No

1
2
3
4

Item
Sewa Gedung
Listrik
Biaya Renovasi
Dental Unit dan Alat

Tahun
5
1
5
5
Total

Jumlah (Rp)
25,000,000
4,800,000
20,000,000
32,000,000

Satuan (Rp)
4340.28
4166.67
3472.22
5555.56
17534.73

Fixed Cost adalah Rp 16.666,68 (dibulatkan menjadi Rp 18.000)

1
1
1
1
5

Hari = 4 Perawatan
Minggu = 24 Perawatan
Bulan = 96 Perawatan
Tahun = 1152 Perawatan
Tahun = 5760 Perawatan

Modul
Endodontik

Nama Perawatan
Kaping pulpa

Trepanasi

Devitalisasi Pulpa

Preparasi 1 Saluran Akar (Stepback)

Preparasi 1 Saluran Akar (Crowndown)

Dressing

Obturasi 1 Saluran Akar (Stepback)

Obturasi 1 Saluran Akar (Crowndown)

Opdent

Tumpatan RK Posterior (L)

Tumpatan RK Posterior (M)

Tumpatan RK Posterior (S)

Tumpatan SIK (L)

Tumpatan SIK (M)

Tumpatan SIK (S)

Tumpatan Klas III

Tumpatan Klas IV

Tumpatan Klas V

Labial Veneer Indirect

Labial Veneer Direct

Tumpatan Sandwich

Onlay/Inlay PFM
Onlay/Inlay Komposit
Proteksi Pulpa

Periodonsi

Scalling Manual

Scalling USS (L)

Scalling USS (M)

Scalling USS (S)

Kuretase

Splinting 1 gigi (Wire)

Splinting 1 gigi (Resin Komposit)

Splinting 1 gigi (Wire dan Resin Komposit)

Frenektomi

Gingivektomi

Aplikasi Ti-es 1 gigi

Orthodonsi

Insersi Fix Orthodonsi (Keramik)

Insersi Fix Orthodonsi (Metal)

Insersi Removable Orthodonsi

Kontrol Fix Orthodonsi (standar)

Bracket lepas (per 1 gigi)

Ganti wire
Ligating per gigi
Kontrol Removable Orthodonsi

Retainer
Bedah Mulut

Ekstraksi Gigi Decidui (Topical)

Ekstraksi Gigi Decidui (Infiltrasi)

Ekstraksi Gigi Tanpa Komplikasi

Ekstraksi Gigi Dengan Komplikasi

Uperculectomi

Odontectomi Klas I

Odontectomi Klas II

Odontectomi Klas III

Pedodonsi

Space Maitener/Regainer

Kontrol Space Maitener/Regainer

Pit dan Fissure Sealant

Topikal Aplikasi Fluor 1 Regio

Stainlees Steel Crown

Poli Carbonat Crown

Prostodonsi

GTS 1 Plat 1 gigi (Akrilik)

GTS 1 Plat 1 gigi (Valvlast)

GTS 1 Gigi Tambahan (Akrilik)

GTS 1 Gigi Tambahan (Valvlast)
Gigi Tiruan Cekat Per Unit (PFM)

Gigi Tiruan Cekat Per Unit (Porcelein)

Gigi Tiruan Lengkap Full (Akrilik)

Gigi Tiruan Lengkap Full (Valvlast)

Gigi Tiruan Lengkap 1 Rahang (Akrilik)

Gigi Tiruan Lengkap 1 Rahang (Valvlast)

Mahkota Jaket Sementara

Mahkota Jaket PFM

Mahkota Jaket All Porcelein

Reparasi dan rebasing GTS dan GTL

Umum

Spulling

Sementasi dengan SIK

Sementasi dengan RK

Sementasi dengan semen seng fosfat

Konsultasi
Cetak Rahang Atas dan Rahang Bawah

Cetak 1 Rahang

Kebutuhan Alat dan Bahan

Harga (Rp)

Alat Diagnostik
Bur bulat
Bur fissure
Steel bur
Ball aplikator
Agat spatula
Plastis instrumen
Cavity Cleanser
Dentin Conditioner
Dycal/Calcimol
Lining SIK
Tumpatan sementara
Paper pad
Lain-lain
Total

70,000
30,000
30,000
15,000
20,000
20,000
20,000
170,000
95,000
100,000
250,000
133,000
20,000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Barbed broach
Larutan irigasi
Lain-lain
Total

70,000
30,000
30,000
75,000
30,000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Plastis instrumen
Arsen
Eugenol
Tumpatan sementara

70,000
30,000
30,000
20,000
100,000
70,000
133,000

Lain-Lain
Total

10,000

Alat Diagnostik
Bur bulat
Bur fissure
Spuit dan jarum irigasi
K-file
H-file
Endoblock
Barbed broach
Larutan irigasi
EDTA
Lain-Lain
Total

70,000
30,000
30,000
26,500
105,000
70,000
150,000
75,000
17,000
100,000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Spuit dan jarum irigasi
K-file
Protaper
Endoblock
Barbed broach
Larutan irigasi
EDTA
Lain-Lain
Total

70,000
30,000
30,000
26,500
105,000
650,000
150,000
75,000
17,000
100,000
10,000

Lentulo
Paper point
Bahan dressing CHkm
Tumpatan sementara
Lain-lain
Total

125,000
27,000
60,000
133,000
10,000

Alat Diagnostik
Spreader
Plugger
Lampu spritus
Gunting
Larutan irigasi
Paper poin
Gutta percha
Endomethasone
Eugenol
Tumpatan sementara
Lain-lain
total

70,000
150,000
18,000
22,000
18,000
17,000
27,000
27,500
200,000
70,000
133,000
10,000

Alat Diagnostik
Spreader
Plugger
Lampu spritus
Gunting
Larutan irigasi
Paper poin
Gutta percha
Endomethasone
Eugenol
Tumpatan sementara
Lain-lain
Total

70,000
150,000
18,000
22,000
18,000
17,000
27,000
27,500
200,000
70,000
133,000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Bur flame
Bur finishing
Articulating paper
Bur polishing
Metal Bur

70,000
30,000
30,000
30,000
30,000
10,000
22,000
15,000

Alat tumpat
Cavity cleanser
Etsa
Bonding
RK flowable
RK packable
Light Cure
Lain-lain
Total

60,000
170,000
50,000
560,000
411,000
275,000
1000000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Bur flame
Bur finishing
Articulating paper
Bur polishing
Metal Bur
Alat tumpat
Cavity cleanser
Etsa
Bonding
RK flowable
RK packable
Light cure
Lain-lain
Total

70,000
30,000
30,000
30,000
30,000
10,000
22,000
15,000
60,000
170,000
50,000
560,000
411,000
275,000
1000000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Bur flame
Bur finishing
Articulating paper
Bur polishing
Metal Bur

70,000
30,000
30,000
30,000
30,000
10,000
22,000
15,000

Alat tumpat
Cavity cleanser
Etsa
Bonding
RK flowable
RK packable
Light cure
Lain-lain
Total

60,000
170,000
50,000
560,000
411,000
275,000
1000000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Bur flame
White alpin poin
Articulating paper
Bur polishing
Metal Bur
Alat tumpat
Cavity cleanser
Varnish
SIK
Dentin conditioner
Lain-lain
Total

70,000
30,000
30,000
30,000
25,000
10,000
30,000
15,000
60,000
170,000
95,000
250,000
95,000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Bur flame
White alpin poin
Articulating paper
Bur polishing
Metal Bur
Alat tumpat
Cavity cleanser

70,000
30,000
30,000
30,000
25,000
10,000
30,000
15,000
60,000
170,000

Vaseline
SIK
Dentin conditioner
Lain-lain
Total

95,000
250,000
95,000
10,000

Alat Diagnostik
Bur bulat
Bur fissure
Bur flame
White alpin poin
Articulating paper
Bur polishing
Metal Bur
Alat tumpat
Cavity cleanser
Vaseline
SIK
Dentin conditioner
Lain-lain
Total

70,000
30,000
30,000
30,000
25,000
10,000
30,000
15,000
60,000
170,000
95,000
250,000
95,000
10,000

Alat Diagnostik
Bur bulat
Bur flame
Finishing strip
Seluloid strip
Bur finishing
Articulating paper
Bur polishing
Metal Bur
Alat tumpat
Cavity cleanser
Etsa
Bonding
RK flowable

70,000
30,000
30,000
30,000

RK packable
Light cure
Lain-lain
Total

10,000

Alat Diagnostik
Bur bulat
Finishing strip
Seluloid strip
Bur flame
Bur finishing
Articulating paper
Bur polishing
Metal Bur
Alat tumpat
Cavity cleanser
Etsa
Bonding
RK flowable
RK packable
Light cure
Lain-lain
Total

70,000

Alat Diagnostik
Bur bulat
Bur flame
Bur finishing
Articulating paper
Bur polishing
Metal Bur
Alat tumpat
Cavity cleanser
Etsa
Bonding
RK flowable

70,000

10,000

RK packable
Light cure
Lain-lain
Total

10,000

Alat Diagnostik
Bur Tappered
Bur flame
Bur finishing
Lain-lain

70,000

Alat Diagnostik
Bur bulat
Finishing strip
Seluloid strip
Bur flame
Bur finishing
Articulating paper
Bur polishing
Alat tumpat
Cavity cleanser
Etsa
Bonding
RK flowable
RK packable
Light cure
Lain-lain

70,000

Alat Diagnostik
Bur bulat
Bur fissure
Bur flame
Articulating paper
Bur polishing
Metal Bur

70,000
30,000
30,000
30,000
10,000
30,000
15,000

10,000

10,000

Alat tumpat
Cavity cleanser
SIK
Dentin conditioner
Etsa
Bonding
RK flowable
RK packable
Light cure
Lain-lain
Total

Vitre bond
Lain-lain

60,000
170,000
250,000
95,000
50,000
560,000
411,000
275,000
1000000
10000

10,000

Alat diagnostik
Scaller Manual
Pumice
Pasta
Brush
Lain-lain

70,000

Alat diagnostik
Tip scaller
Pumice
Pasta
Brush
TSR
Lain-lain
Total

70,000
1,300,000
10,000
2,500
7,500
90,000
10000

Alat diagnostik
Tip scaller
Pumice

70,000
1,300,000
10,000

10,000

Pasta
Brush
TSR
Lain-lain
Total

2,500
7,500
90,000
10000

Alat diagnostik
Tip scaller
Pumice
Pasta
Brush
TSR
Lain-lain
Total

70,000
1,300,000
10,000
2,500
7,500
90,000
10000

Alat diagnostik
Alat kuret
Irigasi
Povidone iodine
Lain-lain

70,000

Alat diagnostik
Needle holder
Tang potong

70,000

Alat diagnostik
Etsa
Bonding
RK flowable
White alpin poin
Light cure
Lain-lain

70,000

Alat diagnostik
Etsa
Bonding

70,000

10,000

10,000

RK flowable
White alpin poin
Light cure
Wire
Lain-lain

10,000

Alat diagnostik
Citoject
Carpule
Needle carpule
Topical anastesi
Spuit injeksi
Larutan anastesi
Povidone iodine
Blade
Scalpel
Needle holder
Jarum
Benang
Periodontal pack
lain lain

70,000

Alat diagnostik
Citoject
Carpule
Needle carpule
Topical anastesi
Spuit injeksi
Larutan anastesi
Povidone iodine
Blade
Scalpel
Needle holder
Jarum
Benang

70,000

10,000

Periodontal pack
Lain-lain

10,000

Ti-es
Spongostan
Alat diagnostik
Bracket
Adhesive
Wire
Power O/chain
Bracket positioner
Distal end cutter
Bracket holder
Light cure
Lain-lain

70,000

Alat diagnostik
Bracket
Adhesive
Wire
Power O/chain
Bracket positioner
Distal end cutter
Bracket holder
Light cure
Lain-lain

70,000

Alat diagnostik
Plat aktif/ekspansi
Lain - lain

70,000

Alat diagnostik
Power O/chain
Tip scaller

70,000

10,000

10,000

10,000

Pumice pasta
Lain-lain

10,000

Adhesive
Bracket
Wire
Wire ligating
Alat diagnostik
Tip scaller
Pumice pasta
Tang ortho
Lain-lain

70,000

10,000

Retainer
Alat diagnostik
Topical anastesi
Povidone iodine
Tang decidui
Lain-lain

70,000

Alat diagnostik
Topical anastesi
Povidone iodine
Tang decidui
Bein
Citoject
Carpule
Needle carpule
Lain-lain

70,000

Alat diagnostik
Topical anastesi

70,000

10,000

10,000

Povidone iodine
Tang
Bein/cryer
Spuit injeksi
Larutan anastesi
Citoject
Carpule
Needle carpule
Lain-lain

10,000

Alat diagnostik
Topical anastesi
Povidone iodine
Tang
Bein/cryer
Spuit injeksi
Larutan anastesi
Citoject
Carpule
Needle carpule
Lain-lain

70,000

Alat diagnostik
Topical anastesi
Povidone iodine
Scalpel
Blade
Spuit injeksi
Larutan anastesi
Citoject
Carpule
Needle carpule
Lain-lain

70,000

Alat diagnostik
Topical anastesi

70,000

10,000

10,000

Povidone iodine
Tang
Blade
Raspa
Scalpel
Bur tulang
Bein/cryer
Spuit injeksi
Larutan anastesi
Citoject
Carpule
Needle carpule
Jarum
Gunting
Needle holder
Benang
Lain-lain
Alat diagnostik
Topical anastesi
Povidone iodine
Tang
Blade
Raspa
Scalpel
Bur tulang
Bein/cryer
Spuit injeksi
Larutan anastesi
Citoject
Carpule
Needle carpule
Jarum
Gunting
Needle holder
Benang

10,000
70,000

Lain-lain

10,000

Alat diagnostik
Topical anastesi
Povidone iodine
Tang
Blade
Raspa
Scalpel
Bur tulang
Bein/cryer
Spuit injeksi
Larutan anastesi
Citoject
Carpule
Needle carpule
Jarum
Gunting
Needle holder
Benang
Lain-lain

70,000

Alat diagnostik
Alat Space Maitener/Regainer
Pumice pasta
Lain-lain

70,000

Alat diagnostik
Pumice pasta
Lain-lain

70,000

Alat diagnostik
Etsa & bonding/dentin conditioner
Brush
Pumice
RK/SIK

70,000

10,000

10,000

10,000

Bur polishing
Lain-lain

10,000

Alat diagnostik
Topical fluor
Brush
Pumice
Microbrush
Lain-lain

70,000

Alat diagnostik
Bur tappered/fissure
Bur torpedo
Bur polishing
SSC
Lain-lain

70,000

Alat diagnostik
Bur tappered/fissure
Bur torpedo
Bur polishing
PCC
Lain-lain

70,000

Alat diagnostik
bahan cetak/alginat
bahan pengisi/gips
Prosesing GTS 1 Plat 1 gigi (Akrilik)
Arkansas stone
Lain-lain

70,000
100,000

Alat diagnostik
Prosesing GTS 1 Plat 1 gigi (Valvlast)
Arkansas stone
Lain-lain

70,000

10,000

10,000

10,000

10,000

10,000

GTS 1 Gigi Tambahan (Akrilik)

GTS 1 Gigi Tambahan (Valvlast)
Alat diagnostik
Bur fissure/tappered
Bur torpedo
Bur finishing
Prosesing
Lain-lain

70,000

Alat diagnostik
Bur fissure/tappered
Bur torpedo
Bur finishing
Prosesing
Lain-lain

70,000

Alat diagnostik
Spritus
Prosesing
Arkansas stone
Lain-lain

70,000

Alat diagnostik
Spritus
Prosesing
Arkansas stone
Lain-lain

70,000

Alat diagnostik
Spritus
Prosesing
Arkansas stone

70,000

10,000

10,000

10,000

10,000

Lain-lain

10,000

Alat diagnostik
Spritus
Prosesing
Arkansas stone
Lain-lain

70,000

Alat diagnostik
Prosesing
Arkansas stone
Lain-lain

70,000

Alat diagnostik
Bur fissure/tappered
Bur torpedo
Bur finishing
Prosesing
Lain-lain

70,000

Alat diagnostik
Bur fissure/tappered
Bur torpedo
Bur finishing
Prosesing
Lain-lain

70,000

Alat diagnostik
Prosesing
Lain-lain

70,000

10,000

10,000

10,000

10,000

Larutan spulling
Spuit injeksi
Lain-lain

10,000

Alat diagnostik

70,000

SIK
Dentin conditioner
Cavity cleanser
Paper pad
Alat tambal
Articulating paper
Lain-lain
Alat diagnostik
Etsa
Primer
Bonding
Semen RK
Cavity cleanser
Paper pad
Alat tambal
Light Cure
Articulating paper
Lain-lain

70,000

Alat diagnostik
Semen seng fosfat
Cavity cleanser
Glass pad
Alat tambal
Articulating paper
Lain-lain

70,000

Konsultasi
Alat diagnostik
Sendok cetak
Malam merah
Alginat
Spuit alginat
Gipstone

70,000

Glass stone
Spatula dan rubber bowl
Alat diagnostik
Sendok cetak
Malam merah
Alginat
Spuit alginat
Gipstone
Glass stone
Spatula dan rubber bowl

70,000

Jumlah Pasien

Harga Satuan (Rp)

350
10
10
10
1,000
1,000
1,000
100
50
50
50
100
200
1

200
3000
3000
1500
20
20
20
1700
1900
2000
5000
1330
100
10000
29790

350
10
10
10
100
1

200
3000
3000
7500
300
10000
24000

350
10
10
1,000
100
100
100

200
3000
3000
20
1000
700
1330

10000
19250

350
10
10
10
30
30
1000
20
50
100
1

350
10
10
10
30
200
1000
20
50
100
1

200
3000
3000
2650
3500
2333.3333333333
150
3750
340
1000
10000
29923.3333333333
200
3000
3000
2650
3500
3250
150
3750
340
1000
10000
30840

50
100
200
100
1

2500
270
300
1330
10000
14400

350
350
350
350
350
50
100
20
100
100
100
1

200
428.5714285714
51.4285714286
62.8571428571
51.4285714286
340
270
1375
2000
700
1330
10000
16809.2857142857

350
350
350
350
350
50
100
20
100
100
100
1

200
428.5714285714
51.4285714286
62.8571428571
51.4285714286
340
270
1375
2000
700
1330
10000
16809.2857142857

350
10
10
10
10
50
10
10

200
3000
3000
3000
3000
200
2200
1500

1000
100
50
100
100
50
1000
1

60
1700
1000
5600
4110
5500
1000
10000
45070

350
10
10
10
10
50
10
10
1000
120
70
120
120
70
1000
1

350
10
10
10
10
50
10
10

200
3000
3000
3000
3000
200
2200
1500
60
1416.6666666667
714.2857142857
4666.6666666667
3425
3928.5714285714
1000
10000
41311.1904761905
200
3000
3000
3000
3000
200
2200
1500

1000
140
90
140
140
90
1000
1

350
10
10
10
20
50
10
10
1000
100
100
50
100
1

60
1214.2857142857
555.5555555556
4000
2935.7142857143
3055.5555555556
1000
10000
38921.1111111111
200
3000
3000
3000
1250
200
3000
1500
60
1700
950
5000
950
10000
33810

350
10
10
10
20
50
10
10
1000
120

200
3000
3000
3000
1250
200
3000
1500
60
1416.6666666667

100
70
120
1

950
3571.4285714286
791.6666666667
10000
31939.7619047619

350
10
10
10
20
50
10
10
1000
140
100
90
140
1

200
3000
3000
3000
1250
200
3000
1500
60
1214.2857142857
950
2777.7777777778
678.5714285714
10000
30830.6349206349

350
10
10
10

200
3000
3000
3000

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350
10
10
10
50
10
10

200
3000
3000
3000
200
3000
1500

1000
100
50
100
50
100
100
50
1000
1

60
1700
5000
950
1000
5600
4110
5500
1000
10000
48820

10000

350

200

10000

350
500
100
50
5
50
1

200
2600
100
50
1500
1800
10000
16250

350
500
100

200
2600
100

50
5
50
1

50
1500
1800
10000
16250

350
500
100
50
5
50
1

200
2600
100
50
1500
1800
10000
16250

350

200

10000

350

200

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200
275,000

10000

350

200

170,000
10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

10000

350

200

170,000
1

10000

350

200

10000

350

200

10000

350

200

350

200

350

200

5,000
350

200

350

200

No

Perawatan
Aplikasi Ti-es 1 gigi
Bracket lepas (per 1 gigi)
Cetak 1 Rahang
Cetak Rahang Atas dan Rahang Bawah
Devitalisasi Pulpa
Dressing
Ekstraksi Gigi Decidui (Infiltrasi)
Ekstraksi Gigi Decidui (Topical)
Ekstraksi Gigi Dengan Komplikasi
Ekstraksi Gigi Tanpa Komplikasi
Frenektomi
Ganti wire
Gigi Tiruan Cekat Per Unit (PFM)
Gigi Tiruan Cekat Per Unit (Porcelein)
Gigi Tiruan Lengkap 1 Rahang (Akrilik)
Gigi Tiruan Lengkap 1 Rahang (Valvlast)
Gigi Tiruan Lengkap Full (Akrilik)
Gigi Tiruan Lengkap Full (Valvlast)
Gingivektomi
GTS 1 Gigi Tambahan (Akrilik)
GTS 1 Gigi Tambahan (Valvlast)
GTS 1 Plat 1 gigi (Akrilik)
GTS 1 Plat 1 gigi (Valvlast)
Insersi Fix Orthodonsi (Keramik)
Insersi Fix Orthodonsi (Metal)
Insersi Removable Orthodonsi
Kaping pulpa
Konsultasi
Kontrol Fix Orthodonsi (standar)
Kontrol Removable Orthodonsi
Kontrol Space Maitener/Regainer
Kuretase
Labial Veneer Direct
Labial Veneer Indirect
Ligating per gigi
Mahkota Jaket All Porcelein
Mahkota Jaket PFM
Mahkota Jaket Sementara
Obturasi 1 Saluran Akar (Crowndown)
Obturasi 1 Saluran Akar (Stepback)
Odontectomi Klas I
Odontectomi Klas II
Odontectomi Klas III

FC

SVC

18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000

10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000

Onlay/Inlay Komposit
Onlay/Inlay PFM
Pit dan Fissure Sealant
Poli Carbonat Crown
Preparasi 1 Saluran Akar (Crowndown)
Preparasi 1 Saluran Akar (Stepback)
Proteksi Pulpa
Reparasi dan rebasing GTS dan GTL
Retainer
Scalling Manual
Scalling USS (L)
Scalling USS (M)
Scalling USS (S)
Sementasi dengan RK
Sementasi dengan semen seng fosfat
Sementasi dengan SIK
Space Maitener/Regainer
Splinting 1 gigi (Resin Komposit)
Splinting 1 gigi (Wire dan Resin Komposit)
Splinting 1 gigi (Wire)
Spulling
Stainlees Steel Crown
Topikal Aplikasi Fluor 1 Regio
Trepanasi
Tumpatan Klas III
Tumpatan Klas IV
Tumpatan Klas V
Tumpatan RK Posterior (L)
Tumpatan RK Posterior (M)
Tumpatan RK Posterior (S)
Tumpatan Sandwich
Tumpatan SIK (L)
Tumpatan SIK (M)
Tumpatan SIK (S)
Uperculectomi

18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000
18,000

10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000
10,000

VC

19,250

30,000
5,000

UC

JM

Total

28,000
28,000
28,000
28,000
47,250
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
58,000
33,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000

5600
5600
5600
5600
9450
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
11600
6600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600

22400
22400
22400
22400
37800
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
46400
26400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400

56,000
56,000
56,000
56,000
94,500
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
116,000
66,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000

33,000

16250
16250
16250

24,000

45,000
41,300
39,000
50,000
34,000
32,000
31,000

28,000
28,000
28,000
28,000
28,000
61,000
28,000
28,000
28,000
28,000
44,250
44,250
44,250
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
28,000
52,000
28,000
28,000
28,000
73,000
69,300
67,000
78,000
62,000
60,000
59,000
28,000

5600
5600
5600
5600
5600
12200
5600
5600
5600
5600
8850
8850
8850
5600
5600
5600
5600
5600
5600
5600
5600
5600
5600
10400
5600
5600
5600
14600
13860
13400
15600
12400
12000
11800
5600

22400
22400
22400
22400
22400
48800
22400
22400
22400
22400
35400
35400
35400
22400
22400
22400
22400
22400
22400
22400
22400
22400
22400
41600
22400
22400
22400
58400
55440
53600
62400
49600
48000
47200
22400

56,000
56,000
56,000
56,000
56,000
122,000
56,000
56,000
56,000
56,000
88,500
88,500
88,500
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
56,000
104,000
56,000
56,000
56,000
146,000
138,600
134,000
156,000
124,000
120,000
118,000
56,000