RS.

PERMATA BUNDA

DATA PRODUK TARIP/KOMPONENT

PEMERIKSAAN RADIOLOGI / RONTGEN.

Kode Produk Tindakan Sim Tarif Baru Js. RS. Tarip

Unit : RAWAT INAP
Sub Unit : CYTO
Kelas : VVIP
ROCVV01 THORAKAL AP, L, O( Rel ) 24 X 30 0.00
ROCVV02 THORAX 18 X 24 (ANAK) 191,000.00 165,625 165,625
ROCVV03 THORAX 24 X 30 0.00
ROCVV04 THORAX 30 X 40(DEWASA) 209,000.00 181,250 181,250
ROCVV05 THORAX 35 X 35 0.00
ROCVV06 THORAX AP & L 18 X 24(ANAK) 225,000.00 195,313 195,313
ROCVV07 THORAX AP & L 24 X 30 0.00
ROCVV08 THORAX AP & L 30 X 40(DEWASA) 256,000.00 221,875 221,875
ROCVV09 THORAX AP & L 35 X 35 0.00
ROCVV10 ABDOMEN 18 X 24(ANAK) 195,000.00 168,750 168,750
ROCVV11 ABDOMEN 24 X 30 0.00
ROCVV110 Brain/head/orbita/kepala non kontras 1,688,000.00 1,125,000 1,125,000
ROCVV111 Brain/head/orbita/kepala dg kontras 3,282,000.00 2,188,000 2,188,000
ROCVV112 Abdomen/thorax non kontras 2,532,000.00 1,688,000 1,688,000
ROCVV113 Abdomen/thorax dg kontras 5,485,000.00 3,657,000 3,657,000
ROCVV114 Leher/cervical/nasofaring non kontras 2,322,000.00 1,548,000 1,548,000
ROCVV115 Leher/cervical/nasofaring dg kontras 5,063,000.00 3,375,000 3,375,000
ROCVV116 Lumbal/extremitas/pelvis/sinus/non kontras 2,428,000.00 1,618,000 1,618,000
ROCVV117 Sinus dg kontras 5,063,000.00 3,375,000 3,375,000
ROCVV118 3D Facial bone/cervical/thoracal/lumbal 3,587,000.00 2,392,000 2,392,000
ROCVV119 PEDIS AP & OB DEWASA 216,000.00 187,500 187,500
ROCVV12 ABDOMEN 30 X 40 214,000.00 185,938 185,938
ROCVV13 ABDOMEN 2 POSISI 18 X 24(ANAK) 225,000.00 195,313 195,313
ROCVV14 ABDOMEN 2 POSISI 24 X 30 0.00
ROCVV15 ABDOMEN 2 POSISI 30 X 40 (DEWASA) 256,000.00 212,875 212,875
ROCVV16 ABDOMEN 3 POSISI (ANAK) 306,000.00 265,625 265,625
ROCVV17 ABDOMEN 3 POSISI (DEWASA) 0.00
ROCVV18 ABDOMEN 3 POSISI 30 X 40 (DEWASA) 338,000.00 293,750 293,750
ROCVV19 PELVIS 24 X 30(ANAK) 195,000.00 168,750 168,750
ROCVV20 PELVIS 30 X 40 (DEWASA) 214,000.00 185,938 185,938
ROCVV21 FEMUR AP & L 24 X 30 (ANAK) 211,000.00 182,813 182,813
ROCVV22 FEMUR AP & L 30 X 40 (DEWASA) 216,000.00 187,500 187,500
ROCVV23 GENU AP & L 211,000.00 182,813 182,813
ROCVV24 CRURIS AP & L 24 X 30 (ANAK) 195,000.00 168,750 168,750
ROCVV25 CRURIS AP & L 30 X 40 (DEWASA) 216,000.00 187,500 187,500
ROCVV26 ANKLE JOINT AP & L 195,000.00 168,750 168,750
ROCVV27 PEDIS AP & OB ANAK 193,000.00 167,188 167,188
ROCVV28 KLAVIKULA AP 193,000.00 167,188 167,188
ROCVV29 SHOULDER JOINT AP & L 211,000.00 182,813 182,813
ROCVV30 HUMERUS AP & L 211,000.00 167,188 167,188
ROCVV31 ART. CUBITI AP & L 18 X 24 193,000.00 163,000 163,000
ROCVV32 ART. CUBITI AP & L 24 X 30 0.00
ROCVV33 ANTEBRACI AP & L 193,000.00 167,188 167,188
ROCVV34 WRIST JOINT AP & L 193,000.00 167,188 167,188
ROCVV35 MANUS AP & L 18 X 24(ANAK) 193,000.00 167,188 167,188
ROCVV36 MANUS AP & L 24 X 30 (DEWASA) 216,000.00 187,500 187,500
ROCVV37 CERVIKAL AP & L 225,000.00 195,313 195,313
ROCVV38 CERVIKAL AP, L, OB 351,000.00 304,688 304,688
ROCVV39 THORAKAL AP & L 24 X 30 0.00
ROCVV40 THORAKAL AP & L 30 X 40 256,000.00 221,875 221,875
ROCVV41 THORAKAL AP, L, O( Rel ) 30 X 40 351,000.00 304,688 304,688
ROCVV42 LUMBAL AP & L 256,000.00 221,875 221,875
ROCVV43 LUMBOSAKRAL AP, L, O 351,000.00 195,313 195,313
ROCVV44 KRANIUM AP & L 225,000.00 195,313 195,313
ROCVV45 TOWNE`S 225,000.00 195,313 195,313
ROCVV46 SCHULLER R & L 225,000.00 195,313 195,313
ROCVV47 MANDIBULA AP 195,000.00 168,750 168,750
ROCVV48 MANDIBULA AP & L 225,000.00 195,313 195,313
ROCVV49 EISHLER R & L 225,000.00 195,313 195,313
ROCVV50 WATER`S 187,000.00 168,750 168,750
ROCVV51 BNO - IVP ( UROGRAFIN ) 0.00
ROCVV52 OMD 656,000.00 570,313 570,313
ROCVV53 OESOPHAGUS 381,000.00 570,313 570,313
ROCVV54 COLON IN LOOP ( BaSo4 ) 658,000.00 532,000 532,000
ROCVV55 COLON IN LOOP ( Urografin ) 0.00
ROCVV56 BNO - IVP (OPTIRAY) 0.00
ROCVV57 URETHROCYSTOGRAFI RETROGR 795,000.00 690,625 690,625
ROCVV58 FISTULOGRAFI 602,000.00 523,438 523,438
ROCVV59 HSG 0.00
ROCVV60 CYSTOGRAFI / URETHROCYSTOGR 575,000.00 500,000 500,000
ROCVV61 APPENDIKOGRAM 301,000.00 260,938 260,938
ROCVV62 BaSo4 / 100 GR 100,000.00
ROCVV63 UROGRAFIN / AMP 0.00
ROCVV64 Iopamiro / 10 ml 90,000.00 71,500 71,500
ROCVV65 BIAYA ADMINISTRASI 2,500.00 2,500 2,500
ROCVV91 CACANEUS AP 24X30 0.00
ROCVV92 CACANEUS AP,R&L 24X30 195,000.00 168,750 168,750
ROCVV93 NASAL AP&L 24X30 225,000.00 195,313 195,313
ROCVV94 NASAL L 18X24 191,000.00 165,625 165,625
ROCVV95 COLON IN LOOP (IOPAMIRO) 935,000.00 812,500 812,500
lumbal ap/lat/ob 351,000.00
sacrum ap/lat 225,000.00
lumbosacral ap/lat 351,000.00
SPN 225,000.00
PANORAMIK 214,000.00
1X EKSPOSE/FILM 20X26 80,000.00
1X EKSPOSE/FILM 26X30 90,000.00
1X EKSPOSE/FILM 35X43 100,000.00
THORACOLUMBAL AP/LAT 256,000.00
THORACOLUMBAL AP/LAT/OB 351,000.00
PEMBACAAN CT SCAN 50,000.00
PEMBACAAN RO 22,500.00