Sheet1

BMHP POLI GIGI DESEMBER 2017

TUMPATAN : PREMEDIKASI TEMPORER FILLING
1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4pc 240pc Rp385.00
5 KAPAS 1gr 1kg Rp53.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 CAVITON 3gr 30gr Rp10,267.00
8 EUGENOL 1ml 20ml Rp650.00
9 DEVITAL 0.1gr 5gr Rp5,200.00
10 SALIVA EJEKTOR 1pc 100pc Rp550.00
11 DENTAL BIB 1pc 100pc Rp330.00
12 GELAS KUMUR DISSPOSIBLE 1pc 100pc Rp352.00
Rp25,316.00

TUMPATAN AMALGAM/ ISOPOST/SILIKAT/GIC

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4pc 240pc Rp385.00
5 KAPAS 1gr 1kg Rp53.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 ARTIKULATING PAPER ½ sheet 144 sheet Rp500.00
8 FUJI 9 GP - 15 gr Rp10,000.00 80
9 DENTIN CONDISIONER 0,5 ml 5,7 ml Rp11,363.00
10 VARNISH 0,5 ml 5,2 ml Rp12,100.00
11 SALIVA EJEKTOR 1 pc 100pc Rp550.00
12 DENTAL BIB 1pc 15 pc Rp330.00
13 GELAS KUMUR DISSPOSIBLE 1 pc 100pc Rp352.00
14 CELULOID STRIPS 1 pc 100pc Rp1,485.00
15 FINISHING STRIPS 1 pc 150 pc Rp2,993.00
Rp47,640.00

TUMPATAN PERAWATAN SYARAF (TIAP KUNJUNGAN)

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4pc 240pc Rp385.00
5 KAPAS 1gr 1kg Rp53.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 CAVITON 2gr 30gr Rp10,267.00
8 HYPOSOL 3 ml 500 ml Rp430.00
9 PAPER POINT 10 pc 200 pc Rp1,760.00
10 CHKM 1 ml 20 ml Rp2,750.00
11 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
12 DENTAL BIB 1 pc 15 pc Rp330.00
13 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp24,406.00

TUMPATAN PERAWATAN SYARAF (EXTIERPATIE PULP)

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00

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3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4pc 240pc Rp385.00
5 KAPAS 1gr 1kg Rp53.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 SPUIT 3CC 1 pc Rp4,000.00
8 HYPOSOL 3 ml 500 ml Rp430.00
9 PAPER POINT 10pc 200 pc Rp1,760.00
10 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
11 DENTAL BIB 1 pc 15 pc Rp330.00
12 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp15,389.00

EKSTRAKSI GIGI SUSU

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4 pc 240pc Rp385.00
5 KAPAS 1g 1kg Rp53.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 ETHYLCHLORIDE SPRAY 100CC 1 cc 100 cc Rp1,320.00
8 DOLONES 0,5 g 5g Rp5,104.00
9 IODIN POVIDONE 2ml 60 ml Rp240.00
10 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp14,983.00

EKSTRAKSI GIGI SUSU DENGAN SUNTIKAN

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4 pc 240pc Rp385.00
5 KAPAS 2g 1kg Rp106.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 ETHYLCHLORIDE SPRAY 100CC 1 cc 100 cc Rp1,320.00
8 DOLONES 0,5 g 5g Rp5,104.00
9 IODIN POVIDONE 2ml 60 ml Rp240.00
10 DENTAL NEEDLE 1 pc 100 pc Rp1,265.00
11 PEHACAIN INJ 1 amp 20 amp Rp3,114.00
12 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp19,415.00

EKSTRAKSI GIGI TETAP

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4 pc 240pc Rp385.00
5 KAPAS 2g 1kg Rp106.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 DENTAL NEEDLE 1 pc 100 pc Rp1,265.00
8 PEHACAIN INJ 1 amp 20 amp Rp3,114.00
9 IODIN POVIDONE 2ml 60 ml Rp240.00
10 TAMPON 2 pc Rp300.00
11 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
12 DENTAL BIB 1 pc 15 pc Rp330.00

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Rp13,621.00

EKSTRAKSI GIGI TETAP TANPA FAKTOR PENYULIT

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 KAPAS 2g 1kg Rp106.00
5 ALKOHOL 70% 10ml 1L Rp3,630.00
6 DENTAL NEEDLE 1 pc 100 pc Rp1,265.00
7 PEHACAIN INJ 1 amp 20 amp Rp3,114.00
8 IODIN POVIDONE 2ml 60 ml Rp240.00
9 TAMPON 2 pc Rp300.00
10 DOLONES 0,5 g 5g Rp5,104.00
11 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
12 DENTAL BIB 1 pc 15 pc Rp330.00
Rp18,340.00

EKSTRAKSI GIGI TETAP DENGAN FAKTOR PENYULIT

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 KAPAS 2g 1kg Rp106.00
5 ALKOHOL 70% 10ml 1L Rp3,630.00
6 DENTAL NEEDLE 1 pc 100 pc Rp1,265.00
7 PEHACAIN INJ 1 amp 20 amp Rp3,114.00
8 IODIN POVIDONE 2ml 60 ml Rp240.00
9 TAMPON 2 pc Rp300.00
10 DOLONES 0,5 g 5g Rp5,104.00
11 HEMOSPON 1 pc 10 pc Rp11,011.00
12 VASELIN 1 gr 25 gr Rp500.00
13 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
14 DENTAL BIB 1 pc 15 pc Rp330.00
15 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp30,401.00

EKSTRAKSI GIGI TETAP & KOMPLIKASI

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 KAPAS 2g 1kg Rp106.00
5 ALKOHOL 70% 10ml 1L Rp3,630.00
6 DENTAL NEEDLE 1 pc 100 pc Rp1,265.00
7 PEHACAIN INJ 1 amp 20 amp Rp3,114.00
8 IODIN POVIDONE 2ml 60 ml Rp240.00
9 TAMPON 2 pc Rp300.00
10 SUTURE 1 pc
11 HEMOSPON 1 pc 10 pc Rp11,011.00
12 CATGUT 10 cm
13 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
14 DENTAL BIB 1 pc 15 pc Rp330.00
15 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp24,797.00

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 Sheet1

EXCISI OPPERCULUM / EXOSTOSIS

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 KAPAS 1g 1kg Rp53.00
5 ALKOHOL 70% 10ml 1L Rp3,630.00
6 DENTAL NEEDLE 1 pc 100 pc Rp1,265.00
7 PEHACAIN INJ 1 amp 20 amp Rp3,114.00
8 IODIN POVIDONE 2ml 60 ml Rp240.00
9 TAMPON 2 pc Rp300.00
10 HEMOSPON 1 pc 10 pc Rp11,011.00
11 SCALPEL BLADE 11 1pc
12 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
13 DENTAL BIB 1 pc 15 pc Rp330.00
14 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp24,744.00

SCALING PER QUADRANT

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 KAPAS 1g 1kg Rp53.00
5 ALKOHOL 70% 10ml 1L Rp3,630.00
6 OCO 0.5 ml 15 ml Rp4,400.00
7 IODIN POVIDONE 2ml 60 ml Rp240.00
8 PASTA GIGI 5g 75 g Rp500.00
9 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
10 DENTAL BIB 1 pc 15 pc Rp330.00
11 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp13,954.00

SPOELING SPLINTING (KONTROL POST OP)

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 KAPAS 1g 1kg Rp53.00
5 ALKOHOL 70% 10ml 1L Rp3,630.00
6 SPUIT 3CC 1 pc Rp4,000.00
7 IODIN POVIDONE 2ml 60 ml Rp240.00
8 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
9 DENTAL BIB 1 pc 15 pc Rp330.00
10 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp13,054.00

TAMBALAN SINAR ( COMPOSITE KECIL)

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4pc 240pc Rp385.00
5 KAPAS 1g 1kg Rp53.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 ARTIKULATING PAPER 1 sheet 144 sheet Rp500.00

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 Sheet1
8 ETCHING - 15 ml Rp1,048.00
9 BONDING - 5 ml Rp4,286.00
10 MICROBRUSH 2 pc 100 pc Rp3,080.00
11 CELULOID STRIPS ½ pc 100pc Rp743.00
12 FINISHING STRIPS 1 pc 150 pc Rp3,000.00
13 HYDCAL 0.4 gr 24 g Rp2,857.00 70
14 FILTEX Z350XT FLOW 0,08 g 4g Rp12,000.00 50
15 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
16 DENTAL BIB 1 pc 15 pc Rp330.00
17 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp36,713.00

TAMBALAN SINAR ( COMPOSITE SEDANG)

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 4pc 240pc Rp385.00
5 KAPAS 1g 1kg Rp53.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 ARTIKULATING PAPER 1 sheet 144 sheet Rp1,100.00
8 ETCHING 0.09 ml 15 ml Rp3,396.00 162/3bln
9 BONDING 0.03 ml 5 ml Rp6,993.00 162/3bln
10 MICROBRUSH 2 pc 100 pc Rp3,080.00
11 CELULOID STRIPS ½ pc 100pc Rp743.00
12 FINISHING STRIPS 1 pc 150 pc Rp3,000.00
13 HYDCAL 0.4 gr 24 g Rp2,857.00 70
14 FILTEX Z350XT UNIV REST DL - 4g Rp5,000.00 100
15 FILTEX Z350XT FLOW - 4g Rp10,000.00
16 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
17 DENTAL BIB 1 pc 15 pc Rp330.00
18 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp45,368.00

TAMBALAN SINAR ( COMPOSITE BESAR)

1 SENSI GLOVES M 2pc 100pc Rp1,100.00
2 SENSI GLOVES S 2pc 100pc Rp1,056.00
3 MASKER EARLOOP 2pc 50pc Rp1,743.00
4 COTTON ROLL 8pc 240pc Rp385.00
5 KAPAS 1g 1kg Rp53.00
6 ALKOHOL 70% 10ml 1L Rp3,630.00
7 ARTIKULATING PAPER 1 sheet 144 sheet Rp1,100.00
8 VITAPEX - 4g Rp2,806.00
9 ETCHING 1 ml 15 ml Rp3,500.00
10 BONDING 0.5 ml 5 ml Rp7,500.00
11 MICROBRUSH 2 pc 100 pc Rp3,080.00
12 CELULOID STRIPS ½ pc 100pc Rp743.00
13 FINISHING STRIPS 1 pc 150 pc Rp3,000.00
14 HYDCAL 0.4 gr 24 g Rp2,857.00 70
15 FILTEX Z350XT UNIV DENTIN - 4g Rp8,700.00
16 FILTEX Z350XT UNIV ENAMEL - 4g Rp10,000.00
17 FILTEX Z350XT FLOW - 4g Rp12,000.00
18 SALIVA EJEKTOR 1 pc 100 pc Rp550.00
19 DENTAL BIB 1 pc 15 pc Rp330.00

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 Sheet1
20 GELAS KUMUR DISSPOSIBLE 1 pc 100 pc Rp352.00
Rp64,485.00

Page 6