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    Alkes Cag Bpjs

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    Agus Supriatna

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    © All Rights Reserved
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    Alkes Cag Bpjs

    Uploaded by

    Agus Supriatna
    24 views5 pages

    Copyright

    © © All Rights Reserved

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    XLSX, PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    24 views5 pages

    Alkes Cag Bpjs

    Uploaded by

    Agus Supriatna

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
    of 5

    PAKET ALKES CAG VIA RADIALIS

    Nama : Diagnosa :
    No. MR : Tindakan :
    Umur : dokter :
    Asal Pasien : Tgl, Tindakan :
    NO ITEM NAME ALKES QTY UNIT KETERANGAN
    1 ALCOHOL SWAB PASTIK METZ 4 PCS
    2 AMPLOP SARANA DIAGNOSTIK 1 PCS STORE CONSUMSION
    3 BISTURI NO 11 AESCULAP 1 PCS
    4 DISPOSABLE ELEKTRODA PHILIP MONITOR 40493E 4 PCS
    5 DISP SYRINGE 1 CC TUBERCULIN TERUMO 1 PCS
    6 DISP SYRINGE 3 CC TERUMO 3 PCS
    7 DISP SYRINGE 5 CC TERUMO 2 PCS
    8 DISP SYRINGE 10 CC TERUMO 2 PCS
    9 DISP SYRINGE 20 CC TERUMO 2 PCS
    10 DVD-RW (VERBATIM) 2 PCS STORE CONSUMSION
    11 GUARDIAN IMAGE COVER (HOGY) 1 PCS
    12 GUIDE WIRE ANGLED 0.035-180CM (RF*GA35183M) 1 EACH
    13 HANSAPLAST LEMBAR 1 LEMBAR
    14 INTRAFIX PRIMELINE LUER LOCK (4021819) 1 EACH
    15 KERTAS GLOSSY PHOTO PAPER A4 2 EACH STORE CONSUMSION
    16 MAP HASIL PEMERIKSAAN DIAGNOSTIK 1 EACH STORE CONSUMSION
    17 MASKER IKAT KARET EARLOOP 4 PCS STORE CONSUMSION
    18 NICHIBAN STEPTY P 40MMX120MM 1 PCS
    19 NON STERIL GLOVE M RUBBERCARE 4 PCS STORE CONSUMSION
    20 OPTITORQUE TIG-5 FR(RH-5TIG110M) 1 EACH
    21 PAKET STERIL KASSA NON X-RAY 10 X 10 CM (ISI 10) PRIMA LAB 1 EACH
    22 PAKET STERIL KASSA SURGILAB 6 X 6 CM (ISI 5) 1 EACH
    23 PISAU CUKUR GILLETTE GOAL KLIK 1 EACH
    24 PRESSURE MONITORING KIT DISP IPEX (RU) 1 EACH
    25 SANGOFIX B-BRAUN 1 EACH
    26 STERIL GLOVE GAMMEX PF 6 1 PCS
    27 STERIL GLOVE GAMMEX PF 6,5 1 PCS
    28 STERIL GLOVE GAMMEX PF 7 1 PCS
    29 STERIL GLOVE GAMMEX PF 7,5 1 PCS
    30 STERIL GLOVE GAMMEX PF 8 1 PCS
    31 SURGEON CAP SIGMA /PRO 4 PCS STORE CONSUMSION
    32 TEGADERM 1623 (6 X 7 CM) 1 PCS
    33 TRANSOFIX BBRAUN 1 EACH
    34 UPER IMAGE COVER (HOGI) 1 EACH
    35 UNDERPAD STERIL ONEMED 60X90 1 EACH
    36 VASOFIX 22G X 1" BRAUNULE 1 EACH

    ITEM NAME OBAT- OBATAN QTY UNIT KETERANGAN


    37 ALKOHOL 70% 100 ML BOTOL IKA 1 EACH
    38 BETADIN SOL 10% 30 ML 1 EACH
    39 INVICLOT 5000II INJ 2 ml
    40 ZAT KONTRAS /100ML 100 ml
    41 NTG INJEKSI 10MG/10ML 1 AMPUL
    42 LIDOCAIN 2% INJ 2ML 1 AMPUL
    43 NACL 0,9% INFUS 500 CC OTSUKA 3 EACH

    ITEM NAME ALKES KONSINYASI QTY UNIT KETERANGAN


    44 CL-ASSIST-CIL PRESSURE MONITORING LINE 60-152CM(13029) 1 EACH
    45 CL-CLEARVIEW 3 MANIFOLD 3-PORT 500PSI 1 EACH
    46 CL-CONTRAS INJ LINE/HIGH PRESSURE 1200PSI-61CM (13001-B) 1 EACH
    47 CL-TRANSRADIAL INTRODUCER SHEATH 6 FR 11 CM MediSense 1 EACH

    PERAWAT SCRUB :
    PERAWAT SIRCULER :
    PAKET ALKES CAG VIA FEMORALIS
    Nama :
    No. MR :
    Umur :
    Asal Pasien :
    NO ITEM NAME ALKES QTY
    1 ALCOHOL SWAB PASTIK METZ 4
    2 AMPLOP SARANA DIAGNOSTIK 1
    3 BISTURI NO 11 AESCULAP 1
    4 DISPOSABLE ELEKTRODA PHILIP MONITOR 40493E 4
    5 DISP SYRINGE 1 CC TUBERCULIN TERUMO 1
    6 DISP SYRINGE 3 CC TERUMO 3
    7 DISP SYRINGE 5 CC TERUMO 2
    8 DISP SYRINGE 10 CC TERUMO 2
    9 DISP SYRINGE 20 CC TERUMO 2
    10 DVD-RW (VERBATIM) 2
    11 FM CREPE 3 INCH (7,5 CM) 1
    12 FM CREPE 6 INCH (15 CM) 1
    13 GUARDIAN IMAGE COVER (HOGY) 1
    14 HANSAPLAST LEMBAR 1
    15 INTRAFIX PRIMELINE LUER LOCK (4021819) 1
    16 KERTAS GLOSSY PHOTO PAPER A4 2
    17 MAP HASIL PEMERIKSAAN DIAGNOSTIK 1
    18 MASKER IKAT KARET EARLOOP 4
    19 NON STERIL GLOVE M RUBBERCARE 4
    20 PAKET STERIL KASSA NON X-RAY 10 X 10 CM (ISI 10) PRIMA LAB 1
    21 PAKET STERIL KASSA SURGILAB 6 X 6 CM (ISI 5) 1
    22 PISAU CUKUR GILLETTE GOAL KLIK 1
    23 PRESSURE MONITORING KIT DISP IPEX (RU) 1
    24 SANGOFIX B-BRAUN 1
    25 STERIL GLOVE GAMMEX PF 6 1
    26 STERIL GLOVE GAMMEX PF 6,5 1
    27 STERIL GLOVE GAMMEX PF 7 1
    28 STERIL GLOVE GAMMEX PF 7,5 1
    29 STERIL GLOVE GAMMEX PF 8 1
    30 SURGEON CAP SIGMA /PRO 4
    31 TEGADERM 1623 (6 X 7 CM) 1
    32 TRANSOFIX BBRAUN 1
    33 UPER IMAGE COVER (HOGI) 1
    34 UNDERPAD STERIL ONEMED 60X90 1
    35 VASOFIX 22G X 1" BRAUNULE 1

    ITEM NAME OBAT - OBATAN QTY


    36 ALKOHOL 70% 100 ML BOTOL IKA 1
    37 BETADIN SOL 10% 30 ML 1
    38 INVICLOT 5000 ui INJ 2
    39 ZAT KONTRAS /100ML 100
    40 LIDOCAIN 2% INJ 2ML 5
    41 NACL 0,9% INFUS 500 CC OTSUKA 3

    ITEM NAME ALKES KONSINYASI QTY


    42 CL-ADVANCE DIAGNOSTIK GUIDE WIRE 0.035-150CM J-TIP(19262) 1
    43 CL-ASSIST-CIL PRESSURE MONITORING LINE 60-152CM(13029) 1
    44 CL- CATH MERIT JR 3.5 6F 1
    45 CL- CATH MERIT JL 3.5 6F 1
    46 CL-CLEARVIEW 3 MANIFOLD 3-PORT 500PSI 1
    47 CL-CONTRAS INJ LINE/HIGH PRESSURE 1200PSI-61CM (13001-B) 1
    48 CL-ELITE FEMORAL INTRODUCER KIT 6 FR-11CM 1
    PERAWAT SCRUB :
    PERAWAT SIRCULER :
    Diagnosa :
    Tindakan :
    dokter :
    Tgl, Tindakan :
    UNIT KETERANGAN
    PCS
    PCS STORE CONSUMSION
    PCS
    PCS
    PCS
    PCS
    PCS
    PCS
    PCS
    PCS STORE CONSUMSION
    EACH
    EACH
    PCS
    LEMBAR
    EACH
    EACH STORE CONSUMSION
    EACH STORE CONSUMSION
    PCS STORE CONSUMSION
    PCS STORE CONSUMSION
    EACH
    EACH
    EACH
    EACH
    EACH
    PCS
    PCS
    PCS
    PCS
    PCS
    PCS STORE CONSUMSION
    PCS
    EACH
    EACH
    EACH
    EACH

    UNIT
    EACH
    EACH
    ml
    ml
    AMPUL
    EACH

    UNIT
    EACH
    EACH
    EACH
    EACH
    EACH
    EACH
    EACH
    PERAWAT SCRUB :
    PERAWAT SIRCULER :

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