Unit Cost Askes 2012 Rsb.bwo

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R. InapPERHITUNGAN TARIF PAKET RAWAT INAP RS. BHAYANGKARA BONDOWOSO TAHUN 2012KLAS IKLAS IIKLAS IIINOURAIANJMLFREKTARIFJMLJMLFREKTARIFJMLJMLFREKTARIFJMLKASUSBIAYAKASUSBIAYAKASUSBIAYAPAKET PELAYANAN PER HARI284831AKOMODASI$112$150,000$16,800,000$192$110,000$21,120,000$12$50,000$600,0002VISITE DOKTER SPESIALIS$56$150,000$8,400,000$192$100,000$19,200,000$12$80,000$960,0003KONSULTASI SPESIALIS$28$150,000$4,200,000$96$100,000$9,600,000$3$80,000$240,0004VISITE DOKTER JAGA$4$50,000$200,000$4$50,000$200,000$3$50,000$150,0005KONSULTASI GIZI$28$20,000$560,000$48$15,000$720,000$3$15,000$45,0006ASUHAN KEPERAWATAN$56$20,000$1,120,000$96$20,000$1,920,000$9$20,000$180,0007TINDAKAN KEPERAWATAN$56$90,000$5,040,000$96$80,000$7,680,000$9$70,000$630,0008PII (LAB SEDERHANA)$56$50,000$2,800,000$96$45,000$4,320,000$8$35,000$280,0009BIAYA ADMINISTRASI$28$50,000$1,400,000$48$50,000$2,400,000$3$50,000$150,00010SEWA ALATKasaGulung$1$158,400$158,400$2$158,400$316,800$1$158,400$158,400Verban / Kassa DRCBuah$56$10,000$560,000$96$10,000$960,000$6$10,000$60,000InfusetBuah$28$19,400$543,200$48$19,400$931,200$3$19,400$58,200AbocathBuah$56$46,000$2,576,000$72$46,000$3,312,000$6$46,000$276,000Spuit 1 ccBuah$28$7,200$201,600$48$7,200$345,600$3$7,200$21,600Spuit 3 ccBuah$84$4,700$394,800$96$4,700$451,200$10$4,700$47,000Spuit 5 ccBuah$28$5,700$159,600$48$5,700$273,600$3$5,700$17,100Spuit 10 ccBuah$14$7,200$100,800$24$7,200$172,800$2$7,200$14,400O2Tabung$12$120,000$1,440,000$24$120,000$2,880,000$2$120,000$240,000AlkoholLiter$14$5,500$77,000$24$5,500$132,000$1$5,500$5,500BetadinLiter$14$6,000$84,000$24$6,000$144,000$2$6,000$12,000PlesterRol$20$10,000$200,000$48$10,000$480,000$3$10,000$30,000Transfusi setBuah$10$37,000$370,000$15$37,000$555,000$2$37,000$74,000Kapas-$28$5,000$140,000$48$5,000$240,000$3$5,000$15,000HandschoenBuah$14$1,500$21,000$24$1,500$36,000$1$1,500$1,500Kanul O2Buah$2$20,400$40,800$6$20,400$122,400$1$20,400$20,400HibiscrubLiter$1$56,500$56,500$1$56,500$56,500$56,5000.0Aquades 500 mlLiter$1$10,800$10,800$2$10,800$21,600$10,8000.0JUMLAH$47,654,500$78,590,700$4,286,100UNIT COST PER HARI$1,701,946$1,637,306$1,428,700Tarif Maksimal AskesTarif Kesepakatan RIIur Biaya Pasien

Paket IIAPAKET II A 2012JUMLAH KASUS :$417NOJENIS PEMERIKSAANFREKJASA SARANAJASA PELAYANANBAHPTARIFBIAYA1DARAH LENGKAP250$13,500$9,000$22,500$45,000$11,250,000HbHematokritLeukositHitung Jenis LeukositEritrositTrombositLEDRetikulositMasa Pembekuan24$4,500$3,600$9,900$18,000$432,000Masa PerdarahanVER/HER/KHERMalariaGolongan darah74$4,500$3,600$9,900$18,000$1,332,0002URINE RUTIN84$6,000$4,800$13,200$24,000$2,016,000RutinProteinGlukosaUrobilinogenBilirubinKetonDarahSedimen3FESES RUTIN9$9,600$4,800$13,200$24,000$216,000WarnaKonsistensiDarahLendirLeukositEritrositSisa makananBakteriJamurParasitJUMLAH$417$15,246,000UNIT COST$36,561Tarif Kesepakatan Paket IIATarif MaksimalIur Biaya Pasien

Paket IIBPAKET II B 2012JUMLAH KASUS :$68NOJENIS PEMERIKSAANFREKJASA SARANAJASA PELAYANANBAHPTARIFBIAYA1KEPALA (SCEDEL)3$30,000$20,000$25,000$75,000$225,0002LEHER (CERVICAL)1$35,000$20,000$30,000$85,000$85,0003THORAX26$25,000$17,000$18,000$60,000$1,560,0004ABDOMEN ( PERUT )7$28,000$19,000$25,000$72,000$504,0005PELVIS4$28,000$19,000$25,000$72,000$288,0006EKSTREMITAS ATAS/BAWAH19$30,000$20,000$25,000$75,000$1,425,0007COLL VERTEBRATA5$37,000$23,000$35,000$95,000$475,0008IVP1$86,000$44,000$420,000$550,000$550,0009DENTAL I2$6,000$6,000$18,000$30,000$60,000JUMLAH68$5,172,000UNIT COST$76,059Tarif Kesepakatan Paket IIBTarif MaksimalIur Biaya Pasien

Paket IICPAKET II C 2012JUMLAH KASUS :$40NOJENIS PEMERIKSAANFREKJASA SARANAJASA PELAYANANBAHPTARIFBIAYA1AUDIOMETRI-0.00.00.00.00.02FUNDUSCOPY-0.00.00.00.00.03OPTHALMOSCOPY-0.00.00.00.00.04REFRAKSI-0.00.00.00.00.05SLIT LAMP EXAMINATION-0.00.00.00.00.06TONOMETRI-0.00.00.00.00.07ECG40$8,000$22,000$5,000$35,000$1,400,000JUMLAH40$1,400,000UNIT COST$35,000Tarif Kesepakatan Paket IICTarif MaksimalIur Biaya Pasien

Paket IIIAPAKET III A 2012NOJENIS PEMERIKSAANFREKJASA SARANAJASA PELAYANANBAHPTARIFBIAYA1Perawatan saluran akar18$20,000$12,500$17,500$50,000$900,0002Cabut gigi8$20,000$12,500$17,500$50,000$400,0003Tambal permanen15$16,000$10,000$14,000$40,000$600,0004Irigasi telinga3$20,000$12,500$17,500$50,000$150,0005Cuci sinus-0.00.00.00.00.06Angkat jahitan4$12,000$7,500$10,500$30,000$120,0007Ganti balut besar15$28,400$17,750$24,850$71,000$1,065,0008Ganti balut kecil5$21,200$13,250$18,550$53,000$265,0009Campusvisi-0.00.00.00.00.010Calculektomi-0.00.00.00.00.011Eksisi tumor kecil1$30,000$18,750$26,250$75,000$75,00012Spuling-0.00.00.00.00.013Epilasi-0.00.00.00.00.014Ekstirpasi corpus alienum2$16,000$10,000$14,000$40,000$80,00015Businasi-0.00.00.00.00.016Pasang kateter25$16,000$10,000$14,000$40,000$1,000,00017Pasang gips1$12,000$7,500$10,500$30,000$30,00018Pasang pesarium-0.00.00.00.00.019Pasang implan-0.00.00.00.00.020Pap smear-0.00.00.00.00.021Biopsi cervic-0.00.00.00.00.022Cauterisasi-0.00.00.00.00.023Incisi abses1$22,000$13,750$19,250$55,000$55,00024Pasang tampon1$9,200$5,750$8,050$23,000$23,00025Labulo plasty-0.00.00.00.00.026Parasentesa-0.00.00.00.00.027Ekstraksi kuku2$26,000$16,250$22,750$65,000$130,00028Rawat luka tanpa jahitan16$21,200$13,250$18,550$53,000$848,00029Necrotomy-0.00.00.00.00.030Jahit luka kecil10$12,000$7,500$10,500$30,000$300,00031Dilatasi phymosis-0.00.00.00.0JUMLAH127$6,041,000UNIT COST$47,567Tarif Kesepakatan Paket IIiATarif MaksimalIur Biaya Pasien

Paket IIIBPAKET III B 2012NOJENIS PEMERIKSAANFREKJASA SARANAJASA PELAYANANBAHPTARIFBIAYA1Cabut gigi dengan komplikasi2$34,000$21,250$29,750$85,000$170,0002Eksisi epulis kecil0.00.00.00.00.03Insisi abses intra oral1$18,000$11,250$15,750$45,000$45,0004Insisi kalazion0.00.00.00.00.05Angka kawat dengan hecting0.00.00.00.00.06Flap sederhana0.00.00.00.00.07Eksisi tumor >5 cm (Kista, Lipoma)0$120,000$75,000$105,000$300,0000.08Graft sederhana0.00.00.00.00.09Jahit palpebra0.00.00.00.00.010Punksi lumbal00.00.00.00.00.011Insisi abses besar$80,000$50,000$70,000$200,0000.012Aspirasi pneumothorax00.00.00.00.00.013Labuloplasty 2 telinga0.00.00.0JUMLAH3$215,000UNIT COST$71,667Tarif Kesepakatan Paket IIIBTarif MaksimalIur Biaya Pasien

Paket IIICPAKET III C 2012NOJENIS PEMERIKSAANFREKJASA SARANAJASA PELAYANANBAHPTARIFBIAYA1Alveolektomi0.00.00.00.00.02Amputasi jari$60,000$37,500$52,500$150,0000.03Injeksi varises0.00.00.00.00.04WSD0.00.00.00.00.05Vena seksi0.00.00.00.00.06Eksisi fibroma0.00.00.00.00.07Sistotomi0.00.00.00.00.08Curretage (lokal)0.00.00.00.00.09Pterygeum0.00.00.00.00.010Pungsi pleura1$300,000$187,500$262,500$750,000$750,00011Fistulektomi0.00.00.00.00.012Odontectomy0.00.00.00.00.013Mecocele0.00.00.00.00.014Tubektomi0.00.00.00.00.015Reposisi dengan anestesi lokal1$200,000$125,000$175,000$500,000$500,000JUMLAH2$1,250,000UNIT COST$625,000Tarif Kesepakatan Paket IIICTarif MaksimalIur Biaya Pasien

Luar Paket LabLUAR PAKET LABORATORIUM TAHUN 2012NOJENIS PEMERIKSAANFREKJASA SARANAJASA PELAYANANBAHPTARIFJUMLAHIKIMIA DARAHTROPONIN1$22,500$18,000$49,500$90,000$90,000CK MB1$22,500$18,000$49,500$90,000$90,000HBDH51$12,000$9,600$26,400$48,000$2,448,000NATRIUM DARAH5$12,000$9,600$26,400$48,000$240,0000.00.0IIDIABETES0.00.0GLUKOSA DARAH PP48$5,500$4,400$12,100$22,000$1,056,000GLUKOSA DARAH PUASA48$5,500$4,400$12,100$22,000$1,056,000GLUKOSA DARAH SEWAKTU215$5,500$4,400$12,100$22,000$4,730,0000.00.0IIIFUNGSI HATI0.00.0ALBUMIN3$5,500$4,400$12,100$22,000$66,000ALKALI PHOSPATE1$6,000$4,800$13,200$24,000$24,000BILIRUBIN INDIREK9$5,500$4,400$12,100$22,000$198,000BILIRUBIN TOTAL9$5,500$4,400$12,100$22,000$198,000GAMMA GT1$6,000$4,800$13,200$24,000$24,000GLOBULIN3$5,500$4,400$12,100$22,000$66,000PROTEIN TOTAL3$5,500$4,400$12,100$22,000$66,000SGOT143$6,000$4,800$13,200$24,000$3,432,000SGPT143$6,000$4,800$13,200$24,000$3,432,000IVFUNGSI GINJALCREATININ41$6,000$4,800$13,200$24,000$984,000ASAM URAT124$5,500$4,400$12,100$22,000$2,728,000UREUM41$5,500$4,400$12,100$22,000$902,0000.00.0VANALISA LEMAK0.00.0CHOLESTEROL TOTAL198$5,500$4,400$12,100$22,000$4,356,000CHO HDL41$5,500$4,400$12,100$22,000$902,000CHO LDL43$5,500$4,400$12,100$22,000$946,000TG172$5,500$4,400$12,100$22,000$3,784,0000.00.0VISEROLOGI0.00.0ANTI HIV1$15,000$7,200$37,800$60,000$60,000ANTI HCV1$15,000$7,200$37,800$60,000$60,000DENGUE BLOT Ig G8$15,000$7,200$37,800$60,000$480,000DENGUE BLOT Ig M8$15,000$7,200$37,800$60,000$480,000HBsAG1$15,000$7,200$37,800$60,000$60,000WIDAL84$12,000$9,600$26,400$48,000$4,032,0000.00.0VIIMIKROBIOLOGI0.00.0SEDIAAN LANGSUNG PERWARNA BTA9$6,000$4,800$13,200$24,000$216,0000.00.00.00.0JUMLAH14560.0$37,206,000UNIT COST0.00.0Tarif Kesepakatan Paket IIIC0.00.0Tarif Maksimal0.00.0Iur Biaya Pasien0.00.0

Paket Ops IOPERASI KELOMPOK I 2012: KASUS INOURAIANSATUANOPERASI KELOMPOK IKASUSFREKHARGAJUMLAH HARGA11JASA SARANA1$250,000$250,0002JASA PELAYANAN0.0OPERATOR1$1,800,000$1,800,000PENATA ANESTHESI0.0ASISTEN0.0INSTRUMEN0.0OMLOUP1$100,000$100,0003PEMAKAIAN BAHPHandscoen2$22,900$45,800Spuit Disp 10ccBuah1$7,200$7,200Spuit Disp 5ccBuah0.0Spuit Disp 3ccBuah0.0Cat Gut Plain (Roll)Roll0.25$27,000$6,750Cut Gut Chromic (Roll)Roll0.25$27,000$6,750Kasa sterilGulung1$6,000$6,000Surgical bladeBuah1$3,600$3,600Betadin1$700$700Alkohol1$800$800Precep1$5,200$5,200Hibiscruphypavix1$1,620$1,620JUMLAH1$2,234,420UNIT COST$2,234,420Tarif Kesepakatan Paket Operasi ITarif MaksimalIur Biaya Pasien

Paket Ops IIOPERASI KELOMPOK II 2012: KASUS INOURAIANSATUANOPERASI KELOMPOK IIKASUSFREKHARGAJUMLAH HARGA11JASA SARANA1$350,000$350,0002JASA PELAYANAN0.0OPERATOR1$4,200,000$4,200,000PENATA ANESTHESI0.0ASISTEN0.0INSTRUMEN0.0OMLOUP1$140,000$140,0003PEMAKAIAN BAHPHandscoen3$22,900$68,700Spuit Disp 10ccBuah1$7,200$7,200Spuit Disp 5ccBuah0.0Spuit Disp 3ccBuah1$4,700$4,700Cat Gut Plain (Roll)Roll0.25$27,000$6,750Cut Gut Chromic (Roll)Roll0.25$27,000$6,750Kasa sterilGulung2$6,000$12,000Surgical bladeBuah1$3,600$3,600Betadin1$1,400$1,400Alkohol1$1,200$1,200Precep1$7,600$7,600Hibiscrup1$14,700$14,700hypavix1$2,700$2,