UNIT COST PEMERIKSAAN RADIOLOGI RS.

BALI JIMBARAN 2018

NO PEMERIKSAAN BHP JUMLAH

1 SKULL AP/LATERAL FILM 28X35 2
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
2 THORAX PA FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
3 BOF FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
4 SKULL AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
3 SHOULDER AP FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
4 CLAVICULA AP FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
5 HUMERUS AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
6 ELBOW AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
 TOTAL
7 ANTEBRACHII AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
8 WRIST AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
9 MANUS AP/OBLIQUE FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
10 PELVIS/SACRUM AP FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
11 HIP JOINT AP FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
12 FEMUR AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
13 GENU AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
14 CRURIS AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
15 ANKLE AP/LATERAL FILM 28X35 1
AMPLOP FILM 1
 KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
16 PEDIS AP/OBLIQUE FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
17 VERTEBRAE CERVICALIS 2 POSISI FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
18 VERTEBRAE CERVICALIS 3 POSISI FILM 28X35 2
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
19 VERTEBRAE CERVICALIS 4 POSISI FILM 28X35 2
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
20 VERTEBRAE THORACALIS 2 POSISI FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
21 VERTEBRAE THORACALIS 3 POSISI FILM 28X35 2
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
22 VERTEBRAE THORACALIS 4 POSISI FILM 28X35 2
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
23 VERTEBRAE LUMBALIS 2 POSISI FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
 TOTAL
24 VERTEBRAE LUMBALIS 3 POSISI FILM 28X35 2
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
25 VERTEBRAE LUMBALIS 4 POSISI FILM 28X35 2
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
26 HSG FILM 28X35 1
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON STERIL 2
KONTRAS MEDIA 25 ml
KASSA STERIL 1 box
ALKOHOL 96% 50 ml
BETADINE 100 ml
KATETER 8/10 2
PEMBALUT 1
AQUABIDES 25 ml 1
TOTAL
27 CT-SCAN KEPALA TANPA KONTRAS 1
NON TRAUMA FILM 35 X 43
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
28 CT-SCAN KEPALA TANPA KONTRAS 2
TRAUMA FILM 35 X 43
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
29 CT-SCAN KEPALA DENGAN 2
KONTRAS FILM 35 X 43
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
KONTRAS MEDIA 50 ml
SPUIT 1 CC 1
SPUIT 50 CC 1
NEEDLE 18 2
WING NEEDLE 21 2
 HEPAPIX 2
ALKOHOL SWAB 5
TOTAL
29 CT-SCAN VERTEBRAE LUMBALIS FILM 35 X 43 2
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
30 2
CT-SCAN EKSTREMITAS ATAS BAWAH FILM 35 X 43
AMPLOP FILM 1
KERTAS A4 3
MASKER 1
HAND SCOON 1
TOTAL
31 USG ABDOMEN ATAS DAN BAWAH KERTAS USG 15
GEL USG 50 ml
TISSUE 4
KERTAS A4 3
AMPLOP USG 1
TOTAL
32 USG ABDOMEN ATAS ATAU BAWAH KERTAS USG 15
GEL USG 50 ml
TISSUE 4
KERTAS A4 3
AMPLOP USG 1
TOTAL
33 USG MAMAE/TYROID/COLI KERTAS USG 15
GEL USG 50 ml
TISSUE 4
KERTAS A4 3
AMPLOP USG 1
TOTAL
34 ABVS KERTAS A4 7
HAND SCOON 1
LOTION 50 ml
TISSUE 4
AMPLOP ABVS 1
MEMBRANE 1
TOTAL
2018

HARGA
Rp 74,880
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 87,680
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 74,880
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 87,680
Rp 74,880
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 87,680
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 74,880
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 87,680
Rp 74,880
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 87,680
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 50,240
Rp 74,880
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 87,680
Rp 74,880
Rp 5,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 87,680
Rp 37,440
Rp 5,000
Rp 3,000
Rp 1,600
Rp 8,600
Rp 141,120
Rp 8,500
Rp 230
Rp 8,700
Rp 116,000
Rp 2,400
Rp 5,800
Rp 338,390
Rp 54,720
Rp 8,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 70,520
Rp 109,440
Rp 8,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 125,240
Rp 109,440
Rp 8,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 274,880
Rp 7,040
Rp 23,320
Rp 3,960
Rp 24,700
Rp 770
Rp 1,400
Rp 461,310
Rp 109,440
Rp 8,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 125,240
Rp 109,440
Rp 8,000
Rp 3,000
Rp 1,600
Rp 3,200
Rp 125,240
Rp 1,500
Rp 9,000
Rp 4,000
Rp 3,000

Rp 17,500
Rp 1,500
Rp 9,000
Rp 4,000
Rp 3,000

Rp 17,500
Rp 1,500
Rp 9,000
Rp 4,000
Rp 3,000

Rp 17,500
Rp 7,000
Rp 3,200
Rp 17,160
Rp 4,000
Rp 3,500
-
Rp 34,860