KODE TINDAKAN BIAYA SARANA JASA TARIF

TD001 PEMERIKSAAN DOKTER UMUM Rp 25,000 Rp 10,000 Rp 35,000

TD002 PEMERIKSAAN DOKTER GIGI Rp 25,000 Rp 10,000 Rp 35,000
TD003 PEMERIKSAAN BIDAN Rp 15,000 Rp 5,000 Rp 20,000
TD004 TIND. INJEKSI Rp 4,000 Rp 6,000 Rp 10,000
TD005 HECTING 1-5 Rp 42,500 Rp 7,500 Rp 50,000
TD006 HECTING 6-10 Rp 85,000 Rp 15,000 Rp 100,000
TD007 HECTING > 10 Rp 102,000 Rp 18,000 Rp 120,000
TD008 AFF HECTING 1-5 Rp 21,250 Rp 3,750 Rp 25,000
TD009 AFF HECTING 6-10 Rp 42,500 Rp 7,500 Rp 50,000
TD010 AFF HECTING > 10 Rp 51,000 Rp 9,000 Rp 60,000
TD011 WT LUKA KECIL Rp 12,750 Rp 2,250 Rp 15,000
TD012 WT LUKA SEDANG Rp 21,250 Rp 3,750 Rp 25,000
TD013 WT LUKA BESAR Rp 29,750 Rp 5,250 Rp 35,000
TD014 WT CROSS INSISI Rp 68,000 Rp 12,000 Rp 80,000
TD015 DEBRIDEMENT LUKA KECIL Rp 25,500 Rp 4,500 Rp 30,000
TD016 DEBRIDEMENT LUKA SEDANG Rp 42,500 Rp 7,500 Rp 50,000
TD017 DEBRIDEMENT LUKA BESAR Rp 68,000 Rp 12,000 Rp 80,000
TD018 RAWAT COMBUTIO Rp 51,000 Rp 9,000 Rp 60,000
TD019 INSISI / EKSISI Rp 59,500 Rp 10,500 Rp 70,000
TD020 EKSTIRPASI Rp 59,500 Rp 10,500 Rp 70,000
TD021 IRIGASI MATA Rp 29,750 Rp 5,250 Rp 35,000
TD022 IRIGASI TELINGA Rp 29,750 Rp 5,250 Rp 35,000
TD023 EVAKUASI CORPAL ANAK Rp 51,000 Rp 9,000 Rp 60,000
TD024 EVAKUASI CORPAL DEWASA Rp 42,500 Rp 7,500 Rp 50,000
TD025 CIRCUMSISI ANAK Rp 255,000 Rp 45,000 Rp 300,000
TD026 CIRCUMSISI DEWASA Rp 382,500 Rp 67,500 Rp 450,000
TD027 NAEGEL EKSTRAKSI Rp 85,000 Rp 15,000 Rp 100,000
TD028 NEBULIZER Rp 55,250 Rp 9,750 Rp 65,000
TD029 PASANG CATETER Rp 17,000 Rp 3,000 Rp 20,000
TD030 PASANG INFUS ANAK Rp 17,000 Rp 3,000 Rp 20,000
TD031 PASANG INFUS BAYI Rp 25,500 Rp 4,500 Rp 30,000
TD032 PASANG INFUS DEWASA Rp 12,750 Rp 2,250 Rp 15,000
TD033 PASANG NGT Rp 34,000 Rp 6,000 Rp 40,000
TD034 PASANG SPALK Rp 17,000 Rp 3,000 Rp 20,000
TD035 PERSALINAN NORMAL Rp 1,200,000 Rp 200,000 Rp 1,400,000
TD036 TINDIK TELINGA Rp 29,750 Rp 5,250 Rp 35,000
TD037 GURAH VAGINA Rp 127,500 Rp 22,500 Rp 150,000
TD038 HECTING PERINEUM Rp 85,000 Rp 15,000 Rp 100,000
TD039 IMUNISASI Rp 21,250 Rp 3,750 Rp 25,000
TD040 LEPAS IMPLANT Rp 127,500 Rp 22,500 Rp 150,000
TD041 LEPAS IUD Rp 85,000 Rp 15,000 Rp 100,000
TD042 PAP SMEAR Rp 127,500 Rp 22,500 Rp 150,000
TD043 PASANG IMPLANT Rp 212,500 Rp 37,500 Rp 250,000
TD044 PASANG IUD Rp 170,000 Rp 30,000 Rp 200,000
TD045 SUNTIK KB 1 BULAN Rp 25,500 Rp 4,500 Rp 30,000
TD046 SUNTIK KB 3 BULAN Rp 29,750 Rp 5,250 Rp 35,000
TD047 TINDAKAN HPP Rp 85,000 Rp 15,000 Rp 100,000
TD048 TINDAKAN RESIKO PERSALINAN Rp 85,000 Rp 15,000 Rp 100,000
TD049 CEK GDS Rp 21,250 Rp 3,750 Rp 25,000
TD050 CEK ASAM URAT Rp 21,250 Rp 3,750 Rp 25,000
TD051 CEK CHOLESTEROL Rp 29,750 Rp 5,250 Rp 35,000
TD052 CEK HB Rp 29,750 Rp 5,250 Rp 35,000
TD053 BEKAM Rp 63,750 Rp 11,250 Rp 75,000
TD054 BEKAM SELURUH BADAN Rp 127,500 Rp 22,500 Rp 150,000
KODE TINDAKAN BIAYA SARANA JASA
TD001 PEMERIKSAAN DOKTER UMUM Rp 25,000 Rp 10,000
TD002 PEMERIKSAAN DOKTER GIGI Rp 25,000 Rp 10,000
TD003 PEMERIKSAAN BIDAN Rp 15,000 Rp 5,000
TD004 TIND. INJEKSI Rp 4,000 Rp 6,000
TD005 HECTING 1-5 Rp 42,500 Rp 7,500
TD006 HECTING 6-10 Rp 85,000 Rp 15,000
TD007 HECTING > 10 Rp 102,000 Rp 18,000
TD008 AFF HECTING 1-5 Rp 21,250 Rp 3,750
TD009 AFF HECTING 6-10 Rp 42,500 Rp 7,500
TD010 AFF HECTING > 10 Rp 51,000 Rp 9,000
TD011 WT LUKA KECIL Rp 12,750 Rp 2,250
TD012 WT LUKA SEDANG Rp 21,250 Rp 3,750
TD013 WT LUKA BESAR Rp 29,750 Rp 5,250
TD014 WT CROSS INSISI Rp 68,000 Rp 12,000
TD015 DEBRIDEMENT LUKA KECIL Rp 25,500 Rp 4,500
TD016 DEBRIDEMENT LUKA SEDANG Rp 42,500 Rp 7,500
TD017 DEBRIDEMENT LUKA BESAR Rp 68,000 Rp 12,000
TD018 RAWAT COMBUTIO Rp 51,000 Rp 9,000
TD019 INSISI / EKSISI Rp 59,500 Rp 10,500
TD020 EKSTIRPASI Rp 59,500 Rp 10,500
TD021 IRIGASI MATA Rp 29,750 Rp 5,250
TD022 IRIGASI TELINGA Rp 29,750 Rp 5,250
TD023 EVAKUASI CORPAL ANAK Rp 51,000 Rp 9,000
TD024 EVAKUASI CORPAL DEWASA Rp 42,500 Rp 7,500
TD025 CIRCUMSISI ANAK Rp 255,000 Rp 45,000
TD026 CIRCUMSISI DEWASA Rp 382,500 Rp 67,500
TD027 NAEGEL EKSTRAKSI Rp 85,000 Rp 15,000
TD028 NEBULIZER Rp 55,250 Rp 9,750
TD029 PASANG CATETER Rp 17,000 Rp 3,000
TD030 PASANG INFUS ANAK Rp 17,000 Rp 3,000
TD031 PASANG INFUS BAYI Rp 25,500 Rp 4,500
TD032 PASANG INFUS DEWASA Rp 12,750 Rp 2,250
TD033 PASANG NGT Rp 34,000 Rp 6,000
TD034 PASANG SPALK Rp 17,000 Rp 3,000
TD035 PERSALINAN NORMAL Rp 1,200,000 Rp 200,000
TD036 TINDIK TELINGA Rp 29,750 Rp 5,250
TD037 GURAH VAGINA Rp 127,500 Rp 22,500
TD038 HECTING PERINEUM Rp 85,000 Rp 15,000
TD039 IMUNISASI Rp 21,250 Rp 3,750
TD040 LEPAS IMPLANT Rp 127,500 Rp 22,500
TD041 LEPAS IUD Rp 85,000 Rp 15,000
TD042 PAP SMEAR Rp 127,500 Rp 22,500
TD043 PASANG IMPLANT Rp 212,500 Rp 37,500
TD044 PASANG IUD Rp 170,000 Rp 30,000
TD045 SUNTIK KB 1 BULAN Rp 25,500 Rp 4,500
TD046 SUNTIK KB 3 BULAN Rp 29,750 Rp 5,250
TD047 TINDAKAN HPP Rp 85,000 Rp 15,000
TD048 TINDAKAN RESIKO PERSALINAN Rp 85,000 Rp 15,000
TD049 CEK GDS Rp 21,250 Rp 3,750
TD050 CEK ASAM URAT Rp 21,250 Rp 3,750
TD051 CEK CHOLESTEROL Rp 29,750 Rp 5,250
TD052 CEK HB Rp 29,750 Rp 5,250
TD053 BEKAM Rp 63,750 Rp 11,250
TD054 BEKAM SELURUH BADAN Rp 127,500 Rp 22,500
 TARIF
Rp 35,000
Rp 35,000
Rp 20,000
Rp 10,000
Rp 50,000 Rp 42,500 Rp 7,500 Rp 50,000
Rp 100,000 Rp 85,000 Rp 15,000 Rp 100,000
Rp 120,000 Rp 102,000 Rp 18,000 Rp 120,000
Rp 25,000 Rp 21,250 Rp 3,750 Rp 25,000
Rp 50,000 Rp 42,500 Rp 7,500 Rp 50,000
Rp 60,000 Rp 51,000 Rp 9,000 Rp 60,000
Rp 15,000 Rp 12,750 Rp 2,250 Rp 15,000
Rp 25,000 Rp 21,250 Rp 3,750 Rp 25,000
Rp 35,000 Rp 29,750 Rp 5,250 Rp 35,000
Rp 80,000 Rp 68,000 Rp 12,000 Rp 80,000
Rp 30,000 Rp 25,500 Rp 4,500 Rp 30,000
Rp 50,000 Rp 42,500 Rp 7,500 Rp 50,000
Rp 80,000 Rp 68,000 Rp 12,000 Rp 80,000
Rp 60,000 Rp 51,000 Rp 9,000 Rp 60,000
Rp 70,000 Rp 59,500 Rp 10,500 Rp 70,000
Rp 70,000 Rp 59,500 Rp 10,500 Rp 70,000
Rp 35,000 Rp 29,750 Rp 5,250 Rp 35,000
Rp 35,000 Rp 29,750 Rp 5,250 Rp 35,000
Rp 60,000 Rp 51,000 Rp 9,000 Rp 60,000
Rp 50,000 Rp 42,500 Rp 7,500 Rp 50,000
Rp 300,000 Rp 255,000 Rp 45,000 Rp 300,000
Rp 450,000 Rp 382,500 Rp 67,500 Rp 450,000
Rp 100,000 Rp 85,000 Rp 15,000 Rp 100,000
Rp 65,000 Rp 55,250 Rp 9,750 Rp 65,000
Rp 20,000 Rp 17,000 Rp 3,000 Rp 20,000
Rp 20,000 Rp 17,000 Rp 3,000 Rp 20,000
Rp 30,000 Rp 25,500 Rp 4,500 Rp 30,000
Rp 15,000 Rp 12,750 Rp 2,250 Rp 15,000
Rp 40,000 Rp 34,000 Rp 6,000 Rp 40,000
Rp 20,000 Rp 17,000 Rp 3,000 Rp 20,000
Rp 1,400,000 Rp 1,190,000 Rp 210,000 Rp 1,400,000
Rp 35,000 Rp 29,750 Rp 5,250 Rp 35,000
Rp 150,000 Rp 127,500 Rp 22,500 Rp 150,000
Rp 100,000 Rp 85,000 Rp 15,000 Rp 100,000
Rp 25,000 Rp 21,250 Rp 3,750 Rp 25,000
Rp 150,000 Rp 127,500 Rp 22,500 Rp 150,000
Rp 100,000 Rp 85,000 Rp 15,000 Rp 100,000
Rp 150,000 Rp 127,500 Rp 22,500 Rp 150,000
Rp 250,000 Rp 212,500 Rp 37,500 Rp 250,000
Rp 200,000 Rp 170,000 Rp 30,000 Rp 200,000
Rp 30,000 Rp 25,500 Rp 4,500 Rp 30,000
Rp 35,000 Rp 29,750 Rp 5,250 Rp 35,000
Rp 100,000 Rp 85,000 Rp 15,000 Rp 100,000
Rp 100,000 Rp 85,000 Rp 15,000 Rp 100,000
Rp 25,000 Rp 21,250 Rp 3,750 Rp 25,000
Rp 25,000 Rp 21,250 Rp 3,750 Rp 25,000
Rp 35,000 Rp 29,750 Rp 5,250 Rp 35,000
Rp 35,000 Rp 29,750 Rp 5,250 Rp 35,000
Rp 75,000 Rp 63,750 Rp 11,250 Rp 75,000
Rp 150,000 Rp 127,500 Rp 22,500 Rp 150,000