Si Boncel: Jaminan: Bpjs Total Tarif Per TGL 27/7/22: Perkiraan Tarif Ya NG Bisa Di Klaim
Si Boncel: Jaminan: Bpjs Total Tarif Per TGL 27/7/22: Perkiraan Tarif Ya NG Bisa Di Klaim
Si Boncel: Jaminan: Bpjs Total Tarif Per TGL 27/7/22: Perkiraan Tarif Ya NG Bisa Di Klaim
Si Boncel
HCU
1 Ny Lasinah 27/07 Obs Dyspnue ec T HFNC Fio2 80% Flow 50 lpm Intake/15 jam : 2123, Jaminan :
68 th 12./40/14.80 B Paru + Electrolit 5
BPJS
0/354.000 Imbalance IVFD Nacl + neurobion 500 ml/ 24 Output/15 jam :340
DPH 2 jam Urine/15 jam : 340
Onset 15 LED: 76 Drip Levofloxacin 1x750 mg H2 BC/15 jam : -1785,5 Total tarif per tgl
Na:132 Inj. Ceftriaxone 1x2 gr H2 Diuresis/15 jam : 0,5c 27/7/22 :
K: 5.3 inj omeprazole 2x40 c/kgbb/jam
DPJP: dr Ric Cl: 89 B.Kumulatif : +1785,5
o Sp. An OAT kat 1x3 tab
Ur/Cr: 52/0.9 NAC 3x200 mg GDS 140 Perkiraan tarif ya
dr Aluisha S GDS:184 ng bisa di klaim :
p. PD Ag (-) MC 6x200cc 29/7 3,799,700
cek elektrolit
Ro: Pneumon
BB: 43 kg ia underlying
TB
AGD
Ph 7.39
PCO2 57.9
PO2 162.4
HCO3 35.4
BE 9.2
28/07
Albumin 3.4
VK
2 Ny. Nur Aini 28/07 IUFD pada G1P0A Misoprostol 25mcg/sublingual usg d poli
25 th DL TH 0 Hamil
GDS Induksi persalinan dgn Folley Cath
DPH 1 pT eter
aPTT
DPJP : dr. so
nia,Sp.OG USG 28/07
EFW 1500
DJJ negatif
LT 4 NON-COVID
3 401 Tn Sahid 25/07 Obs Febris H6 + T IVFD RL 2000 cc/ 24 jam DR 24 JAM Jaminan :
21 th 14.6/ 42/ 4.8/ rombositopenia + Inj Lansoprazole 2x30 mg
BPJS
4700/ 60.000 Dyspepsia + warni Inj Ondan 2x4 mg
DPH 4 ng sign
Onset 6 26/07 Pct 3x500 mg, jika t>38C beri iv 1 Total tarif per tgl
15.6/43/4.90 gr 27/7/22 :
DPJP: dr. Al 0/30.000 Cetirizine 1x10 mg
1.254.000
uisha, Sp. P Ambroxol 3x30 mg
D 18.00
17/49/6.700/ Perkiraan tarif ya
17.000 ng bisa di klaim :
1.047.000
IGG : -
IGM : -
Total biaya sudah m
27/07 elebihi tarif yang bis
06.00 a di klaim.
17.6/50/6400
/28.000
18.00
16/45/8.000/
40.000
28/7
15.1/42/9500
/49.000
4 401 Tn Sofyan 5 26/7 Abdominal Pain e IVFD RL 500 ml/ 8 jam stop : Jaminan :
8 thn 13.2/37/15.1 c Chronic Bowel D Inj Ceftriaxone 1x2 gr H3 hyosine
BPJS
00/288.000 isease + HT Inj Lansoprazole 1x30 mg
DPH 3
OT/PT 53/74 Amlodipin 1x10 mg Total tarif per tgl
DPJP: dr Eka 27/7/22 :
SpPD HbsAg (-) 5.582.278
Ag (-)
5 401 Tn Machmu 27/7 Hematemesis + m IVFD RL 1500 cc/ 24 jam DR/24 jam Jaminan :
d 10.2/31/9.20 elena ec susp gast Drip lansoprazole 6 mg/ jam sela
BPJS
0/157.000 ritis erosif dd siro ma 72 jam (Pakai infus pump) Puasa, pasang ngt ke
DPH:2 sis mbali→ DARAH HITA
Onset :2 27/7 Asam Tranexamat 3x 500mg M KEMERAHAN Total tarif per tgl
USG Peningka Extra Vit K 10mg 27/7/22 :
DPJP: dr Alui tan ekogenisi 28/7 1.195.275
sha SpPD tas parenkim Sucralfat 3x10 cc GDS; 128 mg/dl
kedua ginjal
(Brenbridge TC 300 c / hari selama Perkiraan tarif ya
1), cenderung 2 hari ng bisa di klaim :
proses kronis 1,084,000
pada kedua gi monitor
njal.
Simple cyst gi
njal kiri (ukur
an ± 1.62 x 1.
62 cm).
Fatty liver gra
de 1.
OT/PT 11/11
Ag (-)
28/7
8.1/25/8500/
136000
6 401 Tn Zainuddi 27/7 Selulitis dengan a IVFD RL 500 cc/ 8 jam Aff dc 24 jam post op
n 66 thn 13.1/16.500/ bses pedis dextra Inj Ondansetron 2x 4 mg k/p Diit biasa tinggi protei
495.000 post debridement inj Cefotaxime 2x1 gr H2 n
DPH 2 inj Metronidazole 3x500 mg H2 GF bila rembes
Ur/Cr 44/1.4 Inj PCT 3x1 gr
DPJP dr Ret GDS 105
no SpB PT 15.8
APTT 35.3
INR 1.10
Hbs Ag (-)
7 401 Tn. Yak Varo 22/07 Ulkus DM Digiti IV IVFD RL 500 ml/ 8 jam GDS 28/7 Jaminan :
ni 11.5/36/16.2 Pedis Sinistra pos Drip Cefotaxime 2x1 gr 06.00 153
BPJS
69 th 00/563.000 t amputasi + DM H2
tipe 2 + Hipertens Drip Metronidazole 3x
DPH 3 Ur/Cr 48/1.6 i 500 mg H2 rencana rawat jalan 2 Total tarif per tgl
Drip Paracetamol 3x1 g 9/7 27/7/22 :
DPJP 28/7 r GV dengan perhidrol
5.018.223
dr. Retno, S 9.5/30/8300/ Inj. Ketorolac 3x30 mg dan nacl tidak usah p
P. B 403.000 Inj. Ondansetron 2x4 m ake elastic
g
Perkiraan tarif ya
dr. Aluisha, Novorapid 3x8 ui SC
Sp.PD ng bisa di klaim :
Lisinopril 1x10 mg 5,975,400
8 402 Ny. Linawati 14/07: 11.2/3 Post OP Eksisi Tu IVFD RL 500 cc/ 8 jam→ AFF beng T.a.k Jaminan :
37 th 6/7.400/312. mor Mammae De kak
BPJS
000 xtra Drip Paracetamol 3x1 gr rencana pulang tungg
DPH 3 Inj Ondansentron 3x4 mg 5 menit u visit
sebelum makan Total tarif per tgl
DPJP: 27/7/22 :
dr. Retno, S Cefadroxil 2x500 mg h2
4.462.101
p. B Diit Biasa Tinggi Protein
Perkiraan tarif ya
ng bisa di klaim :
4,234,100
9 402 Ny. Bernade 26/07 GEA dengan dehi IVFD RL 500 cc/ 8 jam Gatal pemberian Levo Jaminan :
th 13.4/41/13.9 drasi sedang + dis Inj. Lansoprazole 1x30 mg floxacin
BPJS
74 th 00/148.000 pepsia + Bacterial Inj. Ondansetron 3x4 mg
Infection Inj Ceftriaxone 1x2 gr H2 Obat STOP:
DPH 3 Na/K/Cl: 136/ Ciprofloxacin 2x500 Total tarif per tgl
Onset 3 3.6/96 Zinc 2x1 tab mg H2 mual STOP 27/7/22 :
New diatab 4x2 tab kp
723.172
DPJP: dr Ek GDS: 152 Ambroxol 3x30mg 28/7
a,SpPD Rontgen Thorax
Diit m.lunak rendah serat Perkiraan tarif ya
ng bisa di klaim :
1,079,600
11 402 Ny Nuraini 27/7 GEA dehidrasi se IVFD NS 0.9 1500 cc/ 24 jam Mual diare - Jaminan :
27 th 14.2/41/11.6 dang teratasi + el Inj Ceftriaxone 1x2 gr H2 BPJS
00/429.000 ektrolit imbalans Inj Ondansentron 2x8 mg
DPH:2 Inj Lansoprazole 2x30 mg
Total tarif per tgl 2
Onset:4 Na 122/ K 3.4
/Cl 91 Loperamid loading 2 tab lanjut 1 t 7/7/22 :
DPJP: dr Alu ab per bab k/p
isha SpPD Attapulgite 1 tab per bab k/p
Perkiraan tarif yan
g bisa di klaim :
1,618,800
402
12 403 An. Alif 25/07 Obs febris h3den IVFD RL 500 cc/ 6 jam Cek DR/24 jam Jaminan :
9 thn 10.9/31/5100 gue fever + GEA Inj Pct 3x400 mg BPJS
32 kg /206.000 dehidrasi ringan + Demam
FL : low intake Zinc 1x1 tab
Total tarif per tgl 2
DPH :4 Cefixime 2x100 mg H3 (s/d H5)
Onset : 3 26/07 Oralit 1 sach/ bab 7/7/22 :
11.4/33/3500 943.292
DPJP : dr. N /188000 Diet lunak
aomi, Sp.A Perkiraan tarif yan
27/7 g bisa di klaim :
12.7/38/122. 1,079,600
000
28/7
13.1/38/3400
/63.000
13 403 An Agwa 26/07 Kejang Demam Pl IVFD RL 1450 ml/ 24 jam hari ini tdk demam Jaminan :
6 th DL dbn ceus Inj Pct 3x200 mg UMUM
e dbn Inj ceftriaxone 1x1gr H2
DPH 3 Ag -
Total tarif per tgl 2
Onset 3 Diazepam supp 10 mg kp kejang
27/07 Ambroxol syr 3x3/4 cth 7/7/22 :
DPJP: dr. Na Ro BP Cetirizine 1x 5 mg 882.596
omi, Sp. A UL Leukosit e
sterase +, Erit
rosit 0-1, Lek
osit Urine 3-
5, epitel + , b
akteri +
28/7
10.4/31/4300
/228.000
14 403 An. Azkia 26/7 encephalopaty ec IVFD RL 1800 cc/ 24 jam DR/24 jam Jaminan :
7 th 11.5/34/6.00 hipokalemia + of parcetamol tab 3x250 mg
BPJS
24,5 kg 0/134.000 h-2 dengue fever >39 Inj Pct 250 mg kp
Led: 35 Inj Ranitidin 2x25 mg
DPH:3 K: 3.2 Total tarif per tgl
Onset : 13 27/7/22 :
27/07
1.820.127
DPJP: dr. Na 12.1/35/3500
omi, Sp. A /140.000
Perkiraan tarif ya
28/7 ng bisa di klaim :
DR 12,8/37/2
600/75.000
1,914,200
El
Na; 134
K;4,7
ch: 99
15 404 Ny. Fitria 15/7 FAM dextra IVFD RL 20 tp, Pro op 28/7
35 tahun 10.7/34/7.20 Inj. Ceftriaxon 1gr/24jam h1
0/430.000
DPH 2
DPJP dr. Ret
no, Sp.B
16 404 Ny Nurhikm 25/7 Abses coli IVFD RL 500cc/ 8 jam Pro op 28/7
ah 65 thn 12.7/41/12.2 Drip Levofloxacin 1x500mg H1
00/303.000
DPH 2
DPJP dr Ret
no SpB
17 405 Ny. Chairun Darah Lengka Polip endometriu Observasi KU KES DJJ TTV dan kaji Pro kuretase
nisa p 25/07/2022 m keluhan
31 th (RSJP) : Rencana tindakan kuretase 28/07/
Hb/HT/Eri/Le 2022 Jam 17.00
DPH 2 u/Trombo : 1 Kolaborasi medis
2.4/39/4.9/7
DPJP dr. Ma 600/367.000
nu, Sp.OG
PT : 14.6
APTT : 33.1
HBsAg : Non
Reaktif
TPHA : Non R
eaktif
RPR/VDRL : N
on Reaktif
Urine Lengka
p 25/07/2022
(RSJP) :
kejernihan : a
gak keruh
blood urine
:p
ositif 2
lekosit (ester
ase) : positif 2
bakteri urine
:p
ositif
18 405 Ny. Tasya 28/07 G1P0A0 UK 6 Min IVFD Asering 500 ml : Asering + N
23 th Hb 11.2 ggu dengan GEA B 1 amp : KaEN Mg3 1:1:1
Ht 32 Dehidrasi Ringan Inj. Omeprazole 1x40 mg
DPH 1 Leu 7.600 Sedang + ISK Ini. Ondancetron 3x4 mg
Trom 341.00 Inj. Ceftriaxone 1x2 gr
DPJP : dr. So 0
nia,Sp.OG GDS 85 Sukralfat syr 3x15 ml
UL
Leu 22-26
Leu esterase
+++
Keton -
19 405 Ny Eti 36 th 28/7 Ab inkomplit pad Cefotaxime 2 gr / IV (1 jam pre o Rencana kuretase 29/
a G2P1A0 hamil 1 p) 7/22
DPH:1 4 minggu Misoprostol 2 tab oral dan 2 tab p
ervaginam Bsk pagi 3 jam sblm k
DPJP: dr So uret kunyah 2 tab mis
nia SpOG o, 2 tab per vaginam
(29/7/22)
Ny Kasiru
DPH:1
408
20 408 An. M. Zulfi 27/7 susp anemia hem O2 1 lpm on NK Transfusi PRC 200cc/1
kar 4.8/16/8.200 olitik IVFD Vemfon 2 jam 2x → 29/7 pagi
10th /238.000 cek DR ulang
PCT 300mg KP demam
DPH 2 CEK GDT TH
Onset 5
DPJP dr. Na
omi, Sp.A
KAMAR BAYI
21 503 Nn. Alzena P 24/07 Susp. TB Paru IVFD RL 14 tpm Stop obat: Jaminan :
utri 11./37/12.80 Inj. Ceftriaxone 1x2 gr H5 Inj. As. Traneksamat 3 BPJS
19 th 0/294.000 Inj. Lansoprazole 1x30 mg x1 amp
Total tarif per tgl 26/
DPH 5 Ro: gambaran Codein 3x10 mg riw hemaptoe 7/22 :
Onset 18 atypical TB NAC 3x200 mg batuk 1.304.051
Asam mefenamat 3x500 mg KP
DPJP: dr. Al 25/07 Perkiraan tarif yan
uisha Sp.PD TCM - g bisa di klaim :
3,799,700
24/07
BTA
Pagi -
Sewaktu -
22 504 Nn. Dewanti 23/07 Confirmed Covid IVFD RL 500 ml/ 8 jam Jaminan :
Sekar Oktavi 16.3/48/12.1 19 +DM tipe 2 + H Inj. Omeprazole 1x40 mg KEMENKES
anti 00/312.000 iperkolesterolemi
21 th a Sansulin 1x16 IU
Total tarif per tgl 2
GDS 199 Novorapid 3x 12 IU
DPH 6 6/7/22 :
Onset 8 gdp 226 Simvastatin 1x20 mg 2.525.951
gd2pp 250 Favipiravir 2x600 H5
dpjp : dr. Ek hba1c 9.8 Becom-Z 2x1 tab Perkiraan tarif yan
a, sp.pd Vit D 1x2000 iu g bisa di klaim :
chol total 202 NAC 3X200 mg 14,168,000
LDL 150 Eflin 2x1 tab
TG 155 Paracetamol 4 x 500 mg
28/7
GDP 161
GD2PP 203
PCR TH
Antigen +
Ro: BP
PCR TH
Jumlah pasien: 22
PICU Lt 3: 0 pasien
HCU/ICU: 0 pasien
Perina : 0 pasien
VK: 0 pasien
Lt 4: 10 pasien
Lt 5: 4 pasien
HCU covid : 0
Regulasi Kalium Protap Hipoglikemi (dr Eka Sp.PD) Protap Drip Insulin (ICU/HCU)
Kuretase Misoprostol 3 tab/ ovula (3 jam pre Op) lapor dulu - Misoprostol 3 tab/ ovula (3 jam pre Op)
Skintest - Skintest
Cefotaxime 2 gram (1 jam pre Op) - Cefotaxime 2 gram (1 jam pre Op
Lab DL, Ur/Cr, As Urat, OT/P DL, CR DL, CR DL, Ur/Cr, As Urat, DL, Ur/Cr, As stlh DPH 10, dila DL, CRP, Ur/Cr, As
T, Elektrolit, Calcium io P P OT/PT, Elektrolit, Urat, Elektrol kukan pengecek Urat, Elektrolit, PT
n, GDS, PT/APTT, INR, PT/APTT, INR, D-Di it, PT/APTT, I an per 2 hari: DL /APTT, INR
D-Dimer, CRP, AGD, an mer, CRP, Albumin NR, CRP & CRP
ti HIV
Thorax v
EKG v
DOSIS AVIGAN :
H1 : 2 x 1600 mg (2x8 tab)
H2-5: 2x600 mg (2x3 tab)
RESFAR: s/d H5
DOSIS REMDESIVIR
● H1: 200 mg drip dlm 3 jam
● H2-9/13: 100 mg drip dlm 3 jam