No. SK: 445/03/427.52.08/2023
10
– 60 Menit
a Hematologi
1 Darah Lengkap 65,000
2 Hemoglobin 15,000
3 Leukosit 10,000
4 Hitung Jenis 10,000
5 LED 10,000
6 Trombosit 10,000
7 Hematokrit 10,000
8 Eritrosit 10,000
9 Eosinofil 10,000
10 Waktu Pendarahan [BT] 8,000
11 Waktu Pembekuan [CT] 8,000
12 Gol. Darah ABO 10,000
13 Gol. Darah Rhesus 10,000
14 Microfilaria 15,000
15 Viskositas Darah 20,000
16 Viskositas Plasma 20,000
b Serologi dan Imunologi
1 Anti HIV rapid/reagen 50,000
2 Anti hepatitis C metode Rapid (Anti HCV) 45,000
3 Antigen Covid Rapid / Reagen 75,000
4 IgG/IgM Dengue 200,000
5 Syphilis rapid test 30,000
6 HBs Ag Kualitatif 45,000
7 HBs Ab Kualitatif 30,000
8 C-Reactive Protein (CRP) 32,000
9 Widal 20,000
10 Rheumatoid Arthritis 30,000
11 Anti Streptolisin (ASTO) 30,000
12 Veneral Disease Research Laboratory (VDRL) 30,000
13 Treponema Pallidum Hemagglutination Rapid (TPHA) 30,000
c Urinalisa
1 Urine Lengkap 30,000
2 Protein 10,000 - 132 - NO JENIS PELAYANAN TARIF (Rp)
3 Glukosa/Reduksi 10,000
4 Urobilin 10,000
5 Bilirubin 10,000
6 Sedimen 10,000
7 pH Urine 10,000
8 Berat Jenis 10,000
9 Urobilinogen 10,000
10 Keton Bodies / Aseton 10,000
11 Nitrit 10,000
d Mikrobiologi Klinik
Feses lengkap 20,000
e Metabolisme Karbohidrat
1 Gula Darah puasa 10,000
2 Gula Darah puasa (Photometer) 20,000
3 Gula Darah 2 JamPP 10,000
4 Gula Darah 2 JamPP (Photometer) 20,000
5 Gula Darah sewaktu 10,000
f Fungsi Hati
1 Albumin 20,000
2 Globulin 20,000
3 Bilirubin Total Direct 20,000
4 SGOT (AST) 20,000
5 SGPT (ALT) 20,000
6 Gamma GT 20,000
7 Fosfatase Alkali 25,000
8 Protein Total 20,000
9 Cholinesterase 70,000
g Profil Lemak
1 Cholesterol Total 20,000
2 Trigliseride 20,000
3 HDL Cholesterol 20,000
4 LDL Cholesterol 20,000
5 Lipid Total 20,000
h Fungsi Ginjal
1 Creatinin 20,000
2 Urid Acid/ asam urat 20,000
3 Creatinin Clearance 25,000
4 Ureum 20,000
i Analisa Analisa Sperma 100,000
j Tes Kehamilan Tes Kehamilan 20,000
k Microbiologi Prep. Direct
1 Prep. Malaria 20,000
2 Prep BTA 30,000
3 Prep. Gram 20,000
Pelayanan Unit Laboratorium Klinik
Petugas Puskesmas :
Eccy Febriantono ( 081332001046)
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