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    Unit Laboratorium: Rumah Sakit Umum Daerah

    Uploaded by

    Sagir Alva
    1. The document is a validation report from the RSUD Kota Depok Hospital Laboratory Unit for a payment bill from PT Buana Astadeca for laboratory testing services provided in 2014. 2. It details the types of tests performed, number of tests, unit prices and total prices. A total of 97,021,960 was validated as accurate based on the number of patient tests recorded in the hospital information system. 3. The Laboratory Unit Head signed off on the report, validating that the payment requested by PT Buana Astadeca matches the number of patient tests performed and is to be used accordingly.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd

    Unit Laboratorium: Rumah Sakit Umum Daerah

    Uploaded by

    Sagir Alva
    24 views6 pages
    1. The document is a validation report from the RSUD Kota Depok Hospital Laboratory Unit for a payment bill from PT Buana Astadeca for laboratory testing services provided in 2014. 2. It details the types of tests performed, number of tests, unit prices and total prices. A total of 97,021,960 was validated as accurate based on the number of patient tests recorded in the hospital information system. 3. The Laboratory Unit Head signed off on the report, validating that the payment requested by PT Buana Astadeca matches the number of patient tests performed and is to be used accordingly.

    Original Description:

    lap.rs.lab

    Original Title

    Ba Validasi November 2015

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    1. The document is a validation report from the RSUD Kota Depok Hospital Laboratory Unit for a payment bill from PT Buana Astadeca for laboratory testing services provided in 2014. 2. It details the types of tests performed, number of tests, unit prices and total prices. A total of 97,021,960 was validated as accurate based on the number of patient tests recorded in the hospital information system. 3. The Laboratory Unit Head signed off on the report, validating that the payment requested by PT Buana Astadeca matches the number of patient tests performed and is to be used accordingly.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    24 views6 pages

    Unit Laboratorium: Rumah Sakit Umum Daerah

    Uploaded by

    Sagir Alva
    1. The document is a validation report from the RSUD Kota Depok Hospital Laboratory Unit for a payment bill from PT Buana Astadeca for laboratory testing services provided in 2014. 2. It details the types of tests performed, number of tests, unit prices and total prices. A total of 97,021,960 was validated as accurate based on the number of patient tests recorded in the hospital information system. 3. The Laboratory Unit Head signed off on the report, validating that the payment requested by PT Buana Astadeca matches the number of patient tests performed and is to be used accordingly.

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    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
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    RUMAH SAKIT UMUM DAERAH

    UNIT LABORATORIUM
    Jl. Raya Muchtar No.99 Sawangan Kota Depok
    Telp. 0251-8602514 Fax. 0251-8602134
    BERITA ACARA VALIDASI
    1 November - 30 November 2015

    tangan dibawah ini Kepala Unit Laboratorium telah melakukan validasi tagihan pembayaran dari PT
    Buana Astadeca untuk pekerjaan Belanja Jasa Kerjasama Operasional Pelayanan Laboratorium pada k
    Pengadaan Obat, Alkes Habis Pakai, Bahan Kimia dan Perlengkapan Farmasi tahun anggaran 2014
    NO
    I

    JENIS PEMERIKSAAN
    HEMATOLOGI
    Golongan Darah ABO + RHESUS
    Hitung Jenis
    LED
    Paket Darah Lengkap ( Hb, Ht, Leuko,
    Trombo, Eri, LED, Hitung Jenis, MCV,
    MCH, MCHC )
    Paket Darah Rutin (Hb, Ht, Leuko,
    Trombo, Eri)

    II

    III

    JUMLAH
    PEMERIKSAAN

    HASIL
    VALIDASI

    235
    18
    326

    235
    18
    326

    58

    58

    24,500

    1,576

    1,576

    12,250

    HEMOSTASIS
    Paket Hemostasis (PT, aPTT, INR)
    KIMIA DARAH
    A DIABETES
    Glukosa Darah 2 Jam PP
    Glukosa Darah Puasa
    Glukosa Darah Sewaktu
    HbA1C
    B FUNGSI HATI
    Albumin
    Alkaline Fostatase
    Bilirubin Direk
    Bilirubin Total
    Gamma GT
    Globulin
    Kolinesterase
    Protein Total
    SGOT/AST

    HARGA
    SATUAN
    (Rp.)
    9,800
    7,350
    7,350

    124,950

    274
    281
    804
    16

    274
    281
    804
    16

    9,065
    9,065
    9,065
    61,250

    43

    43

    72
    76

    72
    76

    7
    443

    7
    443

    12,495
    12,250
    13,230
    13,475
    14,700
    9,800
    29,400
    12,985
    11,270

    SGPT/ALT

    451

    451

    11,270

    C FUNGSI GINJAL
    Asam Urat
    Creatinin
    Ureum

    158
    373
    365

    158
    373
    365

    11,270
    12,740
    12,495

    D PROFIL LIPID
    Kolesterol HDL
    Kolesterol Total
    Trigliserida

    137
    153
    143

    137
    153
    143

    16,415
    15,435
    15,435

    E FUNGSI JANTUNG
    CK
    CKMB
    Hs-CRP
    F ELEKTROLIT
    Paket Elektrolit (Na, K, Cl)
    G ANALISA GAS DARAH
    Anallisa Gas Darah
    IV

    VI

    VII

    IMUNOSEROLOGI
    Anti HAV Rapid
    Anti HBs Rapid
    Anti HCV Rapid
    ASTO / ASO (kuantitatif)
    CRP (kuantitatif)
    Dengue Blot Rapid (IgM & IgG)
    Dengue NS1 Antigen
    HBsAg Rapid
    Rheumatoid Factor
    Widal
    HORMON
    Beta HCG Kuantitatif
    T4
    TSH-s
    URINALISA
    Urinalisa Lengkap
    TES URINE LAINNYA
    Mikroalbumin Urin

    41,650
    51,450
    49,000

    152

    152

    51,450

    66,150

    15

    15

    209

    209

    115

    115

    36,750
    22,050
    58,800
    39,935
    36,750
    58,800
    95,550
    20,580
    27,440
    21,560

    39
    39

    39
    39

    95,550
    47,775
    56,350

    286

    286

    11,270

    9,065

    Protein Kuantitatif
    Protein Urin
    Tes Kehamilan (HCG)
    VIII

    TES NARKOBA
    Amfetamin
    Benzodiazepin
    Morfin
    THC
    Paket Tes Narkoba (AMP + BZO + THC
    + MOR)

    24
    25

    15,925
    6,370
    9,800

    24
    25

    14,210
    14,210
    14,210
    14,210
    64

    64
    6,991

    64,435
    6,991

    Tagihan pembayaran yang diajukan oleh PT. Genta Buana Astadeca sudah sesuai dengan jumlah
    pemeriksaan pasien yang ada didalam Sistem Informasi RSUD Kota Depok.
    Demikian Berita Acara ini dibuat untuk dapat dipergunakan sebagaimana mestinya
    Kepala Unit Laboratorium

    Euis Hindasah
    Nip. 196804212000122002
    Direktur

    pembayaran dari PT. Genta


    Laboratorium pada kegiatan
    hun anggaran 2014 dengan
    JUMLAH HARGA
    SATUAN (Rp.)
    2,303,000
    132,300
    2,396,100
    1,421,000
    19,306,000

    2,483,810
    2,547,265
    7,288,260
    980,000

    537,285
    0
    952,560
    1,024,100
    0
    49,000
    0
    90,895
    4,992,610

    5,082,770

    1,780,660
    4,752,020
    4,560,675

    2,248,855
    2,361,555
    2,207,205

    0
    0
    0

    7,820,400

    330,750

    551,250
    0
    176,400
    0
    0
    58,800
    0
    4,301,220
    0
    2,479,400

    0
    1,863,225
    2,197,650

    3,223,220

    0
    152,880
    245,000

    0
    0
    0
    0
    4,123,840
    97,021,960

    dengan jumlah

    nit Laboratorium

    Hindasah
    04212000122002
    Direktur

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