No.

No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

TariffRS
TotalTarif ( INACBGS Selisih
Los
Rp 15,196,918.00 Rp 21,790,400.00 Rp 6,593,482.00
Rp 1,189,916.00 Rp 8,082,600.00 Rp 6,892,684.00
Rp 1,410,150.00 Rp 8,082,600.00 Rp 6,672,450.00
Rp 1,480,082.00 Rp 8,082,600.00 Rp 6,602,518.00
Rp 1,051,896.00 Rp 8,082,600.00 Rp 7,030,704.00
Rp 2,612,943.00 Rp 8,082,600.00 Rp 5,469,657.00
Rp 2,056,231.00 Rp 8,082,600.00 Rp 6,026,369.00
Rp 1,347,545.00 Rp 8,082,600.00 Rp 6,735,055.00
Rp 2,522,072.00 Rp 8,082,600.00 Rp 5,560,528.00
Rp 1,503,658.00 Rp 8,082,600.00 Rp 6,578,942.00
Rp
897,644.00 Rp 8,082,600.00 Rp 7,184,956.00
Rp 1,547,668.00 Rp 8,082,600.00 Rp 6,534,932.00
Rp 1,917,935.00 Rp 8,082,600.00 Rp 6,164,665.00
Rp 2,298,124.00 Rp 8,082,600.00 Rp 5,784,476.00
Rp 1,464,372.00 Rp 7,572,000.00 Rp 6,107,628.00
Rp 1,086,684.00 Rp 7,572,000.00 Rp 6,485,316.00
Rp 1,782,438.00 Rp 7,247,100.00 Rp 5,464,662.00
Rp 1,409,170.00 Rp 7,247,100.00 Rp 5,837,930.00
Rp 1,158,523.00 Rp 6,621,200.00 Rp 5,462,677.00
Rp
759,689.00 Rp 6,621,200.00 Rp 5,861,511.00
Rp 44,693,658.00 Rp 169,744,800.00 Rp 125,051,142.00

12
1
2
4
4
7
3
5
5
4
3
4
4
2
4
5
6
5
3
3

Dutama
K403
J189
J189
J180
J189
J180
J180
J180
J189
J180
J189
J180
J189
J189
I519
I519
I500
I500
A162
A162

D1
A419
E111
I64
A419
E46
A419
J969
E46
E46
K529
K30
A419
A419
A419
J189
I251
J189
J189
A419
A419

D2
J969
N179
I10

D3
R571
J459

D4

A09
R560
E46

E86

R560

A162

A09

A419
N179
K522
I500
A162
I219

R509

R633

E141

D5

D6

P1

P2
5300

A419

G049

Inacbg
4562 K-1-20-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
J-4-16-III
I-4-24-III
I-4-24-III
I-4-12-III
I-4-12-III
J-4-15-III
J-4-15-III

Deskripsi
PROSEDUR INTESTINAL KOMPLEKS (BERAT)
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
DIAGNOSIS SISTEM PEMBULUH DARAH LAIN-LAIN (BERAT)
DIAGNOSIS SISTEM PEMBULUH DARAH LAIN-LAIN (BERAT)
KEGAGALAN JANTUNG BERAT
KEGAGALAN JANTUNG BERAT
PERADANGAN DAN INFEKSI PERNAFASAN BERAT
PERADANGAN DAN INFEKSI PERNAFASAN BERAT

DPJP
dr. Vivien Maryam, Sp.PD
dr. Agung Wijayanto Sp.P
dr. Agung Wijayanto Sp.P
dr. Agung Wijayanto Sp.P
dr. Ilham Ahmadi, Sp.PD
dr. Dewi Darmawati, Sp.A
dr. Arfianti Chandra Dewi, SpA
dr. Dewi Darmawati, Sp.A
dr. Bondhan Prajati
dr. Meiriani Sari, SpA.
dr. Rinaldo Parulian, Sp.B
dr. Arfianti Chandra Dewi, SpA
dr meiriani sari Sp,A
dr. Meiriani Sari, SpA.
dr. Agung Wijayanto Sp.P
dr. Vivien Maryam, Sp.PD
Dr. Ugun Maryani
dr. Agung Wijayanto Sp.P
dr. Agung Wijayanto Sp.P
dr. Ilham Ahmadi, Sp.PD

No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Klsrawat
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3

Tarif RS
Total Tarif
Selisih
Los
Dutama
Rp 24,649,403.00 Rp 8,082,600.00 Rp (16,566,803.00)
29 J189
Rp 23,607,780.00 Rp 9,772,600.00 Rp (13,835,180.00)
17 E115
Rp 11,646,426.00 Rp 1,552,400.00 Rp (10,094,026.00)
3 J46
Rp 16,934,915.00 Rp 6,945,400.00 Rp (9,989,515.00)
16 E115
Rp 15,184,560.00 Rp 5,677,000.00 Rp (9,507,560.00)
11 K350
Rp 13,000,625.00 Rp 3,568,700.00 Rp (9,431,925.00)
15 A35
Rp 12,663,000.00 Rp 4,088,900.00 Rp (8,574,100.00)
10 A35
Rp 20,400,681.00 Rp 11,962,400.00 Rp (8,438,281.00)
15 E115
Rp 10,191,081.00 Rp 2,598,000.00 Rp (7,593,081.00)
17 G049
Rp 11,520,405.00 Rp 4,655,200.00 Rp (6,865,205.00)
6 O821
Rp 10,518,787.00 Rp 4,032,300.00 Rp (6,486,487.00)
9 K560
Rp 12,285,420.00 Rp 6,516,000.00 Rp (5,769,420.00)
38 K350
Rp 10,023,429.00 Rp 4,307,300.00 Rp (5,716,129.00)
18 Q249
Rp 11,756,220.00 Rp 6,116,900.00 Rp (5,639,320.00)
11 J90
Rp 9,493,979.00 Rp 4,088,900.00 Rp (5,405,079.00)
14 A199
Rp 13,459,690.00 Rp 8,082,600.00 Rp (5,377,090.00)
17 J180
Rp 10,967,015.00 Rp 5,677,000.00 Rp (5,290,015.00)
6 K350
Rp 10,888,170.00 Rp 5,677,000.00 Rp (5,211,170.00)
7 K350
Rp 8,071,035.00 Rp 2,960,500.00 Rp (5,110,535.00)
13 P071
Rp 13,993,982.00 Rp 8,976,000.00 Rp (5,017,982.00)
4 O009

D1
A493
N189
J40
D649
R13
I10
D649
S223
O998
A419
D728
J180
K746
A010
A419

P599
D649

D2
Q315
D649

I64
E880
A09
S3281

D3
R568
E806

D4
A419

D5

D6

D7

D8

P1

P2
8401

864

863
4709

8609
5419

8412

863

Z370

741

K930

A91

D649

K291

E880

R571

4709

3491

5411
5411
R571

9904

N179

5411
A183
J969
Q909

P3

664

4709
4709

9904

Inacbg
J-4-16-III
M-1-50-II
J-4-18-I
L-1-40-II
K-1-40-I
A-4-14-II
A-4-14-III
M-1-02-II
G-4-19-I
O-6-10-III
K-4-15-III
K-1-40-II
I-4-19-III
J-4-20-III
A-4-14-III
J-4-16-III
K-1-40-I
K-1-40-I
P-8-12-I
W-1-20-III

Deskripsi
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
PROSEDUR JARINGAN LUNAK SEDANG
ASTHMA & BRONKIOLITIS RINGAN
PROSEDUR PADA KULIT, JARINGAN BAWAH KULIT DAN PAYUDARA SEDANG
PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN SEDANG
PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN BERAT
PROSEDUR AMPUTASI SEDANG
INFEKSI NON BAKTERI SISTEM PERSARAFAN (TIDAK TERMASUK MENINGITIS VIRUS) RINGAN
PROSEDUR OPERASI PEMBEDAHAN CAESAR BERAT
OBSTRUKSI SALURAN GASTROINTESTINAL BERAT
PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (SEDANG)
GANGGUAN KONDUKSI & ARITMIA JANTUNG BERAT
PLEURAL EFUSI DAN PNEUMOTORAK BERAT
PENYAKIT INFEKSI BAKTERI DAN PARASIT LAIN-LAIN BERAT
SIMPLE PNEUMONIA & WHOOPING COUGH BERAT
PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
PROSEDUR SISTEM PENCERNAAN LAIN-LAIN (RINGAN)
NEONATAL, BBL GROUP-3 TANPA PROSEDUR MAYOR RINGAN
PROSEDUR PADA RAHIM & ADNEKSA BERAT

DPJP
dr. Meiriani Sari, SpA.
dr. Oktavian Irawadi, Sp.BO
dr. Agung Wijayanto Sp.P
dr. Rinaldo Parulian, Sp.B
dr. Adimas Tjindarbumi, Sp. B
dr. Rinaldo Parulian, Sp.B
dr. Ilham Ahmadi, Sp.PD
dr. Oktavian Irawadi, Sp.BO
dr. Dewi Darmawati, Sp.A
dr. Arif Sulistyo, Sp.OG
dr. Arfianti Chandra Dewi, SpA
dr. Adimas Tjindarbumi, Sp. B
dr. Dewi Darmawati, Sp.A
dr. Agung Wijayanto Sp.P
dr. Agung Wijayanto Sp.P
dr. Meiriani Sari, SpA.
dr. Adimas Tjindarbumi, Sp. B
dr. Adimas Tjindarbumi, Sp. B
Dr. Ugun Maryani
dr. Yohanes Fredi Tama, Sp.Og

Rangking
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

Dutama
A91
A09
J180
P034
O828
J189
A010
A162
O821
P599
P211
K30
I639
A279
K922
P071
O020
I500
B349
A150

Jumlah Kasus
105
52
47
30
23
22
21
15
14
11
11
10
10
10
8
6
5
5
5
5

Keterangan
DHF
DIARE
Broncho Pneumonia
Bayi Lahir SC
Persalinan SC
Pneumonia
Typoid
TB Paru
SC Emergency
bayi ikterik
asphiksi ringan
Dyspepsia
stroke non hemoragic
leptospirosis
gastrointestinal bleeding
bblr
abortus imminen
CHF
Viral Infection
tb Paru bta positif