Diagnosa/ Pemeriksaan Lengkap

No Bahan Jumlah Harga (Rp) Unit cost (Rp) Harga Sekarang

Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 0 0 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Gaun Supervisor 20 10,000 500 10,000
5,377

Plat Aktif 1 rahang

No Bahan Jumlah Harga (Rp) Unit cost (Rp)

Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 0 0 395,000
 13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Ligature 40 450,000 11,250 450,000
23 Sendok Cetak 6 16,500 2,750 16,500
24 Alginat 20 65,000 3,250 65,000
25 Gips 20 40,000 2,000 40,000
26 Rubber Bowl 20 35,000 1,750 35,000
27 Spatula 20 7,000 350 7,000
28 Malam Merah 50 135,000 2,700 135,000
29 Proses Lab 1 75,000 75,000 75,000
102,827

Plat Aktif 2 rahang

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1100 55,000
11 Kapas 150 17,500 116.6666666667 17,500
12 plastik alat gulungan 200 0 0 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 112.5 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
 22 Ligature 40 450,000 11250 450,000
23 Sendok Cetak 6 16,500 2750 16,500
24 Alginat 10 65,000 6500 65,000
25 Gips 10 40,000 4000 40,000
26 Rubber Bowl 20 35,000 1750 35,000
27 Spatula 20 7,000 350 7,000
28 Malam Merah 50 135,000 2700 135,000
29 Proses Lab 1 150,000 150000 150,000
183,077

Ekspansi 1 rahang

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 35,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1100 55,000
11 Kapas 150 17,500 116.6666666667 17,500
12 plastik alat gulungan 200 395,000 1975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 112.5 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Ligature 40 450,000 11250 450,000
23 Sendok Cetak 6 16,500 2750 16,500
24 Alginat 10 65,000 6500 65,000
25 Gips 10 40,000 4000 40,000
26 Rubber Bowl 20 35,000 1750 35,000
27 Spatula 20 7,000 350 7,000
28 Malam Merah 50 135,000 2700 135,000
29 Screw Expansi 1 35,000 35000 35,000
30 Proses Lab 1 75,000 75000 75,000
 145,052

Ekspansi 2 rahang / Alat Fungsional

No Bahan Jumlah Harga (Rp) Unit cost (Rp)

1 excavator 5000 20,000 4 20,000

2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Ligature 40 450,000 11,250 450,000
23 Sendok Cetak 6 16,500 2,750 16,500
24 Alginat 10 65,000 6,500 65,000
25 Gips 10 40,000 4,000 40,000
26 Rubber Bowl 20 35,000 1,750 35,000
27 Spatula 20 7,000 350 7,000
28 Malam Merah 50 135,000 2,700 135,000
29 Screw Expansi 2 1 35,000 35,000 35,000
30 Proses Lab 1 150,000 150,000 150,000
220,052

Scaling USS dan Desensitisasi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
 1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Disclosing Agent 50 60,000 1,200 60,000
23 Povidon Iodine 1l 100 75,000 750 75,000
24 Pumice 1/2 l 50 35,000 700 35,000
25 Pasta 50 9,800 196 9,800
26 Brush 2 7,000 3,500 7,000
27 Obat kumur 20 30,000 1,500 30,000
28 Scaller USS 1000 3,900,000 3,900 3,900,000
29 Face Mask 100 20,000 200 20,000
17,698

Kontrol plak DHE

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
 10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Disclosing Agent 50 60,000 1,200 60,000
23 Povidon Iodine 1l 100 75,000 750 75,000
24 Pumice 1/2 l 50 35,000 700 35,000
25 Pasta 50 9,800 196 9,800
26 Brush 10 7,000 700 7,000
27 Face Mask 100 20,000 200 20,000
9,848

Frenektomi / Gingivektomi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 14,000 140 14,000
21 Sabun Cuci 200 14,000 70 14,000
 22 Periodontal Pack 50 75,000 1,500 75,000
23 Benang 120 350,000 2,917 350,000
24 Jarum 12 95,000 7,917 95,000
25 Surgical Blade 100 150,000 1,500 150,000
26 Pehacaine 20 70,000 3,500 70,000
27 Terumo Syringe (Spuit) 100 150,000 1,500 150,000
28 Kassa Steril 200 45,000 225 45,000
29 Glass Plate 20 10,000 500 10,000
30 Set Bedah Minor 1000 165,000 165 165,000
29,566

Fissure Sealant/ Preventive Resin Restoration

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 20,000 20 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 Sealant Clinpro 50 285,000 5,700 285,000
26 Light Cure 1000 1,500,000 1,500 1,500,000
27 Adper prompt L Pop 100 850,000 8,500 850,000
28 Pumice 1/2 l 50 35,000 700 35,000
29 Pasta 50 9,800 196 9,800
30 Brush 10 7,000 700 7,000
 22,628

Topikal aplikasi Fluor (Liquid)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 5000 4,000,000 800 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
28 Pumice 1/2 l 50 35,000 700 35,000
29 Pasta 50 9,800 196 9,800
30 Brush 10 7,000 700 7,000
31 Fluocal 50 230,000 4,600 230,000
11,868

Tumpatan Kls 1 Amalgam (Decidui)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
 7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 20,000 20 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 Semen Spatula 1000 20,000 20 20,000
26 Semen Stoper 1000 20,000 20 20,000
27 bur preparasi flame edenta 20 25,000 1,250 25,000
28 bur preparasi Fissure edenta 20 25,000 1,250 25,000
29 bur finishing flame edenta 20 25,000 1,250 25,000
30 bur steel RA/ Hp edenta 20 10,000 500 10,000
31 shapcut finishing tapered 20 20,000 1,000 20,000
32 shapcut finishing fisure 20 20,000 1,000 20,000
33 amalgam 1 19,000 19,000 19,000
34 amalgamator 5000 4,800,000 960 4,800,000
35 semen seng fosfat 1 4,180 4,180 4,180
36 Articulating Papper 36 120,000 3,333 120,000
39,096

Tumpatan Kls 2 Amalgam (Decidui)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
 10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 20,000 20 20,000
24 Plastis Instrument 1000 20,000 20 150,000
25 Semen Spatula 1000 20,000 20 20,000
26 Semen Stoper 1000 20,000 20 20,000
27 bur preparasi flame edenta 20 25,000 1,250 25,000
28 bur preparasi Fissure edenta 20 25,000 1,250 25,000
29 bur finishing flame edenta 20 25,000 1,250 25,000
30 bur steel RA/ Hp edenta 20 10,000 500 10,000
31 shapcut finishing tapered 20 20,000 1,000 20,000
32 shapcut finishing fisure 20 20,000 1,000 20,000
33 amalgam 1 19,000 19,000 19,000
34 amalgamator 5000 4,800,000 960 4,800,000
35 semen seng fosfat 1 4,180 4,180 4,180
36 Articulating papper 36 120,000 3,333 120,000
36 Matrix Band 50 75,000 1,500 75,000
40,596

Tambalan Kls 3 GIC (Decidui)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
 10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 20,000 20 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 Fuji II GIC 50 6,000 120 6,000
26 Dentin Conditioner 50 3,000 60 3,000
27 Cavity Cleanser 100 315,000 3,150 315,000
28 Articulating Papper 36 120,000 3,333 120,000
29 Vaselin 50 10,000 200 10,000
30 bur preparasi flame edenta 10 25,000 2,500 25,000
31 bur preparasi Fissure edenta 10 25,000 2,500 25,000
32 bur finishing flame edenta 10 25,000 2,500 25,000
33 bur steel RA/ Hp edenta 10 10,000 1,000 10,000
34 shapcut finishing tapered 10 20,000 2,000 20,000
35 shapcut finishing fisure 10 20,000 2,000 20,000
29,426

Tumpatan Kls I Amalgam (permanen)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
 12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 20,000 20 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 Semen Spatula 1000 20,000 20 20,000
26 Semen Stoper 1000 20,000 20 20,000
27 bur preparasi flame edenta 20 25,000 1,250 25,000
28 bur preparasi Fissure edenta 20 25,000 1,250 25,000
29 bur finishing flame edenta 20 25,000 1,250 25,000
30 bur steel RA/ Hp edenta 20 10,000 500 10,000
31 shapcut finishing tapered 20 20,000 1,000 20,000
32 shapcut finishing fisure 20 20,000 1,000 20,000
33 amalgam 0.5 19,000 38,000 19,000
34 amalgamator 5000 4,800,000 960 4,800,000
35 semen seng fosfat 1 4,180 4,180 4,180
36 Articulating Papper 36 120,000 3,333 120,000
58,096

Tumpatan Kls II Amalgam (permanen)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
 13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 20,000 20 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 Semen Spatula 1000 20,000 20 20,000
26 Semen Stoper 1000 20,000 20 20,000
27 bur preparasi flame edenta 20 25,000 1,250 25,000
28 bur preparasi Fissure edenta 20 25,000 1,250 25,000
29 bur finishing flame edenta 20 25,000 1,250 25,000
30 bur steel RA/ Hp edenta 20 10,000 500 10,000
31 shapcut finishing tapered 20 20,000 1,000 20,000
32 shapcut finishing fisure 20 20,000 1,000 20,000
33 amalgam 0.5 19,000 38,000 19,000
34 amalgamator 1000 4,800,000 4,800 4,800,000
35 semen seng fosfat 1 4,180 4,180 4,180
36 Articulating papper 36 120,000 3,333 120,000
36 Matrix Band 50 75,000 1,500 75,000
63,436

Tumpatan Kls I Komposit

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
 13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 20 25,000 1,250 25,000
26 bur preparasi Fissure edenta 20 25,000 1,250 25,000
27 bur finishing flame edenta 20 25,000 1,250 25,000
28 bur steel RA/ Hp edenta 20 10,000 500 10,000
29 shapcut finishing tapered 20 20,000 1,000 20,000
30 shapcut finishing fisure 20 20,000 1,000 20,000
31 Cavity Cleanser 200 315,000 1,575 315,000
32 Etsa 50 95,000 1,900 95,000
33 Bonding 50 790,000 15,800 790,000
34 Resin Komposit dentin 40 352,000 8,800 352,000
35 Resin Komposit email 40 352,000 8,800 352,000
36 Resin Komposit Flowable 50 475,000 9,500 475,000
37 Enhance 20 35,000 1,750 35,000
38 microbrush 50 50,000 1,000 50,000
39 Articulating papper 36 120,000 3,333 120,000
40 Light Cure 1000 10,000,000 10,000 10,000,000
74,021

Tumpatan Kls II Komposit

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
 11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 20 25,000 1,250 25,000
26 bur preparasi Fissure edenta 20 25,000 1,250 25,000
27 bur finishing flame edenta 20 25,000 1,250 25,000
28 bur steel RA/ Hp edenta 20 10,000 500 10,000
29 shapcut finishing tapered 20 20,000 1,000 20,000
30 shapcut finishing fisure 20 20,000 1,000 20,000
31 Cavity Cleanser 200 315,000 1,575 315,000
32 Etsa 50 95,000 1,900 95,000
33 Bonding 50 790,000 15,800 790,000
34 Resin Komposit dentin 40 352,000 8,800 352,000
35 Resin Komposit email 40 352,000 8,800 352,000
36 Resin Komposit Flowable 50 475,000 9,500 475,000
37 Enhance 20 35,000 1,750 35,000
38 microbrush 50 50,000 1,000 50,000
39 Articulating papper 36 120,000 3,333 120,000
40 Light Cure 1000 10,000,000 10,000 10,000,000
41 Matrix Band 50 75,000 1,500
42 Band Holder 1000 7,000,000 7,000
43 Finising Strip 150 449,000 2,993
85,514

Tumpatan Kls III Komposit

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
 5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 20 25,000 1,250 25,000
26 bur preparasi Fissure edenta 20 25,000 1,250 25,000
27 bur finishing flame edenta 20 25,000 1,250 25,000
28 bur steel RA/ Hp edenta 20 10,000 500 10,000
29 shapcut finishing tapered 20 20,000 1,000 20,000
30 shapcut finishing fisure 20 20,000 1,000 20,000
31 Cavity Cleanser 200 315,000 1,575 315,000
32 Etsa 50 95,000 1,900 95,000
33 Bonding 50 790,000 15,800 790,000
34 Resin Komposit dentin 40 352,000 8,800 352,000
35 Resin Komposit email 40 352,000 8,800 352,000
36 Resin Komposit Flowable 50 475,000 9,500 475,000
37 Enhance 20 35,000 1,750 35,000
38 microbrush 50 50,000 1,000 50,000
39 Articulating papper 36 120,000 3,333 120,000
40 Light Cure 1000 10,000,000 10,000 10,000,000
41 seluloit strip 100 120,000 1,200
42 finishing strip 150 449,000 2,993
78,214

Tumpatan Kls IV Komposit

 Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 20 25,000 1,250 25,000
26 bur preparasi Fissure edenta 20 25,000 1,250 25,000
27 bur finishing flame edenta 20 25,000 1,250 25,000
28 bur steel RA/ Hp edenta 20 10,000 500 10,000
29 shapcut finishing tapered 20 20,000 1,000 20,000
30 shapcut finishing fisure 20 20,000 1,000 20,000
31 Cavity Cleanser 200 315,000 1,575 315,000
32 Etsa 50 95,000 1,900 95,000
33 Bonding 50 790,000 15,800 790,000
34 Resin Komposit dentin 40 352,000 8,800 352,000
35 Resin Komposit email 40 352,000 8,800 352,000
36 Resin Komposit Flowable 50 475,000 9,500 475,000
37 Enhance 20 35,000 1,750 35,000
38 microbrush 50 50,000 1,000 50,000
39 Articulating papper 36 120,000 3,333 120,000
40 Light Cure 1000 10,000,000 10,000 10,000,000
41 seluloit strip 100 120,000 1,200
42 finishing strip 150 449,000 2,993
43 mookup 50 1,500,000 30,000
 108,214

Tumpatan Kls V Komposit

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 20 25,000 1,250 25,000
26 bur preparasi Fissure edenta 20 25,000 1,250 25,000
27 bur finishing flame edenta 20 25,000 1,250 25,000
28 bur steel RA/ Hp edenta 20 10,000 500 10,000
29 shapcut finishing tapered 20 20,000 1,000 20,000
30 shapcut finishing fisure 20 20,000 1,000 20,000
31 Cavity Cleanser 200 315,000 1,575 315,000
32 Etsa 50 95,000 1,900 95,000
33 Bonding 50 790,000 15,800 790,000
34 Resin Komposit dentin 40 352,000 8,800 352,000
35 Resin Komposit email 40 352,000 8,800 352,000
36 Resin Komposit Flowable 50 475,000 9,500 475,000
37 Enhance 20 35,000 1,750 35,000
 38 microbrush 50 50,000 1,000 50,000
39 Articulating papper 36 120,000 3,333 120,000
40 Light Cure 1000 10,000,000 10,000 10,000,000
74,021

Tumpatan Kls V GIC

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 1000 4,000,000 4,000 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 1000 20,000 20 20,000
23 Amalgam Carver 1000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 20 25,000 1,250 25,000
26 bur preparasi Fissure edenta 20 25,000 1,250 25,000
27 bur finishing flame edenta 20 25,000 1,250 25,000
28 bur steel RA/ Hp edenta 20 10,000 500 10,000
29 shapcut finishing tapered 20 20,000 1,000 20,000
30 shapcut finishing fisure 20 20,000 1,000 20,000
31 Fuji II GIC 50 600,000 12,000 600,000
32 Dentin Conditioner 50 138,600 2,772 138,600
33 Cavity Cleanser 100 315,000 3,150 315,000
34 Articulating Papper 36 120,000 3,333 120,000
35 Varnish 50 20,000 400
 36 Polishing bur 100 35,000 350
37,168

Inlay

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 5000 0 0 20,000
23 Amalgam Carver 5000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 10 25,000 2,500 25,000
26 bur preparasi Fissure edenta 10 25,000 2,500 25,000
27 bur finishing flame edenta 10 25,000 2,500 25,000
28 bur steel RA/ Hp edenta 10 10,000 1,000 10,000
29 shapcut finishing tapered 10 20,000 2,000 20,000
30 shapcut finishing fisure 10 20,000 2,000 20,000
31 malam biru 50 264,000 5,280 264,000
32 cetak double impression 50 1,500,000 30,000 600,000
33 Glasstone 20 73,500 3,675 73,500
34 Sementasi 10,000 10,000
35 Etsa 100 0 0 95,000
36 Bonding 100 0 0 790,000
 37 Resin Komposit P60 46 0 0 352,000
38 finishing strip 150 450,000 3,000 450,000
39 Articulating papper 36 120,000 3,333 120,000
40 Enhance 100 35,000 350 35,000
41 microbrush 50 50,000 1,000 50,000
42 Light Cure 1000 1,500,000 1,500 1,500,000
43 proses lab 1 250000 250,000
330,661

Onlay

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 5000 0 0 20,000
23 Amalgam Carver 5000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 10 25,000 2,500 25,000
26 bur preparasi Fissure edenta 10 25,000 2,500 25,000
27 bur finishing flame edenta 10 25,000 2,500 25,000
28 bur steel RA/ Hp edenta 10 10,000 1,000 10,000
29 shapcut finishing tapered 10 20,000 2,000 20,000
30 shapcut finishing fisure 10 20,000 2,000 20,000
31 malam biru 50 264,000 5,280 264,000
32 cetak double impression 50 1,500,000 30,000 600,000
 33 Glasstone 20 73,500 3,675 73,500
34 Sementasi 10,000 10,000
35 Etsa 100 0 0 95,000
36 Bonding 100 0 0 790,000
37 Resin Komposit P60 46 0 0 352,000
38 finishing strip 150 450,000 3,000 450,000
39 Articulating papper 36 120,000 3,333 120,000
40 Enhance 100 35,000 350 35,000
41 microbrush 50 50,000 1,000 50,000
42 Light Cure 1000 1,500,000 1,500 1,500,000
43 proses lab 1 250000 250,000
330,661

Overlay

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Burniser 5000 0 0 20,000
23 Amalgam Carver 5000 0 0 20,000
24 Plastis Instrument 1000 20,000 20 20,000
25 bur preparasi flame edenta 10 25,000 2,500 25,000
26 bur preparasi Fissure edenta 10 25,000 2,500 25,000
27 bur finishing flame edenta 10 25,000 2,500 25,000
28 bur steel RA/ Hp edenta 10 10,000 1,000 10,000
 29 shapcut finishing tapered 10 20,000 2,000 20,000
30 shapcut finishing fisure 10 20,000 2,000 20,000
31 malam biru 50 264,000 5,280 264,000
32 cetak double impression 50 1,500,000 30,000 600,000
33 Glasstone 20 73,500 3,675 73,500
34 Sementasi 10,000 10,000
35 Etsa 100 0 0 95,000
36 Bonding 100 0 0 790,000
37 Resin Komposit P60 46 0 0 352,000
38 finishing strip 150 450,000 3,000 450,000
39 Articulating papper 36 120,000 3,333 120,000
40 Enhance 100 35,000 350 35,000
41 microbrush 50 50,000 1,000 50,000
42 Light Cure 1000 1,500,000 1,500 1,500,000
43 proses lab 1 250000 250,000
330,661

Perawatan Saluran Akar Tunggal (pembukaan akses, preparasi)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
25 bur preparasi round edenta 20 25,000 1,250 25,000
26 bur preparasi Fissure edenta 20 25,000 1,250 25,000
27 bur diamendo 20 20,000 1,000 20,000
 28 cavit 60 75,000 1,250 75,000
29 NaOCl 30 40,000 1,333 40,000
30 Salin 50 30,000 600 30,000
31 Barbed Broach/ Nerv Broach 20 50,000 2,500 50,000
32 Cresophen 200 520,000 2,600 520,000
33 Spreader 50 85,000 1,700 85,000
34 endo box pakistan 100 210,000 2,100 210,000
35 K- file 21 mm # 15-40 5 111,000 22,200 111,000
36 K- file VDW 25 mm # 15-40 5 111,000 22,200 111,000
37 K-file 21 #45-80 5 167,000 33,400 167,000
98,656

Perawatan Saluran Akar Ganda (pembukaan akses, preparasi)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
25 bur preparasi round edenta 20 25,000 1,250 25,000
26 bur preparasi Fissure edenta 20 25,000 1,250 25,000
27 bur diamendo 20 20,000 1,000 20,000
28 cavit 60 75,000 1,250 75,000
29 NaOCl 30 40,000 1,333 40,000
 30 Salin 50 30,000 600 30,000
31 Barbed Broach/ Nerv Broach 20 50,000 2,500 50,000
32 Cresophen 200 520,000 2,600 520,000
33 Spreader 50 85,000 1,700 85,000
34 endo box pakistan 100 210,000 2,100 210,000
35 K- file 21 mm # 15-40 3 111,000 37,000 111,000
36 K- file VDW 25 mm # 15-40 3 111,000 37,000 111,000
37 K-file 21 #45-80 3 167,000 55,667 167,000
150,522

Exodonsia gigi permanen tanpa penyulit

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
23 Spuit 100 1,500 15 1,500
24 pehacain 20 63,000 3,150 63,000
25 Citoject 500 5,900,000 11,800 5,900,000
26 Benzotop 50 75,000 1,500 75,000
27 Povidon Iodin 50 75,000 1,500 75,000
28 Alvogyl 200 350,000 1,750 350,000
29 Set tang exo dewasa 500 7,000,000 14,000 1,350,000
 30 bein 500 150,000 300 150,000
39,287

Exodonsia gigi anak infiltrasi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
23 Spuit 100 0 0 1,500
24 pehacain 20 63,000 3,150 63,000
25 Citoject 500 5,900,000 11,800 5,900,000
26 Benzotop 50 75,000 1,500 75,000
27 Povidon Iodin 50 75,000 1,500 75,000
28 Alvogyl 200 0 0 350,000
29 Set tang exo anak 500 7,000,000 14,000 1,350,000
30 bein 500 0 0 150,000
37,222

Perawatan Saluran Akar Anak

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
 1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
25 bur preparasi round edenta 15 25,000 1,667 25,000
26 bur preparasi Fissure edenta 15 25,000 1,667 25,000
27 bur diamendo 20 20,000 1,000 20,000
28 cavit 70 65,000 929 65,000
29 NaOCl 40 40,000 1,000 40,000
30 Salin 60 30,000 500 30,000
31 Barbed Broach/ Nerv Broach 20 50,000 2,500 50,000
32 Cresophen 200 520,000 2,600 520,000
33 Spreader 100 85,000 850 85,000
34 endo box pakistan 100 210,000 2,100 210,000
35 K- file 21 mm # 15-40 20 111,000 5,550 111,000
36 K- file VDW 25 mm # 15-40 20 111,000 5,550 111,000
37 K-file 21 #45-80 20 167,000 8,350 167,000
44,264

Devitalisasi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
 4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
25 bur preparasi round edenta 10 25,000 2,500 25,000
28 cavit 60 75,000 1,250 75,000
29 bahan devit 1000 450,000 450 450,000
9,472

Dressing

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
 17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 cavit 70 75,000 1,071 75,000
23 NaOCl 40 40,000 1,000 40,000
24 Salin 60 30,000 500 30,000
25 bahan sterilisasi SA 50 520,000 10,400 520,000
26 papper point 50 47,000 940 47,000
23,914

Tumpatan sementara/ Observasi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 cavit 70 75,000 1,071 75,000
6,344

Obturasi
 Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 bur preparasi round edenta 10 0 0 25,000
23 bur preparasi Fissure edenta 10 0 0 25,000
24 bur diamendo 10 20,000 2,000 20,000
25 cavit 50 75,000 1,500 75,000
26 Spreader 10 85,000 8,500 85,000
27 Guta perca poins # 15 5 72,000 14,400 72,000
28 Guta perca poins # 20 5 72,000 14,400 72,000
29 Guta perca poins # 25 5 72,000 14,400 72,000
30 Guta perca poins # 30 5 72,000 14,400 72,000
31 Guta perca poins # 35 5 72,000 14,400 72,000
32 Spirtus 20 25,000 1,250 25,000
33 Endometason 50 520,000 10,400 520,000
104,902

Space Maintainer

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
 1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Ligature 40 450,000 11,250 450,000
23 Sendok Cetak 6 16,000 2,667 16,000
24 Alginat 20 75,000 3,750 75,000
25 Gips 20 32,000 1,600 32,000
26 Rubber Bowl 20 28,000 1,400 28,000
27 Spatula 20 20,000 1,000 20,000
28 Malam Merah 50 135,000 2,700 135,000
29 Proses lab 1 150,000 150,000 100,000
183,619

Wire composite splinting / wire splinting

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
 9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Wire Ligature 50 25,000 500 25,000
23 Resin Komposit Flowable 10 475,000 47,500 475,000
24 Needle Holder 500 35,000 70 35,000
25 Gunting 500 30,000 60 30,000
26 Light Cure 1000 7,000,000 7,000 7,000,000
65,132

Odontektomi Kls 1 A

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
 21 Sabun Cuci 200 14,000 70 14,000
23 Spuit 1 1,500 1,500 1,500
24 pehacain 20 63,000 3,150 63,000
25 Citoject 100 5,900,000 59,000 5,900,000
26 Benzotop 50 75,000 1,500 75,000
27 Povidon Iodin 50 75,000 1,500 75,000
28 Alvogyl 200 350,000 1,750 350,000
29 Set tang exo dewasa 1000 1,350,000 1,350 1,350,000
30 bein 1000 200,000 200 200,000
31 Set bedah minor 5000 19,900,000 3,980 19,900,000
83,182

GTC PFM

Jumlah Harga Sekarang

No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 6 16,000 2,667 16,000
23 Alginat 20 85,000 4,250 85,000
24 Gips 20 32,000 1,600 32,000
25 Rubber Bowl 20 35,000 1,750 35,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 264,000 5,280 264,000
28 bur preparasi flame edenta 10 25,000 2,500 25,000
 29 bur preparasi Fissure edenta 10 25,000 2,500 25,000
30 bur finishing flame edenta 10 25,000 2,500 25,000
32 shapcut finishing tapered 10 20,000 2,000 20,000
33 shapcut finishing fisure 10 20,000 2,000 20,000
34 malam biru 50 264,000 5,280 264,000
35 cetak double impression 50 600,000 12,000 600,000
36 Glasstone 20 73,500 3,675 73,500
37 Proses Lab 1 425,000 425,000 425,000
483,254

Sementasi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Ellite Sement 50 363,500 7,270 363,500
23 Articulating papper 36 120,000 3,333 120,000
24 glass plat 50 10,000 200 10,000
25 Plastis instrument 5000 150,000 30 150,000
26 semen spatula 5000 20,000 4 20,000
16,590

GTS
 Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 200 16,000 80 16,000
23 Alginat 20 85,000 4,250 85,000
24 Gips 20 32,000 1,600 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 135,000 2,700 135,000
28 Wire klamer 100 10,000 100 10,000
29 Pigeon Teeth 1 17,000 17,000 17,000
30 Proses Lab 1 350,000 350,000 350,000
382,302

GTL

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
 7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 0 0 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 6 16,000 2,667 16,000
23 Alginat 20 85,000 4,250 85,000
24 Gips 20 32,000 1,600 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 135,000 2,700 135,000
28 Wire klamer 100 10,000 100 10,000
29 Pigeon Teeth 1 17,000 17,000 17,000
30 Proses Lab 1 700,000 700,000 700,000
736,019

Reparasi Gigi Tiruan Akrilik

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,000 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
 14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 0 0 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 6 16,000 2,667 16,000
23 Alginat 20 85,000 4,250 85,000
24 Gips 20 32,000 1,600 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 135,000 2,700 135,000
28 Wire klamer 100 10,000 100 10,000
30 Arkansas stone 10 20,000 2,000 20,000
31 Proses Lab 1 100,000 100,000 100,000
119,689

Relining

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 0 0 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
 21 Sabun Cuci 200 14,000 70 14,000
22 Soft liner 50 1,067,000 21,340 1,067,000
30,142

Rebasing

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 0 0 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 6 16,000 2,667 16,000
23 Alginat 20 85,000 4,250 85,000
24 Gips 20 32,000 1,600 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 135,000 2,700 135,000
28 Wire klamer 100 10,000 100 10,000
29 SC Akrilic 20 200,000 10,000 200,000
30 Arkansas stone 10 20,000 2,000 20,000
31 Proses Lab 1 75,000 75,000 75,000
104,789

Mahkota Jaket Porcelain

 Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 200 16,000 80 16,000
23 Alginat 20 85,000 4,250 85,000
24 Gips 20 32,000 1,600 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 135,000 2,700 135,000
28 bur preparasi flame edenta 20 25,000 1,250 25,000
29 bur preparasi Fissure edenta 20 25,000 1,250 25,000
30 bur finishing flame edenta 20 25,000 1,250 25,000
32 shapcut finishing tapered 20 20,000 1,000 20,000
33 shapcut finishing fisure 20 20,000 1,000 20,000
34 malam biru 50 135,000 2,700 135,000
35 cetak double impression 50 600,000 12,000 600,000
36 Glasstone 20 73,500 3,675 73,500
37 Proses Lab 1 425,000 425,000 425,000
465,427

Mahkota Jaket Akrilik

 Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 200 16,000 80 16,000
23 Alginat 20 85,000 4,250 85,000
24 Gips 20 32,000 1,600 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 135,000 2,700 135,000
28 bur preparasi flame edenta 20 25,000 1,250 25,000
29 bur preparasi Fissure edenta 20 25,000 1,250 25,000
30 bur finishing flame edenta 20 25,000 1,250 25,000
32 shapcut finishing tapered 20 20,000 1,000 20,000
33 shapcut finishing fisure 20 20,000 1,000 20,000
34 malam biru 50 264,000 5,280 264,000
35 cetak double impression 50 600,000 12,000 600,000
36 Glasstone 20 73,500 3,675 73,500
37 Proses Lab 1 275,000 275,000 275,000
318,007

Mahkota Jaket PFM

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
 No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 200 16,000 80 16,000
23 Alginat 20 85,000 4,250 85,000
24 Gips 20 32,000 1,600 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 135,000 2,700 135,000
28 bur preparasi flame edenta 20 25,000 1,250 25,000
29 bur preparasi Fissure edenta 20 25,000 1,250 25,000
30 bur finishing flame edenta 20 25,000 1,250 25,000
32 shapcut finishing tapered 20 20,000 1,000 20,000
33 shapcut finishing fisure 20 20,000 1,000 20,000
34 malam biru 50 264,000 5,280 264,000
35 cetak double impression 50 600,000 12,000 600,000
36 Glasstone 20 35,000 1,750 35,000
37 Proses Lab 1 425,000 425,000 425,000
466,082

Pasak Custom logam

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
 1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 6 16,000 2,667 16,000
23 Alginat 25 85,000 3,400 85,000
24 Gips 25 32,000 1,280 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
26 Spatula 20 20,000 1,000 20,000
27 Malam Merah 50 135,000 2,700 135,000
28 bur preparasi flame edenta 10 25,000 2,500 25,000
29 bur preparasi Fissure edenta 10 25,000 2,500 25,000
30 bur finishing flame edenta 10 25,000 2,500 25,000
32 shapcut finishing tapered 10 20,000 2,000 20,000
33 shapcut finishing fisure 10 20,000 2,000 20,000
34 malam biru 50 264,000 5,280 264,000
35 cetak double impression 75 600,000 8,000 600,000
36 Glasstone 25 73,500 2,940 73,500
37 Proses Lab 1 60,000 60,000 60,000
109,419

Pasak Fiber

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
 2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 350,000 3,500 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
28 bur preparasi flame edenta 10 25,000 2,500 25,000
29 bur preparasi Fissure edenta 10 25,000 2,500 25,000
30 bur finishing flame edenta 10 25,000 2,500 25,000
32 shapcut finishing tapered 10 20,000 2,000 20,000
33 shapcut finishing fisure 10 20,000 2,000 20,000
34 Pasak Fiber 1 165,000 165,000 1,150,000
35 Rely X U100 50 1,430,000 28,600
214,352

Curetage

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
 13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Disclosing Agent 50 60,000 1,200 60,000
23 Povidon Iodine 100 75,000 750 75,000
27 Obat kumur 20 30,000 1,500 30,000
28 Alat curaetage 500 480,000 960 480,000
29 Ti es 20 120,000 6,000 120,000
16,162

Cetak RA dan RB

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 0 0 17,500
12 plastik alat gulungan 200 395,000 1,975 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 100 0 0 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 0 0 45,000
19 Chlorethyl 100 0 0 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 Sendok Cetak 6 16,000 2,667 16,000
23 Alginat 25 85,000 3,400 85,000
24 Gips 25 32,000 1,280 32,000
25 Rubber Bowl 20 28,000 1,400 28,000
 13,932

Tumpatan sementara/ Observasi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 tangue holder ( TA) 100 0 0 350,000
8 alat pres plastik 10000 4,000,000 400 4,000,000
9 sterilisator 5000 0 0 1,950,000
10 celemek 50 55,000 1,100 55,000
11 Kapas 150 17,500 117 17,500
12 plastik alat gulungan 1000 395,000 395 395,000
13 Handscoen XS 50 42,000 840 42,000
14 Pana spray NSK 1000 350,000 350 350,000
15 Masker karet 100 20,000 200 20,000
16 Suction tip 400 45,000 113 45,000
17 Gelas kumur pasien 50 7,500 150 7,500
18 Cotton roll 100 45,000 450 45,000
19 Chlorethyl 100 75,000 750 75,000
20 Alkohol 100 30,000 300 30,000
21 Sabun Cuci 200 14,000 70 14,000
22 cavit 70 75,000 1,071 75,000
23 CaOh 100 35,000 350 35,000
24 SIK 1000 240,000 240 240,000
6,934

Desensitisasi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4 20,000
2 kaca mulut 5000 25,000 5 25,000
3 pincet 5000 20,000 4 20,000
4 sonde 5000 20,000 4 20,000
5 bak instrumen kecil 5000 45,000 9 45,000
6 bak instrumen sedang 5000 60,000 12 60,000
7 Kapas 150 17,500 117 17,500
 8 plastik alat gulungan 1000 390,000 390 390,000
9 Handscoen XS 50 42,000 840 42,000
10 Pana spray NSK 1000 350,000 350 350,000
11 Masker karet 100 20,000 200 20,000
12 Bahan desensititasi 100 600,000 6,000 600,000
7,935

Tumpatan Kompomer

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,100
11 Kapas 150 17,500 117
12 plastik alat gulungan 1000 395,000 395
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 1000 350,000 350
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 45,000 450
19 Chlorethyl 100 75,000 750
20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
22 Kompomer 100 800,000 8,000
13,272
isi 100
Topikal aplikasi Fluor (Gel)

Jumlah
No Bahan Harga (Rp)
Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 3
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 3
4 sonde 5000 20,000 3
5 bak instrumen kecil 5000 45,000 8
6 bak instrumen sedan 5000 60,000 10
7 tangue holder ( TA) 100 350,000 100
8 alat pres plastik 5000 4,000,000 800
9 sterilisator 5000 1,950,000 360
10 celemek 1 55,000 1,000
11 Kapas 150 17,500 123
12 plastik alat gulungan 1000 395,000 395
13 Handscoen XS 50 42,000 800
14 Pana spray NSK 1000 350,000 350
15 Masker karet 100 20,000 275
16 Suction tip 400 45,000 70
17 Gelas kumur pasien 50 7,500 147
18 Cotton roll 100 45,000 400
19 Chlorethyl 100 75,000 950
20 Alkohol 100 30,000 225
21 Sabun Cuci 200 14,000 70
28 Pumice 1/2 l 50 35,000 320
29 Pasta 50 9,800 196
30 Brush 10 7,000 700
31 TAF gel 50 500,000 10000
17,313

Tumpatan Kls 1 Amalgam (Decidui)

Jumlah
No Bahan Harga (Rp)
Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 3
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 3
4 sonde 5000 20,000 3
5 bak instrumen kecil 5000 45,000 8
6 bak instrumen sedan 5000 60,000 10
 7 tangue holder ( TA) 100 350,000 100
8 alat pres plastik 5000 4,000,000 800
9 sterilisator 5000 1,950,000 360
10 celemek 1 55,000 1,000
11 Kapas 150 17,500 123
12 plastik alat gulungan 1000 395,000 395
13 Handscoen XS 50 42,000 800
14 Pana spray NSK 1000 350,000 350
15 Masker karet 100 20,000 275
16 Suction tip 400 45,000 70
17 Gelas kumur pasien 50 7,500 147
18 Cotton roll 100 45,000 400
19 Chlorethyl 100 75,000 950
20 Alkohol 100 30,000 225
21 Sabun Cuci 200 14,000 70
22 Burniser 5000 0 0
23 Amalgam Carver 5000 0 0
24 Plastis Instrument 5000 0 0
25 Semen Spatula 5000 0 0
26 Semen Stoper 5000 0 0
27 bur preparasi flame 20 25,000 1250
28 bur preparasi Fissur 20 25,000 1250
29 bur finishing flame e 20 25,000 1250
30 bur steel RA/ Hp ede 20 10,000 500
31 shapcut finishing tap 20 20,000 1000
32 shapcut finishing fisu 20 20,000 1000
33 amalgam 1 20,000 20,000
34 amalgamator 5000 4,800,000 960
35 semen seng fosfat 1 418,000 4,180
36 Articulating Papper 36 120,000 3,333
isi 200
isi 200
Light Curing Woodpecker LED-B
Light Curing Woodpecker LED-B
isi 100
GTC

Jumlah
No Bahan Harga (Rp)
Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 3 20000
2 kaca mulut 5000 25,000 5 25000
3 pincet 5000 20,000 3 20000
4 sonde 5000 20,000 3 20000
5 bak instrumen kecil 5000 45,000 8 45000
6 bak instrumen sedan 5000 60,000 10 60000
7 tangue holder ( TA) 100 350,000 100 350000
8 alat pres plastik 5000 4,000,000 800 4000000
9 sterilisator 5000 1,950,000 360 1950000
10 celemek 1 55,000 1,000 55000
11 Kapas 150 17,500 123 17500
12 plastik alat gulungan 200 395,000 1,500 395000
13 Handscoen XS 50 42,000 800 42000
14 Pana spray NSK 100 350,000 2,190 350000
15 Masker karet 100 20,000 275 20000
16 Suction tip 400 45,000 70 45000
17 Gelas kumur pasien 50 7,500 147 7500
18 Cotton roll 100 45,000 400 45000
19 Chlorethyl 100 75,000 950 75000
20 Alkohol 100 30,000 225 30000
21 Sabun Cuci 200 14,000 70 14000
22 Sendok Cetak 6 16,000 2,667 16000
23 Alginat 20 85,000 4,250 85000
24 Gips 20 32,000 1,600 32000
25 Rubber Bowl 20 28,000 1,400 28000
26 Spatula 20 20,000 1,000 20000
27 Malam Merah 1 135,000 135,000 135000
28 bur preparasi flame 10 25,000 2500 25000
 29 bur preparasi Fissur 10 25,000 2500 25000
30 bur finishing flame e 10 25,000 2500 25000
32 shapcut finishing tap 10 20,000 2000 20000
33 shapcut finishing fisu 10 20,000 2,000 20000
34 malam biru 50 264,000 5280 264000
35 cetak double impress 50 600,000 12000 600000
36 Glasstone 20 35,000 1,750 35000
37 Proses Lab (3unit) 1 1,275,000 1,275,000 1650000
1,460,489

Sementasi

Jumlah
No Bahan Harga (Rp)
Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 3 20000
2 kaca mulut 5000 25,000 5 25000
3 pincet 5000 20,000 3 20000
4 sonde 5000 20,000 3 20000
5 bak instrumen kecil 5000 45,000 8 45000
6 bak instrumen sedan 5000 60,000 10 60000
7 tangue holder ( TA) 100 350,000 100 350000
8 alat pres plastik 5000 4,000,000 800 4000000
9 sterilisator 5000 1,950,000 360 1950000
10 celemek 1 55,000 1,000 55000
11 Kapas 150 17,500 123 17500
12 plastik alat gulungan 200 395,000 1,500 395000
13 Handscoen XS 50 42,000 800 42000
14 Pana spray NSK 100 350,000 2,190 350000
15 Masker karet 100 20,000 275 20000
16 Suction tip 400 45,000 70 45000
17 Gelas kumur pasien 50 7,500 147 7500
18 Cotton roll 100 45,000 400 45000
19 Chlorethyl 100 75,000 950 75000
20 Alkohol 100 30,000 225 30000
21 Sabun Cuci 200 14,000 70 14000
22 Ellite Sement 50 363,500 7270 363500
23 Articulating papper 36 120,000 3,333 120000
24 glass plat 50 10,000 200 10000
25 Plastis instrument 5000 20,000 4 20000
26 semen spatula 5000 20,000 4 20000
19,854
Perhitungan Tarif prosthodonsia RSIGM Sultan Agung

Konsultasi
No Bahan Jumlah Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20000 4
2 kaca mulut 5000 25000 5
3 pincet 5000 20000 4
4 sonde 5000 20000 4
5 bak instrumen kecil 5000 45000 9
6 bak instrumen sedang 5000 60000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4000000 400
9 sterilisator 5000 0 0
10 celemek 50 55000 1100
11 Kapas 150 17500 117
12 plastik alat gulungan 200 0 0
13 Handscoen XS 50 42000 840
14 Pana spray NSK 1000 0 0
15 Masker karet 100 20000 200
16 Suction tip 400 45000 113
17 Gelas kumur pasien 50 7500 150
18 Cotton roll 100 45000 450
19 Chlorethyl 100 75000 750
20 Alkohol 100 30000 300
21 Sabun Cuci 200 14000 70
22 Gaun Supervisor 20 10000 500
5028
Harga rekomendasi terapi 100,000
Jasa Medis 70% 70,000
RSIGM 30% 30,000

Cetak Hidrokoloid irreversible Cetak double impression

Jumlah
No Bahan Harga (Rp) Unit cost (Rp) No
Sediaan Pasien
1 excavator 5000 20,000 4 1
2 kaca mulut 5000 25,000 5 2
3 pincet 5000 20,000 4 3
4 sonde 5000 20,000 4 4
5 bak instrumen kecil 5000 45,000 9 5
6 bak instrumen sedang 5000 60,000 12 6
7 tangue holder ( TA) 100 0 0 7
8 alat pres plastik 10000 4,000,000 400 8
9 sterilisator 5000 0 0 9
10 celemek 50 55,000 1,100 10
11 Kapas 150 0 0 11
12 plastik alat gulungan 200 395,000 1,975 12
 13 Handscoen XS 50 42,000 840 13
14 Pana spray NSK 100 0 0 14
15 Masker karet 100 20,000 200 15
16 Suction tip 400 45,000 113 16
17 Gelas kumur pasien 50 7,500 150 17
18 Cotton roll 100 0 0 18
19 Chlorethyl 100 0 0 19
20 Alkohol 100 30,000 300 20
21 Sabun Cuci 200 14,000 70 21
22 Sendok Cetak 6 16,000 2,667 22
23 Alginat 25 85,000 3,400 23
24 Gips 25 32,000 1,280 24
25 Rubber Bowl 20 28,000 1,400 25
13,932
Harga rekomendasi terapi 150,000 Harga rekomendasi terapi
Jasa Medis 70% 105,000 Jasa Medis 70%
RSIGM 30% 45,000 RSIGM 30%

Mahkota Jaket PFM Mahkota Jaket profisoris p

Jumlah
No Bahan Harga (Rp) Unit cost (Rp) No
Sediaan Pasien
1 excavator 5000 20,000 4 1
2 kaca mulut 5000 25,000 5 2
3 pincet 5000 20,000 4 3
4 sonde 5000 20,000 4 4
5 bak instrumen kecil 5000 45,000 9 5
6 bak instrumen sedang 5000 60,000 12 6
7 tangue holder ( TA) 100 0 0 7
8 alat pres plastik 10000 4,000,000 400 8
9 sterilisator 5000 0 0 9
10 celemek 50 55,000 1,100 10
11 Kapas 150 17,500 117 11
12 plastik alat gulungan 1000 395,000 395 12
13 Handscoen XS 50 42,000 840 13
14 Pana spray NSK 1000 350,000 350 14
15 Masker karet 100 20,000 200 15
16 Suction tip 400 45,000 113 16
17 Gelas kumur pasien 50 7,500 150 17
18 Cotton roll 100 45,000 450 18
19 Chlorethyl 100 75,000 750 19
20 Alkohol 100 30,000 300 20
21 Sabun Cuci 200 14,000 70 21
22 Sendok Cetak 200 16,000 80 22
23 Alginat 20 85,000 4,250 23
24 Gips 20 32,000 1,600 24
 25 Rubber Bowl 20 28,000 1,400 25
26 Spatula 20 20,000 1,000 26
27 Malam Merah 50 135,000 2,700 27
28 bur preparasi flame edenta 20 25,000 1,250 28
29 bur preparasi Fissure edenta 20 25,000 1,250 29
30 bur finishing flame edenta 20 25,000 1,250 30
32 shapcut finishing tapered 20 20,000 1,000 32
33 shapcut finishing fisure 20 20,000 1,000 33
34 malam biru 50 264,000 5,280 34
35 cetak double impression 50 600,000 12,000 35
36 Glasstone 20 35,000 1,750 36
37 Proses Lab 1 425,000 425,000 37
466,082
Harga rekomendasi terapi 1,950,000 Harga rekomendasi terapi
Jasa Medis 70% 1,365,000 Jasa Medis 70%
RSIGM 30% 585,000 RSIGM 30%

Mahkota Jaket Porcelain emax Mahkota Jaket Porcelain zi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp) No
Sediaan Pasien
1 excavator 5000 20,000 4 1
2 kaca mulut 5000 25,000 5 2
3 pincet 5000 20,000 4 3
4 sonde 5000 20,000 4 4
5 bak instrumen kecil 5000 45,000 9 5
6 bak instrumen sedang 5000 60,000 12 6
7 tangue holder ( TA) 100 0 0 7
8 alat pres plastik 10000 4,000,000 400 8
9 sterilisator 5000 0 0 9
10 celemek 50 55,000 1,100 10
11 Kapas 150 17,500 117 11
12 plastik alat gulungan 1000 395,000 395 12
13 Handscoen XS 50 42,000 840 13
14 Pana spray NSK 1000 350,000 350 14
15 Masker karet 100 20,000 200 15
16 Suction tip 400 45,000 113 16
17 Gelas kumur pasien 50 7,500 150 17
18 Cotton roll 100 45,000 450 18
19 Chlorethyl 100 75,000 750 19
20 Alkohol 100 30,000 300 20
21 Sabun Cuci 200 14,000 70 21
22 Sendok Cetak 200 16,000 80 22
23 Alginat 20 85,000 4,250 23
24 Gips 20 32,000 1,600 24
25 Rubber Bowl 20 28,000 1,400 25
26 Spatula 20 20,000 1,000 26
 27 Malam Merah 50 135,000 2,700 27
28 bur preparasi flame edenta 20 25,000 1,250 28
29 bur preparasi Fissure edenta 20 25,000 1,250 29
30 bur finishing flame edenta 20 25,000 1,250 30
32 shapcut finishing tapered 20 20,000 1,000 32
33 shapcut finishing fisure 20 20,000 1,000 33
34 malam biru 50 135,000 2,700 34
35 cetak double impression 50 600,000 12,000 35
36 Glasstone 20 73,500 3,675 36
37 Proses Lab 1 425,000 425,000 37
465,427
Harga rekomendasi terapi 3,150,000 Harga rekomendasi terapi
Jasa Medis 70% 2,205,000 Jasa Medis 70%
RSIGM 30% 945,000 RSIGM 30%

veneer composite indirect veneer emax

Jumlah
No Bahan Harga (Rp) Unit cost (Rp) No
Sediaan Pasien
1 excavator 5000 20,000 4 1
2 kaca mulut 5000 25,000 5 2
3 pincet 5000 20,000 4 3
4 sonde 5000 20,000 4 4
5 bak instrumen kecil 5000 45,000 9 5
6 bak instrumen sedang 5000 60,000 12 6
7 tangue holder ( TA) 100 0 0 7
8 alat pres plastik 10000 4,000,000 400 8
9 sterilisator 5000 0 0 9
10 celemek 50 55,000 1,100 10
11 Kapas 150 17,500 117 11
12 plastik alat gulungan 1000 395,000 395 12
13 Handscoen XS 50 42,000 840 13
14 Pana spray NSK 1000 350,000 350 14
15 Masker karet 100 20,000 200 15
16 Suction tip 400 45,000 113 16
17 Gelas kumur pasien 50 7,500 150 17
18 Cotton roll 100 45,000 450 18
19 Chlorethyl 100 75,000 750 19
20 Alkohol 100 30,000 300 20
21 Sabun Cuci 200 14,000 70 21
22 Burniser 1000 20,000 20 22
23 Amalgam Carver 1000 0 0 23
24 Plastis Instrument 1000 20,000 20 24
25 bur preparasi flame edenta 20 25,000 1,250 25
26 bur preparasi Fissure edenta 20 25,000 1,250 26
27 bur finishing flame edenta 20 25,000 1,250 27
 28 bur steel RA/ Hp edenta 20 10,000 500 28
29 shapcut finishing tapered 20 20,000 1,000 29
30 shapcut finishing fisure 20 20,000 1,000 30
31 Cavity Cleanser 200 315,000 1,575 31
32 Etsa 50 95,000 1,900 32
33 Bonding 50 790,000 15,800 33
34 Resin Komposit dentin 40 352,000 8,800 34
35 Resin Komposit email 40 352,000 8,800 35
36 Resin Komposit Flowable 50 475,000 9,500 36
37 Enhance 20 35,000 1,750 37
38 microbrush 50 50,000 1,000 38
39 Articulating papper 36 120,000 3,333 39
40 Light Cure 1000 10,000,000 10,000 40
41 seluloit strip 100 120,000 1,200 41
42 finishing strip 150 449,000 2,993 42
43 mookup 50 1,500,000 30,000 43
108,214
Harga rekomendasi terapi 1,000,000 Harga rekomendasi terapi
Jasa Medis 70% 700,000 Jasa Medis 70%
RSIGM 30% 300,000 RSIGM 30%

GTC PFM Maryland bridge

Jumlah
No Bahan Harga (Rp) Unit cost (Rp) No
Sediaan Pasien
1 excavator 5000 20,000 4 1
2 kaca mulut 5000 25,000 5 2
3 pincet 5000 20,000 4 3
4 sonde 5000 20,000 4 4
5 bak instrumen kecil 5000 45,000 9 5
6 bak instrumen sedang 5000 60,000 12 6
7 tangue holder ( TA) 100 0 0 7
8 alat pres plastik 10000 4,000,000 400 8
9 sterilisator 5000 0 0 9
10 celemek 50 55,000 1,100 10
11 Kapas 150 17,500 117 11
12 plastik alat gulungan 200 395,000 1,975 12
13 Handscoen XS 50 42,000 840 13
14 Pana spray NSK 100 350,000 3,500 14
15 Masker karet 100 20,000 200 15
16 Suction tip 400 45,000 113 16
17 Gelas kumur pasien 50 7,500 150 17
18 Cotton roll 100 45,000 450 18
19 Chlorethyl 100 0 0 19
20 Alkohol 100 30,000 300 20
21 Sabun Cuci 200 14,000 70 21
22 Sendok Cetak 6 16,000 2,667 22
 23 Alginat 20 85,000 4,250 23
24 Gips 20 32,000 1,600 24
25 Rubber Bowl 20 35,000 1,750 25
26 Spatula 20 20,000 1,000 26
27 Malam Merah 50 264,000 5,280 27
28 bur preparasi flame edenta 10 25,000 2,500 28
29 bur preparasi Fissure edenta 10 25,000 2,500 29
30 bur finishing flame edenta 10 25,000 2,500 30
32 shapcut finishing tapered 10 20,000 2,000 32
33 shapcut finishing fisure 10 20,000 2,000 33
34 malam biru 50 264,000 5,280 34
35 cetak double impression 50 600,000 12,000 35
36 Glasstone 20 73,500 3,675 36
37 Proses Lab 1 425,000 425,000 37
483,254
Harga rekomendasi terapi 1,750,000 Harga rekomendasi terapi
Jasa Medis 70% 1,225,000 Jasa Medis 70%
RSIGM 30% 525,000 RSIGM 30%

Sementasi

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,100
11 Kapas 150 17,500 117
12 plastik alat gulungan 200 395,000 1,975
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 100 0 0
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 45,000 450
19 Chlorethyl 100 0 0
20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
22 Ellite Sement 50 363,500 7,270
23 Articulating papper 36 120,000 3,333
24 glass plat 50 10,000 200
 25 Plastis instrument 5000 150,000 30
26 semen spatula 5000 20,000 4
16,590
Harga rekomendasi terapi 200,000
Jasa Medis 70% 140,000
RSIGM 30% 60,000

Pasak Fiber

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,100
11 Kapas 150 17,500 117
12 plastik alat gulungan 200 395,000 1,975
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 100 350,000 3,500
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 45,000 450
19 Chlorethyl 100 0 0
20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
28 bur preparasi flame edenta 10 25,000 2,500
29 bur preparasi Fissure edenta 10 25,000 2,500
30 bur finishing flame edenta 10 25,000 2,500
32 shapcut finishing tapered 10 20,000 2,000
33 shapcut finishing fisure 10 20,000 2,000
34 Pasak Fiber 1 165,000 165,000
35 Rely X U100 50 1,430,000 28,600
214,352
Harga rekomendasi terapi 600,000
Jasa Medis 70% 420,000
RSIGM 30% 180,000

Pasak logam prefebricated Pasak logam febricated

 Jumlah
No Bahan Harga (Rp) Unit cost (Rp) No
Sediaan Pasien
1 excavator 5000 20,000 4 1
2 kaca mulut 5000 25,000 5 2
3 pincet 5000 20,000 4 3
4 sonde 5000 20,000 4 4
5 bak instrumen kecil 5000 45,000 9 5
6 bak instrumen sedang 5000 60,000 12 6
7 tangue holder ( TA) 100 0 0 7
8 alat pres plastik 10000 4,000,000 400 8
9 sterilisator 5000 0 0 9
10 celemek 50 55,000 1,100 10
11 Kapas 150 17,500 117 11
12 plastik alat gulungan 200 395,000 1,975 12
13 Handscoen XS 50 42,000 840 13
14 Pana spray NSK 100 350,000 3,500 14
15 Masker karet 100 20,000 200 15
16 Suction tip 400 45,000 113 16
17 Gelas kumur pasien 50 7,500 150 17
18 Cotton roll 100 45,000 450 18
19 Chlorethyl 100 0 0 19
20 Alkohol 100 30,000 300 20
21 Sabun Cuci 200 14,000 70 21
22 Sendok Cetak 6 16,000 2,667 22
23 Alginat 25 85,000 3,400 23
24 Gips 25 32,000 1,280 24
25 Rubber Bowl 20 28,000 1,400 25
26 Spatula 20 20,000 1,000 26
27 Malam Merah 50 135,000 2,700 27
28 bur preparasi flame edenta 10 25,000 2,500 28
29 bur preparasi Fissure edenta 10 25,000 2,500 29
30 bur finishing flame edenta 10 25,000 2,500 30
32 shapcut finishing tapered 10 20,000 2,000 32
33 shapcut finishing fisure 10 20,000 2,000 33
34 malam biru 50 264,000 5,280 34
35 cetak double impression 75 600,000 8,000 35
36 Glasstone 25 73,500 2,940 36
37 Proses Lab 1 60,000 60,000 37
109,419
Harga rekomendasi terapi 400,000 Harga rekomendasi terapi
Jasa Medis 70% 280,000 Jasa Medis 70%
RSIGM 30% 120,000 RSIGM 30%

GTS akrilik (basis + 1 gigi pertama)

Set up per elemen berikutn
Jumlah No
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
 1 excavator 5000 20,000 4 1
2 kaca mulut 5000 25,000 5 2
3 pincet 5000 20,000 4 3
4 sonde 5000 20,000 4 4
5 bak instrumen kecil 5000 45,000 9 5
6 bak instrumen sedang 5000 60,000 12 6
7 tangue holder ( TA) 100 0 0 7
8 alat pres plastik 10000 4,000,000 400 8
9 sterilisator 5000 0 0 9
10 celemek 50 55,000 1,100 10
11 Kapas 150 17,500 117 11
12 plastik alat gulungan 1000 395,000 395 12
13 Handscoen XS 50 42,000 840 13
14 Pana spray NSK 1000 0 0 14
15 Masker karet 100 20,000 200 15
16 Suction tip 400 45,000 113 16
17 Gelas kumur pasien 50 7,500 150 17
18 Cotton roll 100 45,000 450 18
19 Chlorethyl 100 0 0 19
20 Alkohol 100 30,000 300 20
21 Sabun Cuci 200 14,000 70 21
22 Sendok Cetak 200 16,000 80 22
23 Alginat 20 85,000 4,250 23
24 Gips 20 32,000 1,600
25 Rubber Bowl 20 28,000 1,400 Harga rekomendasi terapi
26 Spatula 20 20,000 1,000 Jasa Medis 70%
27 Malam Merah 50 135,000 2,700 RSIGM 30%
28 Wire klamer 100 10,000 100
29 Pigeon Teeth 1 17,000 17,000
30 Proses Lab 1 350,000 350,000
382,302
Harga rekomendasi terapi 675,000
Jasa Medis 70% 472,500
RSIGM 30% 202,500

GTS valplast (basis + 1 gigi pertama)

Jumlah Set up per elemen berikutn
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien No
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5 1
3 pincet 5000 20,000 4 2
4 sonde 5000 20,000 4 3
5 bak instrumen kecil 5000 45,000 9 4
6 bak instrumen sedang 5000 60,000 12 5
7 tangue holder ( TA) 100 0 0 6
8 alat pres plastik 10000 4,000,000 400 7
9 sterilisator 5000 0 0 8
10 celemek 50 55,000 1,100 9
 11 Kapas 150 17,500 117 10
12 plastik alat gulungan 1000 395,000 395 11
13 Handscoen XS 50 42,000 840 12
14 Pana spray NSK 1000 0 0 13
15 Masker karet 100 20,000 200 14
16 Suction tip 400 45,000 113 15
17 Gelas kumur pasien 50 7,500 150 16
18 Cotton roll 100 45,000 450 17
19 Chlorethyl 100 0 0 18
20 Alkohol 100 30,000 300 19
21 Sabun Cuci 200 14,000 70 20
22 Sendok Cetak 200 16,000 80 21
23 Alginat 20 85,000 4,250 22
24 Gips 20 32,000 1,600 23
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000 Harga rekomendasi terapi
27 Malam Merah 50 135,000 2,700 Jasa Medis 70%
28 Wire klamer 100 10,000 100 RSIGM 30%
29 Pigeon Teeth 1 17,000 17,000
30 Proses Lab 1 350,000 350,000
382,302
Harga rekomendasi terapi 1,500,000
Jasa Medis 70% 1,050,000
RSIGM 30% 450,000

GTS Frame akrilik (basis+ 1 gigi pertama)

Jumlah Set up per elemen berikutn
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien No
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5 1
3 pincet 5000 20,000 4 2
4 sonde 5000 20,000 4 3
5 bak instrumen kecil 5000 45,000 9 4
6 bak instrumen sedang 5000 60,000 12 5
7 tangue holder ( TA) 100 0 0 6
8 alat pres plastik 10000 4,000,000 400 7
9 sterilisator 5000 0 0 8
10 celemek 50 55,000 1,100 9
11 Kapas 150 17,500 117 10
12 plastik alat gulungan 1000 395,000 395 11
13 Handscoen XS 50 42,000 840 12
14 Pana spray NSK 1000 0 0 13
15 Masker karet 100 20,000 200 14
16 Suction tip 400 45,000 113 15
17 Gelas kumur pasien 50 7,500 150 16
18 Cotton roll 100 45,000 450 17
 19 Chlorethyl 100 0 0 18
20 Alkohol 100 30,000 300 19
21 Sabun Cuci 200 14,000 70 20
22 Sendok Cetak 200 16,000 80 21
23 Alginat 20 85,000 4,250 22
24 Gips 20 32,000 1,600 23
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000 Harga rekomendasi terapi
27 Malam Merah 50 135,000 2,700 Jasa Medis 70%
28 Wire klamer 100 10,000 100 RSIGM 30%
29 Pigeon Teeth 1 17,000 17,000
30 Proses Lab 1 350,000 350,000
382,302
Harga rekomendasi terapi 2,300,000
Jasa Medis 70% 1,610,000
RSIGM 30% 690,000

GTS Frame-valplast

Jumlah Set up per elemen berikutn

No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien No
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5 1
3 pincet 5000 20,000 4 2
4 sonde 5000 20,000 4 3
5 bak instrumen kecil 5000 45,000 9 4
6 bak instrumen sedang 5000 60,000 12 5
7 tangue holder ( TA) 100 0 0 6
8 alat pres plastik 10000 4,000,000 400 7
9 sterilisator 5000 0 0 8
10 celemek 50 55,000 1,100 9
11 Kapas 150 17,500 117 10
12 plastik alat gulungan 1000 395,000 395 11
13 Handscoen XS 50 42,000 840 12
14 Pana spray NSK 1000 0 0 13
15 Masker karet 100 20,000 200 14
16 Suction tip 400 45,000 113 15
17 Gelas kumur pasien 50 7,500 150 16
18 Cotton roll 100 45,000 450 17
19 Chlorethyl 100 0 0 18
20 Alkohol 100 30,000 300 19
21 Sabun Cuci 200 14,000 70 20
22 Sendok Cetak 200 16,000 80 21
23 Alginat 20 85,000 4,250 22
24 Gips 20 32,000 1,600 23
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000 Harga rekomendasi terapi
 27 Malam Merah 50 135,000 2,700 Jasa Medis 70%
28 Wire klamer 100 10,000 100 RSIGM 30%
29 Pigeon Teeth 1 17,000 17,000
30 Proses Lab 1 350,000 350,000
382,302
Harga rekomendasi terapi 2,850,000
Jasa Medis 70% 1,995,000
RSIGM 30% 855,000

GTS thermoplast

Jumlah Set up per elemen berikutn

No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien No
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5 1
3 pincet 5000 20,000 4 2
4 sonde 5000 20,000 4 3
5 bak instrumen kecil 5000 45,000 9 4
6 bak instrumen sedang 5000 60,000 12 5
7 tangue holder ( TA) 100 0 0 6
8 alat pres plastik 10000 4,000,000 400 7
9 sterilisator 5000 0 0 8
10 celemek 50 55,000 1,100 9
11 Kapas 150 17,500 117 10
12 plastik alat gulungan 1000 395,000 395 11
13 Handscoen XS 50 42,000 840 12
14 Pana spray NSK 1000 0 0 13
15 Masker karet 100 20,000 200 14
16 Suction tip 400 45,000 113 15
17 Gelas kumur pasien 50 7,500 150 16
18 Cotton roll 100 45,000 450 17
19 Chlorethyl 100 0 0 18
20 Alkohol 100 30,000 300 19
21 Sabun Cuci 200 14,000 70 20
22 Sendok Cetak 200 16,000 80 21
23 Alginat 20 85,000 4,250 22
24 Gips 20 32,000 1,600 23
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000 Harga rekomendasi terapi
27 Malam Merah 50 135,000 2,700 Jasa Medis 70%
28 Wire klamer 100 10,000 100 RSIGM 30%
29 Pigeon Teeth 1 17,000 17,000
30 Proses Lab 1 350,000 350,000
382,302
Harga rekomendasi terapi 2,325,000
Jasa Medis 70% 1,627,500
RSIGM 30% 697,500
GTS precision attachment

Jumlah Set up per elemen berikutn

No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien No
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5 1
3 pincet 5000 20,000 4 2
4 sonde 5000 20,000 4 3
5 bak instrumen kecil 5000 45,000 9 4
6 bak instrumen sedang 5000 60,000 12 5
7 tangue holder ( TA) 100 0 0 6
8 alat pres plastik 10000 4,000,000 400 7
9 sterilisator 5000 0 0 8
10 celemek 50 55,000 1,100 9
11 Kapas 150 17,500 117 10
12 plastik alat gulungan 1000 395,000 395 11
13 Handscoen XS 50 42,000 840 12
14 Pana spray NSK 1000 0 0 13
15 Masker karet 100 20,000 200 14
16 Suction tip 400 45,000 113 15
17 Gelas kumur pasien 50 7,500 150 16
18 Cotton roll 100 45,000 450 17
19 Chlorethyl 100 0 0 18
20 Alkohol 100 30,000 300 19
21 Sabun Cuci 200 14,000 70 20
22 Sendok Cetak 200 16,000 80 21
23 Alginat 20 85,000 4,250 22
24 Gips 20 32,000 1,600 23
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000 Harga rekomendasi terapi
27 Malam Merah 50 135,000 2,700 Jasa Medis 70%
28 Wire klamer 100 10,000 100 RSIGM 30%
29 Pigeon Teeth 1 17,000 17,000
30 Proses Lab 1 350,000 350,000
382,302
Harga rekomendasi terapi 6,500,000
Jasa Medis 70% 4,550,000
RSIGM 30% 1,950,000

GTL akrilik perahang GTL flexible per rahang

Jumlah
No Bahan Harga (Rp) Unit cost (Rp) No
Sediaan Pasien
1 excavator 5000 20,000 4 1
2 kaca mulut 5000 25,000 5 2
 3 pincet 5000 20,000 4 3
4 sonde 5000 20,000 4 4
5 bak instrumen kecil 5000 45,000 9 5
6 bak instrumen sedang 5000 60,000 12 6
7 tangue holder ( TA) 100 0 0 7
8 alat pres plastik 10000 4,000,000 400 8
9 sterilisator 5000 0 0 9
10 celemek 50 55,000 1,100 10
11 Kapas 150 17,500 117 11
12 plastik alat gulungan 200 395,000 1,975 12
13 Handscoen XS 50 42,000 840 13
14 Pana spray NSK 100 0 0 14
15 Masker karet 100 20,000 200 15
16 Suction tip 400 45,000 113 16
17 Gelas kumur pasien 50 7,500 150 17
18 Cotton roll 100 0 0 18
19 Chlorethyl 100 0 0 19
20 Alkohol 100 30,000 300 20
21 Sabun Cuci 200 14,000 70 21
22 Sendok Cetak 6 16,000 2,667 22
23 Alginat 20 85,000 4,250 23
24 Gips 20 32,000 1,600 24
25 Rubber Bowl 20 28,000 1,400 25
26 Spatula 20 20,000 1,000 26
27 Malam Merah 50 135,000 2,700 27
28 Wire klamer 100 10,000 100 28
29 Pigeon Teeth 1 17,000 17,000 29
30 Proses Lab 1 700,000 700,000 30
736,019
Harga rekomendasi terapi 3,500,000 Harga rekomendasi terapi
Jasa Medis 70% 2,450,000 Jasa Medis 70%
RSIGM 30% 1,050,000 RSIGM 30%

GTL frame-akrilik per rahang

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,100
11 Kapas 150 17,500 117
 12 plastik alat gulungan 200 395,000 1,975
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 100 0 0
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 0 0
19 Chlorethyl 100 0 0
20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
22 Sendok Cetak 6 16,000 2,667
23 Alginat 20 85,000 4,250
24 Gips 20 32,000 1,600
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000
27 Malam Merah 50 135,000 2,700
28 Wire klamer 100 10,000 100
29 Pigeon Teeth 1 17,000 17,000
30 Proses Lab 1 700,000 700,000
736,019
Harga rekomendasi terapi 4,500,000
Jasa Medis 70% 3,150,000
RSIGM 30% 1,350,000

Reparasi valplast

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,000
11 Kapas 150 17,500 117
12 plastik alat gulungan 1000 395,000 395
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 1000 350,000 350
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 0 0
19 Chlorethyl 100 0 0
 20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
22 Sendok Cetak 6 16,000 2,667
23 Alginat 20 85,000 4,250
24 Gips 20 32,000 1,600
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000
27 Malam Merah 50 135,000 2,700
28 Wire klamer 100 10,000 100
30 Arkansas stone 10 20,000 2,000
31 Proses Lab 1 100,000 100,000
119,689
Harga rekomendasi terapi 1,000,000
Jasa Medis 70% 700,000
RSIGM 30% 300,000

Reparasi Akrilik (lab)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,000
11 Kapas 150 17,500 117
12 plastik alat gulungan 1000 395,000 395
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 1000 350,000 350
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 0 0
19 Chlorethyl 100 0 0
20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
22 Sendok Cetak 6 16,000 2,667
23 Alginat 20 85,000 4,250
24 Gips 20 32,000 1,600
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000
27 Malam Merah 50 135,000 2,700
 28 Wire klamer 100 10,000 100
30 Arkansas stone 10 20,000 2,000
31 Proses Lab 1 100,000 100,000
119,689
Harga rekomendasi terapi 500,000
Jasa Medis 70% 350,000
RSIGM 30% 150,000

Reparasi Akrilik (one visit)

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,000
11 Kapas 150 17,500 117
12 plastik alat gulungan 1000 395,000 395
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 1000 350,000 350
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 0 0
19 Chlorethyl 100 0 0
20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
22 Sendok Cetak 6 16,000 2,667
23 Alginat 20 85,000 4,250
24 Gips 20 32,000 1,600
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000
27 Malam Merah 50 135,000 2,700
28 Wire klamer 100 10,000 100
30 Arkansas stone 10 20,000 2,000
31 Proses Lab 1 100,000 0
19,689
Harga rekomendasi terapi 650,000
Jasa Medis 70% 455,000
RSIGM 30% 195,000
Relining

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,100
11 Kapas 150 17,500 117
12 plastik alat gulungan 200 395,000 1,975
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 100 350,000 3,500
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 0 0
19 Chlorethyl 100 0 0
20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
22 Soft liner 50 1,067,000 21,340
30,142
Harga rekomendasi terapi 550,000
Jasa Medis 70% 385,000
RSIGM 30% 165,000

Rebasing

Jumlah
No Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
1 excavator 5000 20,000 4
2 kaca mulut 5000 25,000 5
3 pincet 5000 20,000 4
4 sonde 5000 20,000 4
5 bak instrumen kecil 5000 45,000 9
6 bak instrumen sedang 5000 60,000 12
7 tangue holder ( TA) 100 0 0
8 alat pres plastik 10000 4,000,000 400
9 sterilisator 5000 0 0
10 celemek 50 55,000 1,100
11 Kapas 150 17,500 117
 12 plastik alat gulungan 1000 395,000 395
13 Handscoen XS 50 42,000 840
14 Pana spray NSK 1000 350,000 350
15 Masker karet 100 20,000 200
16 Suction tip 400 45,000 113
17 Gelas kumur pasien 50 7,500 150
18 Cotton roll 100 0 0
19 Chlorethyl 100 0 0
20 Alkohol 100 30,000 300
21 Sabun Cuci 200 14,000 70
22 Sendok Cetak 6 16,000 2,667
23 Alginat 20 85,000 4,250
24 Gips 20 32,000 1,600
25 Rubber Bowl 20 28,000 1,400
26 Spatula 20 20,000 1,000
27 Malam Merah 50 135,000 2,700
28 Wire klamer 100 10,000 100
29 SC Akrilic 20 200,000 10,000
30 Arkansas stone 10 20,000 2,000
31 Proses Lab 1 75,000 75,000
104,789
Harga rekomendasi terapi 1,000,000
Jasa Medis 70% 700,000
RSIGM 30% 300,000
Cetak double impression

Jumlah
Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20,000 4
kaca mulut 5000 25,000 5
pincet 5000 20,000 4
sonde 5000 20,000 4
bak instrumen kecil 5000 45,000 9
bak instrumen sedang 5000 60,000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4,000,000 400
sterilisator 5000 0 0
celemek 50 55,000 1,100
Kapas 150 0 0
plastik alat gulungan 200 395,000 1,975
 Handscoen XS 50 42,000 840
Pana spray NSK 100 0 0
Masker karet 100 20,000 200
Suction tip 400 45,000 113
Gelas kumur pasien 50 7,500 150
Cotton roll 100 0 0
Chlorethyl 100 0 0
Alkohol 100 30,000 300
Sabun Cuci 200 14,000 70
Sendok Cetak 6 16,000 2,667
set double impression 50 600,000 12,000
Gips 25 32,000 1,280
Rubber Bowl 20 28,000 1,400
22,532
Harga rekomendasi terapi 200,000
Jasa Medis 70% 140,000
RSIGM 30% 60,000

Mahkota Jaket profisoris per element

Jumlah
Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20,000 4
kaca mulut 5000 25,000 5
pincet 5000 20,000 4
sonde 5000 20,000 4
bak instrumen kecil 5000 45,000 9
bak instrumen sedang 5000 60,000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4,000,000 400
sterilisator 5000 0 0
celemek 50 55,000 1,100
Kapas 150 17,500 117
plastik alat gulungan 1000 395,000 395
Handscoen XS 50 42,000 840
Pana spray NSK 1000 350,000 350
Masker karet 100 20,000 200
Suction tip 400 45,000 113
Gelas kumur pasien 50 7,500 150
Cotton roll 100 45,000 450
Chlorethyl 100 75,000 750
Alkohol 100 30,000 300
Sabun Cuci 200 14,000 70
Sendok Cetak 200 16,000 80
Alginat 20 85,000 4,250
Gips 20 32,000 1,600
 Rubber Bowl 20 28,000 1,400
Spatula 20 20,000 1,000
Malam Merah 50 135,000 2,700
bur preparasi flame edenta 20 25,000 1,250
bur preparasi Fissure edenta 20 25,000 1,250
bur finishing flame edenta 20 25,000 1,250
shapcut finishing tapered 20 20,000 1,000
shapcut finishing fisure 20 20,000 1,000
malam biru 50 264,000 5,280
cetak double impression 50 600,000 12,000
Glasstone 20 73,500 3,675
Proses Lab 1 275,000 275,000
318,007
Harga rekomendasi terapi 250,000
Jasa Medis 70% 175,000
RSIGM 30% 75,000

Mahkota Jaket Porcelain zirconia

Jumlah
Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20,000 4
kaca mulut 5000 25,000 5
pincet 5000 20,000 4
sonde 5000 20,000 4
bak instrumen kecil 5000 45,000 9
bak instrumen sedang 5000 60,000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4,000,000 400
sterilisator 5000 0 0
celemek 50 55,000 1,100
Kapas 150 17,500 117
plastik alat gulungan 1000 395,000 395
Handscoen XS 50 42,000 840
Pana spray NSK 1000 350,000 350
Masker karet 100 20,000 200
Suction tip 400 45,000 113
Gelas kumur pasien 50 7,500 150
Cotton roll 100 45,000 450
Chlorethyl 100 75,000 750
Alkohol 100 30,000 300
Sabun Cuci 200 14,000 70
Sendok Cetak 200 16,000 80
Alginat 20 85,000 4,250
Gips 20 32,000 1,600
Rubber Bowl 20 28,000 1,400
Spatula 20 20,000 1,000
 Malam Merah 50 135,000 2,700
bur preparasi flame edenta 20 25,000 1,250
bur preparasi Fissure edenta 20 25,000 1,250
bur finishing flame edenta 20 25,000 1,250
shapcut finishing tapered 20 20,000 1,000
shapcut finishing fisure 20 20,000 1,000
malam biru 50 135,000 2,700
cetak double impression 50 600,000 12,000
Glasstone 20 73,500 3,675
Proses Lab 1 425,000 425,000
465,427
Harga rekomendasi terapi 4,000,000
Jasa Medis 70% 2,800,000
RSIGM 30% 1,200,000

veneer emax

Jumlah
Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20,000 4
kaca mulut 5000 25,000 5
pincet 5000 20,000 4
sonde 5000 20,000 4
bak instrumen kecil 5000 45,000 9
bak instrumen sedang 5000 60,000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4,000,000 400
sterilisator 5000 0 0
celemek 50 55,000 1,100
Kapas 150 17,500 117
plastik alat gulungan 1000 395,000 395
Handscoen XS 50 42,000 840
Pana spray NSK 1000 350,000 350
Masker karet 100 20,000 200
Suction tip 400 45,000 113
Gelas kumur pasien 50 7,500 150
Cotton roll 100 45,000 450
Chlorethyl 100 75,000 750
Alkohol 100 30,000 300
Sabun Cuci 200 14,000 70
Burniser 1000 20,000 20
Amalgam Carver 1000 0 0
Plastis Instrument 1000 20,000 20
bur preparasi flame edenta 20 25,000 1,250
bur preparasi Fissure edenta 20 25,000 1,250
bur finishing flame edenta 20 25,000 1,250
 bur steel RA/ Hp edenta 20 10,000 500
shapcut finishing tapered 20 20,000 1,000
shapcut finishing fisure 20 20,000 1,000
Cavity Cleanser 200 315,000 1,575
Etsa 50 95,000 1,900
Bonding 50 790,000 15,800
Resin Komposit dentin 40 352,000 8,800
Resin Komposit email 40 352,000 8,800
Resin Komposit Flowable 50 475,000 9,500
Enhance 20 35,000 1,750
microbrush 50 50,000 1,000
Articulating papper 36 120,000 3,333
Light Cure 1000 10,000,000 10,000
seluloit strip 100 120,000 1,200
finishing strip 150 449,000 2,993
mookup 50 1,500,000 30,000
108,214
Harga rekomendasi terapi 3,300,000
Jasa Medis 70% 2,310,000
RSIGM 30% 990,000

Maryland bridge

Jumlah
Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20,000 4
kaca mulut 5000 25,000 5
pincet 5000 20,000 4
sonde 5000 20,000 4
bak instrumen kecil 5000 45,000 9
bak instrumen sedang 5000 60,000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4,000,000 400
sterilisator 5000 0 0
celemek 50 55,000 1,100
Kapas 150 17,500 117
plastik alat gulungan 200 395,000 1,975
Handscoen XS 50 42,000 840
Pana spray NSK 100 350,000 3,500
Masker karet 100 20,000 200
Suction tip 400 45,000 113
Gelas kumur pasien 50 7,500 150
Cotton roll 100 45,000 450
Chlorethyl 100 0 0
Alkohol 100 30,000 300
Sabun Cuci 200 14,000 70
Sendok Cetak 6 16,000 2,667
 Alginat 20 85,000 4,250
Gips 20 32,000 1,600
Rubber Bowl 20 35,000 1,750
Spatula 20 20,000 1,000
Malam Merah 50 264,000 5,280
bur preparasi flame edenta 10 25,000 2,500
bur preparasi Fissure edenta 10 25,000 2,500
bur finishing flame edenta 10 25,000 2,500
shapcut finishing tapered 10 20,000 2,000
shapcut finishing fisure 10 20,000 2,000
malam biru 50 264,000 5,280
cetak double impression 50 600,000 12,000
Glasstone 20 73,500 3,675
Proses Lab 1 425,000 425,000
483,254
Harga rekomendasi terapi 2,150,000
Jasa Medis 70% 1,505,000
RSIGM 30% 645,000
Pasak logam febricated
 Jumlah
Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20,000 4
kaca mulut 5000 25,000 5
pincet 5000 20,000 4
sonde 5000 20,000 4
bak instrumen kecil 5000 45,000 9
bak instrumen sedang 5000 60,000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4,000,000 400
sterilisator 5000 0 0
celemek 50 55,000 1,100
Kapas 150 17,500 117
plastik alat gulungan 200 395,000 1,975
Handscoen XS 50 42,000 840
Pana spray NSK 100 350,000 3,500
Masker karet 100 20,000 200
Suction tip 400 45,000 113
Gelas kumur pasien 50 7,500 150
Cotton roll 100 45,000 450
Chlorethyl 100 0 0
Alkohol 100 30,000 300
Sabun Cuci 200 14,000 70
Sendok Cetak 6 16,000 2,667
Alginat 25 85,000 3,400
Gips 25 32,000 1,280
Rubber Bowl 20 28,000 1,400
Spatula 20 20,000 1,000
Malam Merah 50 135,000 2,700
bur preparasi flame edenta 10 25,000 2,500
bur preparasi Fissure edenta 10 25,000 2,500
bur finishing flame edenta 10 25,000 2,500
shapcut finishing tapered 10 20,000 2,000
shapcut finishing fisure 10 20,000 2,000
malam biru 50 264,000 5,280
cetak double impression 75 600,000 8,000
Glasstone 25 73,500 2,940
Proses Lab 1 60,000 60,000
109,419
Harga rekomendasi terapi 750,000
Jasa Medis 70% 525,000
RSIGM 30% 225,000

Set up per elemen berikutnya pada akrilik

Bahan Jumlah Harga (Rp) Unit cost (Rp)
Sediaan Pasien
 excavator 5000 20000 4
kaca mulut 5000 25000 5
pincet 5000 20000 4
sonde 5000 20000 4
bak instrumen kecil 5000 45000 9
bak instrumen sedang 5000 60000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4000000 400
sterilisator 5000 0 0
celemek 50 55000 1100
Kapas 150 17,500 117
plastik alat gulungan 200 0 0
Handscoen XS 50 42000 840
Pana spray NSK 1000 0 0
Masker karet 100 20000 200
Suction tip 400 45000 113
Gelas kumur pasien 50 7500 150
Cotton roll 100 45000 450
Chlorethyl 100 75000 750
Alkohol 100 30000 300
Sabun Cuci 200 14000 70
Gaun Supervisor 20 10000 500
pingeon teeth 1 17,000 17000
22028
Harga rekomendasi terapi 100,000
Jasa Medis 70% 70,000
RSIGM 30% 30,000

Set up per elemen berikutnya pada valplast

Bahan Jumlah Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20000 4
kaca mulut 5000 25000 5
pincet 5000 20000 4
sonde 5000 20000 4
bak instrumen kecil 5000 45000 9
bak instrumen sedang 5000 60000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4000000 400
sterilisator 5000 0 0
 celemek 50 55000 1100
Kapas 150 17,500 117
plastik alat gulungan 200 0 0
Handscoen XS 50 42000 840
Pana spray NSK 1000 0 0
Masker karet 100 20000 200
Suction tip 400 45000 113
Gelas kumur pasien 50 7500 150
Cotton roll 100 45000 450
Chlorethyl 100 75000 750
Alkohol 100 30000 300
Sabun Cuci 200 14000 70
Gaun Supervisor 20 10000 500
pingeon teeth 1 17,000 17000
22028
Harga rekomendasi terapi 200,000
Jasa Medis 70% 140,000
RSIGM 30% 60,000

Set up per elemen berikutnya pada frame-akrilik

Bahan Jumlah Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20000 4
kaca mulut 5000 25000 5
pincet 5000 20000 4
sonde 5000 20000 4
bak instrumen kecil 5000 45000 9
bak instrumen sedang 5000 60000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4000000 400
sterilisator 5000 0 0
celemek 50 55000 1100
Kapas 150 17,500 117
plastik alat gulungan 200 0 0
Handscoen XS 50 42000 840
Pana spray NSK 1000 0 0
Masker karet 100 20000 200
Suction tip 400 45000 113
Gelas kumur pasien 50 7500 150
 Cotton roll 100 45000 450
Chlorethyl 100 75000 750
Alkohol 100 30000 300
Sabun Cuci 200 14000 70
Gaun Supervisor 20 10000 500
pingeon teeth 1 17,000 17000
22028
Harga rekomendasi terapi 150,000
Jasa Medis 70% 105,000
RSIGM 30% 45,000

Set up per elemen berikutnya pada frame-valplast

Bahan Jumlah Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20000 4
kaca mulut 5000 25000 5
pincet 5000 20000 4
sonde 5000 20000 4
bak instrumen kecil 5000 45000 9
bak instrumen sedang 5000 60000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4000000 400
sterilisator 5000 0 0
celemek 50 55000 1100
Kapas 150 17,500 117
plastik alat gulungan 200 0 0
Handscoen XS 50 42000 840
Pana spray NSK 1000 0 0
Masker karet 100 20000 200
Suction tip 400 45000 113
Gelas kumur pasien 50 7500 150
Cotton roll 100 45000 450
Chlorethyl 100 75000 750
Alkohol 100 30000 300
Sabun Cuci 200 14000 70
Gaun Supervisor 20 10000 500
pingeon teeth 1 17,000 17000
22028
Harga rekomendasi terapi 200,000
Jasa Medis 70% 140,000
RSIGM 30% 60,000

Set up per elemen berikutnya pada thermoplast

Bahan Jumlah Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20000 4
kaca mulut 5000 25000 5
pincet 5000 20000 4
sonde 5000 20000 4
bak instrumen kecil 5000 45000 9
bak instrumen sedang 5000 60000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4000000 400
sterilisator 5000 0 0
celemek 50 55000 1100
Kapas 150 17,500 117
plastik alat gulungan 200 0 0
Handscoen XS 50 42000 840
Pana spray NSK 1000 0 0
Masker karet 100 20000 200
Suction tip 400 45000 113
Gelas kumur pasien 50 7500 150
Cotton roll 100 45000 450
Chlorethyl 100 75000 750
Alkohol 100 30000 300
Sabun Cuci 200 14000 70
Gaun Supervisor 20 10000 500
pingeon teeth 1 17,000 17000
22028
Harga rekomendasi terapi 200,000
Jasa Medis 70% 140,000
RSIGM 30% 60,000
Set up per elemen berikutnya pada precision attachment
Bahan Jumlah Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20000 4
kaca mulut 5000 25000 5
pincet 5000 20000 4
sonde 5000 20000 4
bak instrumen kecil 5000 45000 9
bak instrumen sedang 5000 60000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4000000 400
sterilisator 5000 0 0
celemek 50 55000 1100
Kapas 150 17,500 117
plastik alat gulungan 200 0 0
Handscoen XS 50 42000 840
Pana spray NSK 1000 0 0
Masker karet 100 20000 200
Suction tip 400 45000 113
Gelas kumur pasien 50 7500 150
Cotton roll 100 45000 450
Chlorethyl 100 75000 750
Alkohol 100 30000 300
Sabun Cuci 200 14000 70
Gaun Supervisor 20 10000 500
pingeon teeth 1 17,000 17000
22028
Harga rekomendasi terapi 200,000
Jasa Medis 70% 140,000
RSIGM 30% 60,000

GTL flexible per rahang

Jumlah
Bahan Harga (Rp) Unit cost (Rp)
Sediaan Pasien
excavator 5000 20,000 4
kaca mulut 5000 25,000 5
 pincet 5000 20,000 4
sonde 5000 20,000 4
bak instrumen kecil 5000 45,000 9
bak instrumen sedang 5000 60,000 12
tangue holder ( TA) 100 0 0
alat pres plastik 10000 4,000,000 400
sterilisator 5000 0 0
celemek 50 55,000 1,100
Kapas 150 17,500 117
plastik alat gulungan 200 395,000 1,975
Handscoen XS 50 42,000 840
Pana spray NSK 100 0 0
Masker karet 100 20,000 200
Suction tip 400 45,000 113
Gelas kumur pasien 50 7,500 150
Cotton roll 100 0 0
Chlorethyl 100 0 0
Alkohol 100 30,000 300
Sabun Cuci 200 14,000 70
Sendok Cetak 6 16,000 2,667
Alginat 20 85,000 4,250
Gips 20 32,000 1,600
Rubber Bowl 20 28,000 1,400
Spatula 20 20,000 1,000
Malam Merah 50 135,000 2,700
Wire klamer 100 10,000 100
Pigeon Teeth 1 17,000 17,000
Proses Lab 1 700,000 700,000
736,019
Harga rekomendasi terapi 5,000,000
Jasa Medis 70% 3,500,000
RSIGM 30% 1,500,000