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DIAGNOSA
O
1. Bronchopneumonia, unspecified
KODE
ICD
J.18./J.1
3
J44.9
KLS I
KLS II
KLS III
4.922.600,00
4.219.400,00
3.397.900,00
2.912.200,00
2.909.000,00
2.493.500,00
N20.0/N
23
N30.0
2.196.400,00
1.882.600,00
5. Typhoid fever
A01.0
3.930.600,00
3.368.700,00
6. Dispepsia
K30
3.937.800,00
3.375.000,00
A91
2.752.600,00
2.359.400,00
8. Fever, unspecified
R50.9
2.205.500,00
1.890.400,00
B34.9
2.752.600,00
2.359.400,00
Headache
10.
11.Secondary hypertension,
R51
2.202.700,00
1.888.000,00
6.113.700,00
5.240.300,00
3.516.500,0
0
2.426.800,0
0
2.078.100,0
0
1.568.900,0
0
2.807.300,0
0
2.812.700,0
0
1.966.100,0
0
1.575.500,0
0
1.966.100,0
0
1.573.500,0
0
4.367.400,0
0
unspecified I15.9
Non-insulin-dependent diabetes
mellitus with renal
+
complications E11
or (Noninsulin-dependent diabetes mellitus
dr. MIRNAWATI
KET.
4.509.800,00
3.865.900,0
0
3.221.300,0
0
4.509.800,0
0
3.865.900,00
3.221.300,0
0
13.
Hypertensive heart disease with
5.402.400,00
4.630.400,00
4.501.900,0
0
4.509.800,00
3.865.900,00
3.221.300,0
0
4.509.800,00
3.865.900,00
3.221.300,0
0
6.113.700,00
5.240.300,00
4.367.400,0
0
4.509.800,00
3.865.900,0
0
3.221.300,0
0
2.752.500,00
2.359.300,00
1.965.900,0
unspecified I15.9
+ Non-insulin-dependent diabetes
mellitus without
12.complications E11.9
Hypertensive heart disease without
(congestive) heart failure I11.9
16.hypertension I10
Essential (primary)
hypertension I10 Transient cerebral
ischaemic attack,
17.unspecified G45.9
Essential (primary)
hypertension I10
+ Non-insulindependent diabetes mellitus
18.without complications E11.9
19.Non-insulin-dependent diabetes
dr. MIRNAWATI
2.752.500,00
2.359.300,00
1.965.900,0
0
5.908.600,00
5.064.000,00
4.220.400,0
0
4.922.600,0
0
4.219.400,00
3.516.500,0
0
5.908.600,0
0
5.064.000,00
4.220.400,0
0
5.908.600,0
0
5.064.000,00
4.220.400,0
0
9.380.300,00
8.040.200,0
0
6.699.500,0
0
dr. MIRNAWATI
histologically A15.7 +
Bronchopneumonia,
unspecified J18.0
Primary respiratory tuberculosis,
confirmed bacteriologically and
26.histologically A15.7
Insulin-dependent diabetes mellitus
with peripheral circulatory
complications E10.5 OR
Non-insulin-dependent diabetes
mellitus with peripheral circulatory
27.complications E11.5
Non-insulin-dependent diabetes
mellitus with peripheral circulatory
5.908.600,00
5.064.000,0
0
4.220.400,0
0
4.397.800,00
3.769.500,00
3.141.300,
00
6.303.000,0
0
5.402.000,00
4.501.700,
00
5.950.700,00
5.100.600,00
4.250.100,0
0
4.394.300,00
3.766.500,00
3.138.500,0
0
complications E11.5
Gangrene, not elsewhere
28.classified R02
Malignant neoplasm of liver,
unspecified C22.9 Chronic
obstructive pulmonary disease,
unspecified J44.9 Hypertensive
heart disease without (congestive)
29.heart failure I11.9
30.Non-insulin-dependent diabetes
mellitus with renal
dr. MIRNAWATI
complications E11.2
Urinary tract infection, site not
specified N39.0
Essential (primary)
hypertension I10
6.113.700,00
5.240.300,0
0
4.367.400,0
0
3.970.000,00
3.402.800,00
2.835.400,0
0
5.950.700,00
5.100.600,00
4.250.100,0
0
6.125.300,0
0
5.250.800,00
4.375.200,0
0
2.962.100,00
2.539.200,00
2.116.000,0
0
8.935.000,00
7.658.600,00
6.382.200,0
goitre E05.0
35.OR WITH HT
36.Senile cataract, unspecified H25.9
dr. MIRNAWATI
0
4.069.700,0
0
5.698.100,00
4.883.600,00
37.unspecified O33.9
Delivery by emergency caesarean
5.698.100,00
4.883.600,00
38.section O82.1
Delivery by emergency caesarean
4.069.700,0
0
6.287.900,00
5.389.600,00
4.491.300,0
0
39.membranes O75.6
Single spontaneous delivery,
2.852.700,00
2.445.200,00
40.unspecified O80.9
Pneumonia,
2.037.600,0
0
6.917.600,00
5.929.400,00
4.941.600,0
0
41.unspecified J44.9
Dyspepsia K30 Urinary tract
5.906.700,00
5.062.300,00
4.218.600,0
0
4.947.100,00
4.240.400,00
3.533.600,0
0
dr. MIRNAWATI
1.880.600,00
5.425.500,00
4.650.000,00
3.875.400,00
Non-insulin-dependent diabetes
mellitus with peripheral circulatory
4.397.800,00
3.769.500,00
3.141.300,00
10.312.900,00
8.839.600,00
7.365.600,00
2.860.800,00
2.452.000,00
2.383.700,00
3.871.200,00
3.317.900,00
2.765.200,00
46.complications E11.5
OPERASI Non-insulin-dependent
diabetes mellitus with peripheral
curettage 69.09
49.mole O02.0
50.unspecified I21.9
Delivery by emergency caesarean
6.287.900,00
5.389.600,00
4.491.300,00
3.397.900,00
2.912.200,00
2.426.800,00
8.935.000,00
7.658.600,00
6.382.200,00
2.939.800,00
2.520.100,00
2.099.900,00
51.surgery O34.2
Chronic obstructive pulmonary
53.tissue S05.2/H21.8
Other specified arthritis, unspecified
54.site M13.89
dr. MIRNAWATI
3.296.100,00
55.
Diarrhoea and gastroenteritis of
presumed infectious
dr. MIRNAWATI
2.860.800,00
2.452.000,00
2.383.700,00