ANEXA 22 A

Documentele necesare pentru fundamentarea tarifului mediu pe caz rezolvat i a tarifului

pe zi de spitalizare

1. tatul de personal
2. Execuia bugetului instituiei sanitare publice la data de 31.12.2015
3. Ultima form a bugetului de venituri i cheltuieli pentru anul 2015 valabil la 31.12.2015
aprobat de ordonatorul de credite.
4. Lista investigaiilor paraclinice/serviciilor medicale clinice - consultaii interdisciplinare,
efectuate n alte uniti sanitare: nr., tipul, valoare i nr. de bolnavi internai pentru care au fost
efectuate aceste servicii.
5. Stocul de medicamente, materiale sanitare i reactivi la 01.01.2015 i la 31.12.2015
6. Fia de fundamentare a tarifului pentru anul 2016, pe elemente de cheltuieli*)
------------
*) Se completeaz pentru fiecare secie/compartiment pentru care plata se face prin tarif mediu
pe caz rezolvat i pe baz de tarif pe zi de spitalizare
mii lei
______________________________________________________________________________
| ELEMENTE DE CHELTUIELI | Clasificaie | Valoare |
| | bugetar | |
|_____________________________________________________|______________|_________|
| CHELTUIELI CURENTE (I + II + VI) | 01 | |
|_____________________________________________________|______________|_________|
| TITLUL I CHELTUIELI DE PERSONAL | 10 | |
|_____________________________________________________|______________|_________|
| Cheltuieli salariale n bani | 10.01 | |
|_____________________________________________________|______________|_________|
| Salarii de baz | 10.01.01 | |
|_____________________________________________________|______________|_________|
| Salarii de merit | 10.01.02 | |
|_____________________________________________________|______________|_________|
| Indemnizaii de conducere | 10.01.03 | |
|_____________________________________________________|______________|_________|
| Spor de vechime | 10.01.04 | |
|_____________________________________________________|______________|_________|
| Alte sporuri | 10.01.06 | |
|_____________________________________________________|______________|_________|
| Ore suplimentare | 10.01.07 | |
|_____________________________________________________|______________|_________|
| Fond de premii | 10.01.08 | |
|_____________________________________________________|______________|_________|
| Prima de vacan | 10.01.09 | |
|_____________________________________________________|______________|_________|
| Indemnizaii pltite unor persoane din afara | 10.01.12 | |
| unitii | | |
|_____________________________________________________|______________|_________|
| Indemnizaii de delegare | 10.01.13 | |
|_____________________________________________________|______________|_________|
| Indemnizaii de detaare | 10.01.14 | |
|_____________________________________________________|______________|_________|
| Alocaii pentru locuine | 10.01.16 | |
|_____________________________________________________|______________|_________|
| Alte drepturi salariale n bani | 10.01.30 | |
|_____________________________________________________|______________|_________|
| Contribuii | 10.03 | |
|_____________________________________________________|______________|_________|

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| Contribuii de asigurri sociale de stat | 10.03.01 | |
|_____________________________________________________|______________|_________|
| Contribuii de asigurri de omaj | 10.03.02 | |
|_____________________________________________________|______________|_________|
| Contribuii de asigurri sociale de sntate | 10.03.03 | |
|_____________________________________________________|______________|_________|
| Contribuii de asigurri pentru accidente de munc | 10.03.04 | |
| i boli profesionale | | |
|_____________________________________________________|______________|_________|
| Contribuii pentru concedii i indemnizaii | 10.03.06 | |

|_____________________________________________________|______________|_________|
| Contribuii la fondul de garantare a creanelor | 10.03.07 | |
| salariale | | |
|_____________________________________________________|______________|_________|
| TITLUL II BUNURI I SERVICII - TOTAL | 20 | |
|_____________________________________________________|______________|_________|
| Bunuri i servicii | 20.01 | |
|_____________________________________________________|______________|_________|
| Furnituri de birou | 20.01.01 | |
|_____________________________________________________|______________|_________|
| Materiale pentru curenie | 20.01.02 | |
|_____________________________________________________|______________|_________|
| nclzit, iluminat i for motric | 20.01.03 | |
|_____________________________________________________|______________|_________|
| Ap, canal i salubritate | 20.01.04 | |
|_____________________________________________________|______________|_________|
| Carburani i lubrifiani | 20.01.05 | |
|_____________________________________________________|______________|_________|
| Piese de schimb | 20.01.06 | |
|_____________________________________________________|______________|_________|
| Transport | 20.01.07 | |
|_____________________________________________________|______________|_________|
| Pot, telecomunicaii, radio, TV, internet | 20.01.08 | |
|_____________________________________________________|______________|_________|
| Materiale i prestri servicii pentru ntreinere | 20.01.09 | |
| cu caracter funcional | | |
|_____________________________________________________|______________|_________|
| Alte bunuri i servicii pentru ntreinere i | 20.01.30 | |
| funcionare | | |
|_____________________________________________________|______________|_________|
| Reparaii curente | 20.02 | |
|_____________________________________________________|______________|_________|
| Medicamente i materiale sanitare | 20.04 | |
|_____________________________________________________|______________|_________|
| Hran | 20.03 | |
|_____________________________________________________|______________|_________|
| Hran pentru oameni | 20.03.01 | |
|_____________________________________________________|______________|_________|
| Hran pentru animale | 20.03.02 | |
|_____________________________________________________|______________|_________|
| Medicamente | 20.04.01 | |
|_____________________________________________________|______________|_________|
| Materiale sanitare | 20.04.02 | |
|_____________________________________________________|______________|_________|
| Reactivi | 20.04.03 | |
|_____________________________________________________|______________|_________|
| Dezinfectani | 20.04.04 | |
|_____________________________________________________|______________|_________|
| Bunuri de natura obiectelor de inventar | 20.05 | |
|_____________________________________________________|______________|_________|
| Alte obiecte de inventar | 20.05.30 | |
|_____________________________________________________|______________|_________|

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| Deplasri, detari, transferuri | 20.06 | |
|_____________________________________________________|______________|_________|
| Deplasri interne, detari, transferuri | 20.06.01 | |
|_____________________________________________________|______________|_________|
| Deplasri n strintate | 20.06.02 | |
|_____________________________________________________|______________|_________|
| Materiale de laborator | 20.09 | |
|_____________________________________________________|______________|_________|
| Cri, publicaii i materiale documentare | 20.11 | |
|_____________________________________________________|______________|_________|
| Consultan i expertiz | 20.12 | |
|_____________________________________________________|______________|_________|
| Pregtire profesional | 20.13 | |
|_____________________________________________________|______________|_________|
| Protecia muncii | 20.14 | |
|_____________________________________________________|______________|_________|
| Comisioane i alte costuri aferente mprumuturilor | 20.24 | |
| externe | | |
|_____________________________________________________|______________|_________|
| Cheltuieli judiciare i extrajudiciare derivate din | 20.25 | |
| aciuni n reprezentarea intereselor statului, | | |
| potrivit dispoziiilor legale | | |
|_____________________________________________________|______________|_________|
| Alte cheltuieli | 20.3 | |
|_____________________________________________________|______________|_________|
| Protocol i reprezentare | 20.30.02 | |
|_____________________________________________________|______________|_________|
| Alte cheltuieli cu bunuri i servicii | 20.30.30 | |
|_____________________________________________________|______________|_________|
| TITLUL VI TRANSFERURI NTRE UNITI ALE | 51 | |
| ADMINISTRAIEI PUBLICE - TOTAL | | |
|_____________________________________________________|______________|_________|
| Din care: | | |
|_____________________________________________________|______________|_________|
| Aciuni de sntate | 51.01.03 | |
|_____________________________________________________|______________|_________|
| Programe pentru sntate | 51.01.25 | |
|_____________________________________________________|______________|_________|
| Transferuri din bugetul de stat ctre bugetele | 51.01.38 | |
| locale pentru finanarea unitilor de asisten | | |
| medico-sociale | | |
|_____________________________________________________|______________|_________|
| Aparatur i echipamente de comunicaii n urgen | 51.01.08 | |
|_____________________________________________________|______________|_________|
| Transferuri pentru reparaii capitale la spitale | 51.02.11 | |
|_____________________________________________________|______________|_________|
| Transferuri pentru finanarea investiiilor | 51.02.12 | |
| spitalelor | | |
|_____________________________________________________|______________|_________|

MANAGER DIRECTOR MEDICAL DIRECTOR FINANCIAR-CONTABIL

........... ................ ...........................

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