Unit Cost Askes 2012 Rsb.bwo

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PERHITUNGAN TARIF PAKET RAWAT INAP RS. BHAYANGKARA BONDOWOSO TAHUN 2012 KLAS I KLAS II KLAS III NO URAIAN JML FREK TARIF JML JML FREK TARIF JML JML FREK TARIF JML KASUS BIAYA KASUS BIAYA KASUS BIAYA PAKET PELAYANAN PER HARI 28 48 3 1 AKOMODASI 112 ### ### 192 ### ### 12 50,000 600,000 2 VISITE DOKTER SPESIALIS 56 ### ### 192 ### ### 12 80,000 960,000 3 KONSULTASI SPESIALIS 28 ### ### 96 ### ### 3 80,000 240,000 4 VISITE DOKTER JAGA 4 50,000 200,000 4 50,000 200,000 3 50,000 150,000 5 KONSULTASI GIZI 28 20,000 560,000 48 15,000 720,000 3 15,000 45,000 6 ASUHAN KEPERAWATAN 56 20,000 ### 96 20,000 ### 9 20,000 180,000 7 TINDAKAN KEPERAWATAN 56 90,000 ### 96 80,000 ### 9 70,000 630,000 8 PII (LAB SEDERHANA) 56 50,000 ### 96 45,000 ### 8 35,000 280,000 9 BIAYA ADMINISTRASI 28 50,000 ### 48 50,000 ### 3 50,000 150,000 10 SEWA ALAT Kasa Gulung 1 ### 158,400 2 ### 316,800 1 ### 158,400 Verban / Kassa DRC Buah 56 10,000 560,000 96 10,000 960,000 6 10,000 60,000 Infuset Buah 28 19,400 543,200 48 19,400 931,200 3 19,400 58,200 Abocath Buah 56 46,000 ### 72 46,000 ### 6 46,000 276,000 Spuit 1 cc Buah 28 7,200 201,600 48 7,200 345,600 3 7,200 21,600 Spuit 3 cc Buah 84 4,700 394,800 96 4,700 451,200 10 4,700 47,000 Spuit 5 cc Buah 28 5,700 159,600 48 5,700 273,600 3 5,700 17,100 Spuit 10 cc Buah 14 7,200 100,800 24 7,200 172,800 2 7,200 14,400 O2 Tabung 12 ### ### 24 ### ### 2 ### 240,000 Alkohol Liter 14 5,500 77,000 24 5,500 132,000 1 5,500 5,500 Betadin Liter 14 6,000 84,000 24 6,000 144,000 2 6,000 12,000 Plester Rol 20 10,000 200,000 48 10,000 480,000 3 10,000 30,000 Transfusi set Buah 10 37,000 370,000 15 37,000 555,000 2 37,000 74,000 Kapas - 28 5,000 140,000 48 5,000 240,000 3 5,000 15,000 Handschoen Buah 14 1,500 21,000 24 1,500 36,000 1 1,500 1,500 Kanul O2 Buah 2 20,400 40,800 6 20,400 122,400 1 20,400 20,400 Hibiscrub Liter 1 56,500 56,500 1 56,500 56,500 56,500 - Aquades 500 ml Liter 1 10,800 10,800 2 10,800 21,600 10,800 -

Transcript of Unit Cost Askes 2012 Rsb.bwo

PERHITUNGAN TARIF PAKET RAWAT INAP RS. BHAYANGKARA BONDOWOSO TAHUN 2012

KLAS I KLAS II KLAS IIINO URAIAN JML FREK TARIF JML JML FREK TARIF JML JML FREK TARIF JML

KASUS BIAYA KASUS BIAYA KASUS BIAYA

PAKET PELAYANAN PER HARI 28 48 31 AKOMODASI 112 150,000 16,800,000 192 110,000 21,120,000 12 50,000 600,000 2 VISITE DOKTER SPESIALIS 56 150,000 8,400,000 192 100,000 19,200,000 12 80,000 960,000 3 KONSULTASI SPESIALIS 28 150,000 4,200,000 96 100,000 9,600,000 3 80,000 240,000 4 VISITE DOKTER JAGA 4 50,000 200,000 4 50,000 200,000 3 50,000 150,000 5 KONSULTASI GIZI 28 20,000 560,000 48 15,000 720,000 3 15,000 45,000 6 ASUHAN KEPERAWATAN 56 20,000 1,120,000 96 20,000 1,920,000 9 20,000 180,000 7 TINDAKAN KEPERAWATAN 56 90,000 5,040,000 96 80,000 7,680,000 9 70,000 630,000 8 PII (LAB SEDERHANA) 56 50,000 2,800,000 96 45,000 4,320,000 8 35,000 280,000 9 BIAYA ADMINISTRASI 28 50,000 1,400,000 48 50,000 2,400,000 3 50,000 150,000

10 SEWA ALATKasa Gulung 1 158,400 158,400 2 158,400 316,800 1 158,400 158,400 Verban / Kassa DRC Buah 56 10,000 560,000 96 10,000 960,000 6 10,000 60,000 Infuset Buah 28 19,400 543,200 48 19,400 931,200 3 19,400 58,200 Abocath Buah 56 46,000 2,576,000 72 46,000 3,312,000 6 46,000 276,000 Spuit 1 cc Buah 28 7,200 201,600 48 7,200 345,600 3 7,200 21,600 Spuit 3 cc Buah 84 4,700 394,800 96 4,700 451,200 10 4,700 47,000 Spuit 5 cc Buah 28 5,700 159,600 48 5,700 273,600 3 5,700 17,100 Spuit 10 cc Buah 14 7,200 100,800 24 7,200 172,800 2 7,200 14,400 O2 Tabung 12 120,000 1,440,000 24 120,000 2,880,000 2 120,000 240,000 Alkohol Liter 14 5,500 77,000 24 5,500 132,000 1 5,500 5,500 Betadin Liter 14 6,000 84,000 24 6,000 144,000 2 6,000 12,000 Plester Rol 20 10,000 200,000 48 10,000 480,000 3 10,000 30,000 Transfusi set Buah 10 37,000 370,000 15 37,000 555,000 2 37,000 74,000 Kapas - 28 5,000 140,000 48 5,000 240,000 3 5,000 15,000 Handschoen Buah 14 1,500 21,000 24 1,500 36,000 1 1,500 1,500 Kanul O2 Buah 2 20,400 40,800 6 20,400 122,400 1 20,400 20,400 Hibiscrub Liter 1 56,500 56,500 1 56,500 56,500 56,500 - Aquades 500 ml Liter 1 10,800 10,800 2 10,800 21,600 10,800 -

KLAS I KLAS II KLAS IIINO URAIAN JML FREK TARIF JML JML FREK TARIF JML JML FREK TARIF JML

KASUS BIAYA KASUS BIAYA KASUS BIAYAJUMLAH 47,654,500 78,590,700 4,286,100 UNIT COST PER HARI 1,701,946 1,637,306 1,428,700 Tarif Maksimal AskesTarif Kesepakatan RIIur Biaya Pasien

PAKET II A 2012

JUMLAH KASUS : 417

NO JENIS PEMERIKSAAN FREK JASA SARANA JASA PELAYANAN BAHP TARIF BIAYA

1 DARAH LENGKAP 250 13,500 9,000 22,500 45,000 11,250,000 HbHematokritLeukositHitung Jenis LeukositEritrositTrombositLEDRetikulositMasa Pembekuan 24 4,500 3,600 9,900 18,000 432,000 Masa PerdarahanVER/HER/KHERMalariaGolongan darah 74 4,500 3,600 9,900 18,000 1,332,000

2 URINE RUTIN 84 6,000 4,800 13,200 24,000 2,016,000 RutinProteinGlukosaUrobilinogenBilirubinKetonDarahSedimen

3 FESES RUTIN 9 9,600 4,800 13,200 24,000 216,000 WarnaKonsistensiDarahLendirLeukositEritrositSisa makananBakteriJamurParasitJUMLAH 417 15,246,000 UNIT COST 36,561 Tarif Kesepakatan Paket IIATarif MaksimalIur Biaya Pasien

PAKET II B 2012

JUMLAH KASUS : 68

NO JENIS PEMERIKSAAN FREK JASA SARANA JASA PELAYANAN BAHP TARIF BIAYA

1 KEPALA (SCEDEL) 3 30,000 20,000 25,000 75,000 225,000

2 LEHER (CERVICAL) 1 35,000 20,000 30,000 85,000 85,000

3 THORAX 26 25,000 17,000 18,000 60,000 1,560,000

4 ABDOMEN ( PERUT ) 7 28,000 19,000 25,000 72,000 504,000

5 PELVIS 4 28,000 19,000 25,000 72,000 288,000

6 EKSTREMITAS ATAS/BAWAH 19 30,000 20,000 25,000 75,000 1,425,000

7 COLL VERTEBRATA 5 37,000 23,000 35,000 95,000 475,000

8 IVP 1 86,000 44,000 420,000 550,000 550,000

9 DENTAL I 2 6,000 6,000 18,000 30,000 60,000

JUMLAH 68 5,172,000 UNIT COST 76,059 Tarif Kesepakatan Paket IIBTarif MaksimalIur Biaya Pasien

PAKET II C 2012

JUMLAH KASUS : 40

NO JENIS PEMERIKSAAN FREK JASA SARANA JASA PELAYANAN BAHP TARIF BIAYA

1 AUDIOMETRI - - - - - - 2 FUNDUSCOPY - - - - - - 3 OPTHALMOSCOPY - - - - - - 4 REFRAKSI - - - - - - 5 SLIT LAMP EXAMINATION - - - - - - 6 TONOMETRI - - - - - - 7 ECG 40 8,000 22,000 5,000 35,000 1,400,000

JUMLAH 40 1,400,000 UNIT COST 35,000 Tarif Kesepakatan Paket IICTarif MaksimalIur Biaya Pasien

PAKET III A 2012

NO JENIS PEMERIKSAAN FREK JASA SARANA JASA PELAYANAN BAHP TARIF BIAYA

1 Perawatan saluran akar 18 20,000 12,500 17,500 50,000 900,000 2 Cabut gigi 8 20,000 12,500 17,500 50,000 400,000 3 Tambal permanen 15 16,000 10,000 14,000 40,000 600,000 4 Irigasi telinga 3 20,000 12,500 17,500 50,000 150,000 5 Cuci sinus - - - - - - 6 Angkat jahitan 4 12,000 7,500 10,500 30,000 120,000 7 Ganti balut besar 15 28,400 17,750 24,850 71,000 1,065,000 8 Ganti balut kecil 5 21,200 13,250 18,550 53,000 265,000 9 Campusvisi - - - - - -

10 Calculektomi - - - - - - 11 Eksisi tumor kecil 1 30,000 18,750 26,250 75,000 75,000 12 Spuling - - - - - - 13 Epilasi - - - - - - 14 Ekstirpasi corpus alienum 2 16,000 10,000 14,000 40,000 80,000 15 Businasi - - - - - - 16 Pasang kateter 25 16,000 10,000 14,000 40,000 1,000,000 17 Pasang gips 1 12,000 7,500 10,500 30,000 30,000 18 Pasang pesarium - - - - - - 19 Pasang implan - - - - - - 20 Pap smear - - - - - - 21 Biopsi cervic - - - - - - 22 Cauterisasi - - - - - - 23 Incisi abses 1 22,000 13,750 19,250 55,000 55,000 24 Pasang tampon 1 9,200 5,750 8,050 23,000 23,000 25 Labulo plasty - - - - - - 26 Parasentesa - - - - - - 27 Ekstraksi kuku 2 26,000 16,250 22,750 65,000 130,000 28 Rawat luka tanpa jahitan 16 21,200 13,250 18,550 53,000 848,000 29 Necrotomy - - - - - - 30 Jahit luka kecil 10 12,000 7,500 10,500 30,000 300,000

NO JENIS PEMERIKSAAN FREK JASA SARANA JASA PELAYANAN BAHP TARIF BIAYA

31 Dilatasi phymosis - - - - -

JUMLAH 127 6,041,000 UNIT COST 47,567 Tarif Kesepakatan Paket IIiATarif MaksimalIur Biaya Pasien

PAKET III B 2012

NO JENIS PEMERIKSAAN FREK JASA SARANA JASA PELAYANAN BAHP TARIF BIAYA

1 Cabut gigi dengan komplikasi 2 34,000 21,250 29,750 85,000 170,000 2 Eksisi epulis kecil - - - - - 3 Insisi abses intra oral 1 18,000 11,250 15,750 45,000 45,000 4 Insisi kalazion - - - - - 5 Angka kawat dengan hecting - - - - - 6 Flap sederhana - - - - - 7 Eksisi tumor >5 cm (Kista, Lipoma) 0 120,000 75,000 105,000 300,000 - 8 Graft sederhana - - - - - 9 Jahit palpebra - - - - -

10 Punksi lumbal 0 - - - - - 11 Insisi abses besar 80,000 50,000 70,000 200,000 - 12 Aspirasi pneumothorax 0 - - - - - 13 Labuloplasty 2 telinga - - -

JUMLAH 3 215,000 UNIT COST 71,667 Tarif Kesepakatan Paket IIIBTarif MaksimalIur Biaya Pasien

PAKET III C 2012

NO JENIS PEMERIKSAAN FREK JASA SARANA JASA PELAYANAN BAHP TARIF BIAYA

1 Alveolektomi - - - - - 2 Amputasi jari 60,000 37,500 52,500 150,000 - 3 Injeksi varises - - - - - 4 WSD - - - - - 5 Vena seksi - - - - - 6 Eksisi fibroma - - - - - 7 Sistotomi - - - - - 8 Curretage (lokal) - - - - - 9 Pterygeum - - - - -

10 Pungsi pleura 1 300,000 187,500 262,500 750,000 750,000 11 Fistulektomi - - - - - 12 Odontectomy - - - - - 13 Mecocele - - - - - 14 Tubektomi - - - - - 15 Reposisi dengan anestesi lokal 1 200,000 125,000 175,000 500,000 500,000

JUMLAH 2 1,250,000 UNIT COST 625,000 Tarif Kesepakatan Paket IIICTarif MaksimalIur Biaya Pasien

LUAR PAKET LABORATORIUM TAHUN 2012

NO JENIS PEMERIKSAAN FREK JASA SARANA JASA PELAYANAN

I KIMIA DARAHTROPONIN 1 22,500 18,000 CK MB 1 22,500 18,000 HBDH 51 12,000 9,600 NATRIUM DARAH 5 12,000 9,600

II DIABETESGLUKOSA DARAH PP 48 5,500 4,400 GLUKOSA DARAH PUASA 48 5,500 4,400 GLUKOSA DARAH SEWAKTU 215 5,500 4,400

III FUNGSI HATIALBUMIN 3 5,500 4,400 ALKALI PHOSPATE 1 6,000 4,800 BILIRUBIN INDIREK 9 5,500 4,400 BILIRUBIN TOTAL 9 5,500 4,400 GAMMA GT 1 6,000 4,800 GLOBULIN 3 5,500 4,400 PROTEIN TOTAL 3 5,500 4,400 SGOT 143 6,000 4,800 SGPT 143 6,000 4,800

IV FUNGSI GINJALCREATININ 41 6,000 4,800 ASAM URAT 124 5,500 4,400 UREUM 41 5,500 4,400

V ANALISA LEMAKCHOLESTEROL TOTAL 198 5,500 4,400 CHO HDL 41 5,500 4,400 CHO LDL 43 5,500 4,400 TG 172 5,500 4,400

VI SEROLOGIANTI HIV 1 15,000 7,200 ANTI HCV 1 15,000 7,200 DENGUE BLOT Ig G 8 15,000 7,200 DENGUE BLOT Ig M 8 15,000 7,200 HBsAG 1 15,000 7,200 WIDAL 84 12,000 9,600

VII MIKROBIOLOGISEDIAAN LANGSUNG PERWARNA BTA 9 6,000 4,800

JUMLAH 1456UNIT COST

Tarif Kesepakatan Paket IIIC

Tarif Maksimal

Iur Biaya Pasien

LUAR PAKET LABORATORIUM TAHUN 2012

BAHP TARIF JUMLAH

49,500 90,000 90,000 49,500 90,000 90,000 26,400 48,000 2,448,000 26,400 48,000 240,000

- - - -

12,100 22,000 1,056,000 12,100 22,000 1,056,000 12,100 22,000 4,730,000

- - - -

12,100 22,000 66,000 13,200 24,000 24,000 12,100 22,000 198,000 12,100 22,000 198,000 13,200 24,000 24,000 12,100 22,000 66,000 12,100 22,000 66,000 13,200 24,000 3,432,000 13,200 24,000 3,432,000

13,200 24,000 984,000 12,100 22,000 2,728,000 12,100 22,000 902,000

- -

- - 12,100 22,000 4,356,000 12,100 22,000 902,000 12,100 22,000 946,000 12,100 22,000 3,784,000

- - - -

37,800 60,000 60,000 37,800 60,000 60,000 37,800 60,000 480,000 37,800 60,000 480,000 37,800 60,000 60,000 26,400 48,000 4,032,000

- - - -

13,200 24,000 216,000 - - - - - 37,206,000 - - - - - - - -

OPERASI KELOMPOK I 2012 : KASUS I

NO URAIAN SATUANOPERASI KELOMPOK I

KASUS FREK HARGA1

1 JASA SARANA 1 250,000 2 JASA PELAYANAN

OPERATOR 1 1,800,000 PENATA ANESTHESIASISTENINSTRUMENOMLOUP 1 100,000

3 PEMAKAIAN BAHPHandscoen 2 22,900 Spuit Disp 10cc Buah 1 7,200 Spuit Disp 5cc BuahSpuit Disp 3cc BuahCat Gut Plain (Roll) Roll 0.25 27,000 Cut Gut Chromic (Roll) Roll 0.25 27,000 Kasa steril Gulung 1 6,000 Surgical blade Buah 1 3,600 Betadin 1 700 Alkohol 1 800 Precep 1 5,200 Hibiscruphypavix 1 1,620

JUMLAH 1UNIT COSTTarif Kesepakatan Paket Operasi ITarif MaksimalIur Biaya Pasien

OPERASI KELOMPOK IJUMLAH 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 : KASUS I

NO URAIAN SATUANOPERASI KELOMPOK II

KASUS FREK HARGA1

1 JASA SARANA 1 350,000 2 JASA PELAYANAN

OPERATOR 1 4,200,000 PENATA ANESTHESIASISTENINSTRUMENOMLOUP 1 140,000

3 PEMAKAIAN BAHPHandscoen 3 22,900 Spuit Disp 10cc Buah 1 7,200 Spuit Disp 5cc BuahSpuit Disp 3cc Buah 1 4,700 Cat Gut Plain (Roll) Roll 0.25 27,000 Cut Gut Chromic (Roll) Roll 0.25 27,000 Kasa steril Gulung 2 6,000 Surgical blade Buah 1 3,600 Betadin 1 1,400 Alkohol 1 1,200 Precep 1 7,600 Hibiscrup 1 14,700 hypavix 1 2,700

JUMLAH 1UNIT COSTTarif Kesepakatan Paket Operasi ITarif MaksimalIur Biaya Pasien

OPERASI KELOMPOK IIJUMLAH 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 : KASUS III

NO URAIAN SATUANOPERASI KELOMPOK II

KASUS FREK HARGA3

1 JASA SARANA 3 575,000 2 JASA PELAYANAN

OPERATOR 3 4,800,000 PENATA ANESTHESIASISTENINSTRUMENOMLOUP 3 140,000

3 PEMAKAIAN BAHPHandscoen 12 22,900 Spuit Disp 10cc Buah 3 7,200 Spuit Disp 5cc Buah 6 5,700 Spuit Disp 3cc Buah 3 4,700 Cat Gut Plain (Roll) Roll 3 27,000 Cut Gut Chromic (Roll) Roll 3 27,000 siede / Silk 2 27,000 Kasa steril Gulung 9 6,000 Surgical blade Buah 3 3,600 Betadin 90 70 Alkohol 120 40 Precep 36 650 Hibiscrup 45 980 Hansaplasthypavix 45 270 Zydesym 36 668

JUMLAH 3UNIT COSTTarif Kesepakatan Paket Operasi ITarif MaksimalIur Biaya Pasien

OPERASI KELOMPOK IIJUMLAH 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 URAIAN FREK TARIF BIAYA1 KARCIS 126 15,000 ###2 PEMERIKSAAN 126 25,000 ###3 KONSUL 7 ### ###4 TIND. PERAWATAN

###

KET :JUMLAH 126 ###UNIT COST 50,000 TARIF KESEPAKATANTARIF MAKSIMALIUR BIAYA

RAWAT INAP PERINATOLOGIRUMAH SAKIT BHAYANGKARA BONDOWOSO

TAHUN 2012JUMLAH KASUS : 66

NO URAIANPERHITUNGAN TARIF

KET :KASUSFREK BIAYA JML BIAYAPAKET PELAYANAN PER HARI66

1 AKOMODASI PRWTAN 198 ### ###2 VISITE DOKTER SPESIAIS 264 ### ###3 KONSUL DOKTER 66 8,400 554,400 4 VISITE DOKTER JAGA 6 ### 360,000 5 KONSUL GIZI - 6 ASUHAN KEPERAWATAN 66 ### ###7 TINDAKAN KEPERAWATAN 55 ### ###8 PII LAB SEDERHANA 10 ### 250,000 9 CM/ ADM 66 ### ###10 SEWA ALAT -

INKUBATOR 5 ### 175,000 BLUE LIGHT - OXYMETER - VENTILATOR - SUCTION PUMP - INTANT PUMP - INFUS PUMP -

SUB TOTAL NON BAHP - ###11 BAHP -

INFUSET 5 ### 97,000 SALEP MATA 22 5,000 110,000 ABOCATH 9 ### 495,000 DISP 1 CC 360 7,100 ###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 ### 110,000 BETADIN 1 ### 25,000 PLESTER 2 ### 100,000 TRANSFUSISET 1 ### 37,000 NEADLE 26 396 1,800 712,800 SALEP KULIT 22 5,000 110,000 HANDSCOEN 3 ### 150,000 TROMBOPOP 10 ### 200,000 KASA 3 ### 240,000 KAPAS 2 ### 40,000 HYPAVIX 2 ### 255,400 GELANG M 1 ### 50,000

GELANG B 1 ### 50,000 SUB TOTAL BAHP ###JUMLAH TOTAL ###

KET :JUMLAH 66 ###UNIT COST 1,077,436 TARIF KESEPAKATANTARIF MAKSIMALIUR BIAYA

PERHITUNGAN PARTUS NORMALRUMAH SAKIT BHAYANGKARA BONDOWOSO

TAHUN 2012

NO URAIANPARTUS NORMAL PARTUS TIND. PERVAGINA

KS FREK TARIF BIAYA KS FREKPAKET PELAYANAN PER HARI15 1

1 JASA SARANA 15 ### ### 1 2 JASA PELAYANAN 20 ### ### 1 3 VISITE DOKTER 15 ### ###4 KONSUL DOKTER - 5 PENUNJANG MEDIK - 6 CM 15 20,000 300,000 1

10 BAHP - KASSA 150 1,000 150,000 1 VERBAN - INFUSET - ABBOCAT 15 46,000 690,000 1 DISP 1 CC 2 7,100 14,200 1 DISP 3 CC 30 4,700 141,000 1 DISP 5 CC 30 5,700 171,000 1 DISP.10CC - O2 - ALKOHOL 100CC 15 3,000 45,000 1 BETADIN 15 25,000 375,000 1 PLESTER 15 7,500 112,500 1 TRANSFUSISET 15 37,000 555,000 1 KAPAS 15 1,000 15,000 1 CUT GUT 15 15,000 225,000 1 ATCSILK & BRILLONN20JUMLAH ###

UNIT COST ###

PERHITUNGAN PARTUS NORMALRUMAH SAKIT BHAYANGKARA BONDOWOSO

TAHUN 2012

PARTUS TIND. PERVAGINA PARTUS DG SCTARIF BIAYA KS FREK TARIF BIAYA

120,000 120,000 - ### ### -

- - - - - -

20,000 20,000 - - -

1,000 1,000 - - - - -

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

- - - -

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

- - -

### - ###

OPERASI KELOMPOK OBGYN SC 2012 : KASUS 41

NO URAIAN SATUANOPERASI KELOMPOK II

KASUS FREK HARGA41

1 JASA SARANA 41 720,000 2 JASA PELAYANAN

OPERATOR 41 1,500,000 PENATA ANESTHESI 41 313,000 ASISTEN 41 250,000 INSTRUMEN 41 188,000 OMLOUP 41 188,000

3 PEMAKAIAN BAHPHandscoen 246 22,900 Spuit Disp 10cc Buah 20 7,200 Spuit Disp 5cc Buah 41 5,700 Spuit Disp 3cc Buah 82 4,700 Cat Gut Plain (Roll) Roll 82 27,000 Cut Gut Chromic (Roll) Roll 61 27,000 siede / Silk 7 140,000 Kasa steril Gulung 164 6,000 Surgical blade Buah 41 3,600 Betadin 2460 70 Alkohol 2870 40 Precep 492 650 Hibiscrup 615 980 Hansaplast 41 500 hypavixZydesym 492 668 Opsite 41 50,000

JUMLAH 41UNIT COSTTarif Kesepakatan Paket Operasi ITarif MaksimalIur Biaya Pasien

OPERASI KELOMPOK IIJUMLAH 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 CARERUMAH SAKIT BHAYANGKARA BONDOWOSO

TAHUN 2012JUMLAH KASUS : 3

NO URAIANPERHITUNGAN TARIF

KET :KASUSFREK BIAYA JMLPAKET PELAYANAN PER HARI3

1 AKOMODASI PRWTAN 3 ### ###2 VISITE DOKTER SPESIAIS 3 ### ###3 KONSUL DOKTER - 4 ASUHAN KEPERAWATAN 3 ### 60,000 5 TINDAKAN KEPERAWATAN 6 ### ###6 CM/ ADM 3 ### 60,000 7 SEWA ALAT -

OXY METER - SUCTION PUMP - INFUS PUMP -

SUB TOTAL NON BAHP - 8 BAHP -

INFUSET 3 ### 58,200 ABBOCAT 26 3 ### ###ABBOCAT 20 3 ### ###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

TARIF MAKSIMALIUR BIAYA