PERHITUNGAN TARIF PAKET RAWAT INAP RS.

BHAYANGKARA BONDOWOSO TAHUN 2012

NO

1
2
3
4
5
6
7
8
9
10

URAIAN

PAKET PELAYANAN PER HARI

AKOMODASI
VISITE DOKTER SPESIALIS
KONSULTASI SPESIALIS
VISITE DOKTER JAGA
KONSULTASI GIZI
ASUHAN KEPERAWATAN
TINDAKAN KEPERAWATAN
PII (LAB SEDERHANA)
BIAYA ADMINISTRASI
SEWA ALAT
Kasa
Verban / Kassa DRC
Infuset
Abocath
Spuit 1 cc
Spuit 3 cc
Spuit 5 cc
Spuit 10 cc
O2
Alkohol
Betadin
Plester
Transfusi set
Kapas
Handschoen
Kanul O2
Hibiscrub
Aquades 500 ml
JUMLAH

JML
KASUS

KLAS I
FREK
TARIF

JML
BIAYA

28

Gulung
Buah
Buah
Buah
Buah
Buah
Buah
Buah
Tabung
Liter
Liter
Rol
Buah
Buah
Buah
Liter
Liter

JML
KASUS

KLAS II
FREK
TARIF

JML
BIAYA

48

JML
KASUS

KLAS III
FREK
TARIF

JML
BIAYA

112
56
28
4
28
56
56
56
28

150,000
150,000
150,000
50,000
20,000
20,000
90,000
50,000
50,000

16,800,000
8,400,000
4,200,000
200,000
560,000
1,120,000
5,040,000
2,800,000
1,400,000

192
192
96
4
48
96
96
96
48

110,000
100,000
100,000
50,000
15,000
20,000
80,000
45,000
50,000

21,120,000
19,200,000
9,600,000
200,000
720,000
1,920,000
7,680,000
4,320,000
2,400,000

12
12
3
3
3
9
9
8
3

50,000
80,000
80,000
50,000
15,000
20,000
70,000
35,000
50,000

600,000
960,000
240,000
150,000
45,000
180,000
630,000
280,000
150,000

1
56
28
56
28
84
28
14
12
14
14
20
10
28
14
2
1
1

158,400
10,000
19,400
46,000
7,200
4,700
5,700
7,200
120,000
5,500
6,000
10,000
37,000
5,000
1,500
20,400
56,500
10,800

158,400
560,000
543,200
2,576,000
201,600
394,800
159,600
100,800
1,440,000
77,000
84,000
200,000
370,000
140,000
21,000
40,800
56,500
10,800

2
96
48
72
48
96
48
24
24
24
24
48
15
48
24
6
1
2

158,400
10,000
19,400
46,000
7,200
4,700
5,700
7,200
120,000
5,500
6,000
10,000
37,000
5,000
1,500
20,400
56,500
10,800

316,800
960,000
931,200
3,312,000
345,600
451,200
273,600
172,800
2,880,000
132,000
144,000
480,000
555,000
240,000
36,000
122,400
56,500
21,600

1
6
3
6
3
10
3
2
2
1
2
3
2
3
1
1

158,400
10,000
19,400
46,000
7,200
4,700
5,700
7,200
120,000
5,500
6,000
10,000
37,000
5,000
1,500
20,400
56,500
10,800

158,400
60,000
58,200
276,000
21,600
47,000
17,100
14,400
240,000
5,500
12,000
30,000
74,000
15,000
1,500
20,400
-

47,654,500

78,590,700

4,286,100

NO

URAIAN
UNIT COST PER HARI
Tarif Maksimal Askes
Tarif Kesepakatan RI
Iur Biaya Pasien

JML
KASUS

FREK

KLAS I
TARIF

JML
BIAYA
1,701,946

JML
KASUS

FREK

KLAS II
TARIF

JML
BIAYA
1,637,306

JML
KASUS

KLAS III
FREK
TARIF

JML
BIAYA
1,428,700

PAKET II A 2012
JUMLAH KASUS :
NO
1

JENIS PEMERIKSAAN
DARAH LENGKAP
Hb
Hematokrit
Leukosit
Hitung Jenis Leukosit
Eritrosit
Trombosit
LED
Retikulosit
Masa Pembekuan
Masa Perdarahan
VER/HER/KHER
Malaria
Golongan darah
URINE RUTIN
Rutin
Protein
Glukosa
Urobilinogen
Bilirubin
Keton
Darah
Sedimen
FESES RUTIN
Warna
Konsistensi
Darah
Lendir
Leukosit
Eritrosit
Sisa makanan
Bakteri
Jamur
Parasit
JUMLAH
UNIT COST
Tarif Kesepakatan Paket IIA
Tarif Maksimal

417
FREK

JASA SARANA

JASA PELAYANAN

BAHP

TARIF

BIAYA

250

13,500

9,000

22,500

45,000

11,250,000

24

4,500

3,600

9,900

18,000

432,000

74
84

4,500
6,000

3,600
4,800

9,900
13,200

18,000
24,000

1,332,000
2,016,000

9,600

4,800

13,200

24,000

216,000

417

15,246,000
36,561

Iur Biaya Pasien

PAKET II B 2012
JUMLAH KASUS :
NO

JENIS PEMERIKSAAN

68
FREK

JASA SARANA

JASA PELAYANAN

BAHP

TARIF

BIAYA

KEPALA (SCEDEL)

30,000

20,000

25,000

75,000

225,000

LEHER (CERVICAL)

35,000

20,000

30,000

85,000

85,000

THORAX

26

25,000

17,000

18,000

60,000

1,560,000

ABDOMEN ( PERUT )

28,000

19,000

25,000

72,000

504,000

PELVIS

28,000

19,000

25,000

72,000

288,000

EKSTREMITAS ATAS/BAWAH

19

30,000

20,000

25,000

75,000

1,425,000

COLL VERTEBRATA

37,000

23,000

35,000

95,000

475,000

IVP

86,000

44,000

420,000

550,000

550,000

DENTAL I

6,000

6,000

18,000

30,000

60,000

JUMLAH
UNIT COST
Tarif Kesepakatan Paket IIB
Tarif Maksimal
Iur Biaya Pasien

68

5,172,000
76,059

PAKET II C 2012
JUMLAH KASUS :
NO
1
2
3
4
5
6
7

JENIS PEMERIKSAAN

40
FREK

AUDIOMETRI
FUNDUSCOPY
OPTHALMOSCOPY
REFRAKSI
SLIT LAMP EXAMINATION
TONOMETRI
ECG

40

JUMLAH
UNIT COST
Tarif Kesepakatan Paket IIC
Tarif Maksimal
Iur Biaya Pasien

40

JASA SARANA
8,000

JASA PELAYANAN
22,000

BAHP

TARIF
5,000

35,000

BIAYA
1,400,000
1,400,000
35,000

PAKET III A 2012

NO
1
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
31

JENIS PEMERIKSAAN
Perawatan saluran akar
Cabut gigi
Tambal permanen
Irigasi telinga
Cuci sinus
Angkat jahitan
Ganti balut besar
Ganti balut kecil
Campusvisi
Calculektomi
Eksisi tumor kecil
Spuling
Epilasi
Ekstirpasi corpus alienum
Businasi
Pasang kateter
Pasang gips
Pasang pesarium
Pasang implan
Pap smear
Biopsi cervic
Cauterisasi
Incisi abses
Pasang tampon
Labulo plasty
Parasentesa
Ekstraksi kuku
Rawat luka tanpa jahitan
Necrotomy
Jahit luka kecil
Dilatasi phymosis

FREK
18
8
15
3
4
15
5
1
2
25
1
1
1
2
16
10
-

JASA SARANA
20,000
20,000
16,000
20,000
12,000
28,400
21,200
30,000
16,000
16,000
12,000
22,000
9,200
26,000
21,200
12,000
-

JASA PELAYANAN
12,500
12,500
10,000
12,500
7,500
17,750
13,250
18,750
10,000
10,000
7,500
13,750
5,750
16,250
13,250
7,500
-

BAHP
17,500
17,500
14,000
17,500
10,500
24,850
18,550
26,250
14,000
14,000
10,500
19,250
8,050
22,750
18,550
10,500
-

TARIF
50,000
50,000
40,000
50,000
30,000
71,000
53,000
75,000
40,000
40,000
30,000
55,000
23,000
65,000
53,000
30,000
-

BIAYA
900,000
400,000
600,000
150,000
120,000
1,065,000
265,000
75,000
80,000
1,000,000
30,000
55,000
23,000
130,000
848,000
300,000

NO

JENIS PEMERIKSAAN
JUMLAH
UNIT COST
Tarif Kesepakatan Paket IIiA
Tarif Maksimal
Iur Biaya Pasien

FREK
127

JASA SARANA

JASA PELAYANAN

BAHP

TARIF

BIAYA
6,041,000
47,567

PAKET III B 2012

NO
1
2
3
4
5
6
7
8
9
10
11
12
13

JENIS PEMERIKSAAN

FREK

Cabut gigi dengan komplikasi

Eksisi epulis kecil
Insisi abses intra oral
Insisi kalazion
Angka kawat dengan hecting
Flap sederhana
Eksisi tumor >5 cm (Kista, Lipoma)
Graft sederhana
Jahit palpebra
Punksi lumbal
Insisi abses besar
Aspirasi pneumothorax
Labuloplasty 2 telinga

JUMLAH
UNIT COST
Tarif Kesepakatan Paket IIIB
Tarif Maksimal
Iur Biaya Pasien

0
0

JASA SARANA
34,000
18,000
120,000
80,000
-

JASA PELAYANAN
21,250
11,250
75,000
50,000
-

BAHP
29,750
15,750
105,000
70,000
-

TARIF
85,000
45,000
300,000
200,000
-

BIAYA
170,000
45,000
215,000
71,667

PAKET III C 2012

NO

JENIS PEMERIKSAAN

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Alveolektomi
Amputasi jari
Injeksi varises
WSD
Vena seksi
Eksisi fibroma
Sistotomi
Curretage (lokal)
Pterygeum
Pungsi pleura
Fistulektomi
Odontectomy
Mecocele
Tubektomi
Reposisi dengan anestesi lokal
JUMLAH
UNIT COST
Tarif Kesepakatan Paket IIIC
Tarif Maksimal
Iur Biaya Pasien

FREK

1
2

JASA SARANA
60,000
300,000
200,000

JASA PELAYANAN
37,500
187,500
125,000

BAHP
52,500
262,500
175,000

TARIF
150,000
750,000
500,000

BIAYA
750,000
500,000
1,250,000
625,000

LUAR PAKET LABORATORIUM TAHUN 2012

NO
I

II

III

IV

JENIS PEMERIKSAAN

FREK

JASA SARANA

JASA PELAYANAN

KIMIA DARAH
TROPONIN
CK MB
HBDH
NATRIUM DARAH

1
1
51
5

22,500
22,500
12,000
12,000

18,000
18,000
9,600
9,600

DIABETES
GLUKOSA DARAH PP
GLUKOSA DARAH PUASA
GLUKOSA DARAH SEWAKTU

48
48
215

5,500
5,500
5,500

4,400
4,400
4,400

FUNGSI HATI
ALBUMIN
ALKALI PHOSPATE
BILIRUBIN INDIREK
BILIRUBIN TOTAL
GAMMA GT
GLOBULIN
PROTEIN TOTAL
SGOT
SGPT

3
1
9
9
1
3
3
143
143

5,500
6,000
5,500
5,500
6,000
5,500
5,500
6,000
6,000

4,400
4,800
4,400
4,400
4,800
4,400
4,400
4,800
4,800

FUNGSI GINJAL
CREATININ
ASAM URAT
UREUM

41
124
41

6,000
5,500
5,500

4,800
4,400
4,400

VI

VII

ANALISA LEMAK
CHOLESTEROL TOTAL
CHO HDL
CHO LDL
TG

198
41
43
172

5,500
5,500
5,500
5,500

4,400
4,400
4,400
4,400

SEROLOGI
ANTI HIV
ANTI HCV
DENGUE BLOT Ig G
DENGUE BLOT Ig M
HBsAG
WIDAL

1
1
8
8
1
84

15,000
15,000
15,000
15,000
15,000
12,000

7,200
7,200
7,200
7,200
7,200
9,600

MIKROBIOLOGI
SEDIAAN LANGSUNG PERWARNA BTA

6,000

4,800

JUMLAH
UNIT COST
Tarif Kesepakatan Paket IIIC
Tarif Maksimal
Iur Biaya Pasien

1456

HUN 2012
BAHP
49,500
49,500
26,400
26,400

12,100
12,100
12,100

12,100
13,200
12,100
12,100
13,200
12,100
12,100
13,200
13,200

13,200
12,100
12,100

TARIF

JUMLAH

90,000
90,000
48,000
48,000
22,000
22,000
22,000
22,000
24,000
22,000
22,000
24,000
22,000
22,000
24,000
24,000

90,000
90,000
2,448,000
240,000
1,056,000
1,056,000
4,730,000
66,000
24,000
198,000
198,000
24,000
66,000
66,000
3,432,000
3,432,000

24,000
22,000
22,000
-

984,000
2,728,000
902,000
-

12,100
12,100
12,100
12,100

37,800
37,800
37,800
37,800
37,800
26,400

13,200

22,000
22,000
22,000
22,000
60,000
60,000
60,000
60,000
60,000
48,000
24,000
-

4,356,000
902,000
946,000
3,784,000
60,000
60,000
480,000
480,000
60,000
4,032,000
216,000
37,206,000
-

OPERASI KELOMPOK I 2012

NO
1
2

URAIAN

: KASUS I
SATUAN

KASUS
1

JASA SARANA
JASA PELAYANAN
OPERATOR
PENATA ANESTHESI
ASISTEN
INSTRUMEN
OMLOUP
PEMAKAIAN BAHP
Handscoen
Spuit Disp 10cc
Spuit Disp 5cc
Spuit Disp 3cc
Cat Gut Plain (Roll)
Cut Gut Chromic (Roll)
Kasa steril
Surgical blade
Betadin
Alkohol
Precep
Hibiscrup
hypavix
JUMLAH
UNIT COST
Tarif Kesepakatan Paket Operasi I
Tarif Maksimal
Iur Biaya Pasien

Buah
Buah
Buah
Roll
Roll
Gulung
Buah

OPERASI KELOMPOK I
FREK
HARGA
1

250,000

1,800,000

100,000

2
1

22,900
7,200

0.25
0.25
1
1
1
1
1

27,000
27,000
6,000
3,600
700
800
5,200

1,620

OMPOK I
JUMLAH HARGA
250,000
1,800,000
100,000

45,800
7,200
6,750
6,750
6,000
3,600
700
800
5,200
1,620
2,234,420
2,234,420

OPERASI KELOMPOK II 2012

NO
1
2

URAIAN

: KASUS I
SATUAN

KASUS
1

JASA SARANA
JASA PELAYANAN
OPERATOR
PENATA ANESTHESI
ASISTEN
INSTRUMEN
OMLOUP
PEMAKAIAN BAHP
Handscoen
Spuit Disp 10cc
Spuit Disp 5cc
Spuit Disp 3cc
Cat Gut Plain (Roll)
Cut Gut Chromic (Roll)
Kasa steril
Surgical blade
Betadin
Alkohol
Precep
Hibiscrup
hypavix
JUMLAH
UNIT COST
Tarif Kesepakatan Paket Operasi I
Tarif Maksimal
Iur Biaya Pasien

Buah
Buah
Buah
Roll
Roll
Gulung
Buah

OPERASI KELOMPOK II
FREK
HARGA
1

350,000

4,200,000

140,000

3
1

22,900
7,200

1
0.25
0.25
2
1
1
1
1
1
1

4,700
27,000
27,000
6,000
3,600
1,400
1,200
7,600
14,700
2,700

OMPOK II
JUMLAH HARGA
350,000
4,200,000
140,000

68,700
7,200
4,700
6,750
6,750
12,000
3,600
1,400
1,200
7,600
14,700
2,700
4,827,300
4,827,300

OPERASI KELOMPOK III 2012

NO
1
2

URAIAN

: KASUS III
SATUAN

KASUS
3

JASA SARANA
JASA PELAYANAN
OPERATOR
PENATA ANESTHESI
ASISTEN
INSTRUMEN
OMLOUP
PEMAKAIAN BAHP
Handscoen
Spuit Disp 10cc
Spuit Disp 5cc
Spuit Disp 3cc
Cat Gut Plain (Roll)
Cut Gut Chromic (Roll)
siede / Silk
Kasa steril
Surgical blade
Betadin
Alkohol
Precep
Hibiscrup
Hansaplast
hypavix
Zydesym
JUMLAH
UNIT COST
Tarif Kesepakatan Paket Operasi I
Tarif Maksimal
Iur Biaya Pasien

Buah
Buah
Buah
Roll
Roll
Gulung
Buah

OPERASI KELOMPOK II
FREK
HARGA
3

575,000

4,800,000

140,000

12
3
6
3
3
3
2
9
3
90
120
36
45

22,900
7,200
5,700
4,700
27,000
27,000
27,000
6,000
3,600
70
40
650
980

45
36

270
668

OMPOK II
JUMLAH HARGA
1,725,000
14,400,000
420,000

274,800
21,600
34,200
14,100
81,000
81,000
54,000
54,000
10,800
6,300
4,800
23,400
44,100
12,150
24,048
17,285,298
5,761,766

PERHITUNGAN P II BIASA ( IGD )

RUMAH SAKIT BHAYANGKARA BONDOWOSO
TAHUN 2012
JUMLAH KASUS : 126
NO
1
2
3
4

URAIAN
FREK
KARCIS
126
PEMERIKSAAN
126
KONSUL
7
TIND. PERAWATAN

TARIF
BIAYA
15,000 1,890,000
25,000 3,150,000
###### 1,260,000
6,300,000

KET : JUMLAH
126
UNIT COST
TARIF KESEPAKATAN
TARIF MAKSIMAL
IUR BIAYA

6,300,000
50,000

RAWAT INAP PERINATOLOGI

RUMAH SAKIT BHAYANGKARA BONDOWOSO
TAHUN 2012
JUMLAH KASUS : 66
PERHITUNGAN TARIF
NO
URAIAN
KET :
KASUS FREK BIAYA JML BIAYA
PAKET PELAYANAN PER HARI 66
1 AKOMODASI PRWTAN
198 25,000 4,950,000
2 VISITE DOKTER SPESIAIS
264
##### ########
3 KONSUL DOKTER
66
8,400
554,400
4 VISITE DOKTER JAGA
6
60,000
360,000
5 KONSUL GIZI
6 ASUHAN KEPERAWATAN
66
##### 6,600,000
7 TINDAKAN KEPERAWATAN
55
##### ########
8 PII LAB SEDERHANA
10
25,000
250,000
9 CM/ ADM
66
30,000 1,980,000
10 SEWA ALAT
INKUBATOR
5
35,000
175,000
BLUE LIGHT
OXYMETER
VENTILATOR
SUCTION PUMP
INTANT PUMP
INFUS PUMP
SUB TOTAL NON BAHP
- 64,919,400
11 BAHP
INFUSET
5
19,400
97,000
SALEP MATA
22
5,000
110,000
ABOCATH
9
55,000
495,000
DISP 1 CC
360
7,100 2,556,000
DISP 3 CC
66
4,700
310,200
DISP 5 CC
10
5,700
57,000
DISP.10CC
5
7,200
36,000
O2
3
#####
450,000
ALKOHOL 100 CC
2
55,000
110,000
BETADIN
1
25,000
25,000
PLESTER
2
50,000
100,000
TRANSFUSISET
1
37,000
37,000
NEADLE 26
396
1,800
712,800
SALEP KULIT
22
5,000
110,000
HANDSCOEN
3
50,000
150,000
TROMBOPOP
10
20,000
200,000
KASA
3
80,000
240,000
KAPAS
2
20,000
40,000
HYPAVIX
2
#####
255,400
GELANG M
1
50,000
50,000

GELANG B
SUB TOTAL BAHP
JUMLAH TOTAL

KET :JUMLAH
UNIT COST
TARIF KESEPAKATAN
TARIF MAKSIMAL
IUR BIAYA

50,000

50,000
6,191,400
71,110,800

66

71,110,800
1,077,436

PERHITUNGAN PARTUS NORMAL

RUMAH SAKIT BHAYANGKARA BONDOWOSO
TAHUN 2012
PARTUS NORMAL
KS FREK TARIF
BIAYA
PAKET PELAYANAN PER HARI
15
1 JASA SARANA
15 120,000
#######
2 JASA PELAYANAN
20 300,000
#######
3 VISITE DOKTER
15 150,000
#######
4 KONSUL DOKTER
5 PENUNJANG MEDIK
6 CM
15
20,000
300,000
10 BAHP
KASSA
150
1,000
150,000
VERBAN
INFUSET
ABBOCAT
15 46,000
690,000
DISP 1 CC
2
7,100
14,200
DISP 3 CC
30
4,700
141,000
DISP 5 CC
30
5,700
171,000
DISP.10CC
O2
ALKOHOL 100CC
15
3,000
45,000
BETADIN
15 25,000
375,000
PLESTER
15
7,500
112,500
TRANSFUSISET
15 37,000
555,000
KAPAS
15
1,000
15,000
CUT GUT
15 15,000
225,000
ATC
SILK & BRILLON
N20
JUMLAH
#######
UNIT COST
856,247
NO

URAIAN

PARTUS TIND. PERVAGINA

KS
FREK
TARIF
1
1
120,000
1 1,500,000

20,000

1,000

1
1
1
1

46,000
7,100
4,700
5,700

1
1
1
1
1
1

3,000
25,000
7,500
37,000
1,000
15,000

ORMAL
ONDOWOSO

. PERVAGINA
BIAYA
120,000
#######
20,000
1,000
46,000
7,100
4,700
5,700
3,000
25,000
7,500
37,000
1,000
15,000

#######
#######

KS

PARTUS DG SC
FREK
TARIF
BIAYA
-

OPERASI KELOMPOK OBGYN SC 2012

NO
1
2

URAIAN

: KASUS 41
SATUAN

KASUS
41

JASA SARANA
JASA PELAYANAN
OPERATOR
PENATA ANESTHESI
ASISTEN
INSTRUMEN
OMLOUP
PEMAKAIAN BAHP
Handscoen
Spuit Disp 10cc
Spuit Disp 5cc
Spuit Disp 3cc
Cat Gut Plain (Roll)
Cut Gut Chromic (Roll)
siede / Silk
Kasa steril
Surgical blade
Betadin
Alkohol
Precep
Hibiscrup
Hansaplast
hypavix
Zydesym
Opsite
JUMLAH
UNIT COST
Tarif Kesepakatan Paket Operasi I
Tarif Maksimal
Iur Biaya Pasien

Buah
Buah
Buah
Roll
Roll
Gulung
Buah

41

OPERASI KELOMPOK II
FREK
HARGA
41

720,000

41
41
41
41
41

1,500,000
313,000
250,000
188,000
188,000

246
20
41
82
82
61
7
164
41
2460
2870
492
615
41

22,900
7,200
5,700
4,700
27,000
27,000
140,000
6,000
3,600
70
40
650
980
500

492
41

668
50,000

MPOK II
JUMLAH HARGA
29,520,000
61,500,000
12,833,000
10,250,000
7,708,000
7,708,000

5,633,400
144,000
233,700
385,400
2,214,000
1,647,000
980,000
984,000
147,600
172,200
114,800
319,800
602,700
20,500
328,656
2,050,000
145,496,756
3,548,701

ONE DAY CARE

RUMAH SAKIT BHAYANGKARA BONDOWOSO
TAHUN 2012
JUMLAH KASUS : 3
PERHITUNGAN TARIF
NO
URAIAN
KASUS FREK BIAYA
JML
PAKET PELAYANAN PER HARI3
1 AKOMODASI PRWTAN
3
50,000 150,000
2 VISITE DOKTER SPESIAIS
3
80,000 240,000
3 KONSUL DOKTER
4 ASUHAN KEPERAWATAN
3
20,000
60,000
5 TINDAKAN KEPERAWATAN 6
70,000 420,000
6 CM/ ADM
3
20,000
60,000
7 SEWA ALAT
OXY METER
SUCTION PUMP
INFUS PUMP
SUB TOTAL NON BAHP
8 BAHP
INFUSET
3
19,400
58,200
ABBOCAT 26
3
55,000 165,000
ABBOCAT 20
3
46,000 138,000
DISP 1 CC
3
7,100
21,300
DISP 3 CC
3
4,700
14,100
DISP 5 CC
3
5,700
17,100
DISP.10CC
3
7,200
21,600
O2
ALKOHOL
BETADIN
PLESTER
GOEDEL
JELLY
ELECTRODA
ETT
KANULLA
KAPAS
KASSA
SUB TOTAL BAHP
JUMLAH TOTAL
3
#######

KET :JUMLAH
3
UNIT COST
TARIF KESEPAKATAN

#######
455,100

KET :

TARIF MAKSIMAL
IUR BIAYA