Laporan Adm Watsif Juni

TANGGAL MASUK
NO NAMA PASIEN ICU I DAN ASAL No. RM

RUANGAN
29/05/2022,IGD jam
* NY.EULIS SUMIATI 27.12.81
11.00
TN.TJANG NAM 28/05/2022 IGD/OK

* 27:37:37
HIONG jam12.00
31/05/2022,ALM/OK jam
* TN.BACHTIAR 27:37:51
10.30
1 NY.MIL"US 01/06/2022 jam 18.00 27.05.85
02/06/2022,ALM jam
2 TN.LA"ODE 27.37.80
10.00
02/06/2022, IGD jam

3 NY.KATIRAH "12.03.81
23.30
03/06/2022,IGD jam
4 TN.TOHARI 21.87.95
12.30
5 NY.YULIA 04/06/2022, IGD 27:39:49
05/06/2022, IGD jam

6 NN.DINDA 27:39:49
00.12
07/06/2022,IGD-OK jam
7 TN.UTOT . S 27:40:01
18.00
09/06/2022, DHL jam

8 NY.ELGA .D.A 27.39.98
15.30
12/06/2022,DHL jam
9 NY.SUDARMANI 26.81.79
14.00
13/06/2022,IGD jam
10 NY.SOPIAH 27.41.77
13.30
16/06/2022IGD-OK jam
11 NY.MARYAM "26.16.19
02.00
20/06/2022 IGD jam
12 TN.DJATI .N 14:16:55
01.00
20/06/2022, ALMD jam
13 NY.TITU 26.33.98
13.00
22/06/2022, dhl JAM
14 NY.SOATIN 27.43.93
10.45
TN. AGAH 23/06/2022, IGD jam
15 27:46:43
YOUDISTIRA 19.30
23/06/2022,IGD-OK jam
16 NY.JOANIH 27:46:42
20.00
25/06/2022 IGD jam
17 TN.DWI EDI 17:35:46
14.00
27/06/2022, IGD jam
18 NN.NOVELIA.A.M 27:47:49
04.30
27/06/2022, DHL JAM
19 NY. ROSMIATI *21.52.82
13.30
26/06/2022,
20 NY. EPIH BOUGENVILE JAM *24.94.74
20.00
27/6/22, BOUGENVILE
21 TN. HUSAINI *27.47.21
JAM 23.00
28/6/22 IGD/OK JAM

22 TN. AGUS BASUKI *03.62.79
14.45
LAMA
DIAGNOSA PASIEN Hak Kelas
PERAWATAN
Anemia Gravis, Sepsis,AKI dd Akut,

I 10 hari
CKD, CAD,Stroke Lama,TB on OAT
Post Op Craniotomy EVD Decompresi

III 17 hari
Evakuasi
DM Tipe II, Ulkus pedis dex, Melena III 15 hari
Post Op Craniotomy e/c SOL II 2 hari
Fraktur Tibia,Fubula Dex, Fraktur UMUM( jasarah

1 hari
Clavicula Sin arja)
CKD on HD,Anemia, Trombositopeni III 3 hari
Post OP VP Shunt III 1 hari
snh,Status epilepsi,ISK, low Intske II 2 hari
UMUM/
Contusio Paru, Multiple fraktur Costa 2-3 4 hari
jasaraharja
Post Op Craniotomy Decompresi

Evakuasi ICH e.c ICH ganglia basal dex III 6 hari
e.c SH, hemiplegi sin
Post Op LE a/i susp.Illeus,Anemia ,

III 12 hari
Leukositosis, Sepsis
AMS,Susp.encefalopati dd intra kranial

proses, AKI st I, Hipoglikemi,DM tipe ii,
I 25 hari
HHD, ISK, pneumonia CAP dd aspirasi,
hupoalbumin, selilitis pedis Dex
Dyspneu syndrom, DM, KAD,syok

III 2 hari
hipovilemik, AKI, Increase Transaminase
Post Op craniotomy removal tumor sin II 1 hari
Pen.kes, Hiponatremia, Post OP Vp shunt I 3 hari
Status epileptikus, kejang, post op

I 7 hari
craniotomy
CKD On HD, Anemia Gravis perbaikan,
III 2 hari
Hiperkalemia
Status konvulsi, epileptikus ( kejang 0,
I 5 hari
Susp. TB
Post Op Craniotomy I 2 hri
Epilepsi III 2 hari
ICH Traumatika, SAH traumatik, Eema

I 5 hari
cerebri berat
CKD ST V, CH, HEPATITIS, HHD,
III 2 HARI
HIPOALBUMIN
CKD ON HD, DM TIPE II, RENAL

ANEMIA, PNEUMONIA SUSP C-19,
III 3 HARI
EFUSI PELURA DEXTRA, HHD,
DYSPEPSIA SYNDROM
CVD, SH, POST OP CRANIOTOMI

I 4 HARI
DECOMPRESI HEMATOMA
POST OP CRANIOTOMI a/i HT

III
EMERGENCY POST SH
Pemasangan Alat TOTAL
Estimasi STATUS
BILLING
OKSIGEN CVC/CDL
Ventilator 1 hari Rp.39.602.100 Rp.47.040.955
Ventilator 4 hari Rp.67.573.000 Rp.114.549.261
NC Rp.5.120.400 Rp.76.842.610
Ventilator 2 hari Rp.20.264.000 Rp.11.435.921 dr.yudi/dr.des
Jasaraharja
NRM Rp.29.841770 dr.sunaryo/dr.nobel
Rp.20.000.000
NRM Rp.5.089.700 Rp.22.122.122 dr.sinarta/dr.nobel
NRM Rp.11.974.600 dr.yudi/dr.nonel
NRM Rp.6.814.000 dr.imma/dr.nobel
NRM Rp.20.000.000 Rp.13.525.332 dr.aitara/dr.nobel
Ventilator 6 hari Rp.21.906.500 Rp.53.552.381 dr.yudi/dr.nobel
ventilator > 96 jam Rp.64.399.400 Rp.75.975.389 dr.asian/dr.nobel
ventilator > 96 jam CVC/PDT Rp.90.159.400 Rp.127.168.742 dr.renny/dr.des
NC Rp.14.111.757 dr.renny/dr.des
NC dr.yudi/dr.nobel
NRM Rp.13.865.063 dr.sari/dr.nobel
ventiulator > 96 jam CVC Rp.39.211.300 Rp.35.670..300 dr.yudi/dr.nobel

NRM CVC/CDL Rp.28.807.622 dr.sinarta/dr.nobel
Ventilator > 96 jam Rp.39.211.300 Rp.18.582.733 dr.kumalsari/dr.nobel
NC Rp.32.035.239 dr.yudi/dr.nbel
NRM RP.2.578.500 Rp.4.448.979 dr.imma/dr.desvita
ventiulator > 96 jam Rp. 90.159.400 Rp. 9.811.482 dr. Yudi/dr. Des
VENTILATOR < 96 dr. SiNARTA /DR.

Rp. 28.287.200 Rp12,117,595
JAM DES
VENTILATOR > 96 DR. RENNY/DR.

cvc/cdl Rp. 28.000.000 Rp. 43.831.004
JAM NOBELLIA
ventilator > 96 jam Rp. 39.211.300 Rp. 37.719.836 dr. Yudi/dr. Nobellia
ventlator >96 JAM pdt/cvc Rp. 67.573.000 Rp. 98.339.055 dr. Yudi/dr. Desvita
KETERANGAN
Meninggal tgl 7/6/22 jam 22.50
pindah R.DHL tgl 17/6/22 jam 11.00
pindah R.DHL tgl 14/6/22 jam 19.30
Meninggal tgl 2/6/22 jam 17.35
Rujuk RSPAD tgl 2/6/22 jam 22.00
meninggal tgl 4/6/22 jam 11.25
meninggal tgl 3/6/22
pindah ALM tgl 5/6/22
pindah ALM tgl 8/6/22,jm 13.00
pindah Mawar tgl 20/6/22 jam 12.00
pindah DHL tgl 6/7/22 jam 20.15
pindah tgl 16/6/22
pindah ALM tgl 16/6/22 jam 23.00
pindah MWR tgl 22/6/22 jam 22.30
pindah ALM tgl 26/6/22 jam 15.00

pindah ALMD tgl 24/6/22
meninggal tanggal 30/6/2022 jam 05.50
MENINGGAL TANGGAL 28/6/2022
MENINGGAL TANGGAL 28/6/22 JAM

12.00
PINDAH ALAMANDA TANGGAL 30/6/22

JAM 23.00
TANGGAL MASUK
NO NAMA PASIEN ICU COVID DAN ASAL No. RM
RUANGAN
1 TN.SETIYA 01/06/2022 : IGD 27-37-96
2 TN.SYARIF USMAN 04/06/22 : IGD 7/4/1966
3 TN.MARMONO 04/06/2022 : IGD 27-39-57
09/06/2022,KNG-OK
4 NY.EKA 27-40-71
jam 23.30
10/06/2022 IGD jam

5 TN.AHMAD ZAIN 27-40-97
01.30
10/06/2022IGD-OK
6 NY.ERNA AGUS 27-40-94
jam 21.30
13/06/2022 IGD jam

7 TN.KURNIAWAN 27-41-64
14.00
14/06/2022 IGD jam

8 NY.SRI UMIYATUN 27-42-17
07.00
14/06/2022, igd-ok
9 TN.IMMANUEL 18-57-90
JAM 19.00
18/06/2022, IGD jam

10 TN.ARI FARIS 27-44-67
23.00
20/06/2022,IGD-OK
11 TN.M.ERWINSYAH 27-44-88
jam 19.30
20/06/2022 IGD jam

12 NY.EPIH 24-94-74
23.30
21/06/2022,IGD-OK
13 TN.SUNARYO 27-45-86
jam 06.30
22/06/2022, IGD jam
14 NY.DURYATI,S 27-45-86
01.30
15 TN.EDISON .T 23/06/2022, IGD 04-98-39
16 NY.NUSUN ULINA 23/06/2022, IGD 24-46-03
24/06/2022, DHL jam

17 NY. WARSITI 27-44-30
00.15
18 TN.HUSAINI 25/06/2022, OK 27-47-21
26/06/2022, IGD jam

19 NY.SRI SUNARNI 27-24-57
18.00
26/06/2022, IGD jam

20 TN. SALIMOEN 19-62-20
13.00
25/6/22, IGD jam

21 TN.WIBOWO.W.R 16-45-37
23.00
27/06/2022, IGD
22 TN.ACHMAD jam.22.00 27-47-71
27/06/2022,IGD jam
23 Nn.DYAH AYU 03-76-84
19.30
28/06/2022, MAWAR
24 NY.JAITUN 27-46-41
jam 14.00
29/06/2022,IGD jam
25 TN.SLAMET RIYADI
23.40 16-62-12
30/06/2022,IGD jam
26 TN.HARIS JUNAIDI 27-49-04
19.30
30/06/2022, IGD jam
27 AN.ARSYILA . M 27-49-05
19.30
LAMA Pemasangan Alat
PERAWATAN
OKSIGEN CVC/CDL
Post Craniotomy Decompresi Evaluasi ICH Ventilator 6
Kelas III 8 hari
dd SH hari
DM,tipe II, AKI dd CKD, CAD, Ulkus

Kelas III 3 hari NC
gangren pedis Sin, Increase Transaminase
CKD, DM e/c TGT, Stroke berulang, HHD, Ventilator >96

Kelas III 8 hari
CAD jam
Post Op laparatomy Histerectomy Kelas III 2 hari NC
SNH Tromboemboli, DM, Acute Ventilator >96

Kelas III 8 hari
Symtomatic Seizone,HT jam
Post Op VP Shunt, TB Paru dd Pneumonia UMUM 5 hari NRM
Pneumonia C-19, DM Tipe II, HT Jamininan

4 hari NRM
Hemiparese e.c SNH Covid
Hiperkalemia,Hiponatremi, SNH, DM, AKI

Kelas III 8 hari NC CVC/CDL
dd CKD
ventilator >96
Post Craniotomy Removal Tumor Kelas I 5 hari
jam
ADHF, HHD,CHF, AF RVR,edema pulmo

dd TB Paru, AKI dd CKD, Increase Kelas II 2 hari NC
Transaminase, Mild Hiponatremi
Post Op EVD, HT Kelas III 2 hari NC
CKD on HD, DM Tipe II, Renal Anemia,

ventilator >
susp.Pneumonia C-19, Efusi Pleura dex, Kelas III 8 hari
96 jam
HHD, dyspepsia syndrome
SH, Post Op EDH craniotomy a/i ICH ventilator >

Kelas III 5 hari
Ganglia Basal sin e.c SH, Hemiplegi dex 96 jam
Pneumonia C-19 ( PDP ), AKI dd
CKD,susp.CVD stroke, leukositosis reaktif Kelas III 2 hari NRM
dd inflamasi
Kelas I
Pneumonia C-19, HT, Ksta Usus ( jaminan 5 hari NC
Covid )
Kelas I
Pneumonia C-19, HT (jaminan 5 hari NC
Covid)
Kelas
Pneumonia C-19, Post Debridement, Anemia III(jaminan C- 2 hari NC
19)
CVD, SH, Post Op Craniotomy decompresi Kelas I 3 hari Ventilator <
Haematom 96 jam
SNH, status epileptikus, susp.pneumonia Ventilator <

Kelas I 2 hari
CAP 96 jam
Pneumonia C-19, DM tipe II, Asidosis Kelas
metabolik terkompensasi, HHD, AKI st III, I( jaminan 4 hari HFNc
Mild Hipokalemi Covid ) ICU
Pneumonia C-19, Syok Hipovolemi, AKI st.I,

ranap covid 10 hari NC
HHD, Low Intake
SNH, CKD on HD, TB Millier, Susp.TB
Meningitis, AKI dd CKD kls I ( suspek ) 3 hari NRM
pneumonia C-19 ranap covid 6 hari room air
ARDS, TB Paru On OAT, Elektrolit Inbalance, kelas ventulator < 96

1 hari
Pneumonia, Anemia III,suspek jam
Suspek Pneumonia C-19, CKD, CVD Kelas II 1 hari NRM// RJP
Kelas I ranap
Pneumonia C-19 7 hari room air
covid
kelas I ranap
pneumonia C-19, riwayat kejang 7 hari room air
covid
TOTAL DOKTER YG
Estimasi KETERANGAN
BILLING MERAWAT
Rp.64.399.600 Rp60,800,305 dr.Yudi/dr.des pindah R.DHL tgl 8/6/22 jam 19.00
Rp.4.900.00 Rp.7.491.591 dr.Sin/dr.nbl Pindah R.DHL tgl 6/6/22 jam 19.30
Rp.64.399.600 Rp.64.939.053 dr.sin/dr.nbl DNR pimdah KNG 11/6/22
Rp.1.970.746 dr.titi/dr.nbl pindah KNG tgl11/06/22 jam 23.00
Rp.42.913,620 dr.Imma/dr.NBL pindah DHL 17/06/22 jam 15.30
Rp.37,715,765 dr.Yudi/dr.des pindah Mawar tgl 13/06/22 jam 14.00
Rp.19.253.000 Rp.21.714.086 dr.Andi Ibnu Pulang tgl16/06/22 jam 22.30
Rp.8.500.000 Rp.41.182.171 dr.Sin/dr.nbl pindah MWR tgl 21/06/22
Rp.48.146.018 dr.yudi/dr.NBL pindah AGRk tgl 18/06/22
Rp.21.001.418 dr.katrin/dr.NBL pindah ALMD tgl 19/06/22 jam 18.00
Rp.4.660.232 dr.yudi/drnbl pindah MWR tgl 21/06/22 jam 18.45
Rp.28.000.000 Rp.43.831.004 dr.renny/dr.nbl pindah ICU I tgl26/06/22 jam 20.00
Rp64,399,600 Rp..41.585.079 dr.yudi/dr.nbl pindah DHL tgl 25/06/22 jam 13.45

Rp.10.089.000 dr.kum/dr.nbl pindah DHL 24/06/22 jam 00.30
Rp.14.914.000 RP.22.042.577 dr.eko/dr.renny pulang tgl 27/06/22 jam 19.00
Rp.14.914.000 Rp.20.672.595 dr.eko/dr.renny pulang tgl27/06/22 jam 19.00
Rujuk RS.Persahabatan tgl 25/06/22

Rp.14.914.000 Rp.7.305.938 dr.sin
jam.03.00
Rp.23.641700 Rp.27.243.861 dr.yudi/dr.nbl pindah ICU I tgl 27/06/22
Rp.39.602.100 Rp.10.925.705 dr.kumalasari/dr.des meninggal tgl27/06/22 jam 16.20
Rp.19.253.000 Rp.25.494.595 dr.renny/dr.des meninggal tgl 29/6/22 jam 19.00
Rp.19.253.000 Rp.47.776.878 dr.renny/dr.eko pulang tgl 04/06/22 jam 14.30
Rp.10.089.000 Rp.19.143.421 dr.renny/dr.des pindah MWR tgl 29/06/22 jam 13.45
Rp.13.096.00 Rp.20.164.696 dr.Andi Ibnu pulang tgl 02/07/22 jam 19.30
Rp.10.089.000 Rp.23.179.987 dr.eko/dr.nobel meninggal tgl 28/06/22
Rp.19.253.000 Rp.13.423.080 dr.renny/dr.nobel meninggal tgl 30/06/22 jam.00.15
Rp.13.096.00 Rp.19.926.036 dr .andi ibnu pulang tgl 06/07/22 jam 20.15
Rp.14.168.000 Rp.16.975.262 dr.andi ibnu/dr.vanny pulang tgl 06/07/22 jam 20.15

6
TANGGAL MASUK
RUANGAN
01/07/2022,IGD jam
1 AN.RAFASYA 27-49-15
19.30
01/07/2022, IGD jam

2 NY.AYU EKA 27-49-14
19.30
3 NY.RAGIL 01/07/2022, IGD 27-49-47
4 NY. SUTI 02/07/2022, ICU I 27-28-06
5 NY. UMI 01/07/2022, IGD 27-28-06
07/07/2022,IGD jam
6 NY.MURIA ULFA 27-50-65
13.00
07/07/2022,IGD jam
7 NN.ATIKAHDWI.R 27-50-66
13.00
07/07/2022, IGD jam

8 TN.ZULFITRIADI 24-60-46
13.00
09/07/2022,MWR
9 NY.RATNA DEWI 27-49-85
jam 23.00
12/07/2022, ALMD
10 TN.LOUIS . M 27-43-73
jam 19.00
12/07/2022, IGD jam

11 TN. ABBAS 24:57:20
23.30
12 TN.HELMI ADI 13/07/2022, IGD 25-85-31
13/07/2022,IGD-OK
13 NY. NANI 27-52-58
jam 23.00
13/07/2022,IGD jam
14 NY. SRI WIDAYATI *21.04.68
20.30
14/07/2022, IGD jam
15 TN.TRIYONO 13-50-58
18.30
15/07/2022, IGD
16 NY.YULIA . R 27:39:23
jam 21.00
15/07/2022, IGD
17 TN.IMAM . B
jam 21.00
27.52.90
18 TN.TJANG NAM HIONG 7/17/2022 27-37-37
17/07/2022,
19 NY.NINA . K KEBIDANAN jam 15-34-61
20.15
17/07/2022, IGD
20 TN.HENDRA
jam 23.30
26-17-14
20/07/2022, IGD
21 NY.PUJIATI
jam 01.30
26-96-72
20/07/2022, IGD-
22 TN.M.MUNDIR OK jam 23.00 27-54-56
23/07/2022, IGD
23 TN.ACHMAD NAHROWI
jam 00.0
27-55-69
24/07/2022, IGD
24 TN.YOS SURAHMAN
jam 23.30
27-51-61
25/07/2022, igd
25 NY.SUHANAH
JAM 11.30
27-55-94
26 NY. ANDIKA TRI.M 26/07/2022, IGD 06-68-89
27 TN.SOEHARDI 27/07/2022, IGD 27-56-73
28 TN. KAMALUDIN 29/07/2022, IGD 26-81-37

jam 11.00
29 NY.ZULFIE 29/07/2022,IGD 17-17-32

jam 23.30
29/07/2022, IGD
30 AN.AZRIE 24-59-50
jam 23.30
31 AN. HANDO 29/07/2022, IGD 27-57-40
31/07/2022, IGD
32 TN. DONY . S jam 20.30 27-57-88
PERAWATAN
OKSIGEN
kelas I ranap
Pneumonia C-19/ level I 6 hari NC
covid
kelas I ranap
Pneumonia C-19 / level I 6 hari NC
Covid
kelas I ranap
covid
Pneumonia , Status Epileptikus, DM, kelas I/ ICU ventilator <

3 hari
Leukositosis / level 3 Covid 96 jam
kelas II / ranap
covid
kls I dinas
Pneumonia C-19 / level II 5 hari NC
ranap covid
kls II /dinas
ranap covid
kls III ranap

Pneumonoia C-19 / level I 8 hari NC
covid
Pneumonia C-19, TB On OAT, DM Tipe II,

ventilator
Hemiparese, Increase Transaminase, SNH, kls II ICU covid 5 hari
>96 jam
Anemia, AKI st I / level III
kelas I, NON ventilator <

Post Op Craniotomy dd SOL dex 3 hari
covid 96 jam
kelas III,non
Hidrocephalus Akut 2 hari NRM
covid
ranap
Pneumonia C-19/ level I 11 hari NC
covid/siswa
Post Op Vp Shunt e.c Hidrocephalus Akut, kls III non Ventilator <
3 hari
SAH covid covid 96 jam
Pneumonia C-19, SNH riwayat kejang,AKI kls I /ranap

7 hari RM
st I, HHD / level II covid
Pneumonia C-19 ( PDP ), Dyspepsia,
Thrombositopenia, Increase Transaminase, ranap covid 2 hari NRM
ARDS / level II
Status Epileptikus, Susp.SNH dd SH, Ventilator >

Low Intake, AKI, Increase kelas II 7 hari
Transaminase 96 jam
DM Tipe II, Nefropati, DM hiperuremia,

UMUM 3 hari NRM
CAP, stemi anterior
Post Op VP Shunt, debridement, kelas III 2 hari TC

nefrotomy
ventulator >
Ca.Cervix ST II, Susp.Relaps Invasi kelas II 19 hari 96 jam
Pneumonia C-19 / level I ranap Covid 10 hari NC
Pre koma hipoglikemi, Pneumoia CAP, kelas III 8 hari ventilator

HHD, DM Tipe II > 96 jam
ventulator <
Post Op Craniotomy e.c ICH ( KLL ) kelas III 3 hari 96 jam
Susp.pneumonia C-19, SNH, elektrolit ventilator

kelas III 15 hari
Inbalance, HT, hipokalemi, ALO dd CHF > 96 jam
SNH dd SH, Leukositosis, Increase ventilator

Transaminase, AKI dd CKD, Pneumonia kelas III 9 hari
CAP < 96 jam
Susp.pneumonia C-19, Anemia / level I ranap covid 3 hari NC
Susp.pneumonia C-19 / level I ranap covid 2 hari NC
Pneumonia C-19, SNH, HT, AKI, DM, ICU covid 6 hari NRM
elektrolit inbalance
susp.pneumonia C-19, SNH, HT, elektrolit ranap covid 3 hari NC
inbalance / level II
Pneumonia C-19 / level I ranap covid 6 hari NC
level I ranap covid 6 hari NC

Pneumonia C-19, susp.DHF / level I ranap covid 5 hari NC
Pneumonia c-19 / level I ranap covid 3 hari NC

Pemasangan Alat TOTAL DOKTER YG
Estimasi
BILLING MERAWAT
CVC/CDL
Rp.13.096.000 Rp.15.803.671 dr.ibnu/dr.vanny
Rp.13.096.000 Rp.20.754.765 dr.ibnu
Rp.13.096.000 Rp.11.042.786 dr.andi ibnu
Rp.40.495.000 Rp. 53.670.125 dr.ren/dr.ibnu/dr.nob
Rp.13.096.000 Rp.13.378.154 dr.ibnu
Rp. 14.914.000 Rp.22.302.121 dr.ibnu
Rp.13.096.000 Rp.21.776.171 dr.ibnu
Rp.13.096.000 Rp.26.387.260 dr.ibnu
Rp.93.676.000 Rp.52.499.632 dr.ibnu/dr.des
Rp.16.887.400 Rp.28.847.862 dr.yudi/dr.nobel
Rp.96.305,505
Rp.13.096.000 Rp.31.322.878 dr.ibnu
PDT/CVC Rp.34.804.500 Rp.33.214.711 dr.yudi/dr.des
Rp.14.914.000 Rp.16.725.390 dr.kumalasari

Rp.8.968.000 dr.renny/dr.des
Rp.77.279.500 dr.imma/dr.nobel
Rp.14.428.930 dr.des/dr.katri
dr.yudi/dr.des
CDL/CVC
PDT Rp.81.087.600 dr.risa /dr.nobel
Rp.13.096.000 Rp.32.262.102 dr.ibnu
Rp.64.399.600 Rp.45.708.407
cover Jasa raharja

PDT/CVC Rp.65.573.000 dr.Imma/dr des
Rp.40.495.000 dr.Imma/dr.des
Rp.6.470.000 dr.renny/dr.eko
Rp.6.470.000 dr.renny/dr.eko
Rp.19.253.000 dr.ibnu/dr.nobel
Rp.8.968.000 dr.ibnu
Rp.13.096.000 dr.ibnu
Rp.13.096.000 dr.ibnu
Rp.13.096.000 Rp.10.551.777 dr.vanny
Rp.13.096.000 Rp.5.070.008 dr.ibnu

KETERANGAN
pulang tgl 06/07/22 jam 20.15

6
pindah ICU Non Covid tgl 07/06/2022
pulang tgl 05/06/2022 jam 19.30
pulang tgl 11/07/2022 jam 13.45
pulang tgl 11/07/2022 jam 13.45
pulang tgl 14/07/2022 jam 13.00
pindah ALMD tgl 14/07/2022 jam 13.00
pindah iCU Non Covid tgl 13/07/2022
pulang tgl 23/07/2022
pulang tgl 19/07/2022

pinadah ALMD tgl 15/07/2022 jam 23.00
pindah DHL tgl 21/07/2022 jam

23.00
rujuk lepas ke RS. PELNI tgl

17/07/2022 jam 20.45
pulang tgl 26/07/2022 jam 17.00
pindah tgl 22/07/2022
pindah DHL tgl 06/08/2022
meninggal tgl 01/08/2022
pindah MAWAR tgl 27/07/2022
pulang tgl 01/08/2022 jam 20.20
pindah tgl 31/07/2022 jam 19.30
pulang tgl 03/08/2022 jam 14.30
pulang tgl 03/08/2022 jam 14.30


TANGGAL MASUK
RUANGAN
01/08/2022, IGD jam

1 TN.KRISNA . T 27-58-02
20.30
03/08/2022, IGD jam

2 NY.YAYUK 14-32-56
13.30
05/08/2022, IGD jam

3 NY.NANIK . H 27-59-35
00.39
4 TN.SUNARDI 05/08/2022, IGD 27-59-49
10/08/2022, IGD jam

5 TN. ASMADI 27-60-54
10.00
11/08/2022, IGD jam
6 NY.YULIA . R 27-39-23
19.45
12/08/2022, IGD jam
7 NY.MIFTAHUL 19-47-88
19.45
12/08/2022, IGD jam
8 AN.RAFARDAN 27-61-97
19.45
12/08/2022, IGD jam
9 TN. ERFANDI 16-54-38
23.00
10 TN.M.NOVAL 8/12/2022 27-61-41
16/08/2022, IGD jam

11 TN. SUBUR 17-14-98
01.30
16/08/2022,IGD jam
12 NY.YOYOH 12-92-15
19.00
17/08/2022, IGD jam

13 NY.LUTFATULLAELA 27-63-36
23.00
18/08/2022, IGD jam
14 TN.PITONO 12-88-70
19.10
18/08/2022, IGD
15 NY.TATTY 07-32-94
JAM 00.30
20/08/2022, IGD
16 TN.BASTIAN .T
jam 00.30 27-66-86
17 NY.NENNY. S 20/08/2022, IGD "16-03-77
20/08/2022, ALMD
18 TN.ACHMAD. F
jam 22.30
15-25-68
22/08/2022, IGD
19 TN. MUSAR
jam 04.00
27-67-14
22/08/2022, MWR
20 NN.FASYA
jam 19.30
27-62-42
24/08/2022, ANGR
21 TN.BUDI NURHADI jam 23.30 *25-06-38
26/08/2022, IGD
22 NY.SARI YUNITA
jam 14.00
27-69-30
26/08/2022, IGD
23 AN.M.RAKA.W
jam 14.00
27-69-17
27/08/2022, IGD
24 TN.M.YUSUF RANDY
jam 15.40
27-69-65
28/08/2022, IGD
25 NY.REIZA. W jam 01.30 27-69-80
26
27
PERAWATAN
OKSIGEN
Pneumonia C-19,PPOK, Anemia, Increase
ICU covid 8 hari HFNC
transaminase / level
Pneumonia C-19,SNH, HHD, AKI, HT, DM

ICU covid 4 hari HFNC
tipe II / level III
Pneumonia C-19, Susp.SNH, DM Tipe II /

ICU covid 6 hari NRM
level II
Post Op VP Shunte.c SAH, hidrocephalus, ventilator >

ICU covid 7 hari
Pneumonia C-19 96 jam
Pneumonia C-19, Susp.TB, DM, CHF, HT,

ICU covid 5 hari NRM
AKI
ventilator >
Encephalitis TB Non covid 10 hari
96 jam
Susp.Pneumonia C-19 ranap covid 2 hari NC
TB Paru On OAT, Elektrolit In balance,

ICU Non Covid 8 hari HFNC
Anemia
ICH Ganglia Basalis Dex unilateral kiri, ventilator >

ICU Non Covid 6 hari
Hidrocephalus 96 jam
Pneumonia C-19, PPOK, Pneumonia CAP,

respiratory failure tipe II,
ICU covid 4 hari SM-->HFNC
Immunocompromised stste dd septic
condition
ventilator >
Pneumonia CAP, Sepsis, Anemia berat ICU Non Covid 5 hari
96 jam
ventilator <
Efusi Pleura ICU Covid 3 hari
96 jam
Pneumonia C-19, HHD, Dyspepsia Ranap Covid 3 hari NC
Pneuomina C-19 ranap covid 7 hari NC
Dm tipe II, Pneumonia C-19, AKI, ARDS ICU Covid 10 hari ventilator
> 96
B 20 Reaktif, Susp.Meningitis TB ICU Non Covid 12 hari ventilator

> 96 jam
ventilaror
SNH, Tromboemboli, PenKes ICU Non Covid 7 hari
> 96 jam
TB Paru On OAT, Anemia, Low Intake,

Pneumonia CAP, Susp.TB usus,ARDS P- ICU covid 2 hari ventilator
< 96 jam
C-19 bil
SNH, CSVT, Hipokalemia, Leukositosis, ventilator

Kardiomegali ICU Covid 15 hari > 96 jam
Pneumonia C-19 Ranap Covid 6 hari NC
Pneumonia C-19 ranap covid 5 hari NC
ventilator
Susp.Pneumonia C-19, post SLE th 2020 ICU Covid 3 hari < 96 jam
Estimasi
BILLING MERAWAT
CVC/CDL
Rp.14.914.000 Rp.42.843.819 dr.eko/dr.renny/dr.nbl
Rp.19.253.000 Rp.26.207.838 dr.eko/dr.des
Rp.8.968.000 Rp.46.265.576
Rp.76.880.000 Rp.67.476.923
Rp.19.253.000 Rp.47.054.827 dr.ibnu/dr.nobel/dr.ren
Rp.46.142.607 dr.Imma/dr.nobel
Rp.6.470.000 Rp.10.410.805 dr.ibnu
Rp.6.470.000 Rp.8.325.020 dr.vanny
Rp.6.470.000 Rp.11.524.357 dr.andi ibnu
Rp.28.254.573 dr.eko/dr.Des
Rp.11.474.600 Rp.18.621.096 dr.yudi/dr.des
Rp.14.914.000 Rp.28.488.703 dr,ibnu/dr.renny/dr.nobel
Rp.64.399.600 Rp.35.774/678 dr.ibnu/dr.nobel/dr.ren
Rp.20.132.000 Rp.25.119.092 dr.ren/drkatr/dr.nobel
Rp.14.914.000 Rp.22.544.514 dr.eko/ dr.ren
Rp.13.096.000 Rp.28.201.813 dr.eko
Rp.93.676.000 Rp.58.888.089 dr.eko/dr.ren/dr.nobel
Rp.28.008.100 Rp.79.926.532 dr.re/dr.sari/dr.ibnu

dr.nobel
Rp.39.211.300 Rp.34.062.237
Rp.30.093.000 Rp.34.251.493 dr.eko/dr.ren/dr.aitara

dr.des
dr.imma/dr.des/dr.kat dr
Rp.30.093.000 Rp.75.834.814 ren
CVC= DNR
Rp.13.096.000 Rp.17.155.293 dr.ibnu
Rp.6.470.000 Rp.14.078.791 dr.vanny
Rp.13.096.000 Rp.15.398.442 dr.ibnu
CDL/CVC dr.ren/dr.des/dr.eko
WSD Rp.20.132.000 Rp.28.484.130 dr sari
KETERANGAN

6
pindah MAWAR tgl 10/08/2022 jam 01.00
meninggal tgl 14/08/2022 jam19.22
pindah MWR tgl 13/08/2022
pindah MWR tgl 17/08/2022, jam 18.30
pindah DHL tgl 17/08/2022,jam 13.30
pindah MWR, tgl 18/08/2011 jam 19.30
pindah ICU I tgl 20/08/2022 jam 17.30
pulang tgl26/08/2022, jam 17.30

pulang tgl 31/08/2022, jam 13.00
pulang tgl 31/08/2022, jam 13.00
pulang tgl 31/08/2022, jam 13.00
meninggal tgl 30-08-2022 jam 10.15

TANGGAL MASUK
ICU NON COVID
NO NAMA PASIEN DAN ASAL No. RM
RUANGAN
01/08/2022,ANG
1 TN.MULYADI 27-33-31
jam 22.40
02/08/2022,DHL-
2 TN.RIZKY.R 26-55-07
OK jam 07.00
02/08/2022, IGD-
3 TN.NURCAHYO 25-87-70
OK jam 07.00
02/08/2022, IGD
4 TN. IRVANNUL . H 27-20-79
jam 22.00
05/08/2022,ANGR
5 TN.ARIEF. S 27-58-94
jam 16.30
06/08/2022, IGD
6 NY.SRI AMBAR 27-59-85
Jam 00.20
06/08/2022,DHL
7 NY.ASMAH 27-57-63
jam 20.00
07/08/2022, IGD
8 TN.STEFANUS 27-60-10
jam 01.00
08/08/2022, IGD
9 NY.SITI. K 27-60-20
Poenex jam 10.00
10 TN.ASEP . H 10/08/2022, IGD 27-61-02

jam 01.30
10/08/2022, IGD
11 TN.SARIMAN 27-61-01
jam 01.30
12 TN.HARY CAHYONO 11/08/2022, IGD 27-61-37

jam 03.00
11/08/2022, ANGR
13 TN.RAFIF H . R 27-61-03
JAM 14.00
12/08/2022, IGD
14 NY.SULASTRI 27-61-89
jam 23.40
15/08/2022, IGD
15 TN. INDRIAT . P 27-62-63
jam 02.00
16/08/2022, DHL -
16 NY.KARLINA *26-11-55
OK jam 19.30
17/08/2022, DHL
17 TN. DJEMADI 17-13-38
jam 23.00
18/08/2022,OK jam
18 NY.SUGIARTI 27-65-36
03.30
19/08/2022, IGD
19 NY.RESIANA . M *08-02-25
jam 03.00
20/08/2022,
20 TN. PITONO Bougenvile jam 12-88-70
17.30
20/08/2022. OK jam
21 NY.NGAYEM 17-60-33
20.30
20/08/2022, IGD
22 NY.SUMIYATI 27-66-32
jam 01.30
24/08/2022, IGD
23 TN. SRIYONO 27-48-93
jam 00.30
24/08/2022, ANGR
24 TN . BUDI *25-06-38
jam 20.00
25/08/2022, IGD
25 TN.DJOKO . K 24-38-56
jam 13.00
25/08/2022, DHL-OK
26 TN. SENO HARDO 19-82-22
jam 17.00
27/08/2022, MWR
27 NN. UMI LATIFAH 27-69-08
jam 01.00
28 TN.SUGIJONO 28/08/2022, IGD 13-51-45
30/08/2022, OK jam
29 NY.IDA WATI 27-68-57
17.00
31/08/2022, IGD
30 NY. RIN RESTU 26-75-66
jam 00.00
30/08/2022, IGD
31 TN. NASFER 26-59-28
jam 17.00
Hak
DIAGNOSA PASIEN PERAW
Kelas
ATAN OKSIGEN
CKD, N-STEMI, Post URS kelas I 2 hari NRM
Post Op VP Shunt, AKI, SNH, meningitis TB, Infark

kelas III 1 hari NRM
cerebri, pengobatan TB
Ventilstor <
Post Op Craniotomy EVD, SH dd SNH Hidrocephalus kela III 4 hari
96 jam
DM Tipe II, HHD, Anemia, Hipokalemia, CVD, Infark,
UMUM 2 hari NRM
SNH,sus.pneumonia, susp.TB paru
Meningoencephalitis, Anemia, Hipokalemia,
kelas I 3 hari NRM
susp.leptospirosis
Pneumonia CAP, sepsis condition, ALO dd CHF, HT kelas II 1 hari NRM
SNH, CSVT, AKI, HipoAlbumin, Hipokalemia,

kelas III 4 hari NRM
Celulitis, Dispepsia
ventilstor
Post Op craniotomy e/c ICH Basalis Sin kelas I 3 hari
< 96 jam
Post Op SC e/c PEB, HAP, DM Tipe II, Partial Help ventilator
kelas I 3 hari
Syndrom < 96 jam
ICH, IVH kelas III 4 hari ventilator

< 96 jam
ventilator
ICH, Traumatik, Hemisfer cerebri dex, Pneumonia VAP kelas III 8 hari
< 96 jam
ICH Ganglia Basalis Sin, IVC e/c SH, AKI, Pneumonia kelas III 4 hari ventilator
< 96 jam
Susp TB Paru, metastase paru, Post amputasiknee a/i
kelas I 16 hari ventilator
Condoblastoma, pneumonia, ARDS >96 jam
ventilator
Encepalopati, AKI St III, HHD, CKD on HD, Penkes, Sepsis kelas III 5 hari
>96 jam
ventilator
ALO, HHD, Observasi Dypsneu, Hiponatremi, Hipokalemi kelas III 3 hari
< 96 jam
ventilator
Post Op Craniotomy decompresi removal tmor kelas III 3 hari
< 96 jam
DM Tipe II, AKI, HipoAlbumin, Ulkus gr 3-4 kelas I 4 hari NC
ventilator
Post OP Craniotomy decompresi a/i ICH kelas I 2 hari
< 96 jam
ventilator
TB Paru On OAT, HD, CKD, AKI kelas I 13 hari
> 96 jam
ventilator
Gagal Nafas Tipe II, HHD, CHF, DM Tipe II kelas I 4 hari
> 96 jam
Post OP VP Shunt, Akut ICH, DM Tipe II kelas I 2 hari NRM

ventilator
Pneumonia, HHD, HT, ARDS, AKI---HD kelas III 3 hari
< 96 jam
CKD On HD, Anemia Renal, HHD, SNH dd DOC kelas III 3 hari NRM
SNH, AKI, Hipokalemia, Lekositosis, CSVT kelas I 1 hari NRM
ARDS, CHF, Efusi Pleura kelas 2 2 hari NRM
Post Op Craniotomy Cerebral Neuroendoscopy removal

kelas 3 3 hari NC
Tumor
TB Paru, Efusi pleura, Susp.meninngitis TB, Hiponatremi, ventulator

kelas 3 1 hari
Hipo Albumin, Hipokalemia < 96 jam
SNH, Recurent , HT, DM, Hipoklaemia, AKI, HHD kelas 3 3 hari NRM
Post Op Craniotomy Decompresi reoval tumor ec SOL ventilator

Intra kranial ec susp.meningioma, HT, hiperglikemi dd kelas 2 2 hari
< 96 jam
inflamasi
Pneumonia, HHD, ALO, AKI st I, DM Tipe II kelas I 1 hari NC
Hipoxy Encefalophati, SNH kelas 3 2 hari NRM

Estimasi
BILLING MERAWAT
CVC/CDL
Rp.8.261.000 Rp.39.330.801 dr.ren/dr.nobel
Rp.31.667.736 dr.ibnu/dr.nobel
Rp.32.486.807 dr.ren/dr.nobel/dr.sari
Rp.10.000.000 dr.ren / dr.nobel
CVC, tgl 08/08/2022 Rp.6.814.000 Rp.29.071.268 dr.imma/dr.sin/dr.nobel
dr.titi/dr.nobel/dr.renny
Rp.40.049.796
dr ibnu
Rp.56.874.552 dr.yudi/dr.des
Rp.27.835.700 Rp.42.650.284
dr.sunaryo/dr.ek0/dr.sin
Rp.54.000.000 Rp83,749,921
dr.katr
CVC-CDL Rp.64.000.000 Rp.33.388.071 dr.renny/dr.kum dr.nobel
Rp. 17.976.387 Rp.18.840.887 dr.katr/dr.renny dr.nobel
Rp.16.887.000 Rp.40.892.036 dr.yudi/dr.renny dr.nobel

dr.sin/dr.des/dr.eko
Rp.28.970.793
dr.asian
Rp.42.936.617 dr.yudi/dr.des
CVC/CDL/pungsi dr.ibnu/dr.renny
Rp.54.597.000
bronkoskoipi dr.nobel
dr.renny/dr.katri
Rp.26.910.998
dr.nobel
dr.yudi/dr.nobel dr.renny/
Rp.34.804.500 Rp.39.342.063
dr.katr
Rp.28.287.200 Rp.24.550.858 dr.eko/dr.ren/dr.nobel
Rp.13.097.925 dr.renny/dr.nobel
dr.imma/dr.renny
Rp.51.235.464
dr.katr/dr.nobel
dr.ibnu/dr.des/dr.ren
Rp.11.413.740
dr katr
Rp.29.118.276 dr.yudi/dr.nobel
dr.rahmat/dr des
Rp.6.801.056
dr.katr/dr.kuml
dr.imma/dr.des
Rp.14.188.321
dr.sin/dr.katr
dr.yudi/dr.renny
Rp.37.808.033
dr.nobel/dr.kuml
Rp.4.772.048 dr.ren/dr.nobel
dr.kuml/dr.des/dr.ren
Rp.10.345.834
dr.eko/dr.katr
KETERANGAN
pindah tgl 02/08/2022 jam 22.00

#VALUE!
pindah tgl09/08/2022 jam 16.30
meninggal tgl14/08/2022 jam 17.45
meninggal tgl 31/08/2022 jam

pindah Bougenville tgl 24/08/2022 jam

00.05..PCR positif tgl 25/08/2022
meninggal tgl 27/08/20// jam 05.50
pindah AGRK tgl 31/08/2022 jam 22.30
pindah MWR ygl 31/08/2022 jam 22.30

TANGGAL MASUK
NO NAMA PASIEN ICU COVID DAN No. RM
ASAL RUANGAN
01/09/2022, IGD
1 TN.WIRDONO 27-71-19
jam 12.30
01/09/2022, IGD
2 NY. DEWI . S 27-71-56
jam 18.30
01/09/2022, IGD
3 TN.PRASOJO 27-71-42
jam 18.30
01/09/2022, IGD
4 TN. SAMIDI 00-54-23
jam 23.000
04/09/2022, IGD
5 NY. SRI SUMARSIH 27-72-41
jam 19.00
06/09/2022, IGD
6 NY.ALIDA 27-72-80
jam 14.00
07/09/2022, ALM
7 NY.DEWI WAHYUNI 27-73-51
jam 14.00
07/09/2022, MWR
8 NN. DIENTIA . R 27-69-84
jam 20.20
09/09/2022, IGD
9 TN . SUTRISNO 27-73-93
jam 11.30
10/09/2022, IGD
10 NY . NURYANAH 22-61-29
jam 18.00
12/09/2022, ALMD
11 TN.AGUS BENYAMIN 27-76-09
jam
13/09/2022, DHL
12 TN . MUSTAKIM 27-76-09
jam 06.40
13/09/2022, IGD
13 TN . SUTISNA 27-76-72
jam 21.00
14/09/2022, IGD
14 TN . PRISWANTO 27-76-97
jam 18.00
15/09/2022
15 AN . KAYLA . W 27-76-23
MWR jam 08.00
17/09/2022, MWR
16 TN . SLAMET 27-76-08
jam 16.00
17/09/2022,IGD
17 NY . TUSARI 27-78-13
jam 19.00
19/09/2022,ICU
18 TN . ANDI . R 27-76-24
lt.II,jam 16.30
19 20/09/2022, IGD
NY . MUTIARA 27-79-01
jam 18.00
21/09/2022,IGD
20 NY.SYAMSIDAR 18-54-43
jam 10.10
21 23/09/2022, IGD
TN , BANGUN . S 20-75-81
jam 13.00
23/09/2022,IGD
22 NY. RODIAH B. T 07-38-18
jam 20.00
23/09/2022, IGD
23 TN. SUTARYO 01-72-65
jam 23.00
24/09/2022, IGD
24 TN . ABU BAKAR 27-65-55
jam 00.30
27/09/2022,IGD
25 TN. PANUSUNAN . I 07-43-74
jam 23.55
28/09/2022, IGD
26 TN . TUGIMIN 24-76-55
jam 09.15
30/09/2022, IGD
27 NY . DAHLIA 27-82-07
jam 23.30
lama Pemasangan Alat
perawatan
OKSIGEN
Susp.pneumonia covid-19, SNH dd SH, DM Tipe II, kelas 3 icu ventilator >
11 hari
AKI covid 96 jam
kelas 3 ranap
Pneumonia covid-19 6 hari NC
covid
level 2 ICU
Pneumonia covid-19, AKI, gagal nafas 6 hari NRM
covid
level I ranap
Pneumonia covid - 19 5 hari SM
covid
level I ranap
Pneumonia Covid-19 5 hari NC
covid
level I ranap
Pnemumonia covid-19, sequale stroke 4 hari NC
covid
ICU non ventilator <

DM Tipe II, KAD, Asidosis Metabolik, Hiperkalemia 2 hari
COVID, kl 2 96 jam
Pneumonia CAP, TB Paru, Susp.MDR, Low Intake, ICU non ventilator

7 hari
HipoAlbumin COVID, kls III > 96 jam
ICU non
Sup.Pneumonia C - 19 2 hari Ventilator
Covid, kls III
Ventilator <
pneumonia, syock sepsis, TB Paru ICU non Covid 2 hari
96 jam
ICU Non
B 20, SNH, Pneumonia st IV, Toxoplasma 2 hari NRM
Covid,kls I
Pneumonia HAP, AKI, Increase Transaminase, illeus ICU non

5 hari NRM
partial, respirasi failure Covid, kls III
Hiperglikemi, DM tipe II, susp.SNH, Dyspepsia

ranap covid 2 hari NC
Syndrome, HT st I, HiperUrosemia, AKI st I
pneumonia, ARDS, DOC dd Hipoglikemi,

susp.encepalopati, syock sepsis, Hipovolemia,TB ICU non covid,
4 hari NRM
susp.MDR, AKI st I, Increase transaminase, kl III
trombositopeni, efusi pleura sin., hiper kalemia
TB Paru lesi luas, Pneumonia Millier, Haemoptue, ICU non covid, Ventilator <
4 hari
elektrolit inbalance, gizi buruk kls III 96 jam
Pneumonia CAP, Tumor Paru dex st III, Hipo

ICU non covid,
Albumin, Hipoglikemia< DM Tipe II, Hiponatremi, 3 hari HFNC
kls III
Riwayat TB sdh tuntas
Asidosis respiratorik, Post Op craniotomy decompresi
ICU non covid, Ventilator <
removal tumor e/c ICH subcortial reg.parie`tal dex, 4 hari
kls III 96 jam
lesi SOL Intrakranial, Mild hipokalemia
Pneumonia CAP, B20, TB paru on OAT, sepsis ICU non covid,

18 hari HFNC-NRM
anemia kls II
ICU covid, Ventilator <

Pneumoia C-19, TB Paru on OAT, Septic Condition 3 hari
level III 96 jam
Gagal nafas tipe Ie/cpneumonia, elektrolit inbalance,

ICU non covid, Ventilator
asidosis metabolik, SNH, encephalopati, sepsis, AKI, 7 hari
kls III >96 jam
akut syndromatic , seizure, DM, hipokalemia
ICU non covid,

STEMI, Pneumothorax 2 hari NRM
kls I
Pneumonia C-19, HT on therapi,increase ranap covid,

6 hari NC
transaminase level II
Pneumonia C-19, trombositopenia, Increase ranap covid,

6 hari NC
transaminase level I
susp.pneumonia C-19, TB paru lesi luas, pneumonia

HAP, septic condition, MODS, hiperglikemi, AKI tent ICU non covid Ventilator <
2 hari
to CKD, increase transaminase, elektrolit in balance 96 jam
ICU covid, level

Pneumonia C-19, HT,DM tipe II 9 hari NRM
II
HT emergency, ARDS, Pneumonia, DM tipe ICU non covid Ventilator

7 hari
II,cardiomegali, alongasi aorta kls I >96 jam
ARDS, pneumonia, TB paru millier, ICU non covid Ventilator

6 hari
hipoalbumin,hipokalemi,trobositopenia kls III >96 jam
Pemasangan Alat DOKTER YG
Estimasi total billing
MERAWAT
CVC/CDL
level 3
Rp.66.144.038 dr.eko/dr.ren/dr.des
Rp.93.676.000
level 1
Rp.17.571.999 dr.ibnu
Rp.13.096.000
level 2 dr.ibnu/dr.ren/dr.katr
Rp.32.622.386
Rp.14.914.000 dr.nobel
level I
Rp.31.591.555 dr.eko/dr.renny
Rp.13.096.00
Rp.13.096.000 Rp.17.447.603 dr.ibnu
Rp.13.096.000 Rp.14.157.242 dr.eko/dr.ren dr.kuml
Rp.18.769.000 Rp.18.187.045 dr.ren/dr.eko/dr.des
Rp.64.399.600 Rp.38.757.728 dr.ren/dr.eko/dr,des
dr.rahmat/dr.ketrine
Rp.28.088.100
dr.nobel
Rp.34,804,500 Rp.14,267.511 dr.eko/dr.ren/dr.des
dr.imma/dr.ibnu
Rp.22.316.132
dr.ren dr.des
Rp.31.746.519
Rp.6.470.00 Rp.6.242.375 dr.ren/dr.sari/dr.nobel
Rp.31.816.907
dr.vanny/dr.ibnu
Rp.19.882.700 Rp.28.885.152
dr.nobel/dr.meli gizi
Rp.22.844.832 dr.eko/dr.ren/dr.nbl
Rp.42.758.986 dr.yudi/dr.nobel
dr,rahmat/dr.renny
Rp.7.479.300 Rp.74.339.617
dr.nobel
dr.eko/dr.ren
Rp.40.495.000 Rp.27.093.706
dr.nobel
dr.ren/dreko/dr.sari
Rp.64.399.600 Rp.28.885.152
dr.nobel
Rp.7.959.561
Rp.14.419.000 Rp.21.737.453 dr.ibnu/dr.ren
Rp.13.096.000 Rp.22.020.995 dr.ibnu/dr.ren
dr.ibnu/dr.sin/dr.des
Rp.12.955.694
dr,sari
Rp.14.914.000 Rp.68.010.003 dr.eko/dr.dr.ren/dr.nbl
dr.katr/dr.maria
Rp.90.159.400 Rp.39.778.673
dr,nobel/dr.ibnu
Rp.38.998.300 Rp.38.741.428 dr.sin/dr.des

KETERANGAN
pulang tgl 05/09/2022 jam 18.30
pulang tgl 08/09/2022 jam 19.10
pulang 09/09/2022 jam 21.00
pindah ICU lantai II tgl 10/09/2011 jam . 00.30
pindah ALMD tgl 13/09/2022 jam17.30

pindah DHL tgl 20/09/2022 jam15.30
pindah MWR tgl 03/10/2022 jam17.30
meninggal tgl22/09/2022 jam17.53
pulang tgl 28/09/2022 jam11.30
pulang tgl 28/09/2022 jam11.30

TANGGAL MASUK
ICU NON COVID
NO NAMA PASIEN DAN ASAL No. RM
RUANGAN
01/09/2022, OK jam
1 NY,NGAYEM 17-60-33
02.30
02/09/2022,
2 TN. SONO Anggrek 27-30-23
jam 12.00
3 NY . MADE 03/09/2022 , IGD 27-71-96
06/09/2022,
TN . GATOT
4 MAWAR 27-71-05
HARTONO
jam 13.35
06/09/2022, IGD -
5 TN . DJATI . N 14-16-55
OK jam 20.00
07/09/2022, IGD
6 NY . DERLAN . N 27-72-94
jam 02.30
*07/09/2022, IGD
7 TN. JEFFRY . S 27-73-92
jam 23.30
8 NY . SUMAR HAYATI 09/09/2022, DHL 27-73-69

jam15.00
10/09/2022,
9 TN . SUTRISNO BOUGENVILLE 27.73.93
jam 01.00
10/09/2011, DHL
10 TN . SAIFUDIN 27-73-23
jam 11.00
10/09/2022, IGD
11 NT.TETI KUSMIATI jam .12.50 04-88-83
11/09/2022, IGD
12 NY . ASMAH 16-92-07
jam 02.30
12/09/2022, DHL
13 TN . ADE SAHURI 27-74-79
jam 13.30
15/09/2022, ALMD
14 NY.TENTY SETIAWATI 14-51-52
jam 17.30
15 TN. ANDI SETIAWAN 16/09/2022,almd 27-76-24

jam 10.55
18/09/2022, IGD
16 TN . EKSIADI 27-78-26
jam 09.54
20/09/2022, IGD-OK
17 TN.M.PUTRA BAGUS 27-78-76
jam 02.30
24/09/2022, IGD-OK
18 TN.ANWAR M.SOLEH 27-80-07
jam 13.00
25/09/2022, IGD
19 TN. ROBBY ESAU . Y 27-80-58
jam 00.15
26/09/2022, IGD-OK
20 TN. AGFIANDI 27-80-58
jam 05.00
21 Ny.SYAMSIDAR 30/09/2022, DHL 18-54-43

jam 20.00
22
23
24
25
26
27
28
29
30
31
DIAGNOSA PASIEN Hak Kelas PERAWATA
N OKSIGEN
Post Op EVD ec Hidrocephalus akut, ICH ec SH kelas II 2 hari SM
pensiun TNI/
Post Op Laparatomy Gastroyeyunostomy , Systitis 3 hari NRM
kls 1
Post Op EVD e.c Hidrocephalus kelas III 2 hari NC
Pneumonia CAP, TB Inaktif, Increase transaminase, ventilator

kelas III 23 hari
AKI,Tumor Esofagus, Post ROSC > 96 jam
Post Op Craniotomy e.c defect os cranio Stroke,

kelas I 3 hari O2TC
HHD, Increase Transamanise, HipoAlbumin
Pneumonia, Hiponatremi berat, Hipokalemia, DM

kelas I 2 hari NRM
tipe II, HHD, AKI
ventilator
Pneumonia, gagal Nafas, HF, susp,thyroid kelas III 2 hari
< 96 jam
SNH, HHD, CKD, AKI st III, Pneumonia, Post ROSC kelas III 4 hari ventilator
< 96 jam
ventilator
Pneumonia, PPOK, HHD, ADHF kelas III 18 hari
> 96 jam
ventilator
Post Op Debridement, Sepsis, AKI, Elektrolit Inbalane kelas III 4 hari
< 96 jam
HHD, dyspepsia syn OMS, syok hipovolemi, UGB, AKI

st I kelas III 1 hari NRM
DM Tipe II, Bronkopneumonia, AKI, Trombositopenia kelas I 3 hari NRM
SNH< HT< Dimensia, CAD, HHD kelas III 3 hari NRM
SNH, Encephalopati e/c Hiperglikemi, ISK, Ulkus

Decubitus GR II, DM Tipe II, DOC, HHD, Pneumonia kelas I 4 hari NRM
CAP
ARDS, Pneumonia, B20 reaktif kelas II 4 hari HFNC

kelas I/ BPJS ventilator
Post Op Craniotomy Decompresi Evakuasi EDH 6 hari
TK < 96 jam
kelas III / ventilator

Post Op Craniotomy EDH 5 hari
Jasaraharja > 96 jam
Post OP VP Shunt a/I Hidrocephalus + ICH ganglia

ventilator
basal sin, hiperkalemi, HHD, Increase Transaminase, kelas I 6 hari
> 96 jam
AKI ST III, Hiperglikemi, HD ( + )
Post Op VP Shunt Hidrocephalus + IVH + ICH + AKI kelas III 3 hari NC
Post Op Craniotomy EDH Temporal dex kelas III 3 hari NC
SNH, Encephalitis, DM Tipe II, AKI, HHD, Anemia kelas III 3 hari NRM ( DNR )
Pemasangan Alat
Estimasi TOTAL BILLING DOKTER YG MERAWAT
CVC/CDL
Rp.19.882.700 Rp.50.152.214 dr.yudi/dr.des
dr.aitr/dr.emil/
Rp.15.235.200 Rp.88.687.248
dr,nobel/dr.eko/dr.kartr
Rp.19.882.700 Rp.38.332.752 dr.yudi/dr.nobel/dr.sin dr.eko
dr.eko/dr.aitr/dr.nbl
Rp.67,673,000 Rp.119,655,000
dr.yoke/dr,renny
CVC//PDT
dr.yudi/dr.nobel/dr.ibnu/
Rp.23.641,700 Rp,33,785.770
dr.renny
Rp.11.683.193
Rp.10.098.900 dr.des/dr.eko/dr.renny
Rp.28.000.000 Rp.28.438.608 dr,sari/dr.des/dr.renny
dr.rahmat/dr.katr/dr.sin
CVC / PDT Rp.28.008.100 Rp.67.423.560
dr.nobel
dr.aitr/dr.renny/dr.sari
RJP/ EKG Rp.44.509.225
dr.des
RJP // EKG Rp.6.902.184 dr.ren/dr.eko/dr.des
Rp.8.512.600 Rp.20.794.073 dr.sin / dr.des
dr.imma/dr.katr/dr.rifq
Rp.6.814.000 Rp.12.181.279
dr.nobel
dr.sari/dr.renny/dr.rifqi
Rp.25.209.827
dr,nobel
CVC Rp.7.479.300 lanjut ICU II dr.rahmat/dr.ren/dr.nobel

Rp.23.641,700 Rp.41.293.131 dr.yudi/dr.nobel
Rp.20 juta jasaraharja

Rp.63.349.176 dr.yudi/dr.nobel/dr.rifqi
BPJS RP.64.399.600
Rp.90.159.400 Rp.60.942.698 dr.yudi/dr.renny/dr.nobel
Rp.16.887.000 Rp.45.749.805 dr.yudi/dr.nobel/dr.renny
Rp.50.543.694 dr.ren/dr.nobel/dr.sari/dr.eko
KETERANGAN
pindah Anggrek tgl 04/09/2022 jam17.00
meninggal tgl 13/09/2022 jam15.55
meninggal tgl10/09/2022 jam 15.30
pindah ALMD jam 22.00
pindah ICU bougenvile tgl 19/09/2022 jam 16.20

pindah Anggrek tgl 29/09/2022
meninggal tgl 02/10/2022 jam.13.20

TANGGAL
MASUK ICU
NO NAMA PASIEN NON COVID DAN No. RM DIAGNOSA PASIEN
ASAL RUANGAN
1
NY. SYLVIA .T.M
2
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Hak
PERAW Estimasi TOTAL BILLING
Kelas
ATAN OKSIGEN CVC/CDL
DOKTER YG
MERAWAT
KETERANGAN
TANGGAL MASUK ICU
NO NAMA PASIEN NON COVID DAN No. RM
ASAL RUANGAN
NY. SYLVIA .T.M 04/10/2022, ALMD 06-27-14

1 jam 05.00
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
Hak LAMA Pemasangan Alat
DIAGNOSA PASIEN
Kelas PERAWATAN
OKSIGEN
Asidosis respiratorik, AKI on CKD, Anemia, Dyspepsia, ICU non
HHD, DM tipe II civid kls I
Pemasangan Alat DOKTER YG
Estimasi TOTAL BILLING
MERAWAT
CVC/CDL
KETERANGAN

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TANGGAL MASUK

NO NAMA PASIEN ICU I DAN ASAL No. RM

TN.TJANG NAM 28/05/2022 IGD/OK

1 NY.MIL"US 01/06/2022 jam 18.00 27.05.85

02/06/2022, IGD jam

05/06/2022, IGD jam

09/06/2022, DHL jam

28/6/22 IGD/OK JAM

Anemia Gravis, Sepsis,AKI dd Akut,

Post Op Craniotomy EVD Decompresi

DM Tipe II, Ulkus pedis dex, Melena III 15 hari

Post Op Craniotomy e/c SOL II 2 hari

Fraktur Tibia,Fubula Dex, Fraktur UMUM( jasarah

CKD on HD,Anemia, Trombositopeni III 3 hari

Post OP VP Shunt III 1 hari

snh,Status epilepsi,ISK, low Intske II 2 hari

Post Op Craniotomy Decompresi

Post Op LE a/i susp.Illeus,Anemia ,

AMS,Susp.encefalopati dd intra kranial

Dyspneu syndrom, DM, KAD,syok

Post Op craniotomy removal tumor sin II 1 hari

Pen.kes, Hiponatremia, Post OP Vp shunt I 3 hari

Status epileptikus, kejang, post op

Epilepsi III 2 hari

ICH Traumatika, SAH traumatik, Eema

CKD ON HD, DM TIPE II, RENAL

CVD, SH, POST OP CRANIOTOMI

POST OP CRANIOTOMI a/i HT

Ventilator 1 hari Rp.39.602.100 Rp.47.040.955

Ventilator 4 hari Rp.67.573.000 Rp.114.549.261

Ventilator 2 hari Rp.20.264.000 Rp.11.435.921 dr.yudi/dr.des

NRM Rp.5.089.700 Rp.22.122.122 dr.sinarta/dr.nobel

NRM Rp.11.974.600 dr.yudi/dr.nonel

NRM Rp.6.814.000 dr.imma/dr.nobel

NRM Rp.20.000.000 Rp.13.525.332 dr.aitara/dr.nobel

Ventilator 6 hari Rp.21.906.500 Rp.53.552.381 dr.yudi/dr.nobel

ventilator > 96 jam Rp.64.399.400 Rp.75.975.389 dr.asian/dr.nobel

ventilator > 96 jam CVC/PDT Rp.90.159.400 Rp.127.168.742 dr.renny/dr.des

NRM Rp.13.865.063 dr.sari/dr.nobel

ventiulator > 96 jam CVC Rp.39.211.300 Rp.35.670..300 dr.yudi/dr.nobel

Ventilator > 96 jam Rp.39.211.300 Rp.18.582.733 dr.kumalsari/dr.nobel

NRM RP.2.578.500 Rp.4.448.979 dr.imma/dr.desvita

VENTILATOR < 96 dr. SiNARTA /DR.

VENTILATOR > 96 DR. RENNY/DR.

Meninggal tgl 7/6/22 jam 22.50

pindah R.DHL tgl 17/6/22 jam 11.00

pindah R.DHL tgl 14/6/22 jam 19.30

Meninggal tgl 2/6/22 jam 17.35

Rujuk RSPAD tgl 2/6/22 jam 22.00

meninggal tgl 4/6/22 jam 11.25

meninggal tgl 3/6/22

pindah ALM tgl 5/6/22

pindah ALM tgl 8/6/22,jm 13.00

meninggal tgl 12/6/22 jam 06.00

pindah Mawar tgl 20/6/22 jam 12.00

pindah DHL tgl 6/7/22 jam 20.15

pindah tgl 16/6/22

pindah ALM tgl 16/6/22 jam 23.00

pindah MWR tgl 22/6/22 jam 22.30

pindah ALM tgl 26/6/22 jam 15.00

pindah MWR tgl 27/6/22 jam 18.00

pindah ALMD tgl 24/6/22

pindah DHL tgl 26/6/22 jam 19.00