Tabel biaya Pasian Hernia Ingunalis Lateralis (HIL) Dextra Responibilis Oktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 10-Oct BEDAH YAYAT H AP 20284 OPTIME 2/0 TUPPER 1 114,180 114,180 1,845,608
3 MD.526057 IV CAT-SURFLO 20 1 11,136 11,136 SKM
10/10-14/10 INFUS SET 0I-34 1 13,860 13,860
HIL Dex Reponible RINGER LAKTAT-WB 2 5,220 10,440
11-Oct BEDAH MNS 20337 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
2 KETOROLAC 30MG INJ DEXA 2 8,853 17,706
SPUIT 1 CC INS TERUMO 1 3,010 3,010
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
11-Oct OK YUDHIE 22660 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 2 5,220 10,440
ONDANSETRON 8MG INJ 1 15,523 15,523
SURGICRIL 2/0 1 62,645 62,645
POLYESTER 1 2 48,400 96,800
FC 18 GR GOLD RUSCH 1 20,493 20,493
URINE BAG COSMOMED 1 5,280 5,280
BUVIPACAIN INJEKSI 1 23,760 23,760
SPINOCAN 25 G 1 36,366 36,366
WIDAHES 130 ASKIN 1 61,800 61,800
PRONALGES SUPPO ASKIN 1 5,760 5,760
Prostigmin INJ 2 15,500 31,000
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
SILK 2/0 SHARPOINT 1 50,490 50,490
FENTANYL INJ-KF 1 36,960 36,960
12-Oct BEDAH ANDY 22409 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
FC 18 GR GOLD RUSCH 1 20,493 20,493
URINE BAG COSMOMED 1 5,280 5,280
SPUIT 10 CC TERUMO 1 2,027 2,027
FC 16 GR GOLD RUSCH 1 14,355 14,355
13-Oct BEDAH ANDY 22488 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
14-Oct BEDAH ANDY 22364 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA 5 55,000
SILK 2/0 1 4,200
ALKOHOL 100 5,000
JARUM/PLESTER 1 15,000
ARP 1 25,500
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 50 265,000
BHP 128,400
14-Oct 6383 AS. MEFENAMAT 500-KF 15 2,500
1,848,1082 .16/10 BEDAH WAWAN ANDY 20614 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 1,873,626
3 MD 133059 INFUS SET 0I-34 1 13,860 13,860 SKM
16/10-19/10 IV CAT-SURFLO 20 1 11,136 11,136
HIL D Ripondible RINGER LAKTAT-WB 1 5,220 5,220
optime 2/0 18s30j 1 95,040 95,040
CROMIC PTG 3/0 1 59,136 59,136
17-Oct BEDAH ANDY 22222 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
17-Oct OK YUDHIE 22174 PISAU BEDAH 15-AESCULAP 1 2,700 2,700
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ETT 6,5 RUSCH 1 77,933 77,933
DEXAMETASON INJ.-LUCAS 3 1,386 4,158
ATROPIN INJ-ETHICA 1 3,049 3,049
ONDANSETRON 8MG INJ 1 15,523 15,523
FENTANYL INJ-KF 1 36,960 36,960
GREEN POLYESTER 2 86,724 173,448
18-Oct BEDAH ANDY 22254 CEFOTAXIM INJ 1 G-BERNO 2 4,801 9,602
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
19-Oct BEDAH ANDY 23921 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA SEDANG 2 22,000
KASA X RAY 2 26,800
CROMIC 2/0 1 9,800
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 100 5,000
LINAPEN 1 17,000
O2 0.4 4,400
N2O 0.25 31,500
ISOFLURENT 100 530,000
BHP 88,500
1,873,626
3 2-Nov BEDAH AIM ABDUL ANDY ANIOS ADP 55,000 748,700
MD.978257 SKM
02/11-07/11 IODINE 150 30,000
HIL d reponible WASH SCRUB 150 37,500
KASA 2 22,000
KASA X RAY 2 26,800
ALKOHOL 100 5,000
CROMIC 2/0 1 9,800
ARP 1 25,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 60 318,000
BHP 151,200
748,7004 31-Oct BEDAH YAYAN MN 7213 IV CAT-SURFLO 20 1 11,136 11,136 1,508,163
3 MD.699858 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS
31/10-04/11 INFUS SET 0I-34 1 13,860 13,860
Hil D Reponible SPUIT 5 CC TERUMO 1 1,848 1,848
1-Nov OK MARUHUM 23236 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
SARUNG TANGAN TERUGLOVE 7.5 1 9,009 9,009
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 1 1,122 1,122
BUVIPACAIN INJEKSI 1 23,760 23,760
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ BERNO 2 7,883 15,766
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
RINGER LAKTAT-WB 1 5,220 5,220
SPINOCAN 25 G 1 36,366 36,366
PRONALGES SUPPO ASKIN 1 5,760 5,760
INFUS SET 0I-34 1 13,860 13,860
IV CAT-SURFLO 20 1 11,136 11,136
WIDAHES 130 ASKIN 1 61,800 61,800
AS. TRANEKSAMAT INJ 250 MG-BRN 2 3,280 6,560
FENTANYL INJ-KF 1 36,960 36,960
1-Nov BEDAH ANDY 23258 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 GENTAMYCIN INJ.-INF 2 4,032 8,064
KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 5 CC TERUMO 1 1,848 1,848
SPUIT 3 CC TERUMO 4 1,122 4,488
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
1-Nov BEDAH ANDY 7173 SURGICRIL 2/0 1 62,645 62,645
1 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
2-Nov BEDAH ANDY 23299 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 GENTAMYCIN INJ.-INF 2 4,032 8,064
KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 2 1,848 3,696
PARASETAMOL MARIN 3 120 360
2-Nov BEDAH ANDY 23143 KAPTOPRIL 25 ASKIN 9 114 1,026
3-Nov BEDAH ANDY 23020 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 GENTAMYCIN INJ.-INF 2 4,032 8,064
KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 5 CC TERUMO 1 1,848 1,848
SPUIT 3 CC TERUMO 2 1,122 2,244
INFUS SET 0I-34 1 13,860 13,860
IV CAT-SURFLO 20 1 11,136 11,136
4-Nov BEDAH ANDY 23053 AMOKSISILIN 500 INF 15 444 6,660
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA 3 33,000
KASA X RAY 3 40,200
ALKOHOL 100 5,000
SILK 2/0 1/2 2,100
ARP 1 25,500
CROMIC 2/0 1/2 4,900
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 60 318,000
BHP 136,800
1,508,1635 28-Nov BEDAH REDI MN 50623 SURGICRIL 3/0 1 58,960 58,960 1,807,360
3 MD.432559 optime 4/0 18s15f 1 95,040 95,040
28/11-02/12 IV CAT-SURFLO 20 1 11,136 11,136
HIL d reponible INFUS SET 0I-34 1 13,860 13,860
RINGER LAKTAT-WB 1 5,220 5,220
IV CAT-SURFLO 22 1 11,136 11,136
29-Nov OK YUDHIE 25088 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
SURGICRIL 2/0 1 62,645 62,645
DEXAMETASON INJ.-LUCAS 4 1,386 5,544
CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
FENTANYL INJ-KF 1 36,960 36,960
GREEN POLYESTER 2 86,724 173,448
29-Nov BEDAH SIMAMORA 50687 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
2 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
30-Nov BEDAH ANDY 25225 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
OBH 100 ML TDR 1 2,352 2,352
1-Dec BEDAH ANDY 25310 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 10 CC TERUMO 2 2,027 4,054
INFUS SET 0I-34 1 13,860 13,860
02/12 BEDAH ANDY 25407 AMOKSISILIN 500 TABLET BERNO 8 446 3,568
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA 3 14,700
KASA SEDANG 2 22,000
CROMIC 2/0 1/2 4,900
SILK 2/0 1/2 2,100
LINAPEN 1 17,000
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 50 2,500
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 100 530,000
BHP 107,700
1,807,360
6 28/11 BEDAH SANJAYA ANDY ANIOS ADP 55,000 620,550MD.716559 JAMKESMAS
30/11-02/12 IODINE 75 15,000
HIL REPONIBLE WASH SCRUB 75 18,750
KASA 2 22,000
KASA SILVER 2 9,800
LINAPEN 1 17,000
FORMALIN 10 500
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 50 2,500
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 60 318,000
BHP 48,600
BEDAH MSN 585 CIFOTAXIM INJ 1 G-BERNO 1RINGER LAKTAT-WB 1GLUKOSE 5% TERUMO 1SPUTI 5 CC TERUMO 1SPUTI 3 CC TERUMO 1SPUTI 1 CC INS TERUMO 1BUFFECT SIR. 1 37,000
620,5507 14/12 BEDAH UTEP ANDY ANIOS ADP 55,000 1,605,700
MD.500561 JAMKESMAS
14/12-19/12 IODINE 150 30,000
HIL D Reponible WASH SCRUB 150 37,500
KASA SEDANG 4 44,000
CROMIC 2/0 1 9,800
LINAPEN 1 17,000
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 100 5,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 100 530,000
BHP 144,000BEDAH MSN 26325 INFUS SET DWS- TERUMO 1
IV CAT-SURFLO 20 1
RINGER LAKTAT-WB 1 30,000
OK MSN 27195 PISAU BEDAH 10 -AESCULAP 1
SARUNG TANGAN T GLOVE 7 4
MASKER TIE ON SUREPLUS 2
TOPI OPERASI 2
CATGUT CROMIC NO. 2/0 1
SARUNG TANGAN T GLOVE 7 1
SPUIT 5 CC TERUMO 2
SPUIT 3 CC TERUMO 1
BUVIPACAIN INJEKSI 1
KETOROLAC 30MG INJ DEXA 2
TRAMADOL INJ BERNO 2
ONDANSETRON 8MG INJ BERNO 1
RINGER LAKTAT-WB 1
SPINOCAN 25 G 1
Pronalges SUPP 100 1
POLYESTER 1 2
SURGICRIL 2/0 1
WIDAHES 130 ASKIN 1
AS. TRANEKSAMAT INJ 250 MG-BRN 2
FC 18 GR FLEXYCATH 1
URINE BAG COSMOMED 1
FENTANYL INJ-KF 1 603,000
BEDAH ANDY 26404 FC 16 GR FLEXYCATH 1
URINE BAG COSMOMED 1 24,000
1,605,7008 28/11 BEDAH HERRY ANDY ANIOS ADP 55,000 973,400
MD.211859 SKM28/11-02/12 IODINE 100 20,000
HIL d reponible WASH SCRUB 100 25,000
KASA 3 14,700
KASA SEDANG 2 22,000
CROMIC 2/0 1/2 4,900
SILK 2/0 1/2 2,100
LINAPEN 1 17,000
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 50 2,500
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 100 530,000
BHP 105,300
BEDAH MNS 3021 CEFTRIAXON INJ 1 G-HXP 2
SPUIT 10 CC TERUMO 2
TERANOL INJ 30 MG 2
CEFOTAXIM INJ 1 G-BERNO 2
SPUIT 5 CC TERUMO 2
SPUIT 3 CC TERUMO 3
RINGER LAKTAT-WB 2 98,500
973,4009 23/10 BEDAH KANDI AP 6679 INFUS SET 0I-34 1 13,860 13,860 1,692,716
3 MD.792759 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS
23/10-26/10 RINGER LAKTAT-WB 1 5,220 5,220
Reponible
24/10 BEDAH ANDY 23795 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
1 CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
optime 2/0 18s30j 1 95,040 95,040
24/10 OK YUDHIE 23620 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSETRON 8MG INJ 1 15,523 15,523
GREEN POLYESTER 2 86,724 173,448
NACL 0.9% 500 ML-WB 2 5,587 11,174
AS. TRANEKSAMAT INJ 250 MG-BRN 2 3,280 6,560
WIDAHES 130 ASKIN 1 61,800 61,800
SPINOCAN 25 G 1 36,366 36,366
BUVIPACAIN INJEKSI 1 23,760 23,760
PRONALGES SUPPO ASKIN 1 5,760 5,760
FENTANYL INJ-KF 1 36,960 36,960
.24/10 BEDAH ANDY 6717 KETOROLAC INJ 30-BRN 2 11,220 22,440
2 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
25/10 BEDAH ANDY 23686 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
26/10 BEDAH ANDY 23582 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA SEDANG 2 22,000
KASA SILVER 3 14,700
CROMIC 2/0 1/2 4,900
ALKOHOL 100 5,000
ARP 1 25,500
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 60 318,000
BHP 66,600
1,692,716 10 24/10 BEDAH HENDI ANDY 6927 INFUS SET 0I-34 1 13,860 13,860 1,898,070
3 MD 424658 IV CAT-SURFLO 20 1 11,136 11,136 SKM
24/10-28/10 SPUIT 5 CC TERUMO 1 1,848 1,848
24/10 BEDAH MN 6726 SURGICRIL 2/0 1 62,645 62,645
3 SURGICRIL MONOFILAMEN 4/0 1 59,601 59,601
RINGER LAKTAT-WB 1 5,220 5,220
IV CAT-SURFLO 20 1 11,136 11,136
INFUS SET 0I-34 1 13,860 13,860
25/10 BEDAH SIMAMORA 6792 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
2 CIPROFLOXACIN TAB 500 BERNO 10 318 3,180
KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 5 CC TERUMO 1 1,848 1,848
SPUIT 3 CC TERUMO 2 1,122 2,244
25/10 OK YUDHIE 23690 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSETRON 8MG INJ 1 15,523 15,523
GREEN POLYESTER 2 86,724 173,448
FC 18 GR GOLD RUSCH 1 20,493 20,493
URINE BAG COSMOMED 1 5,280 5,280
WIDAHES 130 ASKIN 1 61,800 61,800
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPINOCAN 25 G 1 36,366 36,366
BUVIPACAIN INJEKSI 1 23,760 23,760
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
FENTANYL INJ-KF 1 36,960 36,960
26/10 BEDAH ANDY 23569 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 3 CC TERUMO 3 1,122 3,366
SPUIT 5 CC TERUMO 3 1,848 5,544
27/10 BEDAH ANDY 23449 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 1 1,848 1,848
SPUIT 3 CC TERUMO 2 1,122 2,244
28/10 BEDAH ANDY 23327 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA SEDANG 2 22,000
KASA X RAY 2 26,800
SILK 2/0 1 4,200
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 100 5,000
LINAPEN 1 17,000
O2 0.4 4,400
N2O 0.25 31,500
ISOFLURENT 80 424,000
BHP 109,500
1,898,07011 27/11 BEDAH AYU ANDY ANIOS ADP 55,000 242,200
MD.686559 SKM
27/11-29/11 IODINE 100
HIL D Responibilis WASH SCRUB 100 ,,
KASA SEDANG 3 33,000 CROMIC 2/0 1 9,800 ARP 1 25,500 JARUM 1 15,000 LINAPEN 1 17,000 O2 0.4 4,400N2O 0.25 31,500ISOFLURENT 100
BHP 51,000 242,200
12 12-Oct BEDAH EKA ANDY 20385 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 2,177,2922 MD 611159 optime 2/0 18s30j 1 95,040 95,040 SKM
12/10-16/10 CROMIC 3/0 1 58,212 58,212
Hel s reponible INFUS SET 0I-34 1 13,860 13,860
IV CAT-SURFLO 20 1 11,136 11,136
RINGER LAKTAT-WB 1 5,220 5,220
SPUIT 5 CC TERUMO 1 1,848 1,848
13-Oct OK YUDHIE 22487 CROMIC 2/0 JABAR MEDIKA 1 61,710 61,710
1 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
SARUNG TANGAN TERUGLOVE 7.5 4 9,009 36,036
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
BUVIPACAIN INJEKSI 1 23,760 23,760
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ BERNO 1 7,883 7,883
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
ASERING 3 16,622 49,866
TOTOFUSIN OPS ASKIN 1 44,400 44,400
DEXAMETASON INJ.-LUCAS 3 1,386 4,158
TICRON 1 3113 71 3 74,844 224,532
NACL 0.9% 500 ML-WB 1 5,587 5,587
SARUNG TANGAN TERUGLOVE 7 2 9,009 18,018
SPINOCAN 25 G 1 36,366 36,366
EPHEDRIN INJ-ETHICA 2 14,520 29,040
AS. TRANEKSAMAT INJ 250 MG-BRN 2 3,280 6,560
PETHIDIN INJ-KF 1 14,390 14,390
13-Oct BEDAH ANDY 22306 CEFOTAXIM INJ 1 G-BERNO 2 4,801 9,602
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
14-Oct BEDAH ANDY 22357 CEFOTAXIM INJ 1 G-BERNO 2 4,801 9,602
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
15-Oct BEDAH ANDY 22120 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 4 5,220 20,880
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA SEDANG 4 44,000
CROMIC 2/0 1 9,800
ARP 1 25,500
JARUM 1 15,000
L1NAPEN 1 17,000
ALKOHOL 100 5,000
O2 0.4 4,400
N2O 0.25 31,500
ISOFLURENT 100 530,000
BHP 128,400
14-Oct ANDI 22367 MIKONAZOL CR-KF 1 4,000 4,000
14-Oct ANDI 20576 SPUIT 3 CC TERUMO 4
SPUIT 5 CC TERUMO 1
RINGER LAKTAT-WB 1
SPUIT 1 CC TUB TERUMO 1
AMPISILIN INJ BERNO 1
GENTAMYCIN INJ.-INF 1 25,500
2,177,29213 1-Nov BEDAH NUNU ANDI 7263 RATAN INJ ASKIN 2 1,200 2,400 92,646
2 MD.135659 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS
01/11-03/11 OTSU Y SET 1 11,484 11,484
Hil S reponible IV CAT-SURFLO 20 1 11,136 11,136
SPUIT 3 CC TERUMO 3 1,122 3,366
2-Nov BEDAH ANDI 7500 RINGER LAKTAT-WB 2 5,220 10,440
BHP 48,600
92,646
14 12-Dec BEDAH WIWI MN 26209 SURGICRIL 2/0 1 62,645 62,645 1,560,972
3 MD.413659 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 JAMKESMAS
12/12-16/12 INFUS SET 0I-34 1 13,860 13,860
HIL S REPONIBLE IV CAT-SURFLO 20 1 11,136 11,136
RINGER LAKTAT-WB 1 5,220 5,220
13-Dec BEDAH MS 25950 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
1 SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 5 CC TERUMO 1 1,848 1,848
13-Dec OK SIMMAMORA 25958 GREEN POLYESTER 2 86,724 173,448
1 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
SARUNG TANGAN GAMEX 7 .5 4 9,900 39,600
MASKER TIE ON SUREPLUS 4 792 3,168
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
SARUNG TANGAN TERUGLOVE 7.5 1 9,009 9,009
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 1 1,122 1,122
BUVIPACAIN INJEKSI 1 23,760 23,760
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ BERNO 4 7,883 31,532
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
RINGER LAKTAT-WB 1 5,220 5,220
SPINOCAN 25 G 1 36,366 36,366
PRONALGES SUPPO ASKIN 1 5,760 5,760
EPHEDRIN INJ-ETHICA 1 14,520 14,520
DEXAMETASON INJ.-LUCAS 3 1,386 4,158
FC 18 GR GOLD RUSCH 1 14,256 14,256
URINE BAG COSMOMED 1 5,280 5,280
SILK 2/0 Jabar medika 1 50,490 50,490
FENTANYL INJ-KF 1 36,960 36,960
MILOZ INJ 15 ASKIN 1 14,310 14,310
13-Dec BEDAH SIMMAMORA 25987 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
14-Dec BEDAH ANDY 27111 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
14-Dec BEDAH ANDY 27167 FOLIC ACID TAB 1 MG MARIN 3 48 144
1 CA GLUKONAS INJ 3 12,524 37,572
NASAL OKSIGEN DWS PASCHO 1 21,600 21,600
15-Dec BEDAH ANDY 27181 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
16/12 BEDAH ANDY 51050 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA SEDANG 5 55,000
SILK 2/0 1/2 2,100
LINAPEN 1 17,000
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 100 5,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 50 265,000
BHP 107,700
1,560,972TOTAL 18,647,003Rata-rata 1,331,928
Tabel biaya Pasian Fibro Adenoma MamaeOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL1 19-Oct BEDAH AI HIRIN ANDY 20813 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,342,838
2 MD 032459 INFUS SET 0I-34 1 13,860 13,860 SKM19/10-24/10 IV CAT-SURFLO 20 1 11,136 11,136
Sus fam D SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
20-Oct OK YUDHIE 23961 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSETRON 8MG INJ 1 15,523 15,523
PENROSE DRAIN 5/8 1 78,000 78,000
PRONALGES SUPPO ASKIN 1 5,760 5,760
Prostigmin INJ 1 15,500 15,500
FENTANYL INJ-KF 1 36,960 36,960
20-Oct OK YUDHIE 23809 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
21-Oct BEDAH ANDY 23860 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
22-Oct BEDAH ANDY 23739 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
1 KETOROLAC INJ 30-BRN 4 8,911 35,644
RINGER LAKTAT-WB 4 5,220 20,880
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 4 1,122 4,488
24-Oct BEDAH ANDY 23629 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 4 44,000
CROMIC 2/0 1 9,800
FORMALIN 10 500
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 100 5,000
LINAPEN 1 17,000
O2 0.4 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 141,600
1,342,8382 6-Nov BEDAH SOPIA ANDY 28042 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,315,764
2 MD 675059 INFUS SET 0I-34 1 13,860 13,860 JAMKESMAS
06/11-09/11 IV CAT-SURFLO 20 1 11,136 11,136
FAM D SPUIT 5 CC TERUMO 1 1,848 1,848
CROMIC 3/0 1 58,212 58,212
7-Nov BEDAH AP 28082 SPUIT 5 CC TERUMO 2 1,848 3,696
2 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
7-Nov OK YUDHIE 24964 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 3 5,220 15,660
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
FENTANYL INJ-KF 1 36,960 36,960
DARYANTUL 1 15,394 15,394
PENROSE DRAIN 5/8 1 78,000 78,000
ATROPIN INJ-ETHICA 2 3,049 6,098
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
8-Nov BEDAH AP 28082 SPUIT 5 CC TERUMO 2 1,848 3,696
2 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 3 CC TERUMO 2 1,122 2,244
09/11 BEDAH ANDY 24,735 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA 4 44,000
CROMIC 2/0 1/2 4,900
FORMALIN 20 1,000
ALKOHOL 100 5,000
ARP 1 25,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 1 4,400
N2O 0.25 31,500
ISOFLURENT 60 318,000
BHP 66,600
1,315,7643 23/10 BEDAH HIDAYATI AP 6678 INFUS SET 0I-34 1 13,860 13,860 1,163,791
3 MD.073059 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS
23/10-26/10 RINGER LAKTAT-WB 1 5,220 5,220
Susp FAM S
24/10 BEDAH ANDY 23796 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
24/10 OK YUDHIE 23621 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSETRON 8MG INJ 1 15,523 15,523
PENROSE DRAIN 5/8 1 78,000 78,000
DARYANTUL 1 15,394 15,394
INFUS SET 0I-34 1 13,860 13,860
IV CAT-SURFLO 18 1 11,136 11,136
PRONALGES SUPPO ASKIN 1 5,760 5,760
Prostigmin INJ 2 15,500 31,000
FENTANYL INJ-KF 1 36,960 36,960
.24/10 BEDAH ANDY 6716 KETOROLAC INJ 30-BRN 2 11,220 22,440
2 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
25/10 BEDAH ANDY 23682 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
26/10 BEDAH ANDY 23581 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 1 11,000
KASA SILVER 2 9,800
CROMIC 2/0 1/2 4,900
ALKOHOL 50 2,500
FORMALIN 10 500
ARP 1 25,500
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 66,600
1,163,7914 6-Nov BEDAH MARYANI ANDY 28045 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,153,492
2 MD 456056 INFUS SET 0I-34 1 13,860 13,860 JAMKESMAS
06/11-09/11 IV CAT-SURFLO 20 1 11,136 11,136
FAM S BILATERAL SPUIT 5 CC TERUMO 1 1,848 1,848
7-Nov BEDAH ANDY 24818 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
AMOKSISILIN 500 KF 10 444 4,440
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
7-Nov OK YUDHIE 24966 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 3 5,220 15,660
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
FENTANYL INJ-KF 1 36,960 36,960
DARYANTUL 1 15,394 15,394
PENROSE DRAIN 5/8 1 78,000 78,000
ATROPIN INJ-ETHICA 2 3,049 6,098
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
8-Nov BEDAH ANDY 24866 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
09/11 BEDAH ANDY 24,736 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA 4 44,000
CROMIC 2/0 1/2 4,900
FORMALIN 20 1,000
ALKOHOL 50 2,500
ARP 1 25,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 66,600
1,153,4925 .23/11 BEDAH SANTI ANDY 50088 RINGER LAKTAT-WB 1 5,220 5,220 1,213,735
2 MD 756559 INFUS SET 0I-34 1 13,860 13,860 JAMKESMAS
23/11-28/11 IV CAT-SURFLO 20 1 11,136 11,136
Fam D SPUIT 5 CC TERUMO 1 1,848 1,848
24-Nov BEDAH ANDY 51000 IV CAT-SURFLO 20 1 11,136 11,136
1 IV CAT-SURFLO 22 1 11,136 11,136
24-Nov BEDAH ANDY 28613 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
24-Nov OK ANDY 28633 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ BERNO 4 7,883 31,532
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
IV CAT-SURFLO 20 1 11,136 11,136
EPINEPRIN INJ-ETHICA 2 2,901 5,802
FENTANYL INJ-KF 1 36,960 36,960
24-Nov BEDAH ANDY 28690 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
25-Nov BEDAH ANDY 28722 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 1 8,911 8,911
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 1 1,848 1,848
SPUIT 3 CC TERUMO 2 1,122 2,244
BURNAZIN CR 35 G 1 40,953 40,953
26-Nov BEDAH ANDY 28787 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966
1 KETOROLAC INJ 30-BRN 4 8,911 35,644
RINGER LAKTAT-WB 4 5,220 20,880
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 4 1,122 4,488
27-Nov BEDAH MARUHUM 50708 RINGER LAKTAT-WB 1 5,220 5,220
1 SPUIT 5 CC TERUMO 1 1,848 1,848
SPUIT 20 CC WITHOUT N TER 1 5,742 5,742
28-Nov BEDAH MARUHUM 25174 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA 4 44,000
CROMIC 2/0 1/2 4,900
ALKOHOL 50 2,500
FORMALIN 20 1,000
ARP 1 25,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 135,600
1,213,7356 4-Dec BEDAH SITI NURITHA ANDY ANIOS ADP 55,000 499,000
MD.047259 SKM04/12-06/12 IODINE 100 20,000
FAM d multiple WASH SCRUB 100 25,000
KASA SEDANG 3 33,000
SILK 2/0 1/2 2,100
FORMALIN 20 1,000
ARP 1 25,500
ALKOHOL 100 5,000
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 51,000
ANDI 22368 KALNEX 500 28,000
499,0007 .30/11 BEDAH DEWI ANDY 50548 INFUS SET 0I-34 1 13,860 13,860 1,278,998
2 MD 285346 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 JAMKESMAS
30/11-03/12 RINGER LAKTAT-WB 1 5,220 5,220
FAM S IV CAT-SURFLO 22 1 11,136 11,136
01/12 OK YUDHIE 25315 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
PENROSE DRAIN 5/8 1 78,000 78,000
CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
DEXAMETASON INJ.-LUCAS 5 1,386 6,930
Prostigmin INJ 2 15,500 31,000
EPHEDRIN INJ-ETHICA 2 14,520 29,040
FENTANYL INJ-KF 1 36,960 36,960
1/12 BEDAH AP 50584 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
2 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 3 1,848 5,544
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
02/12 BEDAH ANDY 25363 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
03/12 BEDAH ANDY 25454 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 75 15,000
WASH SCRUB 75 18,750
KA SA SEDANG 2 22,000
CROMIC 2/0 1 9,800
KASA SILVER 2 9,800
FORMALIN 10 500
ARP 1 25,500
ALKOHOL 50 2,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 60 318,000
BHP 66,600
1,278,998 TOTAL 7,967,618 Rata-rata 1,138,231
Tabel Biaya Pasien LimpomatosisOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 3-Oct BEDAH HEDI MN 6303 IV CAT-SURFLO 20 1 11,136 11,136 1,299,540
3 MD 414358 INFUS SET 0I-34 1 13,860 13,860 JAMKESMAS
03/10-05/10 RINGER LAKTAT-WB 1 5,220 5,220
Lipomatosis SPUIT 5 CC TERUMO 1 1,742 1,742
BLUE NYLON 3/0 CUTING/BLUE MONOLON 2 53,460 106,920
4-Oct OK YUDHIE 22718 PISAU BEDAH 10 -AESCULAP 1 2,701 2,701
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
PROANES INJ 1 75,240 75,240
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 11,220 33,660
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,233 2,233
SPUIT 3 CC TERUMO 1 1,371 1,371
SPUIT 5 CC TERUMO 1 1,742 1,742
RINGER LAKTAT-WB 3 5,220 15,660
ONDANSETRON 8MG INJ 1 15,523 15,523
ATROPIN INJ-ETHICA 2 3,049 6,098
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
PRONALGES SUPPO ASKIN 1 5,760 5,760
AS. TRANEKSAMAT INJ 250 MG-BRN 1 3,280 3,280
CROMIC 2/0 SHARPOINT 2 61,710 123,420
FENTANYL INJ-KF 1 36,960 36,960
4-Oct BEDAH MN 6410 RINGER LAKTAT-WB 3 5,220 15,660
2 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
SPUIT 1 CC TUB TERUMO 1 1,955 1,955
KETOROLAC INJ 30-BRN 2 11,220 22,440
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 3 CC TERUMO 2 1,371 2,742
SPUIT 5 CC TERUMO 2 1,742 3,484
5-Oct BEDAH ANDY 20062 AMOKSISILIN 500 KF 10 444 4,440
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA SILVER 6 29,400
CROMIC 2/0 1 29,400
SILK 2/0 1 4,200
ALKOHOL 100 5,000
ARP 1 25,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 49,800
1,299,540
2 18-Dec BEDAH NANA ANDY 27984 INFUS SET 0I-34 1 13,860 13,860 2,240,2652 MD.020461 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS
18/12-21/12 RINGER LAKTAT-WB 1 5,220 5,220
Lipomatosis SPUIT 5 CC TERUMO 1 1,848 1,848
NYLON 4/0 D5 18 SHARPOINT 2 56,100 112,200
CROMIC 4/0 JABAR MEDIKA 1 67,320 67,320
18-Dec BEDAH MN 27994 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
3 SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 5 CC TERUMO 1 1,848 1,848
19-Dec OK YUDHIE 51186 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN GAMEX 7 .5 4 9,900 39,600
MASKER TIE ON SUREPLUS 4 792 3,168
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ BERNO 4 7,883 31,532
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
PEMBALUT ELASTIS TENSOCREPE 10 CM4" 1 68,883 68,883
Prostigmin INJ 2 15,500 31,000
DEXAMETASON INJ.-LUCAS 4 1,386 5,544
FENTANYL INJ-KF 1 36,960 36,960
19-Dec BEDAH SIMAMORA 27839 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
3 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
20-Dec BEDAH ANDY 52063 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 SPUIT 5 CC TERUMO 2 1,848 3,696
21-Dec ANDY 52136 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KA SA SEDANG 5 55,000
ALKOHOL 100 5,000
FORMALIN 40 2,000
ARP 1 25,500
CROMIC 2/0 1/2 4,900
SILK 2/0 1 4,200
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 89,700
28-Dec BEDAH ANDY 29617 RINGER LAKTAT-WB 1
IV CAT-SURFLO 20 1
INFUS SET DWS- TERUMO 1 30,000
YUDHIE 52750 PISAU BEDAH 10 -AESCULAP 1
CROMIC 2/0 JABAR MEDIKA 1
TOPI OPERASI 2
MASKER TIE ON SUREPLUS 2
SARUNG TANGAN T GLOVE 6.5 1
NYLON 3/0 D5 24 SHARPOINT 1
PROANES INJ 1
KALTROFEN SUPP 1
TERANOL INJ 30 MG 5
SPUIT 10 CC TERUMO 1
SPUIT 3 CC TERUMO 1
SPUIT 5 CC TERUMO 1
ONDANE INJ 8MG 1
RINGER LAKTAT-WB 1
SARUNG TANGAN T GLOVE 6.5 2
SURGIVIT STILE 2/0 TAPER 1
TICRON 1 3113 71 1
KALTROFEN SUPP 1
DEXAMETASON INJ.-LUCAS 2 741,000
MARHUM 29701 CEFOTAXIM INJ 1 G-BERNO 2
TERANOL INJ 30 MG 2
RINGER LAKTAT-WB 3
GLUKOSE 5 %-WD 2
SPUIT 5 CC TERUMO 2
SPUIT 3 CC TERUMO 2
SPUIT 1 CC INS TERUMO 1 108,000
SIMAMORA 52572 CEFOTAXIM INJ 1 G-BERNO 4
TERANOL INJ 30 MG 2
SPUIT 3 CC TERUMO 4
SPUIT 5 CC TERUMO 4 95,000
2,240,2653 6-Nov BEDAH MIMIN ANDY 28045 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 1,267,575
2 MD 144759 INFUS SET 0I-34 1 13,860 13,860 SKM06/11-10/11 IV CAT-SURFLO 20 1 11,136 11,136
Limphoma Acute SPUIT 5 CC TERUMO 1 1,848 1,848
7-Nov BEDAH ANDY 28100 SPUIT 5 CC TERUMO 2 1,848 3,696
3 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
7-Nov OK YUDHIE 24965 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 3 5,220 15,660
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
FENTANYL INJ-KF 1 36,960 36,960
PENROSE DRAIN 5/8 1 78,000 78,000
ATROPIN INJ-ETHICA 2 3,049 6,098
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
8-Nov BEDAH ANDY 24861 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
9-Nov BEDAH ANDY 24732 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
10-Nov BEDAH SIMMAMOR 24614 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
1 METRONIDAZOL 500 BERNO 15 140 2,100
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 4 44,000
CROMIC 2/0 1/2 4,900
FORMALIN 20 1,000
ARP 1 25,500
ALKOHOL 50 2,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 115,000
9-NOV BEDAH ANDY 25458 TRAMADOL TAB 50 berno 10
NUTRIFLAM KAP 6 41,000
1,267,5754 14-Nov BEDAH ALIT ANDI ANIOS ADP 55,000 505,900
MD.151753 SKM14/11-16/11 IODINE 150 30,000
Limphoma Kista Ateron WASH SCRUB 100 25,000
KASA SILVER 3 14,700
CROMIC 2/0 2 19,600
KASA SEDANG 2 22,000
FORMALIN 10 500
SILK 2/0 1 4,200
ARP 1 25,500
ALKOHOL 100 5,000
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 51,000
505,9005 1-Nov MATA DEDE AMARANITH 7184 SARUNG TANGAN TERUGLOVE 6.5 8 9,009 72,072 1,422,252
MD.022759 TOPI OPERASI 2 792 1,584 JAMKESMAS
01/11-01/11 MASKER TIE ON SUREPLUS 2 792 1,584
Limpomatosis SPUIT 5 CC TERUMO 1 1,848 1,848
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
LIDOKAIN INJ 2% LUCAS 1 1,254 1,254
CHLORAMFENICOL. SM-KF 1 1,876 1,876
NYLON 10/0 1 198,000 198,000
VYCRIL 8/0-ETHICON 1 198,000 198,000
DEXAMETASON INJ.-LUCAS 1 1,386 1,386
GENTAMYCIN INJ.-INF 1 4,032 4,032
RINGER LAKTAT-WB 1 5,220 5,220
INFUS SET 0I-34 1 13,860 13,860
NEDDLE 27 G TER 1 326 326
AMOKSISILIN 500 KF 9 444 3,996
BHP OK 63,900
BHP MATA 840,000
30-Oct BEDAH ANIS ANDY 7082 IV CAT-SURFLO 20 1 11,136 11,136
1,422,2526 7-Nov BEDAH ELAH SIMAMORA 28103 INFUS SET 0I-34 1 13,860 13,860 995,094
3 MD 291859 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS
07/11-09/11 RINGER LAKTAT-WB 1 5,220 5,220
LIPOMA SPUIT 5 CC TERUMO 1 1,848 1,848
8-Nov OK YUDHIE 24855 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
PENROSE DRAIN 5/8 1 78,000 78,000
FENTANYL INJ-KF 1 36,960 36,960
8-Nov BEDAH ANDY 24899 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
7-Nov BEDAH ANDY 24844 NYLON 2/0 SHARPOINT 1 61,710 61,710
09/11 BEDAH ANDY 24,737 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA 3 33,000
SILK 2/0 1/2 2,100
ALKOHOL 50 2,500
ARP 1 25,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 1 4,400
N2O 0 31,500
ISOFLURENT 35 185,500
BHP 51,000
995,094
7 2 Eman RINGER LAKTAT-WB 1 5,220 5,220 1,272,673
MD 625059 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS
04/12-06/12 SPUIT 5 CC TERUMO 1 1,848 1,848
Sub Limphoma NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
5-Dec BEDAH ANDY 25516 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
5-Dec OK YUDHIE 50265 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ BERNO 4 7,883 31,532
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
DEXAMETASON INJ.-LUCAS 3 1,386 4,158
EPHEDRIN INJ-ETHICA 1 14,520 14,520
FENTANYL INJ-KF 1 36,960 36,960
6-Dec BEDAH ANDY 25583 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 3 33,000
CROMIC 2/0 1 9,800
FORMALIN 20 1,000
ARP 1 25,500
ALKOHOL 100 5,000
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
SEVOFLURENT 35 455,000
BHP 49,800
1,272,673TOTAL 9,003,299Rata-rata 1,286,185
Tabel Biaya Pasien Tumor Mamae DexOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 24-Oct BEDAH ENTIN MN 6731 CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710 1,561,331
3 MD.930459 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 JAMKESMAS
24/10-27/10 RINGER LAKTAT-WB 1 5,220 5,220
Tumor Mammae IV CAT-SURFLO 20 1 11,136 11,136
INFUS SET 0I-34 1 13,860 13,860
25-Oct BEDAH ANDY 23663 CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
1 BLUE NYLON 3/0 CUTING/BLUE MONOLON 1 56,100 56,100
.25/10 BEDAH MN 6798 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
3 CIPROFLOXACIN TAB 500 -INF 6 636 3,816
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
TERANOL INJ 30 MG 2 27,456 54,912
SPUIT 1 CC TUB TERUMO 2 2,178 4,356
SPUIT 5 CC TERUMO 2 1,742 3,484
SPUIT 3 CC TERUMO 2 1,371 2,742
25-Oct OK YUDHIE 23691 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSETRON 8MG INJ 1 15,523 15,523
PENROSE DRAIN 5/8 1 78,000 78,000
Prostigmin INJ 1 15,500 15,500
PRONALGES SUPPO ASKIN 1 5,760 5,760
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
FENTANYL INJ-KF 1 36,960 36,960
26-Oct BEDAH ANDY 23566 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 CIPROFLOXACIN infus-DX 2 30,024 60,048
KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 3 CC TERUMO 3 1,122 3,366
SPUIT 5 CC TERUMO 3 1,848 5,544
27-Oct BEDAH ANDY 23440 AMOKSISILIN 500 KF 15 444 6,660
1 CIPROFLOXACIN TAB 500 -INF 6 636 3,816
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 4 44,000
SILK 2/0 1 4,200
FORMALIN 10 500
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 100 5,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 86,100
1,561,3312 .9/10 BEDAH LINA ANDY 20236 RINGER LAKTAT-WB 1 5,220 5,220 1,238,370
3 MD 220659 IV CAT-SURFLO 20 1 11,136 11,136 SKM09/10-13/10 INFUS SET 0I-34 1 13,860 13,860
Tumor Mammae NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
10-Oct BEDAH ANDY 20277 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
2 KETOROLAC 30MG INJ DEXA 2 8,853 17,706
SPUIT 1 CC INS TERUMO 1 3,010 3,010
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
10-Oct OK YUDHIE 22532 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 2 5,220 10,440
ONDANSETRON 8MG INJ 1 15,523 15,523
PENROSE DRAIN 5/8 1 78,000 78,000
PRONALGES SUPPO ASKIN 1 5,760 5,760
Prostigmin INJ 2 15,500 31,000
FENTANYL INJ-KF 1 36,960 36,960
11-Oct BEDAH ANDY 22659 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
12-Oct BEDAH ANDY 22412 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
13-Oct BEDAH ANDY 22481 AMOKSISILIN 500 KF 15 444 6,660
1 CIPROFLOXACIN TAB 500 -INF 10 636 6,360
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 4 44,000
CROMIC 2/0 1 9,800
ARP 1 25,500
FORMALIN 10 500
ALKOHOL 100 5,000
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 104,100
1,283,3703 2-Nov BEDAH PIPIT SIMAMORA 7321 INFUS SET 0I-34 1 13,860 13,860 1,328,228
2 MD 520959 IV CAT-SURFLO 20 1 11,136 11,136 JAMKESMAS
02/11-08/11 RINGER LAKTAT-WB 1 5,220 5,220
Tumor Mammae
2-Nov BEDAH SIMAMORA 7334 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
3-Nov OK YUDHIE 23197 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
PENROSE DRAIN 5/8 1 78,000 78,000
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
FENTANYL INJ-KF 1 36,960 36,960
3-Nov BEDAH MN 7381 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
3 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
4-Nov BEDAH ANDY 23047 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 3 1,848 5,544
RINGER LAKTAT-WB 2 5,220 10,440
6-Nov BEDAH SIMAMORA 28020 INFUS SET 0I-34 1 13,860 13,860
2 IV CAT-SURFLO 20 1 11,136 11,136
5-Nov BEDAH ANDY 23094 CEFOTAXIM INJ 1 G-HXP 4 4,895 19,580
1 KETOROLAC INJ 30-BRN 4 8,911 35,644
SPUIT 5 CC TERUMO 4 1,848 7,392
SPUIT 3 CC TERUMO 4 1,122 4,488
7-Nov BEDAH ANDY 24948 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
8-Nov BEDAH ANDY 24854 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 4 44,000
ALKOHOL 50 2,500
SILK 2/0 1/2 2,100
ARP 1 25,500
FORMALIN 30 1,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 207,600
1,328,2284 6-Nov BEDAH HENI ANDY 28,040 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,084,047
2 MD 576556 INFUS SET 0I-34 1 13,860 13,860 JAMKESMAS
06/11-09/11 IV CAT-SURFLO 20 1 11,136 11,136
Tumor Mammae SPUIT 5 CC TERUMO 1 1,848 1,848
07/11 BEDAH ANDY 2,408 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 1 5,220 5,220
GLUKOSE 5 %-WD 1 4,247 4,247
07/11 OK YUDHIE 24,963 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 3 5,220 15,660
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
FENTANYL INJ-KF 1 36,960 36,960
DARYANTUL 1 15,394 15,394
PENROSE DRAIN 5/8 1 78,000 78,000
ATROPIN INJ-ETHICA 2 3,049 6,098
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
08/11 BEDAH ANDY 24,862 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA 3 33,000
CROMIC 2/0 1 4,900
FORMALIN 10 500
ARP 1 25,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 1 4,400
N2O 0 31,500
ISOFLURENT 40 212,000
BHP 63,000
1,084,0475 14-Dec BEDAH FUJI ANDY ANIOS ADP 55,000 568,500
MD.790161 JAMKESMAS
14/12-19/12 IODINE 100 20,000
Tumor Mammae WASH SCRUB 100 25,000
KASA SEDANG 3 33,000
SILK 2/0 1 4,200
LINAPEN 1 17,000
ARP 1 25,500
FORMALIN 20 1,000
JARUM 1 15,000
ALKOHOL 100 5,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 146,400
568,500TOTAL 5,780,476Rata-rata 1,156,095
Tabel Biaya Pasien AppendicitisOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 3-Oct BEDAH SRI I MN 6305 IV CAT-SURFLO 20 1 11,136 11,136 2,024,381
3 MD 924658 INFUS SET 0I-34 1 13,860 13,860 SKM
03/10-07/10 RINGER LAKTAT-WB 1 5,220 5,220
Apenddicitis Kronik SPUIT 5 CC TERUMO 1 1,742 1,742
optime 2/0 18s30j 1 95,040 95,040
NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
4-Oct OK YUDHIE 22719 STOMAG TUIBE 16 TERUMO 125 CM 1 15,444 15,444
1 URINE BAG COSMOMED 1 5,940 5,940
PROANES INJ 1 75,240 75,240
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 11,220 33,660
TRAMADOL INJ.-INF 2 7,244 14,488
SPUIT 10 CC TERUMO 1 2,233 2,233
SPUIT 3 CC TERUMO 1 1,371 1,371
SPUIT 5 CC TERUMO 1 1,742 1,742
RINGER LAKTAT-WB 3 5,220 15,660
ETT 6,5 RUSCH 1 77,933 77,933
DEXAMETASON INJ.-LUCAS 4 1,386 5,544
ATROPIN INJ-ETHICA 1 3,049 3,049
ONDANSETRON 8MG INJ 1 15,523 15,523
Prostigmin INJ 2 15,500 31,000
PISAU BEDAH 10 -AESCULAP 1 2,701 2,701
SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
SILK 2/0 SHARPOINT 3 50,490 151,470
NACL 0.9% 500 ML-WB 2 4,834 9,668
SARUNG TANGAN TERUGLOVE 6.5 4 9,009 36,036
SURGIVIT STILE 2/0 TAPER 1 95,040 95,040
POLYSIN IC 14 1 89,760 89,760
FENTANYL INJ-KF 1 36,960 36,960
4-Oct BEDAH MN 6411 RINGER LAKTAT-WB 2 5,220 10,440
2 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
SPUIT 1 CC TUB TERUMO 1 1,955 1,955
KETOROLAC INJ 30-BRN 2 11,220 22,440
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 3 CC TERUMO 2 1,371 2,742
SPUIT 5 CC TERUMO 2 1,742 3,484
5-Oct BEDAH ANDY 20020 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
1 KETOROLAC INJ 30-BRN 2 11,220 22,440
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 2 1,742 3,484
SPUIT 3 CC TERUMO 2 1,371 2,742
6-Oct BEDAH ANDY 22769 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
1 KETOROLAC INJ 30-BRN 2 11,220 22,440
SPUIT 5 CC TERUMO 2 1,742 3,484
SPUIT 3 CC TERUMO 2 1,371 2,742
6-Oct BEDAH ANDY 6471 IV CAT-SURFLO 20 1 11,136 11,136
2 INFUS SET 0I-34 1 13,860 13,860
7-Oct BEDAH ANDY 20159 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA 4 44,000
KASA SILVER 3 14,700
CROMIC 2/0 2 19,600
ALKOHOL 100 5,000
SILK 2/0 2 8,400
ARP 1 25,500
FORMALIN 10 500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 50 265,000
BHP 110,700
2,024,381
2 7-Oct BEDAH DEDE ANDY 20181 RANITIDIN INJ BERNO 1 2,146 2,146 1,951,949
MD.092459 SPUIT 3 CC TERUMO 1 1,371 1,371 SKM
07/10-11/10 SPUIT 5 CC TERUMO 1 1,742 1,742
Appendicitis Akut PARASETAMOL MARIN 6 120 720
8-Oct BEDAH ANDY 22606 CEFOTAXIM INJ 1 G-BERNO 4 4,801 19,204
1 RINGER LAKTAT-WB 4 5,220 20,880
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 5 CC TERUMO 4 1,742 6,968
SPUIT 1 CC TUB TERUMO 1 1,955 1,955
8-Oct OK YUDHIE 22630 PISAU BEDAH 10 -AESCULAP 2 2,701 5,402
1 SARUNG TANGAN TERUGLOVE 6.5 8 9,009 72,072
SARUNG TANGAN TERUGLOVE 7.5 6 9,009 54,054
SURGIVIT STILE 3/0 AILEE 1 81,972 81,972
SURGIVIT STILE 1 CUTTING/SURGION 1 97,416 97,416
STOMAG TUIBE 18 TERUMO 125 CM 1 15,444 15,444
URINE BAG COSMOMED 1 5,940 5,940
NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
SILK 2/0 TUNAS 1 48,708 48,708
DARYANTUL 1 15,394 15,394
NACL 0.9% 500 ML-WB 4 4,834 19,336
TOPI OPERASI 3 792 2,376
MASKER TIE ON SUREPLUS 3 792 2,376
CURASPON 3 50,160 150,480
PROANES INJ 1 75,240 75,240
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 11,220 33,660
TRAMADOL INJ.-INF 2 7,244 14,488
SPUIT 10 CC TERUMO 1 2,233 2,233
SPUIT 3 CC TERUMO 1 1,371 1,371
SPUIT 5 CC TERUMO 1 1,742 1,742
RINGER LAKTAT-WB 1 5,220 5,220
ETT 6,5 RUSCH 1 77,933 77,933
DEXAMETASON INJ.-LUCAS 3 1,386 4,158
ATROPIN INJ-ETHICA 1 3,049 3,049
ONDANSETRON 8MG INJ 1 15,523 15,523
EPHEDRIN INJ-ETHICA 2 14,520 29,040
WIDAHES 130 ASKIN 1 61,800 61,800
PETHIDIN INJ-KF 1 14,390 14,390
MILOZ INJ 15 ASKIN 1 14,310 14,310
8-Oct BEDAH ANDY 20181 CEFOTAXIM INJ 1 G-BERNO 2 4,801 9,602
1 DIAZOLE INF ASKIN 3 9,600 28,800
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 1,955 1,955
SPUIT 3 CC TERUMO 2 1,371 2,742
SPUIT 5 CC TERUMO 2 1,742 3,484
KETOROLAC INJ 30-BRN 2 11,220 22,440
9-Oct BEDAH ANDY 20204 CEFOTAXIM INJ 1 G-BERNO 1 4,801 4,801
1 KETOROLAC INJ 30-BRN 1 11,220 11,220
SPUIT 3 CC TERUMO 1 1,371 1,371
SPUIT 5 CC TERUMO 1 1,742 1,742
10-Oct BEDAH ANDY 22520 CEFOTAXIM INJ 1 G-BERNO 2 4,801 9,602
1 KETOROLAC INJ 30-BRN 2 11,220 22,440
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 2 1,742 3,484
SPUIT 3 CC TERUMO 2 1,371 2,742
11-Oct BEDAH ANDY 22671 AMOKSISILIN 500 KF 15 444 6,660
1 METRONIDAZOL 500 BERNO 15 224 3,360
ANTASID TAB.-KF 15 110 1,650
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA X RAY 4 53,600
ARP 1 25,500
FORMALIN 10 500
ALKOHOL 100 5,000
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 60 318,000
BHP 108,900
1,951,949
3 11-Nov IGD YONI HENNY 24574 INFUS SET 0I-34 1 13,860 13,860 1,999,021
1 MD.556859 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS
11/11-15/11 IV CAT-SURFLO 20 1 11,136 11,136
Appendic Aeut RATAN INJ ASKIN 1 1,200 1,200
SPUIT 3 CC TERUMO 1 1,122 1,122
11-Nov IGD HENNY 24598 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
1 SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 5 CC TERUMO 1 1,848 1,848
DIAZOLE INF ASKIN 1 9,600 9,600
KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
11-Nov BEDAH ANDY 28345 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
3 DIAZOLE INF ASKIN 2 9,600 19,200
KETOROLAC INJ 30-BRN 1 8,911 8,911
SPUIT 5 CC TERUMO 1 1,848 1,848
SPUIT 3 CC TERUMO 1 1,122 1,122
RINGER LAKTAT-WB 2 5,220 10,440
11-Nov OK YUDHIE 28500 PISAU BEDAH 10 -AESCULAP 2 2,072 4,144
3 SARUNG TANGAN TERUGLOVE 6.5 8 9,009 72,072
SARUNG TANGAN TERUGLOVE 7.5 6 9,009 54,054
SURGIVIT STILE 3/0 AILEE/SURGION 1 81,972 81,972
SURGIVIT STILE 1 CUTTING/SURGION 1 97,416 97,416
STOMAG TUIBE 18 TERUMO 125 CM 1 16,632 16,632
URINE BAG COSMOMED 1 5,280 5,280
NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
SILK 2/0 TUNAS 1 48,708 48,708
DARYANTUL 1 15,394 15,394
NACL 0.9% 500 ML-WB 4 5,587 22,348
TOPI OPERASI 3 792 2,376
MASKER TIE ON SUREPLUS 3 792 2,376
CURASPON 80X50X10 3 41,844 125,532
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
SPUIT 10 CC TERUMO 2 2,027 4,054
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
ETT 6,5 RUSCH 1 53,460 53,460
RINGER LAKTAT-WB 1 5,220 5,220
WIDAHES 130 ASKIN 1 61,800 61,800
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
PRONALGES SUPPO ASKIN 1 5,760 5,760
SILK 2/0 Jabar medika 2 50,490 100,980
FENTANYL INJ-KF 1 36,960 36,960
12-Nov BEDAH ANDY 28397 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
2 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
GLUKOSE 5 %-WD 1 4,247 4,247
RINGER LAKTAT-WB 2 5,220 10,440
.13/11 BEDAH ANDY 7476 SPUIT 5 CC TERUMO 3 1,848 5,544
1 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
SPUIT 3 CC TERUMO 2 1,122 2,244
KETOROLAC INJ 30-BRN 2 8,911 17,822
13-Nov BEDAH ANDY 28420 IV CAT-SURFLO 20 1 11,136 11,136
3 INFUS SET 0I-34 1 13,860 13,860
13-Nov BEDAH ANDY 28500 NASAL OKSIGEN DWS PASCHO 1 21,600 21,600
14-Nov BEDAH SIMMAMOR 24121 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
15-Nov BEDAH SIMMAMOR 24509 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
1 RANITIDIN TAB 150-BERNO 10 216 2,160
ANIOS ADP 55,000
IODINE 150 30,000
WASH SCRUB 150 37,500
KASA SEDANG 3 33,000
X RAY 2 26,800
CROMIC 2/0 1 9,800
ALKOHOL 100 5,000
ARP 1 25,500
FORMALIN 10 500
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 50 265,000
BHP 141,000
1,999,021
4 15-Nov BEDAH YUNI ANDY 24000 INFUS SET 0I-34 1 13,860 13,860 1,825,305
1 MD.473259 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS
14/11-18/11 SPUIT 5 CC TERUMO 1 1,848 1,848
Appendicitis
15-Nov BEDAH ANDY 24011 IV CAT-SURFLO 22 2 11,136 22,272
15-Nov OK YUDHIE 24178 optime 2/0 18s30j 1 95,040 95,040
1 ADVANTIME 4/0 1 118,800 118,800
15-Nov OK YUDHIE 24195 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 2-0 TAPER SURGIVENT 3 61,710 185,130
NYLON 3/0 D5 24 SHARPOINT 2 56,100 112,200
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
SILK 2/0 Jabar medika 2 50,490 100,980
IV CAT-SURFLO 18 1 11,136 11,136
INFUS SET 0I-34 1 13,860 13,860
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
Prostigmin INJ 2 15,500 31,000
EPHEDRIN INJ-ETHICA 2 14,520 29,040
FENTANYL INJ-KF 1 36,960 36,960
15-Nov BEDAH MN 29112 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966
2 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
16-Nov BEDAH ANDY 24590 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
17-Nov BEDAH ANDY 24357 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
18-Nov BEDAH ANDY 24262 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 2 22,000
KASA X RAY 1 13,400
CROMIC 2/0 2 19,600
SILK 2/0 1 4,200
ARP 1 25,500
FORMALIN 20 1,000
ALKOHOL 100 5,000
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 60 318,000
BHP 107,700
1,825,3085 21-Nov IGD NENA HENY 25946 INFUS SET 0I-34 1 13,860 13,860 1,017,723
MD.718059 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS
21/11-29/11 IV CAT-SURFLO 20 1 11,136 11,136
Appendicitis Acut KETOROLAC INJ 30-BRN 1 8,911 8,911
CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
DIAZOLE INF ASKIN 1 9,600 9,600
GENTAMYCIN INJ.-INF 1 4,032 4,032
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 5 CC TERUMO 3 1,848 5,544
21-Nov BEDAH ANDY 28914 CEFOTAXIM INJ 1 G-HXP 3 4,895 14,685
1 DIAZOLE INF ASKIN 3 9,600 28,800
GENTAMYCIN INJ.-INF 2 4,032 8,064
KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 4 1,122 4,488
SPUIT 5 CC TERUMO 3 1,848 5,544
RINGER LAKTAT-WB 2 5,220 10,440
22-Nov BEDAH ANDY 28963 KETOROLAC INJ 30-BRN 2 8,911 17,822
1 RINGER LAKTAT-WB 2 5,220 10,440
CEFOTAXIM INJ 1 G-HXP 3 4,895 14,685
DIAZOLE INF ASKIN 3 9,600 28,800
GENTAMYCIN INJ.-INF 2 4,032 8,064
SPUIT 3 CC TERUMO 4 1,122 4,488
SPUIT 5 CC TERUMO 3 1,848 5,544
23-Nov BEDAH ANDY 28842 CEFOTAXIM INJ 1 G-HXP 3 4,895 14,685
1 DIAZOLE INF ASKIN 3 9,600 28,800
GENTAMYCIN INJ.-INF 2 4,032 8,064
KETOROLAC 30MG INJ DEXA 3 8,853 26,559
24-Nov BEDAH ANDY 28640 CEFOTAXIM INJ 1 G-HXP 3 4,895 14,685
1 DIAZOLE INF ASKIN 3 9,600 28,800
GENTAMYCIN INJ.-INF 2 4,032 8,064
KETOROLAC INJ 30-BRN 1 8,911 8,911
INFUS SET 0I-34 1 13,860 13,860
IV CAT-SURFLO 20 1 11,136 11,136
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 3 1,848 5,544
SPUIT 3 CC TERUMO 4 1,122 4,488
25-Nov BEDAH ANDY 28725 RINGER LAKTAT-WB 2 5,220 10,440
1 CEFOTAXIM INJ 1 G-HXP 3 4,895 14,685
DIAZOLE INF ASKIN 3 9,600 28,800
GENTAMYCIN INJ.-INF 2 4,032 8,064
KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 5 CC TERUMO 3 1,848 5,544
SPUIT 3 CC TERUMO 5 1,122 5,610
26-Nov BEDAH ANDY 28786 CEFOTAXIM INJ 1 G-HXP 6 4,895 29,370
1 DIAZOLE INF ASKIN 6 9,600 57,600
GENTAMYCIN INJ.-INF 4 4,032 16,128
KETOROLAC INJ 30-BRN 4 8,911 35,644
RINGER LAKTAT-WB 4 5,220 20,880
SPUIT 5 CC TERUMO 6 1,848 11,088
SPUIT 3 CC TERUMO 8 1,122 8,976
IV CAT-SURFLO 20 2 11,136 22,272
INFUS SET 0I-34 2 13,860 27,720
28-Nov BEDAH ANDY 25166 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 DIAZOLE INF ASKIN 1 9,600 9,600
GENTAMYCIN INJ.-INF 2 4,032 8,064
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 3 1,848 5,544
SPUIT 3 CC TERUMO 7 1,122 7,854
29-Nov BEDAH ANDY 25043 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
BHP 210,000
1,017,723TOTAL 8,818,379Rata-rata 1,763,676
Tabel Biaya Pasien Gangguan GanglionOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 26/10 BEDAH YATI ANDY 6,846 INFUS SET 0I-34 1 13,860 13,860 1,200,0483 MD 633559 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS
26/10-28/10 IV CAT-SURFLO 20 1 11,136 11,136
Ganglion a/r Wrist SPUIT 5 CC TERUMO 1 1,848 1,848
BLUE NYLON 4/0 CUTING/BLUE MONOLON 4/0 1 57,024 57,024
27/10 OK YUDHIE 23,443 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSETRON 8MG INJ 1 15,523 15,523
SURGICRIL 3/0 1 58,960 58,960
PEMBALUT ELASTIS TENSOCREPE 10 CM4" 1 68,883 68,883
Prostigmin INJ 2 15,500 31,000
FENTANYL INJ-KF 1 36,960 36,960
27/10 BEDAH ANDY 23,477 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
GLUKOSE 5 %-WD 1 4,247 4,247
.28/10 BEDAH ANDY 6,948 AMOKSISILIN 500 INF 10 444 4,440
2 AS. MEFENAMAT 500-KF 10 153 1,530
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA 3 33,000
ALKOHOL 50 2,500
ARP 1 25,500
CROMIC 2/0 1/2 4,600
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 47,400
1,200,0482 7-Nov BEDAH ADE MAKMUR ANDY BHP 159,600 159,600
MD.537552 SKM07/11-15/11
Ganglion
159,6003 4-Dec BEDAH BUDIMAN ANDY ANIOS ADP 55,000 710,750
MD.666859 SKM04/12-06/12 IODINE 75 15,000
Ganglion Dorsum WASH SCRUB 75 18,750
KASA SILVER 4 19,600
FORMALIN 10 500
ARP 1 25,500
ALKOHOL 50 2,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
SEVOFLURENT 35 455,000
BHP 51,000
710,7504 4-Dec BEDAH LILIS ANDY ANIOS ADP 55,000 464,700
MD.458459 SKM04/12-06/12 IODINE 100 20,000
Ganglion corist joint S WASH SCRUB 100 25,000
KASA SEDANG 3 33,000
FORMALIN 10 500
ARP 1 25,500
ALKOHOL 50 2,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 49,800
464,7005 7-Dec BEDAH ADE ANDY ANIOS ADP 55,000 463,550
MD.208259 SKM07/12-09/12 IODINE 75 15,000
Ganglion a/n chorist joint D WASH SCRUB 75 18,750
KASA SEDANG 2 22,000
ARP 1 25,500
CROMIC 2/0 1/2 4,900
ALKOHOL 50 2,500
BEDLINER 1 31,200
FORMALIN 10 500
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 49,800
463,550TOTAL 2,998,648Rata-rata 599,729
Tabel Biaya Pasien FibromaOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 5-Oct BEDAH UJANG UMAR AP 6362 IV CAT-SURFLO 20 1 11,136 11,136 1,341,8833 MD.200059 INFUS SET 0I-34 1 13,860 13,860 SKM
05/10-10/10 RINGER LAKTAT-WB 1 5,220 5,220
Sus Fibroma Abses SPUIT 5 CC TERUMO 1 1,742 1,742
6-Oct OK YUDHIE 22780 PISAU BEDAH 10 -AESCULAP 1 2,701 2,701
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
NYLON 5/0 D5 18 SHARPOINT 1 56,100 56,100
CEFOTAXIM INJ 1 G-BERNO 1 4,801 4,801
NOTRIXUM ASKIN 1 42,120 42,120
PROANES INJ 1 75,240 75,240
TRAMADOL INJ BERNO 5 7,883 39,415
ONDANSENTRON INJ 4 MG BERNO askes 1 4,740 4,740
Prostigmin INJ 2 15,500 31,000
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 3 CC TERUMO 5 1,371 6,855
SPUIT 5 CC TERUMO 5 1,742 8,710
SPUIT 10 CC TERUMO 2 2,233 4,466
PETHIDIN INJ-KF 1 14,390 14,390
MILOZ INJ 15 ASKIN 1 14,310 14,310
PEMBALUT ELASTIS TENSOCREPE 7,5 CM3" 1 53,040 53,040
6-Oct BEDAH ANDY 6477 CEFOTAXIM INJ 1 G-BERNO 2 4,801 9,602
2 KETOROLAC INJ 30-BRN 2 11,220 22,440
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 1,955 1,955
SPUIT 5 CC TERUMO 2 1,742 3,484
SPUIT 3 CC TERUMO 2 1,371 2,742
7-Oct BEDAH ANDY 20139 CEFOTAXIM INJ 1 G-BERNO 2 4,801 9,602
1 SPUIT 3 CC TERUMO 2 1,371 2,742
SPUIT 5 CC TERUMO 2 1,742 3,484
8-Oct BEDAH ANDY 22607 CEFOTAXIM INJ 1 G-BERNO 4 4,801 19,204
1 KETOROLAC INJ 30-BRN 4 11,220 44,880
RINGER LAKTAT-WB 4 5,220 20,880
SPUIT 5 CC TERUMO 4 1,742 6,968
SPUIT 3 CC TERUMO 4 1,371 5,484
10-Oct BEDAH ANDY 22556 AMOKSISILIN 500 KF 15 444 6,660
1 METRONIDAZOL 500 BERNO 15 224 3,360
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 4 44,000
ARP 1 25,500
CROMIC 2/0 1 9,800
ALKOHOL 100 5,000
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 133,200
1,341,8832 19-Oct BEDAH WIDANINGSIH ANDY 20813 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,363,608
2 MD 022459 INFUS SET 0I-34 1 13,860 13,860 SKM
19/10-24/10 IV CAT-SURFLO 20 1 11,136 11,136
Fibroma SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
20-Oct OK YUDHIE 23960 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSETRON 8MG INJ 1 15,523 15,523
NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
PRONALGES SUPPO ASKIN 1 5,760 5,760
Prostigmin INJ 2 15,500 31,000
FENTANYL INJ-KF 1 36,960 36,960
20-Oct OK AP 20864 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
2 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
21-Oct BEDAH ANDY 23865 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
22-Oct BEDAH ANDY 23737 CEFTRIAXON INJ 1 G BERNO 2 6,970 13,940
1 KETOROLAC INJ 30-BRN 4 8,911 35,644
RINGER LAKTAT-WB 4 5,220 20,880
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 4 1,122 4,488
24-Oct BEDAH ANDY 23628 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 4 44,000
CROMIC 2/0 1 9,800
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 100 5,000
LINAPEN 1 17,000
O2 0.4 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 162,300
1,363,608
3 2 Anis INFUS SET 0I-34 1 13,860 13,860 1,078,945MD 163959 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS30/10-02/11 SPUIT 5 CC TERUMO 1 1,848 1,848
Fibroma NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
31-Oct OK YUDHIE 7134 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
AS. TRANEKSAMAT INJ 500MG-BRN 1 6,237 6,237
FENTANYL INJ-KF 1 36,960 36,960
MILOZ INJ 15 ASKIN 1 14,310 14,310
31-Oct BEDAH ANDY 7203 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
2 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 1 CC INS TERUMO 1 3,010 3,010
SPUIT 3 CC TERUMO 3 1,122 3,366
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
1-Nov BEDAH ANDY 23219 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 2 5,220 10,440
2-Nov BEDAH ANDY 23106 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KA SA SEDANG 3 33,000
ALKOHOL 50 2,500
FORMALIN 10 500
ARP 1 25,500
CROMIC 2/0 1/2 4,900
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 66,600
1,078,9454 31-Oct BEDAH M.NURALI MN 7215 IV CAT-SURFLO 20 1 11,136 11,136 1,055,685
3 MD.709858 RINGER LAKTAT-WB 1 5,220 5,220 JAMKESMAS31/10-04/11 INFUS SET 0I-34 1 13,860 13,860
Fibroma a/n Dectoid SPUIT 5 CC TERUMO 1 1,848 1,848
31-Oct BEDAH MN 7216 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
1-Nov OK YUDHIE 23230 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
FENTANYL INJ-KF 1 36,960 36,960
1-Nov BEDAH ANDY 23269 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 1 8,911 8,911
RINGER LAKTAT-WB 3 5,220 15,660
GLUKOSE 5 %-WD 2 4,247 8,494
SPUIT 3 CC TERUMO 5 1,122 5,610
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
2-Nov BEDAH ANDY 23102 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
1 KETOROLAC INJ 30-BRN 1 8,911 8,911
RINGER LAKTAT-WB 1 5,220 5,220
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
3-Nov BEDAH ANDI 23176 CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
1 KETOROLAC INJ 30-BRN 1 8,911 8,911
SPUIT 3 CC TERUMO 6 1,122 6,732
4-Nov BEDAH ANDY 23052 AMOKSISILIN 500 INF 15 444 6,660
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA 3 33,000
ALKOHOL 50 2,500
FORMALIN 10 500
SILK 2/0 1/2 2,100
ARP 1 25,500
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 111,300
1,055,685TOTAL 4,840,121Rata-rata 1,210,030
Tabel Biaya Pasien AbsesOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 11-Nov BEDAH YANTI AYU 24660 AMPISILIN INJ BERNO 4 5,335 21,340 1,399,340
1 MD.035759 CEFOTAXIM INJ 1 G-HXP 3 4,895 14,685 JAMKESMAS
11/11-17/11 DIAZOLE INF ASKIN 2 9,600 19,200
Abses a/n post SPUIT 5 CC TERUMO 7 1,848 12,936
12-Nov BEDAH ANDY 24055 AMPISILIN INJ BERNO 5 5,335 26,675
1 DIAZOLE INF ASKIN 2 9,600 19,200
CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 10 CC TERUMO 6 2,027 12,162
SPUIT 3 CC TERUMO 8 1,122 8,976
SPUIT 5 CC TERUMO 6 1,848 11,088
14-Nov BEDAH ANDY 24132 AMPISILIN INJ BERNO 3 5,335 16,005
1 DIAZOLE INF ASKIN 1 9,600 9,600
CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
KETOROLAC INJ 30-BRN 1 8,911 8,911
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 10 CC TERUMO 2 2,027 4,054
SPUIT 5 CC TERUMO 3 1,848 5,544
SPUIT 3 CC TERUMO 4 1,122 4,488
14-Nov BEDAH SIMAMORA 28458 BLUE NYLON 4/0 CUTING/BLUE MONOLON 4/0 1 57,024 57,024
15-Nov BEDAH ANDY 24542 SPUIT 3 CC TERUMO 2 1,122 2,244
1 SPUIT 5 CC TERUMO 5 1,848 9,240
AMPICILIN INJ BERNO 3 4,158 12,474
DIAZOLE INF ASKIN 1 9,600 9,600
CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
KETOROLAC INJ 30-BRN 1 8,911 8,911
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
15-Nov OK YUDHIE 24199 PISAU BEDAH 15-AESCULAP 1 2,700 2,700
1 SARUNG TANGAN TERUGLOVE 6.5 2 9,009 18,018
SARUNG TANGAN TERUGLOVE 7.5 2 9,009 18,018
TOPI OPERASI 3 792 2,376
MASKER TIE ON SUREPLUS 3 792 2,376
PENROSE DRAIN 5/8 1 78,000 78,000
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
INFUS SET 0I-34 1 13,860 13,860
IV CAT-SURFLO 18 1 11,136 11,136
NOTRIXUM ASKIN 1 42,120 42,120
Prostigmin INJ 2 15,500 31,000
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
EPHEDRIN INJ-ETHICA 2 14,520 29,040
FENTANYL INJ-KF 1 36,960 36,960
15-Nov BEDAH AP 20145 SPUIT 10 CC TERUMO 2 2,027 4,054
16-Nov BEDAH ANDY 24588 AMPISILIN INJ BERNO 3 5,335 16,005
1 KETOROLAC INJ 30-BRN 1 8,911 8,911
RINGER LAKTAT-WB 2 5,220 10,440
SPUIT 5 CC TERUMO 5 1,848 9,240
SPUIT 3 CC TERUMO 2 1,122 2,244
17-Nov BEDAH ANDY 29247 AMOKSISILIN 250- INF 15 286 4,290
2 AS. MEFENAMAT 500-KF 8 153 1,224
ANTASID TAB.-KF 15 162 2,430
METRONIDAZOL TAB 250-INF 15 102 1,530
ANIOS ADP 55,000
IODINE 75 15,000
WASH SCRUB 75 18,750
KASA SILVER 4 19,600
CROMIC 2/0 1/2 4,900
SILK 2/0 1/2 2,100
FORMALIN 10 500
ARP 1 25,500
ALKOHOL 50 2,500
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 162,600
1,399,3402 02/11 BEDAH RAVA ANDY 23300 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895 571,629
1 MD.855259 DIAZOLE INF ASKIN 1 9,600 9,600 SKM
01/11-08/11 AMOKSISILIN SYR 125-INF 1 4,081 4,081
Abses a/n post NACL 0.9% 500 ML-WB 1 5,587 5,587
RINGER LAKTAT-WB 1 5,220 5,220
SPUIT 5 CC TERUMO 2 1,848 3,696
03/11 BEDAH ANDY 23182 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
1 RINGER LAKTAT-WB 1 5,220 5,220
SPUIT 10 CC TERUMO 2 2,027 4,054
SPUIT 3 CC TERUMO 3 1,122 3,366
03/11 BEDAH MN 7380 IV CAT-SURFLO 24 2 10,560 21,120
3 INFUS SPALK 4 X 15 1 8,527 8,527
INFUS SET PAED- 0I-34 OTSUKA 1 9,900 9,900
04/11 BEDAH ANDY 23070 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
1 DIAZOLE INF ASKIN 1 9,600 9,600
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 1 5,220 5,220
SPUIT 10 CC TERUMO 2 2,027 4,054
04/11 BEDAH ANDY 29020 INFUS SET PAED- 0I-34 OTSUKA 1 9,900 9,900
1 IV CAT-SURFLO 24 1 10,560 10,560
05/11 BEDAH ANDY 23093 KAEN 3B 2 15,423 30,846
1 SPUIT 10 CC TERUMO 4 2,027 8,108
SPUIT 3 CC TERUMO 4 1,122 4,488
.5/11 BEDAH ANDY 29033 INFUS SET PAED- 0I-34 OTSUKA 1 9,900 9,900
07/11 BEDAH ANDY 24950 SPUIT 10 CC TERUMO 3 2,027 6,081
1 SPUIT 5 CC TERUMO 3 1,848 5,544
07/11 BEDAH ANDY 24814 IV CAT-SURFLO 24 2 10,560 21,120
1 INFUS SET 0I-34 1 13,860 13,860
INFUS SPALK 4 X 15 1 8,527 8,527
08/11 BEDAH ANDY 24869 AMOKSISILIN SYR 125-INF 1 4,081 4,081
1 METROLET SYR 1 11,088 11,088
BHP 309,900 571,629
3 18-Dec BEDAH SURYA MN 27989 IV CAT-SURFLO 24 1 10,560 10,560 1,329,532
3 MD.421161 IV CAT-SURFLO 22 1 11,136 11,136 JAMKESMAS
18/12-21/12 INFUS SET 0I-34 1 13,860 13,860
Abses a/n Femus RINGER LAKTAT-WB 1 5,220 5,220
SPUIT 5 CC TERUMO 1 1,848 1,848
NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100
18-Dec BEDAH MN 27992 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
3 SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 5 CC TERUMO 1 1,848 1,848
19-Dec OK YUDHIE 51185 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN GAMEX 7 .5 4 9,900 39,600
MASKER TIE ON SUREPLUS 4 792 3,168
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ BERNO 4 7,883 31,532
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
PENROSE DRAIN 5/8 1 78,000 78,000
CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
DEXAMETASON INJ.-LUCAS 3 1,386 4,158
FENTANYL INJ-KF 1 36,960 36,960
19-Dec BEDAH AP 27830 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
2 KETOROLAC INJ 30-BRN 1 8,911 8,911
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
20-Dec BEDAH ANDY 52064 CEFOTAXIM INJ 1 G-HXP 1 4,895 4,895
1 KETOROLAC INJ 30-BRN 1 8,911 8,911
SPUIT 5 CC TERUMO 2 1,848 3,696
DIAZOLE INF ASKIN 1 9,600 9,600
21-Dec BEDAH ANDY 52137 AMOKSISILIN SYR 125-INF 1 4,081 4,081
1 METRONIDAZOL TAB 250-INF 6 102 612
PARASETAMOL SYR-INF 1 2,760 2,760
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KA SA SEDANG 3 33,000
ALKOHOL 50 2,500
FORMALIN 10 500
ARP 1 25,500
CROMIC 2/0 1/2 4,900
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
SEVOFLURENT 35 455,000
BHP 71,400
1,329,532
TOTAL 3,300,501
Rata-rata 1,100,167
Tabel Biaya Pasien Soft Tisue TumorOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 16-Oct BEDAH SUNARNI ANDY 20611 NYLON 4/0 D5 18 SHARPOINT 1 56,100 56,100 1,156,910
2 MD.541559 INFUS SET 0I-34 1 13,860 13,860 JAMKEMAS
16/10-18/10 IV CAT-SURFLO 20 1 11,136 11,136
Soft Tisue Tumor RINGER LAKTAT-WB 1 5,220 5,220
17-Oct BEDAH ANDY 22221 CEFTRIAXON INJ 1 G BERNO 1 6,970 6,970
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
17-Oct OK YUDHIE 22176 PISAU BEDAH 15-AESCULAP 1 2,700 2,700
1 SARUNG TANGAN TERUGLOVE 7.5 10 9,009 90,090
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 3/0 HR26 SHARPOINT 1 61,710 61,710
NYLON 2/0 D5 18 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
NOTRIXUM ASKIN 1 42,120 42,120
KETOROLAC INJ 30-BRN 3 8,911 26,733
TRAMADOL INJ.-INF 1 7,244 7,244
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSETRON 8MG INJ 1 15,523 15,523
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
FENTANYL INJ-KF 1 36,960 36,960
PENROSE DRAIN 5/8 1 78,000 78,000
18-Oct BEDAH ANDY 22272 AMOKSISILIN 500 KF 15 444 6,660
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 4 44,000
CROMIC 2/0 1 9,800
ARP 1 25,500
JARUM 1 15,000
ALKOHOL 100 5,000
LINAPEN 1 17,000
O2 0.4 4,400
N2O 0.25 31,500
ISOFLURENT 40 212,000
BHP 39,600
TOTAL 1,156,9102 7-Dec BEDAH WAWAN ANDY 27022 NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100 1,588,181
3 MD 598159 INFUS SET 0I-34 1 13,860 13,860 JAMKESMAS
07/12-12/12 IV CAT-SURFLO 20 1 11,136 11,136
Soft Tissue Tumor IV CAT-SURFLO 22 1 11,136 11,136
RINGER LAKTAT-WB 1 5,220 5,220
8-Dec OK YUDHIE 25691 PISAU BEDAH 10 -AESCULAP 1 2,072 2,072
1 SARUNG TANGAN TERUGLOVE 7.5 5 9,009 45,045
MASKER TIE ON SUREPLUS 2 792 1,584
TOPI OPERASI 2 792 1,584
CROMIC 2-0 TAPER SURGIVENT 1 61,710 61,710
NYLON 3/0 D5 24 SHARPOINT 1 56,100 56,100
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ BERNO 4 7,883 31,532
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG INDO 1 10,032 10,032
PENROSE DRAIN 5/8 1 78,000 78,000
CEFOTAXIM INJ 1 G-HXP 2 4,895 9,790
EPHEDRIN INJ-ETHICA 1 14,520 14,520
DEXAMETASON INJ.-LUCAS 2 1,386 2,772
FENTANYL INJ-KF 1 36,960 36,960
MILOZ INJ 15 ASKIN 1 14,310 14,310
8-Dec BEDAH AP 27069 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966
2 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
DIAZOLE INF ASKIN 3 9,600 28,800
9-Dec BEDAH ANDY 25762 CEFTRIAXON INJ 1 G-HXP 2 7,983 15,966
1 DIAZOLE INF ASKIN 3 9,600 28,800
KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 5 CC TERUMO 2 1,848 3,696
SPUIT 3 CC TERUMO 2 1,122 2,244
BETADIN 60 ML 1 21,054 21,054
10-Dec BEDAH SIMMAMORA 25808 CEFTRIAXON INJ 1 G-HXP 4 7,983 31,932
1 DIAZOLE INF ASKIN 6 9,600 57,600
KETOROLAC INJ 30-BRN 4 8,911 35,644
SPUIT 5 CC TERUMO 4 1,848 7,392
SPUIT 3 CC TERUMO 4 1,122 4,488
.11/12 BEDAH ANDY 26098 RINGER LAKTAT-WB 4 5,220 20,880
11-Dec BEDAH ANDY 26142 SPUIT 3 CC TERUMO 1 1,122 1,122
1 IV CAT-SURFLO 20 1 11,136 11,136
INFUS SET 0I-34 1 13,860 13,860
12/12 BEDAH ANDY 25901 AMOKSISILIN 500 TABLET BERNO 15 446 6,690
1 METRONIDAZOL 500 BERNO 15 140 2,100
METOKLOPAMID TAB.-INF 15 140 2,100
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KASA SEDANG 3 33,000
CROMIC 2/0 1/2 4,900
ARP 1 25,500
FORMALIN 20 1,000
ALKOHOL 50 2,500
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 50 265,000
BHP 126,000
8-Dec BEDAH MARHUM 41217 AMOKSISILIN 500 TABLET BERNO 15
METRONIDAZOL TAB 500-KF 15
ASAM MEFENAMAT TAB 500 INDO 15 16,000
TOTAL 1,588,181TOTAL 2,745,091
Rata-rata 1,364,455
Tabel Biaya Pasien Kista AteronOktober-Desember 2012 RSUD Kota Bandung
No TGL BAG NAMA PASIEN DOKTER NOMOR NAMA OBAT/ALKES JML HARGA TOTAL HRG TOTAL
1 14/11 BEDAH ALIT ANDI 24330 ANIOS ADP 55,000 505,900
MD.151753 IODINE 150 30,000 SKM
14/11-16/11 WASH SCRUB 100 25,000
Kista Ateron KASA SILVER 3 14,700
CROMIC 2/0 2 19,600
KASA SEDANG 2 22,000
FORMALIN 10 500
SILK 2/0 1 4,200
ARP 1 25,500
ALKOHOL 100 5,000
JARUM 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
ISOFLURENT 35 185,500
BHP 51,000
505,900
59 11/12 BEDAH TATANG ANDY 26170 IV CAT-SURFLO 20 1 11,136 11,136 1,225,821
2 MD 119059 INFUS SET 0I-34 1 13,860 13,860 JAMKESMAS
11/12-13/12 RINGER LAKTAT-WB 1 5,220 5,220
Kista Atheroma SPUIT 5 CC TERUMO 1 1,848 1,848
60 12/12 BEDAH ANDY 25876 NYLON 3/0 D5 24 SHARPOINT 2 56,100 112,200
61 12/12 OK YUDHIE 25894 PISAU BEDAH 15-AESCULAP 1 2,700 2,700
1 SARUNG TANGAN GAMEX 7 .5 4 9,900 39,600
MASKER TIE ON SUREPLUS 4 792 3,168
CROMIC 2-0 TAPER SURGIVEN 1 61,710 61,710
PROANES INJ 1 79,200 79,200
KETOROLAC INJ 30-BRN 2 8,911 17,822
TRAMADOL INJ.-INF 2 7,244 14,488
PRONALGES SUPPO ASKIN 1 5,760 5,760
SPUIT 10 CC TERUMO 1 2,027 2,027
SPUIT 3 CC TERUMO 1 1,122 1,122
SPUIT 5 CC TERUMO 1 1,848 1,848
RINGER LAKTAT-WB 1 5,220 5,220
ONDANSENTRON INJ 8 MG IN 1 10,032 10,032
FENTANYL INJ-KF 1 36,960 36,960
62 12/12 BEDAH ANDY 25934 CEFTRIAXON INJ 1 G-HXP 1 7,983 7,983
1 KETOROLAC INJ 30-BRN 2 8,911 17,822
SPUIT 1 CC TUB TERUMO 1 2,178 2,178
SPUIT 3 CC TERUMO 2 1,122 2,244
SPUIT 5 CC TERUMO 2 1,848 3,696
RINGER LAKTAT-WB 2 5,220 10,440
GLUKOSE 5 %-WD 1 4,247 4,247
63 13/12 BEDAH ANDY 25972 AMOKSISILIN 500 TABLET BER 15 446 6,690
ANIOS ADP 55,000
IODINE 100 20,000
WASH SCRUB 100 25,000
KA SA SEDANG 3 33,000
ALKOHOL 100 5,000
FORMALIN 20 1,000
ARP 1 25,500
CROMIC 2/0 1 9,800
JARUM/PLESTER 1 15,000
LINAPEN 1 17,000
O2 0.5 4,400
N2O 0.25 31,500
SEVOFLURENT 35 455,000
BHP 47,400
1,225,821
TOTAL 1,731,721Rata-rata 865,860