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item pelayanan hari 1 hari 2

admin 1
nursing UGD 1
pemeriksaan dr UGD 1
paket BHP UGD 1

perawatan ruangan
Admin Kamar 1
Kamar Kelas III 1 1
Nursing Kelas III 1 1
Visite 1
paket BHP Ruangan 1

rawat luka

Tindakan Operasi 1
Paket OK 1
packet herniotomy 1

Terapi
Ceftriaxon inj 1000 g 2

obat pulang
cefixim tab 2 x100 mg 6
Paracetamol tab 3 x 500 mg 9

TOTAL BIAYA DI LU

paket UGD qty harga total


WIDA RL 500 ML (BP) 1 11,361 11,361
INFUSET DARAH STERA (BP) 1 8,180 8,180
SPUIT 3 CC KIMSMED 1 1,073 1,073
19,505
THREE WAY STOP COCK BEREKOR HOSPITECH
1 19,505
ID BAND PINK ADULT 1 3,249 3,249
poliwin abocath 1 25,740 25,740
69,108

paket ruangan
SPUIT 3 CC KIMSMED 2 1,073 2,146
WIDA RL 500 ML (BP) 2 11,361 22,722
SPUIT 10 CC KIMSMED 4 1,859 7,436
hanscoon steril 1 14,300 14,300
has 2 5,998 11,996
sofratull 1 16,280 16,280
74,880

Paket OK
ALKOHOL 70% / ML 20 107 2,140
COUTER PEN 1 135,849

FOLEY CATHETER CH 16 1 24,310 24,310


POLYMED YANKUAR SUCTION 1 78,650

MAS DHD PF SURGICAL GLOVE 7 5 22,880 114,400


MAS DHD PF SURGICAL GLOVE 7,5 4 22,880 91,520

MESS 15 1 5,663 5,663


BETADINE ONE MED/ml 300 107 32,100
TRANSOFIX /TUSUKAN INFUS 3 9,867 29,601
UNDERPAD NON STERIL OM 1 7,150 7,150

INFLO 18 G OM (BP) 1 8,580 8,580


AQUA INJ 25 ML 1 8,294 8,294
BUNASCAN SPINAL 0.5% 1 90,090 90,090

DEXKETOPROFEN INJ 1 34,320 34,320

LIDOCAIN INJ 2% (BP) 1 2,242 2,242


WIDA NACL 500 ML (BP) 5 10,184 50,920
O2 100 142 14,200
ONDANSENTRON 8MG INJ BERNO (BP) 1 7,150 7,150
WIDA RL 500 ML (BP) 3 11,361 34,083
SPINOCAN G 27 B BRAUN 1 67,210 67,210
SPUIT 1 CC INSULIN TERUMO 1 9,152 9,152
SPUIT 10 CC TERUMO 2 10,439 20,878
SPUIT 3 CC TERUMO 1 6,578 6,578
SPUIT 5 CC KIMSMED 1 1,359 1,359

T LENE 1.0 CFL 1 107.25 107.25

T VIO 2-0 ROUND BODIED 1 118.69 118.69

T VIO 3-0 REVERSE CUTING 1 121.55 121.55

662,287
total qty harga jumlah

1 25,000 25,000
1 70,000 70,000
1 40,000 40,000
1 69,108 69,108

1 35,000 35,000
2 200,000 400,000
2 100,000 200,000
1 75,000 75,000
1 74,880 74,880

108,000 -

1
1 662,287 662,287
1 1,201,200

2 14,300 28,600

6 1,859 11,154
9 200 1,800

TOTAL BIAYA DI LUAR JASA TINDAKAN 1,692,829


INACBG 4,106,200
2,413,371
OPERATOR 865,265.79
ASISTEN 86,526.58
ANASTESI 346,106.32
PENATA 129,789.87
INSTRU MEN 129,789.87

ONLOOP 43,263.29
TINDAKAN 1,600,741.72
CSSD 92,295.02
JASA RS 720,333.77
TOTAL TINDAKAN 2,413,370.51
-
kelas 3
OPERATOR ASISTEN ANASTESI PENATA

937,500 93,750 375,000 140,625


36% 4% 14% 5%

kls 3 4,106,200
kls 2 4,927,400

kls1 5,748,600
TOTAL
INSTRU MEN ONLOOP TINDAKAN CSSD JASA RS
TINDAKAN
140,625 46,875 1,734,375 100,000 780,469 2,614,844
5% 2% 66% 4% 30%