Page 23 - TARIF BPJS (Update Nov 2017)

12 Pengecatan BTA-MB 45,000 3,480 41,520 45,000
13 Pengecatan Difteri 50,000 3,480 46,520 50,000
14 Pengecatan Gram 46,500 3,480 43,020 46,500
IMUNOLOGI / SEROLOGI
1 Alpha Feto Protein ( AFP ) 193,500 4,680 188,820 193,500
2 Anti CCP 385,000 6,000 379,000 385,000
3 Anti CMV IgG 173,500 4,680 168,820 173,500
4 Anti CMV IgM 214,000 4,680 209,320 214,000
5 Anti HAV IgM 240,000 4,680 235,320 240,000
6 Anti HBe 268,500 4,680 263,820 268,500
7 Anti HBs 143,000 4,680 138,320 143,000
8 Anti HCV (ECLIA) 278,500 4,680 273,820 278,500
9 Anti HCV (Rapid) 75,500 3,480 72,020 75,500
10 Anti HIV (ECLIA) 156,500 4,680 151,820 156,500
11 Anti HIV (Rapid) 92,000 3,480 88,520 92,000
12 Anti HSV 2 IgG 260,000 5,880 254,120 260,000
13 Anti HSV 2 IgM 260,000 5,880 254,120 260,000
14 Anti HSV I IgG 277,500 5,880 271,620 277,500
15 Anti HSV I IgM 277,500 5,880 271,620 277,500
16 Anti Rubella IgG 197,000 4,680 192,320 197,000
17 Anti Rubella IgM 299,000 4,680 294,320 299,000
18 Anti Salmonella Thypi IgM 164,000 5,400 158,600 164,000
19 Anti Toxoplasma IgG 174,500 4,680 169,820 174,500
20 Anti Toxoplasma IgM 174,500 4,680 169,820 174,500
21 Antibodi TB IgG 147,000 3,480 143,520 147,000
22 ASTO 53,000 2,340 50,660 53,000
23 Carcinoma Embrio Antigen ( CEA ) 212,000 4,680 207,320 212,000
24 CRP Kualitatif 61,500 2,340 59,160 61,500
25 Dengue Blood IgG IgM 263,000 9,420 253,580 263,000
26 HBeAg 268,500 4,680 263,820 268,500
27 HBsAg (ECLIA) 121,000 4,680 116,320 121,000
28 HBsAg (Rapid) 74,000 3,480 70,520 74,000
29 ICT Malaria 180,000 5,880 174,120 180,000
30 NS 1 Antigen 353,500 5,880 347,620 353,500
31 Prostat spesifik AG (PSA) 331,000 4,680 326,320 331,000
32 Rhematoid Arthritis ( RAF ) 61,500 2,340 59,160 61,500
33 RPR Syphilis Kualitatif 38,000 3,480 34,520 38,000
34 TORCH Lengkap 10 parameter 1,877,000 3,480 1,873,520 1,877,000
35 TPHA 102,500 3,480 99,020 102,500
36 Troponin T 220,000 3,480 216,520 220,000
37 Widal 68,000 4,680 63,320 68,000
SITOLOGI / PA / IMUNOHISTOKIMIA
1 CD 117 643,500 643,500
2 Cerb2 643,500 643,500
3 Cytokeratin 643,500 643,500
4 ER 643,500 643,500
5 HER2 585,000 585,000
6 Hormonal / Sitologi Vagina (VCE) 163,500 163,500
7 Kappa 643,500 643,500
8 KI 67 590,000 590,000
9 Lamda 643,500 643,500
10 LCA 643,500 643,500
11 Pap Smear 163,350 163,350
12 Patologi Anatomi 375,000 375,000
13 pR 643,500 643,500
14 S100 643,500 643,500
15 Sitologi Lain - lain (cairan pleura, acites dll) 367,000 367,000
16 Sitologi Sputum 175,000 175,000
17 Tindakan FNAB 552,500 552,500