BPJS 0001962819843 3524240504580001 IKHSAN L SAMBO 001/004 65 Thn 3 Bln Sequelae of subarachnoid haemorrhage √
68 10-07-2023 0004848 BPJS 0000103106518 3523245112620001 MAFTUCHAH P GAYAM 005/003 Acute upper respiratory infection, unspecified; Hypertensive heart
60 Thn 6 Bln disease with (congestive) heart failure √
69 10-07-2023 0015759 BPJS 0001325621834 3524242605630002 MUHAMMAD ZHUDI L GAYAM 003/004 Hypertensive heart disease with (congestive) heart failure;
60 Thn 1 Bln Rheumatism, unspecified, lower leg √
70 10-07-2023 0027335 BPJS 0002441295112 3524240801580001 SUJONO L BULAK 001/001 65 Thn 6 Bln Acute upper respiratory infection, unspecified √
71 10-07-2023 0039045 BPJS 0000759360429 3524241602400001 KATEM L BANJARANYAR 003/001 83 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √
72 10-07-2023 0026817 BPJS 0002445619803 3524245201500001 DARIYATI P KLECO 001/003 73 Thn 5 Bln Hypertensive heart disease with (congestive) heart failure √
73 10-07-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004 63 Thn 11 Bln Acute upper respiratory infection, unspecified √
74 10-07-2023 0007216 BPJS 0000758406486 3524241906630001 NADI L KARANGAJI 003/003 60 Thn 0 Bln Hypertensive heart disease with (congestive) heart failure √
75 11-07-2023 0003747 BPJS 0002162693957 NAPSIYAH P NGIPIK Acute upper respiratory infection, unspecified; Hyperglycaemia,
76 11-07-2023 0039115 BPJS 0002888734419 BOLAH L BLAWI 001/003 Essential (primary) hypertension; Unspecified viral hepatitis without
63 Thn 6 Bln hepatic coma √
INDIKATOR KELEN
aan Fisik
77 11-07-2023 0010782 UMUM 3524244704560002 MUKANAH P KEBONSARI 004/003 Chronic obstructive pulmonary disease with acute lower respiratory
67 Thn 3 Bln infection √
(congestive) heart failure; Stroke, not specified as haemorrhage or
61 Thn 2 Bln infarction √
79 11-07-2023 0000043 BPJS 0000759805626 3524247112620001 MU`SIYATI P SAMBO 60 Thn 6 Bln Myalgia √
80 11-07-2023 0023317 BPJS 0003002375654 3524244101600089 FITRIYAH P BLAWI 002/004
Insulin-dependent diabetes mellitus with multiple complications;
63 Thn 6 Bln Malaise and fatigue; Other specified disorders of white blood cells √
81 11-07-2023 0036612 BPJS 0003002375643 3524240201580008 SUPARTO L BLAWI 002/004 65 Thn 6 Bln Idiopathic peripheral autonomic neuropathy √
82 11-07-2023 0007140 BPJS 0000758685396 3524245904610001 JUWATI P SAMBO 002/003 Dyspepsia; Hypertensive heart disease without (congestive) heart
83 12-07-2023 0027331 BPJS 0002421232481 3524245010580002 SUKAENI P BANDUT 002/001
64 Thn 9 Bln Acute upper respiratory infection, unspecified; Gastritis, unspecified √
84 12-07-2023 0029915 BPJS 0002237697011 3524245802580001 SANAH P BOTOH 003/002 65 Thn 4 Bln Counselling, unspecified √
85 12-07-2023 0027330 BPJS 0002421232345 3524241811540001 AMIR L BANDUT 002/001 Dyspepsia; Hypertensive heart disease without (congestive) heart
68 Thn 7 Bln failure; Myalgia √
86 12-07-2023 0009134 BPJS 0000759951191 3524247011590001 SUKAENI P WINDU 002/002
Acute ischaemic heart disease, unspecified; Acute subendocardial
myocardial infarction; Hypertensive heart disease with (congestive)
87 12-07-2023 0002652 BPJS 0000103766668 3524241505390001 AMIR L BAKALAN 002/003 84 Thn 1 Bln Caries of dentine √
88 12-07-2023 0039085 BPJS 0003012483183 3524244101590057 KUNTIANAH P BLAWI TENGAH 003/003 Hyperglycaemia, unspecified; Hypertensive heart disease without
64 Thn 6 Bln (congestive) heart failure; Other senile cataract √
89 12-07-2023 0029426 BPJS 0001047270892 PATRIYANTO L PUPUK 001/003 61 Thn 3 Bln Cerebral infarction, unspecified √
90 12-07-2023 0009507 BPJS 0000758433936 YASEH P BR. PELUK 007/003
91 12-07-2023 0039109 BPJS 0003523133024 3524240204500001 IMAM L WARUK 001/001 73 Thn 3 Bln Malignant neoplasm of colon, unspecified √
92 12-07-2023 0017462 BPJS 0000758831951 3524244201550009 KATI P BADAN 002/004 Gastritis, unspecified; Hypertensive heart disease without (congestive)
68 Thn 6 Bln heart failure; Myalgia, hand √
93 13-07-2023 0035121 BPJS 0000758886974 KARTINI P LUNTAS S 001/002 Hypertensive heart disease with (congestive) heart failure; Other senile
79 Thn 6 Bln cataract √
94 13-07-2023 0022778 BPJS 0000757265804 3524244101470032 SALEKAH P GOSO 002/003 76 Thn 6 Bln Rheumatism, unspecified √
96 13-07-2023 0022252 BPJS 0002162609943 3524240101620011 SA'UM L BAKALAN 61 Thn 6 Bln Cerebral infarction due to thrombosis of precerebral arteries √
97 13-07-2023 0016904 BPJS 0002422338197 3524244804620001 SUMI P MORO 001/003 61 Thn 3 Bln Hyperglycaemia, unspecified; Other acute gastritis √
98 13-07-2023 0009108 BPJS 0000758427851 3524240303630003 TIPAN L PUPUS 001/006 60 Thn 4 Bln Other gastritis √
100 14-07-2023 0039109 BPJS 0003523133024 3524240204500001 IMAM L WARUK 001/001 73 Thn 3 Bln Diarrhoea and gastroenteritis of presumed infectious origin √
101 14-07-2023 0001448 BPJS 0002758761832 3524244101420014 SRIAMAH P PELUK 001/003
102 14-07-2023 0020211 BPJS 0000758427636 3524240708490001 SUKADI L PALANGAN 001/002 73 Thn 11 Bln Congestive heart failure √
103 14-07-2023 0015707 BPJS 0001265685873 3524240506600003 IMAM ROSYADI L MAYONG KULON 001/001 63 Thn 1 Bln Myalgia √
104 14-07-2023 0004157 BPJS 0002697610645 3524244807610001 ANIFAH P MAGOK 001/002 Gastritis, unspecified; Non-insulin-dependent diabetes mellitus without
105 14-07-2023 0039112 BPJS 0000759610517 3524244101490032 AMAT P PENCARAN 001/005 Atrial fibrillation and flutter; Heart failure, unspecified; Hypertensive
107 14-07-2023 0006545 BPJS 0000103593644 ABD. KHOLIQ L KARANGAJI 003/003 66 Thn 1 Bln Myalgia √
108 14-07-2023 0027335 BPJS 0002441295112 3524240801580001 SUJONO L BULAK 001/001 65 Thn 6 Bln Acute upper respiratory infection, unspecified √
109 15-07-2023 0007174 UMUM 3524241205530002 HUDI ICHSAN L PENCARAN 70 Thn 2 Bln √
110 17-07-2023 0012504 BPJS 0002248407966 3524245003520001 HJ. MINAH P MENGAI 001/005 71 Thn 4 Bln Congestive heart failure √
111 17-07-2023 0004848 BPJS 0000103106518 3523245112620001 MAFTUCHAH P GAYAM 005/003 Dyspepsia; Hypertensive heart disease without (congestive) heart
112 17-07-2023 0004937 BPJS 0002304533608 3524244101600120 KHASANAH P ALANG-ALANG 002/005 63 Thn 6 Bln Hyperglycaemia, unspecified √
113 17-07-2023 0039164 BPJS 0003523325534 H ASYHARI L DS BANJAREJO 60 Thn 1 Bln Benign neoplasm of brain, unspecified √
114 17-07-2023 0025066 BPJS 0001388131806 3524245104380001 KARSANI P BLAWI UTARA 001/004 85 Thn 3 Bln Acute upper respiratory infection, unspecified √
115 17-07-2023 0031358 BPJS 0000758526208 MUSAROFAH P LOGAWE 001/001 67 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √
116 17-07-2023 0033241 BPJS 0000759231505 KASRI P TERBIS 002/003 55 Thn 4 Bln Essential (primary) hypertension √
117 17-07-2023 0023062 BPJS 0000103902399 3524242704620001 MUJIONO L SAMBO 002/002 61 Thn 2 Bln Rheumatism, unspecified √
118 17-07-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 68 Thn 10 Bln Hyperglycaemia, unspecified √
119 17-07-2023 0030925 BPJS 0001704090216 3524244101560059 NANIK P PULOKERTO 001/001 67 Thn 6 Bln Sequelae of cerebral infarction √
INDIKATOR KELEN
aan Fisik
120 17-07-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 68 Thn 1 Bln Other acute gastritis √
121 17-07-2023 0024607 BPJS 0002248407663 3524241202500001 H.SAMIJAN L MENGAI 001/ 005 73 Thn 5 Bln Hyperplasia of prostate √
122 17-07-2023 0039167 BPJS 0002480122258 3524244706630002 RUKHANAH P SINAN 003/002 60 Thn 1 Bln Senile nuclear cataract √
123 17-07-2023 0012330 BPJS 0000759341856 3524240201550003 IRPAN L LOGAWE 002/001 68 Thn 6 Bln Other senile cataract √
124 17-07-2023 0019019 BPJS 0001536777156 3524244709770002 RUJIANAH P BONSARI 45 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √
125 17-07-2023 0022677 BPJS 0000759011398 3524241008590001 MUCHAMMAD THOEYIB L BONRINGIN 001/004 63 Thn 11 Bln Acute upper respiratory infection, unspecified √
126 17-07-2023 0015034 BPJS 0000758727382 3524244107590003 UMAROH P KARANGANOM WETAN 007/004 64 Thn 0 Bln Hypertensive heart disease with (congestive) heart failure √
127 17-07-2023 0039171 BPJS 0003340640406 MALIKAH P WARUK 001/002 75 Thn 6 Bln Fracture of neck of femur, closed √
128 17-07-2023 0033446 BPJS 0001047286383 3524240201540003 KARMIN L MENGAI 002/006 69 Thn 6 Bln Essential (primary) hypertension √
129 17-07-2023 0016904 BPJS 0002422338197 3524244804620001 SUMI P MORO 001/003 61 Thn 3 Bln Gastritis, unspecified √
130 17-07-2023 0028813 UMUM 3524240406470001 AMAT L TEMBOK 002/003 Acute nasopharyngitis [common cold]; Hypertensive heart disease
131 17-07-2023 0035121 BPJS 0000758886974 KARTINI P LUNTAS S 001/002 79 Thn 6 Bln Presence of intraocular lens √
132 17-07-2023 0039045 BPJS 0000759360429 3524241602400001 KATEM L BANJARANYAR 003/001 Hypertensive heart disease without (congestive) heart failure; Senile
134 17-07-2023 0011272 BPJS 0001047277271 3524247004610001 SUPARNI P NGIPIK Dyspepsia; Hypertensive heart disease without (congestive) heart
135 17-07-2023 0005611 BPJS 0001704058053 3524247112610001 MISKANA L SAMBO 003/004 61 Thn 6 Bln Allergic contact dermatitis, unspecified cause; Myalgia √
136 17-07-2023 0026861 BPJS 0000759326398 3524240108500001 MUKSAN L KEPOH 005/002 72 Thn 11 Bln Acute nasopharyngitis [common cold] √
137 18-07-2023 0001081 BPJS 0003176757055 3524240411590002 ASNAN L TERBIB 00/003 63 Thn 8 Bln Ocular pain √
138 18-07-2023 0021476 BPJS 0000758730014 3524244101520070 ATEMAH P BADAN 001/002 71 Thn 6 Bln Essential (primary) hypertension √
139 18-07-2023 0021405 BPJS 0000757175545 3524244105560002 SAROH P BADAN 002/002 67 Thn 2 Bln Essential (primary) hypertension √
140 18-07-2023 0021499 BPJS 0001047280206 3524244101650063 MARTIK P BADAN 002/002 58 Thn 6 Bln Essential (primary) hypertension √
141 18-07-2023 0033241 BPJS 0000759231505 KASRI P TERBIS 002/003 55 Thn 4 Bln Essential (primary) hypertension √
142 18-07-2023 0036149 BPJS 0000759177382 SUPARNO L ALASMALANG 03/02 62 Thn 10 Bln Essential (primary) hypertension √
143 18-07-2023 0020205 BPJS 0000758119544 3524244103510001 KARSI P WARUK RT 01/RW02 72 Thn 4 Bln Essential (primary) hypertension √
144 18-07-2023 0014109 BPJS 0000758378845 3524244101490016 JASMANI P BR.SIMAN 74 Thn 6 Bln Essential (primary) hypertension √
145 18-07-2023 0020477 BPJS 0001704050752 WARSINI P WINDU 53 Thn 6 Bln Essential (primary) hypertension √
146 18-07-2023 0022668 BPJS 0002845117899 SALBIYAH P WARUK 60 Thn 0 Bln Essential (primary) hypertension √
147 18-07-2023 0025879 BPJS 0001543302246 MOH ASYKURI L WARUK 001/001 44 Thn 5 Bln Essential (primary) hypertension √
148 18-07-2023 0035969 BPJS 0000758682382 3524241212500003 SAMAN L MAYONG TENGAH 003/003 72 Thn 7 Bln Acute ischaemic heart disease, unspecified √
149 18-07-2023 0037750 BPJS 0001704051865 SUTIKAH P KURO 61 Thn 9 Bln Essential (primary) hypertension √
150 18-07-2023 0001392 BPJS 0000103766905 IMAM L MONOLELO 001/002 77 Thn 11 Bln Essential (primary) hypertension √
151 18-07-2023 0011478 BPJS 0000758442879 3524244106450001 SARPILAH L NGAJARAN 78 Thn 1 Bln Essential (primary) hypertension √
152 18-07-2023 0031583 BPJS 0001079091595 UMI SUBCHA P KURO 68 Thn 6 Bln Essential (primary) hypertension √
153 18-07-2023 0021152 BPJS 0000759342936 3524244103550001 TUMU`NINAH P KURO 68 Thn 4 Bln Essential (primary) hypertension √
154 18-07-2023 0017358 BPJS 0000759711521 3524244201590007 SUWARNI P BAKALAN 64 Thn 6 Bln Essential (primary) hypertension √
155 18-07-2023 0020710 BPJS 0000759041684 3524240101500013 KUMARI L BAKALAN 73 Thn 6 Bln Essential (primary) hypertension √
156 18-07-2023 0036544 BPJS 0000757445253 3524244101620081 SURIYAH P MONOLELO 002/002 61 Thn 6 Bln Essential (primary) hypertension √
157 18-07-2023 0013634 BPJS 0002075869337 MULYANI P WINDU 52 Thn 8 Bln Essential (primary) hypertension √
158 18-07-2023 0023206 BPJS 0000757430943 3524242803610001 ALI ARIFIN L KARANGBINANGUN 62 Thn 3 Bln Essential (primary) hypertension √
159 18-07-2023 0019972 BPJS 0001047284144 3524244911540001 MISTRI P PALANGAN 68 Thn 8 Bln Blindness, one eye √
160 18-07-2023 0005141 BPJS 0002732691644 LAMSINAH P SAMBO 002/003 60 Thn 4 Bln Essential (primary) hypertension √
161 18-07-2023 0003206 BPJS 0000103501438 3524240108600001 SUPRIYANTO L SAMBO 001/002 62 Thn 11 Bln Headache √
162 18-07-2023 0033839 BPJS 0000759370263 3524244210570001 HARMINI P WATES 001/002 65 Thn 9 Bln Pleural effusion, not elsewhere classified √
163 18-07-2023 0031323 BPJS 0000758812239 3524244102590001 KUSWATI P BANDUT 64 Thn 5 Bln Essential (primary) hypertension √
164 18-07-2023 0031767 BPJS 0000759089913 3524240101680040 MUDHOFAR L BANDUT 55 Thn 6 Bln Essential (primary) hypertension √
165 18-07-2023 0031551 BPJS 0000758804433 3524244101540033 ROBI'AH P BOGOBABADAN 69 Thn 6 Bln Essential (primary) hypertension √
166 18-07-2023 0026614 BPJS 0001723832649 3524244101460038 SARPIYAH P BANDUT 001/001 77 Thn 6 Bln Essential (primary) hypertension √
167 19-07-2023 0029808 BPJS 0001861880499 3524240101480014 IDRIS L BAKALAN 001/002 75 Thn 6 Bln √
168 20-07-2023 0033437 BPJS 0000790684176 SAPI'I L WINDU 002/001
170 20-07-2023 0012469 BPJS 0000757393615 3524245101550005 KARMINTEN P MENGAI 001/006 68 Thn 6 Bln Erosive (osteo)arthrosis √
171 20-07-2023 0031226 BPJS 0000758437457 NUR MUSTHOFA L PENCARAN BLAWI Dyspepsia; Hypertensive heart disease without (congestive) heart
172 20-07-2023 0013251 BPJS 0002162696409 SUMANI P KEBONSARI 001/001 Dyspepsia; Hypertensive heart disease without (congestive) heart
INDIKATOR KELEN
aan Fisik
173 20-07-2023 0028202 UMUM 3524241310590002 MUNJAROH L BONSARI 002/001 Acute nasopharyngitis [common cold]; Hypertensive heart disease
174 20-07-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 64 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √
175 21-07-2023 0035777 BPJS 0002732692691 KASMONAH P SAMBO 002/003 64 Thn 1 Bln Senile cataract, unspecified √
176 21-07-2023 0013653 BPJS 0000758820284 SUPARTI P BADAN 002/004 Hypertensive heart disease without (congestive) heart failure; Pure
71 Thn 6 Bln hyperglyceridaemia √
177 21-07-2023 0031341 BPJS 0000759772528 3524240101480051 MARJUKI L BAKALAN 77 Thn 6 Bln Essential (primary) hypertension √
178 21-07-2023 0026840 BPJS 0002811410201 3524245707700001 KASMIATUN P BAKALAN RT 02 RW 01 53 Thn 0 Bln Essential (primary) hypertension √
179 21-07-2023 0022306 BPJS 0000759720363 3524244607580001 KANAH P SOMOITO 65 Thn 0 Bln Essential (primary) hypertension √
180 21-07-2023 0015755 BPJS 0000758159998 JAWAHIR L WARUK 72 Thn 8 Bln Essential (primary) hypertension √
181 21-07-2023 0029446 BPJS 0000759025495 KATIMAN L WARUK 002/002 68 Thn 7 Bln Essential (primary) hypertension √
182 21-07-2023 0020210 BPJS 0000759026788 MARINTEN P WARUK RT02/RW02 62 Thn 8 Bln Essential (primary) hypertension √
183 21-07-2023 0025237 BPJS 0002265773466 3524247006490006 LASENI P WINDU 74 Thn 0 Bln Essential (primary) hypertension √
184 21-07-2023 0022874 BPJS 0001704050561 3624255006480002 KASENAH P WINDU 002/001 75 Thn 0 Bln Essential (primary) hypertension √
185 21-07-2023 0028373 BPJS 0000758690875 3524247006480010 SOMANI P WINDU 001/002 75 Thn 0 Bln Essential (primary) hypertension √
186 21-07-2023 0013036 BPJS 0001961115423 3524240510530003 MOH. THOHA L WEDENG 002/003
69 Thn 9 Bln Arthritis, unspecified, lower leg; Spondylosis, unspecified, lumbar region √
187 21-07-2023 0013723 BPJS 0000758884915 3524247006430001 NIMAH P WINDU 80 Thn 0 Bln Essential (primary) hypertension √
188 21-07-2023 0031909 BPJS 0002328236537 3524247006460007 MUDAH P NGIPIK 002/003 77 Thn 0 Bln Essential (primary) hypertension √
189 21-07-2023 0022197 BPJS 0002210213384 3524241709500002 SOLIKAN L WINDU 002/001 72 Thn 10 Bln Essential (primary) hypertension √
190 21-07-2023 0012879 BPJS 0001047282592 3524242601530001 MISKAN L BAKALAN 002/001 70 Thn 5 Bln Essential (primary) hypertension √
191 21-07-2023 0016705 BPJS 0000758126643 3524242306570001 ABD. MANAN L WARUK 002/002 66 Thn 0 Bln √
192 21-07-2023 0030629 BPJS 0002913182627 3524245105710003 MUASAROH P WARUK 002/001 52 Thn 2 Bln √
193 21-07-2023 0012642 BPJS 0001961118516 3524244105570006 MASRIAH P WEDENG 002/003 66 Thn 2 Bln Spondylolysis, lumbar region √
194 21-07-2023 0009108 BPJS 0000758427851 3524240303630003 TIPAN L PUPUS 001/006 60 Thn 4 Bln Dyspepsia √
195 21-07-2023 0030660 BPJS 0000758667069 3524244501530001 JANA P KURO 002/001 70 Thn 6 Bln Urinary tract infection, site not specified √
196 21-07-2023 0036769 BPJS 0000103655575 3524245711600001 ISTIROCHAH P KARANGBINANGUN 001/001 62 Thn 8 Bln Malignant neoplasm overlapping bronchus and lung sites √
197 21-07-2023 0031326 BPJS 0000758769129 3524244101540041 SUKAYAH P BANDUT 002/001 69 Thn 6 Bln Allergic contact dermatitis due to adhesives √
198 21-07-2023 0013541 BPJS 0001386491905 3524245406500001 KASRI P KLECO 002/004 73 Thn 1 Bln Hypertensive heart disease with (congestive) heart failure √
199 21-07-2023 0007140 BPJS 0000758685396 3524245904610001 JUWATI P SAMBO 002/003 Dyspepsia; Hypertensive heart disease without (congestive) heart
200 24-07-2023 0000802 BPJS 0000759116799 3524240101420035 MADRUN L NGAJARAN Dental caries, unspecified; Hypertensive heart disease without
201 24-07-2023 0007036 BPJS 0002811408906 3524245305590001 NGATMONAH P KEBONSARI 001/003 64 Thn 2 Bln Senile cataract, unspecified √
202 24-07-2023 0037723 BPJS 0001047273423 AMIR L BLAWI 67 Thn 0 Bln Asthma, unspecified √
203 24-07-2023 0005665 BPJS 0000759148918 KARTAWI L LUNTAS S 03/001 Chronic obstructive pulmonary disease with acute exacerbation,
204 24-07-2023 0037961 BPJS 0001047279734 3524244101450065 MUTIJAH P NGAJARAN 004/004 78 Thn 6 Bln Senile cataract, unspecified √
205 24-07-2023 0039222 BPJS 0001047279723 3524240101370024 RAMELI L NGAJARAN 004/004 86 Thn 6 Bln Senile cataract, unspecified √
206 24-07-2023 0035616 BPJS 0003101665138 3524244101630035 INDAHYATI P KAUMAN 001/002 60 Thn 6 Bln √
207 24-07-2023 0007707 BPJS 0000759327377 3524244403600001 SULIKAH P DUKOHASRI Non-insulin-dependent diabetes mellitus without complications;
63 Thn 4 Bln Pulmonary oedema √
208 24-07-2023 0010376 BPJS 0000759820961 3524245203600001 KUMANI P WUNGU 001/001 63 Thn 4 Bln Hypertensive heart disease without (congestive) heart failure √
209 24-07-2023 0003799 BPJS 0001447390135 3524245908620001 KATOYAH P MAYONG KULON 001/001 60 Thn 11 Bln Intracerebral haemorrhage, unspecified √
210 24-07-2023 0005055 BPJS 0002265541211 3524246204620001 RIYANAH P KEBONSARI 002/003 Gastritis, unspecified; Hypertensive heart disease without (congestive)
211 24-07-2023 0007216 BPJS 0000758406486 3524241906630001 NADI L KARANGAJI 003/003 60 Thn 1 Bln Hypertensive heart disease without (congestive) heart failure √
212 24-07-2023 0000768 BPJS 0000758485089 3524244101610021 CHOLIFAH P BR. SIMAN 002/001 62 Thn 6 Bln Myalgia √
213 24-07-2023 0002670 BPJS 0000103498457 3524242504540001 DJUWONO L ALANG-ALANG 002/005 69 Thn 2 Bln Chronic renal failure, unspecified √
214 24-07-2023 0027335 BPJS 0002441295112 3524240801580001 SUJONO L BULAK 001/001 65 Thn 6 Bln Chronic disease of tonsils and adenoids, unspecified √
215 24-07-2023 0038713 BPJS 0002162694071 3524247006480009 UMUH P WINDU 003/001 75 Thn 0 Bln Cervical disc disorder with myelopathy √
216 25-07-2023 0019001 BPJS 0001047272319 MUKSAN L PENCARAN 002/005 69 Thn 6 Bln Hyperplasia of prostate √
217 25-07-2023 0006411 BPJS 0003060943402 3524240101460010 ASIKIN L KEPOH 004/002 77 Thn 6 Bln √
218 25-07-2023 0031562 BPJS 0000758593776 3524246008610001 MASNING P KARANGANOM KULON 61 Thn 11 Bln √
219 25-07-2023 0013214 BPJS 0000759143406 3524245104590001 SAMIANI P SINAN 003/003 Hyperuricaemia without signs of inflammatory arthritis and tophaceous
64 Thn 3 Bln disease √
220 25-07-2023 0003708 BPJS 0000759112648 3524246708580001 SHOLIHAH P MAYONG TENGAH 002/003 64 Thn 10 Bln Congestive heart failure √
221 25-07-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006
222 25-07-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 Hypertensive heart disease without (congestive) heart failure; Tinea
68 Thn 2 Bln pedis √
223 25-07-2023 0019010 BPJS 0002162940827 3524240506560002 MASYKUN KHOIRI L WEDENG 001/004 67 Thn 1 Bln Acute nasopharyngitis [common cold] √
INDIKATOR KELEN
aan Fisik
224 25-07-2023 0039231 BPJS 0000759053114 3524240101380001 KARTIB L MAGOK 001/001 Other benign neoplasm of connective and other soft tissue of upper
85 Thn 6 Bln limb, including shoulder √
225 25-07-2023 0001844 BPJS 0003104646625 3524245703600001 INAKAH P PUTATREJO 001/003 63 Thn 4 Bln Hypertensive heart disease without (congestive) heart failure √
226 25-07-2023 0015034 BPJS 0000758727382 3524244107590003 UMAROH P KARANGANOM WETAN 007/004 Conjunctivitis, unspecified; Hypertensive heart disease without
Hypertensive heart disease without (congestive) heart failure; Insulin-
62 Thn 3 Bln dependent diabetes mellitus with multiple complications √
228 26-07-2023 0009108 BPJS 0000758427851 3524240303630003 TIPAN L PUPUS 001/006 60 Thn 4 Bln Gastric ulcer, acute with haemorrhage √
229 26-07-2023 0000737 BPJS 0000788682216 3524242002580001 MOCH. NADJIB L MONOLELO 002/002 65 Thn 5 Bln General medical examination √
230 26-07-2023 0022559 BPJS 0002058535866 3524240101490017 SU'EF L PUPUK 001/003 74 Thn 6 Bln Hypertensive heart disease without (congestive) heart failure √
231 26-07-2023 0008404 BPJS 0002162696635 MUJAINAH P KEBONSARI 001/001 74 Thn 4 Bln Senile cataract, unspecified √
232 26-07-2023 0013269 BPJS 0001704092804 3524244704610001 SUMIATI P BONSARI 62 Thn 3 Bln Senile cataract, unspecified √
233 27-07-2023 0024156 BPJS 0000758949535 3524242201580001 SLAMET L KLECO 65 Thn 6 Bln Tinea cruris √
234 27-07-2023 0008945 BPJS 0002307147298 SAROPAH P BONSARI 002/004
69 Thn 6 Bln Lumbar and other intervertebral disc disorders with myelopathy √
235 27-07-2023 0039245 UMUM 3524243006560001 SUJARI L SAMBO 002/003 67 Thn 0 Bln Open wound of other parts of foot √
236 27-07-2023 0038446 BPJS 0003176547794 3524240101590005 DJAYUS L WATANGAN 002/001 Hyperlipidaemia, unspecified; Hypertensive heart disease without
237 27-07-2023 0028452 BPJS 0000758364412 3524244101590043 HUSNI P KAUMAN 004/002 64 Thn 6 Bln Acute appendicitis, unspecified √
238 27-07-2023 0010859 BPJS 0000759422654 3524244301540001 SUMIATI P BANJARANYAR 003/003 69 Thn 6 Bln Atrial fibrillation and flutter √
239 27-07-2023 0010489 BPJS 0002162609829 3524244101560016 SAMSUNI P BAKALAN 002/002 67 Thn 6 Bln Atrial fibrillation and flutter √
240 28-07-2023 0033999 BPJS 0000103501012 3524244505550001 SUTARNI P BANDUT 001/001 68 Thn 2 Bln Myalgia √
241 28-07-2023 0017986 BPJS 0000758908383 3524241808480001 TASLIMAN L WATANGAN Hypertensive heart disease without (congestive) heart failure;
74 Thn 11 Bln Rheumatism, unspecified √
242 28-07-2023 0017881 BPJS 0000758438278 3524244101620072 MUKARIYAH P PENCARAN 002/005 61 Thn 6 Bln Senile cataract, unspecified √
243 28-07-2023 0005611 BPJS 0001704058053 3524247112610001 MISKANA L SAMBO 003/004 61 Thn 6 Bln Hypertensive heart disease without (congestive) heart failure √
244 28-07-2023 0014550 BPJS 0000757918348 3524240508590001 ACHMAD SU'ALI L GAYAM 005/003 63 Thn 11 Bln Senile cataract, unspecified √
246 28-07-2023 0030660 BPJS 0000758667069 3524244501530001 JANA P KURO 002/001 70 Thn 6 Bln Urinary tract infection, site not specified √
247 28-07-2023 0008953 BPJS 0000758909441 3524244101510003 NANIK P WATANGAN 72 Thn 6 Bln Acute nasopharyngitis [common cold] √
248 31-07-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001 60 Thn 6 Bln Hypertensive heart disease with (congestive) heart failure √
249 31-07-2023 0009107 BPJS 0002161709908 3524241908620002 SIRAM L SUMBEREJO 002/003 60 Thn 11 Bln Myalgia √
250 31-07-2023 0013251 BPJS 0002162696409 SUMANI P KEBONSARI 001/001 62 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
251 31-07-2023 0038578 BPJS 0000759427817 3524241101630003 QOMARI L LUNTAS B 002/007 60 Thn 6 Bln Hebephrenic schizophrenia √
252 31-07-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 68 Thn 11 Bln Myalgia √
253 31-07-2023 0024099 BPJS 0000759057017 3524240101630015 SEKAR L BAKALAN 001/001 60 Thn 6 Bln Atherosclerotic heart disease √
254 31-07-2023 0011748 BPJS 0000758375469 3524244204530001 SULAMI P LUMBANGAN 70 Thn 3 Bln Acute upper respiratory infection, unspecified √
255 31-07-2023 0000502 BPJS 0000103766848 1208230112440001 MOH. MALIKAN L BLAWI 78 Thn 7 Bln Hyperglycaemia, unspecified; Parkinson's disease √
256 31-07-2023 0028515 BPJS 0002162695972 SUMANI P PALANGAN 001/001 76 Thn 6 Bln Senile cataract, unspecified √
258 31-07-2023 0003095 BPJS 0000758351248 3524240101580012 DJANAWI L BANJARANYAR 002/002 65 Thn 6 Bln Cerebral infarction, unspecified √
259 31-07-2023 0039282 BPJS 0002811409615 3524244101600031 SITI MUSOFAH P BANJARANYAR 001/002 63 Thn 6 Bln Myopia √
260 31-07-2023 0014820 BPJS 0001047269654 3524241101610004 SULKAN L LUNTAS S 003/001 62 Thn 6 Bln Acute haemorrhagic gastritis √
261 31-07-2023 0002749 BPJS 0000103767579 3524244101550062 SUKAENI P BANDUT 002/001 68 Thn 6 Bln Insulin-dependent diabetes mellitus with renal complications √
262 31-07-2023 0010014 BPJS 0000757393547 3524241309500001 SARKUM L MENGAI 001/006 72 Thn 10 Bln Stiffness of joint, not elsewhere classified, ankle and foot √
263 31-07-2023 0000416 BPJS 0000103499886 3524240304630002 KHABIB L KEPENG 003/002 Other specified diabetes mellitus with peripheral circulatory
264 31-07-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 68 Thn 2 Bln Atopic dermatitis, unspecified √
Pemeriks
Terapi KIE
a Medis penunjan
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
Terapi KIE
a Medis penunjan
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
Terapi KIE
a Medis penunjan
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
Terapi KIE
a Medis penunjan
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
Terapi KIE
a Medis penunjan
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Pemeriks
Terapi KIE
a Medis penunjan
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
CEKLIST KELENGKAPAN PENGISIAN REKAM MED
Tanggal : : 01-08-2023 s/d 31-08-2023
1 01-08-2023 0033437 BPJS 0000790684176

2 01-08-2023 0014918 BPJS 0002430467548 3524244401550003
3 01-08-2023 0031347 BPJS 0002734828593 3524244101590013
4 01-08-2023 0007036 BPJS 0002811408906 3524245305590001
5 01-08-2023 0005422 BPJS 0000758405362
6 01-08-2023 0009870 BPJS 0000103486241 3524171710620001
7 01-08-2023 0005144 BPJS 0001888188895 3524244101590044
8 01-08-2023 0006411 BPJS 0003060943402 3524240101460010
9 01-08-2023 0018201 BPJS 0000758992678 3524247006570002
10 01-08-2023 0033006 BPJS 0000758570411 3524244101490013
11 01-08-2023 0038024 BPJS 0002608054031 3524240411580001
12 02-08-2023 0004603 BPJS 0000759319176 3524240101610019
13 02-08-2023 0013541 BPJS 0001386491905 3524245406500001
14 02-08-2023 0027189 BPJS 0000757547976 3524244209590001
15 02-08-2023 0039300 BPJS 0000758580985 3524242211630001
16 02-08-2023 0026861 BPJS 0000759326398 3524240108500001
17 02-08-2023 0007216 BPJS 0000758406486 3524241906630001
18 02-08-2023 0031157 BPJS 0002763980032
19 02-08-2023 0029406 BPJS 0002763980436
20 02-08-2023 0034223 BPJS 0001047272736
21 02-08-2023 0001081 BPJS 0003176757055 3524240411590002
22 03-08-2023 0001101 BPJS 0000103499482
23 03-08-2023 0027667 BPJS 0000758474583 3524240103630004
24 03-08-2023 0006823 BPJS 0000759099205 3524242910570001
25 03-08-2023 0034936 BPJS 0002876182492 3524244201570013
26 03-08-2023 0034935 BPJS 0002876182468 3524240101510050
27 03-08-2023 0004848 BPJS 0000103106518 3523245112620001
28 03-08-2023 0009702 BPJS 0000758953541 3524245804530001
29 03-08-2023 0017223 BPJS 0002491569336
30 03-08-2023 0000374 BPJS 0000758757633 3524247112590001
31 03-08-2023 0013095 BPJS 0003055242069 3524245208480001
32 04-08-2023 0010293 BPJS 0000758788571 3524240811600001
33 04-08-2023 0016772 BPJS 0001047282276 3524242009560001
34 04-08-2023 0033491 BPJS 0003048640762 3524244202580002
35 04-08-2023 0004480 BPJS 0001483865482 3524240207480001
36 04-08-2023 0039315 BPJS 0000759232473 3524242011600001
37 04-08-2023 0015894 BPJS 0003504235364 3524242508560002
38 07-08-2023 0027920 BPJS 0001047284379
39 07-08-2023 0031226 BPJS 0000758437457 3524242404470001
40 07-08-2023 0011323 UMUM 3524245311380001
41 07-08-2023 0002817 BPJS 0000759941368
42 07-08-2023 0029426 BPJS 0001047270892
43 07-08-2023 0023397 BPJS 0002218180331
44 07-08-2023 0008116 BPJS 0000103695401 352424
45 07-08-2023 0008945 BPJS 0002307147298
46 07-08-2023 0016772 BPJS 0001047282276 3524242009560001
47 07-08-2023 0024214 BPJS 0000758973306 3524242007550001
48 07-08-2023 0005888 BPJS 0000758317037 3524245201570001
49 07-08-2023 0029991 BPJS 0002741412025 3524244101610040
50 07-08-2023 0023753 BPJS 0002245028398 3524242008540001
51 08-08-2023 0027323 BPJS 0000759284717 3524244101530059
52 08-08-2023 0028202 BPJS 0002449099721
53 08-08-2023 0027880 BPJS 0000759140796 3524244201550010
54 08-08-2023 0028458 BPJS 0002749091602 3524241403620001
55 08-08-2023 0021460 BPJS 0002488312642
56 08-08-2023 0024815 BPJS 0000759751683 3524244101600115
57 08-08-2023 0030348 BPJS 0000758669275 3524240101630016
58 08-08-2023 0039282 BPJS 0002811409615 3524244101600031
59 09-08-2023 0007216 BPJS 0000758406486 3524241906630001
60 09-08-2023 0009524 BPJS 0002941269939 3524245807510001
61 09-08-2023 0027607 BPJS 0000759293739
62 09-08-2023 0013653 BPJS 0000758820284
63 09-08-2023 0035423 BPJS 0001047273221 3524240101560045
64 09-08-2023 0008600 UMUM 3524245405630001
65 09-08-2023 0016773 BPJS 0002255163142 3524240101590086
66 09-08-2023 0001935 BPJS 0000103766984 3524244101550078
67 10-08-2023 0021378 BPJS 0000759226465 3524246101540001
68 10-08-2023 0013251 BPJS 0002162696409
69 10-08-2023 0031282 BPJS 0000758211377 3524244101630006
70 10-08-2023 0011916 BPJS 0000760001488 3524244505490002
71 10-08-2023 0003747 BPJS 0002162693957
72 10-08-2023 0018542 BPJS 0001047279273 3524240709550001
73 10-08-2023 0015809 BPJS 0001047280432 3524240609690001
74 10-08-2023 0015894 BPJS 0003504235364 3524242508560002
75 10-08-2023 0016596 BPJS 0000103501203 3524264702580001
76 10-08-2023 0039350 UMUM 3524241609600001
77 10-08-2023 0007674 BPJS 0000759364626 3524246911570001
78 10-08-2023 0001672 BPJS 0001422789816 3524245204520001
79 11-08-2023 0039358 BPJS 0000758658969 3524240101620018
80 11-08-2023 0027703 BPJS 0001962819843 3524240504580001
81 11-08-2023 0019964 BPJS 0002066070363
82 11-08-2023 0023446 BPJS 0000103590437 3524241508560001
83 14-08-2023 0011117 BPJS 0002913182559
84 14-08-2023 0024437 BPJS 0000758739486 3524247012540001
85 14-08-2023 0006583 BPJS 0000758869874 3524244101500028
86 14-08-2023 0031358 BPJS 0000758526208
87 14-08-2023 0006964 BPJS 0001473142329 3524240601560001
88 14-08-2023 0031226 BPJS 0000758437457 3524242404470001
89 14-08-2023 0014488 BPJS 0003269834144 3524246103610002
90 14-08-2023 0001693 BPJS 0002066720894 3524242001570002
91 14-08-2023 0017442 BPJS 0001897451829 3524243006550005
92 14-08-2023 0016038 BPJS 0000759820511 3524245503610001
93 14-08-2023 0013100 BPJS 0000759501009 3524245503600001
94 14-08-2023 0028813 UMUM 3524240406470001
95 14-08-2023 0005582 BPJS 0003108083027 3524245507580001
96 14-08-2023 0010293 BPJS 0000758788571 3524240811600001
97 14-08-2023 0027363 BPJS 0002459985535 3524240201540001
98 14-08-2023 0039231 BPJS 0000759053114 3524240101380001
99 14-08-2023 0018855 UMUM 3524242312580001
100 14-08-2023 0024214 BPJS 0000758973306 3524242007550001
101 14-08-2023 0022589 BPJS 0000759510628 3524243006450010
102 14-08-2023 0006213 BPJS 0002244527752 3524246508580002
103 14-08-2023 0002336 BPJS 0000758749948 3524244404550001
104 14-08-2023 0003213 BPJS 0000759785927 3524244101550016
105 14-08-2023 0008324 BPJS 0002874881035 3524240101610045
106 14-08-2023 0007480 BPJS 0000103767208 3524241505440001
107 15-08-2023 0011738 BPJS 0002488684645 3524244101540013
108 15-08-2023 0023663 BPJS 0002248461101 3524244201530004
109 15-08-2023 0039381 BPJS 0002626019965 3524241403570001
110 15-08-2023 0030348 BPJS 0000758669275 3524240101630016
111 15-08-2023 0020964 BPJS 0000759092242 3524242204620001
112 15-08-2023 0027502 BPJS 0002162609919 3524240101570072
113 15-08-2023 0026817 BPJS 0002445619803 3524245201500001
114 15-08-2023 0036869 BPJS 0001535057739 3524241212610001
115 15-08-2023 0007216 BPJS 0000758406486 3524241906630001
116 15-08-2023 0031282 BPJS 0000758211377 3524244101630006
117 15-08-2023 0039164 BPJS 0003523325534 3524240306630003
118 15-08-2023 0013957 BPJS 0001047274222 3524241510580001
119 16-08-2023 0029717 BPJS 0000759364569
120 16-08-2023 0039390 BPJS 0000103494396 3524246011610002
121 16-08-2023 0017442 BPJS 0001897451829 3524243006550005
122 16-08-2023 0004848 BPJS 0000103106518 3523245112620001
123 16-08-2023 0011733 BPJS 0002294469077 3524245403370001
124 16-08-2023 0036410 BPJS 0002845119442 3524245101400010
125 16-08-2023 0039381 BPJS 0002626019965 3524241403570001
126 16-08-2023 0027775 BPJS 0001704044362
127 16-08-2023 0010290 BPJS 0000758927237 3524245012620001
128 16-08-2023 0004152 BPJS 0000103501192 3524244610570001
129 16-08-2023 0025087 BPJS 0000758473929 3524245811600002
130 16-08-2023 0000012 BPJS 0000169417719 1208236007520001
131 16-08-2023 0018836 BPJS 0001704045306 3524241010580001
132 16-08-2023 0025248 BPJS 0001825398898 3524240101620041
133 16-08-2023 0003491 BPJS 0000169662251 3517074106500001
134 18-08-2023 0039400 BPJS 0000758923378 3524244101580024
135 18-08-2023 0034764 BPJS 0003078780941 3524244201630007
136 18-08-2023 0007140 BPJS 0000758685396 3524245904610001
137 18-08-2023 0010957 BPJS 0000103630858 3524240303530002
138 18-08-2023 0039401 BPJS 0003006178119 3524240811550001
139 18-08-2023 0021460 BPJS 0002488312642
140 18-08-2023 0010782 UMUM 3524244704560002
141 18-08-2023 0039402 UMUM 3524240101590008
142 18-08-2023 0011151 BPJS 0000758183242 3524244808570001
143 18-08-2023 0023753 BPJS 0002245028398 3524242008540001
144 18-08-2023 0033589 BPJS 0002899917595 3524244707570001
145 21-08-2023 0039414 BPJS 0000758930848 3524244101440007
146 21-08-2023 0015759 BPJS 0001325621834 3524242605630002
147 21-08-2023 0026418 BPJS 0001047281679 3524244101550004
148 21-08-2023 0029531 BPJS 0000758322652
149 21-08-2023 0039412 BPJS 0000759493146 3524244711620001
150 21-08-2023 0036482 BPJS 0001905647668 3524241711520001
151 21-08-2023 0039358 BPJS 0000758658969 3524240101620018
152 21-08-2023 0004122 BPJS 0000759055904 3524245804560001
153 21-08-2023 0015810 BPJS 0000759538787 3524246108630002
154 21-08-2023 0023753 BPJS 0002245028398 3524242008540001
155 21-08-2023 0023943 BPJS 0000759805209 3524243006590001
156 21-08-2023 0037031 BPJS 0000758619044 3524244501560003
157 21-08-2023 0001334 BPJS 0000758916022 3524244405620002
158 21-08-2023 0027240 BPJS 0001704051066 3524247006550008
159 21-08-2023 0033129 BPJS 0002876702477
160 21-08-2023 0027703 BPJS 0001962819843 3524240504580001
161 21-08-2023 0020964 BPJS 0000759092242 3524242204620001
162 21-08-2023 0035068 BPJS 0002935518186 3524241010540001
163 21-08-2023 0017287 BPJS 0000759630339 3524245107530002
164 22-08-2023 0001361 BPJS 0000103767671 3524241503490001
165 22-08-2023 0021286 BPJS 0000759248818
166 22-08-2023 0020353 BPJS 0000759214348
167 22-08-2023 0004848 BPJS 0000103106518 3523245112620001
168 22-08-2023 0039426 BPJS 0003533296544 3524245101600004
169 22-08-2023 0019810 BPJS 0002056262049 3524211408420001
170 22-08-2023 0013181 BPJS 0000758922333 3524244505580001
171 22-08-2023 0039423 UMUM 3578045001630002
172 22-08-2023 0029928 BPJS 0002521214403 3524243006570002
173 22-08-2023 0008595 BPJS 0000103767017 3303096810550001
174 22-08-2023 0029808 BPJS 0001861880499 3524240101480014
175 22-08-2023 0011752 BPJS 0000759262959 3524245706600002
176 22-08-2023 0035616 BPJS 0003101665138 3524244101630035
177 22-08-2023 0037715 BPJS 0000759230199 3524241407620003
178 22-08-2023 0025005 BPJS 0000759924652 3524247006600003
179 22-08-2023 0039487 BPJS 0000757747168 3524245607540001
180 23-08-2023 0039432 BPJS 0002582194869 3524245901610001
181 23-08-2023 0016233 BPJS 0000759161889
182 23-08-2023 0011752 BPJS 0000759262959 3524245706600002
183 23-08-2023 0016645 BPJS 0003503285831 3524244101630012
184 23-08-2023 0013820 BPJS 0002314477394 3524241406460002
185 23-08-2023 0018836 BPJS 0001704045306 3524241010580001
186 23-08-2023 0039426 BPJS 0003533296544 3524245101600004
187 23-08-2023 0034936 BPJS 0002876182492 3524244201570013
188 23-08-2023 0029938 BPJS 0002895413793 3524244606630001
189 23-08-2023 0022677 BPJS 0000759011398 3524241008590001
190 24-08-2023 0025248 BPJS 0001825398898 3524240101620041
191 24-08-2023 0023741 BPJS 0001047280779 3524244302590001
192 25-08-2023 0001000 BPJS 0000758404945 3524241211570001
193 25-08-2023 0019972 BPJS 0001047284144 3524244911540001
194 25-08-2023 0015093 BPJS 0000758692495
195 25-08-2023 0024414 BPJS 0000758141864 3524241111560001
196 25-08-2023 0023218 BPJS 0000759011185 3524245903550001
197 25-08-2023 0015073 BPJS 0001047287024 3524244908600001
198 25-08-2023 0011916 BPJS 0000760001488 3524244505490002
199 25-08-2023 0038486 BPJS 0000759398286 3524241611540001
200 25-08-2023 0033880 BPJS 0000759311109
201 25-08-2023 0030591 BPJS 0001829062451
202 25-08-2023 0037238 BPJS 0003143832388 3524240108520003
203 25-08-2023 0031160 BPJS 0000758992353 3524242911550001
204 25-08-2023 0036055 BPJS 0001704047387 3524241812600002
205 25-08-2023 0030560 BPJS 0002903557735 3524241611500001
206 25-08-2023 0033446 BPJS 0001047286383 3524240201540003
207 25-08-2023 0034377 BPJS 0001262805985 3524244909560001
208 25-08-2023 0020773 BPJS 0001892471038 3524245001580001
209 25-08-2023 0025952 BPJS 0000758718562 3524240709500001
210 25-08-2023 0018746 BPJS 0000759368002 3524240101510040
211 25-08-2023 0030642 BPJS 0000758532576
212 25-08-2023 0028631 BPJS 0000758580232 3524246708550001
213 25-08-2023 0018201 BPJS 0000758992678 3524247006570002
214 25-08-2023 0008324 BPJS 0002874881035 3524240101610045
215 25-08-2023 0005300 BPJS 0002735855166 3524241207770003
216 25-08-2023 0030026 BPJS 0002893621386 3524240804700004
217 25-08-2023 0008712 BPJS 0000758403549 3524240401560001
218 25-08-2023 0010772 BPJS 0002926601109 3524244101560015
219 25-08-2023 0034335 BPJS 0000759698414 3524244101550015
220 25-08-2023 0022257 BPJS 0000759753988 3524240101590016
221 25-08-2023 0034338 BPJS 0002769360939 3524243007590001
222 25-08-2023 0031354 BPJS 0000759678603 3524244101560012
223 25-08-2023 0023449 BPJS 0000759720407 3524244101480009
224 25-08-2023 0031226 BPJS 0000758437457 3524242404470001
225 25-08-2023 0022553 BPJS 0000759034743 3524244101610008
226 25-08-2023 0031335 BPJS 0002073701643 3524244101420009
227 25-08-2023 0031347 BPJS 0002734828593 3524244101590013
228 25-08-2023 0017358 BPJS 0000759711521 3524244201590007
229 25-08-2023 0020555 BPJS 0000759007563 3524244101300014
230 25-08-2023 0024090 BPJS 0000759026777 3524244101590012
231 25-08-2023 0007378 BPJS 0002162609706 3524245201600003
232 25-08-2023 0035718 BPJS 0000759735011
233 25-08-2023 0031323 BPJS 0000758812239 3524244102590001
234 25-08-2023 0024744 BPJS 0000758587195 3524245707600001
235 25-08-2023 0031551 BPJS 0000758804433 3524244101540033
236 25-08-2023 0021476 BPJS 0000758730014 3524244101520070
237 25-08-2023 0021405 BPJS 0000757175545 3524244105560002
238 25-08-2023 0036149 BPJS 0000759177382
239 25-08-2023 0020205 BPJS 0000758119544 3524244103510001
240 25-08-2023 0014109 BPJS 0000758378845 3524244101490016
241 25-08-2023 0033272 BPJS 0002162610044
242 25-08-2023 0031562 BPJS 0000758593776 3524246008610001
243 25-08-2023 0037750 BPJS 0001704051865
244 25-08-2023 0001392 BPJS 0000103766905
245 25-08-2023 0017287 BPJS 0000759630339 3524245107530002
246 25-08-2023 0011478 BPJS 0000758442879 3524244106450001
247 25-08-2023 0031583 BPJS 0001079091595
248 25-08-2023 0020710 BPJS 0000759041684 3524240101500013
249 25-08-2023 0035860 BPJS 0001047278439 3524241710570001
250 25-08-2023 0036544 BPJS 0000757445253 3524244101620081
251 25-08-2023 0023206 BPJS 0000757430943 3524242803610001
252 25-08-2023 0031341 BPJS 0000759772528 3524240101480051
253 25-08-2023 0022306 BPJS 0000759720363 3524244607580001
254 25-08-2023 0015755 BPJS 0000758159998
255 25-08-2023 0017626 BPJS 0000758385663 3524240101600034
256 25-08-2023 0029446 BPJS 0000759025495
257 25-08-2023 0020210 BPJS 0000759026788
258 25-08-2023 0025237 BPJS 0002265773466 3524247006490006
259 25-08-2023 0022874 BPJS 0001704050561 3624255006480002
260 25-08-2023 0028373 BPJS 0000758690875 3524247006480010
261 25-08-2023 0013723 BPJS 0000758884915 3524247006430001
262 25-08-2023 0031909 BPJS 0002328236537 3524247006460007
263 25-08-2023 0022197 BPJS 0002210213384 3524241709500002
264 25-08-2023 0012879 BPJS 0001047282592 3524242601530001
265 25-08-2023 0030629 BPJS 0002913182627 3524245105710003
266 25-08-2023 0010385 BPJS 0000758404012
267 25-08-2023 0008215 BPJS 0000103501732 3524246404610001
268 25-08-2023 0016705 BPJS 0000758126643 3524242306570001
269 25-08-2023 0034978 BPJS 0000759348369 3524240101590034
270 25-08-2023 0028110 BPJS 0002499393341
271 25-08-2023 0008220 BPJS 0003150081854 3524244201590003
272 25-08-2023 0033774 BPJS 0000758644569
273 28-08-2023 0006213 BPJS 0002244527752 3524246508580002
274 28-08-2023 0023943 BPJS 0000759805209 3524243006590001
275 28-08-2023 0012575 BPJS 0002244526716 3524241407550002
276 28-08-2023 0036156 BPJS 0002732691587 3524245110450001
277 28-08-2023 0000768 BPJS 0000758485089 3524244101610021
278 28-08-2023 0008215 BPJS 0000103501732 3524246404610001
279 28-08-2023 0024214 BPJS 0000758973306 3524242007550001
280 28-08-2023 0026346 BPJS 0002084233713 3524244103560001
281 28-08-2023 0035441 BPJS 0003005295873 3524244104590001
282 28-08-2023 0003544 BPJS 0000758593078 3524241204610001
283 28-08-2023 0010782 UMUM 3524244704560002
284 28-08-2023 0022145 BPJS 0000758265658 3524244101610029
285 28-08-2023 0016705 BPJS 0000758126643 3524242306570001
286 28-08-2023 0022783 BPJS 0000758824953 3524244201620007
287 28-08-2023 0006776 BPJS 0000758316262 3524240101470002
288 28-08-2023 0031157 BPJS 0002763980032
289 28-08-2023 0037604 BPJS 0003296945542 3524240501610001
290 28-08-2023 0034133 BPJS 0002439974531 3524244101580030
291 28-08-2023 0031282 BPJS 0000758211377 3524244101630006
292 28-08-2023 0009524 BPJS 0002941269939 3524245807510001
293 28-08-2023 0024879 BPJS 0000751135757 3524240201540004
294 28-08-2023 0039478 BPJS 0003304386178 3524244101620073
295 29-08-2023 0039491 BPJS 0000759490852 3524244101560061
296 29-08-2023 0029938 BPJS 0002895413793 3524244606630001
297 29-08-2023 0005611 BPJS 0001704058053 3524247112610001
298 29-08-2023 0039487 BPJS 0000757747168 3524245607540001
299 30-08-2023 0009197 BPJS 0003004719265 3524245206610001
300 30-08-2023 0000431 BPJS 0000103500213 3524240601550001
301 30-08-2023 0038810 BPJS 0001967005203 3578047006390095
302 30-08-2023 0029573 BPJS 0001047156074 3524222207540002
303 30-08-2023 0036452 BPJS 0000759709427 3524245001400001
304 30-08-2023 0024345 BPJS 0000759987382 3524243006540006
305 30-08-2023 0015854 BPJS 0001047274154 3524241510600001
306 30-08-2023 0008600 UMUM 3524245405630001
307 30-08-2023 0024644 BPJS 0000759735088 3524244201630003
308 31-08-2023 0027888 BPJS 0002896469177
309 31-08-2023 0025066 BPJS 0001388131806 3524245104380001
310 31-08-2023 0039414 BPJS 0000758930848 3524244101440007
311 31-08-2023 0011868 BPJS 0000759574563 3524244201600011
312 31-08-2023 0027502 BPJS 0002162609919 3524240101570072
313 31-08-2023 0037644 BPJS 0003302774379 3524241201450002
314 31-08-2023 0019972 BPJS 0001047284144 3524244911540001
SAPI'I L WINDU 002/001 71 Thn 1 Bln

SULASTRI P KARANGANOM KULON 002/001 68 Thn 6 Bln
NGATMONAH P KEBONSARI 001/003 64 Thn 2 Bln
SINAH P KETAPANG 67 Thn 6 Bln
ASIRIS L BAKALAN 60 Thn 9 Bln
SYAFAATUN P KAUMAN 001/002 64 Thn 7 Bln
ASIKIN L KEPOH 004/002 77 Thn 7 Bln
KHUZAIMAH L MAYONG WETAN 001/004 66 Thn 1 Bln
SUPARTIYA P KURO 003/001 74 Thn 7 Bln
DIDIK MULIADI L WATANGAN 001/002 64 Thn 8 Bln
CHOIRUN L KURO 002/001 62 Thn 7 Bln
KUMAROH P PALANGAN 002/001 63 Thn 11 Bln
SYAKUR L BATURONO 002/002 59 Thn 8 Bln
MUKSAN L KEPOH 005/002 73 Thn 0 Bln
NADI L KARANGAJI 003/003 60 Thn 1 Bln
SUJA'I L KARANGBINANGUN 003/001 85 Thn 7 Bln
CHODIROH P KARANGBINANGUN 003/001 70 Thn 7 Bln
MADARI L PULOKERTO 001/001 66 Thn 10 Bln
ASNAN L TERBIB 00/003 63 Thn 8 Bln
SUKAERI,DRS L SAMBO 002/002 61 Thn 2 Bln
KHUSAIN L KR.ANOM KULON 002/002 60 Thn 5 Bln
ASRUL SONI SIRIGAR L KEPENG 003/002 65 Thn 10 Bln
ALFIATUN P MAGOK 001/001 70 Thn 3 Bln
AHMAD NAÌM L BANJARANYAR 001/002 63 Thn 11 Bln
SUMILAH P KEBONSARI 001/004 74 Thn 11 Bln
MAKSUM L Br. BUTUH 62 Thn 8 Bln
SUMADI L BAKALAN 001/002 66 Thn 10 Bln
SUMIATI P KETAPANG 001/002 65 Thn 6 Bln
SHODIKIN L WEDENG 002/002 75 Thn 1 Bln
SUPENO L ALASMALANG 002/001 62 Thn 8 Bln
REJO L KETAPANG 002/001 66 Thn 11 Bln
SAROÌM L KEBONSARI 002/003 70 Thn 2 Bln
NUR MUSTHOFA L PENCARAN 002/005 76 Thn 3 Bln
MUSA'AH P MAYONG WETAN 001/004 84 Thn 0 Bln
SENATRI P PRIYOSO WETAN 61 Thn 1 Bln
PATRIYANTO L PUPUK 001/003 61 Thn 4 Bln
MUSTARI L KLECO 001/003 74 Thn 5 Bln
MARKAMIN L SAMBO 70 Thn 4 Bln
SAROPAH P BONSARI 002/004 69 Thn 7 Bln
SUMADI L BAKALAN 001/002 66 Thn 10 Bln
INEM P MAGOK 001/002 66 Thn 6 Bln
MUNJAROH L BONSARI 002/001 63 Thn 9 Bln
NINGSIH P BADAN 002/004 68 Thn 7 Bln
NAFIK KHUSYAIRI L GAYAM 005/003 72 Thn 7 Bln
NURJANAH P KR.BINANGUN 63 Thn 7 Bln
SULAJI L WARUK 002/001 60 Thn 7 Bln
SITI MUSOFAH P BANJARANYAR 001/002 63 Thn 7 Bln
UMANI P LUNTAS B 003/007 72 Thn 0 Bln
KALIMAH P KEPOH 005/002 64 Thn 0 Bln
SUPARTI P BADAN 002/004 71 Thn 7 Bln
MATKARIM L PENCARAN 001/005 67 Thn 7 Bln
ASTUTIK P TERBIS 001/003 60 Thn 2 Bln
DURAHMAN L TERBIS 001/003 64 Thn 7 Bln
ARLIYAH P TERBIS 001/003 69 Thn 6 Bln
SUMANI P KEBONSARI 001/001 62 Thn 2 Bln
SUWATUN P MAGOK 001/001 60 Thn 7 Bln
KASRI P WINDU 74 Thn 3 Bln
NAPSIYAH P NGIPIK 66 Thn 1 Bln
SUNARPAN L KARANGBINANGUN 67 Thn 11 Bln
MASNIANTO L KLECO 001/003 53 Thn 11 Bln
REJO L KETAPANG 002/001 66 Thn 11 Bln
SUMARTINI P MORO 65 Thn 6 Bln
NEMU L KARANGANOM KULON 002/001 62 Thn 10 Bln
SAMSIYAH P WATANGAN 001/002 65 Thn 8 Bln
SUYAMA P KLECO 001/10 71 Thn 3 Bln
KAMAD L KETAPANG 002/002 61 Thn 7 Bln
IKHSAN L SAMBO 001/004 65 Thn 4 Bln
MATOKAN L PULOKERTO 002/001 69 Thn 10 Bln
BUDI UTOMO L KURO 003/001 66 Thn 11 Bln
NAWAWI L WARUK 002/001 44 Thn 3 Bln
MARTIYA P SAMBO 003/004 68 Thn 7 Bln
DANIRAH P PUPUK 001/003 73 Thn 7 Bln
MUSAROFAH P LOGAWE 001/001 67 Thn 10 Bln
H MOH ALFAN L BLAWI 67 Thn 7 Bln
UMAR L KR ANOM WETAN 008/004 66 Thn 6 Bln
MISLAN L NGIPIK 003/003 68 Thn 1 Bln
SURIATI P KURIPAN 001/008 62 Thn 4 Bln
SUKARTI P LUNTAS B 003/007 63 Thn 4 Bln
AMAT L TEMBOK 002/003 76 Thn 2 Bln
KARTI P LUNTAS 003/007 65 Thn 0 Bln
MAKSUM L Br. BUTUH 62 Thn 9 Bln
KARSAN L WATANGAN 002/002 69 Thn 7 Bln
KARTIB L MAGOK 001/001 85 Thn 7 Bln
SUPARNO ZAENAL ABDI L KARANGBINANGUN 64 Thn 8 Bln
KARSADI L NGIPIK 003/003 78 Thn 1 Bln
SITI MARLIYAH P PELUK 007/003 68 Thn 7 Bln
MACHFUD L PUPUS 001/006 79 Thn 2 Bln
JANAH P PUPUK 002/003 69 Thn 7 Bln
SULAMI P BLAWI 70 Thn 7 Bln
MIRSODAH L BLAWI 003/002 66 Thn 5 Bln
AHMAD HASYIM L KR ANOM KULON 61 Thn 3 Bln
DARIYATI P KLECO 001/003 73 Thn 7 Bln
UMAR L LUWUK 006/001 61 Thn 8 Bln
H ASYHARI L KLAMPIS 002/006 60 Thn 2 Bln
MUNAWAR L KADU 005/002 64 Thn 10 Bln
DULASIR L WATANGAN 001/002 70 Thn 9 Bln
UMI KULSUM P KURO 001/001 61 Thn 8 Bln
SUKAYAH P KLECO 002/003 86 Thn 5 Bln
SUMINTEN P NGAJARAN 04/04 83 Thn 7 Bln
MIRSODAH L BLAWI 003/002 66 Thn 5 Bln
MUSRI'AH P BANDUT 002/001 69 Thn 0 Bln
SUBIKAH P MAGOK 002/002 60 Thn 8 Bln
SUMARTI, S.PD P BANJARANYAR 003/004 65 Thn 10 Bln
ANI P KRANOM KULON 62 Thn 8 Bln
KAMAH P BLAWI SELATAN 002/002 71 Thn 6 Bln
UNTUNG L KETAPANG 002/001 61 Thn 7 Bln
SALIKHAH P KURO 003/001 73 Thn 7 Bln
ALIYAH P KETAPANG 002/002 65 Thn 7 Bln
ZULFAH P BLAWI UTARA 002/004 60 Thn 7 Bln
JUWATI P SAMBO 002/003 62 Thn 3 Bln
AMIN L MAYONG TENGAH 004/003 70 Thn 5 Bln
TIKNO L MENGAI 002/006 67 Thn 9 Bln
KHOLIS L WATANGAN 002/001 64 Thn 7 Bln
SUMAH P MAGOK 003/002 66 Thn 0 Bln
UMBYAWATI P SAMBO 002/001 66 Thn 1 Bln
MARKIYAMAH P WATANGAN 001/001 79 Thn 7 Bln
MUHAMMAD ZHUDI L GAYAM 003/004 60 Thn 2 Bln
ARKATI P MAGOK 001/001 68 Thn 7 Bln
KHOTIMAH P BLAWI UTARA 001/004 78 Thn 7 Bln
HARTIK P PRIYOSO WETAN 001/001 60 Thn 9 Bln
UMAR L BATURONO 003/002 70 Thn 9 Bln
KAMAD L KETAPANG 002/002 61 Thn 7 Bln
KUNAÌNAH P BADAN 001/004 67 Thn 4 Bln
SUMIATI P PUPUS 003/006 60 Thn 0 Bln
MUSLIKIN L SAMBO 002/002 64 Thn 1 Bln
ROKIBAH P WATES 001/002 67 Thn 7 Bln
SUMI P BONSARI 61 Thn 3 Bln
NENGYAH L NGIPIK 003/003 68 Thn 1 Bln
SENEN GIMUN L NGIPIK 72 Thn 10 Bln
ANWAR L PENCARAN 002 / 005 68 Thn 10 Bln
KASTUMI P NGAJARAN 70 Thn 1 Bln
NUR HADI L SAMBO 003/002 74 Thn 5 Bln
JULAIKHAH P BLAWI 003/002 63 Thn 7 Bln
KASMINTEN P PULOKERTO 68 Thn 3 Bln
ASTUTIK P LUNTAS S 003/001 63 Thn 7 Bln
BAKRI L GABUS 81 Thn 0 Bln
TUMIK P PALANGAN 65 Thn 3 Bln
MUSLIKAH P SAMBO 60 Thn 7 Bln
NISKAN L SAMBO 002/002 66 Thn 1 Bln
MULYATI P KURO 001/001 68 Thn 2 Bln
IDRIS L BAKALAN 001/002 75 Thn 7 Bln
INDAHYATI P KAUMAN 001/002 60 Thn 7 Bln
SUTARNO L TERBIS 002/003 61 Thn 1 Bln
NYANI P PRIYOSO WETAN 001/001 63 Thn 2 Bln
MASRIFAH P GOWAH 001/001 69 Thn 1 Bln
SUPARMI P WATANGAN 001/002 62 Thn 7 Bln
SUJONO L DUKOH 65 Thn 7 Bln
AISYATUN P WARUK 001/002 60 Thn 7 Bln
MILKAN L PERIYOSO WETAN 001/002 77 Thn 2 Bln
ASTUTIK P LUNTAS S 003/001 63 Thn 7 Bln
SHOKHIFAH P BADAN 001/002 60 Thn 2 Bln
UNTUNG L KETAPANG 002/001 61 Thn 7 Bln
SUMI P WATANGAN 64 Thn 6 Bln
MULYADI L KADU 005/002 65 Thn 9 Bln
MISTRI P PALANGAN 68 Thn 9 Bln
MUKNI P WARUK 60 Thn 11 Bln
RUPINAH P KARANGANOM KULON 68 Thn 5 Bln
NURIKA P WARUK 63 Thn 0 Bln
SARMADI L MENGAI 002/006 68 Thn 9 Bln
YAHYA L WEDENG SUKOREJO 64 Thn 8 Bln
MUSLIMAH P GAYAM 60 Thn 9 Bln
DALIL L KARANGANOMWETAN 71 Thn 0 Bln
ABDUL MUHID L WEDENG 67 Thn 8 Bln
ROHIMIN L WEDENG 001/003 62 Thn 8 Bln
MAT HARI L WEDENG 001/002 72 Thn 9 Bln
KARMIN L MENGAI 002/006 69 Thn 7 Bln
HJ. SALAMAH P MENGAI 001/006 66 Thn 11 Bln
SARTI P GUNDIK 65 Thn 7 Bln
MATASIM L WEDENG 72 Thn 11 Bln
ZAINI L ALASMALANG 72 Thn 7 Bln
SUMIYATI P ALAS MALANG 67 Thn 11 Bln
KHUZAIMAH L MAYONG WETAN 001/004 66 Thn 1 Bln
SUHAJI L LUWUK 46 Thn 1 Bln
MOH. TAUHID L MAYONG KULON 001/001 53 Thn 4 Bln
SADIK L BR. KADU 67 Thn 7 Bln
WIDARTI P BAKALAN 002/002 67 Thn 7 Bln
SITI ANAH P BAKALAN RT 01 RW03 68 Thn 7 Bln
TASLIKAN L BAKALAN RT 01 RW 01 64 Thn 7 Bln
KASMOLAN L BAKALAN RT 02 RW 03 64 Thn 0 Bln
MULIASIH P BAKALAN 67 Thn 7 Bln
SARKAMAH P BAKALAN 75 Thn 7 Bln
SRIAMAH P SOMOITO 62 Thn 7 Bln
KASTINAH P BAKALAN 81 Thn 7 Bln
SUWARNI P BAKALAN 64 Thn 7 Bln
SARMIDAH P SOMOITO 93 Thn 7 Bln
JUMAÌYAH P BAKALAN 64 Thn 7 Bln
KASEMU P BANYUURIP 63 Thn 7 Bln
SOMADI L WATANGAN 001/001 63 Thn 7 Bln
KUSWATI P BANDUT 64 Thn 6 Bln
SUTARTI P KURO 002/001 63 Thn 1 Bln
ROBI'AH P BOGOBABADAN 69 Thn 7 Bln
ATEMAH P BADAN 001/002 71 Thn 7 Bln
SAROH P BADAN 002/002 67 Thn 3 Bln
SUPARNO L ALASMALANG 03/02 62 Thn 11 Bln
KARSI P WARUK RT 01/RW02 72 Thn 5 Bln
JASMANI P BR.SIMAN 74 Thn 7 Bln
BAWON P KARANGANOM KULON 86 Thn 6 Bln
MASNING P KARANGANOM KULON 62 Thn 0 Bln
SUTIKAH P KURO 61 Thn 10 Bln
IMAM L MONOLELO 001/002 78 Thn 0 Bln
KASTUMI P NGAJARAN 70 Thn 1 Bln
SARPILAH L NGAJARAN 78 Thn 2 Bln
UMI SUBCHA P KURO 68 Thn 7 Bln
KUMARI L BAKALAN 73 Thn 7 Bln
ALFAN EFENDI L MONOLELO 001/002 65 Thn 10 Bln
SURIYAH P MONOLELO 002/002 61 Thn 7 Bln
ALI ARIFIN L KARANGBINANGUN 62 Thn 4 Bln
MARJUKI L BAKALAN 77 Thn 7 Bln
KANAH P SOMOITO 65 Thn 1 Bln
JAWAHIR L WARUK 72 Thn 9 Bln
ARKAN L KETAPANG 002/001 63 Thn 7 Bln
KATIMAN L WARUK 002/002 68 Thn 8 Bln
MARINTEN P WARUK RT02/RW02 62 Thn 9 Bln
LASENI P WINDU 74 Thn 1 Bln
KASENAH P WINDU 002/001 75 Thn 1 Bln
SOMANI P WINDU 001/002 75 Thn 1 Bln
NIMAH P WINDU 80 Thn 1 Bln
MUDAH P NGIPIK 002/003 77 Thn 1 Bln
SOLIKAN L WINDU 002/001 72 Thn 11 Bln
MISKAN L BAKALAN 002/001 70 Thn 6 Bln
MUASAROH P WARUK 002/001 52 Thn 3 Bln
INAMAH P SAMBO 001/002 62 Thn 4 Bln
ABD. MANAN L WARUK 002/002 66 Thn 2 Bln
KASBULLAH L GUNDIK 001/004 64 Thn 7 Bln
AKOP L BLAWI UTARA 003/004 63 Thn 7 Bln
MUTMAINAH P BAKALAN 64 Thn 7 Bln
TOYIBAH P LOGAWE 68 Thn 4 Bln
MUSLIKIN L SAMBO 002/002 64 Thn 1 Bln
KHAMIM L WEDENG 002/003 68 Thn 1 Bln
KOLAH P SAMBOPINGGIR 77 Thn 10 Bln
CHOLIFAH P BR. SIMAN 002/001 62 Thn 7 Bln
KIMYATIN P PULOKERTO 002/001 67 Thn 5 Bln
SUPIATI P KETAPANG 001/001 64 Thn 4 Bln
KASNAWI L BATURONO 002/002 62 Thn 4 Bln
DARMANI P LUNTAS S 003/001 62 Thn 7 Bln
SUEP KARTOWIYONO L MAGOK 001/002 76 Thn 7 Bln
SUJA'I L KARANGBINANGUN 003/001 85 Thn 7 Bln
KHAMIM L PRIYOSO KULON 001/003 62 Thn 7 Bln
JAMIYAH P SIMAN 002/001 65 Thn 7 Bln
UMANI P LUNTAS B 003/007 72 Thn 1 Bln
USMAN L KADU 005/002 69 Thn 7 Bln
SUMI P BLAWI 001/004 61 Thn 7 Bln
KUSMAH P PENCARAN 002/005 67 Thn 7 Bln
SHOKHIFAH P BADAN 001/002 60 Thn 2 Bln
MISKANA L SAMBO 003/004 61 Thn 7 Bln
MASRIFAH P GOWAH 001/001 69 Thn 1 Bln
GINEM P LUWUK 006/001 62 Thn 2 Bln
KAJATI P PERUM GRAHA KENCANA 004/00284 Thn 2 Bln
SARMAN L BLAWI TENGAH 001/003 69 Thn 1 Bln
TENI P WATANGAN 001/002 83 Thn 7 Bln
SUYATNO L MORO 69 Thn 2 Bln
SOLIKAN L WUNGU 001/001 62 Thn 10 Bln
ASTUTIK P TERBIS 001/003 60 Thn 3 Bln
SUPANI P WATANGAN 60 Thn 7 Bln
TIÀH P TEMBOK 002/003 60 Thn 7 Bln
KARSANI P BLAWI UTARA 001/004 85 Thn 4 Bln
MARKIYAMAH P WATANGAN 001/001 79 Thn 7 Bln
KASTUN P BLAWI 63 Thn 7 Bln
JALI L SUMBERJO 002/003 78 Thn 7 Bln
MISTRI P PALANGAN 68 Thn 9 Bln

Terapi
aan Fisik a

Counselling related to sexual attitude √ √ √
Rheumatism, unspecified, lower leg √ √ √
Rheumatism, unspecified, hand √ √ √
Myalgia √ √ √
Moderate depressive episode √ √ √
Parkinsonism in diseases classified elsewhere √ √ √
Acute pharyngitis, unspecified √ √ √
Acute myocardial infarction, unspecified √ √ √
Acute hepatitis B with delta-agent (coinfection) without hepatic coma √ √ √
Generalized skin eruption due to drugs and medicaments √ √ √
Dyspepsia; Hypertensive heart disease without (congestive) heart failure √ √ √
Diarrhoea and gastroenteritis of presumed infectious origin √ √ √
Acute nasopharyngitis [common cold]; Dyspepsia √ √ √
Hypertensive heart disease without (congestive) heart failure; Non-insu √ √ √
Myalgia √ √ √
Insulin-dependent diabetes mellitus with neurological complications √ √ √
Myalgia, multiple sites √ √ √
Constipation √ √ √
Myalgia √ √ √
Insulin-dependent diabetes mellitus with peripheral circulatory complicat√ √ √
Myalgia √ √ √
Insulin-dependent diabetes mellitus with peripheral circulatory complica √ √ √
Hyperglycaemia, unspecified; Hypertensive heart disease without (congest √ √ √
Essential (primary) hypertension √ √ √
Gastrojejunal ulcer, acute with haemorrhage √ √ √
Gastrojejunal ulcer, acute with haemorrhage √ √ √
Acute nasopharyngitis [common cold]; Hypertensive heart disease without √ √ √
Bilateral inguinal hernia, without obstruction or gangrene √ √ √
Allergic contact dermatitis due to other agents; Hypertensive heart disea √ √ √
Bell's palsy √ √ √
Myalgia √ √ √
Hypertensive heart disease with (congestive) heart failure; Rheumatism, √ √ √
Diabetic cataract √ √ √
Lumbar and other intervertebral disc disorders with radiculopathy √ √ √
Disorder of refraction, unspecified √ √ √
Hypertensive heart disease with (congestive) heart failure; Vertigo of cent√ √ √
Myalgia √ √ √
Headache √ √ √
Acute upper respiratory infection, unspecified; Hypertensive heart diseas√ √ √
Hyperglycaemia, unspecified; Hypertensive heart disease with (congestive√ √ √
Malignant neoplasm of ribs, sternum and clavicle √ √ √
Other forms of angina pectoris √ √ √
Spinal stenosis, lumbar region √ √ √
Insulin-dependent diabetes mellitus with renal complications √ √ √
Intracerebral haemorrhage, unspecified √ √ √
Other benign neoplasm of connective and other soft tissue of abdomen √ √ √
Atrial fibrillation and flutter √ √ √
Other hypertrophic osteoarthropathy, lower leg √ √ √
Rheumatism, unspecified, hand √ √ √
Cutaneous abscess, furuncle and carbuncle, unspecified √ √ √
Chronic obstructive pulmonary disease with acute lower respiratory infe √ √ √
Shoulder lesion, unspecified √ √ √
Myalgia √ √ √
Other inflammatory polyneuropathies √ √ √
Typhoid fever √ √ √
Chronic superficial gastritis √ √ √
Myalgia √ √ √
Hyperglycaemia, unspecified; Hypertensive heart disease with (congestive√ √ √
Osseous stenosis of neural canal, lumbar region √ √ √
Primary gonarthrosis, bilateral √ √ √
Hypertensive heart disease with (congestive) heart failure; Myalgia √ √ √
Hepatomegaly, not elsewhere classified √ √ √
Hypertensive heart disease without (congestive) heart failure; Senile cat √ √ √
Fracture of lower end of femur, closed √ √ √
Benign neoplasm of mediastinum √ √ √
Insulin-dependent diabetes mellitus with peripheral circulatory complica √ √ √
Hypertensive heart disease with (congestive) heart failure; Vertigo of cent√ √ √
Senile nuclear cataract √ √ √
Hypertensive heart disease with (congestive) heart failure; Rheumatism, √ √ √
Angina pectoris with documented spasm √ √ √
Acute lymphadenitis, unspecified √ √ √
Insulin-dependent diabetes mellitus with multiple complications √ √ √
Adherent leukoma; Glaucoma suspect; Senile cataract, unspecified √ √ √
Chronic obstructive pulmonary disease with acute lower respiratory infe √ √ √
Insulin-dependent diabetes mellitus without complications √ √ √
Insulin-dependent diabetes mellitus with multiple complications √ √ √
Other glaucoma √ √ √
Other prurigo √ √ √
Myalgia √ √ √
Intracerebral haemorrhage, unspecified √ √ √
Myalgia √ √ √
Myalgia √ √ √
Glaucoma secondary to other eye disorders √ √ √
Myalgia √ √ √
Hearing loss, unspecified √ √ √
Burn of first degree of trunk; Hypertensive heart disease without (congest√ √ √
Fracture of lower end of humerus, closed √ √ √
Other idiopathic scoliosis, cervical region √ √ √
Pemeriks
Diagnosa aan
KIE
Medis penunjan
g
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
Tanggal : : 01-09-2023 s/d 30-09-2023
1 01-09-2023 0014908 BPJS 0003143832399 3524244101580071

2 01-09-2023 0000764 BPJS 0000757520381 3524247112480003
3 01-09-2023 0039402 UMUM 3524240101590008

4 01-09-2023 0017828 BPJS 0000758469699 3524241708540003
5 01-09-2023 0009702 BPJS 0000758953541 3524245804530001
6 01-09-2023 0023753 BPJS 0002245028398 3524242008540001
7 01-09-2023 0038293 BPJS 0000758550644 3524244101620007
8 01-09-2023 0009850 UMUM 3524240101420017

9 01-09-2023 0033722 UMUM 3524240808610001
10 04-09-2023 0000639 BPJS 0000103500437 3524244111540002
11 04-09-2023 0018163 BPJS 0001047271623
12 04-09-2023 0011868 BPJS 0000759574563 3524244201600011
13 04-09-2023 0033622 BPJS 0001047273232 3524245909610001
14 04-09-2023 0004848 BPJS 0000103106518 3523245112620001
15 04-09-2023 0014348 BPJS 0002249320961 3524242108630002
16 04-09-2023 0038293 BPJS 0000758550644 3524244101620007
17 04-09-2023 0037865 BPJS 0002732685794 3524244101630066
18 04-09-2023 0037961 BPJS 0001047279734 3524244101450065

19 04-09-2023 0024611 BPJS 0001047274391 3524243006520004
20 04-09-2023 0011864 BPJS 0001047271972 3524240101530065
21 04-09-2023 0000641 BPJS 0000103599821 3524241212480002
22 04-09-2023 0030777 BPJS 0000758099024
23 04-09-2023 0000737 BPJS 0000788682216 3524242002580001
24 04-09-2023 0010290 BPJS 0000758927237 3524245012620001
25 04-09-2023 0011272 BPJS 0001047277271 3524247004610001

26 04-09-2023 0039402 UMUM 3524240101590008
27 04-09-2023 0003707 BPJS 0001047274233 3524245109570002

28 04-09-2023 0000308 BPJS 0000759578185 3524240101630051
29 04-09-2023 0028202 BPJS 0002449099721
30 04-09-2023 0019146 BPJS 0003134588444 3524240101590041
31 05-09-2023 0036466 BPJS 0001850979475 3524221506590001
32 05-09-2023 0012268 BPJS 0001704047376 3524244410440001
33 05-09-2023 0007938 BPJS 0000762568266

34 05-09-2023 0010997 BPJS 0000759248864 3524246101580001
35 05-09-2023 0033715 BPJS 0000758845405 3524244101610044
36 05-09-2023 0030607 BPJS 0000758794241 3524240407510001
37 05-09-2023 0000374 BPJS 0000758757633 3524247112590001
38 06-09-2023 0001269 BPJS 0001047278193 3524247012620003
39 06-09-2023 0017880 BPJS 0000758841581
40 06-09-2023 0032001 BPJS 0002474678553 3524240101620015
41 06-09-2023 0020388 UMUM 3524244101570001
42 06-09-2023 0010628 BPJS 0001439232309 3524240101490037

43 06-09-2023 0006976 BPJS 0001439232704 3524245606600001
44 06-09-2023 0030348 BPJS 0000758669275 3524240101630016
45 06-09-2023 0024214 BPJS 0000758973306 3524242007550001
46 06-09-2023 0029573 BPJS 0001047156074 3524222207540002
47 06-09-2023 0029717 BPJS 0000759364569
48 06-09-2023 0017577 BPJS 0000757448291 3524245010590002

49 07-09-2023 0020964 BPJS 0000759092242 3524242204620001
50 07-09-2023 0035518 BPJS 0003106614789 3524246604620001
51 07-09-2023 0016720 BPJS 0000159548973 3524246002530001
52 07-09-2023 0016719 BPJS 0000103768255 3524240901510001
53 07-09-2023 0011864 BPJS 0001047271972 3524240101530065

54 07-09-2023 0007216 BPJS 0000758406486 3524241906630001
55 07-09-2023 0000308 BPJS 0000759578185 3524240101630051

56 07-09-2023 0001725 BPJS 0000103753282 3524240606480002
57 07-09-2023 0009107 BPJS 0002161709908 3524241908620002
58 07-09-2023 0003983 BPJS 0000103885007 352424
59 07-09-2023 0013820 BPJS 0002314477394 3524241406460002

60 07-09-2023 0006124 BPJS 0002204301969 3524244309630001
61 08-09-2023 0006213 BPJS 0002244527752 3524246508580002

62 08-09-2023 0022341 BPJS 0002208979091 3524241803520001
63 08-09-2023 0023960 BPJS 0002208979552 3524245607570001

64 08-09-2023 0027323 BPJS 0000759284717 3524244101530059
65 08-09-2023 0005683 BPJS 0002162609741 3524245201610001
66 08-09-2023 0037927 BPJS 0000758954226 3524245101540002
67 08-09-2023 0030450 BPJS 0002732239449
68 08-09-2023 0027750 BPJS 0001704055544
69 08-09-2023 0005600 BPJS 0000758814287 3524240709590001
70 08-09-2023 0014488 BPJS 0003269834144 3524246103610002
71 08-09-2023 0031226 BPJS 0000758437457 3524242404470001
72 08-09-2023 0000269 BPJS 0000103500369 3524245608590002

73 11-09-2023 0010903 BPJS 0001890137068
74 11-09-2023 0038802 BPJS 0001704090701 3524245100830001
75 11-09-2023 0024099 BPJS 0000759057017 3524240101630015
76 11-09-2023 0023753 BPJS 0002245028398 3524242008540001
77 11-09-2023 0024407 BPJS 0000759302324 3524244101470008
78 11-09-2023 0023062 BPJS 0000103902399 3524242704620001
79 11-09-2023 0033129 BPJS 0002876702477

80 11-09-2023 0008753 BPJS 0000758725806 3524244312560001
81 11-09-2023 0000431 BPJS 0000103500213 3524240601550001
82 11-09-2023 0022793 UMUM 3524244101560041
83 11-09-2023 0003213 BPJS 0000759785927 3524244101550016
84 11-09-2023 0034936 BPJS 0002876182492 3524244201570013
85 11-09-2023 0034935 BPJS 0002876182468 3524240101510050
86 11-09-2023 0013251 BPJS 0002162696409
87 12-09-2023 0011272 BPJS 0001047277271 3524247004610001
88 12-09-2023 0022145 BPJS 0000758265658 3524244101610029
89 12-09-2023 0010993 BPJS 0000757948948 3524241203590003
90 12-09-2023 0039594 BPJS 0000757904949 3524245207510001
91 12-09-2023 0011891 BPJS 0002935518265 3524246008530001
92 12-09-2023 0025418 BPJS 0000758168368 3524240101520046
93 12-09-2023 0018836 BPJS 0001704045306 3524241010580001
94 12-09-2023 0037021 BPJS 0001049391189 3529236108510001

95 12-09-2023 0031510 BPJS 0001258924779
96 13-09-2023 0025593 BPJS 0000759830973 3524240408560001
97 13-09-2023 0022145 BPJS 0000758265658 3524244101610029
98 13-09-2023 0025117 BPJS 0002883093309 3524240108620001
99 13-09-2023 0023062 BPJS 0000103902399 3524242704620001
100 14-09-2023 0037741 BPJS 0000759226083 3524244101620069
101 14-09-2023 0029573 BPJS 0001047156074 3524222207540002
102 14-09-2023 0021573 BPJS 0000759590098 3524240105590002
103 14-09-2023 0011165 BPJS 0001704056815 3524240311420001
104 15-09-2023 0016090 BPJS 0000759507816 3524245010600002
105 15-09-2023 0008117 BPJS 0000103695412 3524246209600002
106 15-09-2023 0031115 BPJS 0000758614037
107 15-09-2023 0027607 BPJS 0000759293739
108 15-09-2023 0020005 BPJS 0002308444255 3524240404560001

109 15-09-2023 0031226 BPJS 0000758437457 3524242404470001
110 15-09-2023 0028945 UMUM 3524240906630002
111 18-09-2023 0022815 BPJS 0000759754484 3524240306580002
112 18-09-2023 0007061 BPJS 0000758430235 3524244101380061
113 18-09-2023 0008325 BPJS 0000759100241 3524244101590058
114 18-09-2023 0021006 BPJS 0001047283132 3524240906570001
115 18-09-2023 0038024 BPJS 0002608054031 3524240411580001
116 18-09-2023 0022689 BPJS 0000759150336 3524244101620076
117 18-09-2023 0016135 BPJS 0001299724918 3524241210540001
118 18-09-2023 0025418 BPJS 0000758168368 3524240101520046
119 18-09-2023 0028458 BPJS 0002749091602 3524241403620001
120 18-09-2023 0015548 BPJS 0000758735504 3524246501590001
121 18-09-2023 0014488 BPJS 0003269834144 3524246103610002
122 18-09-2023 0030956 BPJS 0002900094491 3524242101460001
123 18-09-2023 0012776 BPJS 0002749752336 3524240705520001
124 18-09-2023 0024407 BPJS 0000759302324 3524244101470008
125 18-09-2023 0023062 BPJS 0000103902399 3524242704620001
126 18-09-2023 0020005 BPJS 0002308444255 3524240404560001
127 18-09-2023 0017442 BPJS 0001897451829 3524243006550005
128 18-09-2023 0008730 BPJS 0000758680964 3524247006580007
129 18-09-2023 0024214 BPJS 0000758973306 3524242007550001
130 18-09-2023 0009702 BPJS 0000758953541 3524245804530001
131 18-09-2023 0005029 BPJS 0000759647463 3524240101600080
132 18-09-2023 0039622 UMUM 3524244101460005
133 18-09-2023 0030348 BPJS 0000758669275 3524240101630016
134 18-09-2023 0006896 BPJS 0000759278248 3524245109530001
135 18-09-2023 0005055 BPJS 0002265541211 3524246204620001

136 19-09-2023 0010782 UMUM 3524244704560002
137 19-09-2023 0022197 BPJS 0002210213384 3524241709500002
138 19-09-2023 0031311 BPJS 0001704049705

139 19-09-2023 0027650 BPJS 0000001230041
140 19-09-2023 0009870 BPJS 0000103486241 3524171710620001
141 19-09-2023 0006583 BPJS 0000758869874 3524244101500028
142 19-09-2023 0022036 BPJS 0001047281297 3524246006580001

143 19-09-2023 0039634 BPJS 0002464834127 3524246511590001
144 19-09-2023 0030645 BPJS 0002913088094 3524244101500052

145 19-09-2023 0029928 BPJS 0002521214403 3524243006570002
146 19-09-2023 0004848 BPJS 0000103106518 3523245112620001
147 19-09-2023 0029203 BPJS 0003047931145 3524240101460033

148 20-09-2023 0035616 BPJS 0003101665138 3524244101630035
149 20-09-2023 0030170 BPJS 0002238323207
150 20-09-2023 0021460 BPJS 3524241212500002
151 20-09-2023 0029203 BPJS 0003047931145 3524240101460033
152 20-09-2023 0013653 BPJS 0000758820284
153 20-09-2023 0000338 BPJS 0000103499932
154 20-09-2023 0023753 BPJS 0002245028398 3524242008540001
155 20-09-2023 0033999 BPJS 0000103501012 3524244505550001

156 20-09-2023 0004486 BPJS 0000103768547 3524144512480000
157 20-09-2023 0003522 BPJS 0003101663788 3524240101600033
158 20-09-2023 0038977 BPJS 0000758695814 3524241101450002
159 20-09-2023 0010849 BPJS 0000758829082 3524242303540002
160 20-09-2023 0035774 BPJS 0002732692713
161 20-09-2023 0015707 BPJS 0001265685873 3524240506600003

162 20-09-2023 0008420 BPJS 0000757763583 3524246112600003
163 20-09-2023 0039643 BPJS 0000759520416 3524242611630002

164 20-09-2023 0007140 BPJS 0000758685396 3524245904610001
165 21-09-2023 0020388 UMUM 3524244101570001
166 21-09-2023 0031816 BPJS 0000758418759

167 21-09-2023 0025489 BPJS 0002274891355 3524244304610001
168 21-09-2023 0024437 BPJS 0000758739486 3524247012540001
169 21-09-2023 0021006 BPJS 0001047283132 3524240906570001
170 21-09-2023 0038446 BPJS 0003176547794 3524240101590005
171 21-09-2023 0029991 BPJS 0002741412025 3524244101610040
172 21-09-2023 0008714 BPJS 0000759829724 3524240202590002
173 21-09-2023 0037604 BPJS 0003296945542 3524240501610001

174 21-09-2023 0004895 BPJS 0003525996058 3524240101610030
175 21-09-2023 0026310 BPJS 0000751003378 3524240101530047
176 22-09-2023 0024074 BPJS 0002881391051 3524241101530002

177 22-09-2023 0000919 BPJS 0000103885481 3524056707590001
178 22-09-2023 0018836 BPJS 0001704045306 3524241010580001
179 22-09-2023 0031226 BPJS 0000758437457 3524242404470001

180 22-09-2023 0038476 BPJS 0001917158038 3524244512510002
181 22-09-2023 0032347 BPJS 0001861883155 3524244201560009
182 22-09-2023 0027421 BPJS 0000758725233 3524247006630001
183 22-09-2023 0012393 BPJS 0001704047681 3524244206590001

184 22-09-2023 0010516 BPJS 0000759526547
185 22-09-2023 0004147 BPJS 0000760075716 3524245101620003
186 22-09-2023 0039634 BPJS 0002464834127 3524246511590001
187 22-09-2023 0020500 BPJS 0002162612226 3524245004540001
188 22-09-2023 0010385 BPJS 0000758404012
189 22-09-2023 0010997 BPJS 0000759248864 3524246101580001
190 25-09-2023 0024214 BPJS 0000758973306 3524242007550001
191 25-09-2023 0007061 BPJS 0000758430235 3524244101380061
192 25-09-2023 0025231 BPJS 0002302574499 3524240101390021
193 25-09-2023 0008978 BPJS 0000103885288 3524242012620001
194 25-09-2023 0026986 BPJS 0000758915785 3524240302310001
195 25-09-2023 0024407 BPJS 0000759302324 3524244101470008
196 25-09-2023 0021613 BPJS 0000758346974
197 25-09-2023 0015093 BPJS 0000758692495
198 25-09-2023 0024414 BPJS 0000758141864 3524241111560001
199 25-09-2023 0014929 BPJS 0000758609335 3524245204340002
200 25-09-2023 0023218 BPJS 0000759011185 3524245903550001
201 25-09-2023 0027240 BPJS 0001704051066 3524247006550008
202 25-09-2023 0015073 BPJS 0001047287024 3524244908600001

203 25-09-2023 0011916 BPJS 0000760001488 3524244505490002
204 25-09-2023 0034978 BPJS 0000759348369 3524240101590034
205 25-09-2023 0038486 BPJS 0000759398286 3524241611540001
206 25-09-2023 0033880 BPJS 0000759311109
207 25-09-2023 0030591 BPJS 0001829062451
208 25-09-2023 0031160 BPJS 0000758992353 3524242911550001
209 25-09-2023 0036055 BPJS 0001704047387 3524241812600002
210 25-09-2023 0030560 BPJS 0002903557735 3524241611500001
211 25-09-2023 0033446 BPJS 0001047286383 3524240201540003
212 25-09-2023 0010782 UMUM 3524244704560002
213 25-09-2023 0034377 BPJS 0001262805985 3524244909560001
214 25-09-2023 0020773 BPJS 0001892471038 3524245001580001
215 25-09-2023 0025952 BPJS 0000758718562 3524240709500001
216 25-09-2023 0018746 BPJS 0000759368002 3524240101510040
217 25-09-2023 0030642 BPJS 0000758532576
218 25-09-2023 0028631 BPJS 0000758580232 3524246708550001
219 25-09-2023 0008324 BPJS 0002874881035 3524240101610045
220 25-09-2023 0028110 BPJS 0002499393341
221 25-09-2023 0005300 BPJS 0002735855166 3524241207770003
222 25-09-2023 0030026 BPJS 0002893621386 3524240804700004
223 25-09-2023 0039667 UMUM 3524241602630001
224 25-09-2023 0010489 BPJS 0002162609829 3524244101560016

225 25-09-2023 0008712 BPJS 0000758403549 3524240401560001
226 25-09-2023 0010772 BPJS 0002926601109 3524244101560015
227 25-09-2023 0034335 BPJS 0000759698414 3524244101550015
228 25-09-2023 0022257 BPJS 0000759753988 3524240101590016
229 25-09-2023 0034338 BPJS 0002769360939 3524243007590001
230 25-09-2023 0031354 BPJS 0000759678603 3524244101560012
231 25-09-2023 0023449 BPJS 0000759720407 3524244101480009
232 25-09-2023 0022553 BPJS 0000759034743 3524244101610008
233 25-09-2023 0031348 BPJS 0000759009677 3524244101380063
234 25-09-2023 0001993 BPJS 0000103766646 3524241202490002
235 25-09-2023 0031335 BPJS 0002073701643 3524244101420009

236 25-09-2023 0031347 BPJS 0002734828593 3524244101590013
237 25-09-2023 0017358 BPJS 0000759711521 3524244201590007
238 25-09-2023 0020555 BPJS 0000759007563 3524244101300014
239 25-09-2023 0024090 BPJS 0000759026777 3524244101590012
240 25-09-2023 0007378 BPJS 0002162609706 3524245201600003
241 25-09-2023 0035718 BPJS 0000759735011
242 25-09-2023 0008220 BPJS 0003150081854 3524244201590003
243 25-09-2023 0031323 BPJS 0000758812239 3524244102590001
244 25-09-2023 0031551 BPJS 0000758804433 3524244101540033
245 25-09-2023 0039671 UMUM 3524240609680001
246 25-09-2023 0021476 BPJS 0000758730014 3524244101520070

247 25-09-2023 0021405 BPJS 0000757175545 3524244105560002
248 25-09-2023 0036149 BPJS 0000759177382
249 25-09-2023 0020205 BPJS 0000758119544 3524244103510001
250 25-09-2023 0014109 BPJS 0000758378845 3524244101490016
251 25-09-2023 0033272 BPJS 0002162610044
252 25-09-2023 0031562 BPJS 0000758593776 3524246008610001
253 25-09-2023 0037750 BPJS 0001704051865
254 25-09-2023 0001392 BPJS 0000103766905
255 25-09-2023 0011478 BPJS 0000758442879 3524244106450001
256 25-09-2023 0022793 UMUM 3524244101560041
257 25-09-2023 0031583 BPJS 0001079091595
258 25-09-2023 0021152 BPJS 0000759342936 3524244103550001
259 25-09-2023 0020710 BPJS 0000759041684 3524240101500013
260 25-09-2023 0035860 BPJS 0001047278439 3524241710570001
261 25-09-2023 0036544 BPJS 0000757445253 3524244101620081
262 25-09-2023 0023206 BPJS 0000757430943 3524242803610001
263 25-09-2023 0031341 BPJS 0000759772528 3524240101480051
264 25-09-2023 0022306 BPJS 0000759720363 3524244607580001
265 25-09-2023 0015755 BPJS 0000758159998
266 25-09-2023 0029446 BPJS 0000759025495
267 25-09-2023 0028202 BPJS 0002449099721
268 25-09-2023 0020210 BPJS 0000759026788

269 25-09-2023 0025237 BPJS 0002265773466 3524247006490006
270 25-09-2023 0022874 BPJS 0001704050561 3624255006480002
271 25-09-2023 0028373 BPJS 0000758690875 3524247006480010
272 25-09-2023 0013723 BPJS 0000758884915 3524247006430001
273 25-09-2023 0031909 BPJS 0002328236537 3524247006460007
274 25-09-2023 0022197 BPJS 0002210213384 3524241709500002
275 25-09-2023 0012879 BPJS 0001047282592 3524242601530001
276 25-09-2023 0016705 BPJS 0000758126643 3524242306570001
277 25-09-2023 0030629 BPJS 0002913182627 3524245105710003
278 25-09-2023 0029531 BPJS 0000758322652 3524244101450061
279 25-09-2023 0015824 BPJS 0002758448079 3524246009660001
280 25-09-2023 0008215 BPJS 0000103501732 3524246404610001
281 25-09-2023 0027323 BPJS 0000759284717 3524244101530059
282 26-09-2023 0027703 BPJS 0001962819843 3524240504580001
283 26-09-2023 0013196 BPJS 0000758979854 3524244307590001
284 26-09-2023 0013346 BPJS 0000758655112 3524244708460002
285 26-09-2023 0025521 BPJS 0000758787311 3524244202580001
286 26-09-2023 0001947 BPJS 0001543284786 3524245105570002
287 26-09-2023 0016705 BPJS 0000758126643 3524242306570001
288 26-09-2023 0004586 BPJS 0000759382277 3524245008620002

289 26-09-2023 0039478 BPJS 0003304386178 3524244101620073
290 26-09-2023 0029120 BPJS 0000758935146 3524241310590001
291 27-09-2023 0025551 BPJS 0000758167165 3524240507630002

292 27-09-2023 0024407 BPJS 0000759302324 3524244101470008
293 27-09-2023 0000639 BPJS 0000103500437 3524244111540002
294 27-09-2023 0038810 BPJS 0001967005203 3578047006390095
295 27-09-2023 0039697 BPJS 0000355688278 3524244105550004

296 27-09-2023 0014488 BPJS 0003269834144 3524246103610002
297 27-09-2023 0025103 BPJS 0000759571571 3524242401590002
298 27-09-2023 0009146 UMUM 0003537325517
299 29-09-2023 0039671 UMUM 3524240609680001

300 29-09-2023 0011592 BPJS 0001047277192 3524247006600010
301 29-09-2023 0031226 BPJS 0000758437457 3524242404470001
302 29-09-2023 0023753 BPJS 0002245028398 3524242008540001
303 29-09-2023 0029512 BPJS 0002081552984 3524244101600110

304 29-09-2023 0039708 BPJS 0002757029703 3524241203530001
305 29-09-2023 0018767 UMUM
306 29-09-2023 0015219 BPJS 0000758089629 3524244908610001
307 29-09-2023 0035774 BPJS 0002732692713
308 29-09-2023 0027806 BPJS 0002162694543 3524245007610001
309 29-09-2023 0004691 BPJS 0000759877154 3524244101600062
310 29-09-2023 0004848 BPJS 0000103106518 3523245112620001
311 29-09-2023 0010014 BPJS 0000757393547 3524241309500001
GISIAN REKAM MEDIS POLI LANSIA
L/
Nama Pasien Alamat Usia
P
SITI AMINA P KARANGANOM WETAN 65 Thn 7 Bln

NISWAROTIN P PALANGAN
74 Thn 8 Bln
KHOLIS L WATANGAN 002/001 64 Thn 8 Bln
SHOLIKHIN L KARANGANOM WETAN 69 Thn 0 Bln
69 Thn 0 Bln
MURTIASIH P SAMBO
61 Thn 8 Bln
KABUL L WUNGU 001/001 81 Thn 8 Bln
SUDORI L WATANGAN 001/002 62 Thn 0 Bln
KASTUN P BLAWI 63 Thn 8 Bln
MARHAMAH P PENCARAN 001/005 61 Thn 11 Bln
H SUYATNO L PULOKERTO 002/001 60 Thn 0 Bln
MURTIASIH P SAMBO 61 Thn 8 Bln
SUNANIK P NGAJARAN 004/004
60 Thn 8 Bln
MUTIJAH P NGAJARAN 004/004 78 Thn 8 Bln
ATIM L KADU 005/002 71 Thn 2 Bln
SARUWI L BLAWI 001/003 70 Thn 8 Bln
SAMUWIL L WARUK 001/002 63 Thn 6 Bln
MOCH. NADJIB L MONOLELO 002/002 65 Thn 6 Bln
SUBIKAH P MAGOK 002/002
60 Thn 8 Bln
SUPARNI P NGIPIK 62 Thn 4 Bln
KHOLIS L WATANGAN 002/001
64 Thn 8 Bln
SUNARSEH P BR. KEBUN 002/002 65 Thn 11 Bln
MAT SHOLIHIN L BLAWI 60 Thn 8 Bln
MUNJAROH L BONSARI 002/001 63 Thn 10 Bln
TASLIKAN L SUMBERJO 003/003 64 Thn 8 Bln
SULIKAN L SAMBO 003/006 64 Thn 2 Bln
MARNI P WEDENG
78 Thn 11 Bln
NASIKA P BARON 67 Thn 2 Bln
PATRI P WATANGAN 65 Thn 7 Bln
IMRONAH P LUNTAS S 001/002 62 Thn 8 Bln
MUNIRIN L MAGOK 002/002 72 Thn 2 Bln
AFIFAH P MONOLELO 002/002 60 Thn 8 Bln
SHOFA ASFAH P BADAN 002/002 60 Thn 8 Bln
MUSTOFA L PRIYOSO WETAN 001/002
61 Thn 8 Bln
LAMIDJAH P PUTATREJO 002/003
66 Thn 8 Bln
M. SOLEH L WUNGU 001/001 74 Thn 8 Bln
NURYATI P WUNGU 001/001 63 Thn 2 Bln
SARMAN L BLAWI TENGAH 001/003 69 Thn 1 Bln
DULASIR L WATANGAN 001/002
70 Thn 10 Bln
SUPARMI P ALANG-ALANG 002/005 63 Thn 10 Bln
SUBIKAH P BANDUT 002/001
61 Thn 4 Bln
SRI SAJEKTI P KEPOH
70 Thn 6 Bln
SUMARGONO, SE L KEPOH
72 Thn 7 Bln
SARUWI L BLAWI 001/003 70 Thn 8 Bln
NADI L KARANGAJI 003/003
60 Thn 2 Bln
MAT SHOLIHIN L BLAWI 60 Thn 8 Bln
ASIKAN L SAMBO 001/002
75 Thn 3 Bln
SIRAM L SUMBEREJO 002/003
61 Thn 0 Bln
ASLIKAN ,DRS L SAMBO
63 Thn 8 Bln
MILKAN L PERIYOSO WETAN 001/002 77 Thn 2 Bln
MANIKAH P BANDUT
60 Thn 0 Bln
MISKAL L LUNTAS B 003/007
71 Thn 5 Bln
SUKARIYAH P LUNTAS B 66 Thn 1 Bln
SUPARMI P BAKALAN 001/003 62 Thn 7 Bln
NEMU P PUPUK 002/003 69 Thn 7 Bln
MUALIM L SIMAN 71 Thn 8 Bln
DINING L MAGOK 002/002 63 Thn 1 Bln
SAMSUL L SUMBERJO 64 Thn 0 Bln
NUR MUSTHOFA L PENCARAN 002/005
76 Thn 4 Bln
NUR AFIFAH P MONOLELO 002/002 64 Thn 0 Bln
MAROKAH P BLAWI 71 Thn 8 Bln
MUKAROMAH P PUPUS 003/006 60 Thn 0 Bln
SEKAR L BAKALAN 001/001 60 Thn 8 Bln
MUNIKAH P WATANGAN 001/001 76 Thn 8 Bln
MUJIONO L SAMBO 002/002
61 Thn 4 Bln
SENEN GIMUN L NGIPIK 72 Thn 10 Bln
SUMIATI P KARANGANOM KULON 66 Thn 9 Bln
RUKHAYAH P KLAMPIS 67 Thn 8 Bln
SITI MARLIYAH P PELUK 007/003 68 Thn 8 Bln
SUMANI P KEBONSARI 001/001 62 Thn 3 Bln
SUPARNI P NGIPIK 62 Thn 4 Bln
FATHAN L BR. BATURONO 64 Thn 6 Bln
MUNASIH P BATURONO 002/002 72 Thn 2 Bln
MUNTAIYAH P PENCARAN 002/005 70 Thn 0 Bln
ABD FATAH L PUPUS 001/006 71 Thn 8 Bln
64 Thn 11 Bln
HUSNI P CALAN 001/002 72 Thn 0 Bln
HJ. KARTI P MAYONG NGABLAK 001/002 64 Thn 2 Bln
MURTADJI L PUPUK 67 Thn 1 Bln
ZAINUL IKHSAN L PUPUS 003/006 61 Thn 1 Bln
MUJIONO L SAMBO 002/002 61 Thn 4 Bln
UMAMAH P PUPUS 001/006 61 Thn 8 Bln
SARMAN L BLAWI TENGAH 001/003
69 Thn 1 Bln
HASYIM SUSILO L NGAJARAN 002/003 64 Thn 4 Bln
SLAMET L SAMBO 003/002 80 Thn 10 Bln
MARTIKA P PENCARAN 002/005 62 Thn 11 Bln
MACHRUSAH P SAMBO 002/004 62 Thn 11 Bln
DHOHUWA P GAYAM 005/003
60 Thn 2 Bln
KALIMAH P KEPOH 005/002
64 Thn 2 Bln
SUTRISNO SPD L KAUMAN 001/002 60 Thn 3 Bln
RODJIUN L GOSO 001/003 65 Thn 3 Bln
MAKHMUDA P KEPENG 64 Thn 8 Bln
SOMADI L BANJARANYAR 003/001 66 Thn 3 Bln
DIDIK MULIADI L WATANGAN 001/002 64 Thn 10 Bln
LAMIJAH P KEPENG 002/003 61 Thn 8 Bln
M CHOZIN AMIN L BR. SIMAN 68 Thn 11 Bln
ABD FATAH L PUPUS 001/006 71 Thn 8 Bln
SUWARTI P BONRINGIN 001/004 64 Thn 7 Bln
MUNAWAR L WATANGAN 77 Thn 7 Bln
MUJIONO L SAMBO 002/002 61 Thn 4 Bln
SITI MUJENAH P WINDU 65 Thn 2 Bln
JAMAL L NGAJARAN 001/003 63 Thn 8 Bln
ESWAH P WATANGAN 002/002 77 Thn 8 Bln
60 Thn 8 Bln
INTARLIS P KLECO 002/003
70 Thn 0 Bln
RIYANAH P KEBONSARI 002/003 61 Thn 4 Bln
SOLIKAN L WINDU 002/001
73 Thn 0 Bln
CHODERI L MORO 65 Thn 3 Bln
NGATENI P DEKET 60 Thn 4 Bln
ASIRIS L BAKALAN 60 Thn 11 Bln
DANIRAH P PUPUK 001/003
73 Thn 8 Bln
YATENI P SAMBO 002/002 65 Thn 2 Bln
MARPUAH P GUNDIK 001/004
63 Thn 9 Bln
SUKAEMI P TERBIS 001/003 73 Thn 8 Bln
NISKAN L SAMBO 002/002 66 Thn 2 Bln
60 Thn 9 Bln
ABD. GHOFAR L PUPUS 002/006 77 Thn 8 Bln
INDAHYATI P KAUMAN 001/002 60 Thn 8 Bln
SAMSURI L WARUK 003/001 67 Thn 4 Bln
ABD. GHOFAR L PUPUS 002/006 77 Thn 8 Bln
SUPARTI P BADAN 002/004
71 Thn 8 Bln
NUNUK HERONI ARUMCAHYO P BANDUT 001/001
IRIANIGSIH 61 Thn 4 Bln
69 Thn 1 Bln
SUTARNI P BANDUT 001/001 68 Thn 4 Bln
ZUMAROH P PALANGAN 75 Thn 2 Bln
M ACHWAN L KAUMAN 001/002 63 Thn 8 Bln
SAMIAN L WEDENG 001/001 78 Thn 8 Bln
RATENO L LUNTAS S 001/002 69 Thn 5 Bln
66 Thn 2 Bln
IMAM ROSYADI L MAYONG KULON 001/001 63 Thn 3 Bln
SHOLIHA P KARANGANOM WETAN
008/004 62 Thn 8 Bln
SUKRI L WINDU 003/002 59 Thn 9 Bln
JUWATI P SAMBO 002/003 62 Thn 5 Bln
LAMIDJAH P PUTATREJO 002/003
66 Thn 8 Bln
M.ALI L PALANGAN 66 Thn 5 Bln
ZURIYAH P BLAWI SELATAN 003/002 62 Thn 5 Bln
MARTIYA P SAMBO 003/004 68 Thn 8 Bln
SOMADI L BANJARANYAR 003/001 66 Thn 3 Bln
DJAYUS L WATANGAN 002/001 64 Thn 8 Bln
DASUKI L BR. KEBUN
64 Thn 7 Bln
KHAMIM L PRIYOSO KULON 001/003 62 Thn 8 Bln
NGADIYO L PUPUK 001/003 62 Thn 8 Bln
MUNIR L LUMBANGAN 003/001
70 Thn 8 Bln
YATENO L KLECO 001/003 70 Thn 8 Bln
YAYUK KARSIYAH P WINDU 003/002 64 Thn 1 Bln
64 Thn 11 Bln
SAFIYAH P DS BLAWI 71 Thn 9 Bln
MARNING P BAKALAN 001/002 67 Thn 8 Bln
KAYATUN P SAMBO 002/002
60 Thn 2 Bln
MUNDIYAH L WEDENG 64 Thn 3 Bln
ASMAH P BLAWI 61 Thn 8 Bln
SAROFAH P LUNTAS 002/002 61 Thn 8 Bln
MARPUAH P GUNDIK 001/004 63 Thn 9 Bln
SAWI P WINDU 001/001 69 Thn 5 Bln
PATRI P WATANGAN 65 Thn 8 Bln
YAMIN L KEBONSARI 84 Thn 8 Bln
PUJI WAHONO HARUN ALRASID L WINDU 001/001 60 Thn 9 Bln
SUKANAPI L BONSARI 001/004 92 Thn 7 Bln
SAROH P PULOKERTO 78 Thn 8 Bln
MUKNI P WARUK 61 Thn 0 Bln
NURYANAH P KARANGANOM 89 Thn 5 Bln
RUPINAH P KARANGANOM KULON 68 Thn 6 Bln
68 Thn 2 Bln
NURIKA P WARUK 63 Thn 1 Bln
KASBULLAH L GUNDIK 001/004 64 Thn 8 Bln
SARMADI L MENGAI 002/006 68 Thn 10 Bln
YAHYA L WEDENG SUKOREJO 64 Thn 9 Bln
MUSLIMAH P GAYAM 60 Thn 10 Bln
ABDUL MUHID L WEDENG 67 Thn 9 Bln
ROHIMIN L WEDENG 001/003 62 Thn 9 Bln
MAT HARI L WEDENG 001/002 72 Thn 10 Bln
KARMIN L MENGAI 002/006 69 Thn 8 Bln
HJ. SALAMAH P MENGAI 001/006 67 Thn 0 Bln
SARTI P GUNDIK 65 Thn 8 Bln
MATASIM L WEDENG 73 Thn 0 Bln
ZAINI L ALASMALANG 72 Thn 8 Bln
SUMIYATI P ALAS MALANG 68 Thn 0 Bln
AKOP L BLAWI UTARA 003/004 63 Thn 8 Bln
SUHAJI L LUWUK 46 Thn 2 Bln
MOH. TAUHID L MAYONG KULON 001/001 53 Thn 5 Bln
CHOLICH L WINDU 001/002
60 Thn 7 Bln
SAMSUNI P BAKALAN 002/002 67 Thn 8 Bln
SADIK L BR. KADU 67 Thn 8 Bln
WIDARTI P BAKALAN 002/002 67 Thn 8 Bln
SITI ANAH P BAKALAN RT 01 RW03 68 Thn 8 Bln
TASLIKAN L BAKALAN RT 01 RW 01 64 Thn 8 Bln
KASMOLAN L BAKALAN RT 02 RW 03 64 Thn 1 Bln
MULIASIH P BAKALAN 67 Thn 8 Bln
SARKAMAH P BAKALAN 75 Thn 8 Bln
SRIAMAH P SOMOITO 62 Thn 8 Bln
KASTIAH P BAKALAN 85 Thn 8 Bln
AMIN L WEDENG 002/003
74 Thn 7 Bln
KASTINAH P BAKALAN 81 Thn 8 Bln
SUWARNI P BAKALAN 64 Thn 8 Bln
SARMIDAH P SOMOITO 93 Thn 8 Bln
JUMAÌYAH P BAKALAN 64 Thn 8 Bln
KASEMU P BANYUURIP 63 Thn 8 Bln
SOMADI L WATANGAN 001/001 63 Thn 8 Bln
MUTMAINAH P BAKALAN 64 Thn 8 Bln
KUSWATI P BANDUT 64 Thn 7 Bln
ROBI'AH P BOGOBABADAN 69 Thn 8 Bln
MO'ADI L KEBONSARI 001/003
55 Thn 3 Bln
ATEMAH P BADAN 001/002 71 Thn 8 Bln
SAROH P BADAN 002/002 67 Thn 4 Bln
SUPARNO L ALASMALANG 03/02 63 Thn 0 Bln
KARSI P WARUK RT 01/RW02 72 Thn 6 Bln
JASMANI P BR.SIMAN 74 Thn 8 Bln
BAWON P KARANGANOM KULON 86 Thn 7 Bln
MASNING P KARANGANOM KULON 62 Thn 1 Bln
SUTIKAH P KURO 61 Thn 11 Bln
IMAM L MONOLELO 001/002 78 Thn 1 Bln
SARPILAH L NGAJARAN 78 Thn 3 Bln
RUKHAYAH P KLAMPIS 67 Thn 8 Bln
UMI SUBCHA P KURO 68 Thn 8 Bln
TUMU`NINAH P KURO 68 Thn 6 Bln
KUMARI L BAKALAN 73 Thn 8 Bln
ALFAN EFENDI L MONOLELO 001/002 65 Thn 11 Bln
SURIYAH P MONOLELO 002/002 61 Thn 8 Bln
ALI ARIFIN L KARANGBINANGUN 62 Thn 5 Bln
MARJUKI L BAKALAN 77 Thn 8 Bln
KANAH P SOMOITO 65 Thn 2 Bln
JAWAHIR L WARUK 72 Thn 10 Bln
KATIMAN L WARUK 002/002 68 Thn 9 Bln
63 Thn 11 Bln
MARINTEN P WARUK RT02/RW02 62 Thn 10 Bln
LASENI P WINDU 74 Thn 2 Bln
KASENAH P WINDU 002/001 75 Thn 2 Bln
SOMANI P WINDU 001/002 75 Thn 2 Bln
NIMAH P WINDU 80 Thn 2 Bln
MUDAH P NGIPIK 002/003 77 Thn 2 Bln
SOLIKAN L WINDU 002/001 73 Thn 0 Bln
MISKAN L BAKALAN 002/001 70 Thn 7 Bln
MUASAROH P WARUK 002/001 52 Thn 4 Bln
KHOTIMAH P BLAWI UTARA 001/004 78 Thn 8 Bln
SITI ANAH P BUTUH 003/002 57 Thn 0 Bln
MUNTIAH P BONSARI 002/004 64 Thn 2 Bln
SUTAMAH P MAYONG WETAN 77 Thn 1 Bln
ASNI P MAGOK 65 Thn 7 Bln
NGATMONAH P PUTATREJO 1/3
66 Thn 4 Bln
66 Thn 3 Bln
KAMAH P LUNTAS B 001/007 61 Thn 1 Bln
SUMI P BLAWI 001/004 61 Thn 8 Bln
YAUDI L KEBONSARI 002/004
63 Thn 11 Bln
DIDIK HARIANTO L LOGAWE 001/001 60 Thn 2 Bln
KAJATI P PERUM GRAHA KENCANA
004/002 84 Thn 2 Bln
SARPIAH P PULOKERTO 001/001 68 Thn 4 Bln
KHAYAT L BLAWI UTARA 001/004 64 Thn 8 Bln
NAHNU L PENCARAN 001/005
66 Thn 8 Bln
MO'ADI L KEBONSARI 001/003 55 Thn 3 Bln
TRIANAH P WINDU 63 Thn 2 Bln
69 Thn 1 Bln
MUFAROKAH P PULOKERTO 001/001 63 Thn 8 Bln
BONALI L SAMBO 003/003 70 Thn 6 Bln
SUMARLIK P WATANGAN 61 Thn 7 Bln
KARTINI P WARUK 62 Thn 1 Bln
HARIONO L SAMBO 001/002 66 Thn 2 Bln
MUSAFAÀH P WINDU 003/002 62 Thn 2 Bln
KAYATI P TEMBOK 002/003 63 Thn 8 Bln
SARKUM L MENGAI 001/006 73 Thn 0 Bln

Terapi
aan Fisik a
Other cholelithiasis √ √ √
Insulin-dependent diabetes mellitus with other specified complications √ √ √

Conjunctivitis, unspecified; Hypertensive heart disease without
Cardiomegaly; Pneumonia, unspecified √ √ √
Examination for administrative purposes, unspecified √ √ √
Other keratitis √ √ √
Myalgia √ √ √
Pterygium √ √ √
Primary open-angle glaucoma √ √ √
Hyperglycaemia, unspecified; Open wound of finger(s) without damage
to nail √ √ √
Typhoid fever √ √ √
Acute appendicitis, unspecified √ √ √
Low vision, one eye √ √ √
Heart failure, unspecified √ √ √
Myalgia √ √ √
Tuberculosis of lung, confirmed by sputum microscopy with or without
culture √ √ √
Myalgia √ √ √
Herpesviral infection, unspecified √ √ √
Insulin-dependent diabetes mellitus with peripheral circulatory




Cyst of kidney, acquired; Liver disease, unspecified; Unspecified viral
hepatitis without hepatic coma √ √ √
Chronic renal failure, unspecified; Ileus, unspecified; Other specified
surgical follow-up care √ √ √

Vertigo of central origin √ √ √
Dermatitis, unspecified; Hypertensive heart disease without
Acute upper respiratory infection, unspecified; Typhoid fever √ √ √
Fracture of lumbar vertebra √ √ √
Acute haemorrhagic gastritis √ √ √
Myalgia √ √ √
Hypertensive heart disease with (congestive) heart failure; Vertigo of
central origin √ √ √
Myalgia √ √ √
Haemoptysis √ √ √
Hyperglycaemia, unspecified; Hypertensive heart disease with
Acute lymphadenitis, unspecified √ √ √
Myalgia √ √ √
Coronary artery aneurysm √ √ √
Myalgia √ √ √
Thyrotoxicosis, unspecified √ √ √
Injury of optic nerve and pathways √ √ √
Hypertensive heart disease without (congestive) heart failure; Surgical
follow-up care, unspecified √ √ √
Examination for administrative purposes, unspecified √ √ √
Herpesviral vesicular dermatitis √ √ √
Myalgia √ √ √
Cervical disc disorder, unspecified √ √ √
Myalgia; Other forms of stomatitis √ √ √
Injury of optic nerve and pathways √ √ √

Unilateral or unspecified inguinal hernia, without obstruction or
Urinary tract infection, site not specified √ √ √
Primary generalized (osteo)arthrosis √ √ √
Bursitis of shoulder √ √ √
Acute nasopharyngitis [common cold]; Conjunctivitis, unspecified √ √ √
Arthritis and polyarthritis due to other specified bacterial agents;

Myalgia √ √ √
Calculus of lower urinary tract, unspecified √ √ √
Calculus in urethra √ √ √
Vertigo of central origin √ √ √
Senile incipient cataract √ √ √
Other cholelithiasis √ √ √
Open wound of finger(s) without damage to nail √ √ √

Other atopic dermatitis √ √ √
Chest pain, unspecified √ √ √
Bilateral inguinal hernia, with obstruction, without gangrene √ √ √
Malignant neoplasm of breast, unspecified √ √ √
Asthma, unspecified; Hypertensive heart disease with (congestive)
Hypertensive heart and renal disease with (congestive) heart failure √ √ √

Postmenopausal osteoporosis, lower leg √ √ √
Unspecified abdominal hernia without obstruction or gangrene √ √ √
Arthritis, unspecified, hand √ √ √
Urinary tract infection, site not specified √ √ √
Unilateral or unspecified inguinal hernia, without obstruction or
Chronic ischaemic heart disease, unspecified; Hypertensive heart

Dyspepsia; Myalgia √ √ √
Chronic obstructive pulmonary disease with acute exacerbation,
unspecified; Congestive heart failure √ √ √

Malignant neoplasm of breast, unspecified √ √ √
Myalgia; Myopia √ √ √
Acute subendocardial myocardial infarction √ √ √

Acute renal failure, unspecified; Calculus of kidney √ √ √
Myalgia √ √ √
Hypertensive heart disease without (congestive) heart failure; Other
forms of stomatitis √ √ √
Benign paroxysmal vertigo √ √ √
Open wound of toe(s) with damage to nail √ √ √
Calculus in bladder √ √ √
Pemeriks
Diagnosa aan
KIE
Medis penunjan
g
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
√ √ √
Tanggal : : 01-10-2023 s/d 31-10-2023
INDIKATOR KELEN
aan Fisik
1 02-10-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001 Hyperglycaemia, unspecified; Non-insulin-dependent diabetes mellitus
60 Thn 9 Bln without complications √
2 02-10-2023 0011864 BPJS 0001047271972 3524240101530065 SARUWI L BLAWI 001/003 70 Thn 9 Bln √
3 02-10-2023 0025875 BPJS 0000758426826 3524240101620043 NURSAN L KETAPANG 001/001
61 Thn 9 Bln Other gastritis √
4 02-10-2023 0021572 BPJS 0002326949583 3524244101550075 SAEKAH P BLAWI 002/002 68 Thn 9 Bln √
5 02-10-2023 0039728 BPJS 0000758072327 3524264910530001 FASEHA P SUKOMULYO 2/1
69 Thn 11 Bln Unspecified diabetes mellitus with peripheral circulatory complications √
6 02-10-2023 0039112 BPJS 0000759610517 3524244101490032 AMAT P PENCARAN 001/005 74 Thn 9 Bln √
7 02-10-2023 0031684 BPJS 0000758891114 3524244101580049 DANI P KETAPANG 001/001 Heart failure, unspecified; Hypertensive heart disease with (congestive)
8 02-10-2023 0018767 UMUM SUMARLIK P WATANGAN 61 Thn 7 Bln Open wound of toe(s) without damage to nail √
9 02-10-2023 0025418 BPJS 0000758168368 3524240101520046 ABD FATAH L PUPUS 001/006 71 Thn 9 Bln Chronic obstructive pulmonary disease, unspecified √
10 02-10-2023 0020260 BPJS 0000758392716 3524244101600085 SAMANI P BLAWI UTARA 002/004 63 Thn 9 Bln Presence of intraocular lens √
11 02-10-2023 0039708 BPJS 0002757029703 3524241203530001 BONALI L SAMBO 003/003 70 Thn 6 Bln Hypertensive heart disease without (congestive) heart failure √
12 02-10-2023 0024407 BPJS 0000759302324 3524244101470008 MUNIKAH P WATANGAN 001/001 76 Thn 9 Bln Surgical follow-up care, unspecified √
13 02-10-2023 0027363 BPJS 0002459985535 3524240201540001 KARSAN L WATANGAN 002/002
14 02-10-2023 0039724 BPJS 0001848113302 3524244101450046 MO’APIYAH P KEBONSARI 002/004 Cardiomegaly; Hypertensive heart disease with (congestive) heart
15 03-10-2023 0025551 BPJS 0000758167165 3524240507630002 DIDIK HARIANTO L LOGAWE 001/001 60 Thn 3 Bln Low vision, both eyes √
16 03-10-2023 0020916 BPJS 0000760096664 3524244101470027 PATEMI P LUNTAS S 001/002 76 Thn 9 Bln Glaucoma suspect; Senile cataract, unspecified √
17 03-10-2023 0020720 BPJS 0000789926218 3524244502500001 MUHAIYAH P LOGAWE 001/001
73 Thn 7 Bln Insulin-dependent diabetes mellitus with ophthalmic complications √
18 03-10-2023 0017197 BPJS 0000758420111 3524244101480050 FUTICHAH P MONOLELO 001/002 75 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √
19 03-10-2023 0010516 BPJS 0000759526547 ASMAH P BLAWI 61 Thn 9 Bln Stroke, not specified as haemorrhage or infarction √
20 03-10-2023 0013215 BPJS 0000758384346 3524244110630001 WURTI P BONSARI 60 Thn 0 Bln √
21 03-10-2023 0010539 BPJS 0000758358461 3524244101530046 KAMAH P PUPUS 003/006
70 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √
22 03-10-2023 0023741 BPJS 0001047280779 3524244302590001 SUMI P WATANGAN
23 03-10-2023 0039731 BPJS 0003546195895 3524244101550077 KANAH P BLAWI 001/004 Hypertensive heart disease without (congestive) heart failure; Senile
24 03-10-2023 0039732 BPJS 0003546195794 3524240101510045 SARTIB L BLAWI 001/004 72 Thn 9 Bln Cataract, unspecified; Glaucoma, unspecified √
25 03-10-2023 0002604 UMUM SARSEH P NGIPIK 003/003 Acute nasopharyngitis [common cold]; Hypertensive heart disease
26 03-10-2023 0024316 BPJS 0000103680999 3524246810580002 SITI CHODIDJAH P PENCARAN Erosive (osteo)arthrosis; Hyperglycaemia, unspecified; Hypertensive
64 Thn 11 Bln heart disease without (congestive) heart failure √
27 03-10-2023 0003747 BPJS 0002162693957 NAPSIYAH P NGIPIK
66 Thn 3 Bln Acute nasopharyngitis [common cold]; Hyperglycaemia, unspecified √
28 03-10-2023 0039735 UMUM 3524244506590001 SITI KHOTIMAH P PUPUS 003/006 64 Thn 3 Bln Incomplete uterovaginal prolapse √
29 03-10-2023 0015707 BPJS 0001265685873 3524240506600003 IMAM ROSYADI L MAYONG KULON 001/001
63 Thn 3 Bln Typhoid fever √
30 03-10-2023 0029573 BPJS 0001047156074 3524222207540002 SARMAN L BLAWI TENGAH 001/003 69 Thn 2 Bln Hypertensive heart disease without (congestive) heart failure √
32 04-10-2023 0013983 BPJS 0001047282513 3524242101600002 SUTARNO L BAKALAN
33 04-10-2023 0027168 BPJS 0000103767006 3524242005480001 JAUMAN, S.AG. L KURO 001/001 75 Thn 4 Bln Acute nasopharyngitis [common cold] √
34 04-10-2023 0027641 BPJS 0000758447054 3524244101530027 SITI AMANAH P KETAPANG 001/001 70 Thn 9 Bln Dyspepsia √
35 04-10-2023 0039708 BPJS 0002757029703 3524241203530001 BONALI L SAMBO 003/003 70 Thn 6 Bln Senile cataract, unspecified √
36 04-10-2023 0004651 UMUM 3524242404410001 KASMURI L KLECO 001/003 82 Thn 6 Bln Dermatitis, unspecified √
38 04-10-2023 0021460 UMUM 3524241212500002 NAFIK KHUSYAIRI L GAYAM 005/003 Acute nasopharyngitis [common cold]; Hypertensive heart disease
39 04-10-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 68 Thn 4 Bln Cerebral infarction due to thrombosis of precerebral arteries √
40 05-10-2023 0033239 BPJS 0000759104842 3524246101590005 FATIMAH P ALASMALANG 003/002 Hyperglycaemia, unspecified; Hypertensive heart disease without
41 05-10-2023 0000374 BPJS 0000758757633 3524247112590001 SUMIATUN P SAMBO 003/002 63 Thn 9 Bln Old myocardial infarction √
42 05-10-2023 0013653 BPJS 0000758820284 SUPARTI P BADAN 002/004 Hyperglycaemia, unspecified; Hypertensive heart disease without
43 05-10-2023 0011733 BPJS 0002294469077 3524245403370001 SUKAYAH P KLECO 002/003 Hypertensive heart disease with (congestive) heart failure; Other forms
86 Thn 6 Bln of angina pectoris √
44 05-10-2023 0031926 BPJS 0002752152579 3524241207610002 MAT ARKAN L KEBONSARI 002/003 Cerebral infarction, unspecified; Non-insulin-dependent diabetes
62 Thn 2 Bln mellitus with neurological complications √
45 05-10-2023 0038293 BPJS 0000758550644 3524244101620007 MURTIASIH P SAMBO 61 Thn 9 Bln Other polyp of sinus √
46 05-10-2023 0035616 BPJS 0003101665138 3524244101630035 INDAHYATI P KAUMAN 001/002 Hyperglycaemia, unspecified; Hypertensive heart disease without
47 05-10-2023 0003522 BPJS 0003101663788 3524240101600033 M ACHWAN L KAUMAN 001/002 63 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √
48 05-10-2023 0000388 BPJS 0000757428052 3524244101470040 KASMIATI P KR.BINANGUN Hypertensive heart disease without (congestive) heart failure;
49 05-10-2023 0010556 BPJS 0000759122706 3524240605530001 SUN'AN L MAYONG KULON 002/001 70 Thn 4 Bln Diarrhoea and gastroenteritis of presumed infectious origin √
50 06-10-2023 0024587 BPJS 0003276719346 3524243001540001 TARKAN L MENGAI 001/005 69 Thn 8 Bln Hypertensive heart disease without (congestive) heart failure √
51 06-10-2023 0039731 BPJS 0003546195895 3524244101550077 KANAH P BLAWI 001/004 68 Thn 9 Bln Senile cataract, unspecified √
52 06-10-2023 0033239 BPJS 0000759104842 3524246101590005 FATIMAH P ALASMALANG 003/002 64 Thn 8 Bln Polyarthritis, unspecified, ankle and foot √
53 06-10-2023 0007216 BPJS 0000758406486 3524241906630001 NADI L KARANGAJI 003/003 60 Thn 3 Bln Hypertensive heart disease without (congestive) heart failure √
54 06-10-2023 0031226 BPJS 0000758437457 3524242404470001 NUR MUSTHOFA L PENCARAN 002/005 Hypertensive heart disease without (congestive) heart failure; Vertigo
76 Thn 5 Bln of central origin √
55 06-10-2023 0039768 BPJS 0000758513856 3524246011520001 SUMIJAH P MENGAI 002/006 70 Thn 10 Bln Benign neoplasm of bronchus and lung √
56 06-10-2023 0007762 BPJS 0000103717361 3524247108580001 TRISANAH P KURO 003/001 Hypertensive heart disease without (congestive) heart failure; Otitis
65 Thn 1 Bln media, unspecified √
57 06-10-2023 0036011 BPJS 0000758624962 3524240708590004 SAMSUL L BATURONO 002/002 64 Thn 1 Bln √
58 09-10-2023 0027240 BPJS 0001704051066 3524247006550008 NENGYAH L NGIPIK 003/003 68 Thn 3 Bln Hyperglycaemia, unspecified √
59 09-10-2023 0018187 BPJS 0000758626751 3524244705630001 JUWANAH P LUWUK 006/001 60 Thn 5 Bln Myalgia; Other forms of stomatitis √
60 09-10-2023 0024407 BPJS 0000759302324 3524244101470008 MUNIKAH P WATANGAN 001/001 76 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √
61 09-10-2023 0012268 BPJS 0001704047376 3524244410440001 MARNI P WEDENG 79 Thn 0 Bln Hypertensive heart disease with (congestive) heart failure √
62 09-10-2023 0011417 UMUM YAUB L TERBIS 001/003 80 Thn 11 Bln Senile cataract, unspecified √
63 09-10-2023 0027184 BPJS 0000103768277 SUMIRAN L NGIPIK 002/003 75 Thn 11 Bln Benign neoplasm of prostate √
64 09-10-2023 0000550 BPJS 0000103768288 3524245809580002 HANNA ASTINAH P NGIPIK 65 Thn 0 Bln Thyrotoxicosis, unspecified √
65 09-10-2023 0037373 BPJS 0002121511116 3524240702730001 AYUB L GENTING 006/003 50 Thn 8 Bln Old myocardial infarction √
66 09-10-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 Hyperglycaemia, unspecified; Hypertensive heart disease with
67 09-10-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 70 Thn 9 Bln Essential (primary) hypertension √
68 09-10-2023 0007061 BPJS 0000758430235 3524244101380061 SITI ROICHAH P NGAJARAN 004/004 85 Thn 9 Bln Other gastritis √
69 09-10-2023 0033129 BPJS 0002876702477 SENEN GIMUN L NGIPIK 72 Thn 11 Bln Hyperglycaemia, unspecified √
70 09-10-2023 0025302 BPJS 0000758488555 3524240101500015 MUKARROM L PELUK 001/003 73 Thn 9 Bln Bilateral inguinal hernia, with gangrene √
71 09-10-2023 0027650 BPJS 0000001230041 NGATENI P DEKET 60 Thn 4 Bln Acute haemorrhagic gastritis √
73 09-10-2023 0003437 BPJS 0001704056681 3524247006540003 KASIYATI P SAMBO 002/002 69 Thn 3 Bln Parkinson's disease √
74 09-10-2023 0024587 BPJS 0003276719346 3524243001540001 TARKAN L MENGAI 001/005 69 Thn 8 Bln Senile cataract, unspecified √
75 09-10-2023 0030607 BPJS 0000758794241 3524240407510001 MUNIRIN L MAGOK 002/002 72 Thn 3 Bln Senile cataract, unspecified √
76 09-10-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001 Hyperglycaemia, unspecified; Hypertensive heart disease with
77 09-10-2023 0005611 BPJS 0001704058053 3524247112610001 MISKANA L SAMBO 003/004 61 Thn 9 Bln Myalgia √
78 09-10-2023 0010782 UMUM 3524244704560002 MUKANAH P KEBONSARI 004/003 67 Thn 6 Bln Myalgia √
79 10-10-2023 0012613 BPJS 0000758897818 3524246010570001 KARSIH P WEDENG 65 Thn 11 Bln Atrial fibrillation and flutter √
80 10-10-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002 66 Thn 9 Bln Myalgia √
81 10-10-2023 0017287 BPJS 0000759630339 3524245107530002 KASTUMI P NGAJARAN
70 Thn 2 Bln Tuberculosis of lung, bacteriologically and histologically negative √
82 10-10-2023 0008517 BPJS 0000758582976 3524244101560008 NAÀH P SAMBO 001/004 67 Thn 9 Bln Other senile cataract √
83 10-10-2023 0023108 BPJS 0003503639507 3524241203590001 MARNO L MENGAI 002/006 64 Thn 6 Bln Headache √
84 10-10-2023 0028458 BPJS 0002749091602 3524241403620001 NUR KHAMIM L MENGAI 002/006 61 Thn 6 Bln Acute upper respiratory infection, unspecified √
85 10-10-2023 0039790 BPJS 0003546448918 3524244101510020 RASMI P KETAPANG 001/001 72 Thn 9 Bln Senile cataract, unspecified √
86 10-10-2023 0006871 BPJS 0000758870346 3524240101600028 MUSDIYAR L SUMBEREJO 63 Thn 9 Bln Atherosclerotic heart disease √
87 10-10-2023 0022141 BPJS 0001047270115 3524240101630035 MUKASI L LUNTAS S 003/001 60 Thn 9 Bln Calculus of kidney √
88 11-10-2023 0022778 BPJS 0000757265804 3524244101470032 SALEKAH P GOSO 002/003 76 Thn 9 Bln Other visual disturbances √
89 11-10-2023 0008424 BPJS 0000759574214 3524245712490001 TI'AH P WINDU 001/002 73 Thn 9 Bln Urinary calculus, unspecified √
91 11-10-2023 0029573 BPJS 0001047156074 3524222207540002 SARMAN L BLAWI TENGAH 001/003 69 Thn 2 Bln Surgical follow-up care, unspecified √
92 11-10-2023 0011668 BPJS 0002765884937 3524240101550053 MOCHAMMAD ZEN L KETAPANG 001/001 68 Thn 9 Bln Disorder of urinary system, unspecified √
93 11-10-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004 69 Thn 3 Bln Acute upper respiratory infection, unspecified √
94 11-10-2023 0037339 BPJS 0003265273146 3524243012590004 ABD MUJIB L MONOLELO 002/002 63 Thn 9 Bln Chronic ischaemic heart disease, unspecified √
95 11-10-2023 0007551 BPJS 0000758502325 3524241606560001 DARMIN L WEDENG 001/003 67 Thn 3 Bln Other gastritis √
96 11-10-2023 0009658 BPJS 0001704052192 3524241512610001 NALI L KEPOH 004/002 61 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √
97 11-10-2023 0039800 UMUM 3524260709600001 KANAFI L DROKIYO 001/005 63 Thn 1 Bln General medical examination √
98 11-10-2023 0002938 BPJS 0000758413236 3524246511590003 KHANIFAH P MONOLELO 002/002 63 Thn 10 Bln Cerebral infarction due to thrombosis of cerebral arteries √
99 12-10-2023 0031483 BPJS 0000759112604 3524244302550001 TASLIMAH P LOGAWE 001/001 68 Thn 8 Bln Myalgia √
100 12-10-2023 0039804 BPJS 0000759110872 3524246709520001 SAPI'AH P LOGAWE 001/001 71 Thn 0 Bln Myalgia √
101 12-10-2023 0035627 BPJS 0000758249177 3524244101620006 INANIK P MAGOK 001/001 61 Thn 9 Bln Myalgia √
102 12-10-2023 0023528 BPJS 0001047282524 3524246101620001 SULASTRI P BAKALAN 002/001 61 Thn 8 Bln Hypertensive heart disease with (congestive) heart failure √
103 12-10-2023 0021460 UMUM 3524241212500002 NAFIK KHUSYAIRI L GAYAM 005/003 72 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √
104 12-10-2023 0039809 BPJS 0002484000268 3524242912580001 GUNAWAN L SAMBO 64 Thn 9 Bln Visual disturbance, unspecified √
105 13-10-2023 0029337 BPJS 0002503289283 3524242605590001 M.A KASTARAM L KARANGANOM KULON 001/001 64 Thn 4 Bln Nonorganic sleep disorder, unspecified √
106 13-10-2023 0027331 BPJS 0002421232481 3524245010580002 SUKAENI P BANDUT 002/001 65 Thn 0 Bln Other gastritis √
107 13-10-2023 0027330 BPJS 0002421232345 3524241811540001 AMIR L BANDUT 002/001 68 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √
108 13-10-2023 0016773 BPJS 0002255163142 3524240101590086 DURAHMAN L TERBIS 001/003 64 Thn 9 Bln Scabies √
109 13-10-2023 0039732 BPJS 0003546195794 3524240101510045 SARTIB L BLAWI 001/004 72 Thn 9 Bln Diarrhoea and gastroenteritis of presumed infectious origin √
110 13-10-2023 0030533 BPJS 0000759265121 SUTRAMI P WATANGAN 001/001 66 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √
112 13-10-2023 0008953 BPJS 0000758909441 3524244101510003 NANIK P WATANGAN 72 Thn 9 Bln Myalgia √
113 16-10-2023 0014606 BPJS 0001905651426 3524244304580001 MUCHLISAH P BATURONO 003/002 65 Thn 6 Bln Myalgia √
114 16-10-2023 0039829 BPJS 0000759260428 3524244101620071 KASTONAH P BLAWI TENGAH 002/003 61 Thn 9 Bln Disorder of eye and adnexa, unspecified √
115 16-10-2023 0007140 BPJS 0000758685396 3524245904610001 JUWATI P SAMBO 002/003 62 Thn 5 Bln Other gastritis √
116 16-10-2023 0038523 BPJS 0003304385897 3524243006590012 RAMELI L BLAWI TENGAH 001/004 64 Thn 3 Bln Senile cataract, unspecified √
117 16-10-2023 0006545 BPJS 0000103593644 ABD. KHOLIQ L KARANGAJI 003/003 66 Thn 4 Bln Myalgia √
118 16-10-2023 0004183 BPJS 0000758606635 3524246312620001 SUMARAH P KRANOM KULON 005/003 60 Thn 9 Bln Cerebral infarction, unspecified √
119 16-10-2023 0027667 BPJS 0000758474583 3524240103630004 KHUSAIN L KR.ANOM KULON 002/002 60 Thn 7 Bln Leprosy, unspecified √
120 16-10-2023 0020231 BPJS 0000758934797 3524244403490002 NGATILAH P PALANGAN 74 Thn 7 Bln Other senile cataract √
121 16-10-2023 0024214 BPJS 0000758973306 3524242007550001 NARIYO L MAGOK 001/002 68 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
122 16-10-2023 0005029 BPJS 0000759647463 3524240101600080 JAMAL L NGAJARAN 001/003 63 Thn 9 Bln Myalgia √
123 16-10-2023 0010177 BPJS 0002161138858 3524240101560040 ASRON M. MUNDZIR L BLAWI 003/002 67 Thn 9 Bln Cerebral infarction, unspecified √
124 16-10-2023 0039825 BPJS 0000758575991 3524245508610002 NINGSIH P SAMBO 002/003 62 Thn 2 Bln Hypertensive heart disease with (congestive) heart failure √
126 16-10-2023 0038194 BPJS 0000758623274 3524241209620001 MALIK L BATURONO 002/002 61 Thn 1 Bln Hypertensive heart disease with (congestive) heart failure √
127 16-10-2023 0009197 BPJS 0003004719265 3524245206610001 GINEM P LUWUK 006/001 Hypertensive heart disease with (congestive) heart failure; Other
62 Thn 4 Bln gastritis √
128 17-10-2023 0010604 BPJS 0002043337059 3524240101570026 ATEKAN L SUMBEREJO 001/003 66 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √
129 17-10-2023 0012501 BPJS 0000758730352 3524244912510001 TAMLIYAH P WEDENG 001/002 71 Thn 10 Bln After-cataract √
130 17-10-2023 0014582 BPJS 0003520460283 SUMINI P LUWUK 60 Thn 4 Bln Hydronephrosis with renal and ureteral calculous obstruction √
131 17-10-2023 0020720 BPJS 0000789926218 3524244502500001 MUHAIYAH P LOGAWE 001/001 73 Thn 8 Bln Acute upper respiratory infection, unspecified √
132 17-10-2023 0025453 BPJS 0002774533465 3524245101570004 SUKATI P GUNDIK 001/004
66 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure; Myalgia √
133 17-10-2023 0013820 BPJS 0002314477394 3524241406460002 MILKAN L PERIYOSO WETAN 001/002 77 Thn 4 Bln Vertigo of central origin √
134 17-10-2023 0027667 BPJS 0000758474583 3524240103630004 KHUSAIN L KR.ANOM KULON 002/002 60 Thn 7 Bln Leprosy, unspecified √
135 17-10-2023 0023528 BPJS 0001047282524 3524246101620001 SULASTRI P BAKALAN 002/001 61 Thn 8 Bln Senile cataract, unspecified √
137 17-10-2023 0034133 BPJS 0002439974531 3524244101580030 JAMIYAH P SIMAN 002/001 65 Thn 9 Bln Myalgia √
138 17-10-2023 0025800 BPJS 0001704054971 3524240903610001 ASERI L MAGOK 001/001 62 Thn 7 Bln Congestive heart failure √
139 18-10-2023 0012642 BPJS 0001961118516 3524244105570006 MASRIAH P WEDENG 002/003 66 Thn 5 Bln Spondylolysis, lumbar region √
140 18-10-2023 0033457 BPJS 0002210213687 YATMINAH P WINDU 002/001 68 Thn 2 Bln Cerebral infarction, unspecified √
141 18-10-2023 0022197 BPJS 0002210213384 3524241709500002 SOLIKAN L WINDU 002/001 73 Thn 1 Bln Bilateral inguinal hernia, with obstruction, without gangrene √
143 18-10-2023 0023062 BPJS 0000103902399 3524242704620001 MUJIONO L SAMBO 002/002 61 Thn 5 Bln Hypertensive heart disease with (congestive) heart failure √
144 18-10-2023 0004436 BPJS 0000759358596 3524244101620023 SENAH P KURO 61 Thn 9 Bln Headache √
145 18-10-2023 0013036 BPJS 0001961115423 3524240510530003 MOH. THOHA L WEDENG 002/003 70 Thn 0 Bln Spondylolysis, lumbar region √
146 18-10-2023 0023528 BPJS 0001047282524 3524246101620001 SULASTRI P BAKALAN 002/001 61 Thn 8 Bln Senile cataract, unspecified √
147 18-10-2023 0026717 BPJS 0002448057025 3524241009540001 KASTAM L BLAWI UTARA 003/004 69 Thn 1 Bln Hypertensive heart disease with (congestive) heart failure √
148 18-10-2023 0007216 BPJS 0000758406486 3524241906630001 NADI L KARANGAJI 003/003
149 18-10-2023 0038857 BPJS 0003273680946 3524244101600076 NANIK P TERBIS 002/003 63 Thn 9 Bln Other gastritis √
150 18-10-2023 0031926 BPJS 0002752152579 3524241207610002 MAT ARKAN L KEBONSARI 002/003 Hypertensive heart disease with (congestive) heart failure; Other
62 Thn 3 Bln gastritis √
152 18-10-2023 0000008 BPJS 0001832992773 3524244101540032 SYARIAH P ALASMALANG 003/002
69 Thn 9 Bln Tuberculosis of lung, bacteriologically and histologically negative √
153 19-10-2023 0032143 BPJS 0000103500279 3524243006600011 SANTOSO EDY PURWANTO L BLAWI 002/0005 63 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √
154 19-10-2023 0024607 BPJS 0002248407663 3524241202500001 H.SAMIJAN L MENGAI 001/ 005 73 Thn 8 Bln Other gastritis √
155 19-10-2023 0036769 BPJS 0000103655575 3524245711600001 ISTIROCHAH P KARANGBINANGUN 001/001 62 Thn 11 Bln Malignant neoplasm of bronchus or lung, unspecified √
156 19-10-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 69 Thn 1 Bln Hypertensive heart disease with (congestive) heart failure √
157 19-10-2023 0001878 BPJS 0000103500303 3524246112600002 SAYEKTI HANDAYANI P PENCARAN 002/005 62 Thn 9 Bln Acute upper respiratory infection, unspecified √
159 19-10-2023 0010539 BPJS 0000758358461 3524244101530046 KAMAH P PUPUS 003/006 70 Thn 9 Bln Acute upper respiratory infection, unspecified √
160 19-10-2023 0012479 BPJS 0000758798054 3524240607600001 SUMADI L GUNDIK 001/004 63 Thn 3 Bln Acute upper respiratory infection, unspecified √
161 19-10-2023 0009658 BPJS 0001704052192 3524241512610001 NALI L KEPOH 004/002 61 Thn 10 Bln Acute upper respiratory infection, unspecified √
162 19-10-2023 0017442 BPJS 0001897451829 3524243006550005 MISLAN L NGIPIK 003/003 68 Thn 3 Bln Stroke, not specified as haemorrhage or infarction √
163 19-10-2023 0023632 BPJS 0000758300657 3524241101570001 SELAMET L WATANGAN 002/002 66 Thn 9 Bln Other gastritis √
164 19-10-2023 0012504 BPJS 0002248407966 3524245003520001 HJ. MINAH P MENGAI 001/005 71 Thn 7 Bln Congestive heart failure √
165 20-10-2023 0039860 BPJS 0002885315905 3524244112500001 JAIYA P KARANGANOM WETAN 001/004 72 Thn 10 Bln Calculus of kidney √
166 20-10-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001 Hyperglycaemia, unspecified; Hypertensive heart disease without
168 20-10-2023 0012566 BPJS 0002756614127 3524245506580001 MUHARTIK P WEDENG 001/003
169 20-10-2023 0005439 BPJS 0002616851711 3524241705630001 MUFLIKH L MAYONG TENGAH 001/003 60 Thn 5 Bln Haemorrhage of anus and rectum √
170 20-10-2023 0025875 BPJS 0000758426826 3524240101620043 NURSAN L KETAPANG 001/001 61 Thn 9 Bln Gastritis, unspecified √
171 20-10-2023 0004848 BPJS 0000103106518 3523245112620001 MAFTUCHAH P GAYAM 005/003 60 Thn 10 Bln Hypertensive heart disease without (congestive) heart failure √
172 20-10-2023 0031226 BPJS 0000758437457 3524242404470001 NUR MUSTHOFA L PENCARAN 002/005 76 Thn 5 Bln Hypertensive heart disease without (congestive) heart failure √
173 20-10-2023 0017881 BPJS 0000758438278 3524244101620072 MUKARIYAH P PENCARAN 002/005 61 Thn 9 Bln Counselling, unspecified √
174 21-10-2023 0031514 BPJS 0002695514523 3524245404610001 KHOTIMAH P KLECO 001/003 Hyperglycaemia, unspecified; Hypertensive heart disease without
175 21-10-2023 0039825 BPJS 0000758575991 3524245508610002 NINGSIH P SAMBO 002/003 62 Thn 2 Bln Cataract in other endocrine, nutritional and metabolic diseases √
176 21-10-2023 0025453 BPJS 0002774533465 3524245101570004 SUKATI P GUNDIK 001/004 Acute nasopharyngitis [common cold]; Hypertensive heart disease
177 21-10-2023 0000365 BPJS 0001472030559 3524246012610002 SUTARNI P WINDU Arthritis, unspecified, unspecified site; Hypertensive heart disease
178 21-10-2023 0025800 BPJS 0001704054971 3524240903610001 ASERI L MAGOK 001/001 62 Thn 7 Bln Cataract, unspecified √
179 21-10-2023 0002604 UMUM SARSEH P NGIPIK 003/003 78 Thn 7 Bln Myalgia √
180 21-10-2023 0031690 BPJS 0001733212631 3524241107620002 M. THOYYIB L BATURONO 003/002 61 Thn 3 Bln Acute nasopharyngitis [common cold] √
181 21-10-2023 0032779 BPJS 0000758163104 3524240101570010 SUKAIRI L WARUK 003/002 66 Thn 9 Bln Cataract, unspecified √
182 21-10-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 62 Thn 7 Bln Spinal stenosis, lumbar region √
183 21-10-2023 0016070 BPJS 0000758611798 3524245508600001 MINAWAROH P MAYONG NGABLAK 63 Thn 2 Bln Hyperglycaemia, unspecified √
184 21-10-2023 0010312 BPJS 0001965290319 3524241710510001 SUTARDJO L MAYONG KULON 72 Thn 0 Bln Myalgia √
185 21-10-2023 0039867 BPJS 0002626334785 3524244502550001 SUPARTI P BANJARANYAR 003/004 68 Thn 8 Bln Hypertensive heart disease without (congestive) heart failure √
186 21-10-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004 69 Thn 3 Bln Hypertensive heart disease without (congestive) heart failure √
187 21-10-2023 0038857 BPJS 0003273680946 3524244101600076 NANIK P TERBIS 002/003 63 Thn 9 Bln Gastritis, unspecified √
188 21-10-2023 0028458 BPJS 0002749091602 3524241403620001 NUR KHAMIM L MENGAI 002/006 61 Thn 7 Bln Gastritis, unspecified √
189 21-10-2023 0027667 BPJS 0000758474583 3524240103630004 KHUSAIN L KR.ANOM KULON 002/002 60 Thn 7 Bln Counselling, unspecified √
190 21-10-2023 0001507 BPJS 0000758599828 3524246204550001 ALIFAH P ALASMALANG 002/002 68 Thn 5 Bln Low vision, both eyes √
191 21-10-2023 0039887 BPJS 0000758580524 3524241506540001 KASELAN L SAMBO 002/003 Gastritis, unspecified; Hypertensive heart disease without (congestive)
192 21-10-2023 0012879 BPJS 0001047282592 3524242601530001 MISKAN L BAKALAN 002/001
193 21-10-2023 0013243 BPJS 0001704050087 3524245712550001 SULAEKAH P WINDU 001/001 Hypertensive heart disease without (congestive) heart failure; Low back
67 Thn 10 Bln pain √
194 21-10-2023 0033239 BPJS 0000759104842 3524246101590005 FATIMAH P ALASMALANG 003/002 64 Thn 9 Bln Hyperglycaemia, unspecified √
195 21-10-2023 0023686 BPJS 0002246301461 3524244101520045 MASENI P ALASMALANG 71 Thn 9 Bln Other disorders of lacrimal gland √
196 21-10-2023 0015068 BPJS 0003500275364 3524241205510004 M.CHOIRI L BATURONO 002/002 72 Thn 5 Bln Hypertensive heart disease without (congestive) heart failure √
197 21-10-2023 0028325 BPJS 0000759155253 3524245201530001 KASIATI P ALAS MALANG 70 Thn 9 Bln Urinary tract infection, site not specified √
198 21-10-2023 0039893 UMUM 352424410660002 MUSLIMAH P ALSMALANG 002/002
199 21-10-2023 0030839 BPJS 0000759235746 3524244101560046 JAENAH P ALASMALANG
200 21-10-2023 0031356 BPJS 0000759177606 3524244512560001 LI'AH P ALASMALANG 003/003 66 Thn 10 Bln Arthritis, unspecified, unspecified site √
201 21-10-2023 0017037 UMUM 3524241810620001 SULAIMAN L WARUK 003/001 61 Thn 0 Bln Contusion of knee √
202 21-10-2023 0016719 BPJS 0000103768255 3524240901510001 SUMARGONO, SE L KEPOH
203 21-10-2023 0037516 BPJS 0000758882283 3524240101620004 SUKAERI L KLECO 001/003 61 Thn 9 Bln Hyperglycaemia, unspecified √
204 21-10-2023 0014504 BPJS 0003500275443 3524244710520001 MARSINAH P BATURONO 002/002 Atopic dermatitis, unspecified; Hypertensive heart disease without
205 21-10-2023 0008176 UMUM 3524244101480005 SITI JAEKAH P KLECO 001/003 Dyspepsia; Hypertensive heart disease without (congestive) heart
206 21-10-2023 0017115 BPJS 0002746405642 SUPIYAH P SAMBO 002/003 67 Thn 0 Bln Pterygium √
207 21-10-2023 0033622 BPJS 0001047273232 3524245909610001 MARHAMAH P PENCARAN 001/005 62 Thn 1 Bln Arthritis, unspecified, unspecified site √
208 21-10-2023 0001503 BPJS 0000757542565 3524244102620002 MALIYAH P SAMBO 61 Thn 8 Bln Corns and callosities √
209 23-10-2023 0010290 BPJS 0000758927237 3524245012620001 SUBIKAH P MAGOK 002/002 60 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √
210 23-10-2023 0020660 BPJS 0000103500382 SHOLIKIN L KETAPANG 001/002 74 Thn 1 Bln Chronic ischaemic heart disease, unspecified √
211 23-10-2023 0038969 BPJS 0000103500393 3524245008550001 UMIYANAH P KETAPANGTELU 001/002 68 Thn 2 Bln Spondylosis, unspecified, multiple sites √
212 23-10-2023 0025842 BPJS 0002318244603 3524240706570001 PARIJAN L PUTATREJO 002/003 66 Thn 4 Bln Hydronephrosis with renal and ureteral calculous obstruction √
213 23-10-2023 0018320 BPJS 0000758961189 3524240101530023 LAMIKAN L PUPUK 002/003 70 Thn 9 Bln Sequelae of stroke, not specified as haemorrhage or infarction √
217 23-10-2023 0014606 BPJS 0001905651426 3524244304580001 MUCHLISAH P BATURONO 003/002 65 Thn 6 Bln Atherosclerotic heart disease √
218 23-10-2023 0032143 BPJS 0000103500279 3524243006600011 SANTOSO EDY PURWANTO L BLAWI 002/0005 63 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √
219 23-10-2023 0001878 BPJS 0000103500303 3524246112600002 SAYEKTI HANDAYANI P PENCARAN 002/005 62 Thn 10 Bln Acute upper respiratory infection, unspecified √
221 23-10-2023 0037215 BPJS 0000759063543 3524243006540010 KHUSAEN L KARANGANOM KULON 69 Thn 3 Bln External haemorrhoids with other complications √
222 23-10-2023 0001920 BPJS 0000759389769 3524244102610003 SUKAYAH P KURIPAN 001/008 62 Thn 8 Bln Atherosclerotic heart disease √
223 24-10-2023 0008478 BPJS 0002877928334 3524245101560002 SUMIATI P PUPUK 001/003 67 Thn 9 Bln Cervicalgia, sacral and sacrococcygeal region √
224 24-10-2023 0016233 BPJS 0000759161889 SUJONO L DUKOH 65 Thn 9 Bln Asthma, unspecified √
225 24-10-2023 0004586 BPJS 0000759382277 3524245008620002 KAMAH P LUNTAS B 001/007 61 Thn 2 Bln Malignant neoplasm of axillary tail of breast √
226 24-10-2023 0013541 BPJS 0001386491905 3524245406500001 KASRI P KLECO 002/004 73 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √
227 24-10-2023 0022511 BPJS 0002422656551 SUNARI L BAKALAN 002/002 Insulin-dependent diabetes mellitus with peripheral circulatory
228 24-10-2023 0010937 BPJS 0002471526358 TASRIAH P BR. BUTUH 003/002 68 Thn 0 Bln Pneumonia, unspecified √
229 24-10-2023 0011981 BPJS 0002038243487 3524244101460025 SUARIYAH P KURO 003/001
230 24-10-2023 0035777 BPJS 0002732692691 KASMONAH P SAMBO 002/003 64 Thn 4 Bln Senile cataract, unspecified √
231 24-10-2023 0039910 BPJS 0002464833971 3524240306510001 SUTARMIN L GUNDIK 001/004 72 Thn 4 Bln Senile cataract, unspecified √
232 24-10-2023 0022838 BPJS 0001047280331 3524246207640001 SITI ROHMAH P BANDUT 60 Thn 7 Bln Fever with chills √
233 24-10-2023 0021286 BPJS 0000759248818 JULAIKHAH P BLAWI 003/002 63 Thn 9 Bln Acute upper respiratory infection, unspecified √
234 24-10-2023 0023139 BPJS 0000759550307 3524244410530001 KINAH P NGAJARAN 001/003 70 Thn 0 Bln Senile cataract, unspecified √
236 25-10-2023 0008730 BPJS 0000758680964 3524247006580007 SITI MUJENAH P WINDU 65 Thn 3 Bln Anaemia, unspecified √
237 25-10-2023 0028110 BPJS 0002499393341 AKOP L BLAWI UTARA 003/004 63 Thn 9 Bln Essential (primary) hypertension √
322 25-10-2023 0038857 BPJS 0003273680946 3524244101600076 NANIK P TERBIS 002/003 63 Thn 9 Bln Senile cataract, unspecified √
323 25-10-2023 0005422 BPJS 0000758405362 SINAH P KETAPANG 67 Thn 9 Bln Acute upper respiratory infection, unspecified √
324 25-10-2023 0017881 BPJS 0000758438278 3524244101620072 MUKARIYAH P PENCARAN 002/005 61 Thn 9 Bln Senile cataract, unspecified √
325 25-10-2023 0035518 BPJS 0003106614789 3524246604620001 SUBIKAH P BANDUT 002/001 Hyperglycaemia, unspecified; Hypertensive heart disease with
326 25-10-2023 0039857 BPJS 0000759842998 3524241010610002 SUPRAPTONO L KLAMPIS 002/006 62 Thn 0 Bln Unspecified haemorrhoids without complication √
238 26-10-2023 0015093 BPJS 0000758692495 MUKNI P WARUK 61 Thn 1 Bln Essential (primary) hypertension √
239 26-10-2023 0024414 BPJS 0000758141864 3524241111560001 ABU THOLIB L WARUK 003/001 66 Thn 11 Bln Essential (primary) hypertension √
240 26-10-2023 0014929 BPJS 0000758609335 3524245204340002 NURYANAH P KARANGANOM 89 Thn 6 Bln Essential (primary) hypertension √
241 26-10-2023 0023218 BPJS 0000759011185 3524245903550001 RUPINAH P KARANGANOM KULON 68 Thn 7 Bln Essential (primary) hypertension √
242 26-10-2023 0015073 BPJS 0001047287024 3524244908600001 NURIKA P WARUK 63 Thn 2 Bln Essential (primary) hypertension √
243 26-10-2023 0011916 BPJS 0000760001488 3524244505490002 KASRI P WINDU 74 Thn 5 Bln Essential (primary) hypertension √
244 26-10-2023 0034978 BPJS 0000759348369 3524240101590034 KASBULLAH L GUNDIK 001/004 64 Thn 9 Bln Essential (primary) hypertension √
245 26-10-2023 0038486 BPJS 0000759398286 3524241611540001 SARMADI L MENGAI 002/006 68 Thn 11 Bln Essential (primary) hypertension √
246 26-10-2023 0033880 BPJS 0000759311109 YAHYA L WEDENG SUKOREJO 64 Thn 10 Bln Essential (primary) hypertension √
247 26-10-2023 0030591 BPJS 0001829062451 MUSLIMAH P GAYAM 60 Thn 11 Bln Essential (primary) hypertension √
248 26-10-2023 0031160 BPJS 0000758992353 3524242911550001 ABDUL MUHID L WEDENG 67 Thn 10 Bln Essential (primary) hypertension √
249 26-10-2023 0036055 BPJS 0001704047387 3524241812600002 ROHIMIN L WEDENG 001/003 62 Thn 10 Bln Essential (primary) hypertension √
250 26-10-2023 0030560 BPJS 0002903557735 3524241611500001 MAT HARI L WEDENG 001/002 72 Thn 11 Bln Essential (primary) hypertension √
251 26-10-2023 0033446 BPJS 0001047286383 3524240201540003 KARMIN L MENGAI 002/006 69 Thn 9 Bln Essential (primary) hypertension √
252 26-10-2023 0034377 BPJS 0001262805985 3524244909560001 HJ. SALAMAH P MENGAI 001/006 67 Thn 1 Bln Essential (primary) hypertension √
253 26-10-2023 0020773 BPJS 0001892471038 3524245001580001 SARTI P GUNDIK 65 Thn 9 Bln Essential (primary) hypertension √
254 26-10-2023 0025952 BPJS 0000758718562 3524240709500001 MATASIM L WEDENG 73 Thn 1 Bln Essential (primary) hypertension √
255 26-10-2023 0018746 BPJS 0000759368002 3524240101510040 ZAINI L ALASMALANG 72 Thn 9 Bln Essential (primary) hypertension √
256 26-10-2023 0030642 BPJS 0000758532576 YATIMAH P ALASMALANG 68 Thn 9 Bln Essential (primary) hypertension √
257 26-10-2023 0028631 BPJS 0000758580232 3524246708550001 SUMIYATI P ALAS MALANG 68 Thn 1 Bln Essential (primary) hypertension √
258 26-10-2023 0008324 BPJS 0002874881035 3524240101610045 SAKIR L TERBIS 002/003 62 Thn 9 Bln Essential (primary) hypertension √
259 26-10-2023 0005300 BPJS 0002735855166 3524241207770003 SUHAJI L LUWUK 46 Thn 3 Bln Essential (primary) hypertension √
260 26-10-2023 0008712 BPJS 0000758403549 3524240401560001 SADIK L BR. KADU 67 Thn 9 Bln Essential (primary) hypertension √
261 26-10-2023 0010772 BPJS 0002926601109 3524244101560015 WIDARTI P BAKALAN 002/002 67 Thn 9 Bln Essential (primary) hypertension √
262 26-10-2023 0034335 BPJS 0000759698414 3524244101550015 SITI ANAH P BAKALAN RT 01 RW03 68 Thn 9 Bln Essential (primary) hypertension √
263 26-10-2023 0022257 BPJS 0000759753988 3524240101590016 TASLIKAN L BAKALAN RT 01 RW 01 64 Thn 9 Bln Essential (primary) hypertension √
264 26-10-2023 0034338 BPJS 0002769360939 3524243007590001 KASMOLAN L BAKALAN RT 02 RW 03 64 Thn 2 Bln Essential (primary) hypertension √
265 26-10-2023 0031354 BPJS 0000759678603 3524244101560012 MULIASIH P BAKALAN 67 Thn 9 Bln Essential (primary) hypertension √
266 26-10-2023 0023449 BPJS 0000759720407 3524244101480009 SARKAMAH P BAKALAN 75 Thn 9 Bln Essential (primary) hypertension √
267 26-10-2023 0022553 BPJS 0000759034743 3524244101610008 SRIAMAH P SOMOITO 62 Thn 9 Bln Essential (primary) hypertension √
268 26-10-2023 0031348 BPJS 0000759009677 3524244101380063 KASTIAH P BAKALAN 85 Thn 9 Bln Essential (primary) hypertension √
269 26-10-2023 0031335 BPJS 0002073701643 3524244101420009 KASTINAH P BAKALAN 81 Thn 9 Bln Essential (primary) hypertension √
270 26-10-2023 0031347 BPJS 0002734828593 3524244101590013 KARSITI P BAKALAN 64 Thn 9 Bln Essential (primary) hypertension √
271 26-10-2023 0017358 BPJS 0000759711521 3524244201590007 SUWARNI P BAKALAN 64 Thn 9 Bln Essential (primary) hypertension √
272 26-10-2023 0020555 BPJS 0000759007563 3524244101300014 SARMIDAH P SOMOITO 93 Thn 9 Bln Essential (primary) hypertension √
273 26-10-2023 0024090 BPJS 0000759026777 3524244101590012 JUMAÌYAH P BAKALAN 64 Thn 9 Bln Essential (primary) hypertension √
274 26-10-2023 0007378 BPJS 0002162609706 3524245201600003 KASEMU P BANYUURIP 63 Thn 9 Bln Essential (primary) hypertension √
275 26-10-2023 0035718 BPJS 0000759735011 SOMADI L WATANGAN 001/001 63 Thn 9 Bln Essential (primary) hypertension √
276 26-10-2023 0008220 BPJS 0003150081854 3524244201590003 MUTMAINAH P BAKALAN 64 Thn 9 Bln Essential (primary) hypertension √
277 26-10-2023 0031323 BPJS 0000758812239 3524244102590001 KUSWATI P BANDUT 64 Thn 8 Bln Essential (primary) hypertension √
278 26-10-2023 0031551 BPJS 0000758804433 3524244101540033 ROBI'AH P BOGOBABADAN 69 Thn 9 Bln Essential (primary) hypertension √
279 26-10-2023 0021476 BPJS 0000758730014 3524244101520070 ATEMAH P BADAN 001/002 71 Thn 9 Bln Essential (primary) hypertension √
280 26-10-2023 0021405 BPJS 0000757175545 3524244105560002 SAROH P BADAN 002/002 67 Thn 5 Bln Essential (primary) hypertension √
281 26-10-2023 0036149 BPJS 0000759177382 SUPARNO L ALASMALANG 03/02 63 Thn 1 Bln Essential (primary) hypertension √
282 26-10-2023 0020205 BPJS 0000758119544 3524244103510001 KARSI P WARUK RT 01/RW02 72 Thn 7 Bln Essential (primary) hypertension √
283 26-10-2023 0014109 BPJS 0000758378845 3524244101490016 JASMANI P BR.SIMAN 74 Thn 9 Bln Essential (primary) hypertension √
284 26-10-2023 0033272 BPJS 0002162610044 BAWON P KARANGANOM KULON 86 Thn 8 Bln Essential (primary) hypertension √
285 26-10-2023 0031562 BPJS 0000758593776 3524246008610001 MASNING P KARANGANOM KULON 62 Thn 2 Bln Essential (primary) hypertension √
286 26-10-2023 0037750 BPJS 0001704051865 SUTIKAH P KURO 62 Thn 0 Bln Essential (primary) hypertension √
287 26-10-2023 0001392 BPJS 0000103766905 IMAM L MONOLELO 001/002 78 Thn 2 Bln Essential (primary) hypertension √
288 26-10-2023 0011478 BPJS 0000758442879 3524244106450001 SARPILAH L NGAJARAN 78 Thn 4 Bln Essential (primary) hypertension √
289 26-10-2023 0031583 BPJS 0001079091595 UMI SUBCHA P KURO 68 Thn 9 Bln Essential (primary) hypertension √
290 26-10-2023 0021152 BPJS 0000759342936 3524244103550001 TUMU`NINAH P KURO 68 Thn 7 Bln Essential (primary) hypertension √
291 26-10-2023 0020710 BPJS 0000759041684 3524240101500013 KUMARI L BAKALAN 73 Thn 9 Bln Essential (primary) hypertension √
292 26-10-2023 0035860 BPJS 0001047278439 3524241710570001 ALFAN EFENDI L MONOLELO 001/002 66 Thn 0 Bln Essential (primary) hypertension √
293 26-10-2023 0036544 BPJS 0000757445253 3524244101620081 SURIYAH P MONOLELO 002/002 61 Thn 9 Bln Essential (primary) hypertension √
294 26-10-2023 0023206 BPJS 0000757430943 3524242803610001 ALI ARIFIN L KARANGBINANGUN 62 Thn 6 Bln Essential (primary) hypertension √
295 26-10-2023 0031341 BPJS 0000759772528 3524240101480051 MARJUKI L BAKALAN 77 Thn 9 Bln Essential (primary) hypertension √
296 26-10-2023 0022306 BPJS 0000759720363 3524244607580001 KANAH P SOMOITO 65 Thn 3 Bln Essential (primary) hypertension √
297 26-10-2023 0015755 BPJS 0000758159998 JAWAHIR L WARUK 72 Thn 11 Bln Essential (primary) hypertension √
298 26-10-2023 0028110 BPJS 0002499393341 AKOP L BLAWI UTARA 003/004 63 Thn 9 Bln Senile cataract, unspecified √
299 26-10-2023 0029446 BPJS 0000759025495 KATIMAN L WARUK 002/002 68 Thn 10 Bln Essential (primary) hypertension √
300 26-10-2023 0020210 BPJS 0000759026788 MARINTEN P WARUK RT02/RW02 62 Thn 11 Bln Essential (primary) hypertension √
301 26-10-2023 0025237 BPJS 0002265773466 3524247006490006 LASENI P WINDU 74 Thn 3 Bln Essential (primary) hypertension √
302 26-10-2023 0022874 BPJS 0001704050561 3624255006480002 KASENAH P WINDU 002/001 75 Thn 3 Bln Essential (primary) hypertension √
303 26-10-2023 0028373 BPJS 0000758690875 3524247006480010 SOMANI P WINDU 001/002 75 Thn 3 Bln Essential (primary) hypertension √
304 26-10-2023 0013723 BPJS 0000758884915 3524247006430001 NIMAH P WINDU 80 Thn 3 Bln Essential (primary) hypertension √
305 26-10-2023 0031909 BPJS 0002328236537 3524247006460007 MUDAH P NGIPIK 002/003 77 Thn 3 Bln Essential (primary) hypertension √
306 26-10-2023 0022197 BPJS 0002210213384 3524241709500002 SOLIKAN L WINDU 002/001 73 Thn 1 Bln Essential (primary) hypertension √
307 26-10-2023 0012879 BPJS 0001047282592 3524242601530001 MISKAN L BAKALAN 002/001 70 Thn 9 Bln Essential (primary) hypertension √
308 26-10-2023 0016705 BPJS 0000758126643 3524242306570001 ABD. MANAN L WARUK 002/002 66 Thn 4 Bln Essential (primary) hypertension √
309 26-10-2023 0030629 BPJS 0002913182627 3524245105710003 MUASAROH P WARUK 002/001 52 Thn 5 Bln Essential (primary) hypertension √
310 26-10-2023 0008215 BPJS 0000103501732 3524246404610001 INAMAH P SAMBO 001/002 62 Thn 6 Bln Essential (primary) hypertension √
311 26-10-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 70 Thn 9 Bln Essential (primary) hypertension √
312 26-10-2023 0027703 BPJS 0001962819843 3524240504580001 IKHSAN L SAMBO 001/004 65 Thn 6 Bln Essential (primary) hypertension √
313 26-10-2023 0028642 BPJS 0001047281455 SAKUR L BONRINGIN 001/004 61 Thn 9 Bln Essential (primary) hypertension √
327 26-10-2023 0000641 BPJS 0000103599821 3524241212480002 H. SUMARDI, DRS L BANDUT 002/001 Insulin-dependent diabetes mellitus with peripheral circulatory
328 26-10-2023 0007216 BPJS 0000758406486 3524241906630001 NADI L KARANGAJI 003/003 60 Thn 4 Bln Essential (primary) hypertension √
329 26-10-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 64 Thn 0 Bln Acute upper respiratory infection, unspecified √
330 26-10-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004 69 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √
331 26-10-2023 0002429 BPJS 0000103766657 3524244101520042 SITI KHALIMAH P WEDENG 002/002 71 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √
332 26-10-2023 0018836 BPJS 0001704045306 3524241010580001 ABD KHANAN L KR AJI 003/006 Asthma, unspecified; Hypertensive heart disease with (congestive)
333 26-10-2023 0005665 BPJS 0000759148918 KARTAWI L LUNTAS S 03/001 Chronic obstructive pulmonary disease with acute exacerbation,
334 27-10-2023 0018087 BPJS 0001047278709 3524245903630001 NISMU P ALANG-ALANG 60 Thn 7 Bln Fever with chills √
335 27-10-2023 0001081 BPJS 0003176757055 3524240411590002 ASNAN L TERBIB 00/003 63 Thn 11 Bln Hypertensive heart disease with (congestive) heart failure √
336 27-10-2023 0030956 BPJS 0002900094491 3524242101460001 MUNAWAR L WATANGAN Hypertensive heart disease without (congestive) heart failure; Senile
337 27-10-2023 0038024 BPJS 0002608054031 3524240411580001 DIDIK MULIADI L WATANGAN 001/002 64 Thn 11 Bln Atherosclerotic heart disease √
338 27-10-2023 0008325 BPJS 0000759100241 3524244101590058 MAKHMUDA P KEPENG 64 Thn 9 Bln Acute nasopharyngitis [common cold] √
339 27-10-2023 0006823 BPJS 0000759099205 3524242910570001 ASRUL SONI SIRIGAR L KEPENG 003/002 66 Thn 0 Bln Counselling, unspecified √
340 27-10-2023 0018924 BPJS 0000758994939 3524244101500039 MUHAYATI P BONRINGIN 73 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √
341 27-10-2023 0031115 BPJS 0000758614037 DHOHUWA P GAYAM 005/003
342 27-10-2023 0006428 BPJS 0002257276443 3524244701500001 SITI AISYAH P PUTATREJO 002/003 73 Thn 9 Bln Dyspepsia; Hyperglycaemia, unspecified √
343 27-10-2023 0037715 BPJS 0000759230199 3524241407620003 SUTARNO L TERBIS 002/003 61 Thn 3 Bln Other ulcerative colitis √
314 30-10-2023 0009146 BPJS 0003537325517 NAHNU L PENCARAN 001/005 66 Thn 9 Bln √
315 30-10-2023 0010502 BPJS 0000759496173 3524245707360001 KUMAIYAH P PUPUS 003/006 60 Thn 3 Bln √
344 30-10-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001 Hyperglycaemia, unspecified; Hypertensive heart disease with
345 30-10-2023 0002670 BPJS 0000103498457 3524242504540001 DJUWONO L ALANG-ALANG 002/005 69 Thn 6 Bln Other chronic renal failure √
346 30-10-2023 0010385 BPJS 0000758404012 ACHROM L KARANGBINANGUN 001/001 70 Thn 9 Bln √
disease with (congestive) heart failure; Primary arthrosis of other joints,
67 Thn 9 Bln shoulder region √
348 30-10-2023 0035068 BPJS 0002935518186 3524241010540001 ANWAR L PENCARAN 002 / 005 69 Thn 0 Bln Senile cataract, unspecified √
349 30-10-2023 0005141 BPJS 0002732691644 LAMSINAH P SAMBO 002/003 60 Thn 7 Bln Other primary gonarthrosis √
350 30-10-2023 0029531 BPJS 0000758322652 3524244101450061 KHOTIMAH P BLAWI UTARA 001/004 78 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √
351 30-10-2023 0031226 BPJS 0000758437457 3524242404470001 NUR MUSTHOFA L PENCARAN 002/005 76 Thn 6 Bln Hypertensive heart disease with (congestive) heart failure √
352 30-10-2023 0039956 BPJS 0002882538448 3524245303590002 H. M. AMIN L MAYONG TENGAH 002/003 64 Thn 7 Bln Atherosclerotic heart disease √
353 30-10-2023 0036612 BPJS 0003002375643 3524240201580008 SUPARTO L BLAWI 002/004 65 Thn 9 Bln Atherosclerotic heart disease √
355 30-10-2023 0004981 BPJS 0000758516534 3524241510610001 CHUMAIDI L SAMBO 62 Thn 0 Bln Effusion of joint, hand √
356 30-10-2023 0006327 BPJS 0000103593655 SITI AMINAH P KARANGAJI 60 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √
357 30-10-2023 0013820 BPJS 0002314477394 3524241406460002 MILKAN L PERIYOSO WETAN 001/002 77 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √
358 30-10-2023 0025082 BPJS 0000758748069 3524244204630003 RIYATUN P KARANGANOM KULON 005/003 60 Thn 6 Bln Rheumatism, unspecified, lower leg √
359 30-10-2023 0022187 BPJS 0000759355661 3524244201600001 KAYAH P WATANGAN 001/001 63 Thn 9 Bln √
360 30-10-2023 0024407 BPJS 0000759302324 3524244101470008 MUNIKAH P WATANGAN 001/001 Acute upper respiratory infection, unspecified; Surgical follow-up care,
316 31-10-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004 69 Thn 3 Bln Hypertensive heart disease without (congestive) heart failure √
317 31-10-2023 0027703 BPJS 0001962819843 3524240504580001 IKHSAN L SAMBO 001/004 65 Thn 6 Bln Sequelae of subarachnoid haemorrhage √
318 31-10-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 69 Thn 2 Bln Hypertensive heart disease without (congestive) heart failure √
319 31-10-2023 0035616 BPJS 0003101665138 3524244101630035 INDAHYATI P KAUMAN 001/002 Hypertensive heart disease without (congestive) heart failure; Pure
60 Thn 9 Bln hyperglyceridaemia √
320 31-10-2023 0039976 BPJS 0000103768121 3524245504580002 KASTINING P LUNTAS S 001/002
Hypertensive heart disease with (congestive) heart failure; Pneumonia,
unspecified; Tuberculosis of lung, without mention of bacteriological or
65 Thn 6 Bln histological confirmation √
321 31-10-2023 0039965 BPJS 0000759839376 3524241001590001 SUWITO L PUPUK 001/003 64 Thn 9 Bln Dyspepsia √
361 31-10-2023 0006823 BPJS 0000759099205 3524242910570001 ASRUL SONI SIRIGAR L KEPENG 003/002 66 Thn 0 Bln Senile cataract, unspecified √
362 31-10-2023 0039966 BPJS 0001704093794 3524242207540001 RUSMAN L PALANGAN 001/002 69 Thn 3 Bln Hypertensive heart disease without (congestive) heart failure √
363 31-10-2023 0004981 BPJS 0000758516534 3524241510610001 CHUMAIDI L SAMBO 62 Thn 0 Bln Haemarthrosis, hand √
364 31-10-2023 0025098 BPJS 0001704049402 3524244908560001 YASEMAH P MORO 67 Thn 2 Bln Cellulitis of trunk √
365 31-10-2023 0039962 BPJS 0003219227111 3524244101510004 SARIYEM P WATANGAN 003/001 72 Thn 9 Bln Other gastritis √
366 31-10-2023 0002181 BPJS 0000103499875 3524244203630001 NASIYATIN P KEPENG 003/002 60 Thn 7 Bln Arthrosis, unspecified, shouder region √
367 31-10-2023 0000416 BPJS 0000103499886 3524240304630002 KHABIB L KEPENG 003/002 Insulin-dependent diabetes mellitus with peripheral circulatory
368 31-10-2023 0005611 BPJS 0001704058053 3524247112610001 MISKANA L SAMBO 003/004 61 Thn 10 Bln Hypertensive heart disease without (congestive) heart failure √
369 31-10-2023 0025005 BPJS 0000759924652 3524247006600003 NYANI P PRIYOSO WETAN 001/001 Insulin-dependent diabetes mellitus with peripheral circulatory
Pemeriks
g
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
√ √ √ √ √
Laporan Periodik Diagnosa Pasien
Tanggal : : 01-11-2023 s/d 30-11-2023
INDIKATOR KELENGKAPAN PENGISIAN REK
aan Fisik a
1 01-11-2023 0035059 BPJS 0002268669475 3524241201570001 KASMOLAN L MAGOK 001/001 66 Thn 9 Bln Headache √ √
2 01-11-2023 0000751 BPJS 0002088847844 3524241905620001 YASKURI L BLAWI SELATAN 003/002 61 Thn 5 Bln Calculus of kidney with calculus of ureter √ √
3 01-11-2023 0032143 BPJS 0000103500279 3524243006600011 SANTOSO EDY PURWANTO L BLAWI 002/0005 63 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √ √
4 01-11-2023 0018087 BPJS 0001047278709 3524245903630001 NISMU P ALANG-ALANG 60 Thn 7 Bln Fever with chills √ √
5 01-11-2023 0025082 BPJS 0000758748069 3524244204630003 RIYATUN P KARANGANOM KULON 005/003 60 Thn 6 Bln Headache √ √
6 01-11-2023 0016705 BPJS 0000758126643 3524242306570001 ABD. MANAN L WARUK 002/002 Essential (primary) hypertension; Non-insulin-dependent diabetes
7 01-11-2023 0009658 BPJS 0001704052192 3524241512610001 NALI L KEPOH 004/002 61 Thn 10 Bln Acute nasopharyngitis [common cold]; Dyspepsia √ √
8 01-11-2023 0009108 BPJS 0000758427851 3524240303630003 TIPAN L PUPUS 001/006 60 Thn 7 Bln Gastric ulcer, chronic without haemorrhage or perforation √ √
9 02-11-2023 0033839 BPJS 0000759370263 3524244210570001 HARMINI P WATES 001/002 66 Thn 1 Bln Sequelae of respiratory and unspecified tuberculosis √ √
10 02-11-2023 0004848 BPJS 0000103106518 3523245112620001 MAFTUCHAH P GAYAM 005/003 Dyspepsia; Hypertensive heart disease without (congestive) heart
60 Thn 10 Bln failure √ √
11 02-11-2023 0039197 BPJS 0000759894265 3524244501690002 SULASTIK P PRIYOSO K 001/001 54 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √ √
12 02-11-2023 0031347 BPJS 0002734828593 3524244101590013 KARSITI P BAKALAN 64 Thn 10 Bln Stroke, not specified as haemorrhage or infarction √ √
13 02-11-2023 0039986 BPJS 0000758901947 3524240101570019 SERSAN L PUPUK 001/005 66 Thn 10 Bln Senile cataract, unspecified √ √
14 02-11-2023 0012268 BPJS 0001704047376 3524244410440001 MARNI P WEDENG Hyperglycaemia, unspecified; Hypertensive heart disease without
15 02-11-2023 0002597 BPJS 0000758463129 3524246106570001 MUAYAH P SAMBO 001/002 Hyperglycaemia, unspecified; Hypertensive heart disease without
16 02-11-2023 0031157 BPJS 0002763980032 SUJA'I L KARANGBINANGUN 003/001 85 Thn 10 Bln Acute myocardial infarction, unspecified √ √
17 02-11-2023 0021618 BPJS 0000758401637 ARTIKAH P BLAWI TENGAH 002/003 65 Thn 10 Bln After-cataract; Presence of intraocular lens √ √
18 02-11-2023 0004937 BPJS 0002304533608 3524244101600120 KHASANAH P ALANG-ALANG 002/005 63 Thn 10 Bln Gastric ulcer, acute without haemorrhage or perforation √ √
19 06-11-2023 0018540 UMUM 3524244309480001 SAMIATI P KELCO 002/003 75 Thn 2 Bln Hypertensive heart disease without (congestive) heart failure √ √
20 06-11-2023 0039966 BPJS 0001704093794 3524242207540001 RUSMAN L PALANGAN 001/002 69 Thn 3 Bln Hypertensive heart disease without (congestive) heart failure √ √
21 06-11-2023 0011428 UMUM 3524245204620001 SUWARTIN P MAYONG WETAN 002/004 61 Thn 6 Bln Acute nasopharyngitis [common cold] √ √
22 06-11-2023 0026769 UMUM SOFIYA P KAUMAN 65 Thn 5 Bln Arthritis, unspecified, unspecified site √ √
23 06-11-2023 0007216 BPJS 0000758406486 3524241906630001 NADI L KARANGAJI 003/003 Acute nasopharyngitis [common cold]; Hypertensive heart disease
24 07-11-2023 0022252 BPJS 0002162609943 3524240101620011 SA'UM L BAKALAN 61 Thn 10 Bln Cerebral infarction due to thrombosis of precerebral arteries √ √
25 07-11-2023 0032143 BPJS 0000103500279 3524243006600011 SANTOSO EDY PURWANTO L BLAWI 002/0005 Hypertensive heart disease with (congestive) heart failure;
63 Thn 4 Bln Rheumatism, unspecified √ √
26 07-11-2023 0001878 BPJS 0000103500303 3524246112600002 SAYEKTI HANDAYANI P PENCARAN 002/005 62 Thn 10 Bln Acute upper respiratory infection, unspecified √ √
27 08-11-2023 0000431 BPJS 0000103500213 3524240601550001 RUBADI L BAKALAN 002/003 68 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √ √
28 09-11-2023 0017577 BPJS 0000757448291 3524245010590002 SUPARMI P ALANG-ALANG 002/005 64 Thn 0 Bln Congestive heart failure √ √
29 09-11-2023 0023943 BPJS 0000759805209 3524243006590001 MUSLIKIN L SAMBO 002/002 64 Thn 4 Bln Other gastritis √ √
30 10-11-2023 0026331 BPJS 0000758875645 3524241201600001 SUYITNO L BONRINGIN 001/004 Atrial fibrillation and flutter; Cerebral infarction due to unspecified
63 Thn 9 Bln occlusion or stenosis of precerebral arteries √ √
31 13-11-2023 0040041 BPJS 0002297262104 3524241101530001 KASUWI L WATANGAN 001/002 Hyperglycaemia, unspecified; Hypertensive heart disease without
32 13-11-2023 0005055 BPJS 0002265541211 3524246204620001 RIYANAH P KEBONSARI 002/003 Hypertensive heart disease without (congestive) heart failure; Surgical
61 Thn 6 Bln follow-up care, unspecified √ √
33 13-11-2023 0010385 BPJS 0000758404012 ACHROM L KARANGBINANGUN 001/001 70 Thn 10 Bln Hypertensive heart disease without (congestive) heart failure √ √
34 13-11-2023 0035518 BPJS 0003106614789 3524246604620001 SUBIKAH P BANDUT 002/001 Acute nasopharyngitis [common cold]; Hypertensive heart disease
35 13-11-2023 0039857 BPJS 0000759842998 3524241010610002 SUPRAPTONO L KLAMPIS 002/006 62 Thn 1 Bln Haemorrhage of anus and rectum √ √
36 16-11-2023 0024219 BPJS 0000759030568 3524245407590002 MARIA P KR ANOM KULON 002/001 64 Thn 4 Bln Senile cataract, unspecified √ √
37 16-11-2023 0038680 BPJS 0000757728797 3524244803520002 MALIKA P KR ANOM WETAN 007/004 71 Thn 8 Bln Senile cataract, unspecified √ √
38 16-11-2023 0014921 BPJS 0000758600537 3524244802580001 SUMI P KARANGANOM WETAN 65 Thn 9 Bln Pterygium √ √
39 16-11-2023 0022978 BPJS 0003012186464 3524247004560001 ARUMI P KARANGANOM 002/001 67 Thn 6 Bln Senile cataract, unspecified √ √
40 16-11-2023 0040070 BPJS 0003006388732 3524244201530005 HJ. KASTIÀH P BADAN 002/004 70 Thn 10 Bln √ √
41 16-11-2023 0039966 BPJS 0001704093794 3524242207540001 RUSMAN L PALANGAN 001/002 69 Thn 3 Bln Other senile cataract √ √
42 16-11-2023 0016596 BPJS 0000103501203 3524264702580001 SUMARTINI P MORO 65 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √ √
43 17-11-2023 0036482 BPJS 0001905647668 3524241711520001 UMAR L BATURONO 003/002 71 Thn 0 Bln Segmental and somatic dysfunction , lumbar region √ √
44 17-11-2023 0010859 BPJS 0000759422654 3524244301540001 SUMIATI P BANJARANYAR 003/003 69 Thn 10 Bln Atrial fibrillation and flutter √ √
45 17-11-2023 0019810 BPJS 0002056262049 3524211408420001 BAKRI L GABUS 81 Thn 3 Bln Glaucoma, unspecified √ √
46 17-11-2023 0039910 BPJS 0002464833971 3524240306510001 SUTARMIN L GUNDIK 001/004 72 Thn 5 Bln Calculus of bile duct with cholecystitis √ √
47 17-11-2023 0029424 BPJS 0000758797299 3524241008620003 SUPRAPTO L B TEMBOK 008/003
61 Thn 3 Bln Follow-up examination after other treatment for other conditions √ √
48 17-11-2023 0040086 UMUM 3524245504630001 IMROATUS SHOLIHAH P WEDENG 001/002 Respiratory tuberculosis unspecified, confirmed bacteriologically and
60 Thn 7 Bln histologically √ √
49 17-11-2023 0000496 BPJS 0001047281253 3524247112480001 SITI FADILA P SAMBO 003/004 74 Thn 10 Bln Hypertensive heart disease without (congestive) heart failure √ √
50 17-11-2023 0040088 BPJS 0002732692599 3524246504640002 SITI AMINAH P SAMBO 002/003 59 Thn 6 Bln Senile cataract, unspecified √ √
51 17-11-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 62 Thn 7 Bln Intervertebral disc disorder, unspecified √ √
52 20-11-2023 0030660 BPJS 0000758667069 3524244501530001 JANA P KURO 002/001 Acute upper respiratory infection, unspecified; Hyperglycaemia,
70 Thn 10 Bln unspecified √ √
53 21-11-2023 0021173 BPJS 0000758618414 TANI P KEPOH 004/002 65 Thn 10 Bln Senile cataract, unspecified √ √
54 21-11-2023 0031226 BPJS 0000758437457 3524242404470001 NUR MUSTHOFA L PENCARAN 002/005 Acute nasopharyngitis [common cold]; Hypertensive heart disease
55 21-11-2023 0005225 BPJS 0002162610527 SUMIRAN L KARANGANOM 002/004 34 Thn 11 Bln Senile cataract, unspecified √ √
56 22-11-2023 0035955 BPJS 0002938875671 3524247005540001 KASTI P SAMBO 002/003 69 Thn 5 Bln Pterygium √ √
57 22-11-2023 0007971 BPJS 0000758762504 3524244206650001 NDOKNA P SAMBO 001/003 58 Thn 5 Bln Senile cataract, unspecified √ √
58 22-11-2023 0036152 BPJS 0000759794591 3524246112580001 SUMIATUN P SAMBOPINGGIR 64 Thn 11 Bln Senile cataract, unspecified √ √
59 22-11-2023 0026847 BPJS 0000759763113 3524240805540001 M. NAÌM L SAMBO 69 Thn 6 Bln Senile cataract, unspecified √ √
60 22-11-2023 0039825 BPJS 0000758575991 3524245508610002 NINGSIH P SAMBO 002/003 62 Thn 3 Bln Senile cataract, unspecified √ √
61 22-11-2023 0000737 BPJS 0000788682216 3524242002580001 MOCH. NADJIB L MONOLELO 002/002 65 Thn 9 Bln Atherosclerotic cardiovascular disease, so described √ √
62 22-11-2023 0003444 BPJS 0000758377967 3524240808550001 MALIKAN L SUKLEN 001/004 Hypertensive heart disease without (congestive) heart failure; Senile
63 22-11-2023 0019665 BPJS 0000758378957 3524244101600048 MAIMONAH P SUKLEN 001/004 63 Thn 10 Bln Caries of dentine √ √
64 22-11-2023 0040108 BPJS 0003554888275 3524244201560001 KANAH P MAGOK 001/001
67 Thn 10 Bln Lumbar and other intervertebral disc disorders with myelopathy √ √
65 22-11-2023 0012188 BPJS 0000758693259 3524244407550002 KASTIYAH P WEDENG 002/001 68 Thn 4 Bln Cerebral infarction, unspecified √ √
66 22-11-2023 0033446 BPJS 0001047286383 3524240201540003 KARMIN L MENGAI 002/006 69 Thn 10 Bln √ √
67 22-11-2023 0015034 BPJS 0000758727382 3524244107590003 UMAROH P KARANGANOM WETAN 007/004 Hyperglycaemia, unspecified; Hypertensive heart disease without
68 22-11-2023 0017115 BPJS 0002746405642 SUPIYAH P SAMBO 002/003 67 Thn 1 Bln Presence of intraocular lens √ √
69 23-11-2023 0013177 UMUM 3524244201540006 ASTIKAH P BONSARI 002/004 Hypertensive heart disease with (congestive) heart failure; Other
69 Thn 10 Bln gastritis √ √
70 23-11-2023 0015093 BPJS 0000758692495 MUKNI P WARUK 61 Thn 2 Bln Essential (primary) hypertension √ √
71 23-11-2023 0024414 BPJS 0000758141864 3524241111560001 ABU THOLIB L WARUK 003/001 67 Thn 0 Bln Essential (primary) hypertension √ √
72 23-11-2023 0014929 BPJS 0000758609335 3524245204340002 NURYANAH P KARANGANOM 89 Thn 7 Bln Essential (primary) hypertension √ √
73 23-11-2023 0023218 BPJS 0000759011185 3524245903550001 RUPINAH P KARANGANOM KULON 68 Thn 8 Bln Essential (primary) hypertension √ √
74 23-11-2023 0015073 BPJS 0001047287024 3524244908600001 NURIKA P WARUK 63 Thn 3 Bln Essential (primary) hypertension √ √
75 23-11-2023 0011916 BPJS 0000760001488 3524244505490002 KASRI P WINDU 74 Thn 6 Bln Essential (primary) hypertension √ √
76 23-11-2023 0033880 BPJS 0000759311109 YAHYA L WEDENG SUKOREJO 64 Thn 11 Bln Essential (primary) hypertension √ √
77 23-11-2023 0030591 BPJS 0001829062451 MUSLIMAH P GAYAM 61 Thn 0 Bln Essential (primary) hypertension √ √
78 23-11-2023 0031160 BPJS 0000758992353 3524242911550001 ABDUL MUHID L WEDENG 67 Thn 11 Bln Essential (primary) hypertension √ √
79 23-11-2023 0030560 BPJS 0002903557735 3524241611500001 MAT HARI L WEDENG 001/002 73 Thn 0 Bln Essential (primary) hypertension √ √
80 23-11-2023 0034377 BPJS 0001262805985 3524244909560001 HJ. SALAMAH P MENGAI 001/006 67 Thn 2 Bln Essential (primary) hypertension √ √
81 23-11-2023 0025952 BPJS 0000758718562 3524240709500001 MATASIM L WEDENG 73 Thn 2 Bln Essential (primary) hypertension √ √
82 23-11-2023 0018746 BPJS 0000759368002 3524240101510040 ZAINI L ALASMALANG 72 Thn 10 Bln Essential (primary) hypertension √ √
83 23-11-2023 0030642 BPJS 0000758532576 YATIMAH P ALASMALANG 68 Thn 10 Bln Essential (primary) hypertension √ √
84 23-11-2023 0028631 BPJS 0000758580232 3524246708550001 SUMIYATI P ALAS MALANG 68 Thn 2 Bln Essential (primary) hypertension √ √
85 23-11-2023 0008324 BPJS 0002874881035 3524240101610045 SAKIR L TERBIS 002/003 62 Thn 10 Bln Essential (primary) hypertension √ √
86 23-11-2023 0005300 BPJS 0002735855166 3524241207770003 SUHAJI L LUWUK 46 Thn 4 Bln Essential (primary) hypertension √ √
87 23-11-2023 0030026 BPJS 0002893621386 3524240804700004 MOH. TAUHID L MAYONG KULON 001/001 53 Thn 7 Bln Essential (primary) hypertension √ √
88 23-11-2023 0008712 BPJS 0000758403549 3524240401560001 SADIK L BR. KADU 67 Thn 10 Bln Essential (primary) hypertension √ √
89 23-11-2023 0010772 BPJS 0002926601109 3524244101560015 WIDARTI P BAKALAN 002/002 67 Thn 10 Bln Essential (primary) hypertension √ √
90 23-11-2023 0034335 BPJS 0000759698414 3524244101550015 SITI ANAH P BAKALAN RT 01 RW03 68 Thn 10 Bln Essential (primary) hypertension √ √
91 23-11-2023 0022257 BPJS 0000759753988 3524240101590016 TASLIKAN L BAKALAN RT 01 RW 01 64 Thn 10 Bln Essential (primary) hypertension √ √
92 23-11-2023 0034338 BPJS 0002769360939 3524243007590001 KASMOLAN L BAKALAN RT 02 RW 03 64 Thn 3 Bln Essential (primary) hypertension √ √
93 23-11-2023 0031354 BPJS 0000759678603 3524244101560012 MULIASIH P BAKALAN 67 Thn 10 Bln Essential (primary) hypertension √ √
94 23-11-2023 0023449 BPJS 0000759720407 3524244101480009 SARKAMAH P BAKALAN 75 Thn 10 Bln Essential (primary) hypertension √ √
95 23-11-2023 0022553 BPJS 0000759034743 3524244101610008 SRIAMAH P SOMOITO 62 Thn 10 Bln Essential (primary) hypertension √ √
96 23-11-2023 0031348 BPJS 0000759009677 3524244101380063 KASTIAH P BAKALAN 85 Thn 10 Bln Essential (primary) hypertension √ √
97 23-11-2023 0031335 BPJS 0002073701643 3524244101420009 KASTINAH P BAKALAN 81 Thn 10 Bln Essential (primary) hypertension √ √
98 23-11-2023 0031347 BPJS 0002734828593 3524244101590013 KARSITI P BAKALAN 64 Thn 10 Bln Essential (primary) hypertension √ √
99 23-11-2023 0017358 BPJS 0000759711521 3524244201590007 SUWARNI P BAKALAN 64 Thn 10 Bln Essential (primary) hypertension √ √
100 23-11-2023 0020555 BPJS 0000759007563 3524244101300014 SARMIDAH P SOMOITO 93 Thn 10 Bln Essential (primary) hypertension √ √
101 23-11-2023 0024090 BPJS 0000759026777 3524244101590012 JUMAÌYAH P BAKALAN 64 Thn 10 Bln Essential (primary) hypertension √ √
102 23-11-2023 0007378 BPJS 0002162609706 3524245201600003 KASEMU P BAKALAN 001/001 63 Thn 10 Bln Essential (primary) hypertension √ √
103 23-11-2023 0035718 BPJS 0000759735011 SOMADI L WATANGAN 001/001 63 Thn 10 Bln Essential (primary) hypertension √ √
104 23-11-2023 0008220 BPJS 0003150081854 3524244201590003 MUTMAINAH P BAKALAN 64 Thn 10 Bln Essential (primary) hypertension √ √
105 23-11-2023 0031323 BPJS 0000758812239 3524244102590001 KUSWATI P BANDUT 64 Thn 9 Bln Essential (primary) hypertension √ √
106 23-11-2023 0031551 BPJS 0000758804433 3524244101540033 ROBI'AH P BOGOBABADAN 69 Thn 10 Bln Essential (primary) hypertension √ √
107 23-11-2023 0021476 BPJS 0000758730014 3524244101520070 ATEMAH P BADAN 001/002 71 Thn 10 Bln Essential (primary) hypertension √ √
108 23-11-2023 0021405 BPJS 0000757175545 3524244105560002 SAROH P BADAN 002/002 67 Thn 6 Bln Essential (primary) hypertension √ √
109 23-11-2023 0036149 BPJS 0000759177382 SUPARNO L ALASMALANG 03/02 63 Thn 2 Bln Essential (primary) hypertension √ √
110 23-11-2023 0020205 BPJS 0000758119544 3524244103510001 KARSI P WARUK RT 01/RW02 72 Thn 8 Bln Essential (primary) hypertension √ √
111 23-11-2023 0014109 BPJS 0000758378845 3524244101490016 JASMANI P BR.SIMAN 74 Thn 10 Bln Essential (primary) hypertension √ √
112 23-11-2023 0033272 BPJS 0002162610044 BAWON P KARANGANOM KULON 86 Thn 9 Bln Essential (primary) hypertension √ √
113 23-11-2023 0031562 BPJS 0000758593776 3524246008610001 MASNING P KARANGANOM KULON 62 Thn 3 Bln Essential (primary) hypertension √ √
114 23-11-2023 0037750 BPJS 0001704051865 SUTIKAH P KURO 62 Thn 1 Bln Essential (primary) hypertension √ √
115 23-11-2023 0001392 BPJS 0000103766905 IMAM L MONOLELO 001/002 78 Thn 3 Bln Essential (primary) hypertension √ √
116 23-11-2023 0011478 BPJS 0000758442879 3524244106450001 SARPILAH L NGAJARAN 78 Thn 5 Bln Essential (primary) hypertension √ √
117 23-11-2023 0031583 BPJS 0001079091595 UMI SUBCHA P KURO 68 Thn 10 Bln Essential (primary) hypertension √ √
118 23-11-2023 0021152 BPJS 0000759342936 3524244103550001 TUMU`NINAH P KURO 68 Thn 8 Bln Essential (primary) hypertension √ √
119 23-11-2023 0040114 BPJS 0002916381317 3524247006480002 TUKAH P PRIYOSO WETAN 001/001 75 Thn 4 Bln Senile cataract, unspecified √ √
120 23-11-2023 0020710 BPJS 0000759041684 3524240101500013 KUMARI L BAKALAN 73 Thn 10 Bln Essential (primary) hypertension √ √
121 23-11-2023 0035860 BPJS 0001047278439 3524241710570001 ALFAN EFENDI L MONOLELO 001/002 66 Thn 1 Bln Essential (primary) hypertension √ √
122 23-11-2023 0036544 BPJS 0000757445253 3524244101620081 SURIYAH P MONOLELO 002/002 61 Thn 10 Bln Essential (primary) hypertension √ √
123 23-11-2023 0023206 BPJS 0000757430943 3524242803610001 ALI ARIFIN L KARANGBINANGUN 62 Thn 7 Bln Essential (primary) hypertension √ √
124 23-11-2023 0031341 BPJS 0000759772528 3524240101480051 MARJUKI L BAKALAN 77 Thn 10 Bln Essential (primary) hypertension √ √
125 23-11-2023 0022306 BPJS 0000759720363 3524244607580001 KANAH P SOMOITO 65 Thn 4 Bln Essential (primary) hypertension √ √
126 23-11-2023 0015755 BPJS 0000758159998 JAWAHIR L WARUK 73 Thn 0 Bln Essential (primary) hypertension √ √
127 23-11-2023 0029446 BPJS 0000759025495 KATIMAN L WARUK 002/002 68 Thn 11 Bln Essential (primary) hypertension √ √
128 23-11-2023 0020210 BPJS 0000759026788 MARINTEN P WARUK RT02/RW02 63 Thn 0 Bln Essential (primary) hypertension √ √
129 23-11-2023 0025237 BPJS 0002265773466 3524247006490006 LASENI P WINDU 74 Thn 4 Bln Essential (primary) hypertension √ √
130 23-11-2023 0026509 BPJS 0000759477205 3524244101570049 SAMSIYAH P PRIYOSO WETAN 002/002 66 Thn 10 Bln Senile cataract, unspecified √ √
131 23-11-2023 0022874 BPJS 0001704050561 3624255006480002 KASENAH P WINDU 002/001 75 Thn 4 Bln Essential (primary) hypertension √ √
132 23-11-2023 0028373 BPJS 0000758690875 3524247006480010 SOMANI P WINDU 001/002 75 Thn 4 Bln Essential (primary) hypertension √ √
133 23-11-2023 0013723 BPJS 0000758884915 3524247006430001 NIMAH P WINDU 80 Thn 4 Bln Essential (primary) hypertension √ √
134 23-11-2023 0031909 BPJS 0002328236537 3524247006460007 MUDAH P NGIPIK 002/003 77 Thn 4 Bln Essential (primary) hypertension √ √
135 23-11-2023 0022197 BPJS 0002210213384 3524241709500002 SOLIKAN L WINDU 002/001 73 Thn 2 Bln Essential (primary) hypertension √ √
136 23-11-2023 0012879 BPJS 0001047282592 3524242601530001 MISKAN L BAKALAN 002/001 70 Thn 9 Bln Essential (primary) hypertension √ √
137 23-11-2023 0016705 BPJS 0000758126643 3524242306570001 ABD. MANAN L WARUK 002/002 66 Thn 5 Bln Essential (primary) hypertension √ √
138 23-11-2023 0008215 BPJS 0000103501732 3524246404610001 INAMAH P SAMBO 001/002 62 Thn 6 Bln Essential (primary) hypertension √ √
139 23-11-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 70 Thn 10 Bln Essential (primary) hypertension √ √
140 23-11-2023 0027703 BPJS 0001962819843 3524240504580001 IKHSAN L SAMBO 001/004 65 Thn 7 Bln Essential (primary) hypertension √ √
141 23-11-2023 0006228 BPJS 0002476580308 3524244102600003 SUMAIYAH P PRIYOSO WETAN 002/002 63 Thn 9 Bln Senile cataract, unspecified √ √
142 23-11-2023 0028642 BPJS 0001047281455 SAKUR L BONRINGIN 001/004 61 Thn 10 Bln Essential (primary) hypertension √ √
143 24-11-2023 0033006 BPJS 0000758570411 3524244101490013 SUPARTIYA P KURO 003/001 74 Thn 10 Bln Myalgia √ √
144 24-11-2023 0014720 BPJS 0000758709044 3524246810650001 SENI S. P LUNTAS SOMOWINANGUN 58 Thn 0 Bln Senile cataract, unspecified √ √
145 24-11-2023 0040127 BPJS 0003533296296 3524240101590057 SUEB L LUNTAS S 001/001 64 Thn 10 Bln Senile nuclear cataract √ √
146 24-11-2023 0039522 BPJS 0000760106799 3524245101650011 JANAH P LUNTAS S RT 02 RW 02 58 Thn 10 Bln Senile cataract, unspecified √ √
147 24-11-2023 0001361 BPJS 0000103767671 3524241503490001 NUR HADI L SAMBO 003/002 74 Thn 8 Bln Hypertensive heart disease with (congestive) heart failure √ √
148 24-11-2023 0011151 BPJS 0000758183242 3524244808570001 SUMAH P MAGOK 003/002 Insulin-dependent diabetes mellitus with peripheral circulatory
149 24-11-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004 69 Thn 4 Bln Other psoriasis √ √
150 24-11-2023 0002443 BPJS 0000759433004 3524244801600001 SUWARNI P BANJAREJO 63 Thn 10 Bln Abnormal glucose tolerance test √ √
151 24-11-2023 0040125 BPJS 0000759837036 3524240101550059 MULANI L BANJARANYAR 68 Thn 10 Bln Atopic dermatitis, unspecified √ √
152 24-11-2023 0011446 BPJS 0002615899487 3524244101580054 NAJIYAH P MAYONG WETAN 001/004 65 Thn 10 Bln Calculus of gallbladder with acute cholecystitis √ √
153 24-11-2023 0039115 BPJS 0002888734419 BOLAH L BLAWI 001/003 63 Thn 10 Bln Unspecified viral hepatitis without hepatic coma √ √
154 24-11-2023 0027607 BPJS 0000759293739 KALIMAH P KEPOH 005/002 64 Thn 4 Bln Diarrhoea and gastroenteritis of presumed infectious origin √ √
155 27-11-2023 0029808 BPJS 0001861880499 3524240101480014 IDRIS L BAKALAN 001/002 75 Thn 10 Bln Primary gonarthrosis, bilateral √ √
156 27-11-2023 0031466 UMUM 3524245608540001 MARMAH P BLAWI TENGAH 003/003 69 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √ √
157 27-11-2023 0001935 BPJS 0000103766984 3524244101550078 ISTIROCHA P BLAWI 002/002 68 Thn 10 Bln Bell's palsy √ √
158 28-11-2023 0039174 BPJS 0003214920339 3524245205620001 SUMANING P MAYONG 001/003 Non-insulin-dependent diabetes mellitus with ophthalmic
159 28-11-2023 0035777 BPJS 0002732692691 KASMONAH P SAMBO 002/003 64 Thn 5 Bln Hypertensive heart disease with (congestive) heart failure √ √
160 28-11-2023 0013483 BPJS 0000757269955 3524244104470003 KASTILAH P BADAN 002/002 Hypertensive heart disease without (congestive) heart failure; Senile
161 28-11-2023 0040152 BPJS 0003559837498 3524240809590005 KHOTIB L GUNDIK 001/004 64 Thn 2 Bln Counselling, unspecified √ √
162 28-11-2023 0026845 BPJS 0001867626674 3524247006620006 MUNANTI P PRIYOSO WETAN 002/001 61 Thn 4 Bln Hypertensive heart disease without (congestive) heart failure √ √
163 29-11-2023 0000764 BPJS 0000757520381 3524247112480003 NISWAROTIN P PALANGAN Insulin-dependent diabetes mellitus with peripheral circulatory
164 29-11-2023 0002749 BPJS 0000103767579 3524244101550062 SUKAENI P BANDUT 002/001 Insulin-dependent diabetes mellitus with peripheral circulatory
165 29-11-2023 0027344 BPJS 0002499393745 3524244101620054 MUDAÀTI P BLAWI UTARA 003/004 61 Thn 10 Bln Constipation √ √
166 29-11-2023 0011738 BPJS 0002488684645 3524244101540013 JANAH P PUPUK 002/003 69 Thn 10 Bln Spinal stenosis, lumbar region √ √
167 29-11-2023 0007216 BPJS 0000758406486 3524241906630001 NADI L KARANGAJI 003/003 60 Thn 5 Bln Essential (primary) hypertension; Myalgia √ √
168 29-11-2023 0040159 BPJS 0000759434422 3524241005510002 RAJI L BANJARANYAR 003/002 72 Thn 6 Bln Hyperplasia of prostate √ √
169 30-11-2023 0040166 BPJS 0002619935245 3524244501610004 NGATMINAH P TEMBOK 002/001 62 Thn 10 Bln Cardiomegaly √ √
170 01-11-2023 0012575 BPJS 0002244526716 3524241407550002 KHAMIM L WEDENG 002/003 68 Thn 3 Bln Conjunctivitis, unspecified √ √
172 01-11-2023 0017813 BPJS 0000759714772 3524245407630001 SUKARNI P KLECO 002/003 60 Thn 3 Bln Old myocardial infarction √ √
173 02-11-2023 0010502 BPJS 0000759496173 3524245707360001 KUMAIYAH P PUPUS 003/006 60 Thn 3 Bln Typhoid fever √ √
174 02-11-2023 0006062 BPJS 0002162612092 3524242005520001 CHOTIB L WINDU 001/001 71 Thn 5 Bln Presence of intraocular lens √ √
175 03-11-2023 0039965 BPJS 0000759839376 3524241001590001 SUWITO L PUPUK 001/003 64 Thn 9 Bln Typhoid fever √ √
176 03-11-2023 0015219 BPJS 0000758089629 3524244908610001 KARTINI P WARUK 62 Thn 2 Bln Calculus of kidney √ √
177 03-11-2023 0028202 BPJS 0002449099721 MUNJAROH L BONSARI 002/001 Chronic obstructive pulmonary disease with acute exacerbation,
178 03-11-2023 0023056 BPJS 0000758785522 3524246303510001 KARTI P PUTATREJO 002/003 72 Thn 7 Bln Hypertensive heart disease without (congestive) heart failure √ √
179 03-11-2023 0012881 BPJS 0001704047433 3524246605620001 SA;ADAH P WEDENG 001/003 Dyspepsia; Hypertensive heart disease without (congestive) heart
61 Thn 5 Bln failure √ √
180 06-11-2023 0012575 BPJS 0002244526716 3524241407550002 KHAMIM L WEDENG 002/003 68 Thn 3 Bln Arthritis, unspecified, unspecified site √ √
181 06-11-2023 0030839 BPJS 0000759235746 3524244101560046 JAENAH P ALASMALANG 67 Thn 10 Bln Hypertensive heart disease without (congestive) heart failure √ √
182 06-11-2023 0009870 BPJS 0000103486241 3524171710620001 ASIRIS L BAKALAN 61 Thn 0 Bln Hypertensive heart disease without (congestive) heart failure √ √
183 06-11-2023 0003651 BPJS 0000103498558 3524241501570002 H. HAFITH, DRS L BANDUT 002/001 66 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √ √
184 06-11-2023 0006213 BPJS 0002244527752 3524246508580002 SUKARNI P WEDENG 002/003 65 Thn 2 Bln Atherosclerotic heart disease; Hyperglycaemia, unspecified √ √
185 06-11-2023 0008945 BPJS 0002307147298 SAROPAH P BONSARI 002/004 69 Thn 10 Bln Other specified chronic obstructive pulmonary disease √ √
186 06-11-2023 0008116 BPJS 0000103695401 352424 MARKAMIN L SAMBO 70 Thn 7 Bln Cerebral infarction, unspecified √ √
187 06-11-2023 0039965 BPJS 0000759839376 3524241001590001 SUWITO L PUPUK 001/003 64 Thn 9 Bln Typhoid fever √ √
188 06-11-2023 0031514 BPJS 0002695514523 3524245404610001 KHOTIMAH P KLECO 001/003 62 Thn 6 Bln Disorders of accommodation √ √
189 06-11-2023 0024407 BPJS 0000759302324 3524244101470008 MUNIKAH P WATANGAN 001/001 76 Thn 10 Bln Surgical follow-up care, unspecified √ √
190 06-11-2023 0025375 BPJS 0002264014934 3524240405560002 ABD. MANAB L MENGAI 67 Thn 6 Bln Hypertensive heart disease without (congestive) heart failure √ √
192 07-11-2023 0018087 BPJS 0001047278709 3524245903630001 NISMU P ALANG-ALANG 60 Thn 7 Bln Hypertensive heart disease with (congestive) heart failure √ √
193 07-11-2023 0039412 BPJS 0000759493146 3524244711620001 HARTIK P PRIYOSO WETAN 001/001 61 Thn 0 Bln Senile cataract, unspecified √ √
194 07-11-2023 0024042 BPJS 0002419344145 3524241905550001 SYAFI'I L NGAJARAN 004/004 68 Thn 5 Bln Cerebral infarction due to thrombosis of precerebral arteries √ √
195 07-11-2023 0000502 BPJS 0000103766848 1208230112440001 MOH. MALIKAN L BLAWI 78 Thn 11 Bln Hyperglycaemia, unspecified; Parkinson's disease √ √
196 07-11-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001 60 Thn 10 Bln Hyperglycaemia, unspecified; Myalgia √ √
197 07-11-2023 0019925 BPJS 0000759514105 3524243006530004 SLAMET BUDIONO L MORO 001/003 70 Thn 4 Bln Acute upper respiratory infection, unspecified √ √
198 07-11-2023 0025718 BPJS 0003047668863 3524240201590009 SUWONDO L BANJARANYAR 001/003 64 Thn 10 Bln Acute upper respiratory infection, unspecified √ √
199 07-11-2023 0032060 BPJS 0002892403293 3524246505610001 MUYASRIAH P MAYONG TENGAH 002/003 62 Thn 5 Bln Tuberculosis of lung, confirmed by culture only √ √
200 07-11-2023 0000261 BPJS 0000103767118 KASMINAH P SAMBO 002/001 71 Thn 4 Bln Other specified intervertebral disc degeneration √ √
201 07-11-2023 0025800 BPJS 0001704054971 3524240903610001 ASERI L MAGOK 001/001 62 Thn 7 Bln Tuberculosis of lung, confirmed by culture only √ √
202 08-11-2023 0014049 BPJS 0003111118874 3524240701530001 MAHMUD L SIMAN 70 Thn 10 Bln Asthma, unspecified √ √
203 08-11-2023 0013269 BPJS 0001704092804 3524244704610001 SUMIATI P BONSARI 62 Thn 7 Bln Senile cataract, unspecified √ √
204 08-11-2023 0006545 BPJS 0000103593644 ABD. KHOLIQ L KARANGAJI 003/003 66 Thn 5 Bln Hyperglycaemia, unspecified √ √
205 08-11-2023 0006327 BPJS 0000103593655 SITI AMINAH P KARANGAJI 60 Thn 4 Bln Hypertensive heart disease without (congestive) heart failure √ √
206 08-11-2023 0024099 BPJS 0000759057017 3524240101630015 SEKAR L BAKALAN 001/001 60 Thn 10 Bln Atherosclerotic heart disease √ √
207 08-11-2023 0014488 BPJS 0003269834144 3524246103610002 HJ. MUSFIROH P GAYAM 005/003 62 Thn 7 Bln Arthritis, unspecified √ √
209 09-11-2023 0016165 BPJS 0000103767682 MUÀYANAH P SAMBO 65 Thn 7 Bln Chronic superficial gastritis √ √
210 09-11-2023 0039965 BPJS 0000759839376 3524241001590001 SUWITO L PUPUK 001/003 64 Thn 9 Bln Other gastritis √ √
211 09-11-2023 0020614 BPJS 0000758904478 3524240101620036 IKSAN L SUMBERJO 61 Thn 10 Bln Myalgia √ √
212 09-11-2023 0029928 BPJS 0002521214403 3524243006570002 NISKAN L SAMBO 002/002 66 Thn 4 Bln Myalgia √ √
213 09-11-2023 0023632 BPJS 0000758300657 3524241101570001 SELAMET L WATANGAN 002/002 66 Thn 9 Bln Hyperplasia of prostate √ √
214 09-11-2023 0027323 BPJS 0000759284717 3524244101530059 MUSOFAH P KURO 002/001 70 Thn 10 Bln Essential (primary) hypertension √ √
215 10-11-2023 0010997 BPJS 0000759248864 3524246101580001 PATRI P WATANGAN 65 Thn 9 Bln Acute upper respiratory infection, unspecified √ √
216 10-11-2023 0040037 BPJS 0002484390879 3524240101590071 MAT ZAINI L BLAWI 001/003 64 Thn 10 Bln Senile cataract, unspecified √ √
217 10-11-2023 0039946 BPJS 0000758373456 3524241809630001 MOLYONO AROSID L SIMAN 002/001 60 Thn 1 Bln Counselling, unspecified √ √
218 10-11-2023 0027607 BPJS 0000759293739 KALIMAH P KEPOH 005/002 Acute nasopharyngitis [common cold]; Hypertensive heart disease
219 10-11-2023 0005611 BPJS 0001704058053 3524247112610001 MISKANA L SAMBO 003/004 Dermatitis, unspecified; Hypertensive heart disease without
220 10-11-2023 0029915 BPJS 0002237697011 3524245802580001 SANAH P BOTOH 003/002 65 Thn 8 Bln Presence of intraocular lens √ √
221 10-11-2023 0007378 BPJS 0002162609706 3524245201600003 KASEMU P BAKALAN 001/001 63 Thn 9 Bln Hypertensive heart disease without (congestive) heart failure √ √
222 10-11-2023 0023056 BPJS 0000758785522 3524246303510001 KARTI P PUTATREJO 002/003 Hyperglycaemia, unspecified; Hypertensive heart disease without
223 10-11-2023 0038165 UMUM 3524244201490004 KASIH P KADU 002/002 74 Thn 10 Bln Dyspepsia √ √
63 Thn 5 Bln Insulin-dependent diabetes mellitus with unspecified complications √ √
225 10-11-2023 0006428 BPJS 0002257276443 3524244701500001 SITI AISYAH P PUTATREJO 002/003 Hyperlipidaemia, unspecified; Hypertensive heart disease without
226 10-11-2023 0034496 BPJS 0003143832963 3524240510580001 SALIM L TEMBOK 002/003 Hypertensive heart disease without (congestive) heart failure; Senile
227 13-11-2023 0018001 BPJS 0003503285752 3524241511560001 KHOZIN L WARUK 001/002 66 Thn 11 Bln Gastritis, unspecified √ √
228 13-11-2023 0017442 BPJS 0001897451829 3524243006550005 MISLAN L NGIPIK 003/003 68 Thn 4 Bln Stroke, not specified as haemorrhage or infarction √ √
230 13-11-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 Hyperglycaemia, unspecified; Hypertensive heart disease without
231 13-11-2023 0028458 BPJS 0002749091602 3524241403620001 NUR KHAMIM L MENGAI 002/006 61 Thn 7 Bln Surgical follow-up care, unspecified √ √
232 13-11-2023 0016645 BPJS 0003503285831 3524244101630012 AISYATUN P WARUK 001/002 60 Thn 10 Bln Erosive (osteo)arthrosis √ √
234 13-11-2023 0040037 BPJS 0002484390879 3524240101590071 MAT ZAINI L BLAWI 001/003 64 Thn 10 Bln Senile cataract, unspecified √ √
235 13-11-2023 0010376 BPJS 0000759820961 3524245203600001 KUMANI P WUNGU 001/001 63 Thn 8 Bln Hyperlipidaemia, unspecified √ √
236 13-11-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002 Hyperglycaemia, unspecified; Hypertensive heart disease without
237 13-11-2023 0006776 BPJS 0000758316262 3524240101470002 SUEP KARTOWIYONO L MAGOK 001/002 76 Thn 10 Bln Hyperglycaemia, unspecified √ √
238 13-11-2023 0024407 BPJS 0000759302324 3524244101470008 MUNIKAH P WATANGAN 001/001 Hypertensive heart disease without (congestive) heart failure; Surgical
76 Thn 10 Bln follow-up care, unspecified √ √
239 14-11-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001 60 Thn 10 Bln Hyperglycaemia, unspecified; Myalgia √ √
240 14-11-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004 69 Thn 4 Bln Other gastritis √ √
241 14-11-2023 0000737 BPJS 0000788682216 3524242002580001 MOCH. NADJIB L MONOLELO 002/002 65 Thn 8 Bln Atherosclerotic cardiovascular disease, so described √ √
242 14-11-2023 0034496 BPJS 0003143832963 3524240510580001 SALIM L TEMBOK 002/003 65 Thn 1 Bln Senile cataract, unspecified √ √
243 14-11-2023 0022188 BPJS 0000758841546 3524240207550001 ABD MAJID L BADAN 002/002 70 Thn 9 Bln Primary generalized (osteo)arthrosis √ √
244 14-11-2023 0001718 BPJS 0001837480904 3524241506450001 SAEKAN L KEBONSARI 002/003 78 Thn 4 Bln Perforation of intestine (nontraumatic) √ √
245 14-11-2023 0024219 BPJS 0000759030568 3524245407590002 MARIA P KR ANOM KULON 002/001 64 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √ √
246 14-11-2023 0022978 BPJS 0003012186464 3524247004560001 ARUMI P KARANGANOM 002/001 67 Thn 6 Bln Hypertensive heart disease with (congestive) heart failure √ √
247 14-11-2023 0014921 BPJS 0000758600537 3524244802580001 SUMI P KARANGANOM WETAN 65 Thn 9 Bln Hypertensive heart disease with (congestive) heart failure √ √
248 14-11-2023 0033929 BPJS 0000757728797 3524244803520002 MALIKA P KARANGANOM WETAN 71 Thn 8 Bln Hypertensive heart disease with (congestive) heart failure √ √
249 14-11-2023 0013095 BPJS 0003055242069 3524245208480001 SUMILAH P KEBONSARI 001/004 75 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √ √
250 14-11-2023 0039965 BPJS 0000759839376 3524241001590001 SUWITO L PUPUK 001/003 64 Thn 10 Bln Diarrhoea and gastroenteritis of presumed infectious origin √ √
251 14-11-2023 0037202 BPJS 0000759163959 3524245206530002 SAMINTEN P SINAN 003/003 Hyperglycaemia, unspecified; Hypertensive heart disease with
252 14-11-2023 0036482 BPJS 0001905647668 3524241711520001 UMAR L BATURONO 003/002 70 Thn 11 Bln Myalgia √ √
253 14-11-2023 0036174 BPJS 0000103766635 3524244811520001 RUFIÀH P NGAJARAN 001/003 71 Thn 0 Bln Acute upper respiratory infection, unspecified √ √
254 14-11-2023 0008324 BPJS 0002874881035 3524240101610045 SAKIR L TERBIS 002/003 62 Thn 10 Bln Chronic ischaemic heart disease, unspecified √ √
255 14-11-2023 0004603 BPJS 0000759319176 3524240101610019 CHOIRUN L KURO 002/001 Conjunctivitis, unspecified; Hypertensive heart disease with
256 14-11-2023 0000749 BPJS 0002463473891 3524244101590082 JAROKAH P PULOKERTO 002/001 64 Thn 10 Bln Glaucoma, unspecified √ √
257 14-11-2023 0040052 BPJS 0001704043326 3524241806530001 JASAK L BADAN 001/002 70 Thn 4 Bln Senile cataract, unspecified √ √
258 15-11-2023 0023056 BPJS 0000758785522 3524246303510001 KARTI P PUTATREJO 002/003 72 Thn 7 Bln Hypertensive heart disease with (congestive) heart failure √ √
259 15-11-2023 0007216 BPJS 0000758406486 3524241906630001 NADI L KARANGAJI 003/003
60 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure; Myalgia √ √
260 15-11-2023 0003491 BPJS 0000169662251 3517074106500001 SALIKHAH P KURO 003/001 73 Thn 10 Bln Old myocardial infarction √ √
261 15-11-2023 0017120 BPJS 0002091385787 SUTRIANI P MAYONG NGABLAK 001/002 63 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √ √
262 15-11-2023 0013177 UMUM 3524244201540006 ASTIKAH P BONSARI 002/004 69 Thn 10 Bln Acute upper respiratory infection, unspecified √ √
263 15-11-2023 0025070 BPJS 0001047275458 3524245505570001 MUNASIH P BOMBUNG 007/003 66 Thn 6 Bln Hypertensive heart disease with (congestive) heart failure √ √
264 16-11-2023 0028458 BPJS 0002749091602 3524241403620001 NUR KHAMIM L MENGAI 002/006 61 Thn 8 Bln √ √
265 17-11-2023 0011752 BPJS 0000759262959 3524245706600002 ANIFAH P BLAWI 002/002 63 Thn 5 Bln Counselling, unspecified √ √
266 17-11-2023 0005611 BPJS 0001704058053 3524247112610001 MISKANA L SAMBO 003/004 61 Thn 10 Bln Senile cataract, unspecified √ √
267 17-11-2023 0030438 BPJS 0000757525228 3524243006550001 NAKUWAN L SAMBO 001/003 68 Thn 5 Bln Senile cataract, unspecified √ √
268 17-11-2023 0025417 BPJS 0001704057996 3524245505550001 PAYATI P SAMBO 003/004 68 Thn 6 Bln Senile cataract, unspecified √ √
269 20-11-2023 0040070 BPJS 0003006388732 3524244201530005 HJ. KASTIÀH P BADAN 002/004 70 Thn 10 Bln Chronic tubotympanic suppurative otitis media √ √
270 20-11-2023 0006545 BPJS 0000103593644 ABD. KHOLIQ L KARANGAJI 003/003 66 Thn 5 Bln Myalgia √ √
271 20-11-2023 0009658 BPJS 0001704052192 3524241512610001 NALI L KEPOH 004/002 Atopic dermatitis, unspecified; Hypertensive heart disease with
272 20-11-2023 0001191 BPJS 0000758193219 3524244101560001 MARSANA P BONRINGIN 002/004 67 Thn 10 Bln Myalgia √ √
273 20-11-2023 0011752 BPJS 0000759262959 3524245706600002 ANIFAH P BLAWI 002/002 63 Thn 5 Bln Calculus of kidney √ √
274 20-11-2023 0015882 BPJS 0000757541373 3524246407560001 MUNAWAROH P SAMBO 67 Thn 4 Bln Calculus of gallbladder without cholecystitis √ √
275 20-11-2023 0016723 BPJS 0000759612194 3524244501590004 KHOSIAH P KARANGBINANGUN 64 Thn 10 Bln Atopic dermatitis, unspecified; Other gastritis √ √
276 20-11-2023 0023753 BPJS 0002245028398 3524242008540001 H.M.SARIF L PUTATREJO 001/003 69 Thn 3 Bln Presence of intraocular lens √ √
277 20-11-2023 0012258 BPJS 0000759875861 3524242803540001 MADARI L KURIPAN 69 Thn 7 Bln Glaucoma secondary to drugs √ √
278 20-11-2023 0027335 BPJS 0002441295112 3524240801580001 SUJONO L BULAK 001/001 65 Thn 10 Bln Malignant neoplasm of larynx, unspecified √ √
279 20-11-2023 0039962 BPJS 0003219227111 3524244101510004 SARIYEM P WATANGAN 003/001 72 Thn 10 Bln Other specified urinary incontinence √ √
280 20-11-2023 0010849 BPJS 0000758829082 3524242303540002 RATENO L LUNTAS S 001/002
282 20-11-2023 0013100 BPJS 0000759501009 3524245503600001 SUKARTI P LUNTAS B 003/007 Acute upper respiratory infection, unspecified; Hyperglycaemia,
283 20-11-2023 0018163 BPJS 0001047271623 ACHMAD DARODJI L SUKLEN 001/004 69 Thn 4 Bln Other acute gastritis √ √
284 20-11-2023 0007429 BPJS 0000758951065 3524244111560002 SUTRAMI P WEDENG 002/003 67 Thn 0 Bln Myalgia √ √
285 20-11-2023 0006327 BPJS 0000103593655 SITI AMINAH P KARANGAJI 60 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √ √
286 21-11-2023 0001334 BPJS 0000758916022 3524244405620002 SUMI P BONSARI Glaucoma in other diseases classified elsewhere; Presence of
61 Thn 6 Bln intraocular lens √ √
287 21-11-2023 0013820 BPJS 0002314477394 3524241406460002 MILKAN L PERIYOSO WETAN 001/002 77 Thn 5 Bln Congestive heart failure √ √
288 21-11-2023 0039991 BPJS 0003555851613 3524246305610001 YAMI P MAYONG NGABLAK 62 Thn 5 Bln Counselling, unspecified √ √
290 21-11-2023 0025087 BPJS 0000758473929 3524245811600002 ANI P KRANOM KULON 63 Thn 0 Bln Calculus of bile duct with cholecystitis √ √
291 21-11-2023 0022793 UMUM 3524244101560041 RUKHAYAH P KLAMPIS 67 Thn 10 Bln Dyspepsia √ √
292 21-11-2023 0019925 BPJS 0000759514105 3524243006530004 SLAMET BUDIONO L MORO 001/003 Chronic obstructive pulmonary disease with acute exacerbation,
293 21-11-2023 0024704 BPJS 0002744502322 3524240101540058 SUMADI L PUPUS 002/006 69 Thn 10 Bln Other chronic suppurative otitis media √ √
294 21-11-2023 0033854 UMUM 3524225003630003 MAS'AMAH P BAKALAN 002/003 60 Thn 8 Bln Dyspepsia √ √
295 21-11-2023 0040102 BPJS 0000758480872 3524242806590001 RUSDI L KARANGAJI 003/003 64 Thn 4 Bln Stroke, not specified as haemorrhage or infarction √ √
296 21-11-2023 0022838 BPJS 0001542056747 3524246207640001 SITI ROHMAH P BANDUT 002/001 59 Thn 3 Bln Counselling, unspecified √ √
297 22-11-2023 0011117 BPJS 0002913182559 NAWAWI L WARUK 002/001
298 22-11-2023 0027240 BPJS 0001704051066 3524247006550008 NENGYAH L NGIPIK 003/003 Hyperglycaemia, unspecified; Hypertensive heart disease without
299 22-11-2023 0033129 BPJS 0002876702477 SENEN GIMUN L NGIPIK 73 Thn 1 Bln Hyperglycaemia, unspecified √ √
300 22-11-2023 0026796 BPJS 0000759161439 3524245704520001 TONAH P SINAN 003/003 71 Thn 7 Bln Presence of intraocular lens √ √
301 22-11-2023 0039965 BPJS 0000759839376 3524241001590001 SUWITO L PUPUK 001/003 64 Thn 10 Bln Myalgia √ √
302 22-11-2023 0021351 BPJS 0001995146032 JUWARIATUN P WATANGAN 62 Thn 9 Bln Dermatitis, unspecified √ √
303 22-11-2023 0027214 BPJS 0002477487879 3524240101510019 PARIAJI L BANJARANYAR 001/002 72 Thn 10 Bln Benign neoplasm of prostate; Ileus, unspecified √ √
304 23-11-2023 0012241 BPJS 0000758957016 3524244908590001 NURIPAH P WEDENG Hyperglycaemia, unspecified; Hypertensive heart disease with
61 Thn 6 Bln Acute hepatitis B with delta-agent (coinfection) without hepatic coma √ √
306 23-11-2023 0001990 BPJS 0002741411812 3524240101570037 RASIM L KETAPANG 001/001 66 Thn 10 Bln Senile cataract, unspecified √ √
307 23-11-2023 0000324 BPJS 0000103501653 3524244205540001 TUMIYEM P KARANGBINANGUN 002/001 69 Thn 6 Bln Senile cataract, unspecified √ √
308 23-11-2023 0024607 BPJS 0002248407663 3524241202500001 H.SAMIJAN L MENGAI 001/ 005 73 Thn 9 Bln Hyperplasia of prostate √ √
309 23-11-2023 0016773 BPJS 0002255163142 3524240101590086 DURAHMAN L TERBIS 001/003 64 Thn 10 Bln Other gastritis √ √
311 24-11-2023 0011023 BPJS 0002162611337 RUKIN L LUNTAS S 002/002 67 Thn 10 Bln Senile cataract, unspecified √ √
312 24-11-2023 0021984 BPJS 0000760103919 3524246101570004 YATEMI P LUNTAS S 002/002 56 Thn 10 Bln Pterygium √ √
313 24-11-2023 0030801 BPJS 0002121510892 PATIYEM P LUNTAS S 001/002 66 Thn 10 Bln Senile cataract, unspecified √ √
314 24-11-2023 0004147 BPJS 0000760075716 3524245101620003 SAROFAH P LUNTAS 002/002 61 Thn 10 Bln Senile cataract, unspecified √ √
315 27-11-2023 0040133 BPJS 0002730960292 3524245708560001 KUNAYAH P BLAWI 003/003 67 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √ √
316 27-11-2023 0027775 BPJS 0001704044362 MUSRI'AH P BANDUT 002/001 69 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √ √
318 27-11-2023 0002817 BPJS 0000759941368 SENATRI P PRIYOSO WETAN 61 Thn 4 Bln Senile nuclear cataract √ √
319 27-11-2023 0029406 BPJS 0002763980436 CHODIROH P KARANGBINANGUN 003/001 70 Thn 10 Bln Senile cataract, unspecified √ √
320 27-11-2023 0036174 BPJS 0000103766635 3524244811520001 RUFIÀH P NGAJARAN 001/003 71 Thn 0 Bln Acute upper respiratory infection, unspecified √ √
321 27-11-2023 0035326 BPJS 0000759495328 3524244101520018 DARSIH P KETAPANG 002/002 71 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √ √
322 27-11-2023 0035969 BPJS 0000758682382 3524241212500003 SAMAN L MAYONG TENGAH 003/003 72 Thn 11 Bln Acute ischaemic heart disease, unspecified √ √
323 27-11-2023 0030008 BPJS 0002213117717 3524242903570001 SUEB L SAMBO 001/003 66 Thn 7 Bln Hypertensive heart disease with (congestive) heart failure √ √
324 27-11-2023 0023446 BPJS 0000103590437 3524241508560001 BUDI UTOMO L KURO 003/001 67 Thn 3 Bln Essential (primary) hypertension √ √
325 27-11-2023 0035860 BPJS 0001047278439 3524241710570001 ALFAN EFENDI L MONOLELO 001/002 66 Thn 1 Bln Acute upper respiratory infection, unspecified √ √
326 27-11-2023 0029915 BPJS 0002237697011 3524245802580001 SANAH P BOTOH 003/002
327 27-11-2023 0034764 BPJS 0003078780941 3524244201630007 ZULFAH P BLAWI UTARA 002/004 Insulin-dependent diabetes mellitus with peripheral circulatory
328 27-11-2023 0007480 BPJS 0000103767208 3524241505440001 MACHFUD L PUPUS 001/006 79 Thn 6 Bln Other forms of angina pectoris √ √
329 27-11-2023 0004480 BPJS 0001483865482 3524240207480001 SHODIKIN L WEDENG 002/002 75 Thn 4 Bln Primary generalized (osteo)arthrosis √ √
330 27-11-2023 0024218 BPJS 0000759362231 MOCH. ANWAR L WATANGAN 001/001
331 27-11-2023 0024214 BPJS 0000758973306 3524242007550001 NARIYO L MAGOK 001/002 68 Thn 4 Bln Hypertensive heart disease with (congestive) heart failure √ √
332 27-11-2023 0030348 BPJS 0000758669275 3524240101630016 SULAJI L WARUK 002/001 60 Thn 10 Bln Hyperglycaemia, unspecified √ √
333 27-11-2023 0027502 BPJS 0002162609919 3524240101570072 RUDI L BAKALAN 002/002 66 Thn 10 Bln Myalgia √ √
334 27-11-2023 0005611 BPJS 0001704058053 3524247112610001 MISKANA L SAMBO 003/004 61 Thn 10 Bln Atopic dermatitis, unspecified √ √
335 27-11-2023 0006312 BPJS 0000758830498 3524240108500002 KASNAN L KADU 002/002 73 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √ √
336 28-11-2023 0037031 BPJS 0000758619044 3524244501560003 ROKIBAH P WATES 001/002 67 Thn 10 Bln Acute upper respiratory infection, unspecified √ √
337 29-11-2023 0016390 BPJS 0001832105632 3524241708620005 H.AGUS SALIM, DRS. MM L BLAWI 001/002 61 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √ √
338 29-11-2023 0022783 BPJS 0000758824953 3524244201620007 SUNARTI P BANDUT 001/001 61 Thn 10 Bln Unstable angina √ √
339 29-11-2023 0006776 BPJS 0000758316262 3524240101470002 SUEP KARTOWIYONO L MAGOK 001/002 Insulin-dependent diabetes mellitus with peripheral circulatory
340 29-11-2023 0004152 BPJS 0000103501192 3524244610570001 SUMARTI, S.PD P BANJARANYAR 003/004 66 Thn 1 Bln Atrial fibrillation and flutter √ √
341 29-11-2023 0029531 BPJS 0000758322652 3524244101450061 KHOTIMAH P BLAWI UTARA 001/004 78 Thn 10 Bln Hypertensive heart disease with (congestive) heart failure √ √
342 29-11-2023 0029961 BPJS 0002764871673 3524244908590002 SYAFIÀH P MAYONG KULON 001/001 64 Thn 3 Bln Hypertensive heart disease with (congestive) heart failure √ √
344 30-11-2023 0006327 BPJS 0000103593655 SITI AMINAH P KARANGAJI 60 Thn 5 Bln Hypertensive heart disease with (congestive) heart failure √ √
345 30-11-2023 0006545 BPJS 0000103593644 ABD. KHOLIQ L KARANGAJI 003/003 66 Thn 6 Bln Myalgia √ √
346 30-11-2023 0035616 BPJS 0003101665138 3524244101630035 INDAHYATI P KAUMAN 001/002 60 Thn 10 Bln Hyperlipidaemia, unspecified √ √
347 30-11-2023 0003522 BPJS 0003101663788 3524240101600033 M ACHWAN L KAUMAN 001/002 63 Thn 10 Bln Myalgia √ √
348 30-11-2023 0029928 BPJS 0002521214403 3524243006570002 NISKAN L SAMBO 002/002 66 Thn 5 Bln Myalgia √ √
349 30-11-2023 0025066 BPJS 0001388131806 3524245104380001 KARSANI P BLAWI UTARA 001/004 85 Thn 7 Bln Hypertensive heart disease with (congestive) heart failure √ √
Pemeriks
Diagnosa aan
Terapi KIE
Medis penunjan
g
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √
√ √ √ √

Ceklist Kelengkapan Rekam Medsi Lansia 2023

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Ceklist Kelengkapan Rekam Medsi Lansia 2023

Uploaded by

Copyright:

Available Formats

CEKLIST KELENGKAPAN PENGISIAN REKAM MEDIS POLI LANSIA

1 02-01-2023 0001101 BPJS 0000103499482 SUKAERI,DRS L SAMBO 002/002

39 06-02-2023 0025453 BPJS 0002774533465 SUKATI P GUNDIK 001/004

Gastric ulcer, chronic without haemorrhage or perforation;

Acute conjunctivitis, unspecified; Hypertensive heart disease without

148 20-03-2023 0012143 BPJS 0000759291388 3524246505620001 RUMINAH P WEDENG 001/001

Hypertensive heart disease with (congestive) heart failure; Insulin-

1 03-04-2023 0014483 BPJS 0000758611563 3524246905590001 MAHMUDAH P GAYAM 006/003

Anaemia due to other disorders of glutathione metabolism;

1 02-05-2023 0020388 UMUM 3524244101570001

4 02-05-2023 0011151 BPJS 0000758183242 3524244808570001

7 02-05-2023 0003444 BPJS 0000758377967 3524240808550001

9 02-05-2023 0016645 BPJS 0003503285831 3524244101630012

12 02-05-2023 0005888 BPJS 0000758317037 3524245201570001

13 02-05-2023 0010014 BPJS 0000757393547 3524241309500001

15 02-05-2023 0018082 BPJS 0003176584773 3524245209590003

16 03-05-2023 0011981 BPJS 0002038243487 3524244101460025

19 03-05-2023 0000416 BPJS 0000103499886 3524240304630002

22 03-05-2023 0022963 UMUM 3524244105570003

26 04-05-2023 0008210 BPJS 0001464136839 3524245209530001

28 04-05-2023 0006411 BPJS 0003060943402 3524240101460010

30 04-05-2023 0031347 BPJS 0002734828593 3524244101590013

33 05-05-2023 0004152 BPJS 0000103501192 3524244610570001

35 05-05-2023 0004848 BPJS 0000103106518 3523245112620001

37 05-05-2023 0005882 BPJS 0001829059997 3524241010530001

47 08-05-2023 0011117 BPJS 0002913182559

48 08-05-2023 0027888 BPJS 0002896469177

50 08-05-2023 0036869 BPJS 0001535057739 3524241212610001

52 08-05-2023 0022677 BPJS 0000759011398 3524241008590001

53 08-05-2023 0033230 BPJS 0000758639619

58 08-05-2023 0008116 BPJS 0000103695401 352424

61 08-05-2023 0026346 BPJS 0002084233713 3524244103560001

64 08-05-2023 0000641 BPJS 0000103599821 3524241212480002

68 09-05-2023 0033774 BPJS 0000758644569

69 09-05-2023 0001935 BPJS 0000103766984 3524244101550078

71 09-05-2023 0037831 BPJS 0000759368125 3524247006620003

77 09-05-2023 0022188 BPJS 0000758841546 3524240207550001

80 10-05-2023 0035616 BPJS 0003101665138 3524244101630035

81 10-05-2023 0038684 UMUM 3524240407470001

82 10-05-2023 0038680 BPJS 0000757728797 3524244803520002

83 10-05-2023 0013638 BPJS 0002162613543 3524244101500050

84 10-05-2023 0010782 UMUM 3524244704560002

87 10-05-2023 0037339 BPJS 0003265273146 3524243012590004

89 11-05-2023 0033437 BPJS 0000790684176 3578153006520125

93 11-05-2023 0022783 BPJS 0000758824953 3524244201620007

96 11-05-2023 0008730 BPJS 0000758680964 3524247006580007

101 12-05-2023 0023446 BPJS 0000103590437 3524241508560001

102 12-05-2023 0038698 BPJS 0000759592721 3524240603570001

103 12-05-2023 0004848 BPJS 0000103106518 3523245112620001

105 15-05-2023 0012143 BPJS 0000759291388 3524246505620001

106 15-05-2023 0037988 BPJS 0003176756403 3524240204630002

110 15-05-2023 0024214 BPJS 0000758973306 3524242007550001

111 15-05-2023 0003491 BPJS 0000169662251 3517074106500001

119 16-05-2023 0033487 BPJS 0000758987357 3524245708300001

124 16-05-2023 0002336 BPJS 0000758749948 3524244404550001

128 16-05-2023 0000502 BPJS 0000103766848 1208230112440001

130 17-05-2023 0037238 BPJS 0003143832388 3524240108520003

131 17-05-2023 0022783 BPJS 0000758824953 3524244201620007

135 17-05-2023 0021460 BPJS 0002488312642

136 19-05-2023 0012143 BPJS 0000759291388 3524246505620001

137 19-05-2023 0028325 BPJS 0000759155253 3524245201530001

139 19-05-2023 0002159 BPJS 0000103500966 3524241103620001

141 19-05-2023 0013541 BPJS 0001386491905 3524245406500001

143 19-05-2023 0016596 BPJS 0000103501203 3524264702580001