PERATURAN MENTERI KESEHATAN REPUBLIK INDONESIA

NOMOR 5 TAHUN 2014

TENTANG
PANDUAN PRAKTIK KLINIS BAGI DOKTER DI FASILITAS PELAYANAN
KESEHATAN PRIMER
Dokter akan merujuk pasien apabila memenuhi salah satu dari kriteria
TACC (Time-Age-Complication-Comorbidity) berikut:
Time : jika perjalanan penyakit dapat digolongkan kepada
kondisi kronis atau melewati Golden Time Standard.
Age : jika usia pasien masuk dalam kategori yang
dikhawatirkan meningkatkan risiko komplikasi serta
risiko kondisi penyakit lebih berat.
Complication : jika komplikasi yang ditemui dapat memperberat kondisi
pasien.
Comorbidity : jika terdapat keluhan atau gejala penyakit lain yang
memperberat kondisi pasien.
Selain empat kriteria di atas, kondisi fasilitas pelayanan juga dapat menjadi
dasar bagi dokter untuk melakukan rujukan demi menjamin
keberlangsungan penatalaksanaan dengan persetujuan pasien.

NO

NMKC

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Faskes_I
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
ALAK
BAKUNASE
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BAKUNASE
BAKUNASE
BAKUNASE
BAKUNASE
BAKUNASE
BAKUNASE
BAKUNASE
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BAKUNASE
BAKUNASE
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BAKUNASE
BAKUNASE
BAKUNASE
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NMPPK

KDPPK

RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RS AL Lanta0351R008
RSU LEONA0351R012
RSUD PROF2413R001
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RST WIRASA2413R002
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RSU LEONA0351R012
RSUD PROF2413R001

NOREG

NOSJP

2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0716 0351R0080
2401P0816 0351R0120
2401P0816 2413R0010
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
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2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 2413R0020
2401P0716 2413R0030
2401P0716 2413R0030
2401P0816 0351R0120
2401P0816 2413R0010

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BAKUNASE
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
KOTA KUPA
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEBOBO
OEPOI
OEPOI
OEPOI
OEPOI
OEPOI

RSUD PROF2413R001
RSUD PROF2413R001
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RS BHAYAN 2413R003
RSU LEONA0351R012
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RST WIRASA2413R002
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RS_KARTINI 0351R009
RS_KARTINI 0351R009

2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 2413R0030
2401P0816 0351R0120
2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
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2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 2413R0020
2401P0716 2413R0030
2401P0716 2413R0030
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0716 0351R0090
2401P0716 0351R0090

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OEPOI
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OEPOI
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OEPOI
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OEPOI
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OEPOI
OEPOI
OEPOI
OEPOI
OEPOI
OEPOI
OEPOI
OEPOI
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA

RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RS BHAYAN 2413R003
RSIA DEDAR2413R006
RSIA DEDAR2413R006
RSIA DEDAR2413R006
RSIA DEDAR2413R006
RSIA DEDAR2413R006
RSIA DEDAR2413R006
RSIA DEDAR2413R006
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSUD PROF2413R001
RSUD PROF2413R001
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009

2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 2413R0030
2401P0716 2413R0060
2401P0716 2413R0060
2401P0716 2413R0060
2401P0716 2413R0060
2401P0716 2413R0060
2401P0716 2413R0060
2401P0716 2413R0060
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
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2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090

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OESAPA
OESAPA
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OESAPA
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OESAPA
OESAPA
OESAPA
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OESAPA
OESAPA
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OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
OESAPA
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
PASIR PANJ
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA

RS_KARTINI 0351R009
RSUD PROF2413R001
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RSIA DEDAR2413R006
RSIA DEDAR2413R006
RSIA DEDAR2413R006
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSUD PROF2413R001
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RS BHAYAN 2413R003
RSUD NAIB 0244R001
RSU LEONA0351R012
RSU LEONA0351R012
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001

2401P0716 0351R0090
2401P0816 2413R0010
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0060
2401P0716 2413R0060
2401P0716 2413R0060
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 2413R0010
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 2413R0030
2401P0716 0244R0010
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010

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SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA
SIKUMANA

RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RS_KARTINI 0351R009
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001
RST WIRASA2413R002
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RS BHAYAN 2413R003
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSU LEONA0351R012
RSUD PROF2413R001
RSUD PROF2413R001
RSUD PROF2413R001

2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0716 0351R0090
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010
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2401P0716 2413R0020
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0716 2413R0030
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
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2401P0816 0351R0120
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2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 0351R0120
2401P0816 2413R0010
2401P0816 2413R0010
2401P0816 2413R0010

TGLSJP
6/15/2016
6/27/2016
6/2/2016
6/15/2016
6/22/2016
6/2/2016
6/14/2016
6/13/2016
6/16/2016
6/29/2016
6/2/2016
6/3/2016
6/6/2016
6/7/2016
6/10/2016
6/13/2016
6/17/2016
6/22/2016
6/22/2016
6/27/2016
6/28/2016
6/13/2016
6/15/2016
6/16/2016
6/1/2016
6/9/2016
6/13/2016
6/21/2016
6/8/2016
6/22/2016
6/23/2016
6/8/2016
6/11/2016
6/14/2016
6/15/2016
6/18/2016
6/23/2016
6/14/2016
6/28/2016
6/17/2016
6/14/2016
6/25/2016
6/3/2016
6/15/2016
6/28/2016
6/30/2016

NoKAPst

NMPST

TGLLHRPST

0:00 000014702PAULINA UL
3/15/1958
0:00 000015010FERYANA B
2/17/1965
0:00 000014696SEPTRINA E
9/5/1967
0:00 000014992JOHANES A
7/20/1949
0:00 000087258SYAFIRA
2/1/2003
0:00 000014696DAMESTUS R 12/28/1966
0:00 000087193FAINA
11/1/1963
0:00 000106284ABRAHAM T
4/1/2000
0:00 000087230TETO MARIN 3/24/1992
0:00 000190065rukayah mar 3/28/2002
0:00 000106281MIKAEL JUL
7/1/2004
0:00 000196682WELLEM RO
8/9/1977
0:00 000106283ERMALINDA
6/1/1983
0:00 000138539SUSANA TOS
9/1/1952
0:00 000014696PAHLAWAN 11/10/1969
0:00 000131729RIZKYSAIN
9/4/1994
0:00 000087202SINCE ELLO
10/1/1983
0:00 000108162YULIANA SU 6/15/1978
0:00 000087183AMINAH SA
9/14/1974
0:00 000015030AGUSTINUS
8/27/1987
0:00 000009914KAREL DANT 7/15/1945
0:00 000087199MARIA M PA 10/1/1979
0:00 000143272julianner h.
7/24/1986
0:00 000014998BATSEBA SE
4/4/1948
0:00 000087155ALEKSIA K
10/3/1968
0:00 000020377ANA MARIA
5/16/1959
0:00 000016523ENIKE DJU
12/17/1968
0:00 000014989CARLOS MA
11/4/1974
0:00 000015009RAHEL NAM
2/12/1957
0:00 000106291GILI HAUPIA 11/1/1986
0:00 000106291GILI HAUPIA 11/1/1986
0:00 000019765DOLIS NISN 12/17/1993
0:00 000019765DOLIS NISN 12/17/1993
0:00 000204888muh yunus 12/31/1988
0:00 000014999JOHANIS IS
6/19/1944
0:00 000014980NIMROD TO
9/5/1962
0:00 000015000PUTRI KURN 4/14/1997
0:00 000087212ANI TOY
9/1/1989
0:00 000182321JECKSOM O. 1/23/1997
0:00 000087281MARIANA M
9/1/1969
0:00 000106291MINCE DJAM
4/1/1981
0:00 000190189YULIANA NI
6/13/1978
0:00 000205332ANDA YOKA
8/30/1985
0:00 000108905SALOMI DJA
8/26/1988
0:00 000204609yuliyanti ma 7/17/1988
0:00 000087295NOVRI PADJ
6/1/1990

0:00 P
0:00 P
0:00 P
0:00 L
0:00 P
0:00 L
0:00 P
0:00 L
0:00 P
0:00 P
0:00 L
0:00 L
0:00 P
0:00 P
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 P
0:00 L
0:00 L
0:00 P
0:00 P
0:00 L
0:00 L
0:00 L
0:00 L
0:00 P
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P

JKPST
Kode_Diagnosa_Prosedur
H520
H520
H520
H522
H522
H524
H612
K021
K021
K021
K041
K041
K041
K041
K041
K041
K041
K041
K041
K041
K041
Z348
Z348
H520
H520
H520
H521
H524
H524
K021
K021
K041
K041
K041
K041
K041
K041
K047
K047
K30
N390
Z348
Z348
Z348
Z348
Z348

6/14/2016
6/22/2016
6/16/2016
6/17/2016
6/18/2016
6/16/2016
6/7/2016
6/13/2016
6/28/2016
6/14/2016
6/16/2016
6/13/2016
6/22/2016
6/28/2016
6/9/2016
6/6/2016
6/20/2016
6/9/2016
6/14/2016
6/7/2016
6/13/2016
6/25/2016
6/16/2016
6/17/2016
6/22/2016
6/27/2016
6/30/2016
6/6/2016
6/27/2016
6/7/2016
6/18/2016
6/8/2016
6/2/2016
6/3/2016
6/1/2016
6/7/2016
6/13/2016
6/15/2016
6/15/2016
6/20/2016
6/2/2016
6/8/2016
6/16/2016
6/9/2016
6/20/2016
6/20/2016
6/6/2016
6/6/2016

0:00 000014972LOUISA S.
8/4/1989
0:00 000014703SOFIA NDOE 6/25/1963
0:00 000014995HELEN M.B
5/22/1947
0:00 000014972DAMARIS
5/19/1962
0:00 000015023MAGDALENA 6/17/1959
0:00 000014995ABSON BANG 8/13/1944
0:00 000015018MAWARNI M 6/19/1960
0:00 000015001ERNA SALO
2/28/1970
0:00 000015009MARTHA DI
3/18/1963
0:00 000014696ELISABETH
5/25/1961
0:00 000014972MESAK LA`
6/17/1961
0:00 000142675SAMUEL AL
1/30/2002
0:00 000015029PAULINA RI
6/28/1960
0:00 000014695TIMORTRYANI 6/1/1991
0:00 000181601dora melind
5/5/1999
0:00 000014980SAMUEL SAY 9/17/1952
0:00 000014961FEBBY LIBIA 8/17/1953
0:00 000014982HENDRIK YO 1/16/1958
0:00 000015004YOSINA KAR 1/27/1963
0:00 000015000SIMON NAB
4/6/1952
0:00 000015023PHILIPPUS
9/4/1969
0:00 000014975MAS'AMAH, S 6/17/1979
0:00 000014981LUKAS LAKS
8/5/1974
0:00 000015014DURtjE F. P 12/24/1971
0:00 000014977GAFUR JAFA
7/15/1959
0:00 000014701RAMBU ROK
9/9/1966
0:00 000015022MARYAM
10/14/1971
0:00 000014974JOHANES LA 4/13/1959
0:00 000014989YOVITA NG
2/15/1969
0:00 000014968MARSELINA
9/24/1967
0:00 000014973MUDA BLAE 12/31/1964
0:00 000180848HERLINA RE 9/18/1981
0:00 000204748SUCE HERLI
5/8/1989
0:00 000130821NAEMA FINA 11/29/1984
0:00 000087216YULIANA TEF
3/1/1985
0:00 000157748MARIA M. A
1/6/1986
0:00 000014976VINSESNSIA 5/23/1986
0:00 000087176DINCE KOTA
3/1/1986
0:00 000087302HILDE GUN
11/1/1978
0:00 000203694iranna widor
6/2/1992
0:00 000087217RUTH PUNU
9/1/1979
0:00 000015029LIDIANA N.
7/8/1987
0:00 000014963ELISABETH 12/12/1979
0:00 000087249YUNUS BAN
6/1/1967
0:00 000014963THOMAS LO 10/3/1955
0:00 000015020OBETH LAL
3/12/1952
0:00 000014978YOHANES S
5/15/1971
0:00 000014737LAURENSIUS
7/7/1962

0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 L
0:00 P
0:00 P
0:00 P
0:00 L
0:00 P
0:00 L
0:00 P
0:00 L
0:00 L
0:00 P
0:00 L
0:00 P
0:00 L
0:00 P
0:00 P
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 L
0:00 L
0:00 L
0:00 L

Z349
E785
H520
H520
H520
H524
H524
H524
H524
I10
J00
K047
K047
Z348
Z348
H520
H520
H520
H520
H521
H521
H521
H524
H524
H524
H524
H524
H612
H612
I10
K047
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z349
Z349
Z349
H520
H520
H520
H521
H521

6/7/2016
6/16/2016
6/25/2016
6/27/2016
6/28/2016
6/17/2016
6/22/2016
6/27/2016
6/13/2016
6/15/2016
6/16/2016
6/6/2016
6/8/2016
6/4/2016
6/6/2016
6/9/2016
6/13/2016
6/13/2016
6/15/2016
6/17/2016
6/6/2016
6/6/2016
6/6/2016
6/6/2016
6/8/2016
6/8/2016
6/9/2016
6/11/2016
6/13/2016
6/16/2016
6/18/2016
6/24/2016
6/25/2016
6/27/2016
6/27/2016
6/27/2016
6/27/2016
6/25/2016
6/22/2016
6/16/2016
6/16/2016
6/9/2016
6/9/2016
6/17/2016
6/27/2016
6/16/2016
6/16/2016
6/16/2016

0:00 000086176STEFANIA W
0:00 000131807merlinda an
0:00 000142575RONALD FR
0:00 000126771THERESIA A
0:00 000106289SERVUS DA
0:00 000015007BERGITA NA
0:00 000015019YANTI MARA
0:00 000109005SULASTRI
0:00 000020576YOHANES A.
0:00 000195924sudaryati lu
0:00 000015019YUSTINA MA
0:00 000106288CAUDENSIA
0:00 000132801ERNI WASTI
0:00 000085460DISTA TANE
0:00 000106289ROSITA LISU
0:00 000020430KRISTINA M
0:00 000185139SUMIYATI W
0:00 000020430KRISTINA M
0:00 000085227ECI LODIMU
0:00 000206324YANUARIS A
0:00 000085383YUNITA NUB
0:00 000205847LIDYA WULA
0:00 000087166MEFANTRI
0:00 000014756MARIA YUNI
0:00 000205264christin mei
0:00 000114349ANTONINHA
0:00 000205109ANASTASIA
0:00 000087207IDA A TAPOB
0:00 000204240martina bili
0:00 000137277FRIDOLIN M
0:00 000014699HYASANTRIX
0:00 000206379MARICE YO
0:00 000014978ONNY PAKE
0:00 000127632AGUSTINA C
0:00 000185201LITA MARTH
0:00 000206365MELANIA YU
0:00 000183136milon kartin
0:00 000205926MARISA NEN
0:00 000205847LIDYA WULA
0:00 000014963MARTHEN Y
0:00 000016620ABRAHAM Z
0:00 000015020ANTHONETA
0:00 000014713JACOBIS HA
0:00 000190427marthen ba
0:00 000014708PHILIPUS L
0:00 000014978JAWAB SYAF
0:00 000019648YUNI PADJI
0:00 000015027DELTJI DALL

11/1/2000
6/22/1991
4/25/1987
11/9/1987
12/1/1959
10/7/1961
1/25/1973
9/17/1974
5/22/1969
7/10/1974
2/8/1968
5/1/1966
2/18/1985
6/1/1990
6/1/1987
4/9/1987
7/25/1988
4/9/1987
5/1/1995
9/19/1988
1/1/1993
5/12/1996
5/1/1991
6/1/1988
5/2/1989
7/5/1986
6/6/1988
2/1/1992
9/3/1992
3/6/1990
8/17/1986
1/25/1976
10/20/1976
7/27/1979
5/22/1972
6/8/1990
12/31/1984
3/26/1995
5/12/1996
3/1/1969
10/15/1966
11/14/1957
12/24/1959
3/18/1959
4/30/1938
6/14/1965
6/26/1978
5/17/1971

0:00 P
0:00 P
0:00 L
0:00 P
0:00 L
0:00 P
0:00 P
0:00 P
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 L
0:00 P
0:00 L
0:00 L
0:00 L
0:00 L
0:00 P
0:00 P

H521
H521
H521
H521
H521
H522
H524
H524
H524
H524
H524
H603
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z349
H520
H520
H521
H521
H521
H521
H524
H524
H524

6/22/2016
6/20/2016
6/1/2016
6/1/2016
6/8/2016
6/9/2016
6/15/2016
6/27/2016
6/6/2016
6/6/2016
6/21/2016
6/3/2016
6/8/2016
6/13/2016
6/13/2016
6/13/2016
6/14/2016
6/16/2016
6/20/2016
6/25/2016
6/28/2016
6/29/2016
6/13/2016
6/6/2016
6/15/2016
6/17/2016
6/30/2016
6/13/2016
6/25/2016
6/6/2016
6/17/2016
6/23/2016
6/6/2016
6/27/2016
6/20/2016
6/25/2016
6/30/2016
6/30/2016
6/27/2016
6/28/2016
6/10/2016
6/14/2016
6/24/2016
6/29/2016
6/11/2016
6/13/2016
6/27/2016
6/29/2016

0:00 000015028JACOB PENI

0:00 000014729MARIANA AO
0:00 000020016DIANA I. O
0:00 000205304erny sofia b
0:00 000020016DIANA I. O
0:00 000203608INDRI BUDI
0:00 000020016DIANA I. O
0:00 000205841NAOMI MAT
0:00 000014973ERNA S. M.
0:00 000014989SOFIA SUSA
0:00 000014989SOFIA SUSA
0:00 000204827haryani ayu
0:00 000185772MayliNA IM
0:00 000087307OFIYANI S L
0:00 000182508APLIANA W
0:00 000087276ARIF SURYA
0:00 000204152ANGGRIANI
0:00 000205338marwadi hes
0:00 000014706YENNY BAIT
0:00 000087238DORTIA TA
0:00 000114640MARIA IMAK
0:00 000087276ARIF SURYA
0:00 000015025ANA MAGDA
0:00 000015019SUFITJE MA
0:00 000015022ROSYIDA YA
0:00 000162090VONI ELISA
0:00 000020119I NENGAH P
0:00 000129787ADE PUTRI
0:00 000117621fERONIKA R
0:00 000016386YULIANA RI
0:00 000087263ESTER TAM
0:00 000015009SARCE BAIK
0:00 000180547YULIUS TED
0:00 000106282NOVEM TAN
0:00 000020100YEBERTINI S
0:00 000019439ELYANOR M.
0:00 000190657YASINTA SU
0:00 000015170UMBU EDA
0:00 000015010SEMUEl joh
0:00 000014701SANCI AMEL
0:00 000014991SITTI NURM
0:00 000015183THERESIA F
0:00 000015016SITTI NURA
0:00 000131966UPA J. J. S
0:00 000087238RUBEN MON
0:00 000203423maria lasib
0:00 000015010GRADIANA
0:00 000130442CHArLIE TH

3/14/1968
11/18/1946
6/5/1984
3/20/1995
6/5/1984
10/19/1991
6/5/1984
6/26/1986
5/16/1989
4/30/1983
4/30/1983
8/3/1995
5/31/1985
12/1/1982
1/23/1984
10/1/1981
1/10/1994
3/23/1990
6/7/1979
12/1/1983
5/30/1991
10/1/1981
6/1/1968
10/10/1950
8/10/1963
1/26/1960
12/27/2000
6/19/1994
2/27/1974
6/29/1971
11/1/1978
12/2/1962
7/17/1986
11/1/1991
4/26/1985
8/25/1985
8/23/1986
2/25/1960
9/25/1959
9/8/1972
5/10/1955
2/26/1992
11/7/1963
6/20/1971
9/3/1946
11/19/1984
4/9/1959
4/6/1987

0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
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0:00 P
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0:00 P
0:00 P
0:00 P
0:00 P
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0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 P
0:00 P
0:00 L

H524
K041
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
E119
H520
H520
H520
H521
H522
H522
H524
H524
K041
K047
Z348
Z348
Z348
Z348
E119
H520
H520
H521
H521
H521
H521
H521
H521
H521
H522

6/1/2016
6/10/2016
6/10/2016
6/28/2016
6/2/2016
6/7/2016
6/18/2016
6/20/2016
6/22/2016
6/27/2016
6/1/2016
6/6/2016
6/9/2016
6/6/2016
6/6/2016
6/4/2016
6/13/2016
6/9/2016
6/16/2016
6/9/2016
6/3/2016
6/3/2016
6/3/2016
6/6/2016
6/6/2016
6/14/2016
6/17/2016
6/20/2016
6/28/2016
6/2/2016
6/2/2016
6/6/2016
6/8/2016
6/13/2016
6/13/2016
6/15/2016
6/20/2016
6/20/2016
6/25/2016
6/30/2016
6/30/2016
6/30/2016
6/13/2016
6/6/2016
6/8/2016

0:00 000108143MARIA YULI

1/3/1978
0:00 000015027ALEXANDER 2/11/1954
0:00 000014982ARKILAUS S
4/21/1968
0:00 000015025MARIA PETR 5/16/1974
0:00 000205787kornelis tim
10/9/1974
0:00 000014696NAEMA PAND 9/8/1953
0:00 000015011MATHEUS DA 10/20/1960
0:00 000087194MARTHA A L
3/1/1976
0:00 000014699SENI LANGG
7/8/1959
0:00 000014709SUSANA Y.
6/10/1952
0:00 000020931DIELLA GOD 10/15/2011
0:00 000014987MONIKA HE
3/26/1998
0:00 000087195THERESIA
9/12/1968
0:00 000016357MARSELINA
9/17/1966
0:00 000014983DOMINGGUS
1/1/1969
0:00 000106287YAKOMINA P
4/1/1974
0:00 000014997WASNI DOL
6/28/1966
0:00 000087185MELIANA PA
5/1/2001
0:00 000085035KATRIN DOK
9/1/2003
0:00 000108987YERI IDAMIN 6/17/1979
0:00 000087182ESTER BIFE
4/1/2000
0:00 000085258IDAMINA NO
5/1/1988
0:00 000108987YERI IDAMIN 6/17/1979
0:00 000087180SUSANA A
1/1/1981
0:00 000014701MARGARETA
1/8/1974
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0:00 000109998NOVITA mar 11/25/1996
0:00 000109998NOVITA mar 11/25/1996
0:00 000205622YASINTA N
12/11/1980
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0:00 000087266TRESNAWAT
7/1/1992
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12/1/1996
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8/18/1984
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2/12/1981
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9/12/1993
0:00 000183481MARTHA M.
3/10/1987
0:00 000196454yona srisuna 2/10/1981
0:00 000108987YERI IDAMIN 6/17/1979
0:00 000206395LENI FERAWA 2/24/1990
0:00 000108223YUSTHINA
6/18/1981
0:00 000182120jolita jasmin 7/12/1987
0:00 000195896dorince kolo 12/20/1980
0:00 000108987YERI IDAMIN 6/17/1979

0:00 P
0:00 L
0:00 L
0:00 P
0:00 L
0:00 P
0:00 L
0:00 P
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 L
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P
0:00 P

H524
H524
H524
H524
H524
H524
H524
H524
H524
H524
H603
H603
H603
I10
J459
K021
K021
N390
N390
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z348
Z349
Z349

nosa_Primer_Skunder_Prosedur
Level KDINACBGNmInaCBGNmDokter
Hypermetro1
Hypermetro1
Hypermetro1
Astigmatis 1
Astigmatis 1
Presbyopia 1
Impacted c 1
Caries of de1
Caries of de1
Caries of de1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Supervision1
Supervision1
Hypermetro1
Hypermetro1
Hypermetro1
Myopia
1
Presbyopia 1
Presbyopia 1
Caries of de1
Caries of de1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Necrosis of 1
Periapical a1
Periapical a1
Dyspepsia 1
Urinary trac1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1

Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
Z-3-25-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
U-3-16-0
U-3-16-0
U-3-16-0
U-3-16-0
Q-5-12-0
U-3-16-0
U-3-16-0
U-3-16-0
U-2-32-0
U-2-32-0
Q-5-44-0
Q-5-40-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Z-3-25-0

PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
M.A.S. Wahy
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR DRG
PADAANGGU
GIG
PROSEDUR dr.
ULTRASO
indrawa
PENYAKIT KRONIS
Maria Surina
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
Eunike Cahy
PROSEDUR Katarina
PADA GIGAni
PROSEDUR Katarina
PADA GIGAni
PROSEDUR Leonora
PADA GIG
J. Ti
PROSEDUR Lela
PADAKGIG
Haria
GIGI
Lela K Haria
PROSEDUR Lela
PADAKGIG
Haria
PROSEDUR Lela
PADAKGIG
Haria
PROSEDUR Imelda
PADA GIG
Ora A
PROSEDUR Imelda
KECIL PSiant
PROSEDUR Lela
KECIL
K PHaria
PENYAKIT KRONIS
Stefany Adi
INFEKSI SALURAN
Widhitomo,
PROSEDUR DR
ULTRASO
INA, SP
PROSEDUR dr.
ULTRASO
Niko Hu
PENYAKIT KRONIS
dr. Niko Hu
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR Yuniwati
ULTRASOG

TarifRS
120800
124800
52000
120800
80000
52000
122140
180000
180000
180000
180000
180000
180000
180000
180000
180000
180000
180000
180000
180000
180000
100000
270006
120800
105523
73563
62000
85000
52000
200000
290000
200000
402508
104730
402508
246000
406563
111795
105550
118725
177990
175000
333000
150000
100000
170000

TarifCBG
161000
161000
171300
161000
171300
171300
171300
176800
176800
176800
176800
176800
176800
176800
176800
176800
176800
176800
176800
176800
176800
333300
171300
161000
171300
171300
171300
161000
171300
181600
181600
181600
181600
133100
181600
181600
181600
163800
163800
171300
134100
333300
333300
166300
333300
375000

Supervision1
Hyperlipida1
Hypermetro1
Hypermetro1
Hypermetro1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Essential ( 1
Acute nasop1
Periapical a1
Periapical a1
Supervision1
Supervision1
Hypermetro1
Hypermetro1
Hypermetro1
Hypermetro1
Myopia
1
Myopia
1
Myopia
1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Impacted c 1
Impacted c 1
Essential ( 1
Periapical a1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Hypermetro1
Hypermetro1
Hypermetro1
Myopia
1
Myopia
1

Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-42-0
U-2-32-0
U-2-32-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
U-2-32-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0

PENYAKIT KRONIS
Maria Surina
PENYAKIT KRONIS
Maria Abelie
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Leonora J. Ti
PENYAKIT AKUT
M.A.S.
KEWahy
PROSEDUR Imelda
KECIL POra A
PROSEDUR Lela
KECIL
K PHaria
PROSEDUR dr.
ULTRASO
Niko Hu
PROSEDUR dr.
ULTRASO
Jansen,
PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Rahmatia, d
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
M.A.S. Wahy
PENYAKIT KRONIS
M.A.S. Wahy
PENYAKIT KRONIS
Prijander L.
PROSEDUR Ivone
KECIL R.
P Lua
PROSEDUR DR
ULTRASO
INA, SP
PROSEDUR dr.
ULTRASO
Niko Hu
PROSEDUR dr.
ULTRASO
Niko Hu
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
Jansen,
PROSEDUR dr.
ULTRASO
Jansen,
PROSEDUR dr.
ULTRASO
Jansen,
PROSEDUR dr.
ULTRASO
Jansen,
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR Maria
ULTRASO
Surina
PROSEDUR Maria
ULTRASO
Surina
PROSEDUR Maria
ULTRASO
Surina
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
dr. Eunike C

20000
366907
120800
85000
80000
120800
52000
52000
52000
100000
74550
176000
110730
333000
100000
120800
124800
52000
52000
52000
52000
52000
52000
62000
62000
52000
52000
179500
206080
501488
176000
170000
333000
333000
100000
104000
100000
100000
100000
100000
180000
193750
180000
85000
124800
52000
85000
128100

171300
171300
161000
161000
171300
161000
171300
171300
171300
171300
146100
163800
163800
333300
333300
161000
161000
171300
171300
171300
171300
171300
171300
171300
171300
171300
171300
171300
171300
171300
163800
333300
333300
333300
333300
333300
333300
333300
333300
333300
375000
375000
375000
161000
161000
171300
161000
161000

Myopia
1
Myopia
1
Myopia
1
Myopia
1
Myopia
1
Astigmatis 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Other infect1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Hypermetro1
Hypermetro1
Myopia
1
Myopia
1
Myopia
1
Myopia
1
Presbyopia 1
Presbyopia 1
Presbyopia 1

Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0

PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
M.A.S. Wahy
PROSEDUR dr.
ULTRASO
laurens
PROSEDUR dr.
ULTRASO
shanty w
PROSEDUR dr.
ULTRASO
shanty w
PROSEDUR dr.
ULTRASO
shanty w
PROSEDUR dr.
ULTRASO
shanty w
PROSEDUR dr.
ULTRASO
shanty w
PROSEDUR dr.
ULTRASO
shanty w
PROSEDUR dr.
ULTRASO
shanty w
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
Jansen,
PROSEDUR dr.
ULTRASO
Jansen,
PROSEDUR dr.
ULTRASO
Jansen,
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
indrawa
PENYAKIT KRONIS
dr. Unedo,
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
Kris Ch
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
Unedo,
PENYAKIT KRONIS
dr. indrawa
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
Unedo,
PROSEDUR Lorens
ULTRASO
Paul
PENYAKIT KRONIS
Maria Surina
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
dr. Cosmas

85000
85000
52000
52000
52000
120800
124800
85000
62000
54490
62000
130035
333000
205000
211000
205000
205000
116586
235445
205000
100000
100000
100000
335000
103000
100000
100000
100000
100000
100000
100000
100000
100000
100000
195000
100000
100000
193750
53750
120800
120800
85000
85000
118100
73563
120800
85000
120800

161000
161000
171300
171300
171300
161000
161000
161000
171300
171300
171300
171300
333300
333300
333300
333300
333300
333300
333300
333300
333300
333300
333300
333300
333300
333300
333300
166300
333300
333300
333300
333300
333300
166300
333300
333300
333300
375000
171300
161000
161000
161000
161000
161000
171300
161000
161000
161000

Presbyopia 1
Necrosis of 1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Non-insulin 1
Hypermetro1
Hypermetro1
Hypermetro1
Myopia
1
Astigmatis 1
Astigmatis 1
Presbyopia 1
Presbyopia 1
Necrosis of 1
Periapical a1
Supervision1
Supervision1
Supervision1
Supervision1
Non-insulin 1
Hypermetro1
Hypermetro1
Myopia
1
Myopia
1
Myopia
1
Myopia
1
Myopia
1
Myopia
1
Myopia
1
Astigmatis 1

Q-5-44-0
Q-5-12-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Q-5-44-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
U-3-16-0
U-2-32-0
Z-3-25-0
Q-5-44-0
Q-5-44-0
Z-3-25-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0

PENYAKIT KRONIS
dr. Cosmas
GIGI
Andi Gunawa
PROSEDUR dr.
ULTRASO
Niko Hu
PROSEDUR dr.
ULTRASO
Niko Hu
PROSEDUR dr.
ULTRASO
laurens
PENYAKIT KRONIS
DR. Lourens
PENYAKIT KRONIS
dr. Niko Hu
PROSEDUR dr.
ULTRASO
Niko Hu
PROSEDUR dr.
ULTRASO
shanty w
PROSEDUR dr.
ULTRASO
shanty w
PENYAKIT KRONIS
dr. shanty w
PROSEDUR dr.
ULTRASO
indrawa
PENYAKIT KRONIS
dr. indrawa
PROSEDUR dr.
ULTRASO
indrawa
PROSEDUR dr.
ULTRASO
indrawa
PENYAKIT KRONIS
dr. Jansen,
PROSEDUR dr.
ULTRASO
Kris Ch
PROSEDUR dr.
ULTRASO
Jansen,
PROSEDUR dr.
ULTRASO
indrawa
PENYAKIT KRONIS
dr. Unedo,
PROSEDUR dr.
ULTRASO
Unedo,
PROSEDUR dr.
ULTRASO
indrawa
PENYAKIT KRONIS
Leonora J. Ti
PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
dr. Cosmas
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
dr. Cosmas
PROSEDUR Lela
PADAKGIG
Haria
PROSEDUR Lela
KECIL
K PHaria
PROSEDUR dr.
ULTRASO
Niko Hu
PENYAKIT KRONIS
Herwinda, d
PENYAKIT KRONIS
dr. Unedo,
PROSEDUR dr.
ULTRASO
Jansen,
PENYAKIT KRONIS
Stefany Adi
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
dr. Eunike C
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
dr. Novita
PENYAKIT KRONIS
Sitti Rahmat
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Eunike Cahy
PENYAKIT KRONIS
Eunike Cahy

85000
30000
333000
333000
333000
333000
150000
333000
205000
205000
205000
100000
100000
100000
508100
100000
100000
100000
100000
100000
100000
100000
20000
85000
52000
62000
85000
85000
85000
85000
120800
252508
180730
333000
80000
100000
101500
343200
52000
81343
85000
124800
85000
85000
62000
62000
90000
52000

161000
133100
333300
333300
333300
166300
166300
333300
333300
333300
166300
333300
166300
333300
333300
166300
333300
333300
333300
166300
333300
333300
171300
161000
171300
171300
161000
161000
161000
161000
161000
181600
163800
333300
166300
166300
333300
171300
171300
171300
161000
161000
161000
161000
171300
171300
171300
171300

Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Presbyopia 1
Other infect1
Other infect1
Other infect1
Essential ( 1
Asthma, uns1
Caries of de1
Caries of de1
Urinary trac1
Urinary trac1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1
Supervision1

Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
Q-5-44-0
U-3-16-0
U-3-16-0
Q-5-40-0
Q-5-40-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Q-5-44-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Z-3-25-0
Q-5-44-0
Q-5-44-0

PENYAKIT KRONIS
dr. Eunike C
120800
PENYAKIT KRONIS
dr. Eunike C
85000
PENYAKIT KRONIS
dr. Novita
85000
PENYAKIT KRONIS
dr. Cosmas
85000
PENYAKIT KRONIS
Eunike Cahy
62000
PENYAKIT KRONIS
Vivi Yanti W
73563
PENYAKIT KRONIS
Rahmatia, d
62000
PENYAKIT KRONIS
Eunike Cahy
62000
PENYAKIT KRONIS
Rahmatia, d
52000
PENYAKIT KRONIS
Sitti Rahmat
52000
PENYAKIT KRONIS
M.A.S. Wahy
126510
PENYAKIT KRONIS
M.A.S. Wahy
140035
PENYAKIT KRONIS
M.A.S. Wahy
69500
PENYAKIT KRONIS
Lowry Yuanit
20000
PENYAKIT KRONIS
Prijander L.
126125
PROSEDUR Katarina
PADA GIGAni
120000
PROSEDUR Katarina
PADA GIGAni
290000
INFEKSI SALURAN
Prijander L.
261000
INFEKSI SALURAN
Regina Maya 1210000
PROSEDUR DR
ULTRASO
INA, SP
170000
PROSEDUR dr.
ULTRASO
Niko Hu
333000
PROSEDUR dr.
ULTRASO
Niko Hu
333000
PROSEDUR dr.
ULTRASO
Niko Hu
333000
PROSEDUR dr.
ULTRASO
Niko Hu
333000
PROSEDUR dr.
ULTRASO
Niko Hu
333000
PENYAKIT KRONIS
dr. DAIMAN,
150000
PROSEDUR dr.
ULTRASO
Niko Hu
333000
PENYAKIT KRONIS
dr. Niko Hu
150000
PROSEDUR dr.
ULTRASO
Niko Hu
333000
PENYAKIT KRONIS
dr. indrawa
100000
PROSEDUR dr.
ULTRASO
indrawa
100000
PENYAKIT KRONIS
dr. indrawa
100000
PROSEDUR dr.
ULTRASO
Jansen,
100000
PROSEDUR dr.
ULTRASO
indrawa
100000
PROSEDUR dr.
ULTRASO
Jansen,
100000
PROSEDUR dr.
ULTRASO
Unedo,
100000
PROSEDUR dr.
ULTRASO
indrawa
100000
PROSEDUR dr.
ULTRASO
Unedo,
106000
PROSEDUR dr.
ULTRASO
Unedo,
100000
PROSEDUR dr.
ULTRASO
indrawa
100000
PROSEDUR dr.
ULTRASO
Jansen,
100000
PROSEDUR dr.
ULTRASO
Jansen,
100000
PROSEDUR Maria
ULTRASO
Surina 332000
PENYAKIT KRONIS
Maria Surina
80000
PENYAKIT KRONIS
Maria Surina
43750

161000
161000
161000
161000
171300
171300
171300
171300
171300
171300
171300
171300
171300
171300
171300
181600
181600
134100
134100
333300
333300
333300
333300
333300
333300
166300
333300
166300
333300
166300
333300
166300
333300
333300
333300
333300
333300
333300
333300
333300
333300
333300
375000
171300
171300

C2
1
1
B
1
B
B
B
C
C
C
C
C
C
C
C
C
C
C
C
C
C
1
B
2
B
B
B
2
B
B
B
B
B
B
B
B
B
B
B
B
B
C
C
C
1
B

/ V / RSU
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/

V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/

RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU

/ V / RSU
/ V / RSU
/ V / RSU
/ V / RSU
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/

V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/

RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU

/ V / RSU

NmJnsPulang JnsPelSJP
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat

RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL

Waktu

Penyebab Dirujuk Ke FKRTL

Usia Komplikasi Komorbiditi

B
B
1
1
B
1
B
B
B
B
B
B
B
C
1
1
1
B
B
B
B
B
B
B
B
B
B
B
B
B
B
C
C
C
1
2
2
1
1
1
B
B
B
1
1
B
4
1

/ V / RSU Sehat
/ V / RSU Sehat
Sehat
Sehat
/ V / RSU Sehat
Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
Sehat
Sehat
Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
/ V / RSU Sehat
/ V / RSU Sehat
/ V / RSU Sehat
Sehat
Sehat
/ V / RSU Sehat
Sehat
Sehat

RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL

1
1
B/
B/
B/
3
1
1
B/
B/
B/
B/
C/
C/
C/
C/
C/
C/
C/
C/
2
1
1
2
2
2
1
2
3
2
2
1
1
4
2
1
1
B/
B/
1
1
31
1
1
B/
1
1
1

V / RSU
V / RSU
V / RSU

V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/

RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU

V / RSU
V / RSU

V / RSU

Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat

RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL

2
B
C
C
C
C
C
C
C
C
C
4
2
1
1
6
2
1
1
2
1
7
B
3
B
B
1
1
1
1
1
B
B
C
C
2
1
B
B
B
1
1
3
1
B
B
B
B

/
/
/
/
/
/
/
/
/
/

V/
V/
V/
V/
V/
V/
V/
V/
V/
V/

RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU

/ V / RSU
/ V / RSU
/ V / RSU

/
/
/
/

V/
V/
V/
V/

RSU
RSU
RSU
RSU

/ V / RSU
/ V / RSU
/ V / RSU

/
/
/
/

V
V
V
V

/
/
/
/

RSU
RSU
RSU
RSU

Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat

RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL

1
1
1
1
B
B
B
B
B
B
B
B
B
B
B
B
B
B
B
C
C
C
C
C
C
C
C
C
C
3
5
2
1
7
1
1
1
1
1
1
1
1
B
B
B

/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/
/

V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/
V/

RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU
RSU

/ V / RSU
/ V / RSU
/ V / RSU

Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat
Sehat

RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL
RJTL

ujuk Ke FKRTL
Sarana Prasana Faskes