30 DIAGNOSA

RAWAT JALAN

INACBG's
NO NAMA DIAGNOSA KODE DIAGNOSA
PHACO Rawat Jalan
1 Presence of intraocular lens Z96,1 - 192,700
2 SENILE CATARACT H25,9 7,363,800 192,700
3 PRESBYOPIA H52,4 - 192,700
4 CHF I50,0 - 553,700
5 Neuropathic artropathy M14,9 - 192,700
6 TB PARU A15,0 - 192,700
7 HEART FAILURE I50,9 - 192,700
8 ASTIGMATISM H52,2 - 192,700
9 PJK I25,2 - 192,700
10 HYPERMETROPIA H52,0 - 192,700
11 ISPA J06,9 - 194,100
12 GLAUCOMA H40,9 - 192,700
13 HHF I11,0 - 192,700
14 MYOPIA H52,1 - 192,700
15 EPILEPSY G40,9 - 192,700
16 DM TIPE 2 E11,9 - 192,700
17 RETINOPATHY H35,9 - 192,700
18 GRAVIDA Z35,6 - 315,000
19 DYSPEPSIA K30 - 257,300
20 PTERYGIUM H11,0 - 192,700
21 POLYNEUROPATHY G62,9 - 192,700
22 HYPERTENSI I10 - 192,700
23 DEPRESI R46,8 - 192,700
24 HEADACHE SYNDROMES G44,8 - 192,700
25 OTITIS MEDIA H66,9 - 194,100
26 ASMA J45,9 - 192,700
27 CEREBRAL INFARK I63,9 - 192,700
28 Disorder of refraction H52,7 - 192,700
29 CONJUNCTIVITIS H10,8 - 192,700
30 SCABIES B86 - 192,700
 30 DIAGNOSA
RAWAT INAP

TARIF INACBG'S
NO NAMA DIAGNOSA KODE DIAGNOSA
KELAS 1 KELAS 2 KELAS 3
1 NEONATUS P03,4 3,467,300 3,467,300 3,467,300
2 TIFOID A01,0 3,053,600 2,617,400 2,181,200
3 GEA K52,9 2,052,100 1,759,000 1,465,800
4 BRONCHITIS J40 3,883,200 3,328,400 2,773,700
5 BRONCHOPNEUMONIA J18.9 4,863,300 4,168,500 3,473,800
6 DYSPEPSIA K30 1,813,300 1,554,300 1,295,200
7 SC A/I LETAK LINTANG O64 7,048,800 6,041,800 5,034,900
8 SC A/I PREV SC O34,2 7,048,800 6,041,800 5,034,900
9 SC A/I RUI O42,9 7,048,800 6,041,800 5,034,900
10 LBP M54,36 3,996,300 3,425,400 2,854,500
11 HIPEREMESIS O21,0 2,918,400 2,501,500 2,084,600
12 SC A/I FETAL DISTRESS O61 7,048,800 6,041,800 5,034,900
13 HIDRONEFROSIS N13.2 4,742,200 4,064,800 3,387,300
14 ISPA J06.9 2,665,200 2,284,500 1,903,700
15 TUMOR PAYUDARA + EKSISI D24 + 85.21 7,082,500 6,070,700 5,058,900
16 DISENTRI A06,0 1,813,300 1,554,300 1,295,200
17 HIPERTENSI I10 2,566,300 2,199,700 1,833,100
18 HIPERTENSI HEART DISEASE I11 3,758,600 3,221,700 2,684,700
19 CHF I50 3,758,600 3,221,700 2,684,700
20 HEADACHE G44,8 2,871,800 2,461,600 2,051,300
21 SC A/I PANGGUL SEMPIT O65,5 7,048,800 6,041,800 5,034,900
22 MORBILI STAD ERUPSI B05.9 2,202,300 1,887,700 1,573,100
23 DM TIPE 2 + NEUROPATI E11,5 6,219,600 5,331,100 4,442,600
24 DM TIPE 1 + NEUROPATI E10,5 6,219,600 5,331,100 4,442,600
25 HERNIA INGUINAL + HERNIORAPHY K40,9 + 53.0 6,609,000 5,664,900 4,720,700
26 MISSED ABORTION O02,1 1,347,800 1,155,300 962,700
27 ASTHMA J45.9 2,996,000 2,568,000 2,140,000
28 ISK N39,0 4,005,100 3,432,900 2,860,800
29 ABORTUS INCOMPLETE + KURET O04,4 + 69.09 2,418,300 2,072,800 1,727,300
30 COPD J44 3,997,400 3,426,300 2,855,300