Lampiran 3 Data Demografi Pasien Pneumonia RSUP H.Adam Malik
Kelamin Tgl Masuk Tgl Keluar Status
Lama
Ciprofloksasin (Infus)
+ Ceftriakson (Injeksi) 54.32.30 AD 65 Lk 4-Jan-13 11-Jan-13 Pbj 7 1.32
Eritromisin(oral) +
Ceftriakson (injeksi) 54.94.23 MH 71 Lk 25-Feb-12 3-Mar-12 Pbj 6 1.52
54.38.76 ST 48 Pr 25-Feb-13 2-Feb-13 Pbj 5 2.24
54.45.10 SF 57 Pr 3-Feb-13 8-Feb-13 Pbj 5 2.46
3
Cefotaxim(injeksi) +
Gentamisin (injeksi) 52.72.67 IW 63 Lk 3-mei-12 13-mei-12 Pbj 10 1.2
56.05.37 RS 12 Pr 24-mei-12 29-mei-12 Pbj 5 1.39
51.60.03 SB 68 Lk 23-mei-13 3-mei-13 Pbj 10 2.05
55.72.67 MI 45 Pr 28-Apr-13 8-mei-13 Pbj 10 1.73
4
Ceftriakson(Injeksi) +
Ciprofloksasin (oral) 54.00.36 BH 62 Pr 23-Jan-13 29-Jan-13 Pbj 6 0.68
Ceftrikson(Injeksi) +
Gentamisin (Injeksi) 56.69.89 RN 37 Lk 11-Jul-13 18-Jul-13 Pbj 7 3.07
Ceftazidin (injeksi) +
Ciprofloksasin(Injeksi) 56.85.28 HS 44 Lk 25-Jul-13 7-agt-13 Pbj 12 0.76
49.59.18 NH 47 Lk 9-Jan-12 17-Jan-12 Pbj 8 0.83
41.65.96 KL 56 Lk 15-Feb-12 19-Feb-12 Pbj 4 1.68
50.99.99 RS 39 Lk 1-Apr-12 5-Apr-12 Pbj 4 0.99
8
Ampisilin (Injeksi) +
Gentamisin (injeksi) 58.21.45 SM 11 (bln) Lk 20-Nov-13 24-Nov-13 Pbj 4 2.24
58.54.30 MR 1 (bln) Lk 23-des-13 27-des-13 Pbj 4 1.08
54.84.78 AL 5 (bln) Lk 16-Feb-13 22-Feb-13 Pbj 6 0.95
9
Ceftriakson (injeksi) +
Cefadroksil (oral) 56.41.84 RH 71 Pr 24-Jun-12 1-Jul-13 Pbj 7 1.69
54.84.97 BS 51 Pr 16-Feb-12 21-Feb-12 Pbj 6 1.14
Lampiran 4 Biaya Rawat Inap Pasien Pneumonia RSUP H. Adam Malik
No Rekam Medik Lama Rawat inap Kelas Rawat inap Biaya Per hari Rawat Inap (Rp)
54.84.78 6 III 45000 270000
56.41.84 7 III 45000 315000
54.84.97 6 III 45000 270000
