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DID RADIOLOGI

16

NAME Outpatient:0 VVIP VIP 1


Thorax 120000.00 120000.00 120000.00 120000.00
Thorax PA/Lateral 205000.00 205000.00 205000.00 205000.00
Schedel 175000.00 175000.00 175000.00 175000.00
Sinus Paranasal 225000.00 225000.00 225000.00 225000.00
Madibula 130000.00 181000.00 168000.00 156000.00
Temporo Mandibular Joint (TMJ) 220000.00 275000.00 260000.00 247000.00
Mastoid 165000.00 214000.00 202000.00 190000.00
OS Nasal 145000.00 194000.00 182000.00 170000.00
Basis Cranii 200000.00 249000.00 237000.00 224000.00
BNO / Abdomen 140000.00 140000.00 140000.00 140000.00
Abdomen 3 Posisi 315000.00 315000.00 315000.00 315000.00
Pelvis 225000.00 225000.00 225000.00 225000.00
HIP Joint 152000.00 201000.00 189000.00 176000.00
Cervical AP - Lateral 225000.00 225000.00 225000.00 225000.00
Thoracal AP - Lateral 225000.00 225000.00 225000.00 225000.00
Vert Lumbalis 192000.00 242000.00 230000.00 218000.00
Thoracolumbal AP - Lateral 225000.00 225000.00 225000.00 225000.00
Lumbosacral AP - Lateral 192000.00 242000.00 230000.00 218000.00
OS Sacrum 172000.00 222000.00 209000.00 196000.00
OS Coccygeus 172000.00 222000.00 209000.00 196000.00
OS Sterum 152000.00 201000.00 189000.00 176000.00
Blaas 138000.00 188000.00 175000.00 163000.00
Atresia ani 285000.00 285000.00 285000.00 285000.00
Alar Orburator 165000.00 214000.00 202000.00 190000.00
Humerus 152000.00 201000.00 189000.00 176000.00
Elbow Joint 225000.00 225000.00 225000.00 225000.00
Wrist Joint 130000.00 181000.00 168000.00 156000.00
Manus 225000.00 225000.00 225000.00 225000.00
Clavicula 130000.00 181000.00 168000.00 156000.00
Shoulder Joint 225000.00 225000.00 225000.00 225000.00
Scapula 130000.00 181000.00 168000.00 156000.00
Femur 152000.00 201000.00 189000.00 176000.00
Genu / Knee Joint 130000.00 181000.00 168000.00 156000.00
Cruris 152000.00 201000.00 189000.00 176000.00
Ankle Joint 130000.00 181000.00 0.00 156000.00
Pedis 130000.00 181000.00 168000.00 156000.00
Patella 130000.00 181000.00 168000.00 156000.00
Antebrachi 152000.00 201000.00 189000.00 176000.00
Bone Survey 726000.00 776000.00 763000.00 751000.00
Calcaneus 130000.00 181000.00 168000.00 156000.00
Thorax Lumbal 233000.00 283000.00 270000.00 258000.00
Thorax Lateral 130000.00 181000.00 168000.00 156000.00
Thorax Top Lordotik 225000.00 225000.00 225000.00 225000.00
Thorax PA - Top Lordotik 213000.00 263000.00 250000.00 238000.00
ORBITA 200000.00 249000.00 237000.00 224000.00
Cervical AP - Lateral - Oblique 325000.00 325000.00 325000.00 325000.00
Thoracal AP - Lateral - Oblique 325000.00 325000.00 325000.00 325000.00
Thoracolumbal AP - Lateral - Oblique 325000.00 325000.00 325000.00 325000.00
Lumbosacral AP - Lateral - Oblique 302000.00 242000.00 344000.00 325000.00
Sacrum 152000.00 201000.00 189000.00 176000.00
Coxae 225000.00 225000.00 225000.00 225000.00
Coxygeus 152000.00 201000.00 189000.00 176000.00
Cravicula Bilateral 260000.00 360000.00 335000.00 311000.00
Scapula Bilateral 260000.00 360000.00 335000.00 311000.00
Sholder Joint Bilateral 260000.00 360000.00 335000.00 311000.00
Humerus Bilateral 302000.00 401000.00 377000.00 352000.00
Antebrachi Bilateral 302000.00 401000.00 377000.00 352000.00
Cubiti / Elbow Joint Bilateral 260000.00 360000.00 335000.00 311000.00
Writs Joint Bilateral 260000.00 360000.00 335000.00 311000.00
Manus Bilateral 260000.00 360000.00 335000.00 311000.00
Femur Bilateral 302000.00 401000.00 377000.00 352000.00
Cruris Bilateral 302000.00 401000.00 377000.00 352000.00
Genu / Kne Joint Bilateral 260000.00 360000.00 335000.00 311000.00
Patella Bilateral 260000.00 360000.00 335000.00 311000.00
Pedis Bilateral 260000.00 360000.00 335000.00 311000.00
Angkle Joint Bilateral 260000.00 360000.00 335000.00 311000.00
Calcenus Bilateral 260000.00 360000.00 335000.00 311000.00
Scedel / Cranium 200000.00 249000.00 237000.00 224000.00
Cravicula 130000.00 181000.00 168000.00 156000.00
Mandibula 130000.00 181000.00 168000.00 156000.00
Lumbosacral AP 0.00 0.00 0.00 0.00
Ekstremitas AP/Lat 205000.00 205000.00 205000.00 205000.00
Ekstremitas Ki/Ka 325000.00 325000.00 325000.00 325000.00
Coxae Ki/Ka 325000.00 325000.00 325000.00 325000.00
Coxygeus AP/Lat 225000.00 225000.00 225000.00 225000.00
Elbow Joint Ki/Ka 325000.00 325000.00 325000.00 325000.00
Manus Ki/Ka 325000.00 325000.00 325000.00 325000.00
Babygram 225000.00 225000.00 225000.00 225000.00
Appendicogram 625000.00 625000.00 625000.00 625000.00
Cystogram 625000.00 625000.00 625000.00 625000.00
BNO-IVP 925000.00 925000.00 925000.00 925000.00
Colon Inloop 925000.00 925000.00 925000.00 925000.00
HSG 1120000.00 1120000.00 1120000.00 1120000.00
USG Abdomen 600000.00 600000.00 600000.00 600000.00
GI

2 3
120000.00 120000.00
205000.00 205000.00
175000.00 175000.00
225000.00 225000.00
144000.00 130000.00
233000.00 220000.00
177000.00 165000.00
157000.00 145000.00
212000.00 200000.00
140000.00 140000.00
315000.00 315000.00
225000.00 225000.00
164000.00 152000.00
225000.00 225000.00
225000.00 225000.00
205000.00 192000.00
225000.00 225000.00
205000.00 192000.00
184000.00 172000.00
184000.00 172000.00
164000.00 152000.00
151000.00 138000.00
285000.00 285000.00
177000.00 165000.00
164000.00 152000.00
225000.00 225000.00
144000.00 130000.00
225000.00 225000.00
144000.00 130000.00
225000.00 225000.00
144000.00 130000.00
164000.00 152000.00
144000.00 130000.00
164000.00 152000.00
144000.00 130000.00
144000.00 130000.00
144000.00 130000.00
164000.00 152000.00
739000.00 726000.00
144000.00 130000.00
246000.00 233000.00
144000.00 130000.00
225000.00 225000.00
226000.00 213000.00
212000.00 200000.00
325000.00 325000.00
325000.00 325000.00
325000.00 325000.00
307000.00 302000.00
164000.00 152000.00
225000.00 225000.00
164000.00 152000.00
286000.00 260000.00
286000.00 260000.00
286000.00 260000.00
326000.00 302000.00
326000.00 302000.00
286000.00 260000.00
286000.00 260000.00
286000.00 260000.00
326000.00 302000.00
326000.00 302000.00
286000.00 260000.00
286000.00 260000.00
286000.00 260000.00
286000.00 260000.00
286000.00 260000.00
212000.00 200000.00
144000.00 130000.00
144000.00 130000.00
0.00 0.00
205000.00 205000.00
325000.00 325000.00
325000.00 325000.00
225000.00 225000.00
325000.00 325000.00
325000.00 325000.00
225000.00 225000.00
625000.00 625000.00
625000.00 625000.00
925000.00 925000.00
925000.00 925000.00
1120000.00 1120000.00
600000.00 600000.00