|
|||
| Paket | Harga | ||
| Persalinan Normal |
|
||
| Persalinan dengan Penyulit |
|
||
| Caesar Normal |
|
||
| Kuret |
|
||
| Persalinan Tanpa Nyeri (ILA) |
|
||
| Caesar ERACS |
|
||
| Pelayanan | Harga | ||
| Kamar, Jasa Perawatan dan Visite Dokter |
|
||
|
|||
| Paket | Harga | ||
| Persalinan Normal |
|
||
| Persalinan dengan Penyulit |
|
||
| Caesar Normal |
|
||
| Kuret |
|
||
| Persalinan Tanpa Nyeri (ILA) |
|
||
| Caesar ERACS |
|
||
| Persalinan dengan bidan |
|
||
| Pelayanan | Harga | ||
| Kamar, Jasa Perawatan dan Visite Dokter |
|
||
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| Konsultasi Bidan (ANC+VT) |
|
IGD Rp. 50.000 + Jasa Rp. 50.000 | ||
| Pemeriksaan Dokter Umum |
|
|||
| Pemeriksaan Spesialis Kandungan USG CITO |
|
|||
| Pemeriksaan Spesialis Anak |
|
|||
| Konsultasi Biasa + USG Biasa |
|
|||
| Pemeriksaan USG 4D |
|
|||
| Pemeriksaan CTG |
|
|||
| Pemeriksaan EKG |
|
|||
| Papsmear |
|
|||
| Pasang IUD (Intrauterine Device ) |
|
sampai dengan Rp. 3.000.000, Tergantung jenis IUD | ||
| Lepas IUD Tanpa Anastesi |
|
|||
| Lepas IUD Dengan Penyulit |
|
sampai dengan Rp. 1.000.000 | ||
| Jasa Suntik |
|
|||
| Vaksinasi TT Ibu Hamil |
|
|||
| Tindik Degan Bidan |
|
|||
| KURETASE |
|
|||
| Heating (per cm atau per jahitan) |
|
Barang pemakaian di hitung tersendiri | ||
| Jahitan IGD |
|
|||
| Pasien Sumbatan ASI |
|
|||
| Nebulizer |
|
IGD 50.000 + Nebul 50.000 + Jasa 25.000, Tidak Termasuk OBAT | ||
| Instrumen |
|
|||
| Administrasi Rawat Jalan |
|
|||
| Konsultasi Ganti Perban |
|
|||
| Konsultasi Tambahan |
|
Konsultasi lebih dari 10 Menit |
||
| Spiral Andalan |
|
|||
| (B1) DJJ |
|
|||
| (B2) VT |
|
|||
| (B3) CTG |
|
|||
| (B4) RAPID PASIEN INAP |
|
|||
| (B5) Rapid Penunggu |
|
|||
| (B6) INJEKSI |
|
|||
| (B7) SUNTIK KB |
|
|||
| (B8) PEMASANGAN INFUS IV DEWASA |
|
|||
| (B9) PEMASANGAN INFUS IV ANAK |
|
|||
| (B10) PEMASANGAN INFUS TALI PUSAT |
|
|||
| (B11) SUCTION (RAWAT JALAN DAN INAP) |
|
|||
| (B12) LEPAS KATETER URINE |
|
|||
| (B13) SPOOLING BLAST |
|
|||
| (B14) PASANG KATETER URIN DC |
|
|||
| (B15) NEBULASI |
|
|||
| (B16) PEMASANGAN NGT |
|
|||
| (B17) PEMERIKSAAN EKG |
|
|||
| (B18) RESUSITASI NEONATUS |
|
|||
| (B19) RESUSITASI JANTUNG PARU |
|
|||
| (B20) DC SHOCK |
|
|||
| (B21) OBSERVASI (>6JAM) |
|
|||
| (B22) OBSERVASI (<6JAM) |
|
|||
| (B23) BILAS LAMBUNG |
|
|||
| (B24) LAVEMENT |
|
|||
| (B25) BLAST PUNCTIO |
|
|||
| (B26) PASANG TEMPON HIDUNG ANTERIOR |
|
|||
| (B27) IRIGASI MATA/TELINGA/HIDUNG |
|
|||
| (B28) CEK GDS STICK |
|
|||
| (B29) PEMBERIAN OKSIGEN PER LITER PER JAM (MAKS 4 1/JAM) |
|
|||
| (B30) PEMBERIAN OKSIGEN PER LITER PER JAM (>4 1/JAM) |
|
|||
| (B31) VISUM |
|
|||
| (B32) PASANG ET |
|
|||
| (B33) PERAWATAN LUKA DRESSING KECIL |
|
|||
| (B34) PERAWATAN LUKA DRESSING BESAR |
|
|||
| (B35) HECTING LUKA KECIL (15 JAHITAN) |
|
|||
| (B36) HECTING LUKA SEDANG (6-10 JAHITAN) |
|
|||
| (B37) HECTING LUKA BERAT (> 10 JAHITAN) |
|
|||
| (B38) LEPAS JAHITAN (<5) |
|
|||
| (B39) LEPAS JAHITAN (>5) |
|
|||
| (B40) EKSTRAKSI CORPAL TELINGA / HIDUNG |
|
|||
| (B41) EKSTRAKSI CORPAL MATA |
|
|||
| (B42) INSISI ABSES |
|
|||
| (B43) PASANG SPALK EKSTERMITAS SUPERIOR |
|
|||
| (B44) PASANG SPALK EKSTREMITAS INFERIOR |
|
|||
| (B45) PASANG ELASTIC BANDDAGE |
|
|||
| (B46) LEPAS GIPS |
|
|||
| (B47) CABUT KUKU |
|
|||
| (B48) AMPUTASI JARI |
|
|||
| (K1) KONSULTASI VISITE DOKTER SPESIALIS |
|
|||
| (K2) KONSULTASI DOKTER UMUM |
|
|||
| (K3) KONSULTASI DOKTER SPESIALIS VIA TELEPON |
|
|||
| (S1) SARANA IGD |
|
|||
| (S2) REGISTRASI PASIEN |
|
|||
| (U1) REGISTRASI PASIEN |
|
|||
| (U2) JASA POLI UMUM |
|
|||
| (U3) INJEKSI |
|
|||
| (U4) NEBULIUZER |
|
|||
| (U5) LEPAS KATETER |
|
|||
| (U6) PEMERIKSAAN EKG |
|
|||
| (U7) PASANG TAMPON |
|
|||
| (U8) LEPAS TAMPON |
|
|||
| (U9) IRIGASI MATA/TELINGA/HIDUNG |
|
|||
| (U10) DRESSING KECIL |
|
|||
| (U11) DRESSING BESAR |
|
|||
| (U12) LEPAS JAHITAN |
|
|||
| (U13) EKSTRAKSI TELINGA / HIDUNG |
|
|||
| (U14) EKSTRAKSI MATA |
|
|||
| (U15) INSISI ABSES |
|
|||
| (A) KONSULTASI BIASA |
|
|||
| (B) KONSULTASI GANTI PERBAN |
|
|||
| (C) KONSULTASI TAMBAHAN (JIKA KONSULTASI LEBIH DARI 10) |
|
|||
| (D) JASA SUNTIK |
|
|||
| (E) SPIRAL ANDALAN |
|
|||
| (F) SPIRAL SILVERLINE 200 AG |
|
|||
| (G) SPIRAL SILVERLINE 380 AG |
|
|||
| (H) SPIRAL MIRENA |
|
|||
| (I) SPIRAL NOVA T |
|
|||
| (J) PASANG IMPLANT |
|
|||
| (K) PASANG PESSARIUM |
|
|||
| (L) LEPAS IUD |
|
|||
| (M) LEPAS IMPLANT |
|
|||
| (N) LEPAS PASANG PESSARIUM |
|
|||
| (O) USG 4 DIMENSI PRINT HITAM PUTIH |
|
|||
| (P) USG 4 DIMENSI PRINT WARNA |
|
|||
| (Q) USG DOFLER 1 |
|
|||
| (R) USG DOFLER 2 |
|
|||
| (S) USG TRANSVAGINAL |
|
|||
| (T) VT/PEMBERIAN OBAT PERVAGINAM |
|
|||
| (U) VAGINA TOILET |
|
|||
| (V) INSISI ABSES |
|
|||
| (W) SURAT SAKIT & SURAT LAIN-LAIN |
|
|||
| (X) CTG |
|
|||
| (Y) CTG BIDAN/PERAWAT |
|
|||
| (Z) NEBULIUZER |
|
|||
| (ZA) NEBULIUZER BIDAN ATAU PERAWAT |
|
|||
| (ZB) PAPSMEAR BIASA |
|
|||
| (ZC) PAPSMEAR SERVIRAY A.1 |
|
|||
| (ZD) BIOPSI SERVIKS |
|
|||
| (ZE) TES IVA |
|
|||
| (ZF) VAKSIN CERVARIX |
|
|||
| (ZG) VAKSIN GARDASIL |
|
|||
| (ZH) INJEKSI DIVALIN |
|
|||
| (ZI) VAKSIN TT |
|
|||
| JASA EUVAX B 0.5 ML |
|
|||
| JASA ROTATEG |
|
|||
| JASA HEXAXIM |
|
|||
| JASA SYNFLORIX PFS |
|
|||
| JASA AVAXIM 80 |
|
|||
| JASA TYPHIM VI 0.5 ML |
|
|||
| JASA PENTABIO 0.5 ML |
|
|||
| JASA VARIVAX |
|
|||
| JASA FLUQUADRI 0.5 ML |
|
|||
| JASA BCG |
|
|||
| JASA FLUQADRI 0.25 |
|
|||
| JASA KONSULTASI |
|
|||
| KONSULTASI NUTRISI PENYAKIT METABOLIK |
|
|||
| JASA MMR |
|
|||
| JASA IMOJEF |
|
|||
| JASA ROTARIX |
|
|||
| JASA VAXIGRIF TETRA |
|
|||
| JASA ROTARIX + SYNFLORI PFS |
|
|||
| JASA SYNFLORI PFS + ROTATEG |
|
|||
| (P1) VAKSIN POLIO |
|
|||
| (P2) PENTABIO + OPV |
|
|||
| (P3) BCG |
|
|||
| (P4) MR |
|
|||
| (P5) IPV (POLIOMYELITIS) |
|
|||
| (P6) HEPATITIS |
|
|||
| (P7) PCV |
|
|||
| (P8) PENTABIO + PREVENAR |
|
|||
| (P9) PENTABIO + ROTANAL |
|
|||
| (P10) PENTABIO + PREVENAR + ROTANAL |
|
|||
| JASA EUVAX B 1 ML |
|
|||
| BUKU KANDUNGAN |
|
|||
| BUKU IMUNISASI ANAK |
|
|||
| USG ABDOMEN |
|
|||
| USG + PARTUS NORMAL |
|
|||
| SC + LAB |
|
|||
| SC + LAB (CPD +SC) |
|
|||
| USG + LAB + SC |
|
|||
| PARTUS NORMAL + HECTING |
|
|||
| KURET (BLIGHTED OVUM ) |
|
|||
| KURET (ABORTUS INKOMPLIT) |
|
|||
| USG TRANSVAGINAL FERTILITAS |
|
|||
| JASA SUNTIK VAKSIN |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| Darah Rutin |
|
|||
| Golongan Darah, Rhesus |
|
|||
| GDT (dr. Sp. PK) |
|
|||
| GDT (Analis) |
|
|||
| PT, APTT |
|
|||
| Cek CT |
|
|||
| Cek BT |
|
|||
| Gula Darah |
|
|||
| SGOT |
|
|||
| SGPT |
|
|||
| Trigliserida |
|
|||
| Asam Urat |
|
|||
| Kolestrol Total |
|
|||
| HbSAg |
|
|||
| HIV |
|
|||
| IgG, igM |
|
|||
| Tubex TF |
|
|||
| Ns 1 |
|
|||
| CRP Kuantitatif |
|
|||
| Urine Lengkap |
|
|||
| Urea/Ureum |
|
|||
| Creatinin |
|
|||
| HCG Tes |
|
|||
| Pewarnaan Gram |
|
|||
| Rapid Test Antigen |
|
|||
| Sipilis |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| Prenatal Yoga |
|
Perorangan | ||
| Couple yoga |
|
Untuk pasangan |
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| Pijat Laktasi |
|
15 menit | ||
| Masase baby |
|
Buka |
| Pelayanan | Tarif | Keterangan | Belum Terdata |
|---|---|---|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN OPERASI KELAS 3 |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| Sarana Akomodasi Ibu |
|
|||
| Sarana Akomodasi Ibu |
|
|||
| Sarana Akomodasi Ibu |
|
|||
| Sarana Akomodasi Ibu |
|
|||
| Sarana Akomodasi Ibu |
|
|||
| Sarana Akomodasi Ibu |
|
|||
| Sarana Akomodasi Ibu |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| Makan Pasien |
|
|||
| Makan Pasien |
|
|||
| Makan Pasien |
|
|||
| Makan Pasien |
|
|||
| Makan Pasien |
|
|||
| Makan Pasien |
|
|||
| Makan Pasien |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| Visite dokter Sp. A kls 3 SC |
|
|||
| Visite dokter Sp.OG kls 3 SC |
|
|||
| Tindakan Keperawatan SC |
|
|||
| Visite dokter Sp. A kls 2 SC |
|
|||
| Visite dokter Sp.OG kls 2 SC |
|
|||
| Tindakan Keperawatan SC |
|
|||
| Visite dokter Sp. A kls 1 SC |
|
|||
| Visite dokter Sp.OG kls 1 SC |
|
|||
| Tindakan Keperawatan SC |
|
|||
| Visite dokter Sp. A Vip II SC |
|
|||
| Visite dokter Sp.OG Vip II SC |
|
|||
| Tindakan Keperawatan SC |
|
|||
| Visite dokter Sp. A Vip I SC |
|
|||
| Visite dokter Sp.OG Vip I SC |
|
|||
| Tindakan Keperawatan SC |
|
|||
| Visite dokter Sp. A Vip Utama SC |
|
|||
| Visite dokter Sp.OG Vip Utama SC |
|
|||
| Tindakan Keperawatan SC |
|
|||
| Visite dokter Sp. A V VIP SC |
|
|||
| Visite dokter Sp.OG V VIP SC |
|
|||
| Tindakan Keperawatan SC |
|
|||
| Visite dokter Sp. A kls 3 PN |
|
|||
| Visite dokter Sp.OG kls 3 PN |
|
|||
| Tindakan Keperawatan PN |
|
|||
| Visite dokter Sp. A kls 2 PN |
|
|||
| Visite dokter Sp.OG kls 2 PN |
|
|||
| Tindakan Keperawatan PN |
|
|||
| Visite dokter Sp. A kls 1 PN |
|
|||
| Visite dokter Sp.OG kls 1 PN |
|
|||
| Tindakan Keperawatan PN |
|
|||
| Visite dokter Sp. A VIP II PN |
|
|||
| Visite dokter Sp.OG VIP II PN |
|
|||
| Tindakan Keperawatan PN |
|
|||
| Visite dokter Sp. A VIP I PN |
|
|||
| Visite dokter Sp.OG VIP I PN |
|
|||
| Tindakan Keperawatan PN |
|
|||
| Visite dokter Sp. A Vip Utama PN |
|
|||
| Visite dokter Sp.OG Vip Utama PN |
|
|||
| Tindakan Keperawatan PN |
|
|||
| Visite dokter Sp. A V VIP PN |
|
|||
| Visite dokter Sp.OG V VIP PN |
|
|||
| Tindakan Keperawatan PN |
|
|||
| Administrasi PN V VIP |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| Administrasi SC KLS 3 |
|
|||
| Administrasi SC KLS 2 |
|
|||
| Administrasi SC KLS 1 |
|
|||
| Administrasi SC VIP II |
|
|||
| Administrasi SC VIP I |
|
|||
| Administrasi SC VIP UTAMA |
|
|||
| Administrasi SC V VIP |
|
|||
| Administrasi PN KLS 3 |
|
|||
| Administrasi PN KLS 2 |
|
|||
| Administrasi PN KLS 1 |
|
|||
| Administrasi PN VIP II |
|
|||
| Administrasi PN VIP I |
|
|||
| Administrasi PN VIP UTAMA |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN OPERASI KELAS 2 |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN OPERASI KELAS 1 |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN OPERASI KELAS VIP II |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN OPERASI KELAS VIP I |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN OPERASI KELAS VIP UTAMA |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN OPERASI KELAS V VIP |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN PERSALINAN NORMAL KELAS 3 |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN PERSALINAN NORMAL KELAS 2 |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN PERSALINAN NORMAL KELAS 1 |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN PERSALINAN NORMAL VIP II |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN PERSALINAN NORMAL VIP I |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN PERSALINAN NORMAL VIP UTAMA |
|
| Pelayanan | Tarif | Keterangan | ||
|---|---|---|---|---|
| TINDAKAN PERSALINAN NORMAL V VIP |
|