RS ISLAM NAMIRA

JLN. KH. AHMAD DAHLAN. NO 17 PANCOR, SELONG, NTB

0376 (21004)
E-mail : namira_klinik@yahoo.com

DATA TARIF LABORATORIUM

Kode Nama Pemeriksaan J.S.Rumah Sakit Paket BHP J.M.Perujuk J.M. Dokter J.M. Petugas K.S.O Menejemen Total Tarif
A01 DL (Automatis) 60,000 0 0 0 0 0 0 60,000
A02 CT/BT 18,000 0 0 0 0 0 0 18,000
A03 Malaria 24,000 0 0 0 0 0 0 24,000
B01 Widal 30,000 0 0 0 0 0 0 30,000
B02 Glukose sewaktu 30,000 0 0 0 0 0 0 30,000
B03 Glukose puasa 30,000 0 0 0 0 0 0 30,000
B04 Glukose.2JPP 30,000 0 0 0 0 0 0 30,000
J000002 Haemoglobin 60,000 0 0 0 0 0 0 60,000
J000003 Leukosit 8,500 0 0 0 0 0 0 8,500
J000004 LED 8,500 0 0 0 0 0 0 8,500
J000005 Diff. Count 8,500 0 0 0 0 0 0 8,500
J000006 Trombosit 60,000 0 0 0 0 0 0 60,000
J000007 PCV 8,500 0 0 0 0 0 0 8,500
J000008 Erytrosit 8,500 0 0 0 0 0 0 8,500
J000009 Gol. Darah 30,000 0 0 0 0 0 0 30,000
J000011 BIL.BAYI < 5 Hari 35,000 0 0 0 0 0 0 35,000
J000017 Trygliserida 48,000 0 0 0 0 0 0 48,000
J000018 Asam Urat 42,000 0 0 0 0 0 0 42,000
J000019 SGOT 28,000 0 0 0 0 0 0 28,000
J000020 SGPT 28,000 0 0 0 0 0 0 28,000
J000021 Alkali Phosphatase 36,000 0 0 0 0 0 0 36,000
J000022 Billirubin 42,000 0 0 0 0 0 0 42,000
J000023 Ureum 32,500 0 0 0 0 0 0 32,500
J000024 Creatinin 32,500 0 0 0 0 0 0 32,500
J000026 Albumin 30,000 0 0 0 0 0 0 30,000
J000027 DENGUE (NS1 Ag) 250,000 0 0 0 0 0 0 250,000
J000028 HDL 30,000 0 0 0 0 0 0 30,000
J000029 LDL 18,000 0 0 0 0 0 0 18,000
J000031 HBsAG 36,000 0 0 0 0 0 0 36,000
J000032 PP. Tes 18,000 0 0 0 0 0 0 18,000
J000033 VDRL / TPHA 90,000 0 0 0 0 0 0 90,000
J000034 Anti H. Phylori 132,000 0 0 0 0 0 0 132,000
J000035 DENGUE/IGG, IGM 300,000 0 0 0 0 0 0 300,000
J000036 Globulin 12,000 0 0 0 0 0 0 12,000
J000037 Rematoid Faktor 60,000 0 0 0 0 0 0 60,000
J000038 FT4 368,500 0 0 0 0 0 0 368,500
J000039 Electrolite 302,000 0 0 0 0 0 0 302,000
J000040 BTA 24,000 0 0 0 0 0 0 24,000

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Kode Nama Pemeriksaan J.S.Rumah Sakit Paket BHP J.M.Perujuk J.M. Dokter J.M. Petugas K.S.O Menejemen Total Tarif
J000041 GRAM 24,000 0 0 0 0 0 0 24,000
J000042 FL 24,000 0 0 0 0 0 0 24,000
J000043 URINE LENGKAP 30,000 0 0 0 0 0 0 30,000
J000046 GDS 30,000 0 0 0 0 0 0 30,000
J000048 Cholestrol 42,000 0 0 0 0 0 0 42,000
J000050 DARAH SAMAR (FOB) 175,000 0 0 0 0 0 0 175,000
J000051 Anti HCV (ICT) 125,000 0 0 0 0 0 0 125,000
J000054 Protein Urine 30,000 0 0 0 0 0 0 30,000
J000055 TOTAL PROTEIN 30,000 0 0 0 0 0 0 30,000
J000056 ENDOKRINOLOGI 35,000 0 0 0 0 0 0 35,000
J000057 HDT 285,000 0 0 0 0 0 0 285,000
J000061 B HCG 798,000 0 0 0 0 0 0 798,000
J000062 ANA TES 939,000 0 0 0 0 0 0 939,000
J000063 CALCIUM 0 0 0 0 0 0 0 160,000
J000064 ANTI ds DNA NCx 782,000 0 0 0 0 0 0 782,000
J000065 ft4 prodia 443,000 0 0 0 0 0 0 443,000
J000066 TSHS prodia 348,000 0 0 0 0 0 0 389,000
J000067 sypilis 0 0 0 0 0 0 0 90,000
J000068 Anti HBs 84,000 0 0 0 0 0 0 84,000
J000072 TROPONIN 911,000 0 0 0 0 0 0 911,000
J000073 FT3 538,000 0 0 0 0 0 0 538,000
J000074 T3 352,000 0 0 0 0 0 0 352,000
J000075 TSHS 160,000 0 0 0 0 0 0 120,000
J000076 LDH 178,000 0 0 0 0 0 0 178,000
J000077 HBA1C 216,000 0 0 0 0 0 0 216,000
J000078 ADENOSINE DIAMINASE (ADA) 0 562,000 0 0 0 0 0 562,000
J000079 NAPZA 0 210,000 0 0 0 0 0 210,000
J000080 T4 0 0 0 0 0 0 0 352,000
J000081 Plasma Protrombin Time 0 0 0 0 0 0 0 186,000
J000082 INR 0 0 0 0 0 0 0 571,000
J000083 Kalsium 0 0 0 0 0 0 0 151,000
J000084 Pap smear 0 0 0 0 0 0 0 392,000
J000085 igra 0 0 0 0 0 0 0 1,035,000
J000086 FERRITIN 413,000 0 0 0 0 0 0 413,000
J000088 tibc 0 0 0 0 0 0 0 204,000
J000089 NLR 0 0 0 0 0 0 0 0
J000090 ALC 0 0 0 0 0 0 0 0
J000092 Rapid test antibody 60,000 0 0 0 0 0 0 60,000
J000094 PROGESTERON 0 0 0 0 0 0 0 607,500
J000095 ESTROGEN TOTAL 0 0 0 0 0 0 0 1,793,500
J000096 RAPID ANTIBODY 0 0 0 0 0 0 0 150,000
J000097 HBA1C 216,000 0 0 0 0 0 0 216,000
J000098 retikulosit 80,000 0 0 0 0 0 0 80,000
J000099 HIV Immuno Chromatografhic 0 0 0 0 0 0 0 0
J000100 Anti Hiv 0 0 0 0 0 0 0 500,000
J000101 Rapid Test Antigen 55,000 0 0 0 0 0 0 55,000

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Kode Nama Pemeriksaan J.S.Rumah Sakit Paket BHP J.M.Perujuk J.M. Dokter J.M. Petugas K.S.O Menejemen Total Tarif
J000102 hepatitis C 0 0 0 0 0 0 0 96,000
J000103 HVP DNA 0 0 0 0 0 0 0 749,000
J000104 genose 0 0 0 0 0 0 0 40,000
J000105 Eosinofil % 33,000 0 0 0 0 0 0 33,000
J000106 Se Serum 398,000 0 0 0 0 0 0 398,000
J000107 Fe Serum 445,000 0 0 0 0 0 0 445,000
J000108 UIBC Direk 205,000 0 0 0 0 0 0 205,000
J000110 Transferin 562,000 0 0 0 0 0 0 562,000
J000112 TSHS Rsud 323,500 0 0 0 0 0 0 323,500
J000113 TCM 0 0 0 0 0 0 0 0
J000114 PCR 300,000 0 0 0 0 0 0 300,000
J000115 Pemeriksaan PA Kecil 450,000 0 0 0 0 0 0 450,000
J000116 Pemeriksaan PA Sedang 600,000 0 0 0 0 0 0 600,000
J000117 Pemeriksaan PA Besar 800,000 0 0 0 0 0 0 800,000
J000118 PA Radikalis 1,000,000 0 0 0 0 0 0 1,000,000

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