paket no.3.xls

KURETASE

JENIS PEMAKAIAN NAMA PEMERIKSAAN JENIS PEMERIKSAAN

PEMERIKSAAN PENUNJANG EKGLaboratorium Hematologi Rutin 1

Blooding TimeProtombinTimeAPTTGDS

ALKES

Oksigen 6 L/menit per jamDisc. 20%

BMHP

OBAT

KURETASE

KURETASE

NAMA PEMAKAIAN JUMLAH PEMBIAYAANUNIT COST BIAYA

1 26,105 95,000 1 3,081 44,000 1 43,651 153,000 1 43,651 153,000 1 26,500 62,000

Masker 4 2,200 4,000 Medicotest Adult 3 8,726 30,300 Folley cateter 12/14 1 10,450 15,100 Apron film 1 3,850 2,934 Underpad 60x90 1 2,500 3,600 Syringe 5 mL Terumo 2 1,469 6,200 Syringe 5mL Onemed 2 1,040 1,400 Sryringe 10 ml Onemed 1 1,509 2,100 Syringe 3 mL Onemed 1 1,001 1,400 Syringe 1 mL Onemed 1 496 700 Blood Set JKN 1 6,600 9,250 Iv cath 18 / 20 1 7,580 14,000 Iv Dressing 1 2,805 5,500 Swab Alkohol Onemed 10 1,218 1,600 Sarung Tangan 6,5 2 5,968 10,000 Sarung Tangan 7,5 1 3,135 5,000 Sarung Tangan S/M 0.1 3,754 4,760 Nasal Kanula Dws 1 4,950 7,150

Povidone Iodine 60 mL 1 4,238 8,300 Formalin 0.06 2,148 3,000 Microshield 500 mL 0.2 14,230 23,140 Gigazyme 0.01 2,717 3,930 Gelang pasien 1 1,289 3,000 Kasa Besar (x-ray) 270 roll, 30 lb 0.11 17,325 35,393 Kasa spinal(Hidrofil)540/roll,3lb 0.01 1,575 3,218 Pot 75 ml 1 1,372 2,200

Ondansentron 4 mg inj 3 8,507 24,600 Ketorolak Inj 30mg 3 7,540 21,000 Tramadol inj 3 16,500 25,500 Wida RL 2 10,400 13,600 Bupivakain spinal inj 1 23,760 45,700 Lidokain inj 5% 1 20,900 28,600 Fentanyl 15 mg 2 68,000 95,000 Pethidin inj 2 26,583 34,400 Nacl 0,9 % 25 ml 1 4,179 5,500 Water for Injeksi 25 ml 1 4,180 5,500 Recofol 1 74,507 120,000 Sedacum inj 1 44,550 65,000 Cefadroxil 500 mg tab 10 6,302 12,000 Asam Mefenamat 500 mg 15 1,980 4,500 Methylergometrin 1,25mg tab 10 1,470 2,500 Sangobion caps 10 9,970 13,000

KURETASE

Pitogin injeksi 1 7,547 9,800 Methylergometrin inj 1 3,355 5,000 Asam Tranexamat 500 mg 2 9,608 28,600 Ketamin Hameln 3 48,593 69,000 Dexamethasone inj 2 4,000 5,600 TOTAL 659,563 1,348,574

Myomectomy-Kistectomy


PEMERIKSAAN PENUNJANG EKGRadiologi Thorax FotoLaboratorium Hematologi Rutin 1

Blooding TimeProtombin TimeAPTTGDS

ALKES

Oksigen 6 L/menit per jamDisc 20%BMHP


OBAT



1 67,500 172,000 1 26,105 95,000 1 3,081 44,000 1 43,651 153,000 1 43,651 153,000 1 26,500 62,000

Masker 4 2,200 4,000 Medicotest Adult 3 8,726 30,300 Folley cateter 12/14 1 10,450 15,100 Urine bag 1 3,850 2,934 Chromic 1 3 189,918 241,500 Chromic 2/0 HR 37 S 2 117,040 217,200 Vio 1 3 224,599 306,750 Mono 3/0 MU 52 Triton 1 96,220 133,000 Hansaplast 1 500 220 Lomatul H 10x10 2 27,170 38,000 Fixomul 10 cm 76992,40 cm 40 12,000 8,417 Transofix 1 5,841 8,500 Apron film 3 2,750 3,700 Pisau Cukur 1 770 2,000 Underpad 60x90 1 2,500 3,600 Silk 1 3 145,778 206,100 Silk 2 3 205,425 310,500 Pisau aesculap 20 1 2,475 3,500 Spinocan 27 G B-Braun 1 43,560 63,000 Syringe 20 ml One Med 1 1,056 1,500 Syringe 10 ml One Med 2 1,509 2,100 Syringe 5 ml One Med 2 1,040 1,400 Syringe 3ml One Med 2 1,001 1,400 Syringe 1 ml One Med 1 496 700 Syringe 5 mL Terumo 1 1,469 6,200 Transfusi set JKN 1 6,600 9,250 Abbocath no 18 2 15,159 28,000 Tegaderm kecil JKN 1 2,805 5,500 Swab Alkohol Onemed 10 1,218 1,600 Sarung Tangan S/M 0.4 15,015 19,040 Sarung tangan 6,5 5 15,571 25,000 Sarung Tangan 7 2 5,968 10,000 Sarung Tangan 7,5 2 6,270 10,000

Povidone Iodine 60 mL 1 4,238 8,300 Alkhohol 1 lt, 60 cc 0.06 1,691 2,145 Microshield 500mL 0.2 14,230 23,140 Gigazyme 0.01 2,717 3,930 Gelang pasien 2 1,289 3,000 Kasa Besar (x-ray) 270 roll, 30 lbr 0.11 17,325 35,393 Kasa perut(Hidrofil) 40/roll, 6 lbr 0.15 23,625 48,263 Kasa spinal (Hidrofil)540/roll, 3 lbr 0.01 1,575 3,218 Kasa Tooffer(Hidrofil) 270/roll,6 lbr 0.02 3,150 6,435


Micropore 1 inc 9 M, 10 cm 0.01 203 335

Bupivakain Spinal Inj 1 23,760 45,700 Lidokain inj 5% 1 20,900 28,600 Fentanyl 15 mg 2 68,000 95,000 Pethidin inj 2 26,583 34,400 Nacl 0,9 % 25 ml 1 4,179 5,500 Water for Injeksi 25 ml 1 4,180 5,500 RL infus Wida(Ecosol RL) 5 26,000 34,000 Nacl 0,9% 500 ml Wida(Ecosol Nacl 2 26,675 37,500 Tramadol 100 mg/2ml 3 16,500 25,500 Ketorolak inj 3 7,540 21,000 Ranitidin inj 3 6,768 10,500 Ondancentron 4 mg inj 3 8,507 24,600 Ketamin Hameln 3 48,593 69,000 Amoxiclav 625 mg tab 15 73,864 106,500 Asam mefenamat 15 1,980 4,500 Proplate Adult 1 48,152 69,000 Dexametason 5mg inj 2 4,000 5,600 Asam Traxenamat 500 mg inj 2 9,608 28,600 Sedacum inj 1 44,550 65,000 TOTAL 1,927,818 3,249,168

Histerektomi




ALKES


Histerektomi

OBAT

Histerektomi


1 67,500 172,000 1 26,105 95,000 1 3,081 44,000 1 43,651 153,000 1 43,651 153,000 1 26,500 62,000

Masker 4 2,200 4,000 Medicotest Adult 3 8,726 30,300 Folley cateter 12/14 1 10,450 15,100 Urine bag 1 3,850 2,934 Chromic 1 3 189,918 241,500 Chromic 2/0 HR 37 S 3 175,560 325,800 Mono 3/0 Triton 1 96,220 133,000 Vio 1 3 224,599 306,750 Silk 1 3 145,778 206,100 Silk 2 3 205,425 310,500 Hansaplast 1 500 220 Fixomul 10 cm 76992,40 cm 40 12,000 8,417 Transofix 1 5,841 8,500 Apron film 3 2,750 3,700 Pisau Cukur 1 770 2,000 Underpad 60x90 1 2,500 3,600 Pisau aesculap 20 1 2,475 3,500 Spinocan 27 G B-Braun 1 43,560 63,000 Syringe 20 ml One Med 1 1,056 1,500 Syringe 10 ml One Med 2 1,509 2,100 Syringe 5 ml One Med 2 1,040 1,400 Syringe 3ml One Med 2 1,001 1,400 Syringe 1 ml One Med 1 496 700 Syringe 5 ml Terumo 1 1,469 6,200 Transfusi set JKN 1 6,600 9,250 Abbocath no 18 2 15,159 28,000 Tegaderm kecil JKN 1 2,805 5,500 Swab Alkohol Onemed 10 1,218 1,600 Sarung Tangan S/M 0.4 15,015 19,040 Sarung tangan 6,5 5 15,571 25,000 Sarung Tangan 7 2 5,968 10,000 Sarung Tangan 7,5 2 6,270 10,000 Canul Oksigen 1 4,950 7,150

Povidone Iodine 60 mL 1 4,238 8,300 Alkhohol 1 lt, 60 cc 0.06 1,691 2,145 Microshield 500mL 0.2 14,230 23,140 Gigazyme 0.01 2,717 3,930 Gelang pasien 2 1,289 3,000 Kasa Besar (x-ray) 270 roll, 30 lbr 0.11 17,325 35,393 Kasa perut(Hidrofil) 40/roll, 6 lbr 0.15 23,625 48,263 Kasa spinal (Hidrofil)540/roll, 3 lbr 0.01 1,575 3,218 Kasa Tooffer(Hidrofil) 270/roll,6 lbr 0.02 3,150 6,435

Histerektomi

Micropore 1 inc 9 M, 10 cm 0.01 203 335

Bupivakain Spinal Inj 1 23,760 45,700 Lidokain 5% inj 1 20,900 28,600 Fentanyl 15 mg 2 68,000 95,000 Pethidin inj 2 26,583 34,400 Nacl 0,9 % 25 ml 1 4,179 5,500 Water for Injeksi 25 ml 1 4,180 5,500 RL infus Wida(Ecosol RL) 5 26,000 34,000 Nacl 0,9% 500 ml Wida(Ecosol Nacl) 2 26,675 37,500 Tramadol Inj 3 16,500 25,500 Ketorolak Inj 3 7,540 21,000 Ranitidin inj 3 6,768 10,500 Ondansetron inj 4mg 3 8,507 24,600 Ketamin Hameln 3 48,593 69,000 Amoxiclav 625 mg tab 15 73,864 106,500 Asam mefenamat 15 1,980 4,500 Proplate Adult 1 48,152 69,000 Dexametason 5mg inj 2 4,000 5,600 Asam Traxenamat 500 mg inj 2 9,608 28,600 Cefriaxon 1 gr/Cefotaxim 1 gr 2 18,562 24,000 Sedacum inj 1 44,550 65,000 TOTAL 1,982,680 3,350,918

laparatomi Anak




ALKES


laparatomi Anak

OBAT

laparatomi Anak


1 67,500 172,000 1 26,105 95,000 1 3,081 44,000 1 43,651 153,000 1 43,651 153,000 1 26,500 62,000

Masker 4 2,200 4,000 Medicotest Adult 3 8,726 30,300 Folley cateter 12/14 1 10,450 15,100 Urine bag 1 3,850 2,934 Silkam 3.0 3 169,538 289,500 Silkam 4.0 3 143,550 248,850 Safil 3.0 3 297,330 441,000 Safil 4.0 3 294,525 363,000 Lomatul H 10x10 2 27,170 38,000 Fixomul 10 cm 76992,40 cm 40 12,000 8,417 Transofix 1 5,841 8,500 Apron film 3 2,750 3,700 ETT no 3/3,5/4 1 770 2,000 Underpad 60x90 1 2,500 3,600 Pisau aesculap 15 1 2,475 3,500 Spinocan /nedle Caudal 1 43,560 63,000 Syringe 20 ml One Med 1 1,056 1,500 Syringe 10 ml One Med 2 1,509 2,100 Syringe 5 ml One Med/ 5 ml Terumo 2 1,040 1,400 Syringe 3ml One Med 2 1,001 1,400 Syringe 1 ml One Med 1 496 700 Syringe 5 mL Terumo 1 1,469 6,200 Transfusi set JKN 1 6,600 9,250 Iv cath 22/24 2 15,159 28,000 IV Dressing JKN 1 2,805 5,500 Tegaderm Pad Kecil 1 8,593 14,000 Swab Alkohol Onemed 10 1,218 1,600 Sarung Tangan S/M 0.4 15,015 19,040 Sarung Tangan 6,5 5 15,571 25,000 Sarung Tangan 7 2 5,968 10,000 Sarung Tangan 7,5 2 6,270 10,000 Nasal Kanul Anak 1 6,895 9,800

Povidone Iodine 60 mL 1 4,238 8,300 Alkohol 1 lt, 60 cc 0.06 1,691 2,145 Microshield 500 mL 0.2 14,230 23,140 Gigazyme 0.01 2,717 3,930 Gelang pasien 2 1,289 3,000 Kasa Besar (x-ray) 270 roll, 30 lbr 0.11 17,325 35,393 Kasa perut(Hidrofil) 40/roll, 6 lbr 0.15 23,625 48,263 Kasa spinal (Hidrofil)540/roll, 3 lbr 0.01 1,575 3,218 Kasa Tooffer(Hidrofil) 270/roll,6 lbr 0.02 3,150 6,435 Micropore 1 inc 9 M, 10 cm 0.01 203 335

laparatomi Anak

Bupivakain Spinal Inj 1 23,760 45,700 Liidokain inj 5% 1 20,900 28,600 Fentanyl 15 mg 2 68,000 95,000 Pethidin inj 2 26,583 34,400 Nacl 0,9 % 25 ml 1 4,179 5,500 Water for Injeksi 25 ml 1 4,180 5,500 RL infus Wida(Ecosol RL) 3 15,600 20,400 Nacl 0,9% 500 ml Wida(Ecosol Nacl) 2 10,670 15,000 Tramadol 100 mg/2ml 3 16,500 25,500 Ketorolak inj 30mg 3 7,540 21,000 Ranitidin inj 3 6,768 10,500 Ondancentron 4 mg inj 3 8,507 24,600 Sedacum inj 1 44,550 65,000 Sevodex 250 ml 30 274,890 420,000 Antalgin inj 3 4,787 5,700 Proplate 1 48,152 69,000 Dexametason 5mg inj 2 4,000 5,600 Asam Traxenamat 500 mg inj 2 9,608 28,600 Ketamin Hameln 3 48,593 69,000 Recofol inj 1 74,507 120,000 Tracrium inj 1 44,440 57,800 TOTAL ### ###

Laparatomi Dewasa




ALKES


Laparatomi Dewasa

OBAT

Laparatomi Dewasa


1 67,500 172,000 1 26,105 95,000 1 3,081 44,000 1 43,651 153,000 1 43,651 153,000 1 26,500 62,000

Masker 4 2,200 4,000 Medicotest Dewasa 3 16,874 45,300 Folley cateter 12/14 1 10,450 15,100 Urine bag 1 3,850 2,934 Silkam 2 1 68,475 103,500 Safil 2/0 1 84,150 117,800 Silkam 3.0 1 56,513 96,500 Silk 1 1 48,593 68,700 Vio 1 1 74,866 102,250 Vio 3/0 1 73,337 100,100 Hansaplast 1 500 220 Hernia Mesh 2 144,500 105,500 Fixomul 10 cm 76992,40 cm 40 12,000 8,417 Transofix 1 5,841 8,500 Apron film 3 2,750 3,700 ETT no 6,5/7/7,5 1 52,800 84,800 Underpad 60x90 1 2,500 3,600 Pisau aesculap 20 1 2,475 3,500 Spinocan 27 G B-Braun 1 43,560 63,000 Syringe 20 ml One Med 1 1,056 1,500 Syringe 10 ml One Med 2 1,509 2,100 Syringe 5 ml One Med 2 1,040 1,400 Syringe 3ml One Med 2 1,001 1,400 Syringe 1 ml One Med 1 496 700 Syringe 5 mL Terumo 1 1,469 6,200 Transfusi set JKN 1 6,600 9,250 Abbocath no 18 2 15,159 28,000 Tegaderm kecil JKN 1 2,805 5,500 Swab Alkohol Onemed 10 1,218 1,600 Sarung Tangan S/M 0.4 15,015 19,040 Sarung tangan 6,5 5 15,571 25,000 Sarung Tangan 7 2 5,968 10,000 Sarung Tangan 7,5 2 6,270 10,000 Canul Oksigen 1 4,950 7,150

Povidone Iodine 60 mL 1 4,238 8,300 Alkhohol 1 lt, 60 cc 0.06 1,691 2,145 Microshield 500 mL 0.2 14,230 23,140 Gigazyme 0.01 2,717 3,930 Gelang pasien 2 1,289 3,000 Kasa Besar (x-ray) 270 roll, 30 lbr 0.11 17,325 35,393 Kasa perut(Hidrofil) 40/roll, 6 lbr 0.15 23,625 48,263 Kasa spinal (Hidrofil)540/roll, 3 lbr 0.01 1,575 3,218

Laparatomi Dewasa

Kasa Tooffer(Hidrofil) 270/roll,6 lbr 0.02 3,150 6,435 Micropore 1 inc 9 M, 10 cm 0.01 203 335

Bupivakain Spinal Inj 1 23,760 45,700 Lidokain 5% Inj 1 20,900 28,600 Fentanyl inj 2 68,000 95,000 Pethidin inj 2 26,583 34,400 Nacl 0,9 % 25 ml 1 4,179 5,500 Water for Injeksi 25 ml 1 4,180 5,500 RL infus Wida(Ecosol RL) 5 26,000 34,000 Nacl 0,9% 500 ml Wida(Ecosol Nacl 5 26,675 37,500 Tramadol 100mg/2mL 3 16,500 25,500 Ketorolak inj 3 7,540 21,000 Ranitidin inj 3 6,768 10,500 Ondancentron 4 mg inj 3 8,507 24,600 Sevodex 250 ml 30 ml 274,890 420,000 Ceftriaxone inj/Cefotaxime inj 2 18,564 24,000 Plate Cauter 1 48,152 69,000 Dexametason 5mg inj 2 4,000 5,600 Asam Traxenamat 500 mg inj 2 9,608 28,600 TOTAL 1,661,696.15 2,794,418.35

paket no.3.xls

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