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Laporan Tarif Katarak JKN
Laporan Tarif Katarak JKN
HERMINA SOLO
PAKET OP KATARAK JKN kelas 1
N
o
Uraian
ke
t
Biaya (Rp)
1,545,200.00
500,000.00
2,000,000.00
7 Sewa OK
500,000.00
8 Jasa paramedis
200,000.00
9
1
0
1
0
1
1
240,650.00
EKG
Lab pre op katarak(GD,
HR1,Ureum, kretinin)
50,000.00
Admin 1%
77,260.00
Total
5,368,110.00
255,000.00
Coding kelas 1
Diagnosa : Cataract
tindakan: other operation on
cornea
7,726,000.00
Selisih coding
2,357,890.00
Uraian
Biaya (Rp)
1,324,460.00
500,000.00
4 Sewa OK
500,000.00
2,000,000.00
ke
t
5 Jasa paramedis
200,000.00
240,650.00
7 EKG
Lab pre op katarak(GD,
8 HR1,Ureum, kretinin)
50,000.00
9 Admin 1%
66,223.00
Total
255,000.00
5,136,333.00
Coding kelas 2
Diagnosa : Cataract
tindakan: other operation on
cornea
6,622,300.00
Selisih coding
1,485,967.00
Uraian
Biaya (Rp)
1,103,720.00
500,000.00
4 Sewa OK
500,000.00
5 Jasa paramedis
200,000.00
240,650.00
7 EKG
50,000.00
255,000.00
9 Admin 1%
55,186.00
Total
2,000,000.00
4,904,556.00
ke
t
Selisih coding
614,044.00
Gentamycin inj
Dexamethason
inj
3,692.26
5,600.00
2,002.00
2,800.00
lidokain inj
2,191.20
2,500.00
handschoon
32,000.00
46,000.00
spuit 1cc
spuit 3 cc
2
1
1,001.00
2,000.00
583.00
1,050.00
spuit 10 cc
1,100.00
1,500.00
RL 500 cc Wida
7,150.00
10,000.00
Povidone iodine
As mefenamat
500mg
ciprofloxacin 500
mg
4,081.00
8,300.00
10
1,320.00
3,000.00
10
5,335.00
8,500.00
Midriasil ED
Floxa ED mini
dose
30,968.44
42,000.00
26,482.50
41,200.00
Pantokain ED
Bupivakain
(Markain)
Chloramfenicol
ED
14,210.61
19,000.00
23,760.00
45,000.00
1,563.10
2,200.00
157,440.11
240,650.00
TOTAL