POLRI DAERAH JAWA TIMUR

BIDANG KEDOKTERAN DAN KESEHATAN

RS. BHAYANGKARA HASTA BRATA BATU

TARIF KAMAR RAWAT INAP RUANG MELATI DAN BOUGENVILE

JASA VISITE DOKTER

NO KAMAR TARIF
SPESIALIS
1 VIP Rp300,000 Rp100,000
2 KELAS 1 UTAMA (MELATI 11 DAN MELATI 12, BOUGENVILE 7) Rp250,000 Rp80,000
3 KELAS 1 (MELATI 1-MELATI 6, BOUGENVILE 4, 5, 6, , 9,10) Rp225,000 Rp80,000
4 KELAS 2 (MELATI 7 - MELATI 10, BOUGENVILE 8) Rp180,000 Rp60,000
5 KELAS 3 ( MELATI 13, BOUGENVILE 2 DAN BOUGENVILE 3) Rp75,000 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 KAMAR MAKAN AIR LISTRIK

1 VIP VIP Rp65,000 Rp6,000 Rp30,720
2 KELAS 1 UTAMA MELATI 11, 12, BOUGENVILE 7 Rp55,000 Rp6,000 Rp17,280
3 KELAS 1 MELATI 1 - MELATI 6 Rp55,000 Rp6,000 Rp17,280
4 BOUGENVILE 4, 5, 6, 7, 9, 10 Rp55,000 Rp6,000 Rp17,280
5 KELAS 2 MELATI 7 - MELATI 10, BOUGENVILE 8 Rp45,000 Rp6,000 Rp7,680
6 KELAS 3 MELATI 13 Rp35,000 Rp6,000 Rp15,360
7 BOUGENVILE 1 Rp35,000 Rp6,000 Rp7,680
8 BOUGENVILE 2 Rp35,000 Rp6,000 Rp7,680
9 BOUGENVILE 3 Rp35,000 Rp6,000 Rp7,680
10 TAHANAN Rp35,000 Rp6,000 Rp7,680

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
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

JASA TINDAKA
NO TINDAKAN BHP AIR LISTRIK SEWA ALAT
VIP
1 TTV Rp5,000 Rp900 Rp1,920 Rp2,000 Rp8,000
2 INJEKSI Rp2,500 Rp900 Rp1,920 Rp8,000
3 PASANG INFUS ANAK Rp10,000 Rp900 Rp1,920 Rp8,000
4 PASANG INFUS DEWASA Rp7,000 Rp900 Rp1,920 Rp8,000
5 PASANG CATETER Rp10,000 Rp900 Rp1,920 Rp15,000
6 PASANG NGT Rp10,000 Rp900 Rp1,920 Rp15,000
7 EKG Rp5,000 Rp900 Rp9,600 Rp10,000 Rp10,000
8 NEBULEZER Rp5,000 Rp900 Rp9,600 Rp10,000 Rp7,000
9 KUMBAH LAMBUNG Rp20,000 Rp900 Rp1,920 Rp10,000
10 AFF INFUS Rp4,000 Rp900 Rp1,920 Rp8,000
11 AFF NGT Rp4,000 Rp900 Rp1,920 Rp8,000
12 AFF CATETER Rp4,000 Rp900 Rp1,920 Rp8,000
13 PASANG MAYO Rp10,000 Rp900 Rp1,920 Rp15,000
14 RAWAT LUKA RINGAN Rp15,000 Rp900 Rp1,920 Rp5,000 Rp15,000
15 RAWAT LUKA SEDANG Rp20,000 Rp900 Rp1,920 Rp5,000 Rp20,000
16 RAWAT LUKA BERAT Rp30,000 Rp900 Rp1,920 Rp5,000 Rp25,000
17 SUCTION Rp10,000 Rp900 Rp9,600 Rp5,000 Rp15,000
18 RJP 5 SIKLUS Rp1,000 Rp900 Rp1,920 Rp5,000 Rp15,000
19 PASANG O2 / 2000L Rp2,000 Rp900 Rp1,920 Rp10,000 Rp10,000
20 SEWA MONITOR Rp10,000 Rp900 Rp15,000 Rp156,000 Rp20,000
21 PASANG SYRING PUMP Rp10,000 Rp900 Rp15,000 Rp50,000 Rp20,000
22 PASANG INFUS PUMP Rp10,000 Rp900 Rp15,000 Rp50,000 Rp20,000
23 AFF TRAKSI Rp4,000 Rp900 Rp1,920 Rp8,000
24 GANTI SPOOLING Rp5,000 Rp900 Rp1,920 Rp8,000
25 VERBED Rp5,000 Rp900 Rp1,920 Rp8,000
26 SPOOLING MANUAL Rp15,000 Rp900 Rp1,920 Rp15,000
27 PEMBERIAN TRANFUSI / LABU Rp5,000 Rp900 Rp1,920 Rp7,000
28 AFF DRAIN Rp4,000 Rp900 Rp1,920 Rp8,000
29 REGULASI INSULIN Rp2,500 Rp900 Rp1,920 Rp8,000
30 RAWAT JENAZAH Rp20,000 Rp900 Rp1,920 Rp20,000
31 PEMBERIAN DIET NGT/HARI Rp5,000 Rp900 Rp1,920 Rp8,000

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
RINCIAN TARIF RUANG MELATI DAN BOUGENVILE
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 TARIF RS
KELAS 3 VIP KELAS 1 UT KELAS 1 KELAS 2 KELAS 3
Rp14,820 Rp30,000 Rp25,000 Rp25,000 Rp20,000 Rp15,000
Rp9,320 Rp25,000 Rp20,000 Rp20,000 Rp15,000 Rp10,000
Rp17,820 Rp45,000 Rp40,000 Rp35,000 Rp30,000 Rp25,000
Rp14,820 Rp35,000 Rp30,000 Rp25,000 Rp20,000 Rp15,000
Rp17,820 Rp35,000 Rp30,000 Rp30,000 Rp25,000 Rp20,000
Rp17,820 Rp35,000 Rp30,000 Rp30,000 Rp25,000 Rp20,000
Rp28,500 Rp40,000 Rp35,000 Rp35,000 Rp32,000 Rp30,000
Rp29,500 Rp40,000 Rp35,000 Rp35,000 Rp32,000 Rp30,000
Rp25,820 Rp37,000 Rp35,000 Rp35,000 Rp30,000 Rp27,000
Rp11,820 Rp20,000 Rp17,000 Rp17,000 Rp15,000 Rp13,000
Rp11,820 Rp20,000 Rp17,000 Rp17,000 Rp15,000 Rp13,000
Rp11,820 Rp20,000 Rp17,000 Rp17,000 Rp15,000 Rp13,000
Rp17,820 Rp35,000 Rp30,000 Rp30,000 Rp25,000 Rp20,000
Rp27,820 Rp40,000 Rp35,000 Rp35,000 Rp32,000 Rp30,000
Rp34,820 Rp50,000 Rp45,000 Rp45,000 Rp40,000 Rp35,000
Rp47,820 Rp65,000 Rp60,000 Rp60,000 Rp55,000 Rp50,000
Rp30,500 Rp42,000 Rp37,000 Rp37,000 Rp35,000 Rp32,000
Rp13,820 Rp35,000 Rp30,000 Rp30,000 Rp25,000 Rp20,000
Rp19,820 Rp30,000 Rp25,000 Rp25,000 Rp23,000 Rp20,000
Rp188,900 Rp250,000 Rp200,000 Rp200,000 Rp200,000 Rp200,000
Rp95,900 Rp100,000 Rp100,000 Rp100,000 Rp100,000 Rp100,000
Rp95,900 Rp100,000 Rp100,000 Rp100,000 Rp100,000 Rp100,000
Rp11,820 Rp20,000 Rp17,000 Rp17,000 Rp15,000 Rp13,000
Rp12,820 Rp20,000 Rp17,000 Rp17,000 Rp15,000 Rp13,000
Rp12,820 Rp20,000 Rp17,000 Rp17,000 Rp15,000 Rp13,000
Rp22,820 Rp40,000 Rp35,000 Rp35,000 Rp32,000 Rp30,000
Rp11,820 Rp15,000 Rp15,000 Rp15,000 Rp15,000 Rp15,000
Rp11,820 Rp20,000 Rp17,000 Rp17,000 Rp15,000 Rp13,000
Rp9,320 Rp25,000 Rp20,000 Rp20,000 Rp15,000 Rp10,000
Rp42,820 Rp50,000 Rp50,000 Rp50,000 Rp50,000 Rp50,000
Rp12,820 Rp20,000 Rp17,000 Rp17,000 Rp15,000 Rp13,000
 SELISIH
VIP KELAS 1 UT KELAS 1 KELAS 2 KELAS 3
Rp12,180 Rp8,180 Rp8,180 Rp4,180 Rp180
Rp11,680 Rp7,680 Rp7,680 Rp3,680 Rp680
Rp24,180 Rp20,180 Rp15,180 Rp11,180 Rp7,180
Rp17,180 Rp13,180 Rp8,180 Rp4,180 Rp180
Rp7,180 Rp7,180 Rp7,180 Rp5,180 Rp2,180
Rp7,180 Rp7,180 Rp7,180 Rp5,180 Rp2,180
Rp4,500 Rp2,000 Rp2,000 Rp1,500 Rp1,500
Rp7,500 Rp3,000 Rp3,000 Rp500 Rp500
Rp4,180 Rp4,680 Rp4,680 Rp2,180 Rp1,180
Rp5,180 Rp3,180 Rp3,180 Rp2,180 Rp1,180
Rp5,180 Rp3,180 Rp3,180 Rp2,180 Rp1,180
Rp5,180 Rp3,180 Rp3,180 Rp2,180 Rp1,180
Rp7,180 Rp7,180 Rp7,180 Rp5,180 Rp2,180
Rp2,180 Rp2,180 Rp2,180 Rp2,180 Rp2,180
Rp2,180 Rp2,180 Rp2,180 Rp2,180 Rp180
Rp2,180 Rp2,180 Rp2,180 Rp2,180 Rp2,180
Rp1,500 Rp1,500 Rp1,500 Rp2,500 Rp1,500
Rp11,180 Rp11,180 Rp11,180 Rp9,180 Rp6,180
Rp5,180 Rp3,180 Rp3,180 Rp2,180 Rp180
Rp48,100 Rp1,100 Rp1,100 Rp8,100 Rp11,100
Rp4,100 Rp4,100 Rp4,100 Rp4,100 Rp4,100
Rp4,100 Rp4,100 Rp4,100 Rp4,100 Rp4,100
Rp5,180 Rp3,180 Rp3,180 Rp2,180 Rp1,180
Rp4,180 Rp2,180 Rp2,180 Rp1,180 Rp180
Rp4,180 Rp2,180 Rp2,180 Rp1,180 Rp180
Rp7,180 Rp7,180 Rp7,180 Rp7,180 Rp7,180
Rp180 Rp680 Rp680 Rp1,180 Rp3,180
Rp5,180 Rp3,180 Rp3,180 Rp2,180 Rp1,180
Rp11,680 Rp7,680 Rp7,680 Rp3,680 Rp680
7180 Rp7,180 Rp7,180 Rp7,180 Rp7,180
4180 Rp2,180 Rp2,180 Rp1,180 Rp180
 DAFTAR TARUF RUANG MELATI DAN BOUGENVILE

TARIF RS
NO TINDAKAN
VIP KELAS 1 UT KELAS 1 KELAS 2
1 TTV/HARI Rp30,000 Rp25,000 Rp25,000 Rp20,000
2 INJEKSI/HARI Rp25,000 Rp20,000 Rp20,000 Rp15,000
3 PASANG INFUS ANAK/1 KALI PASANG Rp45,000 Rp40,000 Rp35,000 Rp30,000
4 PASANG INFUS DEWASA/1 KALI PASANG Rp35,000 Rp30,000 Rp25,000 Rp20,000
5 PASANG CATETER/ 1 KALI PASANG Rp35,000 Rp30,000 Rp30,000 Rp25,000
6 PASANG NGT/ 1 KALI PASANG Rp35,000 Rp30,000 Rp30,000 Rp25,000
7 EKG/ 1KALI TINDAKAN Rp40,000 Rp35,000 Rp35,000 Rp32,000
8 NEBULEZER/HARI Rp40,000 Rp35,000 Rp35,000 Rp32,000
9 KUMBAH LAMBUNG/ HARI Rp37,000 Rp35,000 Rp35,000 Rp30,000
10 AFF INFUS/ 1 KALI TINDAKAN Rp20,000 Rp17,000 Rp17,000 Rp15,000
11 AFF NGT/1 KALI TINDAKAN Rp20,000 Rp17,000 Rp17,000 Rp15,000
12 AFF CATETER/ 1 KALI TINDAKAN Rp20,000 Rp17,000 Rp17,000 Rp15,000
13 PASANG MAYO/ 1 KALI TINDAKAN Rp35,000 Rp30,000 Rp30,000 Rp25,000
14 RAWAT LUKA RINGAN/HARI Rp40,000 Rp35,000 Rp35,000 Rp32,000
15 RAWAT LUKA SEDANG/HARI Rp50,000 Rp45,000 Rp45,000 Rp40,000
16 RAWAT LUKA BERAT/HARI Rp65,000 Rp60,000 Rp60,000 Rp55,000
17 SUCTION/HARI Rp42,000 Rp37,000 Rp37,000 Rp35,000
18 RJP 5 SIKLUS/ 1 KALI TINDAKAN Rp35,000 Rp30,000 Rp30,000 Rp25,000
19 PASANG O2 / 2000L Rp30,000 Rp25,000 Rp25,000 Rp23,000
20 PASANG MONITOR/HARI Rp250,000 Rp250,000 Rp250,000 Rp250,000
21 PASANG SYRING PUMP/HARI Rp100,000 Rp100,000 Rp100,000 Rp100,000
22 PASANG INFUS PUMP/HARI Rp100,000 Rp100,000 Rp100,000 Rp100,000
23 AFF TRAKSI/1 KALI TINDAKAN Rp20,000 Rp17,000 Rp17,000 Rp15,000
24 GANTI SPOOLING /HARI Rp20,000 Rp17,000 Rp17,000 Rp15,000
25 VERBED/ 1 KALI TINDAKAN Rp20,000 Rp17,000 Rp17,000 Rp15,000
26 SPOOLING MANUAL/ 1 KALI TINDAKAN Rp40,000 Rp35,000 Rp35,000 Rp32,000
27 PEMBERIAN TRANFUSI / LABU Rp15,000 Rp15,000 Rp15,000 Rp15,000
28 AFF DRAIN/ 1 KALI TINDAKAN Rp20,000 Rp17,000 Rp17,000 Rp15,000
29 REGULASI INSULIN/ HARI Rp25,000 Rp20,000 Rp20,000 Rp15,000
30 RAWAT JENAZAH Rp50,000 Rp50,000 Rp50,000 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