Page 22 - TARIF BPJS (Update Nov 2017)

3 Alkali Phosphatase 29,500 3,480 26,020 29,500
4 Alkohol Darah 140,000 - 140,000 140,000
5 Analisa Gas Darah 230,000 5,880 224,120 230,000
6 Asam Urat 23,500 3,480 20,020 23,500
7 Bilirubin Direk 20,500 3,300 17,200 20,500
8 Bilirubin Indirek 12,500 1,140 11,360 12,500
9 Bilirubin Total 20,500 3,300 17,200 20,500
10 BUN 17,500 3,480 14,020 17,500
11 C(P)K 50,000 4,680 45,320 50,000
12 Calsium 30,000 4,680 25,320 30,000
13 CCT 1 56,000 10,560 45,440 56,000
14 Cholinesterase 74,500 3,480 71,020 74,500
15 CK-MB 60,000 4,680 55,320 60,000
16 Gamma-GT 39,000 5,880 33,120 39,000
17 Globulin 6,500 780 5,720 6,500
18 Glukosa 2 jam PP 19,500 3,480 16,020 19,500
19 Glukosa Kurva 2 19,500 3,480 16,020 19,500
20 Glukosa Kurva 3 19,500 3,480 16,020 19,500
21 Glukosa Puasa 19,500 3,480 16,020 19,500
22 Glukosa Sewaktu 19,500 3,480 16,020 19,500
23 Glukosa Toleransi Test 122,000 9,000 113,000 122,000
24 HBA1C 185,500 4,680 180,820 185,500
25 HDL Kolesterol 54,500 3,480 51,020 54,500
26 Kreatinin 25,000 3,480 21,520 25,000
27 LDH 52,000 2,340 49,660 52,000
28 LDL Kolesterol 14,000 2,400 11,600 14,000
29 LDL Kolesterol (Direct) 72,500 3,480 69,020 72,500
30 Magnesium 70,000 3,480 66,520 70,000
31 Paket Elektrolit 194,000 1,140 192,860 194,000
32 Rasio A : G 10,000 1,140 8,860 10,000
33 Rasio Kreatinin : BUN 10,000 1,140 8,860 10,000
34 SGOT / ASAT 23,500 3,480 20,020 23,500
35 SGPT / ALAT 23,500 3,480 20,020 23,500
36 Total Kolesterol 23,000 3,480 19,520 23,000
37 Total Lipids 55,000 3,480 51,520 55,000
38 Total Protein 19,500 3,480 16,020 19,500
39 Triglycerida 25,000 3,480 21,520 25,000
40 Ureum 22,000 3,480 18,520 22,000
HORMON
1 Beta HCG 267,000 267,000
2 Estradiol Serum 252,000 4,680 247,320 252,000
3 FSH Serum 201,000 4,680 196,320 201,000
4 LH Serum 214,500 7,020 207,480 214,500
5 Progesteron Serum 245,500 4,680 240,820 245,500
6 Prolactin Serum 212,500 4,680 207,820 212,500
7 T-3 Total Serum 186,500 4,680 181,820 186,500
8 T-4 Total Serum 186,500 4,680 181,820 186,500
9 Testosteron Serum 234,000 4,680 229,320 234,000
10 TSH Serum 158,000 4,680 153,320 158,000
MIKROBIOLOGI
1 Kultur Aerob MO Umum & Sens Ab 267,500 11,760 255,740 267,500
2 Kultur Air 236,500 11,760 224,740 236,500
3 Kultur Anaerob 263,000 11,760 251,240 263,000
4 Kultur Empedu 384,000 11,760 372,240 384,000
5 Kultur Makanan 127,000 11,760 115,240 127,000
6 Kultur Minuman 126,500 11,760 114,740 126,500
7 Kultur S/S Tinja 153,000 15,300 137,700 153,000
8 Kultur Sterilitas 250,000 11,760 238,240 250,000
9 Mikroskopis Jamur (KOH) 39,000 3,480 35,520 39,000
10 Mikroskopis Trichomonas (NaCl) 39,000 3,480 35,520 39,000
11 Pengecatan BTA-KP 45,000 3,480 41,520 45,000