120 Menit
II. | TARIF PEMERIKSAAN LABORATORIUM | ||||||||||||
No | Jenis Pemeriksaan | Poliklinik/ | Tarif | Kelas II / | Tarif | Kelas I / ICU / VIP / | Tarif | ||||||
Kelas III | Rujukan luar | Utama | |||||||||||
BAKHP | JP | BAKHP | JP | JRS | BAKHP | JP | JRS | ||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | ||||
1. | Darah Hematologi | ||||||||||||
a. | Rutin | 20,000 | 1,500 | Rp 21,500 | 20,000 | 2,000 | 600 | Rp 22,600 | 20,000 | 2,500 | 750 | Rp 23,250 | |
1. Hemoglobin (Hb) | 1,250 | 1,000 | 300 | 1,250 | 400 | ||||||||
2. Erytrocyt | 1,250 | 1,000 | 300 | 1,250 | 400 | ||||||||
3. Leukocyt | 1,250 | 1,000 | 300 | 1,250 | 400 | ||||||||
4. Haemogram (DHT) | 2,000 | 2,500 | 750 | 3,500 | 1,200 | ||||||||
6. Trombocyt | 2,000 | 2,000 | 600 | 2,500 | 750 | ||||||||
7. Hematokrit | 1,250 | 1,000 | 300 | 1,250 | 400 | ||||||||
8. Hitung Eosinophil | 1,500 | 2,000 | 600 | 2,500 | 750 | ||||||||
5. LED (BSS) | 750 | 1,250 | Rp 2,000 | 750 | 1,000 | 300 | Rp 2,050 | 750 | 1,250 | 400 | Rp 2,400 | ||
b. | Parasitologi | ||||||||||||
1. -Malaria | 50,000 | 2,250 | Rp 52,250 | 50,000 | 2,000 | 600 | Rp 52,600 | 50,000 | 3,000 | 900 | Rp 53,900 | ||
- Dengue | 120,000 | 2,250 | Rp 122,250 | 120,000 | 2,000 | 600 | Rp 122,600 | 120,000 | 3,000 | 900 | Rp 123,900 | ||
2. Filaria | 2,000 | 1,500 | Rp 3,500 | 2,000 | 2,000 | 600 | Rp 4,600 | 3,500 | 3,000 | 900 | Rp 7,400 | ||
d. | Serologi | ||||||||||||
1. Widal | 3,250 | 3,750 | Rp 7,000 | 3,250 | 4,000 | 1,200 | Rp 8,450 | 4,000 | 4,500 | 1,350 | Rp 9,850 | ||
2. VDRL | 2,500 | 2,000 | 600 | 3,500 | 1,200 | ||||||||
3. TPHA | 2,000 | 2,500 | 750 | 3,500 | 1,200 | ||||||||
4. RAF | 2,000 | 2,500 | 750 | 3,500 | 1,200 | ||||||||
5. HBsAg + Anti HBs | 39,500 | 5,500 | Rp 45,000 | 45,000 | 2,500 | 750 | Rp 48,250 | 45,000 | 4,500 | 1,350 | Rp 50,850 | ||
6. HBsAg | 17,500 | 2,500 | Rp 20,000 | 17,500 | 3,750 | 1,125 | Rp 22,375 | 20,000 | 4,500 | 1,350 | Rp 25,850 | ||
2. | -Fungsi Pembekuan | Rp - | Rp - | Rp - | |||||||||
a. | Bleeding time | 2,000 | 1,500 | Rp 3,500 | 2,000 | 1,000 | 300 | Rp 3,300 | 2,000 | 1,250 | 450 | Rp 3,700 | |
b. | Clothing time | 1,500 | 1,000 | 300 | 1,250 | 450 | |||||||
c. | Protrombin time | 2,500 | 3,500 | 1,050 | 4,500 | 1,350 | |||||||
d. | APTT | 3,000 | 3,500 | 1,050 | 4,500 | 1,350 | |||||||
e. | Titer Fibrinogen | 2,500 | 3,500 | 1,050 | 4,500 | 1,350 | |||||||
- Sumsum tulang | 5,000 | 8,000 | 2,400 | 10,000 | 3,000 | ||||||||
- Hapusan darah tepi | 5,250 | 7,750 | Rp 13,000 | 5,250 | 8,000 | 2,400 | Rp 15,650 | 5,250 | 12,500 | 3,750 | Rp 21,500 | ||
- Golongan darah | 23,000 | 1,250 | Rp 24,250 | 23,000 | 2,000 | 600 | Rp 25,600 | 23,000 | 2,500 | 750 | Rp 26,250 | ||
- Analisa gas darah | 66,000 | 7,500 | Rp 73,500 | 70,000 | 5,000 | 1,500 | Rp 76,500 | 70,000 | 11,000 | 3,300 | Rp 84,300 | ||
- Elektrolit (Na,K dan Ca) | 40,000 | 5,500 | Rp 45,500 | 42,000 | 5,500 | 1,650 | Rp 49,150 | 40,000 | 7,500 | 2,250 | Rp 49,750 | ||
- Serum protein elektroforesa | 4,000 | 5,000 | 1,500 | 7,000 | 2,100 | ||||||||
- ASTO / ASO | 2,500 | 3,000 | 900 | 4,000 | 1,200 | ||||||||
- Elisa Sitometri | 3,750 | 2,500 | 750 | 5,000 | 1,500 | ||||||||
3. | Kimia Darah | ||||||||||||
- Gula Darah:Puasa | 5,000 | 3,000 | Rp 8,000 | 5,000 | 1,500 | 450 | Rp 6,950 | 5,000 | 2,500 | 750 | Rp 8,250 | ||
- 2 jam PP | 5,000 | 3,000 | Rp 8,000 | 5,000 | 1,500 | 450 | Rp 6,950 | 5,000 | 2,500 | 750 | Rp 8,250 | ||
- sewaktu | 5,000 | 3,000 | Rp 8,000 | 5,000 | 1,500 | 450 | Rp 6,950 | 5,000 | 2,500 | 750 | Rp 8,250 | ||
- Cholesterol total | 16,250 | 3,250 | Rp 19,500 | 16,500 | 2,000 | 600 | Rp 19,100 | 16,500 | 3,500 | 1,200 | Rp 21,200 | ||
- HDI,cholesterol | 23,500 | 2,500 | Rp 26,000 | 26,000 | 1,500 | 450 | Rp 27,950 | 26,000 | 3,000 | 900 | Rp 29,900 | ||
- LDI,cholesterol | 57,500 | 2,000 | Rp 59,500 | 60,000 | 1,500 | 450 | Rp 61,950 | 60,000 | 3,000 | 900 | Rp 63,900 | ||
- Trigiiserida | 12,000 |