DESEMBER

Lampiran 2
Instrumen Penghitungan Kinerja Administrasi dan Manajemen Puskesmas

Skala
No Jenis Variabel Definisi Operasional Nilai
Nilai 0 Nilai 4 Nilai 7 Nilai 10
(1) (2) (3) (4) (5) (6) (7) (8)
1.1.Manajemen Umum
23. Pengolahan LB 1 Persamaan jumlah kunj. Px di lapo. LB Lb 1 - kunjungan Lb 1 - kunjungan Lb 1 - kunjungan Lb 1 - kunjungan .....
penyakit v/s Kunjungan 1 penyakit + kunj. Kasus terpadu = tidak terpadu ≤ 40 % terpadu ≤ 70 % terpadu > 70 %
Terpadu valid
24. Pengolahan LB 1 Persamaan jumlah kunj. Px di lapo. LB Lb 1 - sikda = Lb 1 ≠ sikda ≤ 40 % Lb 1 ≠ sikda ≤ 70 % Lb 1 ≠ sikda > 70 % .....
penyakit v/s Sikda 1 penyakit + kunj. Kasus + Sikda tidak valid
Ginerik Plus
LAPORAN TAHUNAN DATA KESAKITAN PENYAKIT DI KAB SITUBONDO (PMK 514/2015)
Puskesmas / Klinik / Dokter Praktek Swasta = KENDIT Bulan = DESEMBER Tahun = 2019
TINGK
AT KODE JUMLAH KASUS BARU DAN LAMA ( UMUR DAN JENIS KELAMIN) JUMLAH KASUS BARU JUMLAH KASUS LAMA JUMLAH
JUMLAH
NO NAMA PENYAKIT KEMA RUJUKAN
ICPC II ICD X 0-7 HR 8-28 HR 1-11 BLN 1-4 THN 5-9 THN 10-14 THN 15-19 THN 20-44 THN 45-59 THN >59 THN JUM LAH L P JUM LAH L P JUM LAH RUJUKAN
MPU BALIK
AN
A. Kelompok Umum
Respiratory tuberkulosis, bacteriologiccaly and

1. Tuberkolosis ( TB ) Paru 4 A A 70 Tuberkulosis A15
histologically confirmed 0 0 0 0 1 0 7 14 23 18 63 4 7 11 19 33 52 63 11
2. Tuberkolosis ( TB ) dengan HIV
TB 3 A A 70 Tuberkulosis A15 Respiratory tuberkulosis, bacteriologiccaly and - - - - -

histologically confirmed
Asymptomatic human immunodeficiency virus (HIV)
HIV B90 HIV-infection/AIDS Z21 - - - - -
infection status
3. Morbili 4 A A 71 Measles B05.9 Measles without complication (Measles NOS). - - - - -
4. Varisela 4 A A 72 Chickenpox B01.9 Varicella without complication (Varicella NOS) - - - - -
5. Malaria 4 A A 73 Malaria B54 Unspecified malaria - - - - -
6. Leptospirosis 4 A A 78 Infection disease other/ NOS A27.9 Leptospirosis, unspecified - - - - -

B74 Filariasis
7. Filariasis 4 A D96 Woms/other parasites B74.0 Filariasis due to Wuchereria bancrofti - - - - -
B74.1 Filariasis due to Brugia malayi
B74.2 Filariasis due
Omphalitis ofto Brugia timori
newborn with or without mild
8. Infeksi Pada Umbilikus 4 A A94 Perinatal morbidity other P38 haemorrhage - - - - -
9. Kandidiasis Mulut 4 A A 78 Infection disease other/ NOS B37.9 Candidiasis unspecified - - - - -
10. Lepra 4 A A 78 Infection disease other/ NOS A30 Leprosy [Hansen disease] 0 0 0 0 0 0 0 1 0 0 1 1 0 1 - 1 1
11. Keracunan Makanan 4 A A 86 Effect Non Medical Substance T62.2 Other Ingested (parts of plant(s)) - - - - -
12. Alergi Makanan 4 A A 92 Allergy/ allergic reaction NOS L27.2 Dermatitis due to ingested food - - - - -
13. Syok 3 B K 99 Cardiovascular disease other R57.9 Shock, unspecified - - - - -
14. Reaksi Anafilaktik 4 A A92 Allergy/allergic reaction NOS T78.2 Anaphylactic shock, unspecified - - - - -
15. Demam Dengue dan Demam 4 A A77 Viral disease other/NOS A90 Dengue fever - - - - -
Berdarah Dengue
A91 Dengue haemorrhagic fever - - - - -
B. Darah, Pembentukan Darah, Sistem Imun
1. Anemia Defiisiensi Besi 4 A B80 Iron Deficiency Anaemia 280 Iron Deficiency Anemias - - - - -
Asymptomatic Human Immunodeficiency Virus (HIV)

2. HIV / AIDS tanpa komplikasi 4 A B90 HIV-infection/AIDS Z21 infection status 0 0 0 0 0 0 0 1 1 0 2 1 0 1 0 1 1 2 1
3. Lupus Eritamatosus Sistemik 3 A L99 Systemic Lupus Erythematosus M32 Systemic Lupus Erythematosus - - - - -
4. Limfadenitis 4 A L04.9 Acute lymphadenitis, unspecified B70 Lymphadenitis Acute 0 0 0 0 0 0 0 2 0 0 2 2 0 2 - 2 2
C. Digestive
1. Ulkus Mulut (Aftosa, Herpes) 4 A D83 Mouth / tongue / lip disease K12 Stomatitis and related lesions 0 0 0 0 0 0 0 1 0 0 1 0 1 1 - 1 1
K12.0 Recurrent oral aphtae - - - - -
K12.1 Other form of stomatitis - - - - -

Gastro-oesophageal reflux disease without
2. Refluksgastroesofageal 4 A D84 Oesphagus disease K21.9
oesophagitis 0 0 0 0 0 0 0 1 1 0 2 0 2 2 - 2 2
3. Gastritis 4 A D07 Dyspepsia/indigestion K29.7 Gastritis, unspecified 0 0 1 0 2 5 3 58 45 36 150 61 73 134 8 8 16 150 134
Digestive syndrome/complaint
4. Intoleransi Makanan 4 A D29 K90.4 Malabsorption due to intolerance - - - - -
other
5. Malabsorbsi Makanan 3 A D29 Digestive syndrome/complaint K90.9 Intestinal malabsorbtion, unspecified - - - - -
other
6. Demam Tifoid 4 A D70 Gastrointestinal infection A01.0 Typhoid fever 0 0 3 10 24 28 5 76 30 15 191 77 78 155 16 20 36 191 155
7. Gastroenteritis (termasuk disentri, Gastroenteritis presumed Diarrhoea and gastroenteritis of presumed infection
kolera dan giardiasis) 4 A D73 infection A09 origin 0 0 0 2 8 9 3 14 15 10 61 25 36 61 - 61 61
8. Disentri Basiler dan Disentri Amuba 4 A D70 Gastrointestinal infection A06.0 Acute amoebic dysentery - - - - -
9. Perdarahan Gastroenteritis 3 A D14 Haematemesis/vomiting blood K92.2 Gastrointestinal haemorrhage, unspecified - - - - -
D15 / Melaena / Rectal Bleeling

D16 K62.5 Haemorrhage of anus and rectum - - - - -
10. Hemoroid Grade 1 – 2 4 A D95 Anal fissure/perianal abscess I84 Haemorrhoids 0 0 0 0 0 0 1 1 0 0 2 2 0 2 - 2 2
11. Hepatitis A 4 A D72 Viral Hepatitis B15 Acute Hepatitis A - - - - -
12. Hepatitis B 3 A D72 Viral Hepatitis B16 Acute Hepatitis B - - - - -
13. Kolesistitis 3 A D98 Cholecystitis/cholelithiasis K81.9 Cholecystitis, unspecified - - - - -
14. Apendisitis Acut 3 A S87 Appendicitis K35.9 Acute appendicitis 0 0 0 0 0 0 0 1 0 0 1 0 1 1 - 1 1
15. Peritonitis 3 A D99 Disease digestive system, other K65.9 Peritonitis, unspecified - - - - -
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NO NAMA PENYAKIT KEMA RUJUKAN RUJUKAN
MPU ICPC II ICD X 0-7 HR 8-28 HR 1-11 BLN 1-4 THN 5-9 THN 10-14 THN 15-19 THN 20-44 THN 45-59 THN >59 THN JUM LAH L P JUM LAH L P JUM LAH BALIK
AN
D71 / Mumps / Disease digestive
16. Parotitis 4 A D99 system, other B26 Mumps - - - - -
17. Askariasis / Cacing gelang 4 A D96 Worms/ other parasites B77.9 Ascariaris unspecified - - - - -
18. Ankylostomiasis / Cacing tambang 4 A D96 Worms/other parasites B76.0 Ankylostomiasis - - - - -
B76.1 Necatoriasis - - - - -
19. Skistosomiasis 4 A D96 Worm/outer parasite B65.9 Skistosomiasisunspecified - - - - -
B65.2 Schistomiasis due to S. japonicum - - - - -
20. Taeniasis 4 A D96 Worms/other parasites B68.9 Taeniasis - - - - -
21. Strongiloidiasis 4 A D96 Worms/other parasites B78.9 Strongyloidiasis - - - - -
D. Mata
1. Mata Kering / Dry eye 4 A F99 Eye/adnexa disease, other H04.1 Otherdisorders of lacrimal gland - - - - -
2. Buta Senja 4 A F99 Eye/adnexa disease other H53.6 Night blindness - - - - -
3. Hordeolum 4 A F72 Blepharitis/stye/chalazion H00.0 Hordeolum and other deep inflammation of eyelid - - - - -
4. Konjungtivitis
Konjungtivitis Infeksi 4 A F70 Conjunctivitis infectious H10.9 Conjunctivitis, unspecified 0 0 0 0 0 1 0 5 2 1 9 3 4 7 2 2 9 7
Konjungtivitis Alergi F71 Conjunctivitis allergic H10.1 Acute atopic conjunctivitis - - - - -
5. Blefaritis 4 A F72 Blepharitis/stye/chalazion H01.0 Blepharitis - - - - -
6. Perdarahan Subkonjungtiva 4 A F75 Contusion/ haemorrhage eye H57.8 Other specified disorders of eye and adnexa - - - - -
7. Benda Asing di Konjungtiva 4 A F76 Foreign body in eye T15.9 Foreign body on external eye, part unspecified - - - - -
8. Astigmatism 4 A F91 Refractive error H52.2 Astigmatisme - - - - -
9. Hipermetropia 4 A F91 Refractive error H52.0 Hypermetropia ringan - - - - -
10. Miopia Ringan 4 A F91 Refractive error H52.1 Myopia - - - - -
11. Presbiopia 4 A F91 Refractive error H52.4 Presbyopia - - - - -
12. Katarak Pada Pasien Dewasa 2 F92 Cataract H26.9 Cataract, unspecified 0 0 0 0 0 0 0 0 0 2 2 0 2 2 - 2 2
13. Glaukoma Akut 4 A F93 Glaucoma H40.2 Primary angle-closure glaucoma - - - - -
14. Glaukoma Kronis 3 B F93 Glaucoma H40.2 Primary angle-closure glaucoma - - - - -
15. Trichiasis 4 A F99 Eye / adnexa disease, other H02 Entropion and trichiasis of eyelid - - - - -
16. Episkleritis 4 A F99 Eye / adnexa disease, other H15.1 Episcleritis - - - - -
17. Trauma Kimia Mata 3 A F79 Injury eye other T26 Burn and corrosion confined to eye and adnexa - - - - -
18. Laserasi Kelopak Mata 3 A F79 Injury eye other S01.1 Open wound of eyelid and periocular area - - - - -
19. Hifema 3 A F75 Contusion/haemorrhage eye H21.0 Hyphaema - - - - -
20. Retinopaty Diabetik 2 F83 Retinopathy H36.0 Diabetic retinopathy - - - - -
E. Telinga
1. Otitis Eksterna 4 A H70 Otitis externa H60.9 Otitis externa, unspecified 0 0 0 0 0 1 0 0 0 0 1 0 1 1 - 1 1
2. Otitis Media Akut 4 A H71 Acute otitis media/myringitis H65.0 Acute serous otitis media - - - - - - - 3 2 1 6 2 3 5 1 - 1 6 5
H65.1 Other acure nonsuppurative otitis media - - - - -
H66.0 Acute suppurative otitis media - - - - -
3. Otitis Media Supuratif Kronik 3 A H74 Chronic otitis media H66.1 Chronic tubotympanic suppurative otitis media - - - - -
H66.2 Chronic atticoantral suppurative otitis media - - - - -
H66.3 Other chronic suppurative otitis media 0 0 0 0 0 0 0 0 0 1 1 1 0 1 - 1 1
4. Benda Asing di Telinga 3 A H76 Foreign body in ear T16 Foreign body in ear - - - - -
5. Seromen Prop H81 Excessive ear wax H61.2 Impacted cerumen - - - - -
F. Kardiovaskuler
Ischaemic heart disease with

1. Angina Pektoris Stabil 3 B K74
angina
I20.9 Angina pectoris, unspecified 0 0 0 0 0 0 0 0 1 0 1 0 1 1 - 1 1
2. Infark Miokard 3 B K75 Acute Myocardial Infarction I21.9 Acute Myocardial Infarction, Unspecified - - - - -
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3. Takikardia 3 B K79 Paroxysmal Tachicardy R00.0 Tachicardy Unspecified - - - - -
I47.1 Supraventicular Tachicardy - - - - -
I47.2 Ventricular Tachicardy - - - - -
4. Gagal Jantung Akut dan Kronis K77 Heart failure I50.9 Heart failure, unspecified 0 0 0 0 0 0 0 0 5 4 9 1 2 3 5 1 6 9 3
3 B Akut
3 A Kronik
5. Cardiorespiratory Arrest 3 B K80 Cardiac arrhytmia NOS R09.2 Respiratory arrest/ Cardiorespiratory failure - - - - -
6. Hipertensi Esensial K86 Hypertension uncomplicated I10 Essential (primary) hypertension 0 0 0 0 0 0 0 15 44 82 141 45 70 115 7 19 26 141 115
G. Muskuloskeletal 211
1. Fraktur Terbuka 3 B L76 Fracture other T14 Fracture of unspecified body 0 0 0 3 1 3 3 18 20 7 55 29 26 55 - 55 55
2. Fraktur Tertutup 3 B L76 Fracture other T14 Fracture of unspecified body - - - - -
3. Polimiagia Reumatik 3 A L99 Musculosceletal disease other M53.3 Polymyalgia rheumatica - - - - -
4. Artritis Reumatoid 3 A L99 Musculosceletal disease other M53.3 Polymyalgia rheumatica 0 0 0 0 0 0 0 0 1 0 1 1 0 1 - 1 1
5. Artritis, Osteoartritis 3 A L91 Osteoarthrosis other M19.9 Osteoarthrosis other 0 0 0 0 0 0 0 0 1 1 2 0 2 2 - 2 2
6. Vulnus 3 B S.16 Bruise / Contusion T14.1 Open wound of unspecified body region 3 2 2 6 - 13 8 5 13 - 13 13
S.17 Abration / Scratch / Blister
4 A S.18 Laceration / Cut
7. Lipoma 4 A S78 Lipoma D17.9 Benign lipomatous neoplasm - - - - -
H. Neurologi
1. Tension Headche 4 A N95 Tension Headache G44.2 Tension–type headache 0 0 0 0 0 1 2 12 11 10 36 12 12 24 5 7 12 36 24
2. Migren 4 A N89 Migraine G43.9 Migraine, unspecified 0 0 0 0 0 0 0 1 0 0 1 0 1 1 - 1 1
3. Vertigo 4 A N17 Vertigo/dizziness R42 Dizziness and giddiness 0 0 0 0 0 0 0 4 1 2 7 0 6 6 1 0 1 7 6
4. Tetanus 4 A N72 Tetanus A35 Other tetanus - - - - -
5. Rabies 3 B A77 Viral disease other/NOS A82.9 Rabies, Unspecified - - - - -
6. Malaria Selebral 3 B A73 Malaria B50 Plasmodium falciparum with cerebral complication - - - - -
7. Epilepsi 3 A N88 Epilepsy G40.9 Epilepsy, unspecified - - - - -
8. Transient Ischemuk Attack / TIA 3 B K89 Transient cerebral ischaemia G45.9 Transient cerebral ischaemic attack, unspecified - - - - -
9. Stroke 3 B K90 Stroke/cerebrovascular accident I63.9 Cerebral infarction, unspecified - - - - -
10. Bells’ Palsy 4 A N91 Facial paralysis/Bells’ palsy G51.0 Bells’ palsy - - - - -
11. Status Epilepsi 3 B N88 Epilepsy G41.9 Status epilepticus, unspecified - - - - -
12. Delirium 3 A P71 Organic psychosis other F05.9 Delirium, unspecified - - - - -
13. Kejang Deman 4 A N07 Convulsion/Seizure R56.0 Febrile convulsions 0 0 0 0 1 0 0 0 0 0 1 1 0 1 - 1 1
14. Tetanus Neonatorum 3 B N72 Tetanus A33 Tetanus Neonatorum - - - - -
I. Psikiatri
1. Gangguan Somatofrom 4 A P75 Somatization disorder F45 Somatoform disorders - - - - -
2. Demensia 3 A P70 Dementia F03 Unspecified dementia - - - - -
3. Imsomnia 4 A P06 Sleep disturbance F51 Insomnia non organik pada psikiatri - - - - -
4. Gangguan campuran Eksietas dan 3 A P74 Anxiety Disorder (anxiety state) F41.2 Mixed Anxiety and Depression Disorder - - - - -
depresi
5. Gangguan Psikotik 3 A P98 Psychosis NOS/other F20 Chronic Psychotic Disorder - - - - -
J. Respirasi
1. Influenza 4 A R80 Influenza J11 Influenza, virus not identified 0 0 0 2 0 2 0 3 4 4 15 6 9 15 - 15 15

Upper respiratory infection
2. Pharyngitis Acut 4 A R74
acute
J02.9 Acute pharyngitis, unspecified 0 0 0 0 1 0 0 2 4 3 10 8 2 10 - 10 10
3. Laringitis Acut 4 A R77 Laryngitis/tracheitis acute J04.0 Acute laryngitis - - - - -
4. Tonsilitis Acut 4 A R76 Tonsillitis acute J03 Acute tonsillitis 0 0 0 0 1 0 0 0 3 0 4 0 4 4 - 4 4

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J35 Chronic tonsilitis - - - - -
5. Bronkitis Akut 4 A R78 Acute bronckitis /bronchiolitis J20.9 Acute bronchitis, unspecified - - - - - 1 - 1 3 - 5 2 3 5 - 5 5
6. Asma Bronkial (Asma Stabil) 4 A R96 Asthma J45 Asthma 0 0 1 0 2 0 2 8 12 29 54 23 26 49 1 4 5 54 49
7. Status Asmatikus (Asma Acut Berat) 3 B R03 Wheezing J45.902 Unspecified asthma with status asthmaticus - - - - -
8. Pneumonia Aspirasi 3 B R99 Respiratory disease other J69.0 Pneumonitis due to food and vomit - - - - -
9. Pneumonia dan Bronkopneumonia 4 A R81 Pneumonia J18.0 Bronchopneumonia, unspecified - - - - -
J18.9 Pneumonia, unspecified - - - - -
10. Pneumothoraks 4 A R99 Respiratory Disease Other J93.9 Respiratory Disease other - - - - -
11. PPOK (Penyakit Paru Obstruktif Chronic Obstructive Pulmonary

3 B R95 J44.9 Chronic Obstructive Pulmonary Diseasesm unspecified 1 1 - 4 6 1 2 3 2 1 3 6 3
Kronis) Diseases
12. Epistaksis 4 A R06 Nose bleed/epistaxis R04.0 Epistaxis - - - - -
Foreign body
13. Benda Asing di Hidung 4 A R87 nose/larynx/bronch T17.1 Foreign body in nostril - - - - -
14. Furunkel Pada Hidung 4 A R73 Boil/abscess nose J34.0 Abscess, furuncle and carbuncle of nose 0 0 0 1 1 0 0 0 0 0 2 1 1 2 - 2 2
15. Rhinitis Akut 4 A R74 acute J00 Acute nasopharyngitis (common cold) 0 0 0 0 0 0 2 0 1 2 5 2 3 5 - 5 5
16. Rhinitis Vasomotor 4 A R97 Allergic rhinitis J30.0 Vasomotor rhinitis - - - - -
17. Rhinitis Alergik 4 A R97 Allergic rhinitis J30.4 Allergic rhinitis, unspecified - - - - -
18. Sinusitis (Rinosinusitis) 4 A R75 Sinusitis acute / chronic J01 Acute sinusitis (Rinosinusitis akut) 0 0 0 0 0 0 0 1 0 0 1 0 1 1 - 1 1
3 A J32 Chronic sinusitis (Rinosinusitis kronik) 0 0 0 0 0 0 0 1 0 0 1 - 1 0 1 1 -
K. Kulit
1. Miliaria 4 A S92 Sweat gland disease L74.3 Miliaria, unspecified - - - - -
2. Veruka Vulgaris 4 A S03 Warts B07 Viral warts - - - - -
3. Herpes Zoster 4 A S70 Herpes Zoster B02.9 Zoster without complication 0 0 0 0 0 0 0 0 1 0 1 0 1 1 - 1 1
4. Herpes Simpleks 4 A S71 Herpes Simplex B00.9 Herpesviral infection, unspecified 0 0 0 0 0 0 0 0 1 0 1 1 0 1 - 1 1
5. Moluskum Kontagiosum 4 A S95 Molluscum contagiosum B08.1 Molluscum contagiosum - - - - -
6. Reaksi Gigitan Serangga 4 A S12 Insect bite/sting T63.4 Venom of other arthropods - - - - -
7. Skabies 4 A S72 Scabies/other acariasis B86 Scabies 0 0 0 0 0 1 0 0 0 0 1 1 0 1 - 1 1
8. Pedikulosis Kapitis / kutu rambut 4 A S73 Pediculosis/skin infestation other B85.0 Pediculosis due to Pediculus humanus capitis - - - - -
9. Pedikulosis Pubis / kutu kemaluan 4 A S73 Pediculosis/skin infestation other B85.3 Pthiriasis - - - - -
10. Dermatofitosis 4 A S74 Dermatophytosis B35 Dermatophytosis 0 0 0 0 0 0 0 1 1 0 2 0 2 2 - 2 2
B35.0 Tinea barbae and tinea capitis - - - - -
B35.1 Tinea unguium - - - - -
B35.2 Tinea manuum - - - - -
B35.3 Tinea pedis - - - - -
B35.4 Tinea corporis - - - - -
B35.5 Tinea imbricate - - - - -
B35.6 Tinea cruris - - - - -
B35.8 Other dermatophytoses - - - - -
11. Pitiriasis Versikolor / Tinea

Versikolor 4 A S76 Skin infection other B36.0 Pityriasis versicolor - - - - -
12. Pioderma 4 A S84 Impetigo L01 Impetigo 0 0 0 0 1 0 0 0 0 0 1 0 1 1 - 1 1
4 A L02 Cutaneous abscess, furuncle and carbuncle 0 0 0 0 0 0 0 0 0 1 1 1 0 1 - 1 1
4 A L08.0 Pyoderma - - - - -
4 A Folikulitis superfisialis
4 A Furunkel, Furunkulosis dan Karbunkel
Impetigo krustosa (impetigo contagiosa) dan Impetigo

4 A
bulosa
4 A Ektima (impetigo ulseratif)

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13. Erysipelas 4 A S76 Skin infection other A 46 Erysipelas - - - - -
14. Dermatitis Seboroik 4 A S86 Dermatitis seborrhoeic L21 Seborrhoeic dermatitis - - - - -
15. Dermatitis Atopik 4 A S87 Dermatitis/atopic eczema L20 Atopic dermatitis 0 0 0 0 0 0 0 2 3 7 12 3 5 8 2 2 4 12 8
16. Dermatitis Numularis 4 A S87 Dermatitis/atopic eczema L20.8 Other atopic dermatitis - - - - -
17. Liken Simpleks Kronik

3 A S87 Dermatitis/atopic eczema L28.0 Lichen simplex chronicus - - - - -
(Neurodermatitis Sirkumkripta)
18. Dermatitis Kontak Alergik (DKA) 3 A S88 Dermatitis contact/allergic L23 Allergic contact dermatitis 0 0 0 3 5 2 4 58 33 35 140 53 81 134 3 3 6 140 134
19. Dermatitis Kontak Iritan 4 A S88 Dermatitis contact/allergic L24 Irritant contact dermatitis 0 0 0 0 0 0 0 1 1 4 6 4 2 6 - 6 6
20. Napkin Eczema (Dermatitis Popok) 4 A S89 Diaper rash L22 Diaper (napkin) dermatitis - - - - -
21. Dermatitis Perioral 4 A S99 Skin disease other L71.0 Perioral dermatitis - - - - -
22. Pitiriasis Rosea 4 A S90 Pityriasis rosea L42 Pityriasis rosea - - - - -
23. Eritrasma 4 A S76 Skin infection other L08.1 Erythrasmay - - - - -
24. Skrofuloderma 4 A A 70 Tuberculosis A 18.4 Tuberculosis of skin and subcutaneous tissue - - - - -
25. Hidradenitis Supuratif 4 A S92 Sweat gland disease L73.2 Hidradenitis suppurativa - - - - -
26. Akne Vulgaris Ringan 4 A S96 Acne L70.0 Acne vulgaris - - - - -
27. Urtikaria S98 Urticaria L50 Urticaria - - - - -
L50 L50.9Urticaria, unspecified - - - - -
4 A Urtikaria akut
3 A Urtikaria kronis
28. Exanthematous Drug Eruption 4 A S07 Rash generalized L27.0 Generalized skin eruption due to drugs and - - - - -
medicament
Generalized skin eruption due to drugs and
29. Fixed Drug Eruption 4 A A85 Adverse effect medical agent L27.0 - - - - -
medicaments
30. Cutaneus Larva Migrans 4 A D96 Worms/other parasites B76.9 Hookworm disease, unspecified - - - - -
31. Luka Bakar Derajat I dan II 4 A S14 Burn/scald T30 Burn and corrosion, body region unspecified - - - - -
T31 Burns classified according to extent of body surface - - - - -

involved
T32 Corrosions classified according to extent of body - - - - -

surface involved
32. Ulkus Pada Tungkai 4 A S97 Chronic Ulcer Skin I83.0 Varicose veins of lower extremities with ulcer - - - - -
L97 Ulcer of lower limb, notelsewhere classifi - - - - -
33. Sindrom Stevens Johnson 3 B S99 Skin disease other L51.1 Bullous erythema multiforme - - - - -
L. Metabolik Endokrin Dan Nutrisi - -
1. Obesitas 4 A T82 Obesity, T83 overweight E66.9 Obesity unspecified - - - - -
2. Tirotoksikosis 3 B T85 Hipertiroidisme/tirotoksikosis E05.9 Tirotoksikosis unspecified 0 0 0 0 0 0 1 1 0 0 2 2 0 2 - 2 2
3. Diabetes Melitus Type 2 4 A T90 Diabetes non-insulin dependent E11 Non-insulin-dependent diabetes mellitus 0 0 0 0 0 0 0 3 13 5 21 4 6 10 5 6 11 21 10
4. Hiperglikemia Hiperosmolar Non Abnormal result invetigation

3 B A91 R73.9 Hyperglycaemia unspecified - - - - -
Ketotik NOS
5. Hipoglikemia T87 Hypoglycaemia E16.2 Hypoglycaemia unspecified - - - - -
4 A Hipoglikemia ringan
3 B Hipoglikemia berat
Endocrine/metabolic/nutritional Hyperuricemia without signs ofinflammatory arthritis

6. Hiperiricemia-Gout Arthritis 4 A T99 E79.0 - - - - -
disease other and tophaceous disease
T92 Gout M10 Gout 0 0 0 0 0 0 0 2 1 3 6 3 2 5 0 1 1 6 5
7. Lipidemia 4 A T93 Lipid disorder E78.5 Hiperlipidemia - - - - -
8. Malnutrisi Energi Protein (MEP) 4 A T91 Vitamin/nutritional deficiency E46 Unspecified protein-energy malnutrition - - - - -
M. Saluran Kemih
1. Infeksi Saluran Kemih 4 A U71 Cystitis/urinary infection others N39.0 Urinary tract infection, site not specified 0 0 0 0 0 0 0 2 1 2 5 4 0 4 1 0 1 5 4
Acute tubulo-interstitial nephritis (applicable to: acute
2. Pielonefritis Tanpa Komplikasi 4 A U70 Pyelonephritis / pyelitis N10 - - - - -
pyelonephritis)
3. Fimosis 4 A Y81 Phimosis N47 Phimosis - - - - -
4. Parafimosis 4 A Y81 Paraphimosis N47.2 Paraphimosis - - - - -

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N. Kesehatan Wanita
Uncomplicated labour/delivery
1. Kehamilan Normal 4 A W90
livebirth
O80.9 Single spontaneous delivery, unspecified 0 0 0 0 0 0 2 19 0 0 21 0 21 21 - 21 21
2. Hiperemesis Gravidarum 3 B W05 Pregnancy vomiting/nausea O21.0 Mild hyperemis gravidarum - - - - -
3. Anemia Defisiensi Besi pada

4 A B80 Irondeficiency anaemia D50 Iron deficiency anaemia - - - - -
Kehamilan
4. Pre Eklamsia 3 B W81 Toxaemia of pregnancy O14.9 Pre-eclampsia, unspecified 0 0 0 0 0 0 0 2 0 0 2 0 2 2 - 2 2
5. Eklamsia 3 B W81 Toxaemia of pregnancy O15.9 Eclampsia, unspecified as to time period 0 0 0 0 0 0 0 1 0 0 1 0 1 1 - 1 1
6. Abortus 4 A W82 Abortion spontaneous O03.9 Unspecified abortion, complete, without complication - - - - -
Unspecified abortion, incomplete, without

3 B W82 Abortion spontaneous O06.4 complication - - - - -
3 B O02.1 Abortus insipiens - - - - -
Complicated labour/delivery
7. Ketuban Pecah Dini 3 A W92 042.9 Premature rupture of membrane, unspecified - - - - -
livebirth
8. Persalinan Lama 3 B W92 Life birth O63.9 Long labour - - - - -
W93 Still birth
9. Perdarahan Post Partum 3 B W17 Post partum bleeding 072.1 Other Immediate Postpartum haemorrhage - - - - -
10. Ruptur Perineum Tingkat 1-2 4 A W92 livebirth O70.0 First degree perineal laceration during delivery - - - - -
Breast symptom/complaint
11. Mastitis 4 A X21 N61 Inflammatory disorders of breast - - - - -
female other
Breast disorder in pregnancy
12. Inverted Nipple / Putting Susu Datar 4 A W.95 O92.02 Retracted nipple associated with the puerperium - - - - -
other
Nipple symptom/complaint
X.20 O92.03 Retracted nipple associated with lactation - - - - -
female
13. Cracked Nipple / Nyeri Putting Susu 4 A W.95 other O92.12 Cracked nipple associated with the puerperium - - - - -
X.20 Nipple symptom/complaint O92.13 Cracked nipple associated with lactation - - - - -

female
O. Penyakit Kelamin
1. Flour Albus / Vaginal Discharge Non

Gonore 4 A X14 Vaginal discharge N98.9 Flour Albus - - - - -
X71 Gonore pada wanita
X72 Urogenital candidiasis pada

wanita
X73 Trikomoniasis urogenital pada

wanita
X92 Klamidia genital pada wanita
2. Sifilis 3 A Y70 Syphilis male A51 Early syphilis - - - - -
X70 Syphilis female A51.0 Primary genital syphilis - - - - -
A52 Late syphilis - - - - -
A53.9 Syphilis, unspecified - - - - -

Gonorrhoea female, Y71
3. Gonore 4 A X71 A54.9 Gonococcal infection, unspecified - - - - -
Gonorrhoea male
4. Vaginitis 4 A X84 Vaginitis N76.0 Acute Vaginitis - - - - -
5. Vulvitis 4 A X84 Vaginitis/Vulvitis N76.0 Acute Vaginitis - - - - -
P. LAIN - LAIN
1 Malnutrisi Energi Protein (MEP) E46 - - - - -
2 Nyeri Haid (Dismenorrhoe) N94 0 0 0 0 0 1 0 0 0 0 1 0 1 1 - 1 1
3 Kecelakaan Lalu Lintas/KLL V29.9 - - - - -
4 Pemeriksaan Kesehatan Umum Z00.0 0 0 0 0 2 20 233 900 744 651 2,550 1120 1429 2,549 1 0 1 2,550 2,549
5 Pemeriksaan Kesehatan Bayi Dan Anak Z00.1 - - - - -

Secara Rutin
6 Imunisasi BCG Z23.2 - - - - -
7 Imunisasi Tetanus Z23.5 - - - - -
Imunisasi Dan Kemoterapi Pencegahan

8 Lainnya Z23.0 - - - - -
9 Imunisasi Poliomielitis Z24.0 - - - - -
10 Imunisasi Rabies Z24.2 - - - - -
11 Imunisasi Campak Z24.4 - - - - -

TINGK
JUMLAH
AN
12 Imunisasi Hepatitis Virus A24.6 - - - - -
13 Imunisasi Gabungan Dpt (Difteri, Pertusis, Z27.1 - - - - -

Tetanus)
14 Pengelolaan Kontrasepsi Z30 - - - - - - - 1 1 - 2 - 2 2 2 -
15 Pengawasan Kehamilan Normal Z34 - - - - -
Pengawasan Kehamilan Dengan Risiko

16 Z35 - - - - -
Tinggi
17 Bayi Normal Z38.0 - - - - -
Perawatan Dan Pemeriksaan Pasca

18 Persalinan Z39 0 0 0 0 0 0 0 5 0 0 5 0 5 5 - 5 5
Khitanan Menurut Agama Dan Adat

19 Kebiasaan Z41.2 - - - - -
20 Tindik telinga Z41.3 - - - - -
21 Schizoprenia F20 - - - - - - - 2 - 2 4 - - 3 1 4 4 -
22 ISPA J06 - - - 3 9 21 17 110 45 42 247 105 130 235 6 6 12 247 235
23 Ptyrigium H11.0 - - - - -
24 Batuk R05 0 0 0 0 3 1 0 3 3 0 10 4 6 10 - 10 10
25 Demam Yang Tdk Diketahui Sebabnya R50 - - -
26 Myalgia M79.1 0 0 0 0 0 1 2 229 286 345 863 335 387 722 52 89 141
27 Atritis Reumatik I55 - - -
28 Dispepsia K30 0 0 0 0 0 1 0 10 4 3 18 6 9 15 1 2 3
29 Luka di Kepala S00 - - -

K90
30 Nausea and vomiting/mual muntah stroke R11 0 0 0 0 0 2 0 5 3 0 10 7 3 10 -
/cere
31 Infark Serebral/STROKE 3 B brova Iunspecified
63.9 cerebral infarction G80 - - -
scular
32 Sakit Kepala accide R51 0 0 0 0 2 2 5 85 74 50 218 80 120 200 5 13 18
nt
33 Imunisasi MR Z27.4 - - -
34 Meno Metroragi N92 - - -
35 Anoreksia R63 0 0 0 0 0 0 0 0 0 2 2 1 1 2 -
36 Gagal Ginjal Kronis/GGK N18.9 0 0 0 0 0 0 0 2 1 0 3 - 0 3 3
37 Pertusis A37.9 - - -
38 Tumor ganas pada payudara C50 - - -
Connective and other soft tissue of

39 abdomen 0 0 0 0 1 0 0 0 1 0 2 0 2 2 -
40 Male genital organ, unspecified 0 0 0 0 1 0 0 0 0 0 1 1 0 1
41 Nontoxic goitre, unspecified 0 0 0 0 0 0 0 1 0 0 1 0 1 1
42 Pure hypercholesterolaemia 0 0 0 0 0 0 0 0 4 0 4 0 4 4
43 Parkinsons disease 0 0 0 0 0 0 0 0 0 1 1 1 0 1
44 Idiopathic
peripheral autonomic
neuropathy 0 0 0 0 0 0 0 0 1 0 1 1 0 1
45 Disorder of refraction, unspecified 0 0 0 0 0 0 1 1 3 0 5 2 1 3 1 1 2
46 Tinnitus 0 0 0 0 0 0 0 0 1 0 1 0 1 1
47 Hypertensive heart disease 0 0 0 0 0 0 0 0 2 0 2 0 1 1 - 1 1
48 Low back pain 0 0 0 0 0 0 0 2 2 1 5 2 1 3 2 - 2
49 Hyperplasia of prostate 0 0 0 0 0 0 0 0 1 8 9 8 1 9
50 Hydrocele and spermatocele 0 1 0 0 0 0 0 0 0 0 1 1 1
51 Inflammatory disease of cervix uteri 0 0 0 0 0 0 0 0 3 0 3 3 3
52 Other female pelvic inflammatory diseases 0 0 0 0 0 0 0 1 0 0 1 1 1
53 Abnormal uterine and vaginal bleeding, 0 0 0 0 0 0 1 0 0 1 2 1 1 1 1

unspecified
54 Hipertensi kehamilan 0 0 0 0 0 0 0 1 0 0 1 1 1
55 Sectio Caecarea 0 0 0 0 0 0 0 2 0 0 2 2 2
TINGK
JUMLAH
AN
56 Neonatal jaundice, unspecified 0 1 0 0 0 0 0 0 0 0 1 1 1
57 Malaise and fatigue 0 0 0 0 0 0 0 1 1 0 2 1 1 2
- - -
R. GIGI DAN MULUT
41 Persistensi K00.6 - - -
42 Karies Dentin (Hiperemia Pulpa) K02.1 0 0 0 0 3 1 1 8 7 1 21 6 10 16 3 2 5
43 Pulpitis K04.0 0 0 0 0 0 0 0 4 0 0 4 2 2 4 -
44 Necrosis Pulpa K04.1 - - -
45 Periodonitis Apikalis Kronis K04.5 - - -
46 Abses Periapikal tdk melibatkan sinus K04.7 0 0 0 0 1 0 0 0 1 0 2 1 1 2 -
47 Anomali Letak Gigi K07.4 0 0 0 0 0 1 0 0 0 1 2 1 0 1 1 - 1
48 Ginggivitis Kronis K05.1 - - - - - - 1 4 - 5 1 4 5 -
49 Gangren Radik, Ulcus Dicubitus K08.3 - - -
50 Periodonitis Kronis K05.3 - - - - - - - 1 1 1 3 2 1 3 -
51 Gigi Impaksi K01.1 - - -
52 Fraktur Korona S02.51 - - -
53 Neoplasma Rongga Mulut C09.9 - - - - -
54 Excessive attrition of teeth K03.0 - - -
55 Other diseases of hard tissue of teeth,

unspecified K03.9 - - -
56 Disturbances in tooth eruption 0 0 0 0 11 2 0 0 0 0 13 8 5 13 -
57 - - -
Jumlah - 2 5 24 81 110 299 1,717 1,480 1,398 5,116 2,091 2,643 4,734 153 229 382 - -
Situbondo, 17 Februari 2020 382

Kepala UPTD Puskesmas Pelaksana
Hj. Lilik Maria Ulfah,S.ST.M.M.Kes Yuvita Try Agustin,S.Kep.,Ners

NIP. 19720830 199203 2 005
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Puskesmas / Klinik / Dokter TING
Praktek Swasta = Bulan = Tahun =
KAT KODE JUMLAH KASUS BARU DAN LAMA ( UMUR DAN JENIS KELAMIN) JUMLAH KASUS LAMA JUMLAH
JUMLAH
NO NAMA PENYAKIT KEM RUJUKAN
AMP ICPC II ICD X 0-7 HR 8-28 HR 1-11 BLN 1-4 THN 5-9 THN 10-14 THN 15-19 THN 20-44 THN 45-59 THN >59 THN JUM LAH L P JUM LAH L P JUM LAH RUJUKAN BALIK
UAN
A. Kelompok Umum
1. Tuberkolosis ( TB ) Paru 4 A A 70 Tuberkulosis A15 - - - - - - - - - - - - - - - - - - -
TB 3 A A 70 Tuberkulosis A15 - - - - - - - - - - - - - - - - - - -
Asymptomatic human immunodeficiency virus
HIV B90 HIV-infection/AIDS Z21 - - - - - - - - - - - - - - - - - - -
(HIV) infection status
3. Morbili 4 A A 71 Measles B05.9 Measles without complication (Measles NOS). - - - - - - - - - - - - - - - - - - -
4. Varisela 4 A A 72 Chickenpox B01.9 Varicella without complication (Varicella NOS) - - - - - - - - - - - - - - - - - - -
5. Malaria 4 A A 73 Malaria B54 Unspecified malaria - - - - - - - - - - - - - - - - - - -
6. Leptospirosis 4 A A 78 Infection disease other/ NOS A27.9 Leptospirosis, unspecified - - - - - - - - - - - - - - - - - - -

B74 Filariasis
B74.0 Filariasis due to Wuchereria bancrofti
7. Filariasis 4 A D96 Woms/other parasites - - - - - - - - - - - - - - - - - - -
B74.2 Filariasis
Omphalitisdue to Brugia with
of newborn timori
or without mild
8. Infeksi Pada Umbilikus 4 A A94 Perinatal morbidity other P38 - - - - - - - - - - - - - - - - - - -
haemorrhage
9. Kandidiasis Mulut 4 A A 78 Infection disease other/ NOS B37.9 Candidiasis unspecified - - - - - - - - - - - - - - - - - - -
10. Lepra 4 A A 78 Infection disease other/ NOS A30 Leprosy [Hansen disease] - - - - - - - - - - - - - - - - - - -
11. Keracunan Makanan 4 A A 86 Effect Non Medical Substance T62.2 Other Ingested (parts of plant(s)) - - - - - - - - - - - - - - - - - - -
12. Alergi Makanan 4 A A 92 Allergy/ allergic reaction NOS L27.2 Dermatitis due to ingested food - - - - - - - - - - - - - - - - - - -
13. Syok 3 B K 99 Cardiovascular disease other R57.9 Shock, unspecified - - - - - - - - - - - - - - - - - - -
14. Reaksi Anafilaktik 4 A A92 Allergy/allergic reaction NOS T78.2 Anaphylactic shock, unspecified - - - - - - - - - - - - - - - - - - -
15. Demam Dengue dan Demam
4 A A77 Viral disease other/NOS A90 Dengue fever - - - - - - - - - - - - - - - - - - -
Berdarah Dengue
A91 Dengue haemorrhagic fever - - - - - - - - - - - - - - - - - - -
1. Anemia Defiisiensi Besi 4 A B80 Iron Deficiency Anaemia 280 Iron Deficiency Anemias - - - - - - - - - - - - - - - - - - -
Asymptomatic Human Immunodeficiency Virus
2. HIV / AIDS tanpa komplikasi 4 A B90 HIV-infection/AIDS Z21 - - - - - - - - - - - - - - - - - - -
(HIV) infection status
Systemic Lupus
3. Lupus Eritamatosus Sistemik 3 A L99 M32 Systemic Lupus Erythematosus - - - - - - - - - - - - - - - - - - -
Erythematosus
Acute lymphadenitis,
4. Limfadenitis 4 A L04.9 B70 Lymphadenitis Acute - - - - - - - - - - - - - - - - - - -
unspecified
C. Digestive
1. Ulkus Mulut (Aftosa, Herpes) 4 A D83 Mouth / tongue / lip disease K12 Stomatitis and related lesions - - - - - - - - - - - - - - - - - - -
K12.0 Recurrent oral aphtae - - - - - - - - - - - - - - - - - - -
K12.1 Other form of stomatitis - - - - - - - - - - - - - - - - - - -

Gastro-oesophageal reflux disease without
2. Refluksgastroesofageal 4 A D84 Oesphagus disease K21.9 - - - - - - - - - - - - - - - - - - -
oesophagitis
3. Gastritis 4 A D07 Dyspepsia/indigestion K29.7 Gastritis, unspecified - - - - - - - - - - - - - - - - - - -
4. Intoleransi Makanan 4 A D29 K90.4 Malabsorption due to intolerance - - - - - - - - - - - - - - - - - - -
other
5. Malabsorbsi Makanan 3 A D29 K90.9 Intestinal malabsorbtion, unspecified - - - - - - - - - - - - - - - - - - -
other
6. Demam Tifoid 4 A D70 Gastrointestinal infection A01.0 Typhoid fever - - - - - - - - - - - - - - - - - - -
7. Gastroenteritis (termasuk Gastroenteritis presumed Diarrhoea and gastroenteritis of presumed
4 A D73 A09 - - - - - - - - - - - - - - - - - - -
disentri, kolera dan giardiasis) infection infection origin
8. Disentri Basiler dan Disentri
4 A D70 Gastrointestinal infection A06.0 Acute amoebic dysentery - - - - - - - - - - - - - - - - - - -
Amuba
9. Perdarahan Gastroenteritis 3 A D14 Haematemesis/vomiting blood K92.2 Gastrointestinal haemorrhage, unspecified - - - - - - - - - - - - - - - - - - -
D15 /
Melaena / Rectal Bleeling K62.5 Haemorrhage of anus and rectum - - - - - - - - - - - - - - - - - - -
D16
10. Hemoroid Grade 1 – 2 4 A D95 Anal fissure/perianal abscess I84 Haemorrhoids - - - - - - - - - - - - - - - - - - -
11. Hepatitis A 4 A D72 Viral Hepatitis B15 Acute Hepatitis A - - - - - - - - - - - - - - - - - - -

TING
JUMLAH
UAN
12. Hepatitis B 3 A D72 Viral Hepatitis B16 Acute Hepatitis B - - - - - - - - - - - - - - - - - - -
13. Kolesistitis 3 A D98 Cholecystitis/cholelithiasis K81.9 Cholecystitis, unspecified - - - - - - - - - - - - - - - - - - -
14. Apendisitis Acut 3 A S87 Appendicitis K35.9 Acute appendicitis - - - - - - - - - - - - - - - - - - -

Disease digestive system,
15. Peritonitis 3 A D99 K65.9 Peritonitis, unspecified - - - - - - - - - - - - - - - - - - -
other
D71 / Mumps / Disease digestive
16. Parotitis 4 A B26 Mumps - - - - - - - - - - - - - - - - - - -
D99 system, other
17. Askariasis / Cacing gelang 4 A D96 Worms/ other parasites B77.9 Ascariaris unspecified - - - - - - - - - - - - - - - - - - -
18. Ankylostomiasis / Cacing
4 A D96 Worms/other parasites B76.0 Ankylostomiasis - - - - - - - - - - - - - - - - - - -
tambang
B76.1 Necatoriasis - - - - - - - - - - - - - - - - - - -
19. Skistosomiasis 4 A D96 Worm/outer parasite B65.9 Skistosomiasisunspecified - - - - - - - - - - - - - - - - - - -
B65.2 Schistomiasis due to S. japonicum - - - - - - - - - - - - - - - - - - -
20. Taeniasis 4 A D96 Worms/other parasites B68.9 Taeniasis - - - - - - - - - - - - - - - - - - -
21. Strongiloidiasis 4 A D96 Worms/other parasites B78.9 Strongyloidiasis - - - - - - - - - - - - - - - - - - -
D. Mata
1. Mata Kering / Dry eye 4 A F99 Eye/adnexa disease, other H04.1 Otherdisorders of lacrimal gland - - - - - - - - - - - - - - - - - - -
2. Buta Senja 4 A F99 Eye/adnexa disease other H53.6 Night blindness - - - - - - - - - - - - - - - - - - -
3. Hordeolum 4 A F72 Blepharitis/stye/chalazion H00.0 Hordeolum and other deep inflammation of eyelid - - - - - - - - - - - - - - - - - - -
4. Konjungtivitis
Konjungtivitis Infeksi 4 A F70 Conjunctivitis infectious H10.9 Conjunctivitis, unspecified - - - - - - - - - - - - - - - - - - -
Konjungtivitis Alergi F71 Conjunctivitis allergic H10.1 Acute atopic conjunctivitis - - - - - - - - - - - - - - - - - - -
5. Blefaritis 4 A F72 Blepharitis/stye/chalazion H01.0 Blepharitis - - - - - - - - - - - - - - - - - - -
6. Perdarahan Subkonjungtiva 4 A F75 Contusion/ haemorrhage eye H57.8 Other specified disorders of eye and adnexa - - - - - - - - - - - - - - - - - - -
7. Benda Asing di Konjungtiva 4 A F76 Foreign body in eye T15.9 Foreign body on external eye, part unspecified - - - - - - - - - - - - - - - - - - -
8. Astigmatism 4 A F91 Refractive error H52.2 Astigmatisme - - - - - - - - - - - - - - - - - - -
9. Hipermetropia 4 A F91 Refractive error H52.0 Hypermetropia ringan - - - - - - - - - - - - - - - - - - -
10. Miopia Ringan 4 A F91 Refractive error H52.1 Myopia - - - - - - - - - - - - - - - - - - -
11. Presbiopia 4 A F91 Refractive error H52.4 Presbyopia - - - - - - - - - - - - - - - - - - -
12. Katarak Pada Pasien Dewasa 2 F92 Cataract H26.9 Cataract, unspecified - - - - - - - - - - - - - - - - - - -
13. Glaukoma Akut 4 A F93 Glaucoma H40.2 Primary angle-closure glaucoma - - - - - - - - - - - - - - - - - - -
14. Glaukoma Kronis 3 B F93 Glaucoma H40.2 Primary angle-closure glaucoma - - - - - - - - - - - - - - - - - - -
15. Trichiasis 4 A F99 Eye / adnexa disease, other H02 Entropion and trichiasis of eyelid - - - - - - - - - - - - - - - - - - -
16. Episkleritis 4 A F99 Eye / adnexa disease, other H15.1 Episcleritis - - - - - - - - - - - - - - - - - - -
17. Trauma Kimia Mata 3 A F79 Injury eye other T26 Burn and corrosion confined to eye and adnexa - - - - - - - - - - - - - - - - - - -
18. Laserasi Kelopak Mata 3 A F79 Injury eye other S01.1 Open wound of eyelid and periocular area - - - - - - - - - - - - - - - - - - -
19. Hifema 3 A F75 Contusion/haemorrhage eye H21.0 Hyphaema - - - - - - - - - - - - - - - - - - -
20. Retinopaty Diabetik 2 F83 Retinopathy H36.0 Diabetic retinopathy - - - - - - - - - - - - - - - - - - -
E. Telinga
1. Otitis Eksterna 4 A H70 Otitis externa H60.9 Otitis externa, unspecified - - - - - - - - - - - - - - - - - - -
2. Otitis Media Akut 4 A H71 Acute otitis media/myringitis H65.0 Acute serous otitis media - - - - - - - - - - - - - - - - - - -
H65.1 Other acure nonsuppurative otitis media - - - - - - - - - - - - - - - - - - -
H66.0 Acute suppurative otitis media - - - - - - - - - - - - - - - - - - -
3. Otitis Media Supuratif Kronik 3 A H74 Chronic otitis media H66.1 Chronic tubotympanic suppurative otitis media - - - - - - - - - - - - - - - - - - -
TING
JUMLAH
UAN
H66.2 Chronic atticoantral suppurative otitis media - - - - - - - - - - - - - - - - - - -
H66.3 Other chronic suppurative otitis media - - - - - - - - - - - - - - - - - - -
4. Benda Asing di Telinga 3 A H76 Foreign body in ear T16 Foreign body in ear - - - - - - - - - - - - - - - - - - -
5. Seromen Prop H81 Excessive ear wax H61.2 Impacted cerumen - - - - - - - - - - - - - - - - - - -
F. Kardiovaskuler
1. Angina Pektoris Stabil 3 B K74 I20.9 Angina pectoris, unspecified - - - - - - - - - - - - - - - - - - -
angina
2. Infark Miokard 3 B K75 Acute Myocardial Infarction I21.9 Acute Myocardial Infarction, Unspecified - - - - - - - - - - - - - - - - - - -
3. Takikardia 3 B K79 Paroxysmal Tachicardy R00.0 Tachicardy Unspecified - - - - - - - - - - - - - - - - - - -
I47.1 Supraventicular Tachicardy - - - - - - - - - - - - - - - - - - -
I47.2 Ventricular Tachicardy - - - - - - - - - - - - - - - - - - -
4. Gagal Jantung Akut dan Kronis K77 Heart failure I50.9 Heart failure, unspecified - - - - - - - - - - - - - - - - - - -
3 B Akut
3 A Kronik
5. Cardiorespiratory Arrest 3 B K80 Cardiac arrhytmia NOS R09.2 Respiratory arrest/ Cardiorespiratory failure - - - - - - - - - - - - - - - - - - -
6. Hipertensi Esensial K86 Hypertension uncomplicated I10 Essential (primary) hypertension - - - - - - - - - - - - - - - - - - -
1. Fraktur Terbuka 3 B L76 Fracture other T14 Fracture of unspecified body - - - - - - - - - - - - - - - - - - -
2. Fraktur Tertutup 3 B L76 Fracture other T14 Fracture of unspecified body - - - - - - - - - - - - - - - - - - -
3. Polimiagia Reumatik 3 A L99 Musculosceletal disease other M53.3 Polymyalgia rheumatica - - - - - - - - - - - - - - - - - - -
4. Artritis Reumatoid 3 A L99 Musculosceletal disease other M53.3 Polymyalgia rheumatica - - - - - - - - - - - - - - - - - - -
5. Artritis, Osteoartritis 3 A L91 Osteoarthrosis other M19.9 Osteoarthrosis other - - - - - - - - - - - - - - - - - - -
6. Vulnus 3 B S.16 Bruise / Contusion T14.1 Open wound of unspecified body region - - - - - - - - - - - - - - - - - - -
7. Lipoma 4 A S78 Lipoma D17.9 Benign lipomatous neoplasm - - - - - - - - - - - - - - - - - - -
H. Neurologi
1. Tension Headche 4 A N95 Tension Headache G44.2 Tension–type headache - - - - - - - - - - - - - - - - - - -
2. Migren 4 A N89 Migraine G43.9 Migraine, unspecified - - - - - - - - - - - - - - - - - - -
3. Vertigo 4 A N17 Vertigo/dizziness R42 Dizziness and giddiness - - - - - - - - - - - - - - - - - - -
4. Tetanus 4 A N72 Tetanus A35 Other tetanus - - - - - - - - - - - - - - - - - - -
5. Rabies 3 B A77 Viral disease other/NOS A82.9 Rabies, Unspecified - - - - - - - - - - - - - - - - - - -
6. Malaria Selebral 3 B A73 Malaria B50 Plasmodium falciparum with cerebral complication - - - - - - - - - - - - - - - - - - -
7. Epilepsi 3 A N88 Epilepsy G40.9 Epilepsy, unspecified - - - - - - - - - - - - - - - - - - -
8. Transient Ischemuk Attack / TIA 3 B K89 Transient cerebral ischaemia G45.9 Transient cerebral ischaemic attack, unspecified - - - - - - - - - - - - - - - - - - -
Stroke/cerebrovascular
9. Stroke 3 B K90 I63.9 Cerebral infarction, unspecified - - - - - - - - - - - - - - - - - - -
accident
10. Bells’ Palsy 4 A N91 Facial paralysis/Bells’ palsy G51.0 Bells’ palsy - - - - - - - - - - - - - - - - - - -
11. Status Epilepsi 3 B N88 Epilepsy G41.9 Status epilepticus, unspecified - - - - - - - - - - - - - - - - - - -
12. Delirium 3 A P71 Organic psychosis other F05.9 Delirium, unspecified - - - - - - - - - - - - - - - - - - -
13. Kejang Deman 4 A N07 Convulsion/Seizure R56.0 Febrile convulsions - - - - - - - - - - - - - - - - - - -
14. Tetanus Neonatorum 3 B N72 Tetanus A33 Tetanus Neonatorum - - - - - - - - - - - - - - - - - - -
I. Psikiatri
TING
JUMLAH
UAN
1. Gangguan Somatofrom 4 A P75 Somatization disorder F45 Somatoform disorders - - - - - - - - - - - - - - - - - - -
2. Demensia 3 A P70 Dementia F03 Unspecified dementia - - - - - - - - - - - - - - - - - - -
3. Imsomnia 4 A P06 Sleep disturbance F51 Insomnia non organik pada psikiatri - - - - - - - - - - - - - - - - - - -
4. Gangguan campuran Eksietas Anxiety Disorder (anxiety
3 A P74 F41.2 Mixed Anxiety and Depression Disorder - - - - - - - - - - - - - - - - - - -
dan depresi state)
5. Gangguan Psikotik 3 A P98 Psychosis NOS/other F20 Chronic Psychotic Disorder - - - - - - - - - - - - - - - - - - -
J. Respirasi
1. Influenza 4 A R80 Influenza J11 Influenza, virus not identified - - - - - - - - - - - - - - - - - - -

2. Pharyngitis Acut 4 A R74 J02.9 Acute pharyngitis, unspecified - - - - - - - - - - - - - - - - - - -
acute
3. Laringitis Acut 4 A R77 Laryngitis/tracheitis acute J04.0 Acute laryngitis - - - - - - - - - - - - - - - - - - -
4. Tonsilitis Acut 4 A R76 Tonsillitis acute J03 Acute tonsillitis - - - - - - - - - - - - - - - - - - -
J35 Chronic tonsilitis - - - - - - - - - - - - - - - - - - -
5. Bronkitis Akut 4 A R78 Acute bronckitis /bronchiolitis J20.9 Acute bronchitis, unspecified - - - - - - - - - - - - - - - - - - -
6. Asma Bronkial (Asma Stabil) 4 A R96 Asthma J45 Asthma - - - - - - - - - - - - - - - - - - -

7. Status Asmatikus (Asma Acut J45.90
3 B R03 Wheezing Unspecified asthma with status asthmaticus - - - - - - - - - - - - - - - - - - -
Berat) 2
8. Pneumonia Aspirasi 3 B R99 Respiratory disease other J69.0 Pneumonitis due to food and vomit - - - - - - - - - - - - - - - - - - -
9. Pneumonia dan
4 A R81 Pneumonia J18.0 Bronchopneumonia, unspecified - - - - - - - - - - - - - - - - - - -
Bronkopneumonia
J18.9 Pneumonia, unspecified - - - - - - - - - - - - - - - - - - -
10. Pneumothoraks 4 A R99 Respiratory Disease Other J93.9 Respiratory Disease other - - - - - - - - - - - - - - - - - - -
11. PPOK (Penyakit Paru Obstruktif Chronic Obstructive Chronic Obstructive Pulmonary Diseasesm
3 B R95 J44.9 - - - - - - - - - - - - - - - - - - -
Kronis) Pulmonary Diseases unspecified
12. Epistaksis 4 A R06 Nose bleed/epistaxis R04.0 Epistaxis - - - - - - - - - - - - - - - - - - -
Foreign body
13. Benda Asing di Hidung 4 A R87 T17.1 Foreign body in nostril - - - - - - - - - - - - - - - - - - -
nose/larynx/bronch
14. Furunkel Pada Hidung 4 A R73 Boil/abscess nose J34.0 Abscess, furuncle and carbuncle of nose - - - - - - - - - - - - - - - - - - -
15. Rhinitis Akut 4 A R74 J00 Acute nasopharyngitis (common cold) - - - - - - - - - - - - - - - - - - -
acute
16. Rhinitis Vasomotor 4 A R97 Allergic rhinitis J30.0 Vasomotor rhinitis - - - - - - - - - - - - - - - - - - -
17. Rhinitis Alergik 4 A R97 Allergic rhinitis J30.4 Allergic rhinitis, unspecified - - - - - - - - - - - - - - - - - - -
18. Sinusitis (Rinosinusitis) 4 A R75 Sinusitis acute / chronic J01 Acute sinusitis (Rinosinusitis akut) - - - - - - - - - - - - - - - - - - -
3 A J32 Chronic sinusitis (Rinosinusitis kronik) - - - - - - - - - - - - - - - - - - -
K. Kulit
1. Miliaria 4 A S92 Sweat gland disease L74.3 Miliaria, unspecified - - - - - - - - - - - - - - - - - - -
2. Veruka Vulgaris 4 A S03 Warts B07 Viral warts - - - - - - - - - - - - - - - - - - -
3. Herpes Zoster 4 A S70 Herpes Zoster B02.9 Zoster without complication - - - - - - - - - - - - - - - - - - -
4. Herpes Simpleks 4 A S71 Herpes Simplex B00.9 Herpesviral infection, unspecified - - - - - - - - - - - - - - - - - - -
5. Moluskum Kontagiosum 4 A S95 Molluscum contagiosum B08.1 Molluscum contagiosum - - - - - - - - - - - - - - - - - - -
6. Reaksi Gigitan Serangga 4 A S12 Insect bite/sting T63.4 Venom of other arthropods - - - - - - - - - - - - - - - - - - -
7. Skabies 4 A S72 Scabies/other acariasis B86 Scabies - - - - - - - - - - - - - - - - - - -

Pediculosis/skin infestation
8. Pedikulosis Kapitis / kutu rambut 4 A S73 B85.0 Pediculosis due to Pediculus humanus capitis - - - - - - - - - - - - - - - - - - -
other
9. Pedikulosis Pubis / kutu Pediculosis/skin infestation
4 A S73 B85.3 Pthiriasis - - - - - - - - - - - - - - - - - - -
kemaluan other
10. Dermatofitosis 4 A S74 Dermatophytosis B35 Dermatophytosis - - - - - - - - - - - - - - - - - - -
B35.0 Tinea barbae and tinea capitis - - - - - - - - - - - - - - - - - - -
B35.1 Tinea unguium - - - - - - - - - - - - - - - - - - -
B35.2 Tinea manuum - - - - - - - - - - - - - - - - - - -

TING
JUMLAH
UAN
B35.3 Tinea pedis - - - - - - - - - - - - - - - - - - -
B35.4 Tinea corporis - - - - - - - - - - - - - - - - - - -
B35.5 Tinea imbricate - - - - - - - - - - - - - - - - - - -
B35.6 Tinea cruris - - - - - - - - - - - - - - - - - - -
B35.8 Other dermatophytoses - - - - - - - - - - - - - - - - - - -

4 A S76 Skin infection other B36.0 Pityriasis versicolor - - - - - - - - - - - - - - - - - - -
Versikolor
12. Pioderma 4 A S84 Impetigo L01 Impetigo - - - - - - - - - - - - - - - - - - -
4 A L02 Cutaneous abscess, furuncle and carbuncle - - - - - - - - - - - - - - - - - - -
4 A L08.0 Pyoderma - - - - - - - - - - - - - - - - - - -

Impetigo krustosa (impetigo contagiosa) dan
4 A
Impetigo bulosa
13. Erysipelas 4 A S76 Skin infection other A 46 Erysipelas - - - - - - - - - - - - - - - - - - -
14. Dermatitis Seboroik 4 A S86 Dermatitis seborrhoeic L21 Seborrhoeic dermatitis - - - - - - - - - - - - - - - - - - -
15. Dermatitis Atopik 4 A S87 Dermatitis/atopic eczema L20 Atopic dermatitis - - - - - - - - - - - - - - - - - - -
16. Dermatitis Numularis 4 A S87 Dermatitis/atopic eczema L20.8 Other atopic dermatitis - - - - - - - - - - - - - - - - - - -
17. Liken Simpleks Kronik
3 A S87 Dermatitis/atopic eczema L28.0 Lichen simplex chronicus - - - - - - - - - - - - - - - - - - -
18. Dermatitis Kontak Alergik (DKA) 3 A S88 Dermatitis contact/allergic L23 Allergic contact dermatitis - - - - - - - - - - - - - - - - - - -
19. Dermatitis Kontak Iritan 4 A S88 Dermatitis contact/allergic L24 Irritant contact dermatitis - - - - - - - - - - - - - - - - - - -
20. Napkin Eczema (Dermatitis
4 A S89 Diaper rash L22 Diaper (napkin) dermatitis - - - - - - - - - - - - - - - - - - -
Popok)
21. Dermatitis Perioral 4 A S99 Skin disease other L71.0 Perioral dermatitis - - - - - - - - - - - - - - - - - - -
22. Pitiriasis Rosea 4 A S90 Pityriasis rosea L42 Pityriasis rosea - - - - - - - - - - - - - - - - - - -
23. Eritrasma 4 A S76 Skin infection other L08.1 Erythrasmay - - - - - - - - - - - - - - - - - - -
24. Skrofuloderma 4 A A 70 Tuberculosis A 18.4 Tuberculosis of skin and subcutaneous tissue - - - - - - - - - - - - - - - - - - -
25. Hidradenitis Supuratif 4 A S92 Sweat gland disease L73.2 Hidradenitis suppurativa - - - - - - - - - - - - - - - - - - -
26. Akne Vulgaris Ringan 4 A S96 Acne L70.0 Acne vulgaris - - - - - - - - - - - - - - - - - - -
27. Urtikaria S98 Urticaria L50 Urticaria - - - - - - - - - - - - - - - - - - -
L50 L50.9Urticaria, unspecified - - - - - - - - - - - - - - - - - - -
4 A Urtikaria akut
28. Exanthematous Drug Eruption 4 A S07 Rash generalized L27.0 - - - - - - - - - - - - - - - - - - -
medicament
29. Fixed Drug Eruption 4 A A85 Adverse effect medical agent L27.0 - - - - - - - - - - - - - - - - - - -
medicaments
30. Cutaneus Larva Migrans 4 A D96 Worms/other parasites B76.9 Hookworm disease, unspecified - - - - - - - - - - - - - - - - - - -
31. Luka Bakar Derajat I dan II 4 A S14 Burn/scald T30 Burn and corrosion, body region unspecified - - - - - - - - - - - - - - - - - - -
Burns classified according to extent of body
T31 - - - - - - - - - - - - - - - - - - -
surface involved
Corrosions classified according to extent of body
T32 - - - - - - - - - - - - - - - - - - -
surface involved
32. Ulkus Pada Tungkai 4 A S97 Chronic Ulcer Skin I83.0 Varicose veins of lower extremities with ulcer - - - - - - - - - - - - - - - - - - -
L97 Ulcer of lower limb, notelsewhere classifi - - - - - - - - - - - - - - - - - - -
33. Sindrom Stevens Johnson 3 B S99 Skin disease other L51.1 Bullous erythema multiforme - - - - - - - - - - - - - - - - - - -
L. Metabolik Endokrin Dan Nutrisi

TING
JUMLAH
UAN
1. Obesitas 4 A T82 Obesity, T83 overweight E66.9 Obesity unspecified - - - - - - - - - - - - - - - - - - -
2. Tirotoksikosis 3 B T85 Hipertiroidisme/tirotoksikosis E05.9 Tirotoksikosis unspecified - - - - - - - - - - - - - - - - - - -

Diabetes non-insulin
3. Diabetes Melitus Type 2 4 A T90 E11 Non-insulin-dependent diabetes mellitus - - - - - - - - - - - - - - - - - - -
dependent
4. Hiperglikemia Hiperosmolar Non Abnormal result invetigation
3 B A91 R73.9 Hyperglycaemia unspecified - - - - - - - - - - - - - - - - - - -
Ketotik NOS
5. Hipoglikemia T87 Hypoglycaemia E16.2 Hypoglycaemia unspecified - - - - - - - - - - - - - - - - - - -
Endocrine/metabolic/nutritiona Hyperuricemia without signs ofinflammatory
6. Hiperiricemia-Gout Arthritis 4 A T99 E79.0 - - - - - - - - - - - - - - - - - - -
l disease other arthritis and tophaceous disease
T92 Gout M10 Gout - - - - - - - - - - - - - - - - - - -
7. Lipidemia 4 A T93 Lipid disorder E78.5 Hiperlipidemia - - - - - - - - - - - - - - - - - - -
8. Malnutrisi Energi Protein (MEP) 4 A T91 Vitamin/nutritional deficiency E46 Unspecified protein-energy malnutrition - - - - - - - - - - - - - - - - - - -
M. Saluran Kemih

Cystitis/urinary infection
1. Infeksi Saluran Kemih 4 A U71 N39.0 Urinary tract infection, site not specified - - - - - - - - - - - - - - - - - - -
others
Acute tubulo-interstitial nephritis (applicable to:
2. Pielonefritis Tanpa Komplikasi 4 A U70 Pyelonephritis / pyelitis N10 - - - - - - - - - - - - - - - - - - -
acute pyelonephritis)
3. Fimosis 4 A Y81 Phimosis N47 Phimosis - - - - - - - - - - - - - - - - - - -
4. Parafimosis 4 A Y81 Paraphimosis N47.2 Paraphimosis - - - - - - - - - - - - - - - - - - -
N. Kesehatan Wanita

Uncomplicated labour/delivery
1. Kehamilan Normal 4 A W90 O80.9 Single spontaneous delivery, unspecified - - - - - - - - - - - - - - - - - - -
livebirth
2. Hiperemesis Gravidarum 3 B W05 Pregnancy vomiting/nausea O21.0 Mild hyperemis gravidarum - - - - - - - - - - - - - - - - - - -
4 A B80 Irondeficiency anaemia D50 Iron deficiency anaemia - - - - - - - - - - - - - - - - - - -
Kehamilan
4. Pre Eklamsia 3 B W81 Toxaemia of pregnancy O14.9 Pre-eclampsia, unspecified - - - - - - - - - - - - - - - - - - -
5. Eklamsia 3 B W81 Toxaemia of pregnancy O15.9 Eclampsia, unspecified as to time period - - - - - - - - - - - - - - - - - - -
Unspecified abortion, complete, without
6. Abortus 4 A W82 Abortion spontaneous O03.9 - - - - - - - - - - - - - - - - - - -
complication
Unspecified abortion, incomplete, without
3 B W82 Abortion spontaneous O06.4 - - - - - - - - - - - - - - - - - - -
complication
3 B O02.1 Abortus insipiens - - - - - - - - - - - - - - - - - - -
7. Ketuban Pecah Dini 3 A W92 042.9 Premature rupture of membrane, unspecified - - - - - - - - - - - - - - - - - - -
livebirth
8. Persalinan Lama 3 B W92 Life birth O63.9 Long labour - - - - - - - - - - - - - - - - - - -
W93 Still birth
9. Perdarahan Post Partum 3 B W17 Post partum bleeding 072.1 Other Immediate Postpartum haemorrhage - - - - - - - - - - - - - - - - - - -
10. Ruptur Perineum Tingkat 1-2 4 A W92 O70.0 First degree perineal laceration during delivery - - - - - - - - - - - - - - - - - - -
livebirth
Breast symptom/complaint
11. Mastitis 4 A X21 N61 Inflammatory disorders of breast - - - - - - - - - - - - - - - - - - -
female other
12. Inverted Nipple / Putting Susu Breast disorder in pregnancy O92.0
4 A W.95 Retracted nipple associated with the puerperium - - - - - - - - - - - - - - - - - - -
Datar other 2
Nipple symptom/complaint O92.0
X.20 Retracted nipple associated with lactation - - - - - - - - - - - - - - - - - - -
female 3
13. Cracked Nipple / Nyeri Putting Breast disorder in pregnancy O92.1
4 A W.95 Cracked nipple associated with the puerperium - - - - - - - - - - - - - - - - - - -
Susu other 2
Nipple symptom/complaint O92.1
X.20 Cracked nipple associated with lactation - - - - - - - - - - - - - - - - - - -
female 3
O. Penyakit Kelamin
1. Flour Albus / Vaginal Discharge
4 A X14 Vaginal discharge N98.9 Flour Albus - - - - - - - - - - - - - - - - - - -
Non Gonore
Urogenital candidiasis pada
X72
wanita
Trikomoniasis urogenital pada
X73
wanita
TING
JUMLAH
UAN
2. Sifilis 3 A Y70 Syphilis male A51 Early syphilis - - - - - - - - - - - - - - - - - - -
X70 Syphilis female A51.0 Primary genital syphilis - - - - - - - - - - - - - - - - - - -
A52 Late syphilis - - - - - - - - - - - - - - - - - - -
A53.9 Syphilis, unspecified - - - - - - - - - - - - - - - - - - -

Gonorrhoea female, Y71
3. Gonore 4 A X71 A54.9 Gonococcal infection, unspecified - - - - - - - - - - - - - - - - - - -
Gonorrhoea male
4. Vaginitis 4 A X84 Vaginitis N76.0 Acute Vaginitis - - - - - - - - - - - - - - - - - - -
5. Vulvitis 4 A X84 Vaginitis/Vulvitis N76.0 Acute Vaginitis - - - - - - - - - - - - - - - - - - -
P. LAIN - LAIN
1 Malnutrisi Energi Protein (MEP) E46 - - - - - - - - - - - - - - - - - - -
2 Nyeri Haid (Dismenorrhoe) N94 - - - - - - - - - - - - - - - - - - -
3 Kecelakaan Lalu Lintas/KLL V29.9 - - - - - - - - - - - - - - - - - - -
4 Pemeriksaan Kesehatan Umum Z00.0 - - - - - - - - - - - - - - - - - - -

Pemeriksaan Kesehatan Bayi Dan
5 Z00.1 - - - - - - - - - - - - - - - - - - -
Anak Secara Rutin
6 Imunisasi BCG Z23.2 - - - - - - - - - - - - - - - - - - -
7 Imunisasi Tetanus Z23.5 - - - - - - - - - - - - - - - - - - -

Imunisasi Dan Kemoterapi
8 Z23.0 - - - - - - - - - - - - - - - - - - -
Pencegahan Lainnya
9 Imunisasi Poliomielitis Z24.0 - - - - - - - - - - - - - - - - - - -
10 Imunisasi Rabies Z24.2 - - - - - - - - - - - - - - - - - - -
11 Imunisasi Campak Z24.4 - - - - - - - - - - - - - - - - - - -
12 Imunisasi Hepatitis Virus A24.6 - - - - - - - - - - - - - - - - - - -

Imunisasi Gabungan Dpt (Difteri,
13 Z27.1 - - - - - - - - - - - - - - - - - - -
Pertusis, Tetanus)
14 Pengelolaan Kontrasepsi Z30 - - - - - - - - - - - - - - - - - - -
15 Pengawasan Kehamilan Normal Z34 - - - - - - - - - - - - - - - - - - -

Pengawasan Kehamilan Dengan
16 Z35 - - - - - - - - - - - - - - - - - - -
Risiko Tinggi
17 Bayi Normal Z38.0 - - - - - - - - - - - - - - - - - - -
18 Z39 - - - - - - - - - - - - - - - - - - -
Persalinan
19 Z41.2 - - - - - - - - - - - - - - - - - - -
Kebiasaan
20 Tindik telinga Z41.3 - - - - - - - - - - - - - - - - - - -
21 Schizoprenia F20 - - - - - - - - - - - - - - - - - - -
22 ISPA J06 - - - - - - - - - - - - - - - - - - -
23 Ptyrigium H11.0 - - - - - - - - - - - - - - - - - - -
24 Batuk R05 - - - - - - - - - - - - - - - - - - -
25 Demam Yang Tdk Diketahui Sebabnya R50 - - - - - - - - - - - - - - - - - - -
26 Myalgia M79.1 - - - - - - - - - - - - - - - - - - -
27 Atritis Reumatik I55 - - - - - - - - - - - - - - - - - - -
28 Dispepsia K30 - - - - - - - - - - - - - - - - - - -
29 Luka di Kepala S00 - - - - - - - - - - - - - - - - - - -

K90
strok
30 Nausea and vomiting/mual muntah R11 - - - - - - - - - - - - - - - - - - -
e/cer
ebrov I 63.9 cerebral infarction
31 Infark Serebral/STROKE 3B G80 - - - - - - - - - - - - - - - - - - -
ascul unspecified
ar
32 Sakit Kepala R51 - - - - - - - - - - - - - - - - - - -
accid
ent
33 Imunisasi MR Z27.4 - - - - - - - - - - - - - - - - - - -
TING
JUMLAH
UAN
34 Meno Metroragi N92 - - - - - - - - - - - - - - - - - - -
35 Anoreksia R63 - - - - - - - - - - - - - - - - - - -
36 Gagal Ginjal Kronis/GGK N18.9 - - - - - - - - - - - - - - - - - - -
37 Pertusis A37.9 - - - - - - - - - - - - - - - - - - -
38 Tumor ganas pada payudara C50 - - - - - - - - - - - - - - - - - - -
39 - - - - - - - - - - - - - - - - - - -
40 - - - - - - - - - - - - - - - - - - -
R. GIGI DAN MULUT
41 Persistensi K00.6 - - - - - - - - - - - - - - - - - - -
42 Karies Dentin (Hiperemia Pulpa) K02.1 - - - - - - - - - - - - - - - - - - -
43 Pulpitis K04.0 - - - - - - - - - - - - - - - - - - -
44 Necrosis Pulpa K04.1 - - - - - - - - - - - - - - - - - - -
45 Periodonitis Apikalis Kronis K04.5 - - - - - - - - - - - - - - - - - - -
46 Abses Periapikal tdk melibatkan sinus K04.7 - - - - - - - - - - - - - - - - - - -
47 Anomali Letak Gigi K07.4 - - - - - - - - - - - - - - - - - - -
48 Ginggivitis Kronis K05.1 - - - - - - - - - - - - - - - - - - -
49 Gangren Radik, Ulcus Dicubitus K08.3 - - - - - - - - - - - - - - - - - - -
50 Periodonitis Kronis K05.3 - - - - - - - - - - - - - - - - - - -
51 Gigi Impaksi K01.1 - - - - - - - - - - - - - - - - - - -
52 Fraktur Korona S02.51 - - - - - - - - - - - - - - - - - - -
53 Neoplasma Rongga Mulut C09.9 - - - - - - - - - - - - - - - - - - -
54 Excessive attrition of teeth K03.0 - - - - - - - - - - - - - - - - - - -

Other diseases of hard tissue of teeth,
55 K03.9 - - - - - - - - - - - - - - - - - - -
unspecified
56 - - - - - - - - - - - - - - - - - - -
57 - - - - - - - - - - - - - - - - - - -
Jumlah - - - - - - - - - - - - - - - - - - -
Situbondo, -
Kepala UPTD Puskesmas Pelaksana
_____________________ __________________
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Puskesmas / Klinik / Dokter Praktek Swasta = Bulan = Tahun =
TINGK
AT KODE JUMLAH KASUS BARU DAN LAMA ( UMUR DAN JENIS KELAMIN) JUMLAH KASUS LAMA JUMLAH
NO NAMA PENYAKIT KEMA JUMLAH RUJUKAN
MPU ICPC II ICD X 0-7 HR 8-28 HR 1-11 BLN 1-4 THN 5-9 THN 10-14 THN 15-19 THN 20-44 THN 45-59 THN >59 THN JUM LAH L P JUM LAH L P JUM LAH RUJUKAN BALIK
AN
A. Kelompok Umum

1. Tuberkolosis ( TB ) Paru 4 A A 70 Tuberkulosis A15 histologically confirmed - - -

TB 3 A A 70 Tuberkulosis A15 histologically confirmed - - -
HIV B90 HIV-infection/AIDS Z21 - - -
infection status
3. Morbili 4 A A 71 Measles B05.9 Measles without complication (Measles NOS). - - -
4. Varisela 4 A A 72 Chickenpox B01.9 Varicella without complication (Varicella NOS) - - -
5. Malaria 4 A A 73 Malaria B54 Unspecified malaria - - -
6. Leptospirosis 4 A A 78 Infection disease other/ NOS A27.9 Leptospirosis, unspecified - - -

B74 Filariasis
7. Filariasis 4 A D96 Woms/other parasites B74.0 Filariasis due to Wuchereria bancrofti - - -
ofto
Brugia timori
Omphalitis newborn with or without mild
8. Infeksi Pada Umbilikus 4 A A94 Perinatal morbidity other P38 haemorrhage - - -
9. Kandidiasis Mulut 4 A A 78 Infection disease other/ NOS B37.9 Candidiasis unspecified - - -
10. Lepra 4 A A 78 Infection disease other/ NOS A30 Leprosy [Hansen disease] - - -
11. Keracunan Makanan 4 A A 86 Effect Non Medical Substance T62.2 Other Ingested (parts of plant(s)) - - -
12. Alergi Makanan 4 A A 92 Allergy/ allergic reaction NOS L27.2 Dermatitis due to ingested food - - -
13. Syok 3 B K 99 Cardiovascular disease other R57.9 Shock, unspecified - - -
14. Reaksi Anafilaktik 4 A A92 Allergy/allergic reaction NOS T78.2 Anaphylactic shock, unspecified - - -
Berdarah Dengue 4 A A77 Viral disease other/NOS A90 Dengue fever - - -
A91 Dengue haemorrhagic fever - - -
1. Anemia Defiisiensi Besi 4 A B80 Iron Deficiency Anaemia 280 Iron Deficiency Anemias - - -

2. HIV / AIDS tanpa komplikasi 4 A B90 HIV-infection/AIDS Z21 - - -
infection status
3. Lupus Eritamatosus Sistemik 3 A L99 Systemic Lupus Erythematosus M32 Systemic Lupus Erythematosus - - -
4. Limfadenitis 4 A L04.9 Acute lymphadenitis, unspecified B70 Lymphadenitis Acute - - -
C. Digestive
1. Ulkus Mulut (Aftosa, Herpes) 4 A D83 Mouth / tongue / lip disease K12 Stomatitis and related lesions - - -
K12.0 Recurrent oral aphtae - - -
K12.1 Other form of stomatitis - - -
2. Refluksgastroesofageal 4 A D84 Oesphagus disease K21.9 Gastro-oesophageal reflux disease without - - -
oesophagitis
3. Gastritis 4 A D07 Dyspepsia/indigestion K29.7 Gastritis, unspecified - - -
4. Intoleransi Makanan 4 A D29 Digestive syndrome/complaint K90.4 Malabsorption due to intolerance - - -
other
5. Malabsorbsi Makanan 3 A D29 K90.9 Intestinal malabsorbtion, unspecified - - -
other
6. Demam Tifoid 4 A D70 Gastrointestinal infection A01.0 Typhoid fever - - -
4 A D73 A09 - - -
kolera dan giardiasis) infection origin
8. Disentri Basiler dan Disentri Amuba 4 A D70 Gastrointestinal infection A06.0 Acute amoebic dysentery - - -
9. Perdarahan Gastroenteritis 3 A D14 Haematemesis/vomiting blood K92.2 Gastrointestinal haemorrhage, unspecified - - -
D15 /
D16 Melaena / Rectal Bleeling K62.5 Haemorrhage of anus and rectum - - -
10. Hemoroid Grade 1 – 2 4 A D95 Anal fissure/perianal abscess I84 Haemorrhoids - - -
11. Hepatitis A 4 A D72 Viral Hepatitis B15 Acute Hepatitis A - - -

TINGK
JUMLAH
AN
12. Hepatitis B 3 A D72 Viral Hepatitis B16 Acute Hepatitis B - - -
13. Kolesistitis 3 A D98 Cholecystitis/cholelithiasis K81.9 Cholecystitis, unspecified - - -
14. Apendisitis Acut 3 A S87 Appendicitis K35.9 Acute appendicitis - - -
15. Peritonitis 3 A D99 Disease digestive system, other K65.9 Peritonitis, unspecified - - -
16. Parotitis 4 A D71 / Mumps / Disease digestive B26 Mumps - - -

D99 system, other
17. Askariasis / Cacing gelang 4 A D96 Worms/ other parasites B77.9 Ascariaris unspecified - - -
18. Ankylostomiasis / Cacing tambang 4 A D96 Worms/other parasites B76.0 Ankylostomiasis - - -
B76.1 Necatoriasis - - -
19. Skistosomiasis 4 A D96 Worm/outer parasite B65.9 Skistosomiasisunspecified - - -
B65.2 Schistomiasis due to S. japonicum - - -
20. Taeniasis 4 A D96 Worms/other parasites B68.9 Taeniasis - - -
21. Strongiloidiasis 4 A D96 Worms/other parasites B78.9 Strongyloidiasis - - -
D. Mata
1. Mata Kering / Dry eye 4 A F99 Eye/adnexa disease, other H04.1 Otherdisorders of lacrimal gland - - -
2. Buta Senja 4 A F99 Eye/adnexa disease other H53.6 Night blindness - - -
3. Hordeolum 4 A F72 Blepharitis/stye/chalazion H00.0 Hordeolum and other deep inflammation of eyelid - - -
4. Konjungtivitis
Konjungtivitis Infeksi 4 A F70 Conjunctivitis infectious H10.9 Conjunctivitis, unspecified - - -
Konjungtivitis Alergi F71 Conjunctivitis allergic H10.1 Acute atopic conjunctivitis - - -
5. Blefaritis 4 A F72 Blepharitis/stye/chalazion H01.0 Blepharitis - - -
6. Perdarahan Subkonjungtiva 4 A F75 Contusion/ haemorrhage eye H57.8 Other specified disorders of eye and adnexa - - -
7. Benda Asing di Konjungtiva 4 A F76 Foreign body in eye T15.9 Foreign body on external eye, part unspecified - - -
8. Astigmatism 4 A F91 Refractive error H52.2 Astigmatisme - - -
9. Hipermetropia 4 A F91 Refractive error H52.0 Hypermetropia ringan - - -
10. Miopia Ringan 4 A F91 Refractive error H52.1 Myopia - - -
11. Presbiopia 4 A F91 Refractive error H52.4 Presbyopia - - -
12. Katarak Pada Pasien Dewasa 2 F92 Cataract H26.9 Cataract, unspecified - - -
13. Glaukoma Akut 4 A F93 Glaucoma H40.2 Primary angle-closure glaucoma - - -
14. Glaukoma Kronis 3 B F93 Glaucoma H40.2 Primary angle-closure glaucoma - - -
15. Trichiasis 4 A F99 Eye / adnexa disease, other H02 Entropion and trichiasis of eyelid - - -
16. Episkleritis 4 A F99 Eye / adnexa disease, other H15.1 Episcleritis - - -
17. Trauma Kimia Mata 3 A F79 Injury eye other T26 Burn and corrosion confined to eye and adnexa - - -
18. Laserasi Kelopak Mata 3 A F79 Injury eye other S01.1 Open wound of eyelid and periocular area - - -
19. Hifema 3 A F75 Contusion/haemorrhage eye H21.0 Hyphaema - - -
20. Retinopaty Diabetik 2 F83 Retinopathy H36.0 Diabetic retinopathy - - -
E. Telinga
1. Otitis Eksterna 4 A H70 Otitis externa H60.9 Otitis externa, unspecified - - -
2. Otitis Media Akut 4 A H71 Acute otitis media/myringitis H65.0 Acute serous otitis media - - -
H65.1 Other acure nonsuppurative otitis media - - -
H66.0 Acute suppurative otitis media - - -
3. Otitis Media Supuratif Kronik 3 A H74 Chronic otitis media H66.1 Chronic tubotympanic suppurative otitis media - - -
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JUMLAH
AN
H66.2 Chronic atticoantral suppurative otitis media - - -
H66.3 Other chronic suppurative otitis media - - -
4. Benda Asing di Telinga 3 A H76 Foreign body in ear T16 Foreign body in ear - - -
5. Seromen Prop H81 Excessive ear wax H61.2 Impacted cerumen - - -
F. Kardiovaskuler

1. Angina Pektoris Stabil 3 B K74 I20.9 Angina pectoris, unspecified - - -
angina
2. Infark Miokard 3 B K75 Acute Myocardial Infarction I21.9 Acute Myocardial Infarction, Unspecified - - -
3. Takikardia 3 B K79 Paroxysmal Tachicardy R00.0 Tachicardy Unspecified - - -
I47.1 Supraventicular Tachicardy - - -
I47.2 Ventricular Tachicardy - - -
4. Gagal Jantung Akut dan Kronis K77 Heart failure I50.9 Heart failure, unspecified - - -
3 B Akut
3 A Kronik
5. Cardiorespiratory Arrest 3 B K80 Cardiac arrhytmia NOS R09.2 Respiratory arrest/ Cardiorespiratory failure - - -
6. Hipertensi Esensial K86 Hypertension uncomplicated I10 Essential (primary) hypertension - - -
1. Fraktur Terbuka 3 B L76 Fracture other T14 Fracture of unspecified body - - -
2. Fraktur Tertutup 3 B L76 Fracture other T14 Fracture of unspecified body - - -
3. Polimiagia Reumatik 3 A L99 Musculosceletal disease other M53.3 Polymyalgia rheumatica - - -
4. Artritis Reumatoid 3 A L99 Musculosceletal disease other M53.3 Polymyalgia rheumatica - - -
5. Artritis, Osteoartritis 3 A L91 Osteoarthrosis other M19.9 Osteoarthrosis other - - -
6. Vulnus 3 B S.16 Bruise / Contusion T14.1 Open wound of unspecified body region - - -
7. Lipoma 4 A S78 Lipoma D17.9 Benign lipomatous neoplasm - - -
H. Neurologi
1. Tension Headche 4 A N95 Tension Headache G44.2 Tension–type headache - - -
2. Migren 4 A N89 Migraine G43.9 Migraine, unspecified - - -
3. Vertigo 4 A N17 Vertigo/dizziness R42 Dizziness and giddiness - - -
4. Tetanus 4 A N72 Tetanus A35 Other tetanus - - -
5. Rabies 3 B A77 Viral disease other/NOS A82.9 Rabies, Unspecified - - -
6. Malaria Selebral 3 B A73 Malaria B50 Plasmodium falciparum with cerebral complication - - -
7. Epilepsi 3 A N88 Epilepsy G40.9 Epilepsy, unspecified - - -
8. Transient Ischemuk Attack / TIA 3 B K89 Transient cerebral ischaemia G45.9 Transient cerebral ischaemic attack, unspecified - - -
9. Stroke 3 B K90 Stroke/cerebrovascular accident I63.9 Cerebral infarction, unspecified - - -
10. Bells’ Palsy 4 A N91 Facial paralysis/Bells’ palsy G51.0 Bells’ palsy - - -
11. Status Epilepsi 3 B N88 Epilepsy G41.9 Status epilepticus, unspecified - - -
12. Delirium 3 A P71 Organic psychosis other F05.9 Delirium, unspecified - - -
13. Kejang Deman 4 A N07 Convulsion/Seizure R56.0 Febrile convulsions - - -
14. Tetanus Neonatorum 3 B N72 Tetanus A33 Tetanus Neonatorum - - -
I. Psikiatri
TINGK
JUMLAH
AN
1. Gangguan Somatofrom 4 A P75 Somatization disorder F45 Somatoform disorders - - -
2. Demensia 3 A P70 Dementia F03 Unspecified dementia - - -
3. Imsomnia 4 A P06 Sleep disturbance F51 Insomnia non organik pada psikiatri - - -
4. Gangguan campuran Eksietas dan 3 A P74 Anxiety Disorder (anxiety state) F41.2 Mixed Anxiety and Depression Disorder - - -
depresi
5. Gangguan Psikotik 3 A P98 Psychosis NOS/other F20 Chronic Psychotic Disorder - - -
J. Respirasi
1. Influenza 4 A R80 Influenza J11 Influenza, virus not identified - - -
2. Pharyngitis Acut 4 A R74 Upper respiratory infection acute J02.9 Acute pharyngitis, unspecified - - -
3. Laringitis Acut 4 A R77 Laryngitis/tracheitis acute J04.0 Acute laryngitis - - -
4. Tonsilitis Acut 4 A R76 Tonsillitis acute J03 Acute tonsillitis - - -
J35 Chronic tonsilitis - - -
5. Bronkitis Akut 4 A R78 Acute bronckitis /bronchiolitis J20.9 Acute bronchitis, unspecified - - -
6. Asma Bronkial (Asma Stabil) 4 A R96 Asthma J45 Asthma - - -
7. Status Asmatikus (Asma Acut Berat) 3 B R03 Wheezing J45.902 Unspecified asthma with status asthmaticus - - -
8. Pneumonia Aspirasi 3 B R99 Respiratory disease other J69.0 Pneumonitis due to food and vomit - - -
9. Pneumonia dan Bronkopneumonia 4 A R81 Pneumonia J18.0 Bronchopneumonia, unspecified - - -
J18.9 Pneumonia, unspecified - - -
10. Pneumothoraks 4 A R99 Respiratory Disease Other J93.9 Respiratory Disease other - - -
Kronis) 3 B R95 Diseases J44.9 Chronic Obstructive Pulmonary Diseasesm unspecified - - -
12. Epistaksis 4 A R06 Nose bleed/epistaxis R04.0 Epistaxis - - -
Foreign body
13. Benda Asing di Hidung 4 A R87 T17.1 Foreign body in nostril - - -
nose/larynx/bronch
14. Furunkel Pada Hidung 4 A R73 Boil/abscess nose J34.0 Abscess, furuncle and carbuncle of nose - - -
15. Rhinitis Akut 4 A R74 Upper respiratory infection acute J00 Acute nasopharyngitis (common cold) - - -
16. Rhinitis Vasomotor 4 A R97 Allergic rhinitis J30.0 Vasomotor rhinitis - - -
17. Rhinitis Alergik 4 A R97 Allergic rhinitis J30.4 Allergic rhinitis, unspecified - - -
18. Sinusitis (Rinosinusitis) 4 A R75 Sinusitis acute / chronic J01 Acute sinusitis (Rinosinusitis akut) - - -
3 A J32 Chronic sinusitis (Rinosinusitis kronik) - - -
K. Kulit
1. Miliaria 4 A S92 Sweat gland disease L74.3 Miliaria, unspecified - - -
2. Veruka Vulgaris 4 A S03 Warts B07 Viral warts - - -
3. Herpes Zoster 4 A S70 Herpes Zoster B02.9 Zoster without complication - - -
4. Herpes Simpleks 4 A S71 Herpes Simplex B00.9 Herpesviral infection, unspecified - - -
5. Moluskum Kontagiosum 4 A S95 Molluscum contagiosum B08.1 Molluscum contagiosum - - -
6. Reaksi Gigitan Serangga 4 A S12 Insect bite/sting T63.4 Venom of other arthropods - - -
7. Skabies 4 A S72 Scabies/other acariasis B86 Scabies - - -
8. Pedikulosis Kapitis / kutu rambut 4 A S73 Pediculosis/skin infestation other B85.0 Pediculosis due to Pediculus humanus capitis - - -
9. Pedikulosis Pubis / kutu kemaluan 4 A S73 Pediculosis/skin infestation other B85.3 Pthiriasis - - -
10. Dermatofitosis 4 A S74 Dermatophytosis B35 Dermatophytosis - - -
B35.0 Tinea barbae and tinea capitis - - -
B35.1 Tinea unguium - - -
B35.2 Tinea manuum - - -

TINGK
JUMLAH
AN
B35.3 Tinea pedis - - -
B35.4 Tinea corporis - - -
B35.5 Tinea imbricate - - -
B35.6 Tinea cruris - - -
B35.8 Other dermatophytoses - - -

4 A S76 Skin infection other B36.0 Pityriasis versicolor - - -
Versikolor
12. Pioderma 4 A S84 Impetigo L01 Impetigo - - -
4 A L02 Cutaneous abscess, furuncle and carbuncle - - -
4 A L08.0 Pyoderma - - -
4 A Impetigo krustosa (impetigo contagiosa) dan Impetigo

bulosa
13. Erysipelas 4 A S76 Skin infection other A 46 Erysipelas - - -
14. Dermatitis Seboroik 4 A S86 Dermatitis seborrhoeic L21 Seborrhoeic dermatitis - - -
15. Dermatitis Atopik 4 A S87 Dermatitis/atopic eczema L20 Atopic dermatitis - - -
16. Dermatitis Numularis 4 A S87 Dermatitis/atopic eczema L20.8 Other atopic dermatitis - - -
17. Liken Simpleks Kronik 3 A S87 Dermatitis/atopic eczema L28.0 Lichen simplex chronicus - - -
18. Dermatitis Kontak Alergik (DKA) 3 A S88 Dermatitis contact/allergic L23 Allergic contact dermatitis - - -
19. Dermatitis Kontak Iritan 4 A S88 Dermatitis contact/allergic L24 Irritant contact dermatitis - - -
20. Napkin Eczema (Dermatitis Popok) 4 A S89 Diaper rash L22 Diaper (napkin) dermatitis - - -
21. Dermatitis Perioral 4 A S99 Skin disease other L71.0 Perioral dermatitis - - -
22. Pitiriasis Rosea 4 A S90 Pityriasis rosea L42 Pityriasis rosea - - -
23. Eritrasma 4 A S76 Skin infection other L08.1 Erythrasmay - - -
24. Skrofuloderma 4 A A 70 Tuberculosis A 18.4 Tuberculosis of skin and subcutaneous tissue - - -
25. Hidradenitis Supuratif 4 A S92 Sweat gland disease L73.2 Hidradenitis suppurativa - - -
26. Akne Vulgaris Ringan 4 A S96 Acne L70.0 Acne vulgaris - - -
27. Urtikaria S98 Urticaria L50 Urticaria - - -
L50 L50.9Urticaria, unspecified - - -
4 A Urtikaria akut
28. Exanthematous Drug Eruption 4 A S07 Rash generalized L27.0 Generalized skin eruption due to drugs and - - -
medicament
29. Fixed Drug Eruption 4 A A85 Adverse effect medical agent L27.0 medicaments - - -
30. Cutaneus Larva Migrans 4 A D96 Worms/other parasites B76.9 Hookworm disease, unspecified - - -
31. Luka Bakar Derajat I dan II 4 A S14 Burn/scald T30 Burn and corrosion, body region unspecified - - -
Burns classified according to extent of body surface

T31 involved - - -
T32 Corrosions classified according to extent of body - - -

surface involved
32. Ulkus Pada Tungkai 4 A S97 Chronic Ulcer Skin I83.0 Varicose veins of lower extremities with ulcer - - -
L97 Ulcer of lower limb, notelsewhere classifi - - -
33. Sindrom Stevens Johnson 3 B S99 Skin disease other L51.1 Bullous erythema multiforme - - -

TINGK
JUMLAH
AN
1. Obesitas 4 A T82 Obesity, T83 overweight E66.9 Obesity unspecified - - -
2. Tirotoksikosis 3 B T85 Hipertiroidisme/tirotoksikosis E05.9 Tirotoksikosis unspecified - - -
3. Diabetes Melitus Type 2 4 A T90 Diabetes non-insulin dependent E11 Non-insulin-dependent diabetes mellitus - - -
4. Hiperglikemia Hiperosmolar Non 3 B A91 Abnormal result invetigation R73.9 Hyperglycaemia unspecified - - -
Ketotik NOS
5. Hipoglikemia T87 Hypoglycaemia E16.2 Hypoglycaemia unspecified - - -
6. Hiperiricemia-Gout Arthritis 4 A T99 disease other E79.0 and tophaceous disease - - -
T92 Gout M10 Gout - - -
7. Lipidemia 4 A T93 Lipid disorder E78.5 Hiperlipidemia - - -
8. Malnutrisi Energi Protein (MEP) 4 A T91 Vitamin/nutritional deficiency E46 Unspecified protein-energy malnutrition - - -
M. Saluran Kemih
1. Infeksi Saluran Kemih 4 A U71 Cystitis/urinary infection others N39.0 Urinary tract infection, site not specified - - -
2. Pielonefritis Tanpa Komplikasi 4 A U70 Pyelonephritis / pyelitis N10 - - -
pyelonephritis)
3. Fimosis 4 A Y81 Phimosis N47 Phimosis - - -
4. Parafimosis 4 A Y81 Paraphimosis N47.2 Paraphimosis - - -
N. Kesehatan Wanita
1. Kehamilan Normal 4 A W90 Uncomplicated labour/delivery O80.9 Single spontaneous delivery, unspecified - - -
livebirth
2. Hiperemesis Gravidarum 3 B W05 Pregnancy vomiting/nausea O21.0 Mild hyperemis gravidarum - - -
4 A B80 Irondeficiency anaemia D50 Iron deficiency anaemia - - -
Kehamilan
4. Pre Eklamsia 3 B W81 Toxaemia of pregnancy O14.9 Pre-eclampsia, unspecified - - -
5. Eklamsia 3 B W81 Toxaemia of pregnancy O15.9 Eclampsia, unspecified as to time period - - -
6. Abortus 4 A W82 Abortion spontaneous O03.9 Unspecified abortion, complete, without complication - - -
3 B W82 Abortion spontaneous O06.4 Unspecified abortion, incomplete, without - - -

complication
3 B O02.1 Abortus insipiens - - -
7. Ketuban Pecah Dini 3 A W92 042.9 Premature rupture of membrane, unspecified - - -
livebirth
8. Persalinan Lama 3 B W92 Life birth O63.9 Long labour - - -
W93 Still birth
9. Perdarahan Post Partum 3 B W17 Post partum bleeding 072.1 Other Immediate Postpartum haemorrhage - - -
10. Ruptur Perineum Tingkat 1-2 4 A W92 O70.0 First degree perineal laceration during delivery - - -
livebirth
11. Mastitis 4 A X21 Breast symptom/complaint N61 Inflammatory disorders of breast - - -

female other
12. Inverted Nipple / Putting Susu Datar 4 A W.95 Breast disorder in pregnancy O92.02 Retracted nipple associated with the puerperium - - -
other
X.20 female O92.03 Retracted nipple associated with lactation - - -
13. Cracked Nipple / Nyeri Putting Susu 4 A W.95 other O92.12 Cracked nipple associated with the puerperium - - -
X.20 female O92.13 Cracked nipple associated with lactation - - -
O. Penyakit Kelamin
1. Flour Albus / Vaginal Discharge Non 4 A X14 Vaginal discharge N98.9 Flour Albus - - -
Gonore

wanita

wanita

TINGK
JUMLAH
AN
2. Sifilis 3 A Y70 Syphilis male A51 Early syphilis - - -
X70 Syphilis female A51.0 Primary genital syphilis - - -
A52 Late syphilis - - -
A53.9 Syphilis, unspecified - - -
3. Gonore 4 A X71 Gonorrhoea female, Y71 A54.9 Gonococcal infection, unspecified - - -

Gonorrhoea male
4. Vaginitis 4 A X84 Vaginitis N76.0 Acute Vaginitis - - -
5. Vulvitis 4 A X84 Vaginitis/Vulvitis N76.0 Acute Vaginitis - - -
P. LAIN - LAIN
1 Malnutrisi Energi Protein (MEP) E46 - - -
2 Nyeri Haid (Dismenorrhoe) N94 - - -
3 Kecelakaan Lalu Lintas/KLL V29.9 - - -
4 Pemeriksaan Kesehatan Umum Z00.0 - - -
5 Pemeriksaan
Kesehatan Bayi Dan Anak
Z00.1 - - -
Secara Rutin
6 Imunisasi BCG Z23.2 - - -
7 Imunisasi Tetanus Z23.5 - - -
8 Imunisasi Dan Kemoterapi Pencegahan Z23.0 - - -

Lainnya
9 Imunisasi Poliomielitis Z24.0 - - -
10 Imunisasi Rabies Z24.2 - - -
11 Imunisasi Campak Z24.4 - - -
12 Imunisasi Hepatitis Virus A24.6 - - -
Imunisasi Gabungan Dpt (Difteri, Pertusis,

13 Tetanus) Z27.1 - - -
14 Pengelolaan Kontrasepsi Z30 - - -
15 Pengawasan Kehamilan Normal Z34 - - -
16 Pengawasan Kehamilan Dengan Risiko Z35 - - -

Tinggi
17 Bayi Normal Z38.0 - - -

18 Persalinan Z39 - - -

19 Kebiasaan Z41.2 - - -
20 Tindik telinga Z41.3 - - -
21 Schizoprenia F20 - - -
22 ISPA J06 - - -
23 Ptyrigium H11.0 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -
28 Dispepsia K30 - - -

K90
30 Nausea and vomiting/mual muntah stroke R11 - - -
/cere
31 Infark Serebral/STROKE 3 B brova I 63.9 cerebral infarction G80 - - -
scular unspecified
32 Sakit Kepala accide R51 - - -
nt
TINGK
JUMLAH
AN
35 Anoreksia R63 - - -
36 Gagal Ginjal Kronis/GGK N18.9 - - -
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
42 Karies Dentin (Hiperemia Pulpa) K02.1 - - -
43 Pulpitis K04.0 - - -
46 Abses Periapikal tdk melibatkan sinus K04.7 - - -
47 Anomali Letak Gigi K07.4 - - -
48 Ginggivitis Kronis K05.1 - - -
50 Periodonitis Kronis K05.3 - - -
53 Neoplasma Rongga Mulut C09.9 - - -
55 Other
diseases of hard tissue of teeth,
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
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- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
P. LAIN - LAIN
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
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- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
P. LAIN - LAIN
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
P. LAIN - LAIN
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
P. LAIN - LAIN
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
P. LAIN - LAIN
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
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- - - #REF! -
- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
P. LAIN - LAIN ( Bila ada yang baru atau di tambah,ditambahkan atau diketik di excel rekap Kabupaten)
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
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- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
TINGK
AN
A. Kelompok Umum


infection status

B74 Filariasis
ofto
Brugia timori

infection status
C. Digestive
oesophagitis
other
other
4 A D73 A09 - - -
D15 /

TINGK
JUMLAH
AN

D99 system, other
D. Mata
4. Konjungtivitis
E. Telinga
TINGK
JUMLAH
AN
F. Kardiovaskuler

angina
3 B Akut
3 A Kronik
H. Neurologi
I. Psikiatri
TINGK
JUMLAH
AN
depresi
J. Respirasi
Foreign body
nose/larynx/bronch
K. Kulit

TINGK
JUMLAH
AN

Versikolor

bulosa
4 A Urtikaria akut
medicament

T31 involved - - -

surface involved

TINGK
JUMLAH
AN
Ketotik NOS
M. Saluran Kemih
pyelonephritis)
N. Kesehatan Wanita
livebirth
Kehamilan

complication
livebirth
W93 Still birth
livebirth

female other
other
O. Penyakit Kelamin
Gonore

wanita

wanita

TINGK
JUMLAH
AN

Gonorrhoea male
5 Pemeriksaan
Z00.1 - - -
Secara Rutin

Lainnya

13 Tetanus) Z27.1 - - -

Tinggi


22 ISPA J06 - - -
24 Batuk R05 - - -
26 Myalgia M79.1 - - -

K90
/cere
scular unspecified
nt
TINGK
JUMLAH
AN
37 Pertusis A37.9 - - -
39 - - -
40 - - -
R. GIGI DAN MULUT
43 Pulpitis K04.0 - - -
55 Other
K03.9 - - -
unspecified
56 - - -
57 - - -
Jumlah - - - - - - - - - - - - - - - - - - -
-
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
- - - #REF! -
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- - - #REF! -
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Lampiran 2

Instrumen Penghitungan Kinerja Administrasi dan Manajemen Puskesmas

Respiratory tuberkulosis, bacteriologiccaly and

2. Tuberkolosis ( TB ) dengan HIV

TB 3 A A 70 Tuberkulosis A15 Respiratory tuberkulosis, bacteriologiccaly and - - - - -

3. Morbili 4 A A 71 Measles B05.9 Measles without complication (Measles NOS). - - - - -

4. Varisela 4 A A 72 Chickenpox B01.9 Varicella without complication (Varicella NOS) - - - - -

5. Malaria 4 A A 73 Malaria B54 Unspecified malaria - - - - -

6. Leptospirosis 4 A A 78 Infection disease other/ NOS A27.9 Leptospirosis, unspecified - - - - -

10. Lepra 4 A A 78 Infection disease other/ NOS A30 Leprosy [Hansen disease] 0 0 0 0 0 0 0 1 0 0 1 1 0 1 - 1 1

13. Syok 3 B K 99 Cardiovascular disease other R57.9 Shock, unspecified - - - - -

A91 Dengue haemorrhagic fever - - - - -

B. Darah, Pembentukan Darah, Sistem Imun

Asymptomatic Human Immunodeficiency Virus (HIV)

4. Limfadenitis 4 A L04.9 Acute lymphadenitis, unspecified B70 Lymphadenitis Acute 0 0 0 0 0 0 0 2 0 0 2 2 0 2 - 2 2

K12.0 Recurrent oral aphtae - - - - -

K12.1 Other form of stomatitis - - - - -

9. Perdarahan Gastroenteritis 3 A D14 Haematemesis/vomiting blood K92.2 Gastrointestinal haemorrhage, unspecified - - - - -

D15 / Melaena / Rectal Bleeling

10. Hemoroid Grade 1 – 2 4 A D95 Anal fissure/perianal abscess I84 Haemorrhoids 0 0 0 0 0 0 1 1 0 0 2 2 0 2 - 2 2

11. Hepatitis A 4 A D72 Viral Hepatitis B15 Acute Hepatitis A - - - - -

12. Hepatitis B 3 A D72 Viral Hepatitis B16 Acute Hepatitis B - - - - -

13. Kolesistitis 3 A D98 Cholecystitis/cholelithiasis K81.9 Cholecystitis, unspecified - - - - -

14. Apendisitis Acut 3 A S87 Appendicitis K35.9 Acute appendicitis 0 0 0 0 0 0 0 1 0 0 1 0 1 1 - 1 1

18. Ankylostomiasis / Cacing tambang 4 A D96 Worms/other parasites B76.0 Ankylostomiasis - - - - -

19. Skistosomiasis 4 A D96 Worm/outer parasite B65.9 Skistosomiasisunspecified - - - - -

B65.2 Schistomiasis due to S. japonicum - - - - -

20. Taeniasis 4 A D96 Worms/other parasites B68.9 Taeniasis - - - - -

21. Strongiloidiasis 4 A D96 Worms/other parasites B78.9 Strongyloidiasis - - - - -

Konjungtivitis Infeksi 4 A F70 Conjunctivitis infectious H10.9 Conjunctivitis, unspecified 0 0 0 0 0 1 0 5 2 1 9 3 4 7 2 2 9 7

Konjungtivitis Alergi F71 Conjunctivitis allergic H10.1 Acute atopic conjunctivitis - - - - -

5. Blefaritis 4 A F72 Blepharitis/stye/chalazion H01.0 Blepharitis - - - - -

8. Astigmatism 4 A F91 Refractive error H52.2 Astigmatisme - - - - -

9. Hipermetropia 4 A F91 Refractive error H52.0 Hypermetropia ringan - - - - -

10. Miopia Ringan 4 A F91 Refractive error H52.1 Myopia - - - - -

11. Presbiopia 4 A F91 Refractive error H52.4 Presbyopia - - - - -

13. Glaukoma Akut 4 A F93 Glaucoma H40.2 Primary angle-closure glaucoma - - - - -

14. Glaukoma Kronis 3 B F93 Glaucoma H40.2 Primary angle-closure glaucoma - - - - -

16. Episkleritis 4 A F99 Eye / adnexa disease, other H15.1 Episcleritis - - - - -

19. Hifema 3 A F75 Contusion/haemorrhage eye H21.0 Hyphaema - - - - -

20. Retinopaty Diabetik 2 F83 Retinopathy H36.0 Diabetic retinopathy - - - - -

H65.1 Other acure nonsuppurative otitis media - - - - -

H66.0 Acute suppurative otitis media - - - - -

H66.2 Chronic atticoantral suppurative otitis media - - - - -

H66.3 Other chronic suppurative otitis media 0 0 0 0 0 0 0 0 0 1 1 1 0 1 - 1 1

5. Seromen Prop H81 Excessive ear wax H61.2 Impacted cerumen - - - - -

Ischaemic heart disease with

I47.1 Supraventicular Tachicardy - - - - -

I47.2 Ventricular Tachicardy - - - - -

G. Muskuloskeletal 211

5. Artritis, Osteoartritis 3 A L91 Osteoarthrosis other M19.9 Osteoarthrosis other 0 0 0 0 0 0 0 0 1 1 2 0 2 2 - 2 2

S.17 Abration / Scratch / Blister

4 A S.18 Laceration / Cut

7. Lipoma 4 A S78 Lipoma D17.9 Benign lipomatous neoplasm - - - - -

1. Tension Headche 4 A N95 Tension Headache G44.2 Tension–type headache 0 0 0 0 0 1 2 12 11 10 36 12 12 24 5 7 12 36 24

2. Migren 4 A N89 Migraine G43.9 Migraine, unspecified 0 0 0 0 0 0 0 1 0 0 1 0 1 1 - 1 1

3. Vertigo 4 A N17 Vertigo/dizziness R42 Dizziness and giddiness 0 0 0 0 0 0 0 4 1 2 7 0 6 6 1 0 1 7 6

4. Tetanus 4 A N72 Tetanus A35 Other tetanus - - - - -

5. Rabies 3 B A77 Viral disease other/NOS A82.9 Rabies, Unspecified - - - - -

7. Epilepsi 3 A N88 Epilepsy G40.9 Epilepsy, unspecified - - - - -

9. Stroke 3 B K90 Stroke/cerebrovascular accident I63.9 Cerebral infarction, unspecified - - - - -

10. Bells’ Palsy 4 A N91 Facial paralysis/Bells’ palsy G51.0 Bells’ palsy - - - - -

11. Status Epilepsi 3 B N88 Epilepsy G41.9 Status epilepticus, unspecified - - - - -