DAFTAR ISI
| BIAYA OPERASIONAL
A BIAYA PELAYANAN
1. Biaya Pegawai
1.1. Gaji Pegawai BLUD Tidak Tetep
4.2. Penghasilan Lainnya Pegawai SLUD Tidak Tetap
2. Biaya Bahan
24° Biaya Obat
22. Biaya Alkes
23. Biaya Behan dan Alat Laborat
24° Biaya Bahan dan Alat Radiologi
25° Biaya Bahan Makan
3 Biaya Jasa Pelayanan
31 Biaya Jasa Pelayanan
4 Biaya Pemetiharean
41 Biaya Kalbrasi
4.2 Biaya Pemeliharaan Alat Kedokteran
5 Biaya Barang dan Jasa
5.1 Biaya Linen
5.2. Biaya Cetakan
6 Biaya Pelayanan Lain-lain
6.1 Biaya Pelyn, Pasien 8PUS, PKMS,Jamkesda dl
6.2. Biaya Pemulasaraan
63. Biaya Pasien TB (Resisten obat)
B_ BIAYA UMUM DAN ADMINISTRAS!
1. Biaya Pegawai
1.4 Biaya Lembur Pegawai
2. Biaya Administrasi Kantor
241 Biaya Benda Pos dan Pengiriman
22. BiayaATK
23° Biaya Penggandaan
24 Biaya Kepustakaan
25. Biaya Pakaian DinasiKerja
28 Biaya Makan Minum non Pasien
27. Biaya Letang
28 Biaya Langganan MedialSurat KabariMajalah
29° Biaya Langganan Listk/AiTelp Intemet
2.40. Biaya Dokumentasi
2.41 Biaya Piket dan Outsourcing
2.42 Biaya Perjalanan Dinas
2.13. Biaya Honorarium kepanitiaan
2.44 Biaya Keanggotaan
2.45 Biaya Akomodasi dan Transportasi
3 Biaya Pemelinaraan
3.1 Biaya Pemel, Rumdin dan Godung
3.2. Biaya Pemel,Insalasiiaingan
33. Siaya Pemel AlatTransportasi
34 Biaya Pemel, Tehnolog nformasi
35. Biaya Pemel.Alat Kantor dan RT
36 Biaya Pemel.Perlengkapan Kantor
37 Biaya Pemel Fisk lainnya
Hal
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2 4 Blaya Barang dan Jasa
4A
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46
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4.10
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443
444
445
4.16
4a7
Biaya Bahan dan Alat Sanitasi
Biaya Bahan Pembersih dan Alat Kebersihan
Biaya Bahan Bakar
Biaya Bahan Gas
Biaya Bahan dan Alat Dapur'Pantry
Biaya Pengisian tab, Pemadam Ketakaran
Eiaya Peralatan Listrk/ElektronikiKedokteran
Biaya Peralatan Kerja
Biaya Peralatan Kantor dan RT
Blaya Jasa Konsutans!
Biaya Korie Mutu dan Keselamatan Pasien (KMKP)
Biaya Peningkatan Mutu SOM
Biaya Jasa Pengembangan SIM IT
Biaya Jasa Kebersihan
Biaya Jasa Sewa
Biaya Jasa Sampah/Pemeritsaan Air Udara,Gas
Biaya Jasa Pengelolaan Sampah Infeksius
5 Biaya Promosi dan Publikasi
5A
52
Biaya Promosi
Biaya Publikasi
6 Biaya Umum dan Administrasi Lainnya
6A
62
Biaya Premi Asuransi dan Kesehaten
Biaya Sosial/Bercana Alam
|i BIAYA NON OPERASIONAL,
Ill BIAYA INVESTASI
4 Tanah
2. Bangunan dan Gedung
3 Peralatan dan Mesin
a1
32
33
34
Peralatan Kedokteran/Kesehatan
Peralatan Kantor dan RT
Perlengkapan RS
Komputer dan Printer
4 Aset Tetap Lainnya
44
44
44
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46 [PROGRAM 1.0210202.1% __ - Program Poninghatan Mutu Polayanan Kesehatan BLUD
KEGIATAN _ :1.02..02.02.12.0001 - Kegiatan Pelayanan dan Pendukung Pelayenan
ANGGARAN BELANJA BLUD TAHUN ANGGARAN 2016
|RSUD Dr. MOEWARDI
IBIAYA OPERASIONAL
660,000,000,000
'544,000.000.000
[8 |BIAYAPELAYANAN 487.170.789.000
[1 Baya Pegawai 30.000.000.000
aj Pegawai BLUD Tidak Tetap 277.752.700.000
SLTA 2350.00 €.102.000.000
_ 2,260,000 513.000.000
2.450.000 852.600.000
2.450.000,
2,650,000 96,400,000
2,650,000 | _£.416.600,000
2.750.000 | 2.804.000.000
—s
[poker umm 3,750,000 | 360,000,000
Dokter Spesais femmes 000,000 $00,000.000
- 7.500.000 270,000.000
D Tidak Tetap 2.247 300.000
7 —2280000| 8.500.000
- ‘9 2.250000 42.750,000,
2.450.000 77,050,000
2.450.000 | 1146. 150.000
2.650.000 7.960.000
“2.850.000 | 201.400.000
a St Protes 2.750.000 | 242,000,000
Dotter Umum — 3.750.000 30,00.000
ea Dotter Spesials $000,000 75:000.000
DokiorProlesor 7.500.000 72500.000
L 274.925.0330
7 Blaya Bahan
24 Blaya Obat
TAnalgea, ane, nina
160.371.783.000
2.047.153000|_ 2.64%.153.000
[7 lanes =e 5 a 732.152.000 732.152.000
7 3 [Anialerg dan obaluniuk anaflaksis 4140.722.000 | 1.140.722.000
41.120.146.000 | __1.120.146.000
020,695.00
358.682.000 | 7 35
797.330.000 797.330.000
“46:508.000.000 | 46 508.000.000
“Anineoplastk,inosupresan dan ot
|palaut
4 Antipatkinson - 7 80-186 000
i 7 $35,985 000
0am na ang
“14 [Procuk daran dan penggant plasma
- ~36:885.688.000 | _35.885.688.000
12 Diagnostik
3.848.94%.000 | 3.848,941.000
i] 13 [Oisniekton aseptic 463.203000| _465.203.000
| 14 [Gigi dan mult, bat dan bahan | —~320-748.00 | 320.745.000
15 [Divethdan obal unukhiprtof postat_ 4,026.386,000 | 11026 384.000
16 THorman.obat endokrin lin dan konraseptik
\] 7 Kascovashuler, bal
Auli bat tophal
fel 19 TLartan elektro, nuts di
—_2.507.231.000 |" 2.567.234,000
~11.226.078,000 | 71.226.079.000
2.018.338,000 [2.019 338.000
¥2.027.941.000 | 12027_941.000
~___35.696.000 35.696.000
32,074.00 32.074.000 [_ Pskotamake E 264,382,000
a 2 |Releksan oll perfor dan panghanbat kolnesierase 501.634.000 | 501.634.000
| 4 Saluran coma _| 3.472.460.000 | 3.472.460.000
25 | Saluran napas 934.884.000 | 994,864,000
|_| 26 [Sistem mun ~ [796 648.00 | 796,648,000
7 |Teinga,nidung dan tenggorokan 144.335.000 | __ 144.35.000
28 vitamin dan mineral | 2827 316.000 | ~2¢27.318.000
[2s Ios mes I 5.195.128.000| _5.196.129.000
0 1406.35.00 | 11.406.359.000
Lf
2.2_Biaya Alk - -
‘A. Alkes Habis Pakal__ = = €4.823,000.000
1 [tester $42,087,000 "543.087 000
2 40,442,000 40442000
i 46.610.000 | &46.610.000
4 2734.746.000 | 273%.748.000,
20.985 00 70985.000
739.945 000|_739.545 000
__47.611.000 47,611,000
| 200,000 2.090.000
1 174795000] _174.715000
[Colostomy bag “Tahun zasro.000| 28310000,
Slr bag - en 354.526.000| $54,626 000
12 livestasiruang “fan 171.992.000[ _171.932.000
“13 [Rectal tube fan 4870.000 4.570.000
14 |Fotbel. catheter aman 7 aan 736.452.000| 796 452.000
- 15 [Female catheter _ 1 fahun 834.000 8.334.000,
| 7 = “1 fiahun 11.444,000 1.444.000
- 1 fatwa 326.563.000 326.563.000
1 tahun 492.167.000 | _492.187.000
+ litun [~~ _319.6800000 | 319.690.000
Tatu £3.903,886.000 | ~3.903688.000,
atu ‘44.171.000 | 244.17,000
fat 3344312000 | 5.344.312.000,
“fata 1.507765 000] 507.755 000
[haba 191.95.000| __131.951.000
tatu '353849.000 | __353.849.000
——_1ftahun 33020.125.000 | $026. 125.000,
1 fahun €53.233000 | __853.233.000
ins set ata “san845 000| 15.648 000
3 [HD cabeler bt fahun 1.358.000] 51 35.000
30] caheter 1 fiahun 7[516.943.000 | 1.816 543.000
[731 Feudemaye 1 fin 183.500.000| 183,500.00
37 |Hanasccenparjang : 1 finan | —<7096-38.000 | 086388 00
oe medial oon ~—t}tanan | 349.998,000 | 34. 093.000
[Se ster “i fahan | 1.153.172.000 | 1.153.172.0900
Cc 35 Monioing - 1 shun 1.607.000 | _61.607.000,
[36 [outipiece 1 tahun 20.43.000 20,433,000
37 [Nasal canul oxygen fin 330.634.000] 330634000
[fiat 302618000] 302618000
a "Than 1.278.000 81.278.000
“4a 1 fabun 528.000 5.228.000
41 [Stip gula dara 1 fahun 795.045.000 | 785.045.000
a2 Lubricant —— 1 fiahun 31459.545.000 | 1459.545.000,
F i 1 Jahun 4.770.000 4.770.000
44 eheast ead “Hahn 3.797.000, 3797.00
~ [4s [Humiter 1 ftabun 469.608.000 | 463608.000
46 [Seem ziger - [7 fatwn 28,360,000 28-360.000
"aT |Getang pasion tar 19878.000 49878,000 48 [Nal bedah
49 [Bedanjantungset "| 37031.364.000 | 3.031.364. 000
Too» Sata set 386,017.00 386,017.00
Bedahortoped set___ = 2.369722.000 | 3.368.722.000
Bedah pastsaraVanak sel tun 272618.000 | _4.272618.000
53 [Bedah urolg set tahun 235,222,000 __736.222.000
$4 [Embalage a ian 255802000 | 255,802.000
55 |Perlngkapan gia) ttn 716.000 97.186.000
56 Hemodiaisa set tan 560,318,000 | 18.50.318.000
i a] conan aun 1,985.662.000 | __1.985.662.000,
|B. Rehabitasi medic = 300,00.000
Tat bantu gerak ee aha 30010000000 | 300.000.000
i C.MatadanTelinga _ | 300,000,000
~"T acamata den aa banks denga nT) “wopoo00 | 300.00.000,
“| hBahan Series 880 — t= Tessar.
t 1 Tautclave Tepe Steam e700 | 2064.000
2 [autoclave Tepe EO a ie 272.150 544.300
| [5 esinfetan pre cleaning (enn 1 346.000] 138.224 000
4 10 al |____se8.a00 | 121.000.00 |
_5 [Desinlettan Tingkat Tinggi OTT 2.925.000 | $8.500.000
Eon! gi Steam TM a [tox | 4.153.000 | 785.000
mt T Nasa [Gung [7485 | 194.200
| 8 [lnm cemicalindiaior EO [box _| 582.500 | 990.000
box 421.500 058.000
box 4,925,000, 250.000
[box 1.644.500 | __16445.000
12] Sten Bag 7.5 amen Roel 500.000 1+2000.000
13 Stor Bag 10 emx200m Rook 575.000| _115.000.000
a ert Bag 15 mx 200 m - ool 00.000 | 96.000.000
9 20m 2 7,550,000 | 198.000.0090
7 ‘Stel. Bag 25 em x 200 m —_ - 123 300.000
[teri Bag 25cm x 100m { Gussel) 200,000
Tyvek rol 100 Xt00m 23,100,000
Tyvek rol 200 X100m_ 3.968250 39.682.500
Tyvek rol 250x100 4.950.000 $8400.00
"| 21 [Hydrogen Peroxide 8.250000 41,250.00
2,260,000 4.560.000
3630,000[ 130.680.000
105,000 25,200.00
oo 3196500| 112974000
TMatriube Lubccant Spray (Spray Penghlang Karat) 517.000 18812.000
7 27 [Thermal paper ukuren 1 Yom aa 687.500 98,000.000
[____ Elventaris Ruang | 7.000.000,000
[nventars ren am + [tahun [000,000,000 | 000.000.000
IE 3 076380.000|-
| | 26,974.000.000
ie | a0 est 2000) 640.000.000
| 500 | Test 63.250] 31,625,000]
2K "5897 100] 141.530.400
: z[k | 5.142800] 123.420000
See eae | eens msc sone zac
a 6956.40) 27825600
36 |_Kt 4088700 __147.193.200
36 ei 8.250.330] 297.011.800 " ‘Volumes satus
9 Vidas CKVE, 270.816.00
10 Vidas Fein 5.376.800] 256,086.40
“1 [vidas FSH ~ 4973.93] 4873823
12 [Vidas FT3 6.207.300] 148.975.200
13 |Vidas FTN, 7.026.800] 337.286.400]
|| 16 vidas Hegre 560.600 68 408009
15 [Vidas HEsAg Ura 3.538.700] 17,693.50
16 Vidas TPSA 7.910.100 94.921.200
17 Vides Troponin Ura 24[ Kt 72098.800] —290.373600
18 [vidas TSH [Kt 884.100] 186 436.809
19 [Apoproein Control Serum (H) 12 |e 2.248400) 28.980 800
_| 20 [Autosera STG-N(R1) —_ [1] Kt 2.071.960] 2.071.960
21 |autosera STGN (R2) +] Kt 1.381.830) 4.381.920
22 (Cholestest LOL(R1) 15|_Kt 5.655.100 84.826.500
fT 23 [Cholestest LOL (R2) 15] Kit 1.690.700] 25.360.500|
ie 24 |CholestestN-HOL(R1) 15| Kit 1.626.900] 24.403.500|
iz 25 [CholestestN- HDL (R2) 15| Kit 1.472.900] 22.003.500|
26 |[CholestestN Catraior _ [i 3.247.255 2.989.029
71 [Pureaulo $ CHON(R1) +e 1.695.155 1,695.15]
© | 28 Pueauto $ HON (R2) +4 4.017.280 4.017.260]
29 Pueauto S CRP (R1) 2| Kt 840.409 1.680.800
[30 |Pureauio SCRP(R2)— 2|_Kt 6.292.000 72584.000
| 31 Thawte immunology Coniievi83 70K 1371709 13717. 000
[=z ssp CRP Calbator i Kt 3005536] 3.065.538)
“1 4.123809 32.478.000
[ei _[ 2.356.200 47,124,000
[Ki 4,017 060] 4.017.060
[Ke 858.535 3599.36
as Kit 690.000] 6.900.000
[Kt | 1.173.000] 4.173.000]
[Ke ~__ 895000] 1.610.000
168 [BUTO al 194.500 32676 000
si/i0 mi 194500 32576 009
! 81/10 ml 250,000) ____750.000
| “1$05.700 160.078.209
| a 6008) 232.608. 480
Coag Con N'+ 9.664.876) 144,973,140
| a Ineoplasn Cl +2 - “1035.650) ___188.417.000|
[Neoplastn C15 1.798.138) 278949.528
|STACACI2 025M 3607-858) 7.647.168
8 /STA Omen Koler 4.016.232 4.016.232
DOACTHC Morphine Matamp 5.850.000 74,250,000
Dengue g Gilg M Sip 1767500) 32.178000
| 371250 16:706.250
iia - 1.870.000] 299,200,000]
[| ~~ s4 [Hepatitis C Vius Antibody Test Sip 2.000.000] 6.000.000]
65 [Tuberuostes = ra T1206] isia.74
56 |CBC Tine Pac Box ¥7.457.000] 174,570,000
- 57 [Dif Time Pac — Box, 17.57.00] 174,570.00
58 [Sheath Rinse as Box_[-___ 6983.000] 167592009
a | Box | 7.885.000] 188.760.000|
ath ie Box, 42220.000 24,440,000
[Konrl Set Auio Rete Sin 4 eet 7-844 00] 4.128.000
Reagent Esbach 2 [aus00m 356.400 712.800
4 [Reagent None 4 |[aus00m 108.000] 432000]
Reagent Pand 4 [500m 190.000 760.000
|Giemsais Soiuion — - 30 [aws00m) 100.009 30000.000
: — 30] eu25n| 480.000) 14.400.000
__| 36 [e050] ~—"725 000] 6.100.000 ahs TRICE
aS vais
L 8 Xyil (Xylene) GR Bue. 062.500 262.509
[68 Tnmersion ot too 500.000 3,000.00]
70 [acai Acid Glacial 00% Buz 565,000 565.000
"71 [itt injecion = Facon 6.000 7.320.009
Ta |Miestilé/ Mbiseniy i [Gain “(000.000) ~2000.000
73 JAquabidestWiater Gne 11 - 4.000 | ew 1009 8.000.000]
7 74 JEQAS Cinieal Chemistry(Monthiy)Program - Kit_[20.500000] 41,000,000}
75 [Gauichek Uinaiysis Contl Bevel aK 4.750.009 $500,000
Bt 100 400.009 4.000.000
[ews00m 425.060 4.500.000
76 |TruCalU(Mtcabraion,——_ Kit 554.000 3.108.000
i 78 [Tu Lab N (Kontrol Normal - kt 2413.62 4481.72)
80/[Tu Lab (Konto Pathog) [«t 2.485.890) 14 915.360)
8 [Alain Washing Soliton —_ 01500 4.163.448] 41.884.128
C ‘82 [Acid Washing Solution 010 /500r 1.163.448] 20.942.064)
83 [Aburin __ Test — 8.700] 121.800.000]
| Pata Fostatase TALE Test 10.650] 37.275.000|
85 [Birabin Diet Test ‘700| 47850000]
[_ £86 |Bilrubin Total Test 8.700] 47,850,000]
aT [Choesterat Test 14400] 288.000.000
er Test 7.000] 220,000.00
| 63 [Gamma SF a Test 10.650] 21,300,000]
i 90 [Goose Test 700] 304.800.000
31 [Hbate Tast 30.000] 316,000,000)
92 iBCT (TBC. Test 39.250] 70850.000
{ [83 |iron (SI) Test 39.250] 70.650.000]
‘94 [LDH Test 2070] 2.420.000
ea 95 |SGOT/ AST Test 8.700] 130,500,000]
96 |SGPTVALT Test 8700[ 130,500,000)
—_ 97 [Total Frotein Test 87,000] 522,000,000]
“| 96 | Tigyseride Test 14.400] 268.000.000]
Test ‘8700[174.000.000]
Test 700] 404.400 00]
n9as8ay{Mounly)Program 17. Kt 21,570.00 3.140.000
[ApoB auto N “Dai (Rt) + (2) it ~~ 3.418300] 201512.800
[Kt i7i787o] 3435.70]
Kit “1812 745] 5.438.235
2,06. 009 40,00.009
~_4200.000] 100 00.000
2.700.000] 64.000.000}
[2.560.060] '37.500,000]
2.850.000 2.750.000
7.500.000] 270.06.000
3.250.000] 26:000.000
3596860] 7,397,720
4100.00] 1800.00
7500.00 35,000,000
716.300] 7.183.000
— 750.009 8.400000
4.500.000] 162.000.000
4.500.000) 162,000,009
2.850.000 7.100.000
4850000] 349.200.000
2.850.000] 205,200,009]
1.850.000] 1.100.000
2.850.000) 4.200.009
2.650.000) 159.000.000
74.086 55] 15.666. 825
5.450 00] 32,700.000 Ha
127] he01 a 1 Kt 7300.00 2300.000
12e[biricap Pree] 6 aa F-72000] 112200000
~ [7 Raaltinicap Hemegoting] 2[ ia 17.820.009 35 640.000
7120) nian immureiping am +a 76 50.000 16. 500.00
"31 ]Conel Protea (5x1 i Ao 5.610.000 1,720.00
1
= i 7 xat_[¥2220.000 12220.000
7 [kt 2.244.000 4.486.000
: “tu i —— autig 750.000 750.000
|| “tas[Prote Ceanser — tin 301.500] 272.000
~136|Alconoh 70% Bato 33.000] 660000]
Taquabidest Pro injeksiOitsu Water Injeksi 25 mi 2.500] 600,000]
$0035.00] 725.186.200
463.000 8.977600]
| 3.135.000 3.135.009
Tra eit Pre Trigger Sol 1,01 2.607 200] 33.586. 400
~142|Accitect Trigger Sol 1.0L - 863.50] 10:362.000
: y43[achtet ConcenateWash 8 826.300) 38, 566.000
| __144lArcitect Anil HCV Qualitative Reagent 1007 __13.337 500] 400.125.000]
6514 4519320 4819.30]
[cpap 3195.000] 3.135.000
CT 147[Divent 297.000] 178.620.000
I +aa|LA lyse _ - 2.791.000 133,968,000)
| ‘glLeo (Lyse : 5.581.500] 133 956.000
7 3907-000 73.140 000
ee “~5.767.500] 173.025 000]
| 162-18 0 Divert - 4.072.000] 732,960,000
455M 18 CFE Lys 3.320.500] 166 025.000
164-18 Rinse OO 3.265.000] $87,700,000
“55)BGA + Lactate =e 10.000) 1,320.000.000
156|Aution Sick 7 508.200 2.196.800
| erlvidas HOS - 4757 665) 4.757.665
a fdasCA1S9 ae - 6.107.200] 122,144,000]
Mediatape i $0 - $56,600] 100.188.00]
[Medtape Chek 1 584.103 6.973236
IMedtape Chek 2 6.973235
1.283.600
74850.000 24,860,000
6874.88] 82,498.20
036.625] 241,758,088
= [Pak 1000) 121.000] 14:520,000|
____16T|Micropipette _ S| Pes 2.750.000] ____13.750.000]
(coven meetin - 2 Bush 50.000 00.000
169|Cup Sample (ita {4 F00 pos 200.000 800.000
Deck — 12 [Pawt000) 750,000] 9000000]
Disp. Synge * [5 | Dosrt00 374.00] +,870.000
[Dis. Synge 70 5 | Dos00 210-000 1,050.00]
Disp. Syringe 3 cc 7.800 | Dos100 00.000] 180.000.000]
lisp. SyingeSce 1,800 | Dos/100| 140.000 252,000,000
and Scoen —[- 875 Dos 37.000 32375,000
aru BMP z Ts ua 335.000] 4.675.000
‘Tr|Kertas Sang - 15.00] 500.000
“7a)Kim Wipes 52.009 64,000
- ‘79lLens Paper 25,000 509.000
180|Masker 40.009 6.00,009
789.125] 1.014.750
| 15.000 7.500.000
4.200] 35.976.000
386.000 4.980.000
825.000 1.850.000 : S E INGEN
CI 20 [Cover gass(22x22mm) pack 72.000 7,200,600]
[ 21 [Masher — bak 45:00 1.125.009
4 22 [Fomadehide = iter 35,00 4.250.000
23 [Miroscope side Fosied pack 30.000 4.506.009
|_| “24 [Past caps akoho sti) box 33.009 980,000
[28 srandon RY Akon bot 748.009 10472.000
| [26 [aquades ste _ bot ____16.000 4.260.000
27 [Kwikit Stain, SHANOON pack 313.000 6.397.009
| 28 [Cover glass (2140 mm) a 60 [pack 110.000 6.600.000
29 [Formal Fox Concentrate formain) 20__[batal 850.009 17,000.00
—| at Henatoyn - + [box 000.000) 3.000.009
I
: Talat Habis Pakai 387,998.000)
L 1 [Disposable Mcrtore Bi bowS0bp 71650000] 38,750.009
[Feeney 1000 bat 150.000 150.000
| [Goa kur $0 mL bi 100.000 100.009
4 [Beker glass 10007 [i 150.000 150.000
L 5 [Cyttunnel Single While —_—_ box 77550,000 73.250.000
"| © [Poly - Lysine Gass Side lbox “000.000 $,000.00]
7 Piet Lj 2.000) 1,600,000]
- © [Batangpengadik = i 20.000 20.00
9 |Spuitnjksi 3 mi - + foox006 150.000 150.000
10 [Sput ijk 20 mi = 15 [bows0 363.000 445.000
| 11 [Box preparat 2 150.000 5.000.000
12 |Jarum 23.6 10.000 110.000
43 Jarum 25 6 10.0 770.000
1 [kets sting 40.000 600.000
| 15 [Pot salep_ = 1.800 2,700,000)
16 [Kerarang plas untuk bok 60.000 4,200.00]
iz 4 [Swap 15000 30.000
[Pisa dagingt 60.00 360.000
Koter 2 7o.900| 70.00]
125000 25.000
130000 130.000
45.000 45.000
“23 |Guning operas 750000 300.000
28 [oyoside oO 7.400.000 | ¥8.000.000
|| 25 icemen Spell so.000| 50.000
26 FFitercard Sane 300.000 4.000.000]
27 Lamp Sener - 120.000 120000
| Blades 2.300.000 18.400,000)
| ‘10.000 | __$60.000|
~__ 30.000 90.000
30.000 30.000
| "7500.000 3.50000]
| - 35.000 350,000
tt 801000] 600.000
| 500.000 2500.000)
50.00|_ 750.000
250,000,000] 250,000.000
+,500.000.000
1,359.125.000|
7 1,560,000] 4.550.000)
* 25.000 125,000
i 50.000 77500000)
| 25,000 250.000
| 360.000 7,850.00]
Lt 10009 2,000.00 186) Tssve _ 1.600] Rol 2,750]
Nec Tube Serum CAdmiPiasic | 2.000 Bost00 176.000] ~~ 352.000.000
Yellow Tip 30 [Paw 110,000 3.30000]
[ei 1] ig 15:00] 15,000
onoseed Vacuum Tube 10 | Dos t00 860,000 600.000
Nee Tube Ka EDTA 2m [2.00 Dos 100 473.260] 346.500.000
[Swab Alcohol 1008 x 120 Asia Paciie —— | 2000 [oosst00 71.009 42,000.00
[STA Cuvette 30] box 107036 400] ~~ 301.092.000
IKertas Nashua 25| Rol 6.000 150.000
Plestern But 750 | Pan200 70.625 1468.75
Parafim 1) Rol jarz7a7) 147272]
Need fash back Bout 138.100] 188.650.000
Wing needle Bow80 484.000 48.40.009
IKSEDTA 0 Sex Aquisel Bowt00 181500 21.780.000
[Soclum Civate{ ml ex aquisel Bow100 187.000 37,400,000
Sodium Cirale 27 miex 80 BouS0 217-200] 316.000
| Kertas Barcode Ral 424.000 67.120.000
Tabung Mika Pais1000) 200.000 6.000.009
[Aono 70% ier 21.500 4.936.000
: [Akotol 25% ~ titer [43.725 874.500
Vidas PCT Kit 9.008.000 190,080,000]
30] Box 73.10.000 €33,000.009
[a 15,950,000 3.800.000
it 6.050.000 24,200009
Box 550.00 48,500,009
~—21ifgosin [a00m 700.000 10,500,000
212/Thiaain Stain Made From Concentrate {511500m 1.400.000] 33.600.000]
213[Hematlogy soon 700.000 1.800.000
hy ~_2alaero 500m 4.260.000 -45:000.000
ris at Bowie 106.200] 780 398.09
ap Wingset SLBC 23175 7 | 500.000 2.000.000}
[Accupower HEV Quantitative it 30.98.009 $2.597.009
_ prep Viral ONA/ RN it 25476.000| 76.428 000
| [re ae Tesi [00.000] 399,200.00
22O|EQAS Homoglobine Program [it 7418.95] 45.837 890
~Z2NTHIV 18 Antbogy - it 1.400.000 3.600009
Kit 825.000] 1.650.000]
| _ 602.380.000
| 714,385,009
[ 0 pack 145.000] 11.800.000]
15__ [box 5.400.000] 2.000.000
a Paraplast 30 |kg [~~ 2001000] ~~ 6.000.000]
Kaset tissu embeding (lanpa tu box | 7,400,000 000.009
| ite 30.000] 6 240,000
iowair— (350.000 | 31.250000
bow? We _€75.000] 1.360.000
box 3,803.00] 3.003.000
bas 670.000 40,050.00
d owas tr 560.000 4480 000]
a lwo 870.000 4.740.000
box $5000] 8 260.000
lumi | ~85.00] 510.000
wen | 700.000 000.000)
pack ~_ 3.500] 210.000
4 7 “jbox 30.000 150.000
ocx | 10.000) 5.760.000]
pack 2,000,000) “72,000,000
[bok __ 372,000} 8.184.000] __ dos 100 $500,000]
dos/1000 5.500.000
; [Bactec : PEDS Pus [dss500u 3.500.000]
Bact: PuseAerabic F [dos50bu 500.000
[Bod Sheep 260 600.000
F Disk Amici - 1 Ipawécatl 300,000)
Disk Ampiciin Subacimn —_ 1 Ipavicatl 300.000
a “| _1_Ipattcatd 300.000
7 | 1 pews 300.000
= 1 [pekScad 3000001
Disk Amita a pata 300.000
Disk Ciprofloxacin 1 paiscatt 200.000
Disk Cetazcime + |pakscat 300.00)
Disk Cetviaxone 1 patiscat 300.000
(Disk Cetazolne “1 Ipakscat 300.000
Diskcetslexn 1 peta 300.000
Disk Cetadrox 1 pais 300.000]
Disk Cetacior pa 300.009
Disk Ceturoxime - 4 paki 300.000
[1 Jpawscaid 300.000
1 patscatd 300.000)
| pata 300.000)
L a [pacar 300.000)
~30[0isk Cefepime — | 1 Ipatiscatr 300.000
31 Disk Doxciin + IpailScaty 300000
~~ 32st Entromye 1 [patdscair 300.000
~33[0iskEtapene 1 fpatiscaud 300.000
(isk Geni “| paca 300.000
- 35[0isk Karvoryon eesenam ane aa 300.000)
35)0isk Levofloxacin TP fpscat 300.000
—_a7[Disk Linezolid - 1 pakScat 300.00]
Disk Moxitoxacin pate 300.000
39)0isk Meropenem 1 pata 300.000
“| 1 pata 300.000
“1 Ipatiscat 300.000
- “| paléscat 300,000]
@3[Disk Tevacycin - 1 IpaldScaty 300,000
4)Disk Vancomycin t if 300.000
“45)Disk Fluconazole = 1__|patiScatr 300,000]
46|Disk Nystatin ae pasate 300.000
‘47|Disk Voriconazole _ _ 1 |paidScatrd 300.000]
48) 0isk Optochin ~1_Jpatéscad 300.000
~—48)0isk Bacirac pasate 00.000
50|Eniebe Malaria bows [1.600.000
“s1/Giemsa — —[ow2s0mi 400.000
cH 100 2.200.000] 2.200000
lies0 4.100.000] 4.400 000
bw 100m 500.000 2.000.060
500m ~~ ¥.000.00] 4.000.000
io acon 4,300.00] 7.000.000
7 5 __|1kiv250m] 1.200.000] 6,000,000]
“= + wivroony 350.000 350,000
| fac [00.0] 200.000
eOlLugol 1 fier 500.00 500.000
4 [etl 0 lite —[—— —s000 7000000
| @2\Mac Concey Agar 15. fows0onu 7,300,000 500.000
| 63/Media TB IL. : ma 100 2.800.009] 30,800,000]
Galeda Transpon Amies : 15 _[box50 1.200.000] 18,000,000
G5|Mueles Hinton Agar “3___[os00gr] 1.100.000 3.300000] SSTRINCIANTREREMTUNGAN Maag]
[ vata oHargal Salta
Media DT - bW500g¢ 8,200,000] 8,200.00
[Media SDA : u500qr 1.000.000] 1.000.000]
INAOH Reagent = ows 00gr 600.000 600.000
Nutrient Agar ws00gr 7,350,000 30250.000
Nutient Broth iw500qr[___ 1.300.000 4,300,000]
PPLO Age ~ 5 fbowt0 700.000 700.000
Presept 2597 fws000e 500.000 500,000
Soitus iter 25.000 1,250,000
Staphaurex test tbo 500.000 2.500.000]
[Sveam Kebsiela Oyioca a 2.000.000 2.000.000]
Steam Pseudomonas Aerogenes a “000.000 1.000.000
[Seam EnlerococcusCasselfiawus tab 2.000.000) 2.000.000]
Seam Staphylococcus Aureus a +,000.000 4.000.000
[Tg MPT 64 rapid = bow +,500.000 3,000.00]
Val OO 2omibua 1.200 600,009
vies 2ASTN - ~ |i 300,000] 348,060.00
Nitec 2 AST kite 2,300.00] 115.000 000)
|Viee 2GN test tte 2,300,000] 336.200.000
a ie 7.300.000] 184.060.000
- nkiv20tes| 2.300.000 73000.000
Wit a a20ts| 2300,009 20 700.000
iee 2AST ST OF 2s 2.300.000) 1,500.00]
“a Soliton 2k 2.500000) 7500 00]
| ~ 146.378.000
| sod p00.000 0.000.000
|" 500m 3,000.00) 1.000.000
7 00m 20.000| 600.000}
ie Meth oo = 500ml 50.000] 1.500.000]
[[-slpci fast carl focsindecoionz - S000 500.00 2500 000]
[[elanaerogen. ace ~foow 10 7.100.000 5500000]
| —TiBeckergass 1 - = buat 40.000 200.000
| geecee ove toc ere - pats 0004 10.000 330.000
| 7 “Biber - lit 30.000] 3,000,000]
| [Bo peparat ‘| 150.000 4,500.00]
| _1i]horampericaine low 300.000 $00,000
| [Coverpast tex [ai 1004 40.000] 400.000
| [Deck glass - \oss1000| 30000 3500.000
buat 75.000 375.000
[dos 2000 50.000 600.000
2500 1.260.000
3500 [750.000
| 30.000 400,009
—21000.000 000.000
20.000 000,000
- 150.000 300.000
7 300.000 7.500.000
200.000 200.00
“1000 1.000.060]
| ~ R000 [~~~ 5.000.000
| - _ | —_toa000 [5.000.000]
5000 fous ~ 2000 0.000.000
Potsted 2500__fbuan 2000] 5.000.000]
Plas hip uk 15125 100 fuow 100 36.000 3 500.009
[Plastik hip uk 11122 100 fbowt00 75000 2.500.000
Paraiim ‘000.000 | 10.00.000
| aalscapi - ee 700.000 700.000
Cr 3ilSendok tandut - 75000 250.000
I 1.500 500,009
10 =
"
BS UURAIAN
____35|Sputinjeksismi___ 2000 6,000.00]
Bel Spunk 10m — 2500 750.00
a Tatung i 000.000, 12000.000
36) Tabung : 15000 7.500.000
-asftissue 2500 4,250.00)
| 40)Wingset SLBCS 7 - 600.000 “800.000
Yetlow tins 00.000 300.000
11920,000 4,920.00]
0,000000.000
"7000.000.000 | _10.000000.000,
- 2500.000,000
2.490.220.000
2600000 65,000.000
5.000 4.750.000,
524,000 3.900.000
(Grid Uk 35x43 11,000.00 14,000.00,
Dry imaging Fin (OI) HD 7.0001 ie7so0.000
41.000 500.000
67.000 6 700.000
41.000 100.000
67.000 ‘845,875,000
37.000 | 686.0000000
~~ 30000 75:00.000
star maging Firm (OT28) e700 20,100000
thermal Daystar imaging Fi 26x35 Agia ___ 37.000 11,100,000
14 [Dual Pack Injector MSCT a ii ~ 529.000] 241,490,000
_18 [OVO RW Eig 15.000 7.500.000
8 16.000 3.000.000
ei 7706.000 3.100.000
El 2,800,000 4.000.000
ei 17,000,000 5,000,000
Bi 800.000 800.000
Bi 7.906.000 2.906.000
Bi 3.500.000 35,000,000
9970.000
“| Taster Radictrapi Uk HOG7O2 mm i Taraaeo | 22100000
2 |Masker Radioterapi Uk. $00%x350x2,4 mm bit 4.710.000, 51,300,000,
[a ibaa oo 1 sroo00 | 16360.000
[| °R5" iba Bahamian i. : ET
- Bahan Makan untuk Persediaanl Stok (shan Kering): |
00 | 2.400.000
37:00 450,000
ee 36,700 101.000
| 41 Bumbu Pecel 39.500 5,382.500
[5 | Bunga pekak 17.000 255.000
| 6 | Brambang goreng 72500 1.250:000
| —10.000| 30.000
soo] 144.000
7 20500] 1332500
10] Fermipan - 16.500 16.500
“11 Garam dapur = 76,960,000
2
| a
| 14 |_Kecap rendah kalori
| Tecan macs 9 rae . z
: Sa: Sn al
~[ 16] Kecap an z me 4 | Bt 15.500 372.000
17 | Saus bumbu 15 [a 55600 834.000
[18] Saus bumbu asam manis 5 Bil 38.000 195.000
| 18) ote g 38800 732.800
20 Mustard Bt 35500 706.500
sae kg 730.000 9.200.000
| Mercia bi Kg 230,000 3.450.000
—_ [3s 10.300 103.000
7 Bu 41.000 205,000
25 | “Pengembarg ue ns: 5.600 336.000
Pelembutive [ons 5600 336.000
27 | Penyedap masaken Bt 33600 7.608.000
Rese 7 70__| ons 13.200 $24,000
23 |" Soos ings Bt 32.000 512.000
‘0s Tam - Bit 70.500 482.000
Bis 15.500 558.000
‘aos fomat sachet - Bis 4.600 460.000
‘aos Tomal kemasan bolo) 8 73.200 6.032.000,
ai 50000 150.000
[200 “ons __ 19.800 360.000
7 “2 Tons 17500 210.000
37] Tomato Pasla - [42 | kg 26000] 336.000
“Tong caisawi eas 18.500 222.000
Terasi dang 15 | Ons 17.500 252.500
32500} 1.700.000
46.300 | 108490.000
Bawang put 4.000 | 86.10.000
! [Cengk 34.000 816.000
Jahe 20.000 000.000
Jamar upg 27.250 7.085.000
|_damur putin 29.500 1.800.000,
Jamut kancing 42.500[ 2.040.000
15.600 734.000
{ 23.500 3.085.000
: 35.500 426.000
4820017712000]
2 16.500 584,00 |
- 42.750 4702500
1 15800 373.200
alma 14.250 590.000
CT 185000 | 6.860.000
|_[- 7 Tepung bores 22.800 2.180.000
— | 58) Tepung bub 30.000 7,200,000
~ [581 Tepung kanji 7 19500 702.000
| 60| Tepung maezena “Dos 13500 550.000,
61] Tepung pant Kg 9.950 4.987 500
82 | Tepung eri : ra 21.200 9.080.000
[3 ames Bis 75000 725.000
et Beas a _| ‘7.800 | 1068,000,000
[es kentang” 1g 18.800 37 600.000
| [68 rina dalam kemasan bata! Des: 53.£00 3.228.000
7 | vem go" RSUD Or Hoewal_ 6500 | Dos 34500 | 224,900.000
- ‘Ai Minum dalam kemasan Gala efi Gain 31.500 55.125 000
i Cokit bub - Des 35.200 689.600
alee - Bis 30500 1.830.000,
Hopi rasa choc : Dos 23.800 371.200
4 721 Kopi instant UD Dr Woewar 00 seh 2200 220,000
73 "op nstan kemasan boo aT 44.200 2.121.600
74] Non Dairy Creamer | es | 43.500 2.088.000) stl
i
Teh car Kemasan = 73.000 145.000
Teh coup berogo RSUD Dr Moeward 900 108.200,
Tehwangi — 3850 47,580,000,
{karan Enieral mengandung kal, inggi vitamin) 420.000 8400000,
‘Makanan Enteral mengandung BCAA. LOLA, Lacilod 42 __| 195.300 8.202600
80] Makanan Enteral Tinggi BCAA [a 167.750 26.285,000,
‘BI Makanan Enteral Tinggi Protein 1900 85.750] 162925.000
'82| Formula Enteral untuk gangguan pencerraan Gan pe} 120 36.100 4352000
83,| Formula Enleral untuk Pasien Luka Bakar, Bedah, Kal _ 120 52300 6.276.000
4 | Formula Bay Brat Badan Lahr Rendahkemasan 10 240 65400 15:696.000
[ 85 FormulaBayitipoalergenk | 20 308.750 6.175.000
86 | Formula Bay Prematrusia 6.12 blankemasan 370] 6 165000 1.320.000,
87 | Formula Bay -12 bulan unuk Keperiuan MedisKhusl 20 350,000 7.000.000,
| 88 | Formula bayi 0 bin dengan isla protein kedeisi_| 60 39.300 1,965,000
@9]| Susu Kedelal Tinggi Protein - 240 46.350| 3924.00
90 | Susu kental manis 40 18.000 720.000
91 | Susu ful cream nsan kemasan 200 gr 60 26.900 1.614.000,
$2 Susuful cream instan emasen 600g" ___—(|_ 600, 01500 31,200,000
~ 93 | Susu 8ay 0-6 bulanKemasan 135 gt [70 15000 1.800.000,
94 | Susu Bayi 0-6 bulankemasan 160 gr 120, 25 500 3.060.000,
95 | Susu Bayi 06 bulan kemasan 180 [0 ‘34475 4.197.000
96 | "Susu Bayi 0-6 bulan Kemasan 200 gr 10 38.500 385,000
97 | Susu Bayi 6-18 bulan Kemasan 1 10 78500 785.000
98 | Susu formula bay Bebas Isto [0 |- 74600] 746.000
"Susu Bayi erat Lai Renda Femasan 200 gr | 120 61.200 7.344.000,
45.500 6.825.000
57.500 34,500,000
325.000 19500.000
325.000 24.375 000
Susu Anak 15 tahun 58.200 42,624,000
105) Susu Bay Brat Lahr Rendahkemasan 400 gr 703.500| 1.314.000
| 73500 72.785.000
72500 | 362.500.000
185000 28.080.000
408) Bow kerng Z 5.500 | 4.104.000
| ‘team crates asa abon 7500 37.500
| 2280 000
| - _ 77-500
| - 430.000
150.000
150.000
"3000.00
ot awar bi 20.000.000
i awa put 1.750.000
19| Sus kerng 2500 71260.000
120] Guta haus 19.500 41170000,
| 121] Gul aval 20.500 74,600.00
| 122) “Guia pas 1100 330.000
| Guia pasr 19600 96,000,000
| ula past ermasan 20.500 640.000
| 125|_Diabetic sweetener - 121.000 14520.000
| 126| Sup oe 39.000 170.000,
52000 7.560.000
77600 13248.000
| “50 ~~ 1.897.500
s 4.031.250,
| - [| s 148.500
| — 500.000,
© 4.350.000 Noy con =: URINGIANBEREITUNGANES
Siamese URAAN Valu rT
134] Soon [462 | Bis 15.500 7.161.000
__135|_Spaghelt_ _ Bas. 28.000 700.000
“136) Butler hum _ Kg 38.500 ‘385.000
7| Maat ee “Kg 44.500 701880.000
4 "138]_Margarine puih “kg [2250 270.000
‘Minyak goreng kemasan 2 I Bis 42.750 771.802.500
Minyakgereng Kemasan 1 Tr Bis 77200 138720000
141] _Minyak Jequng_ - a [Bt 91.000 10.920.000
finyak Wien —_ Bt 40.000 600.000
Kelapa z Bu 7500 | 7.000.000
‘Alumunium - Fol 7 Dos 45.000 6.075.000
i, ee - = ~ Pak 19.500 1.170.000
| Flexible Drinking Straw (sedotan bengkok) | | Bis 2.500 500.000
Gelaspasik dsposile uk 75x5cn pak 37.500 7437-500,
Galas plastk disposible (keci) | Pak 11.000 792.000,
Gels plastk dsposble beriogs RSUD Or oeward | 1500 | Pak 17.500 | _101250.000,
anfongplasikes uc TKg | 58S | Pak | 1.800 10.237.500
Kantong plas z 585_| Pak 17.500 10.237.500,
Kantong plastic uk: 6 Kg ~| 1800 Pak 11.000 19,800,000
Kantong last {1200 “Pak 17.000 30.600.000
Kantong plastik uk: 3Kg | 48 [Pak 17.000 816.000
‘Kantong plastik klip besar 360_| Pak 34.500 12,420.00
_| 156|__Kantong pias Nip keci _ 360_| Pak. 7.500 2.700.000
_ 4157] Keranjang buah 50. Bh 4.500 225.000
i 158 |_Kertas pembunghus nasifood grade ¥35000_| “ube 750 107.250.000
__ 159) Kerasroi 2 : 18 | bb 2.500 47.500
| 160) _Kertas pembungkus makanzn [16 pak. 45.000 720.000
161] _Kardus makan berlogo "RSUD Dr Moewarci” ‘300000 | 6h 4500 | __1.350,000.000
162] Mangkuk mika — | 45000 [eh 2.100 ‘$4,500,000
; 163] Mika Snack keci oo 16500_[_ eh 750 42,375.00
‘Mika Snack Besar 4250_[ Bh 3.450 4312500
| ing wrap 7 [Dos 255.000 76.500.000
| Plaslik spuit jumbo — | 10 Pa 36400 364.000
L "Serbetkert _| 760 | Pak 6.500 940,000
“Steofoam tema sj “380 [ah 360 267.000
: "Sendok makan pastk being ASU br Noeward™ | 750000 | Bh 000 | 750.000.000
7 ~Sendok garpu makan past S| Pak 35.000 790.000
| Plastik pembunghus sendok berlogo "RSUD DrMoew| 60000_| Bh 800 48,000,000
TTusuk bay 5 Ee 75.000 280.000
Tusuksale 7 18800 1410000
some 798.000 | __1.440.000
— - 7 7.500 78.000.000
6! _Krupuk Udang ce a 65.100 7.161.000
2 7, Makaroni 8 | Kg 36.500 2.117.000
Meses [2 aks 39.00, 47.600
Madu | 735 | sachet _ $500 742.500
Perino nes ae Ed 9.800 352.800
[ a 15.500 | 372.000
| 25.600 256.000
60.000 4.800.000
~ 66.000 |___—_—482.000
| aan Makan untuk Kebutuhan Haran (Bahn Basch) —
i | “Bahan Makan : Lauk-pauk dan Snack
Bakso daging ayam _ 44300 | 585.000
1881“ Bakso doping ap 500| 20475000]
187 Sosis ayam 65.000} 4.225.000]
188] Sov spi ~~ axon [1596.00
39) Nugget Snivzel 56.700 27.216,000
4 oly
[" | aging Asap - Bis 60.000 300.000
Ctak-Otak Bandeng 7 Bis 28.500 4,339,500,
7 Tahu pth a Bi $50) 6.200.000
194) Tem Bi Z000 34. 998.000
| “1961 Tempe b _ Bi eo} 207.200
[496] “Banana ra _ Bh 3.000 49:500.000
197] Rot kaca Bh 2800 50 400.000
Bh 3.000 7250000
8h 2000 43.500.000
So Bh 2.000 45,000000
a eh 2800 5.600000,
202) Cake buah kei as | en 2.950 17.700.000
203) Bolviukus 2860 4 250.000
‘2o4|_ Sos pant 2450 _____1.298.500
— “rs| Krk 3.000 300000,
0 1750 8.750.000
| ivan 2.800 4.484.000,
[on] Lapis jo 2850 | ___61.300.000
~~ 29| Pastel daging 4.500 2.250.000
| Sosis panggang 2950 8.100.000
| 211) Lumpur manis 3000 64.000.000
2650 4.192500,
2800 60.400.000
| am2000 46,800,000
- - 3.000 | _— 54.000.000
“216| Dadar pisang 2750 14.575, 000
27) Mento _ 2400 | _____ 1.080.000
W Bh 3,000 4.000000
Kapetar Bh 3200 6.960.000
Getuk ke eh 2250 41012500
Sus via Bh 3000] 26.500.000
8h 3.000 900.000
&h 3.900 7.016.000,
[- Bn, 2.800 4.536.000
- = 3200/ 6.184.000
mn Bh 3109 30.220000
| Nagasarpisang Bh 2900 44,950000
Muka manis Bh 2750 41,250.000
Lumpur asin Bh 3600 5.760.000
230) Matin - [oh 3600 4.000.000
“231 _Kroket dadar dogg Bh 3700 $920,000
| BixaAmbon “Bh 3.000 30,000,000
Bakpao daging oo Bh 3400 5.440.000
Resoleskentang 1600_| Bh 3.900 240.000
Pastel sayur 1800 |e 3750 000,000,
736| Bandeng presio — s730_| Bor 000 78.0000000
esi 0 Tihs cae ae oo 30 5.000 1,480,000
2a Dapig ag K $3500 | 6928625.000
_ 2391 Daging ayam ging 420 | K 59800 25.116.000
240] “aging sai super_ sg 77.0001 378.250.000
[7 2aiT aging ang api uy 360_|_ko _ 178.000 62,300,000
242) Filet daca ayam 55.500 26.362.500
“2431 Hal sapiiotal_ 98.000 12:348.000
kan fut kacangan 72.800 | _254800.000
| Ikan lat tenn 97.800 | 342:300.000
Filet kan 97.800 2.934.000
Paru 94.400 4.416.000
Fempelo at 4500 4.350.000 Nore iF
© URAIAN
Tau puyuh 3
Tur aya ig 35500 | 362.100.000
sang basah ur Kg 98.000 8.190.000
ig 18400 1.340.000
Xg 12.500 71.875.000
ra 12.600 10392000
Kg 27500 7.680.000
7 19 9000 1.170.000
Bunga kool ig 726.500 17.225.00
Ceme ig 1.000 000.000
‘aun bawang ig | 16.000 182000
Daun brambarg Ka) 25.000 312.000
Daun kemangi ig 1.000 188.000
‘Daun mens (Sa. ig 19800 257.000
‘Daun pandan wengi_ ig 14.500 174.000
Daun pisang 7 Ub 10.500 210.00
Dan Seid ns 30.000 510.000
Janien ig 32000 78200.000
Jepan a "9 32.000 25.600.000,
Jagung maris muda bongol Kg 17.500 3887 500
Jagung mars packing Kg 22.000 30,000
Kapri 33,000 75 520.000
17500 5.250.000
71.500 73 680.000,
19.250 18480.000,
“Kult mein 15000 675.000
|" Lombok nj 30000 7560.00
| 216) Lombok meah 60.000 7.800.000
“a71| Lombok rani 60000 800.000
par 20.000 580.000,
al eoo00| 3.240.000
| 240) 77.800 6171600
| 10.000 30.00.000,
\_| 11400 695.400
1100 [5472000
| 3000 455.000,
| 5500 26000
77.500 73516.00
17.800 17.286.000
19250 228.690.000,
70.000 300.000
Jeruk lemon
~ 297} Melon super
301) Pepaya
isang Ambon Tewargmangu
303] _Pisang kepk kuring
isang impor
Pisang susu
| Pann ia
6
25,750,000,
‘515.200
3.075.000
49500
72500
882.500
525,000
730.000
95,00.000
5.991.250
250,250,000
4,100,000
76.000.000,
133600, 000
738.900.000
306,000
300,000
600,000
7230'550.000 a = aN
3. Biaya Pelayanan . 165.585.726.000,
Bina Ja Plan ~__| | Tahun | 166 585.725.000 | — 166.585:72.000
a 6750.000.000
[ jaa ~ 850,000,000
1 | tahan 30,000 000 50,000,000
TE Patan 100,000,000 | ~~ 200,000,000
|
s C 900,000,000 |
| | C 4.736.700.000|
1 - 1 73.400.000 13400.000
Z lanaestesiVentign 1_| 2.000.000 72.000.000
2 APF (Automatic Prosser Film) nan aa 4.800.000 | 800.000
audiometry mar 4.350.000 72700.000
Aula Retrakio Meter cement "1.090.000 | 11.00.0090
jocave - t 5.500.000 5.500.000,
by acl ee ee ne 5.720.000, 572,000
F Bed Electic OO i 4.950.000 450.000
[Bed Side Monitor eee | aes 7500.000| 16,500,000
Bor Tulang (mirospeed) nan 16500000 | 16.500.000
[1 Teor Syarat - 1 22.275 000 72.275,000
[72 fBroncoscopy 4 1.000.000, "7.000.000
43 [Cam X-Ray Unt 1 #6,00,000 6,00.000
14 [Cath Lab 7 1 6.000000] 55.000.000
15 [Central Monitor 1 77 500.000 77-500.000
16 [Cobalt 60 4 wnt “10.000.000] —_140.000.000
(Cpap + Compressor + | uni 6.500.000 6.500.000
| (Cranio Mario Facial [anit 3.200.000 1.200.000
(cRRT = pega ee | ra 5.500000 5.500.000
[CTG (Careio Toro Graphy) _ [uni 1.000.000 1.000.000
[CT Scan MS-CT ee 1 | unit "330,000,000 | 330.000.000
|| 22 [uetangan tora : sexed 3:300,000 3,300,000
[| 23 decubitus Pump 2.200.000 2.200.000,
i fo 43 200.000 13200.000
j + 16 500.000, 16,500,000
7 i 13200.000, 13,200,000,
[4.950.000 4950.000
8.250.000 8.250.000
44,00.000 4.000.000
wees 16 500.000 16.500.000,
31 [Blecvo Simuiator 11,000,000 [~~ 11.000.000
RiewG 86,000.000 8.000.000
77,906,000 77:000.000
| ‘1.000.000 | 1.000.000,
| 72,000.000| ~~ 72000.000
| "2.500.000 277 500.000
| regulator Gas Medk 550.000 $50,000
gMesin | 76,500,000 6.500.000
fant Warmer 3300.000 3.300000
~— 550.000 $50,000
| 5.260.000 __ 5.280.000
3,300,000 3.300.000
Lampy Tindakan $50,000 4.100.000
. Laparoscopy 7 500.000 16: 500.000
Laser Therapy 72,000000 72,000.000
Lens Meter 3.300.000, 3.300.000
|Mamography 46.500.000 16.500.000
___ #8 Meja Operas 440o,000| 4.400.000 Nae ti
iH
_ | unit 4950.000 4:350.000,
“30 ai SS [anit 27500.000 77-500000
PanoramicX-Ray a [nit 72.00.000| 22.220.000
[Pesawat X-Ray Oiagnosic [unt 24,200,000 24,200,000
5 Fun s00.000 6.500.000
[anit 6.050000 6.050.000
"5.500.000 [5.500.000
7 41,000,000 1.000.000
1.000.000 1,000,000
- 2,750,000 | 2.750.000
9.800.000 9.800.000
8.250.000 8.250.000
41,000.000 1.000.000
4.650.000, 1.850.000
[spirometi_— nara 72.550,000 22.550.000
Steam Steisator 1 7.050.000 17.050.000
65 Stenisaior Kec eae ean 4.650.000 4,650,000
7 7 1 500.000 6.500.000
imulaion XRay_ [4 77 506.000 27,500,000
{Suction Pump, fea 1.650.000, 1.850.000,
[Synge pung a4 5.260.000 5.260.000
| Telescope uolgh a a 5.000.000 | $5.000.000,
3 27.000] _€25.000
jen 3.850000 3.850000
a [4 31,450.000 21.450.000
al bu 1 ~2750,000 2.750.000
|_| 75 Tua Sound Therapy 1 2.750.000, 2.750.000,
[ 76 |UsG : [ 38 500,000 38,500,000
a = 9.900000 900.000
- $0800.00] 30.800.000
[8 warm i 4,106,000 4.100.000
80 )X Ray general a — 000.000 6.000.000
81x Rey mobile aan 73,100.00 | —__23.100,000
‘0.300000
17,000,000, +.000.000
2 a 16.500.000, 1.500.000
Blood Gas Anaizer 900.000 9.800.000
Centiuge ¢ 800.000 35,200,000
Elect Analzer 2 [uni ¥5,000.000 | 110.000.000
Eektolte -D, Jokoh [nit 55:00.000 56,000.000
Incubator CO? - 2 | unit 78.600.000 57 200000
B Lamina Flow Biological Salety Cabinet 2 [Unit 28.600.000 57,200,000
1 2 13750.000 77 500.000
[~ 1 13,750,000 13750.000
1 6.050000| 6.050000
ne 11,000.00 71,.000.000,
| Biya Kontak Sevice 3755.000.000
ml 1+ [Cath Lad 78%,0000000 784,000,000
iste 2 286,000,000 | $72.000.000
| 2 385,000,000 [770,000,000
1 495,000,000 | 495.000.000
| _2 275.000.000 ‘$50,000,000
si 4 [it | 275 090.000 | 775.00.000
puto Radiogathy (CR) 2 | unit 5.000.000 | 110,000,000,
| 5 Xeay smulator 1 %90.000.000 | 200,000,000
5 Biya Barong dn ST oo ee]
18 Hi
S4_Blaya Linen 7300000200
1 [Anak ref hurden (ana) 7 Eo 250.000
2 [Anak rl krden (uth 17 50.000 250.000
3 [apr Kerpus, masak Giz 70 718.000 75,000,000,
[Baju pasenpuin dewasa 1780 yoz000| —__ 178.500.000
[5 Teej bayi 15 105.00 1.575000
6 [Bajja clana IBS hiau muda (siden) 380 140.00 3.000.000
7 [Bau kerja cslana 18S hj tua Perawat 360 “40.000 [49,000,000
[8 [Baj kerja clanaiGD Jngga/rarge (Perawa 200 "40.000 | 28.000.000
[Bau key colana IGD bru mua {Dole Specs 10 140,000 _14.000.000
1 feu teria ovina IGD Merah Muda ( ResidenPPOS) [200 140,000 78:00.000,
[7 eu Rea cola 16D Kuring Muda (Co Ass) — 9 140.000 7.000.000
12 [Bs kerja colana IGD Ungu(Sswa Perewal) 0 140.000 1.200.000
13 [as kerja colaa pone. 00 40.000] 14000000
“4 [au ker coiana IP 100 140.000 "000.000
Bau teya colana HOU 7 0 ‘40.000 5.600.000
Bau key celana HOU NEOIKERT. BI 40.000] 3.500.000
Bj heya Rasilgi dan Raditerep [0 140.000 7.000.000
Bajv ej clana PUK IGD 1BS,P1_ “00 140.00 4.000.000
Bajukeyacelana CSSO, Laundry — 7 0 “40.000 7.000.000
[Baju kerja Home Cre a al “40.000 [5.680 000
Bantal Dakron 300 115.000 34 500.000,
22 [Baya Cusian barang RST orden 600, 25000 16,000,000
- D, 60x 70, arbi ua _ | 500 45000 72,500,000
26 [Duk kei 80 x60, dau 7 00 [Le s0.000| 30,000.00
25 uk Sedang 120 X200ariijau 150 730,000 19.50.000,
26 [Duk Lubang 100m X 24Qom oil iu 150 150,000 72:500.000
27 Tas Mea Derong f0Qcm X 75cm, ci jay 160 40000 | —_21.000.000
28 |Sarung Mea Mayo TSem x Stem dria 150 ‘aa000| 19500000
2a fuk besar 200em X 300em Dr ja L100 200.000| 0.000000
7 FBunghus besarhjau double 140X250, 50 780.000 3000-000
FF JOvk bear bn muda 40cm X 250m “700 [Lemar 140.000 +4000.000
Fs [uk tea Tem X 70cm Del Bry Muda 400 | Lembar 45000 18000000
A | io [ tembar [0.000 14.000 000 |
‘uk Lubang Keel 7. 100 Lembar | 45.000 500.000,
Alas Meja OP Oouble260cm X 120em,OrilBruMda_| 100 | Lembar 720.00 73.000.000,
wins Musa | 100 | Lembar 145.00 14 500.000
Bunghus Besar {40cm X 120en Ol Bru Musa Dob 100 | Lembar “e0.000| 1.000.000
iSunghus Sang tO0em X 202m, Ol Bru Muda Dos 100 | Lembar 140,000 | 14.000.000,
‘Gedong bay KBRT dan PICU 90 x90 om ane! “F000 | Lembar| 30000| 30.00.000
[Gung Dakon 00 Guan | __ 128.000 25:00.000,
aT [Handuk OPH 400 | Lembar £7.00 800.000
42 |Handuk OP Biru uk.standar a 400 | Lembar 47.000 18.800.000
$3 [Handuk Sedang 100 | Lebar $7,000 400.000
[400 | embar | 68000 6.500.000
0 Yerba | 26800] 18975000
525.000 0500.00 |
u Keya UDSS ‘0.000 | —_ 2.600.000,
48 6g Kea POS (ese 200.000 00.000,
49 Wes OP mansetiBS,cihiau 142500] 142.500.000
30 Jas OP mance of bu 2500] 42750000
51 Vas OF manse dl pun 7 0 Le 2800] 14250000
$2 las Peindunggai || tember 125500 7,590,000
Ss as peindung aster [20] Lemar 128 500 '3795.000
[kaos kerja unlok masak Gi {20 | Lembar 135000 1.200.000
5 [Kain Oxort pu dan ju moda [250 Meter 37500| 9.375.000
Kordynsekal plastk 200 x 300, Polos 250 | Lombar 720.000 | 180.000.000
Perak OSKAR merah dan hjau tn XIbrpek. piptn| 2000 | Lembar 73000] 146.000.000
Pefak OSKARmerandanhiauGuung =| __—780/| Mater 5500] 49125.000, | 59 | Sarung bantal bir, ue 60 x70 2.000 | Lembar 40.000 0.000.000
60 Sorung bantal Hjau tosca, uk 6070. 1.000 [Lambar 40.000 40.000.000
Z 61 |Sarung banal Hjau muda, uk 50 70 31000 | Lembar 40,000 | 120.000.000
| [2 [Saran bantal pin, uk 50x 70 100 | Lembar 40.000 4.000.000
163 |Sarung bantal pu uk 60x 70 — 100 | Lembar 40.000 000.000
io 64 [Sarung bantal katun motif boneka, uk 50x70 100 | Lembar 55.000 5.500.000
65 [Sarg guing Pin, uk 5 X 90 — 100 | Lembar 45.000 4 500.000
5 | Sarung guing hau tosca, uk 45X90 1,000 | Lembar 45,000 45,000.000
im 67 |Selmut ek 2.500 | Lembar 0.000 | 200.000.000
68 |Selimut WOOL Hijau & Pink 1.000 | Lembar 185.000 [185,000,000
fs 69 | Sepry Katun King Kol ( Super ViBjuk 160em X 280em 10 Lembar 450.000 500.000
70 | Sarung Banta Katun Kin Kol ( Super VB)uk. 50 om X10 Lembar 0,000 $00,000
71 | Sarung Guling King Kol ( Super Vi8)uk.SOcm x 100em | 10/| Lembar 100.000 4,000,000,
C] 72 Stk Laken King Kai (Super ViB]uk100em X t60em 10] Lembar 170.000 4.700.000
73 [Bad Cover King Kl {Super VIBjuk 1200m X 200m 10] Lembar 540.000 5400000
74 | SepryKalun Jopang ( VIB Auk 160am X 270m 20 | Lembar 720.000 4400000
75 |Sarung Bantl Katun Jepang( VIB Aluk.60em X 7Oem 20 | Lembar £0,000 +,200.000
76 | Sarung Guin KatunJepang (VIB A)ukS0em X 002m | —_20| Lembar 20,000 4.600.000
77 [Suk aken Kalun Jepang (VIB Ajus.1000m x 1606 20 | Lembar 85000 4.700.000,
i= 78 [Bad Cover Kalun Jepang{ VIB Auk. 200m 160cm 20 | Lembar 245,000 4,900,000,
79 | Sepry bru uk. 160x270 - —|[200 | tembar 140.000 | 280.000.000
[Sepey Hiau tosca uk. 160% 270 1.000 | Lembar 140.000 [140,000,000
[Sepry pink uk, 160 x270 100 | Lenbar 140.000 14,000,000
[Sepry hijau muda uk. 160x 270 31000 | Lenbar 140.000 | 420.000.000
[Seory put wt. 160 x 270 100 | Lembar 140.000 __+4.000.000
“& |Seprytatun motif boneka uk. 160 100/[Lembar 150.000 | 15000.000
~85]/Shon periak pos dan embang |_| Lembar o.000| 3.500.000
| [Steklaken bir, uk. 100 X 2000 | Lembar 0.500) 101.200.000
| 17 [Stok akon pink, uk. 100 X 160 100 | Lembar 50.600 5.060.000
188 [Sik laken_hjau tosca, uk. 100 X [7000 | tembar 0.600 | $0600.000
89 [sek len jaw muda , uk 100% 180, 3.000 | Lemnbar 0.600 151.800.000
Z 90 |[Steklaken putin , uk. 100 X 160 100 | Lembar 50.600 060.000
— 51 [Ste aken katun mot boneka, uk 100X160 100 [Lemar 64.750 | ___8475.000
[ 92 [Tali Pender - 300 | Lembar 10.000 3,000,000
83 [Wasp handuk polos FF Sit00 Pema 7.000| __ 21.000.000
[Tap nn pas z 734.000 | 7,940,000
596.000 $5950.000
[Se Bi Gotan
[Tutu rak linen plas uk. 140X76
900,039,740,
Untuk Kantor —
1 Tagenda S. 7 Bid 72100 1.710.000
4 Tagenda Svat Masuk tbr 2.00| 1.210.000
73 Tamplp Kop 00 [bbe 360 ___8750.000,
*VAmplop Kop besa(las) “ee 2250 1.275000
[5 [Amplop Pll Terpacu te 3200 1.920000
8 Amplop Foensk 34x26 _ Ur 2350] 1.880.000,
— [7 [arto ur 215 8.280.000
[8 |Amplop Radiotersaphy kecil dg kop _ tbr 275|_____8.250,000
Ts Tampon pu polos Tor 220 3.300.000
10 TAmpop Echo Pun _ Ube zo| 3.960.000,
71 [Ampop Hams be $50 560.00
Tamplop Kardolog Fu 54x24 “Lr 1575 | 5.985.000
[AmplopAskes asi Medical Chek Up th 4950 7.800.000
270] 14.424.000,
73200 7.920000
30.180 160750
52.800 724.000
52800 156.000
148.00 3.700.000
20 | Buku Agenda koluar is 150 3.700.000,
21 [Buku Agenda masuk Kelar isi 69 4.740.000,
5 22 [Buku ProtokolTeraphy NCR. 450 be 52.800 23.760.000
|] [Bui Lap Operas NCR 600|__bk 52.600 31,580,000
CI 24 [Buku Resume 1 RSUO NCR 700|__bk 52.800 36,960,000
[25 [Buku Resume 2 RSUD NCR 700] bk 52.800 6.960.000
[| 128 feuku Formuarium Nasional 250) bk e1400| 20.3500,
| [27 euku Retonstiwsi Stositica NCR : 250) bk 52.800 13,200,000
[| 728 Teuku taporen Peak 10] bk 150000 4.500.000
28 [Guku Surat Pesanan Psiotropica 1 30] bk 7s00| 626.000
130 [Buku formule Kematan NCR 75[bk 52800 960.000
FT sus cation pemberanobaNO BOO bk 52500| 15.40.00,
La hemadnamkNCR | 200k 52800 0.560.000
33 [Buku pelayanan Gici__ __ —_ i) 75.000 5250,000
[Blangko HCU cendana — | isan] 2400 3.600.000
[Blangko HCU IGD ae 1500) Lor 2400 3.600.000
Blangko HU Malai 1 [1500] Lor 2.400 3600000
Buku Formui Playanan Keshatan Haj 35] bk 24 500 857.500
iBlangko HCU Beda = 1600) Lbr 2.200 300.000
[Blanko OP 3 00 2.200 3.300.000
[Buku PKMSNCR 80 be 32800| 4224000,
Bu Formularum RSOM [200] te 80.500 76.10.000
Buku Kirke POS _ ___200| “bx 50500 10,100,000
Buku Datar Oba Askes RSDW ~ zoo] te | ___60800 6.100.000
[Buku Yan Med / SPM __ | 80 100.000 |
[Buku Ringkasan pulang 7 NCR - a0. 4.724.000
i [Buku Ringkasan Pung 2 NCR : | 00] be 4.224.000
Karu ABCD V2 FBCKun “709) Bl 440 791-560
Kartu Gudang Farmasi 8C Kun = 2000) Ba 770 6.160.000
Tkartu Karek BCPth — 5000] Ba Tro] 3.850.000,
"| Karty Perpustakaan = | 500] tbr s0[ 275000
5 [kvilansi BKUNCR Fis 250 | 100) “Bat #800 4.580.000
‘62 [Kwitansi Nota Kontrak PaniiaPergadaan 1/2 fl isi 100 10 Bal 18.150, 181.500
[_[__|'53 IKwtans GO isi 60 sett set 20 20] bal 24.200 484.000
54 kwlansi ambi obat 1/3 ol isi 10016 120] B91 9.100 “092.000
55 |KwitansiLoundry 250] Ba 73.20] 3.300.000
56 [Kwtansi CSSD 250] tal 13.200 3.300.000,
ST |KwitansiR. nap NCR 7 300] Ba 48.400 14 520.000
58 [Kwitansi Ambulan 2 FNCR |__ 20] tal 24.200 484.000
| Ts8 fwtans Trio 150] bal 36.00 5 445.000
60 Kart Lebaran ee —__ | 300 |r 4400 [13.2000
"| 61 [Kantongplasiktebal Kal (Name tak) 4,000 | br 3.025 3.025.000
|__[62 Menu Gai 8¢ + lamina 700 | tbr 6500 / __4.760000
7 3 [Peri Pengelvaran barang bd 13.200 940.000,
| Te Peetu th 765.000| 1.650.000
| Fes Papen nama meet oe #2400 | 2.060.500]
66 [Stker UkFol(bahan Stier) “| x00) “be 7.450 72:350.000
67 ‘Seminar | Simposium _ __$50| Ibe 8.800 | 4.840000
| - | ~0000.000 | ~~ 400.00.000
as 600) br 13200 ___ 7.820.000
7000) or 4400 [4.400.000
To 7 _ 399.960.260,
: 1 [Anpiop Pat “2606 aaa] 123200000
“| 52 anamnesis HVS Fol 000 [Lor 108 4182000
6000 | Ube 2 154,000
[3 [Anamnesis HVS 2 mk
Lor 165 90.000
00 | Lor 120 40.000
br zo] 100.000 LI 7 Jamplop RO41 x46 BC dg logo 45000] Ube 7.800 116 500.000
1 [ampiop RO 40 x32 BC og ogo 13.000 | ~ br 7.150 92,950,000
[Ampop unt syaraf_Coviat 4.500 [Lor 2.900 4.360.000
[Ampiop USG Glossy 72000 | Lor 900) 10:800.000
[Amplop Hasi EKocardilogh 6.000 | ~Lbr 11.100 8.600.000
[Amplop Endoscopy 3500 [tbr 16500 57-750.000
[Ampiop UrasonograRiUSG 4.500 [br 9.550 14.325 000
[Amplop Racoteraphy (bewjambon 3500 Lor 2.850 9.975.000
[Ampiop Broncoscopy Glossy logo 1.500 | Lor 15.000 2.500.000
[Ampop nasi milk pasen 76000 [tbr 880 4.080.000
[Bon Makan {13 FCO mk 20.000 | “Ube 55 4,100,000
[Bayi aru lair HVS F a 10.000 | Ube 449 | 4.490.000
[Bay Baru Lahr HVS 2mk 15.000] Ube 164 2.460.000
[Buku Imanolgi = 5 | Suku 50.500 752500
[Buku Sensus Hain Lab Kink a Buku 150.500 752.500
[Buku Instaasi La. Cito Dk 15000| 226.000
'Biaya Pemerksaan rehab medi pavilion be 8 71043,000
'iaya pemeriksaan RO Oaviliun BC Hijau Ube 800 | 30.800.000
[Bend 22 a bal 25s00| 8.070.000
[Buku Peminjaman Rekam Medk NCR 12 [tk 11,000 720.000
[27 [Buk Laporen Perslnan is 150 kr [« 315000 1575000
{Buku istaasilaborat Suku 48.000 88.000
Buku paoiogi Anatom _ tk 48.000| 686.000
[Blangho Celak 1/2 ol CD [br ‘20 3.060.000
Blangko Celak CO 2 muka_ Ur 255 [5.366.000
Blangko Celak V2f0l VS [ar 120 | 10,800,000
Blangho Cetak oI HVS 2 maka z Ube 255 | _102.000.000|
Blangko Celak 1/2 HVS Warna [tbr 126 3.150000
Blangho Celak Foo HVS warna i muha tor_| 75] 36,000,000
“6 |Blangko Celak HVS Wama 2muka [tor 265 79.500.000
Blangho Celak 2BC [to | 40 13200.000
[Blangho Cetak foo BC 1 mula - Lo 880, 26.400.000
[Blangho Celak fol BC 2muka bor 1540 32.340.000
[lanko celak 1/2 BC 2mk [tor 50 [8.800.000
Banko Catak 144 BC t mk 330 [4.620.000
[Blanko cetak = 935 24 310.000
| [Blanko cetak D cma 4375 [___19.260000
[Blankocetak 3F — 1375 | __ 206250000
Blank cetak COP 132 2376000
[Blanko Cook HVS Fol mk ‘49 5600.000
Blanko HVS dengan wamna 2k 385 6.990.000
[lanko membukarahasiapasien HVS 168 894.000
[Buku surat pesanan Pskotropita NCR 12F wars 71530500
(Catalan keperawatan HVS Q 448 4.788000
(Cattnprkmbanganterinlogrias HVS warna 2mk 265 | __10.600.000
(Copy esep K. 1/3 CD _ 75 026.000
Datta: Pasion Kear RS QHVS 1 mk 4 |__1,788.000
[FPP Lab Pavilun HVS warma _ 175 4,750,000
Form Demam Berdarah — 35000| 6.260.000
56 |Gratk QHVS DF 2m 1975 9.875.000
265; 795.000
148 3.278000
432] 2.310.000
25 __24.750.000
715 5720000
[62 [Kartu icenitas Serbobot FEC 2mk 230 4.140000
| 63 fs BC 4x cota _ 71965 5877500
64 [Kartu pengamban has Lab 14 F CO 55 4.100000
65 [Kartu Perksa Pasion a 1325 7.000.000
2 Kartu unggupasien 7.600.000,
io 6 |Laoporan Anaslesi Q HVS mk dg Wama 385; 1288750,
Gf |Lembar EKG Q HVS 1 mk 149 447.000
169 [Laporan Kasus Kematian 148 745.000
~ | 10 [Leaflet dit neprotic SK. HVS 48 1.415.500,
[Fr eeatetvs 449 | 788 00
| 72 [Lebel Obat «CO 132[ 2376000
73 |Laporan anesthes pavilisn [tbr 308 3.080.000
74 [Map Pasien vor Berogo Ube 3900 1564.000.000
75 Menu plinan gi dg warna 1/2 F Sx [tor 325 ___ 5.650.000
|_[- 176 [Pengkajan asunan kowrin RJ 12 = CD fm Ube 82 4.100000
C 77 [Penempelan resep Q HVS 1 mk Ube ao] 4768000
~ 17a [Permian LaboratF CO 1 mi Ube 132 5.940.000
‘| 79 |Pimpinan Persalinan QHVS 1 a Ube 148 2.236.000
|_| _[80|Pemeriksaan FiskHVSF ibe 148 2.607.500
[Tt Teemeriksaan Fisk HVS F ni Ube 285, 4.107.500
| 62 [Pemeriksaan Fisk HVS warna : 7 265 4.107.500
83 [Pemerissaan Fisk HVS wama dg wama 2 mk 15.500] br 385 6.122500
{4 [Pulang Paksa 1/2 FHVS 1 mk be 120) +,800.000
‘85 [Perminiaan Pemerksaan Lab CO 1 mk ube 132 +.648.000
[86 [Pengobatan OM HVS F be 265 2.650.000
[a7 [Pomerksaan Radiodasnotk HVS 2k br 255 2.650.000,
Pelaksanaan pembelan obat Pav HVS 2 mk br 265 2.650.000
[Permohonan menjadi pasien probadi HVS br 148 4.490.000
Pemyatan membuka rahasiakedoiteran HVS wama | 8.000 Lbr 175 1.400.000
Resop Pethigin - 00] Bat 7150 715.000
Rese Ranap BPIS 1/3 olis 1001b 5000 Bal 45000 75,000,000
Resep Ra Jal BPIS 173 olisi 100 b —| 2000) eet +5.000| 42000000
[Resep Ra Nap Non BPS 19 Folisii001er 72200] — Bl 15,000 2.000.000
FResep Raja Non BPJS 1/3 foisi 100 b NCR 2600) Bat 715.000 #2,000.000
06 [Surat Keahvan 12 F HVS {mk _ 7.586 [Lie 120) 959,760
Surat Isirahat 12 FAVS 1 mk [tbe | 120| 960.000
at Kelerangan Dokter 1/2 F HV tbe - 600.000
[758 Surat Rutan 12 F HVS tm tbr ‘0 | 600.000
00| Surat ln Keluar V4 BC Hiau tbr 200 30.000
~~ [101 Surat Penyerahan Jenazah HVS br 49 664,000
| 102| Sure inet nosokomil HVS tbr 168 7.344.000,
~/108/Stempel Telapak kai Bayi HVS.O br 109 ~ 774.800
108| Surat Keterangan Kematian CDQ tbr 48 819.500
[ios srattandaseteran NCR Bik san00 | ~Zo0n00
| 105| Surat sekorbukan pajak NCR Buku EN EE
i jaa aterangan dla prawn 2H Lbs w20| 2400000
- [ber 385 96.250000
- - br “sz 2.470.800
tbr —sa7| 6045600
- akan aan “tor 125[ 1.638.000
: *12[Uraian pelayanan fii terapi be wu9| 372500
[~ Viste Konsul HVS Warea be 25[ 2.271.050
|| Biya Pelayanan Lain-lain ___1-4107900.000
|" 6.1_ Biya Pely. Pasion 8°15, PANS di 4.700.000000 |" 1.200.000.000
] 82 Bigya Pemulasoraan 60,000.000 €0,000.000
|__| — 63 Blaya Pasien 18 (Resisien Oba +50.000.000 | 150.000.000
B |BIAVA UNUN-DAN AOMINISTRASI — - “Reawaze ooo
|__| 1 Biaya Pegawai :
[| Biaya Lembur Pegawai : e
2 Biaya Adminsirasi Kantor - - 18543.600.000, Kertas rol hitung
"24 Blaya Benda Pos dan Pengiriman ‘ [thn 8.000.000 18,000,000
22 Blaya ATK - jemeze +(500.000.000|
+ [Amplop poo 20 000.000
3793 379.300
| 6.000| 360.000
4 9.107 | 1.320 554,000
~ 5 [Binder Kip No. 155) _ 4.200 [buat 1.990 8.358000,
“6 [Binder Kip No. 260 3320 5976.00
~ 7 [Batpoit Top ~ ~ 3.850 13.860.000
a [Bopain Peni eee 5.000 60.000
9 [Bopoint Meja ~~ buat 9.900 594,000
10 [Boipoint Parker 5 fon 396.000 4.980.000
[11 [Bolpoint Baliner - 90 [bh 32.500 2925000
12 [Buku Agenda isi 100 ee ~ 15.050 4.515.000
_] 13 [Buku Agendas 200 a fouah 30.200] 12080000
| “4 [Buku Expedisi 8.500 1.700.000
15 [Buku Quart is 100, 9.000 7,200,000
16 [Buku Tus is 18 - ‘100|__720.000
47 [Buku Kas Debit Kresit 31.000 188.000
18 [Cap tanggalan 12500 | 450.000
19 [Cater Basar 20.000 | 720.000
20 |cDR 7200 | _§760.000
21 [Clear Holders 4o br 77500 4.500.000,
[22 Jcompac Fas 16 GB 11500.000| 3.000.000
23 [DVDR 10.000 4.000.000
24 [ile Box Flo 15000 750.000
25 File box iplek 18.900 | 7.560.000
26 Fle Box Arsp 17.000 34,000,000
27 |Flasdisk 8 G8 795.000 20.650.000
| [28 esis 16 G8 580.000 2320000
23 [Flasisk 32 G3 800.000 3200000
[30 aris Mica 40 om 5000| 500.000
31 [Hekmasin besar 35.000 3.500.000
[32 Hesmasin ket - 18.000 400,000
33 [Hang Map / Map Ganiung 30 bua 5450 163.500
34 [isi Bolpont Pentel 15 fol 12500 187.500
35 Islas Nachi_keci 380 fo! 7.000 760.000
: 36 Islas nachitanggung _ 160 rot 41.000 4.760.000,
i 37 |isolas bola balk 60 fo! 14.000 240.000
38 is Staples Jumbo - 50 dos 30.200] 110.000
38 is steps besar z 7.000 [dos 11650 3300000
[40 los 1.800 9.000.000
at loan 77.000 308000
Eval an 500 60.000
43 kal lowe 22.500 | 6.860.000
4 oan 7.100.000 3.200000.
45 or 2400 2.400.000 |
8 pai 41500" 1.6600000,
at Io 60.500 7,865,000
L pak 71900 4,085,000,
a 2 ~ 40 pak 51300 2.052000
“50 jKertas Thermal - 160 frot 33800 [5.070.000
51 [Kertas| a a 180 [ol 77200 4,080.00
82 lets HVS 70 gr Barwa | 750 rem 71500 3.628000 |
“53 [Keras HVS T0groio S00 rem 5,000] 209000.000
Ht keras HVS 70 grhuarlo $3900|__107.800000
55 [ketas HVS DF bergaris 38.700 387.000
Kertas Kaver : 47.400] 7.065.000
31000 480,000 ia 58 kertas samak payung 94,000
59 (Kertas Foto Closy 9.424.000
160 |karias Komputer 3play PRS 0 12x 11 454. 700.000
61 [Kertas Komp 3 pay 3 warna 9 12x11 4.000000
62 |Kertas Sicker Fl 330.000
63 [klip Keo 1.000.000
64 [kip Jumbo 800.000
[65 IKertas Rol antiian 7.000.000
68 |Logiter Profesional R 600 3.000.000,
[67 [Label Beng Yu 113 1.894.000,
i 6 [Label Beng Yu 101 2.354.000
69 [Lak ban §cm 2.610.000,
|" 70tintaiot 1200 000
71 [Master Risograf 14,320.00
72 [Memory Card 32 Brome 20040.000
[7 esi tang 14 gt 400.000
Perforator kal
“Ta [Nomerator G45 450,000
75 Map Odner folo_ —_¥11000.000
76 |Ordner Bantek 37,500,000
77 [Pensil 2B 2,260,000
78 [Pensil Merah tity 4.200.000
or i 4,930,000,
“Bo Plan Wer Bet OT
2,100.000
3 a ko ; $5000
@2[Piamesnietc 21.500
83) itung IR 58,000
tt [Pasik OHP /Transparan_ 52800
85 [Pos tA 08Penyekat Buku kal 12200
788 Pos it A 03Penyetat Buku bsr 15000
87 Pastk Fie 1.500
~ 88 [Pembatas Bantex 18.950
@[Penghapus Whieboard 1.000
0 |oiner Laser 315.000
16900
43.400 434.000,
165 000 42,375,000,
ia Prinierpson LX 310 _ 35.000/ 11,900,000
[Set BR 40 petkan 2500| 375.000
[Soe Transparenteka 11.275 | 13.530.000
ib a 900] 19,800.00
10450 ¥2.54,000
- 7.850[ 2.355.000.
“00 9150 549.000
“or Sadar ou iat SO) 7.000
““rt2|Saples SOL 1.640.000
103| Stempel RSUD Or, Moowar 1.050.000
‘Stempel trodat {600.000
'Stempe Digtal 40.000
‘Stempel Poltbik 800 00
Stempel Peat stral 160.000
Stop map polos ketas 4.000.000
[Stopmap = 010.000
‘Slop map doubal folder |____ 435.000
122000
—_1916.000
3.336.000
4.152.000,
90.000
16 950.000
Fy “7 [Tna caveie BC 12950.000
“18{Tinta Catidge BCT 21 Back [3 [ower 235,000 705.000
i |] alin Catdgo HP 22 Color 3 [ust 736000 | 88.000
720|Tnta Catidge Pha 830 35 [buah 260.000 14,300.000,
1721 [TintaCatidge Pema 831 a7 Iowan 310.000 14570.000,
[| ‘Tinta HP lassarjet 2100 2 [bvah 288.000 576.000
a 123[Tna refi = 7 100 bua 47800 | ___§2580.000
(| 126 Tnta rfl nis 3 veh 50.00 180.000
[28h ita retttoner 00 [owen 152.500 7000.000
| [126i isograt — 24 bo 510.000 12240.000,
|__t27l Tinta Spidol - 40 bu ‘2000480000
[8 inta Toner fio op) 12 [kg 770.000 240,000
a 128Tnta Toner ase 1760, _ 2 [buah $28,000 4.858.000,
130\Tipex _ [ito Jovan 7.850 785,000
‘31|Tinta Catidge RP 6D wamna ——_Sfbuah 780.000 7.400.000,
[ena Catidge HP 6D Black [ova] 280,000 4.120.000,
133|Tnta catidge PGBIO atom 280,000 7.080.000
| 134[ Tinta catndge CL 811 45 [on 320,000 4.400.000
135| Tinta Cabidge 740 20 bm 785,000 5.700.000
| 136[ Tinta Cabidge 741 20 om 325.000 500.000
|____137|Tinta Catridge 564 = 12 [oh 250.000 3.000.000
136 Tinta Cavidge 602 ~ 6 [on 260,000 1,560,000
|_| 138 Tinta Catidge 35 fon 250.000 4.000.000,
“40|Tinta cage 36, 3fn 260.000 780,000
“| Tinta cade 745, 20 on 280.000 600.000
“42 Tinta Catidge 748 - 15 fon 310.000 450,000
“43 Tintacaidge 98 3 fbn 310.000 $30,000
a UC “al Tinta caidge 805 fon 310.000 930.000
Hs ita Cai 75074 ra sr0c00| 7.750.000
ia Tinta Catidge toner 960,000 3.840.000
4 Li Tinta cap digial 22.000 ~ 220.000
Tinta Rion TLP SeiesBiack “00.000 | $80.000.000
[| atin ton 20 Series 3 360000] 7.200.000
fea Tinta Epson ( Fulmark) 2.640.000
I Tinta Al - 455,000
- ita T6641 600.000,
i Tina Botol Alkeno 130.000 __ 910.000,
- a _ 1 [tahun 4,840,700 4,840,700
[1723 Taya Pengpandaan TT seooooane | Toa
~ 24 lBiaya Kepust 1 ftahun 20.000.000 7.000.000,
“25 Biaya Pakaian DinasiKerja 576.000.000
_ BelajaPalaion DnasHaign \— 7.000.000
~~ Aaministvasperawat,bidan, meds, nya
| paramecis non perawatan apoteker 300,000 | 380,000500
Peja stir (pa) —_ 300.000 4.400.000,
ejabatstrutural wart) 300,000 | 6.000.000
390.000 | 2.400.000
300.000 4,200,000
300.000 | $88,000.000
‘300.000 | +41 600.000
300.000] 600.000
300.000 91.800.000
‘00.000 | 418000.000
300,000.000 | ~~ 300,000,000
| s.000.000.000 | "2.900.000.000
65,000,000, 65,000,000
2% 2:10 /Blaya Dokumentas| - | iti 5.000.000 5,000,000,
(|--2:1 [Baya Pike dan Outsourcing - 759,600,000
iit 4. Tenaga Pengamanan/POLRIKoraril 3 12 [bin 300,000 10,800,000 |
ia 2. Tim Satpl PPIDShub af 300.000 10,800,000,
3. Dannw ___ 5a} 2.000.000 | 1.416.000.000
4. Outsourcing geting woman - at 000.000 120.00.000
%, Outsourcing operator telepon 2 lo 2.000.000 48,000000
6. Outsourcing Laundry dan pembarla ef 12 fun 2.900.000 | __148,000.000
T.kinmas - eft fhm 110.000.000 110.000.000,
|| 2:12 “Biaya Perjalanan Dinas 1 [thn 300,000,000
[| 2.13" Blaya Honorarium Kepaniiaan —
Ei a. Biaya Honorarium Pelaksanan Keg atan 322.400.000"
ie “[Pejabat Pengella Tekns Kepiatan (PPTK) BM 7800.00 4.800.000
" 2[Pjaat Pengelola Teknis Kegiatan (PPTK) Non BM 1.600.000 57,600,000
“3]Pania ISO, Jesa Medis Superisi, Tm Tarp SP, 700.000.000] — 200.000.000,
anita Anggaran, Pana Pengadaen Pegawi Tin
|_| lose, Pana Keriasama _
7 ®, Baya Honorarium Pokja PengadaanBarangidasa 712,200,000
: 1[ketua Poa BM 2 fata 7.400.000, 50 400.000
2|Seketaris Poa BM 312 [bulan 4.100.000, 38600.000
| 3[Anggola Pokja BM. [12 foulan 50.000] ___31.200.000
7 4[Ketua PokjaNon BM 3172 Tbuan [1.300.000 | 48,800.000
eivelaris Pokja Non BM 312 fouian 4.050.000 37. 800.000
~ | slanggota Poke Non BM 12 [uian 650,000 31 200.000
4lkelua Penerirahasl 12 foulan 800,000 57 600.000
‘5[Seketaris Penerma nasi 12 fovlan 700.000 ~50.400.000,
‘6]Anggota Penerima has 12 [oun 600,000 6.400.000
‘9[Pejabat Pengadaan 7 12 |bulan 850,000 5.000.000
" 1|Pejabat Penerima Hast 12 [oun 800,000 67,200.000
11]Penanggungiawab Swakella 12 [oun 500.000 18,000,000
12|Tim Teknis/Pemesan Obal 12 [buan 560.000 | _138.600.000
1A] Sekai PPKomiPPTK 72oion £00000/ 6000006]
‘. Blaya Honorarium Pengelola Keglatan SKPD/BLUD _341.400,000
“[Pejabat Pembuat Komitmen _ 500.000 | __90000.000
2 [Pejabat Penatausahaan Kevangan — 200.000 600.000
L 3[Perencanaan . 650.000 780,000
~~ AlPenganggaran - 650,000 700.000
5\Verifixas! 650.000 7:800.000
B ‘6|Pembantu Verifkasi ee 550,000 | —___ 6.600.000.
T[akwntans 50,000 7.800.000,
afer — 50.000| 7.900000
“a)Bendahara Unum BLUD_ - "4.200.000 | ~~ “44400.000 |
i Bendanara Pengoluaran BLUD 50.000 | 72,800,000
Bendahara Pengoluaran SKPD eso.000| 7.800.000
E Pembanty Bendahara Pengeuaran SKPD dani 560.000 5 200000
560.000 6.600.000
ial ‘50.000 | __10.200.000
_ “400,000 | ___28:800.000
700,000 16.800.000
600.000 | ~~ 7,200,000
| 450.000] 400.000
- Big Honorarium Pens |" 583.200.000
__t]Pemimpin 8LUD 00.000 | 102000.000|
Z Pejabat Kevangan BLUD 6.500.000 78.000.000
7 PejabatTeknis LUD. 6.500.000 __78.000.000
450,000 | 65,400,000 5 Angeta Dewan Pengawas BLU 4900.000[ 735200000
6 |Sekretais Dewan Pengawas BLUD a]___12 Poulan 2,050,000 24,600,000,
b [| laya Honorarum Doster Japa ‘shun 7.000.000 | 16.000000,
[Ie Biaya Honorrum DPLP a 160 ‘ ftahun | 4to.a00.000 | 1.410.800.000
214 Bia - = 40,000:000
fi Zaonoo | 2.000000,
a — inn 4.000.000 000 000,
_ ihn 4.000000 000000,
| 215|Biaya Akomodasidan Transportasl | (thn 300,000,000 | 300.000.000
——a
1 aya Fra Raa cn ig | aan |
1 [Pet MessRumein ings 700.000.000| 200.000.000,
— [2 | Pemetnarean pageripengs 30.000 7.100.000
2 |Pemetharaan pengecatan enter 15.000 __450,060.000
4 [Pemeinaraan pengecatan cincing 38.000 | 1.500,000.00
CT 5 |[Pemelinaraen pengecatan nding dengan cat minyak | 4000 | m2 30.000 120.000000
6 [Pemetinaraan Penataan tamanlsewataman | 12 auan 25,000,000 | _300.000.000
7 [Betana uran/ PBB. z 1 | iehun 30,000,000 | 30,000,000
' [Pemetharaanfpenggantian plafon dan enerit 490.000 | 400.000.000
'-[Pemeiharaanperblkanalapkerpus 200.000 | 200.000000
10 |Pemeiharaan lanai dindng vil 450,000 | __226.000.000
11 Pemeiharaan lanai cndig keramik 450.000 | 150.000000
12 [Pemeltaraaniperbakan pintujendela iz 175.000 3.000.000
13 [Penggantan pintujendela a 200 bh 2,000,000 |" 400,000,000
‘4 [Pemelnaraariperbakansauranlimbah a hujan [|| ¥20.000.000 120,000,000
15 [Perlengkapan RT dan kurasseptitank T[s_} 50.00.00 | ~~ 50,000,000
16 |[Pemetharaan Counter, ak oba rang awa inappolk t[ Is | 250,000.00 | 250.000.000
17 [Pembuatandpenambahan papan ramalpapan peunjk {1 | is 150,000,000 | _150.000.000
16 [Pembuatan sekatkacaalumunisrtipleldgypsum. 1/8 120,000,000 | 120.000.000
19 [Pengendalan dan pencegahan pest antl 2 |_Suan 500.000 | _102.000.000
Pemel,Instalasidaringa - 504.4000)
‘ a Perelaran srngan 153.800.000
4 Pompa disrbusi at 75000000, 25,000,000
| Pengganian Valve = t0_|_ bush 500.000| 5.000.000
} Pengganiian Check Valve _ 11 | buah 300.000 3.300.000
Prbakan Water Treatment ———=SSS|_ tt 70,000,000 | 10,000,000
i Pengecatan ee 1 [is 0.000.000 | 10.000.000
Pemada
im Perbaikan Pompa_ 10.000.000, *10:000,000
- Tusen ep 250.000 500.00
[- |e Fengeostan Va 7.500000/ 1.500000
| i. Pressure Tank 2500000 | __2500.000
C fe. Kopel - 2.500.000] 28000000
: - 300.000 Lousy
=i oO 0.000 |
a 500.000 [ reins
iC Tk dengan ipa distibus idan 71 500.000 [71500000
[| Pemethnaraan rant 50.00.000 0.000.000
Biaya pemelharaanInsalasl air limbahikotor 350500.000,
4 Tf herator sania is 300000 1.500.000
Tr 2]Oifuser FOX PAL = Bush 7.750.000 | __16500.000
| 5[PembersnaPengurasan PAL unit 76.000.000 [4.000.000
iz “4 [Pemetharaan Porpa Linbah abel 72,900.000 | 22.00.000|
B abet $5:000.000| $5.00.000 a Perganoapomota por PAL Cane Pe roto se
‘onapeen PAL +f per [ost | aero ano
_8|Rumpon(media bioreaktor) FBK IPAL 6 m3, 8.000.000 48,000,000
Sees Bonet s | am Senoano| se0r0000
i|4 ‘eooono| ‘4000000
Biaya Pemeliharaan Alat Transportasi [ 300,000,000
ia Sven = fan] a
2/Penggantian suku cadang ‘iftahun 120,568,000 420,568,000
___3/Bahan baker minyallgas dan pelumas 12}bulan_ 50,000,000 |" 600.000.000
4) Surat Tanda Nomor Kendaraan _ ‘tahun 12.76.00, 12.776,000,
——~iseots tena ‘hen 0800] sooo
_3.4_ Biaya Pemeliharaan Tehnolog! Informasi 4 |tahun '895.000.000 '895.000.000
25° Bays Preiarean Atatr dan RT a6 0
1 dogs aretharanWacbiRRave EE 00
[Amari kay | 4 14,000,000 14,000,000
Thea a PL Cada) i satoaio[ setnood
__3]Butet ae 1 "3.000.000, 3.000.000
____afecry | 1 40.00.00 40,000,000
Slip cece 200000 toto
leans — I ‘eit | —teroap0
"7 Kune! alma 1 is 4.000.000 | —__4.000.000
tan pti Sims ea ‘00 zs0000
Farber oe tanoaps|eomnoot
to)kursipat cae 30.000.006 |" 30.000000 |
“ersten =e Taioato| —7sthond
asap aos Sation | ~~ Sotoo0
roskrgg he ‘oanoany | omon0
[Kursi tunggu renteng 2 1 is 18,000.000 | ___18.000.000
15|Loker —_ 1 is 3.750.000 3.750.000
Meja Bio _ al is 7.500.000 7.500.000
IMeja sidang _ 1 is 3.000.000[ 3.000.000
carey da ea apo aiosii| ——Preon00
[Mesin hitung = 1.500.000 1.500.000
slim ien ee ‘atin | ano
Fes ttt je sata] enon
Rene ie 300 Benoa
Stpeten te
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