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POLRI DAERAH JAWA TIMUR BIDANG KEDOKTERAN DAN KESEHATAN RS. BHAYANGKARA HASTA BRATA BATU



TARIF KAMAR RAWAT INAP RUANG MELATI DAN BOUGENVILE NO



KAMAR



1 VIP 2 KELAS 1 UTAMA (MELATI 11 DAN MELATI 12, BOUGENVILE 7) 3 KELAS 1 (MELATI 1-MELATI 6, BOUGENVILE 4, 5, 6, , 9,10) 4 KELAS 2 (MELATI 7 - MELATI 10, BOUGENVILE 8) 5 KELAS 3 ( MELATI 13, BOUGENVILE 2 DAN BOUGENVILE 3)



TARIF Rp300,000 Rp250,000 Rp225,000 Rp180,000 Rp75,000



JASA VISITE DOKTER SPESIALIS Rp100,000 Rp80,000 Rp80,000 Rp60,000 Rp50,000



E JASA VISITE DOKTER UMUM DR.IAN Rp70,000 Rp110,000 Rp60,000 Rp100,000 Rp60,000 Rp100,000 Rp50,000 Rp90,000 Rp40,000 Rp80,000



POLRI DAERAH JAWA TIMUR BIDANG KEDOKTERAN DAN KESEHATAN RS. BHAYANGKARA HASTA BRATA BATU



RINCIAN KAMAR RAWAT INAP NO



KELAS 1 VIP 2 KELAS 1 UTAMA 3 KELAS 1 4 5 KELAS 2 6 KELAS 3 7 8 9 10



KAMAR VIP MELATI 11, 12, BOUGENVILE 7 MELATI 1 - MELATI 6 BOUGENVILE 4, 5, 6, 7, 9, 10 MELATI 7 - MELATI 10, BOUGENVILE 8 MELATI 13 BOUGENVILE 1 BOUGENVILE 2 BOUGENVILE 3 TAHANAN KET : TV LED 21" =50 WATT X Rp. 192 = 9600 KULKAS = 70 WATT X Rp. 192 = 13440 LAMPU = 40 WATT X Rp.192 = 7680 TARIF MAKAN TIAP PX TARIF AIR TIAP PX TARIF LISTRIK TIAP BED



MAKAN AIR Rp65,000 Rp55,000 Rp55,000 Rp55,000 Rp45,000 Rp35,000 Rp35,000 Rp35,000 Rp35,000 Rp35,000



LISTRIK Rp6,000 Rp30,720 Rp6,000 Rp17,280 Rp6,000 Rp17,280 Rp6,000 Rp17,280 Rp6,000 Rp7,680 Rp6,000 Rp15,360 Rp6,000 Rp7,680 Rp6,000 Rp7,680 Rp6,000 Rp7,680 Rp6,000 Rp7,680



KEBERSIHAN BIAYA MODAL TARIF RS SELISIH Rp30,000 Rp131,720 Rp300,000 Rp168,280 Rp25,000 Rp103,280 Rp250,000 Rp146,720 Rp25,000 Rp103,280 Rp225,000 Rp121,720 Rp25,000 Rp103,280 Rp225,000 Rp121,720 Rp20,000 Rp78,680 Rp180,000 Rp101,320 Rp10,000 Rp66,360 Rp75,000 Rp8,640 Rp10,000 Rp58,680 Rp75,000 Rp16,320 Rp10,000 Rp58,680 Rp75,000 Rp16,320 Rp10,000 Rp58,680 Rp75,000 Rp16,320 Rp10,000 Rp58,680 Rp75,000 Rp16,320



POLRI DAERAH JAWA TIMUR BIDANG KEDOKTERAN DAN KESEHATAN RS. BHAYANGKARA HASTA BRATA BATU



NO



TINDAKAN



1 TTV 2 INJEKSI 3 PASANG INFUS ANAK 4 PASANG INFUS DEWASA 5 PASANG CATETER 6 PASANG NGT 7 EKG 8 NEBULEZER 9 KUMBAH LAMBUNG 10 AFF INFUS 11 AFF NGT 12 AFF CATETER 13 PASANG MAYO 14 RAWAT LUKA RINGAN 15 RAWAT LUKA SEDANG 16 RAWAT LUKA BERAT 17 SUCTION 18 RJP 5 SIKLUS 19 PASANG O2 / 2000L 20 SEWA MONITOR 21 PASANG SYRING PUMP 22 PASANG INFUS PUMP 23 AFF TRAKSI 24 GANTI SPOOLING 25 VERBED 26 SPOOLING MANUAL 27 PEMBERIAN TRANFUSI / LABU 28 AFF DRAIN 29 REGULASI INSULIN 30 RAWAT JENAZAH 31 PEMBERIAN DIET NGT/HARI



BHP Rp5,000 Rp2,500 Rp10,000 Rp7,000 Rp10,000 Rp10,000 Rp5,000 Rp5,000 Rp20,000 Rp4,000 Rp4,000 Rp4,000 Rp10,000 Rp15,000 Rp20,000 Rp30,000 Rp10,000 Rp1,000 Rp2,000 Rp10,000 Rp10,000 Rp10,000 Rp4,000 Rp5,000 Rp5,000 Rp15,000 Rp5,000 Rp4,000 Rp2,500 Rp20,000 Rp5,000



AIR Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900 Rp900



LISTRIK Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp9,600 Rp9,600 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp9,600 Rp1,920 Rp1,920 Rp15,000 Rp15,000 Rp15,000 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920 Rp1,920



SEWA ALAT Rp2,000



Rp10,000 Rp10,000



Rp5,000 Rp5,000 Rp5,000 Rp5,000 Rp5,000 Rp10,000 Rp156,000 Rp50,000 Rp50,000



JASA TINDAKA VIP Rp8,000 Rp8,000 Rp8,000 Rp8,000 Rp15,000 Rp15,000 Rp10,000 Rp7,000 Rp10,000 Rp8,000 Rp8,000 Rp8,000 Rp15,000 Rp15,000 Rp20,000 Rp25,000 Rp15,000 Rp15,000 Rp10,000 Rp20,000 Rp20,000 Rp20,000 Rp8,000 Rp8,000 Rp8,000 Rp15,000 Rp7,000 Rp8,000 Rp8,000 Rp20,000 Rp8,000



RINCIAN TARIF RUANG MELATI DAN BOUGENVILE JASA TINDAKAN KELAS 1 UT KELAS 1 KELAS 2 Rp7,000 Rp7,000 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp10,000 Rp10,000 Rp7,000 Rp10,000 Rp10,000 Rp7,000 Rp7,500 Rp7,500 Rp5,000 Rp6,500 Rp6,500 Rp6,000 Rp7,500 Rp7,500 Rp5,000 Rp7,000 Rp7,000 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp10,000 Rp10,000 Rp7,000 Rp10,000 Rp10,000 Rp7,000 Rp15,000 Rp15,000 Rp10,000 Rp20,000 Rp20,000 Rp15,000 Rp10,000 Rp10,000 Rp7,000 Rp10,000 Rp10,000 Rp7,000 Rp7,000 Rp7,000 Rp6,000 Rp17,000 Rp17,000 Rp10,000 Rp20,000 Rp20,000 Rp20,000 Rp20,000 Rp20,000 Rp20,000 Rp7,000 Rp7,000 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp10,000 Rp10,000 Rp7,000 Rp6,500 Rp6,500 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp7,000 Rp7,000 Rp6,000 Rp20,000 Rp20,000 Rp20,000 Rp7,000 Rp7,000 Rp6,000



KELAS 3 VIP KELAS 1 UT Rp5,000 Rp17,820 Rp16,820 Rp4,000 Rp13,320 Rp12,320 Rp5,000 Rp20,820 Rp19,820 Rp5,000 Rp17,820 Rp16,820 Rp5,000 Rp27,820 Rp22,820 Rp5,000 Rp27,820 Rp22,820 Rp3,000 Rp35,500 Rp33,000 Rp4,000 Rp32,500 Rp32,000 Rp3,000 Rp32,820 Rp30,320 Rp5,000 Rp14,820 Rp13,820 Rp5,000 Rp14,820 Rp13,820 Rp5,000 Rp14,820 Rp13,820 Rp5,000 Rp27,820 Rp22,820 Rp5,000 Rp37,820 Rp32,820 Rp7,000 Rp47,820 Rp42,820 Rp10,000 Rp62,820 Rp57,820 Rp5,000 Rp40,500 Rp35,500 Rp5,000 Rp23,820 Rp18,820 Rp5,000 Rp24,820 Rp21,820 Rp7,000 Rp201,900 Rp198,900 Rp20,000 Rp95,900 Rp95,900 Rp20,000 Rp95,900 Rp95,900 Rp5,000 Rp14,820 Rp13,820 Rp5,000 Rp15,820 Rp14,820 Rp5,000 Rp15,820 Rp14,820 Rp5,000 Rp32,820 Rp27,820 Rp4,000 Rp14,820 Rp14,320 Rp5,000 Rp14,820 Rp13,820 Rp4,000 Rp13,320 Rp12,320 Rp20,000 Rp42,820 Rp42,820 Rp5,000 Rp15,820 Rp14,820



BIAYA MODAL KELAS 1 KELAS 2 Rp16,820 Rp15,820 Rp12,320 Rp11,320 Rp19,820 Rp18,820 Rp16,820 Rp15,820 Rp22,820 Rp19,820 Rp22,820 Rp19,820 Rp33,000 Rp30,500 Rp32,000 Rp31,500 Rp30,320 Rp27,820 Rp13,820 Rp12,820 Rp13,820 Rp12,820 Rp13,820 Rp12,820 Rp22,820 Rp19,820 Rp32,820 Rp29,820 Rp42,820 Rp37,820 Rp57,820 Rp52,820 Rp35,500 Rp32,500 Rp18,820 Rp15,820 Rp21,820 Rp20,820 Rp198,900 Rp191,900 Rp95,900 Rp95,900 Rp95,900 Rp95,900 Rp13,820 Rp12,820 Rp14,820 Rp13,820 Rp14,820 Rp13,820 Rp27,820 Rp24,820 Rp14,320 Rp13,820 Rp13,820 Rp12,820 Rp12,320 Rp11,320 Rp42,820 Rp42,820 Rp14,820 Rp13,820



I DAN BOUGENVILE



AL KELAS 3 Rp14,820 Rp9,320 Rp17,820 Rp14,820 Rp17,820 Rp17,820 Rp28,500 Rp29,500 Rp25,820 Rp11,820 Rp11,820 Rp11,820 Rp17,820 Rp27,820 Rp34,820 Rp47,820 Rp30,500 Rp13,820 Rp19,820 Rp188,900 Rp95,900 Rp95,900 Rp11,820 Rp12,820 Rp12,820 Rp22,820 Rp11,820 Rp11,820 Rp9,320 Rp42,820 Rp12,820



VIP KELAS 1 UT Rp30,000 Rp25,000 Rp25,000 Rp20,000 Rp45,000 Rp40,000 Rp35,000 Rp30,000 Rp35,000 Rp30,000 Rp35,000 Rp30,000 Rp40,000 Rp35,000 Rp40,000 Rp35,000 Rp37,000 Rp35,000 Rp20,000 Rp17,000 Rp20,000 Rp17,000 Rp20,000 Rp17,000 Rp35,000 Rp30,000 Rp40,000 Rp35,000 Rp50,000 Rp45,000 Rp65,000 Rp60,000 Rp42,000 Rp37,000 Rp35,000 Rp30,000 Rp30,000 Rp25,000 Rp250,000 Rp200,000 Rp100,000 Rp100,000 Rp100,000 Rp100,000 Rp20,000 Rp17,000 Rp20,000 Rp17,000 Rp20,000 Rp17,000 Rp40,000 Rp35,000 Rp15,000 Rp15,000 Rp20,000 Rp17,000 Rp25,000 Rp20,000 Rp50,000 Rp50,000 Rp20,000 Rp17,000



TARIF RS KELAS 1 Rp25,000 Rp20,000 Rp35,000 Rp25,000 Rp30,000 Rp30,000 Rp35,000 Rp35,000 Rp35,000 Rp17,000 Rp17,000 Rp17,000 Rp30,000 Rp35,000 Rp45,000 Rp60,000 Rp37,000 Rp30,000 Rp25,000 Rp200,000 Rp100,000 Rp100,000 Rp17,000 Rp17,000 Rp17,000 Rp35,000 Rp15,000 Rp17,000 Rp20,000 Rp50,000 Rp17,000



KELAS 2 Rp20,000 Rp15,000 Rp30,000 Rp20,000 Rp25,000 Rp25,000 Rp32,000 Rp32,000 Rp30,000 Rp15,000 Rp15,000 Rp15,000 Rp25,000 Rp32,000 Rp40,000 Rp55,000 Rp35,000 Rp25,000 Rp23,000 Rp200,000 Rp100,000 Rp100,000 Rp15,000 Rp15,000 Rp15,000 Rp32,000 Rp15,000 Rp15,000 Rp15,000 Rp50,000 Rp15,000



KELAS 3 Rp15,000 Rp10,000 Rp25,000 Rp15,000 Rp20,000 Rp20,000 Rp30,000 Rp30,000 Rp27,000 Rp13,000 Rp13,000 Rp13,000 Rp20,000 Rp30,000 Rp35,000 Rp50,000 Rp32,000 Rp20,000 Rp20,000 Rp200,000 Rp100,000 Rp100,000 Rp13,000 Rp13,000 Rp13,000 Rp30,000 Rp15,000 Rp13,000 Rp10,000 Rp50,000 Rp13,000



VIP KELAS 1 UT Rp12,180 Rp8,180 Rp11,680 Rp7,680 Rp24,180 Rp20,180 Rp17,180 Rp13,180 Rp7,180 Rp7,180 Rp7,180 Rp7,180 Rp4,500 Rp2,000 Rp7,500 Rp3,000 Rp4,180 Rp4,680 Rp5,180 Rp3,180 Rp5,180 Rp3,180 Rp5,180 Rp3,180 Rp7,180 Rp7,180 Rp2,180 Rp2,180 Rp2,180 Rp2,180 Rp2,180 Rp2,180 Rp1,500 Rp1,500 Rp11,180 Rp11,180 Rp5,180 Rp3,180 Rp48,100 Rp1,100 Rp4,100 Rp4,100 Rp4,100 Rp4,100 Rp5,180 Rp3,180 Rp4,180 Rp2,180 Rp4,180 Rp2,180 Rp7,180 Rp7,180 Rp180 Rp680 Rp5,180 Rp3,180 Rp11,680 Rp7,680 7180 Rp7,180 4180 Rp2,180



SELISIH KELAS 1 Rp8,180 Rp7,680 Rp15,180 Rp8,180 Rp7,180 Rp7,180 Rp2,000 Rp3,000 Rp4,680 Rp3,180 Rp3,180 Rp3,180 Rp7,180 Rp2,180 Rp2,180 Rp2,180 Rp1,500 Rp11,180 Rp3,180 Rp1,100 Rp4,100 Rp4,100 Rp3,180 Rp2,180 Rp2,180 Rp7,180 Rp680 Rp3,180 Rp7,680 Rp7,180 Rp2,180



KELAS 2 KELAS 3 Rp4,180 Rp180 Rp3,680 Rp680 Rp11,180 Rp7,180 Rp4,180 Rp180 Rp5,180 Rp2,180 Rp5,180 Rp2,180 Rp1,500 Rp1,500 Rp500 Rp500 Rp2,180 Rp1,180 Rp2,180 Rp1,180 Rp2,180 Rp1,180 Rp2,180 Rp1,180 Rp5,180 Rp2,180 Rp2,180 Rp2,180 Rp2,180 Rp180 Rp2,180 Rp2,180 Rp2,500 Rp1,500 Rp9,180 Rp6,180 Rp2,180 Rp180 Rp8,100 Rp11,100 Rp4,100 Rp4,100 Rp4,100 Rp4,100 Rp2,180 Rp1,180 Rp1,180 Rp180 Rp1,180 Rp180 Rp7,180 Rp7,180 Rp1,180 Rp3,180 Rp2,180 Rp1,180 Rp3,680 Rp680 Rp7,180 Rp7,180 Rp1,180 Rp180



DAFTAR TARUF RUANG MELATI DAN BOUGENVILE NO



TINDAKAN



1 TTV/HARI 2 INJEKSI/HARI 3 PASANG INFUS ANAK/1 KALI PASANG 4 PASANG INFUS DEWASA/1 KALI PASANG 5 PASANG CATETER/ 1 KALI PASANG 6 PASANG NGT/ 1 KALI PASANG 7 EKG/ 1KALI TINDAKAN 8 NEBULEZER/HARI 9 KUMBAH LAMBUNG/ HARI 10 AFF INFUS/ 1 KALI TINDAKAN 11 AFF NGT/1 KALI TINDAKAN 12 AFF CATETER/ 1 KALI TINDAKAN 13 PASANG MAYO/ 1 KALI TINDAKAN 14 RAWAT LUKA RINGAN/HARI 15 RAWAT LUKA SEDANG/HARI 16 RAWAT LUKA BERAT/HARI 17 SUCTION/HARI 18 RJP 5 SIKLUS/ 1 KALI TINDAKAN 19 PASANG O2 / 2000L 20 PASANG MONITOR/HARI 21 PASANG SYRING PUMP/HARI 22 PASANG INFUS PUMP/HARI 23 AFF TRAKSI/1 KALI TINDAKAN 24 GANTI SPOOLING /HARI 25 VERBED/ 1 KALI TINDAKAN 26 SPOOLING MANUAL/ 1 KALI TINDAKAN 27 PEMBERIAN TRANFUSI / LABU 28 AFF DRAIN/ 1 KALI TINDAKAN 29 REGULASI INSULIN/ HARI 30 RAWAT JENAZAH



VIP KELAS 1 UT Rp30,000 Rp25,000 Rp25,000 Rp20,000 Rp45,000 Rp40,000 Rp35,000 Rp30,000 Rp35,000 Rp30,000 Rp35,000 Rp30,000 Rp40,000 Rp35,000 Rp40,000 Rp35,000 Rp37,000 Rp35,000 Rp20,000 Rp17,000 Rp20,000 Rp17,000 Rp20,000 Rp17,000 Rp35,000 Rp30,000 Rp40,000 Rp35,000 Rp50,000 Rp45,000 Rp65,000 Rp60,000 Rp42,000 Rp37,000 Rp35,000 Rp30,000 Rp30,000 Rp25,000 Rp250,000 Rp250,000 Rp100,000 Rp100,000 Rp100,000 Rp100,000 Rp20,000 Rp17,000 Rp20,000 Rp17,000 Rp20,000 Rp17,000 Rp40,000 Rp35,000 Rp15,000 Rp15,000 Rp20,000 Rp17,000 Rp25,000 Rp20,000 Rp50,000 Rp50,000



TARIF RS KELAS 1 Rp25,000 Rp20,000 Rp35,000 Rp25,000 Rp30,000 Rp30,000 Rp35,000 Rp35,000 Rp35,000 Rp17,000 Rp17,000 Rp17,000 Rp30,000 Rp35,000 Rp45,000 Rp60,000 Rp37,000 Rp30,000 Rp25,000 Rp250,000 Rp100,000 Rp100,000 Rp17,000 Rp17,000 Rp17,000 Rp35,000 Rp15,000 Rp17,000 Rp20,000 Rp50,000



KELAS 2 Rp20,000 Rp15,000 Rp30,000 Rp20,000 Rp25,000 Rp25,000 Rp32,000 Rp32,000 Rp30,000 Rp15,000 Rp15,000 Rp15,000 Rp25,000 Rp32,000 Rp40,000 Rp55,000 Rp35,000 Rp25,000 Rp23,000 Rp250,000 Rp100,000 Rp100,000 Rp15,000 Rp15,000 Rp15,000 Rp32,000 Rp15,000 Rp15,000 Rp15,000 Rp50,000



KELAS 3 Rp15,000 Rp10,000 Rp25,000 Rp15,000 Rp20,000 Rp20,000 Rp30,000 Rp30,000 Rp27,000 Rp13,000 Rp13,000 Rp13,000 Rp20,000 Rp30,000 Rp35,000 Rp50,000 Rp32,000 Rp20,000 Rp20,000 Rp250,000 Rp100,000 Rp100,000 Rp13,000 Rp13,000 Rp13,000 Rp30,000 Rp15,000 Rp13,000 Rp10,000 Rp50,000