Daftar Harga Peralatan dan Obat RSIA

No. Nama Harga 74 Kanamicyn Inj 25,000 1 x 12 amp

1 Albumin 20 % 1,900,000 / vial 75 Kasa Gulung 20,000
2 Aminofluid 500 ml 150,000 76 Kasa Steril 20,000
3 Aminophylline Inj 15,000 1 x 30 Amp 77 Kasa Steril + Aquades 30,000
4 Ampisilin Inj 20,000 1 x 10 amp 78 Kenacort Inj 125,000 / vial
5 Antrain / Novalgin Inj 30,000 1 x 5 amp 79 Keterolac Inj 20,000 1 x 6 amp
6 Apron 10,000 100 bh 80 Kondom 2,000
7 Aquades 10,000 81 Laminaria ( utk kuret ) 140,000
8 Artesunat 1 Ampul 60,000 82 Lidocain 1 Amp 15,000 1 x 100 Amp
9 Asam Traneksamat Inj 20,000 83 Loroscorbion 150,000
10 Atropin Inj 20,000 1 x 100 84 Luminal Inj ( phenobarbital ) 20,000 1 x 30 Amp
11 Benang plain 2/0 300,000 85 Masker 3,000 1 x 50 pcs
12 Benang prolene 5/0 300,000 86 Masker Oksigen Bayi 30,000
13 Benang Prolene 7/0 300,000 87 Masker Oksigen Dewasa 30,000
14 Benang Proline 3/0 350,000 88 Metronidazole Infus 80,000 btl
15 Benang Slik 2/0 125,000 89 MGSO4 10,000 Surabaya
16 Benang Vicryl 3/0 150,000 90 Myomergin Inj 20,000
17 Bisturi 15,000 91 NaCL 30,000
18 Bledstop Inj 20,000 1 x 10 Amp 92 NaCL 100cc 28,000 1 x 25 btl
19 Bricasma Inj 35,000 1 x 5 vial 93 Neorobion Injeksi 1 Ampul 35,000 1 x 20 Amp
20 Brignat / Meylon Inj 35,000 /botol 94 Neorosanbe Inj 70,000
21 Busnacen Spinal 95,000 1 x 5 amp 95 NGT No.05 20,000
22 Cairan D10 1 fals 25,000 96 Novalgin Inj 30,000 1 x 5 amp
23 Cairan D5 1 fals 30,000 97 Oksigen /liter 1,000
24 Cairan RL 1 fals 30,000 98 Oksigen 1 Jam 90,000
25 Calcii Gluconas Inj 25,000 99 Omeprazole Inj 80,000 1x5
26 Canul 07 90,000 100 Ondansetron Inj 20,000 1 x 5 amp
27 Canul 08 90,000 101 Opsite 100,000 1 x 20
28 Cat Gut (benang operasi) 125,000 102 Pehaeain / Lidocaine 15,000
29 Catapras Inj 100,000 / amp 103 Pemakaian Obat Bius (utk Kuret) 400,000
30 Cateter 18 60,000 kuret / SC 104 Pethidin Inj 35,000 1 x 10 Amp
31 Cefazolin Inj 35,000 105 Phohem Inj 30,000 5 x 10
32 Ceftriaxon 25,000 106 Piton / Phytogin Inj / Oksitosin 20,000 1 x 10 Amp
33 Chromic 2/0 125,000 107 Pompa Asi 125,000
34 Cord klem 5,000 108 Pospargin Inj 20,000 1 x 10 Amp
35 Cosmofer Inj 175,000 1 x 5 amp 109 Primperan Inj 25,000 1 x 6 amp
36 CPZ Inj 20,000 110 Profenid Supp (=fetik) 20,000
37 CTG 75,000 111 Quinine Inj / Kina Inj 20,000 1 x 100 Amp
38 D5 10 20,000 112 Ranitidin Inj 10,000 1 x 10 amp
39 Daryant (=opsite) 50,000 1 x 10pcs 113 Recofol 125,000 1 x 5 amp
40 Decadryl Inj 30,000 114 Ruculax Inj 185,000 2 x 5 amp
41 Decamidon Inj 20,000 115 Salep Mata ( oxytetra ) 5,000
42 Dexametason Inj 20,000 1 x 100 Amp 116 Sarung 130,000
43 Diazepam Inj 25,000 1 x 30 Amp 117 Scopamin Inj ( Buscopan Inj ) 30,000 1 x 5 amp
44 Dot Susu 35,000 118 Selang Nasal O2 Bayi 20,000
45 Durogesic 12 25,000 / lbr 119 Selang Nasal O2 Dewasa 20,000
46 Endrolin Inj 1,800,000 120 Silet 8,000
47 Ephedrine Inj 50,000 121 Sinar Bayi / Foto therapy 75,000 /jam
48 Epineprin Inj 25,000 1 x 30 Amp 122 Softex 35,000 1 box
49 ETT 7,0 80,000 pcs 123 Spatel Kayu 5,000 / pcs
50 ETT 7,5 80,000 pcs 124 Spoit 10cc 10,000 1 x 100pcs
51 Farmadol Drip 110,000 botol 125 Spoit 1cc 10,000 1 x 100pcs
52 Femele Cateter No.16 20,000 1 x 100 pcs 126 Spoit 20cc 15,000 1 x 100pcs
53 Folly Cateter No. 16&18 ( operasi ) 60,000 1 x 10 pcs 127 Spoit 3cc 10,000 1 x 100pcs
54 Folly Cateter No. 8,10 ( SIS ) 60,000 1 x 10 128 Suction Chateter No.10 20,000 1 x 50 pcs
55 Folly Cateter No.10 ( SIS ) 60,000 1 x 10 pcs 129 Sucttion Cateter No. 6,7,8 (utk bayi) 25,000 1 x 50 pcs
56 Furosemid Inj 15,000 1 x 25 amp 130 Syinto 1 Amp 20,000
57 Gelang Bayi Biru / Pink 3,000 1 x 100 pcs 131 Topi Operasi 3,000 1 x 50 pcs
58 Gelang Dewasa 4,000 132 Tramadol Inj 20,000 1 x 5 amp
59 Gentamicin Inj 40,000 133 Tranfusi Set 30,000 SC
60 Gudel Karet 45,000 / pcs 134 Triway Stop Rock 25,000 1 x 50 pcs
61 Gurita 40,000 135 Underpad 20,000 1 x 10 pcs
62 Handsaplast 1,000 1 x 100 pcs 136 Urine Bag 10,000 1 x 10 pcs
63 Handscoen Gynekologi 60,000 137 Vaksin Hepatitis 2,500,000
64 Handscoen Non Steril 10,000 138 Venflon 18 30,000 1 x 50 pcs
65 Handscoen Steril 20,000 139 Venflon 20 30,000 1 x 50 pcs
66 Hipafix 5 x 5 100,000 1 x 50 pcs 140 Venflon 22 ( anak ) 40,000 1 x 50 pcs
67 hypafix 10 x 5 150,000 10 x 5 141 Venflon 24 (utk bayi) 40,000 1 x 100 pcs
68 hypafix 15 x 5 210,000 142 Vik K / Neo K 25,000 1 x 5 amp
69 Infus Set Makro ( Dewasa ) 30,000 1 x 50 pcs 143 Vitamin C Inj 20,000 1 x 100 Amp
70 Infus Set Mikro ( Bayi ) 35,000 Surabay 144 Waslap 20,000
71 Inkubator 300,000 Per hari 145 WI 25cc (OTS WI) 10,000 Surabaya
72 KAEN MG3 15,000 1 x 10 vial 146 Widahes 100,000 btl
73 Kalnetason Inj(=Dexa) 15,000
 Pemerikasaan Lab

1 CT / BT (Pembekuan darah) 25,000

2 DDR 25,000
3 Darah Lengkap 75,000
4 GDS 25,000
5 Urine Rutin 30,000
6 Golda 30,000
7 Analisa Sperma 50,000
8 Hepatitis (Hbsag) 50,000
9 EKG 75,000

Tindakan

1 Pasang Spiral 5 thn (Nova T) 750,000

2 Pasang Spiral 7 thn 500,000
3 PA 750,000
4 Papsmear 500,000
5 Lepas Spiral + Implan 250,000
6 USD 4 D 350,000
7 USD CD 375,000
8 USD CD + Print Warna 450,000
9 GV 100,000
10 Saline InfusionSonografi (SIS) 550,000

SUSU

1 BMT Lactoferin 200 GR 55,000

2 BMT Lactoferin 400 Gr 90,000
3 BMT Lactoferin 800 Gr 160,000
4 BMT Platinum 400 Gr 120,000
5 BMT Platinum 800 Gr 230,000
6 Prenagen Emesis Coklat 200 Gr 50,000
7 Prenagen Esensis Coklat 360g 55,000
8 Prenagen Esensis Plain 200g 40,000
9 Prenagen Esensis Vanila 200g 40,000
10 Prenagen Lactamom Coklat 200g 40,000
11 Prenagen Mommy Coklat 400 Gr 70,000
12 Prenagen Mommy Strawbery 400 Gr 70,000
13 Prenagen Momy Coklat 200g 40,000
14 Prenagen Momy Vanila 200g 40,000
 Daftar Obat Apotek Farmika

No. Nama Obat Harga Ket

1 Interpril 5 mg 5,000 3 x 10
2 Interpril 10 mg 7,000 3 x 10
3 Myobat 5,000 5 x 10
4 Lapras 15,000 2 x 10
5 Zycin 30,000 1x3
6 Mucottusan 2,500 10 x 10
7 Lodia 2,000 6 x 10
8 Ostelox 13,000 2 x 10
9 Bisoprolol 4,000 3 x 10
10 Cetirizine 1,000 2 x 10
11 Inflamide 215,000 btl
12 Cardisan 5mg 8,000 5 x 10
13 Mefinter 3,000 25 x 4
 Rincian Tindakan Dokter

1 Sunat 500,000 ( diluar obat minum)

Sunat di OK 750,000
500,000 dr.Anastesi (diluar alkes+obat)
2 Nebu / Asap 100,000 ( diluar obat minum)

3 GO 500,000 ( termsk jasa dokter dan obat2:

1. Ganamicyn Inj 2 amp
2. Aquades 1 btl
3. Cipro 10 tab
4. Golmun 6 tab
Kelebihan obat dikenakan biaya

4 Jahit Luka 125,000 Jasa Dokter, diluar alkes dan obat

5 Tindik telinga 50,000

6 VT 50,000

7 Suntik KB 1 bln 30,000

8 Suntik KB 3 bln 25,000

9 Suntik TT 20,000

10 Jasa racik obat 40,000 ( diluar harga obat )

11 Jasa Bidan Suntik 20,000

12 Imunisasi 25,000
13 Imunisasi Influenza 375,000 ( Hyberix )
14 Imunisasi Sinflorix 900,000 (+konsul dokter anak) Radang Otak
15 Hepatitis B 2,750,000

* untuk jasa tindakan jahit luka (konsultasi dengan dokter ttg kesulitan tindakan)

Rincian Tindakan Kuret:

1.Kanul 90,000
2.Dispo 10cc 10,000
3.Lidocain Inj 30,000
4.Fetik Sup 30,000
5.Alprazolam 10,000
6.Handscoen Steril 20,000
7.Handscoen Non S 10,000
8.Jasa Kuret 1,800,000
9.Underpad 20,000
(+) obat minum

Rincian Tindakan SIS:

1. Jasa SIS 550,000
2. Folly Cateter 50,000
3. Fetik 40,000 2 supp
4. Lidocain 30,000 2 amp
5. Handscoen Steril 20,000
6. Handscoen Non Steril 10,000
7. Underpad 15,000
8. Dispo 10cc 10,000
9. Dispo 3cc 10,000
10.Kondom 2,000
 184 Mefinal / Dentacid 3,500 10 x 10 274 Sonoskin Melladerm 207,000 5 x 10
185 Meloxicam 15 mg 6,000 5 x 10 275 Spiramycin 500 4,000 10 x 10
186 Mertigo 7,000 10 x 10 276 Spironolacton 4,000 1x5
187 Metformin 500 2,500 10 x 10 277 Stesolid 10 mg 81,000 1x5
188 Metformin 850 mg 3,500 10 x 10 278 Stesolid 5 mg 58,000 2 x 10
189 Methylprednisolone 1,500 10 x 10 279 Strocain 3,500 10 x 6
190 Metoclorpamide (Vosea) 2,000 10 x 10 280 Suldox 6,000 1 x 10
191 Metronidazole 500 mg 3,000 10 x 10 281 Telfas 41,000 1 x 12
192 Meylon 25cc 25,000 3x1 282 Termometer 18,000 1 x 50
193 Microginon 3,000 1 x 28 283 Tespek Acon 18,000 / btl
194 Microlax 35,000 3x1 284 Tilidon syr (vasedon) 87,000 /btl
195 Minyak Telon 29,000 285 Torasic 10 mg 19,000 1 x 6 amp
196 Molakrim 30 gram 23,000 1 tube 286 Tramadol Capsul 2,000 1 x 10
197 Motilex 3,500 10 x 10 287 Tramadol Supp (Dolona Sup) 37,000 tube
198 Mucera Drop 15 ml 58,000 /btl 288 Tranfulmin Salep 92,000 10 x 10
199 Mucos Drop 63,500 /btl 289 Tremenza Tab ( librofed ) 5,000 / btl
200 Mucotein Syr 75,000 290 Triaminic batuk 75,000 btl
201 Mucotein tab 11,000 2 x 10 291 Triaminic Ekspetoran 75,000 / btl
202 Mucotussan 29,000 10 x 10 292 Triaminic pilek 75,000 10 x 10
203 Mustella 702,000 /tube 293 Trichodazole 3,000 5 x 30
204 Myconazole Cream 12,000 1 x 24 tube 294 Trombo Aspilets 2,500 / tube
205 Myco-Z 173,000 tube 295 Trombophop Cream 92,000 3 x 10
206 Mylanta Syr 52,000 / btl 296 Urdahex 23,000 10 x 10
207 Myobat 8,000 5 x 10 297 Urinter 8,000
208 Napros 20 mg 13,000 3 x 10 298 Vaksin Flu Dewasa (Flu Bio) 345,000 u/ Dewasa
209 Natrium Diclofenat 25mg 2,000 5 x 10 299 Vaksin Hepatitis B (Engerix Inj) 230,000 utk Anak
210 Natrium Diclofenat 50mg 2,500 5 x 10 300 Vaksin Hepatitis B (Engerix Inj) 230,000 / pcs
211 Neorobat tab 3,500 10 x 10 301 Vaksin HPV 1,150,000
212 Nepatic Gabapentin 12,000 5 x 10 302 Vaksin Influenza Hyberix ( Hyberix ) 432,000 Hyberix
213 Neurodex 3,500 10x20 303 Vaksin MMR 288,000
214 Neurosanbe 4,000 10 x 10 304 Vaksin Radang Otak (Sinflorix) 1,035,000 Sinflorix
215 Nexium Tab 35,000 4x7 305 Vectrin Syr 98,000 / btl
216 Nifedipin 1,500 10 x 10 306 Vectrine 300 mg 12,000 2 x 10
217 Norelut 8,000 10 x 10 307 Ventolin Inhaler 190,000 / btl
218 Norit tab 1,500 12 x 40 308 Ventolin Nebules 29,000 4 x 5 vial
219 Novaclor tab (Farsycol) 2,000 10 x 10 309 Vipalbumin 12,000 3 x 10
220 Nufadol Syr (Paracetamol Syr) 23,000 310 Vipalmubin Syr 46,000 1 x 3
221 OB Herbal 23,000 1 x 48 311 Visanne 650,000 /box 2strip
222 Omeprazole 20 mg 2,500 3 x 10 312 Visine 23,000 1 x 12 btl
223 Omeproxil (Ciproflocaxin) 2,500 1 x 10 313 Vit C whitening 403,000 1 x 10 amp
224 Ondansentron tab 6,000 2x6 314 Vitamin A 1,500 1 x 50 tab
225 Oralit 2,000 1 x 100 sacet 315 Vitamin B6 1,500 1 x 1000
226 Ossoral 2,500 6x10 316 Vitamin C tab 1,500 1x1000tab
227 Oste Forte 17,500 10 x 6 317 Voltaren 20 g (Voltadex) 92,000 / tube
228 Osteoflam 12,000 30 cap 318 Vometa Drop 92,000 / btl
229 Osteopor 10,000 btl 319 Vometa Syr 87,000
230 Ottopain Tetes Telinga 72,000 10 x 10 320 Vomilat Tab 3,000 3 x 10
231 Ottoprim Forte 2,500 1 x 25 321 Vosedon syr 87,000 /btl
232 Oxytetra (Salep mata) 6,000 / btl 322 Zentarin syr (Ibuprofen syr) 12,000
233 Pamol drop 35,000 /btl 323 Zinc 200mg tab 2,000 10 x 10
234 Pamol syr 29,000 /btl 324 Zincpro Syrup 58,000 / btl
235 Pamol Tab 1,500 10 x 10 325 Zycin 250 mg 29,000 2x4
236 Paracetamol tab 1,000 30 cap 326 Zycin 500 mg 46,000 1x3
237 Parasetamol syr 18,000 327
238 PIL KB 29,000 1 x 12 328
239 PK Powder 10,000 10 x 10 329
240 Plasminex (Kalnex) 10,000 10x10 330
241 Predison 1,500 4 x 25 331
242 Prenamia 2,500 4 x 25 332
243 Prenatin DF 4,000 5 x 10 333
244 Prestrenol 7,000 / btl 334
245 Primadex Syr 12,000 10 x 10 335
246 Primadex Tab 2,500 1x1000tab 336
247 Primaquine 15 mg 1,500 / btl 337
248 Primperan tab (Sotatic) 2,000 10x10
249 Propepsa Syrup 115,000 10 x 10
250 propranolol 10 mg 1,500 25 x 4
251 Pyrantel 125 mg 2,500 / btl
252 Pyrantel Syr (Konvermex) 23,000 3 x 10
253 Qidrox 15,000 3 x 10
254 Ranitidin Tab 2,500 / btl
255 Reco Tetes Mata 17,500 3 x 10
256 Recolfar 12,000 / btl
257 Renasistin Drop 98,000
258 Rhinos Drop 81,000
259 Rhinos Syr 58,000 5 x 10
260 Rhinos tab 12,000 10 x 10
261 Rhitez 10mg 9,000 3x10
262 Salbutamol 2mg 1,500 10x10
263 Salbutamol 4mg 2,000 10x10
264 Sangobion 3,000 25x10
265 Sanmag 2,500 / btl
266 Sanmag Syr 52,000 / btl
267 Sanmol Drop 29,000 / btl
268 Sanmol Syrup 29,000 25 x 4 tab
269 Sanmol Tab 1,500 tube
270 Scabimite 58,000 5 x 10
271 Simvastatin 8,000 / pak
272 Softex 41,000 / pack
273 Softex (Satuan) 6,000 / pcs

Ketr : Harga dapat berubah sewaktu-waktu tanpa pemberitahuan terlebih dahulu

 Biaya Pemeriksaan PAKET

1 Aff Spiral 250,000

2 Aff Susuk 300,000
3 Ganti Verban / Aff Hechting 200,000
4 Imunisasi Hyberix 900,000 (+ konsul Dr.Afdal)
5 Imunisasi Influenza 375,000
6 Inj. TT 20,000
7 Jahit Luka 125,000 Jasa Dokter, diluar alkes dan obat
8 KB 1 Bulan 30,000
9 KB 3 Bulan 25,000
10 Konsultasi 125,000
11 Kuret Poliklinik 1,800,000 Di Luar Obat
12 LC-Prep 1,000,000
13 Pap'Smear 750,000
14 Pasang Spiral Cu T 500,000
15 Pasang Spiral Nova T 750,000
16 Pasang Susuk / Implant 300,000
17 Pemeriksaan Ginekologi + Konsultasi 250,000
18 SIS 700,000
19 Sunat Laser 750,000 Di Luar Obat
20 USG 2D + Konsultasi 250,000
21 USG 4D + Konsultasi 450,000
22 USG 4D + Konsultasi 375,000 Tanpa CD
23 USG Abdomen 2D + Konsultasi 300,000

Jasa & Tindakan Dokter UMUM

1 Hecting <5 Jahitan 150,000

2 Hecting 5-10 Jahitan 200,000
3 Hecting >10 Jahitan 275,000
4 Aff hecting ( Lepas Jahitan ) & Rawat Luka 150,000
5 Rawat Luka Ekstonasi ( Luka Kecil ) 75,000
6 Spooling Telinga 150,000
7 Epistaksis + Tampon Kateter ( pasang kateter lwt hidung ) 100,000

NB : Di luar AlKes yang digunakan

es dan obat
 PEMERIKSAAN LAB

No Keterangan Harga 45 Secret Vagina / Gram Stain 100,000

1 Alkaline Phosphatase / ALKP 40,000 46 Albumin 35,000
2 Analisa Sperma 60,000 47 Globulin 30,000
3 Anti HBs 70,000 48 HBA 1 C 295,000
4 Anti HCV ( Hepatitis C Virus ) 70,000 49 Racio Cholestrol
5 Bilirubin Direk 40,000 50 Lab Prodia B-HCG 1,000,000
6 Bilirubin Indirek 40,000 51 HB Meter 30,000
7 Bilirubin Total 45,000 52 PSA / Prostat Spesific Antigen 90,000
8 Blood Gass / Astrup 270,000 53
9 BSN / Puasa 30,000
10 BSPP / Post Prandial 30,000
11 BSS / GDS 30,000
12 Ca ( Calium ) 30,000
13 Cholestrol 40,000 SUSU
14 CK-MB 85,000
15 CL ( Clorida ) 60,000 1 BMT Lactoferin 200 GR 55,000
16 CPK 105,000 2 BMT Lactoferin 400 Gr 110,000
17 Creatinine 40,000 3 BMT Lactoferin 800 Gr 160,000
18 Creatinine Clearance 75,000 4 BMT Platinum 400 Gr 120,000
19 CT/BT 30,000 5 BMT Platinum 800 Gr 230,000
20 Darah Lengkap ( DL ) 75,000 6 Mom & Me (Hamil) 55,000
21 DDR 25,000 7 Prenagen Emesis Coklat 200g (Mual muntah) 55,000
22 DDR ( Pake Stick / RDT ) 35,000 8 Prenagen Emesis Coklat 400g 80,000
23 EKG 150,000 9 Prenagen Esensis 180g (Program) 55,000
24 Golda 35,000 10 Prenagen Esensis Coklat 360g 55,000
25 GTT 70,000 11 Prenagen Esensis Plain 200g 55,000
26 HBeAg 100,000 12 Prenagen Esensis Vanila 200g 55,000
27 HBs Ag 70,000 13 Prenagen Lactamom Coklat 200g (Menyusui) 55,000
28 HDL Cholesterol 100,000 14 Prenagen Momy Coklat 200g (Hamil) 55,000
29 HIV 150,000 15 Prenagen Momy Coklat 400g 70,000
30 K ( Kalium ) 60,000 16 Prenagen Momy Strawbery 400g 70,000
31 LDH 70,000 17 Prenagen Momy Vanila 200g 55,000
32 LDL Cholesterol 100,000 18 BMT P - HP 400g (Alergi susu) 0 - 6 bulan 150,000
33 LFT (Fungsi Hati) Bilirubin Direk / Indirek, 240,000 19 BMT P - HP 800g (Alergi susu) 270,000
Albumin, Globulin, SGOT, SGPT, GGT, Alkali Forfatase 20 Chil Kid P - HP 400g (Alergi Susu) 1 - 3 Tahun 135,000
34 Na ( Natrium ) 60,000 21 Chil Mil P - HP 400g (Alergi susu) 7 - 11 bulan 150,000
35 Protein Total 40,000 22 HBA 1 C
36 RFT 75,000 23 Chil Kid 800g 260000
37 SGOT 75,000 24 Entrasol 200g 45,000
38 SGPT 75,000
39 Total Lipid / Lemak Darah 280,000
40 Triglycerids 40,000
41 Troponin T ( Rapid ) 265,000
42 Ureum 40,000
43 Urid Acid ( Asam Urat ) 40,000
44 Urine Lengkap (UL) 40,000
 SUSU

1 BMT Lactoferin 200 GR 50,000

2 BMT Lactoferin 400 Gr 90,000
3 BMT Lactoferin 800 Gr 160,000
4 BMT Platinum 400 Gr 120,000
5 BMT Platinum 800 Gr 230,000
6 Mom & Me (Hamil) 50,000
7 Prenagen Emesis Coklat 200g (Mual muntah) 50,000
8 Prenagen Emesis Coklat 400g 80,000
9 Prenagen Esensis 180g (Program) 50,000
10 Prenagen Esensis Coklat 360g 55,000
11 Prenagen Esensis Plain 200g 50,000
12 Prenagen Esensis Vanila 200g 50,000
13 Prenagen Lactamom Coklat 200g (Menyusui) 50,000
14 Prenagen Momy Coklat 200g (Hamil) 50,000
15 Prenagen Momy Coklat 400g 70,000
16 Prenagen Momy Strawbery 400g 70,000
17 Prenagen Momy Vanila 200g 50,000
18 BMT P - HP 400g (Alergi susu) 0 - 6 bulan 150,000
19 BMT P - HP 800g (Alergi susu) 270,000
20 Chil Kid P - HP 400g (Alergi Susu) 1 - 3 Tahun 135,000
21 Chil Mil P - HP 400g (Alergi susu) 7 - 11 bulan 150,000
22
23
DAFTAR HARGA PASIEN KERJASAMA RAWAT JALAN

TINDAKAN URAIAN HARGA

ADM LAMA / BARU 25,000
Dokter Spesialis 125,000
USG USG 2 D 150,000
USG 4 D 450,000
Dokter Spesialis 125,000
GV
GV 125,000
UMUM Dokter Umum 100,000
Dokter Umum 100,000
UGD lbh dr jam 9 mlm
UGD 75,000
Dokter Spesialis 125,000
SIS
Tindakan SIS 700,000
Dokter Spesialis 125,000
KURET
Tindakan Kuret 1,800,000