| No. | Kode Item | Nama Item | Harga HNA | Satuan Stok | Status |
|---|---|---|---|---|---|
| A01 | Administrasi Rawat Inap | 100000 | 1 | ||
| A02 | Biaya Pendaftaran Rawat Jalan | 50000 | 1 | ||
| A03 | Biaya Kartu Pasien | 20000 | 1 | ||
| D000131 | Biaya dr. Umum | 50000 | 1 | ||
| D000132 | Biaya Konsultasi dr. Spesialis THT | 100000 | 1 | ||
| D000133 | Dokter Spesialis 50k | 50000 | 1 | ||
| D000134 | Dokter Spesialis 75k | 75000 | 1 | ||
| D000135 | Dokter Spesialis 100k | 100000 | 1 | ||
| F000121 | Paracetamol | 20000 | Sirup | 1 | |
| F000122 | Paramex | 30000 | Sirup | 1 | |
| F000123 | Alerfed | 50000 | Tablet | 1 | |
| F000124 | Methylprednisolone | 75000 | Sirup | 1 | |
| F000125 | Amoxan | 25000 | Sirup | 1 | |
| F000126 | Amoxicillin | 25000 | Tablet | 1 | |
| F000127 | Antasida | 30000 | Tablet | 1 | |
| F000128 | Ibu Profen | 45000 | Sirup | 1 | |
| F000129 | Ketokonazol | 50000 | Tablet | 1 | |
| F000130 | Promag | 10000 | Tablet | 1 | |
| F000131 | Ceftriaxone | 25000 | 1 | ||
| F000132 | Metformin | 35000 | 1 | ||
| KL000122 | Nasal Cannula | 35000 | |||
| KL000132 | Kasa | 8000 | |||
| KL000142 | Suntikan | 10000 | |||
| KL000162 | Masker Medis | 10000 | |||
| OP00111 | Suntik | 50000 | 1 | ||
| OP00112 | Perawatan luka | 20000 | 1 | ||
| OP00113 | Pemasangan infus | 10000 | 1 | ||
| OP00114 | Terapi | 100000 | 1 | ||
| OP00115 | Hemodialisis | 200000 | 1 | ||
| OP00116 | Rontgen (X-ray) | 50000 | 1 | ||
| OP00117 | CT Scan | 50000 | 1 | ||
| OP00118 | USG | 50000 | 1 | ||
| OP00119 | Transfusi darah | 50000 | 1 | ||
| OP00120 | Pemeriksaan kehamilan | 100000 | 1 | ||
| OP00121 | Resusitasi jantung-paru | 150000 | 1 | ||
| OP00122 | Operasi Kecil | 1000000 | 1 |