Rawat Inap Januari 2014

470 3,313,500
120 581,400
2 5,700
45 108,000
3 27,360
-
118 336,300
75 213,750
-
43 110,940
-
43 161,250
-
43 64,500
-
43 64,500
-
42 258,300
-
1 1,800
-
1 2,016
-
-
-
20 630,000
30 756,000
101 252,500
-
101 252,500
-
101 252,500
-
25 93,750
68 275,400
14 63,000
-
1 5,000
10 80,000
-
7 28,000
-
3 3,000
14 14,000
1 5,000

Rp 7,959,966
Rawat Jalan Januari 2014

256 1,443,840
5 19,380
6 10,944
6 9,216
-
-
3 5,472
10 18,240
-
2 3,302
-
2 4,800
-
2 1,920
-
2 1,920
-
15 59,040
-
-
-
-
-
-
-
15 302,400
-
-
-
-
-
-
-
3 7,200
3 7,776
63 181,440
-
-
-
-
-
-
10 10,000
5 5,000
-
Rp 2,091,890
 TARIF LABORATORIUM RAWAT JALAN

No Jenis Pemeriksaan Reagen Sarana JP Alkes BHP Konsul RAJAL

1 DARAH RUTIN 25,500 8,360 5,640 9,000 48,500
2 DARAH 3PARAMETER 21,700 7,924 3,876 9,000 42,500
3 LAJU ENDAP DARAH 1,000 5,176 1,824 - 8,000
4 GOLONGAN DARAH 6,000 4,464 1,536 1,000 13,000
5 GAMBARAN DARAH TEPI GD1 1,000 20,704 7,296 1,000 50,000 80,000
6 GAMBARAN DARAH TEPI GD2
7 CT / BT - 5,176 1,824 1,000 8,000
8 Gula darah 1 5,000 5,176 1,824 2,000 14,000
9 Gula darah 2
10 Ureum 1 13,400 4,949 1,651 2,000 22,000
11 Ureum 2
12 Creatini 1 9,500 7,100 2,400 2,000 21,000
13 Creatini 2
14 SGPT 1 18,000 3,040 960 2,000 24,000
15 SGPT 2
16 SGOT 1 18,000 3,040 960 2,000 24,000
17 SGOT 2
18 Bil Total / Direk 1 23,000 11,064 3,936 3,000 41,000
19 Bil Total / Direk 2
20 Cholesterol 1 15,600 3,960 1,440 2,000 23,000
21 Cholesterol 2
22 Trigliserid 1 28,500 4,887 1,613 2,000 37,000
23 Trigliserid 2
24 Asam Urat 1 16,700 3,571 1,229 2,000 23,500
25 Asam Urat 2
26 ELEKTROLIT 1 42,000 56,900 20,160 3,000 122,000
27 ELEKTROLIT 2
28 HBsAg 1 14,700 4,700 1,600 2,000 23,000
29 HBsAg 2
30 HCV 1 28,300 4,600 1,600 2,000 36,500
31 HCV 2
32 HIV 1 36,600 4,800 1,600 2,000 45,000
33 HIV 2
34 URINE RUTIN 5,000 7,100 2,400 3,000 17,500
35 FAECES RUTIN 1,000 7,408 2,592 2,000 13,000
36 WIDAL 1 21,000 8,120 2,880 4,000 36,000
37 WIDAL 2
38 KULTUR DARAH RUJUK LUAR
39 PA A1
40 PA A2
41 PTAG
42 DARAH PMI
43 PP TEST 4,000 1,000 6,000 11,000
44 PROTEIN URIN 2,000 1,000 3,000 6,000
45 MALARIA 80,000 5,000 10,000 95,000
Klaten, 11 Agustus 2010
RSIA 'Aisyiyah Klaten
Direktur,

Dr. H. M. Maimun
 TARIF LABORATORIUM

No Jenis Pemeriksaan Reagen Sarana JP Alkes BHP Konsul RANAP RAJAL

1 DARAH RUTIN 25,500 16,450 7,050 9,000 58,000 48,500
2 DARAH 3PARAMETER 21,700 11,305 4,845 9,000 46,850 42,500
3 LAJU ENDAP DARAH 1,000 6,650 2,280 - 9,930 8,000
4 GOLONGAN DARAH 6,000 5,600 1,920 1,000 14,520 13,000
5 GAMBARAN DARAH TEPI GD1 1,000 26,600 9,120 1,000 50,000 87,720 80,000
6 GAMBARAN DARAH TEPI GD2 1,000 26,600 9,120 5,000 50,000 91,720
7 CT / BT - 6,650 2,280 1,000 9,930 8,000
8 Gula darah 1 5,000 6,650 2,280 2,000 - 15,930 14,000
9 Gula darah 2 5,000 6,650 2,280 4,000 - 17,930
10 Ureum 1 13,400 6,020 2,064 2,000 - 23,484 22,000
11 Ureum 2 13,400 6,020 2,064 4,000 - 25,484
12 Creatini 1 9,500 8,750 3,000 2,000 - 23,250 21,000
13 Creatini 2 9,500 8,750 3,000 4,000 - 25,250
14 SGPT 1 18,000 3,500 1,200 2,000 - 24,700 24,000
15 SGPT 2 18,000 2,800 960 4,000 - 25,760
16 SGOT 1 18,000 3,500 1,200 2,000 - 24,700 24,000
17 SGOT 2 18,000 2,800 960 4,000 - 25,760
18 Bil Total / Direk 1 23,000 14,350 4,920 3,000 - 45,270 41,000
19 Bil Total / Direk 2 23,000 13,650 4,680 7,000 - 48,330
20 Cholesterol 1 15,600 5,250 1,800 2,000 - 24,650 23,000
21 Cholesterol 2 15,600 5,250 1,800 4,000 - 26,650
22 Trigliserid 1 28,500 5,880 2,016 2,000 - 38,396 37,000
23 Trigliserid 2 28,500 5,880 2,016 4,000 - 40,396
24 Asam Urat 1 16,700 4,480 1,536 2,000 - 24,716 23,500
25 Asam Urat 2 16,700 4,480 1,536 4,000 - 26,716
26 ELEKTROLIT 1 42,000 73,500 25,200 3,000 143,700 122,000
27 ELEKTROLIT 2 42,000 73,500 25,200 7,000 147,700
28 HBsAg 1 14,700 5,800 2,000 2,000 24,500 23,000
29 HBsAg 2 14,700 5,800 2,000 6,000 28,500
30 HCV 1 28,300 5,800 2,000 2,000 38,100 36,500
31 HCV 2 28,300 5,800 2,000 6,000 42,100
32 HIV 1 36,600 5,800 2,000 2,000 46,400 45,000
33 HIV 2 36,600 5,800 2,000 6,000 50,400
34 URINE RUTIN 5,000 8,750 3,000 3,000 19,750 17,500
35 FAECES RUTIN 1,000 9,450 3,240 2,000 15,690 13,000
36 WIDAL 1 21,000 10,500 3,600 4,000 39,100 36,000
37 WIDAL 2 21,000 10,500 3,600 8,000 43,100
38 KULTUR DARAH RUJUK LUAR 260,000 4,000 5,000 269,000
39 PA A1 140,000 8,000 7,500 155,500
40 PA A2 250,000 12,000 7,500 269,500
41 PTAG 77,000 4,000 8,000 89,000
42 DARAH PMI 250,000 4,000 5,000 259,000
-
-

Klaten, 11 Agustus 2010

RSIA 'Aisyiyah Klaten
Direktur,

Dr. H. M. Maimun
 TARIF LABORATORIUM

No Jenis Pemeriksaan Reagen Sarana JP Alkes BHP Konsul RANAP RAJAL

1 DARAH RUTIN 25,500 16,450 7,050 9,000 58,000 48,500
2 DARAH 3PARAMETER 21,700 11,305 4,845 9,000 46,850 42,500
3 LAJU ENDAP DARAH 1,000 6,650 2,850 - 10,500 8,000
4 GOLONGAN DARAH 6,000 5,600 2,400 1,000 15,000 13,000
5 GAMBARAN DARAH TEPI GD1 1,000 26,600 11,400 1,000 50,000 90,000 80,000
6 GAMBARAN DARAH TEPI GD2 1,000 26,600 11,400 5,000 50,000 94,000
7 CT / BT - 6,650 2,850 1,000 10,500 8,000
8 Gula darah 1 5,000 6,650 2,850 2,000 - 16,500 14,000
9 Gula darah 2 5,000 6,650 2,850 4,000 - 18,500
10 Ureum 1 13,400 6,020 2,580 2,000 - 24,000 22,000
11 Ureum 2 13,400 6,020 2,580 4,000 - 26,000
12 Creatini 1 9,500 8,750 3,750 2,000 - 24,000 21,000
13 Creatini 2 9,500 8,750 3,750 4,000 - 26,000
14 SGPT 1 18,000 3,500 1,500 2,000 - 25,000 24,000
15 SGPT 2 18,000 2,800 1,200 4,000 - 26,000
16 SGOT 1 18,000 3,500 1,500 2,000 - 25,000 24,000
17 SGOT 2 18,000 2,800 1,200 4,000 - 26,000
18 Bil Total / Direk 1 23,000 14,350 6,150 3,000 - 46,500 41,000
19 Bil Total / Direk 2 23,000 13,650 5,850 7,000 - 49,500
20 Cholesterol 1 15,600 5,250 2,250 2,000 - 25,100 23,000
21 Cholesterol 2 15,600 5,250 2,250 4,000 - 27,100
22 Trigliserid 1 28,500 5,880 2,520 2,000 - 38,900 37,000
23 Trigliserid 2 28,500 5,880 2,520 4,000 - 40,900
24 Asam Urat 1 16,700 4,480 1,920 2,000 - 25,100 23,500
25 Asam Urat 2 16,700 4,480 1,920 4,000 - 27,100
26 ELEKTROLIT 1 42,000 73,500 31,500 3,000 150,000 122,000
27 ELEKTROLIT 2 42,000 73,500 31,500 7,000 154,000
28 HBsAg 1 14,700 5,800 2,500 2,000 25,000 23,000
29 HBsAg 2 14,700 5,800 2,500 6,000 29,000
30 HCV 1 28,300 5,800 2,500 2,000 38,600 36,500
31 HCV 2 28,300 5,800 2,500 6,000 42,600
32 HIV 1 36,600 5,800 2,500 2,000 46,900 45,000
33 HIV 2 36,600 5,800 2,500 6,000 50,900
34 URINE RUTIN 5,000 8,750 3,750 3,000 20,500 17,500
35 FAECES RUTIN 1,000 9,450 4,050 2,000 16,500 13,000
36 WIDAL 1 21,000 10,500 4,500 4,000 40,000 36,000
37 WIDAL 2 21,000 10,500 4,500 8,000 44,000
38 KULTUR DARAH RUJUK LUAR 260,000 5,000 5,000 270,000
39 PA A1 140,000 10,000 7,500 157,500
40 PA A2 250,000 15,000 7,500 272,500
41 PTAG 77,000 5,000 8,000 90,000
42 DARAH PMI 250,000 5,000 5,000 260,000

Klaten, 11 Agustus 2010

RSIA 'Aisyiyah Klaten
Direktur,

Dr. H. M. Maimun
 TARIF LABORATORIUM

No Jenis Pemeriksaan Reagen Sarana JP Alkes BHP Konsul RANAP RAJAL RAJAL
1 DARAH RUTIN 25,500 16,450 7,050 9,000 58,000 48,255 48,500
2 DARAH 3PARAMETER 21,700 11,305 4,845 9,000 46,850 42,490 42,500
3 LAJU ENDAP DARAH 1,000 6,650 2,850 - 10,500 7,935 8,000
4 GOLONGAN DARAH 6,000 5,600 2,400 1,000 15,000 12,840 13,000
5 GAMBARAN DARAH TEPI GD1 1,000 26,600 11,400 1,000 50,000 90,000 79,740 80,000
6 GAMBARAN DARAH TEPI GD2 1,000 26,600 11,400 5,000 50,000 94,000 83,740 84,000
7 CT / BT - 6,650 2,850 1,000 10,500 7,935 8,000
8 Gula darah 1 5,000 6,650 2,850 2,000 - 16,500 13,935 14,000
9 Gula darah 2 5,000 6,650 2,850 4,000 - 18,500 15,935 16,000
10 Ureum 1 13,400 6,020 2,580 2,000 - 24,000 21,678 22,000
11 Ureum 2 13,400 6,020 2,580 4,000 - 26,000 23,678 24,000
12 Creatini 1 9,500 8,750 3,750 2,000 - 24,000 20,625 21,000
13 Creatini 2 9,500 8,750 3,750 4,000 - 26,000 22,625 23,000
14 SGPT 1 18,000 3,500 1,500 2,000 - 25,000 23,650 24,000
15 SGPT 2 18,000 2,800 1,200 4,000 - 26,000 24,920 25,000
16 SGOT 1 18,000 3,500 1,500 2,000 - 25,000 23,650 24,000
17 SGOT 2 18,000 2,800 1,200 4,000 - 26,000 24,920 25,000
18 Bil Total / Direk 1 23,000 14,350 6,150 3,000 - 46,500 40,965 41,000
19 Bil Total / Direk 2 23,000 13,650 5,850 7,000 - 49,500 44,235 44,500
20 Cholesterol 1 15,600 5,250 2,250 2,000 - 25,100 23,075 23,000
21 Cholesterol 2 15,600 5,250 2,250 4,000 - 27,100 25,075 25,000
22 Trigliserid 1 28,500 5,880 2,520 2,000 - 38,900 36,632 37,000
23 Trigliserid 2 28,500 5,880 2,520 4,000 - 40,900 38,632 39,000
24 Asam Urat 1 16,700 4,480 1,920 2,000 - 25,100 23,372 23,500
25 Asam Urat 2 16,700 4,480 1,920 4,000 - 27,100 25,372 25,500
26 ELEKTROLIT 1 42,000 73,500 31,500 7,000 154,000 125,650 126,000
27 ELEKTROLIT 2 42,000 73,500 31,500 3,000 150,000 121,650 122,000
28 HBsAg 1 14,700 5,800 2,500 6,000 29,000 26,760 27,000
29 HBsAg 2 14,700 5,800 2,500 2,000 25,000 22,760 23,000
30 HCV 1 28,300 5,800 2,500 6,000 42,600 40,360 40,500
31 HCV 2 28,300 5,800 2,500 2,000 38,600 36,360 36,500
32 HIV 1 36,600 5,800 2,500 6,000 50,900 48,660 49,000
33 HIV 2 36,600 5,800 2,500 2,000 46,900 44,660 45,000
34 URINE RUTIN 5,000 8,750 3,750 3,000 20,500 17,125 17,500
35 FAECES RUTIN 1,000 9,450 4,050 2,000 16,500 12,855 13,000
36 WIDAL 1 21,000 10,500 4,500 8,000 44,000 39,950 40,000
37 WIDAL 2 21,000 10,500 4,500 4,000 40,000 35,950 36,000
38 KULTUR DARAH RUJUK LUAR 260,000 5,000 5,000 270,000
39 PA A1 140,000 10,000 7,500 157,500
40 PA A2 250,000 15,000 7,500 272,500
41 PTAG 77,000 5,000 8,000 90,000
42 DARAH PMI 250,000 5,000 5,000 260,000

Klaten, 11 Agustus 2010

RSIA 'Aisyiyah Klaten
Direktur,

Dr. H. M. Maimun
 TARIF LABORATORIUM

No Jenis Pemeriksaan H. Reagen Sarana JP Alkes BHP Konsul Total RANAP 30%SRN 20%JP
1 DARAH RUTIN 25,500 16,450 7,050 9,000 58,000 4,935 1,410
2 DARAH 3PARAMETER 21,700 11,305 4,845 9,000 46,850 3,392 969
3 LAJU ENDAP DARAH 1,000 6,650 2,850 - 10,500 1,995 570
4 GOLONGAN DARAH 6,000 5,600 2,400 1,000 15,000 1,680 480
5 GAMBARAN DARAH TEPI 1,000 26,600 11,400 1,000 50,000 90,000 7,980 2,280
6 GAMBARAN DARAH TEPI 1,000 26,600 11,400 5,000 50,000 94,000 7,980 2,280
7 CT / BT - 6,650 2,850 1,000 10,500 1,995 570
8 Gula darah 1 5,000 6,650 2,850 2,000 - 16,500 1,995 570
9 Gula darah 2 5,000 6,650 2,850 4,000 - 18,500 1,995 570
10 Ureum 1 13,400 6,020 2,580 2,000 - 24,000 1,806 516
11 Ureum 2 13,400 6,020 2,580 4,000 - 26,000 1,806 516
12 Creatini 1 9,500 8,750 3,750 2,000 - 24,000 2,625 750
13 Creatini 2 9,500 8,750 3,750 4,000 - 26,000 2,625 750
14 SGPT 1 18,000 3,500 1,500 2,000 - 25,000 1,050 300
15 SGPT 2 18,000 2,800 1,200 4,000 - 26,000 840 240
16 SGOT 1 18,000 3,500 1,500 2,000 - 25,000 1,050 300
17 SGOT 2 18,000 2,800 1,200 4,000 - 26,000 840 240
18 Bil Total / Direk 1 23,000 14,350 6,150 3,000 - 46,500 4,305 1,230
19 Bil Total / Direk 2 23,000 13,650 5,850 7,000 - 49,500 4,095 1,170
20 Cholesterol 1 15,600 5,250 2,250 2,000 - 25,100 1,575 450
21 Cholesterol 2 15,600 5,250 2,250 4,000 - 27,100 1,575 450
22 Trigliserid 1 28,500 5,880 2,520 2,000 - 38,900 1,764 504
23 Trigliserid 2 28,500 5,880 2,520 4,000 - 40,900 1,764 504
24 Asam Urat 1 16,700 4,480 1,920 2,000 - 25,100 1,344 384
25 Asam Urat 2 16,700 4,480 1,920 4,000 - 27,100 1,344 384
26 ELEKTROLIT 1 42,000 73,500 31,500 7,000 154,000 22,050 6,300
27 ELEKTROLIT 2 42,000 73,500 31,500 3,000 150,000 22,050 6,300
28 HBsAg 1 14,700 5,800 2,500 6,000 29,000 1,740 500
29 HBsAg 2 14,700 5,800 2,500 2,000 25,000 1,740 500
30 HCV 1 28,300 5,800 2,500 6,000 42,600 1,740 500
31 HCV 2 28,300 5,800 2,500 2,000 38,600 1,740 500
32 HIV 1 36,600 5,800 2,500 6,000 50,900 1,740 500
33 HIV 2 36,600 5,800 2,500 2,000 46,900 1,740 500
34 URINE RUTIN 5,000 8,750 3,750 3,000 20,500 2,625 750
35 FAECES RUTIN 1,000 9,450 4,050 2,000 16,500 2,835 810
36 WIDAL 1 21,000 10,500 4,500 8,000 44,000 3,150 900
37 WIDAL 2 21,000 10,500 4,500 4,000 40,000 3,150 900
38 KULTUR DARAH RUJUK LU 260,000 5,000 5,000 270,000
39 PA A1 140,000 10,000 7,500 157,500
40 PA A2 250,000 15,000 7,500 272,500
41 PTAG 77,000 5,000 8,000 90,000
42 DARAH PMI 250,000 5,000 5,000 260,000
43

Klaten, 28 Juli 2010

RSIA 'Aisyiyah Klaten
Direktur,

Dr. H. M. Maimun
TARIF RAJAL SELISIH
48,255 9,745 3400 48,255
42,490 4,361
7,935 2,565
12,840 2,160
79,740 10,260
83,740 10,260
7,935 2,565
13,935 2,565
15,935 2,565
21,678 2,322
23,678 2,322
20,625 3,375
22,625 3,375
23,650 1,350
24,920 1,080
23,650 1,350
24,920 1,080
40,965 5,535
44,235 5,265
23,075 2,025
25,075 2,025
36,632 2,268
38,632 2,268
23,372 1,728
25,372 1,728
125,650 28,350
121,650 28,350
26,760 2,240
22,760 2,240
40,360 2,240
36,360 2,240
48,660 2,240
44,660 2,240
17,125 3,375
12,855 3,645
39,950 4,050
35,950 4,050
270,000
157,500
272,500
90,000
260,000
 TARIF LABORATORIUM
RAWAT INAP
No Jenis Pemeriksaan H. Reagen Sarana JP Alkes BHP Konsul Total
1 DARAH RUTIN 25,500 16,450 7,050 9,000 58,000
2 LAJU ENDAP DARAH 1,000 6,650 2,850 - 10,500
3 GOLONGAN DARAH 6,000 5,600 2,400 1,000 15,000
4 GAMBARAN DARAH TEPI GD1 1,000 26,600 11,400 1,000 50,000 90,000
5 GAMBARAN DARAH TEPI GD2 1,000 26,600 11,400 5,000 50,000 94,000
6 CT / BT - 6,650 2,850 1,000 10,500
7 Gula darah 1 5,000 6,650 2,850 2,000 - 16,500
8 Gula darah 2 5,000 6,650 2,850 4,000 - 18,500
10 Ureum 1 13,400 6,020 2,580 2,000 - 24,000
11 Ureum 2 13,400 6,020 2,580 4,000 - 26,000
13 Creatini 1 9,500 8,750 3,750 2,000 - 24,000
14 Creatini 2 9,500 8,750 3,750 4,000 - 26,000
16 SGPT 1 18,000 2,800 1,200 2,000 - 24,000
17 SGPT 2 18,000 2,800 1,200 4,000 - 26,000
19 SGOT 1 18,000 2,800 1,200 2,000 - 24,000
20 SGOT 2 18,000 2,800 1,200 4,000 - 26,000
22 Bil Total / Direk 1 23,000 14,350 6,150 3,000 - 46,500
23 Bil Total / Direk 2 23,000 13,650 5,850 7,000 - 49,500
24 Cholesterol 1 15,600 5,250 2,250 2,000 - 25,100
25 Cholesterol 2 15,600 5,250 2,250 4,000 - 27,100
27 Trigliserid 1 28,500 5,880 2,520 2,000 - 38,900
28 Trigliserid 2 28,500 5,880 2,520 4,000 - 40,900
30 Asam Urat 1 16,700 4,480 1,920 2,000 - 25,100
31 Asam Urat 2 16,700 4,480 1,920 4,000 - 27,100
33 ELEKTROLIT 1 42,000 73,500 31,500 7,000 154,000
34 ELEKTROLIT 2 42,000 73,500 31,500 3,000 150,000
35 HBsAg 1 14,700 5,800 2,500 6,000 29,000
36 HBsAg 2 14,700 5,800 2,500 2,000 25,000
37 HCV 1 28,300 5,800 2,500 6,000 42,600
38 HCV 2 28,300 5,800 2,500 2,000 38,600
39 HIV 1 36,600 5,800 2,500 6,000 50,900
40 HIV 2 36,600 5,800 2,500 2,000 46,900
41 URINE RUTIN 5,000 8,750 3,750 3,000 20,500
42 FAECES RUTIN 1,000 9,450 4,050 2,000 16,500
43 WIDAL 1 21,000 10,500 4,500 8,000 44,000
44 WIDAL 2 21,000 10,500 4,500 4,000 40,000
45 KULTUR DARAH RUJUK LUAR 260,000 5,000 5,000 270,000
47 PA A1 140,000 10,000 7,500 157,500
48 PA A2 250,000 15,000 7,500 272,500
49 PTAG 77,000 5,000 8,000 90,000
50 DARAH PMI 250,000 5,000 5,000 260,000

Klaten, 28 Juli 2010

RSIA 'Aisyiyah Klaten
Direktur,

Dr. H. M. Maimun
16500
18500
24000
26000
24000
26000
24000
26000
24000
26000
46500
49500
25100
27100
38900
40900
25100
27100
 TARIF LABORATORIUM
RAWAT JALAN

No Jenis Pemeriksaan H. Reagen Sarana JP Alkes BHP Konsul Total

1 DARAH RUTIN 25,500 9,100 3,900 9,000 47,500
2 LAJU ENDAP DARAH 1,000 6,650 2,850 - 10,500
3 GOLONGAN DARAH 6,000 4,200 1,800 1,000 13,000
4 GAMBARAN DARAH TEPI GD1 1,000 19,600 8,400 1,000 50,000 80,000
5 GAMBARAN DARAH TEPI GD2 1,000 19,600 8,400 5,000 50,000 84,000
6 CT / BT - 6,650 2,850 1,000 10,500
7 Hematologi 3 prmtr 17,000 9,100 3,900 9,000 - 39,000
8 Gula darah 1 5,000 4,550 1,950 1,000 - 12,500
9 Gula darah 2 5,000 4,550 1,950 3,000 - 14,500
10 Gula darah 3 5,000 4,550 1,950 6,500 - 18,000
11 Ureum 1 13,400 3,570 1,530 1,000 - 19,500
12 Ureum 2 13,400 3,570 1,530 3,000 - 21,500
13 Ureum 3 13,400 3,570 1,530 7,000 - 25,500
14 Creatini 1 9,500 6,300 2,700 1,000 - 19,500
15 Creatini 2 9,500 6,300 2,700 3,000 - 21,500
16 Creatini 3 9,500 6,300 2,700 7,000 - 25,500
17 SGPT 1 11,500 4,900 2,100 1,000 - 19,500
18 SGPT 2 11,500 4,900 2,100 3,000 - 21,500
19 SGPT 3 11,500 4,900 2,100 7,000 - 25,500
20 SGOT 1 11,500 4,900 2,100 1,000 - 19,500
21 SGOT 2 11,500 4,900 2,100 3,000 - 21,500
22 SGOT 3 11,500 4,900 2,100 7,000 - 25,500
23 Bil Total / Direk 1 23,000 9,450 4,050 3,000 - 39,500
24 Bil Total / Direk 2 23,000 9,450 4,050 7,000 - 43,500
25 Cholesterol 1 15,600 2,730 1,170 1,000 - 20,500
26 Cholesterol 2 15,600 2,730 1,170 3,000 - 22,500
27 Cholesterol 3 15,600 2,730 1,170 7,000 - 26,500
28 Trigliserid 1 28,500 2,730 1,170 1,000 - 33,400
29 Trigliserid 2 28,500 2,730 1,170 3,000 - 35,400
30 Trigliserid 3 28,500 2,730 1,170 7,000 - 39,400
31 Asam Urat 1 16,700 1,960 840 1,000 - 20,500
32 Asam Urat 2 16,700 1,960 840 3,000 - 22,500
33 Asam Urat 3 16,700 1,960 840 7,000 - 26,500
34 ELEKTROLIT 1 42,000 56,000 24,000 7,000 129,000
35 ELEKTROLIT 2 42,000 56,000 24,000 3,000 125,000
36 HBsAg 1 14,700 5,800 2,500 6,000 29,000
37 HBsAg 2 14,700 5,800 2,500 2,000 25,000
38 URINE RUTIN 5,000 5,950 2,550 3,000 16,500
39 FAECES RUTIN 1,000 8,750 3,750 2,000 15,500
40 WIDAL 1 21,000 10,500 4,500 8,000 44,000
41 WIDAL 2 21,000 10,500 4,500 4,000 40,000
42 HCV 1 28,300 5,800 2,500 6,000 42,600
43 HCV 2 28,300 5,800 2,500 2,000 38,600

Klaten, 28 Juli 2010

RSIA 'Aisyiyah Klaten
Direktur,

Dr. H. M. Maimun
 TARIF LABORATORIUM
RAWAT INAP
No Jenis Pemeriksaan H. Reagen Sarana JP Alkes BHP Konsul Total
1 DARAH RUTIN 25,500 16,450 7,050 9,000 58,000
2 LAJU ENDAP DARAH 1,000 6,650 2,850 - 10,500
3 GOLONGAN DARAH 6,000 5,600 2,400 1,000 15,000
4 GAMBARAN DARAH TEPI GD1 1,000 26,600 11,400 1,000 50,000 90,000
5 GAMBARAN DARAH TEPI GD2 1,000 26,600 11,400 5,000 50,000 94,000
6 CT / BT - 6,650 2,850 1,000 10,500
7 Gula darah 1 5,000 6,650 2,850 1,000 - 15,500
8 Gula darah 2 5,000 6,650 2,850 3,000 - 17,500
9 Gula darah 3 5,000 6,650 2,850 6,500 - 21,000
10 Ureum 1 13,400 6,000 2,600 1,000 - 23,000
11 Ureum 2 13,400 6,000 2,600 3,000 - 25,000
12 Ureum 3 13,400 6,000 2,600 7,000 - 29,000
13 Creatini 1 9,500 8,750 3,750 1,000 - 23,000
14 Creatini 2 9,500 8,750 3,750 3,000 - 25,000
15 Creatini 3 9,500 8,750 3,750 7,000 - 29,000
16 SGPT 1 11,500 7,350 3,150 1,000 - 23,000
17 SGPT 2 11,500 7,350 3,150 3,000 - 25,000
18 SGPT 3 11,500 7,350 3,150 7,000 - 29,000
19 SGOT 1 11,500 7,350 3,150 1,000 - 23,000
20 SGOT 2 11,500 7,350 3,150 3,000 - 25,000
21 SGOT 3 11,500 7,350 3,150 7,000 - 29,000
22 Bil Total / Direk 1 23,000 13,650 5,850 3,000 - 45,500
23 Bil Total / Direk 2 23,000 13,650 5,850 7,000 - 49,500
24 Cholesterol 1 15,600 5,250 2,250 1,000 - 24,100
25 Cholesterol 2 15,600 5,250 2,250 3,000 - 26,100
26 Cholesterol 3 15,600 5,250 2,250 7,000 - 30,100
27 Trigliserid 1 28,500 5,900 2,500 1,000 - 37,900
28 Trigliserid 2 28,500 5,900 2,500 3,000 - 39,900
29 Trigliserid 3 28,500 5,900 2,500 7,000 - 43,900
30 Asam Urat 1 16,700 4,500 1,900 1,000 - 24,100
31 Asam Urat 2 16,700 4,500 1,900 3,000 - 26,100
32 Asam Urat 3 16,700 4,500 1,900 7,000 - 30,100
33 ELEKTROLIT 1 42,000 73,500 31,500 7,000 154,000
34 ELEKTROLIT 2 42,000 73,500 31,500 3,000 150,000
35 HBsAg 1 14,700 5,800 2,500 6,000 29,000
36 HBsAg 2 14,700 5,800 2,500 2,000 25,000
37 HCV 1 28,300 5,800 2,500 6,000 42,600
38 HCV 2 28,300 5,800 2,500 2,000 38,600
39 HIV 1 36,600 5,800 2,500 6,000 50,900
40 HIV 2 36,600 5,800 2,500 2,000 46,900
41 URINE RUTIN 5,000 8,750 3,750 3,000 20,500
42 FAECES RUTIN 1,000 9,450 4,050 2,000 16,500
43 WIDAL 1 21,000 10,500 4,500 8,000 44,000
44 WIDAL 2 21,000 10,500 4,500 4,000 40,000
45 KULTUR DARAH RUJUK LUAR 260,000 5,000 5,000 270,000
47 PA A1 140,000 10,000 7,500 157,500
48 PA A2 250,000 15,000 7,500 272,500
49 PTAG 77,000 5,000 8,000 90,000
50 DARAH PMI 250,000 5,000 5,000 260,000

Klaten, 28 Juli 2010

RSIA 'Aisyiyah Klaten
Direktur,

Dr. H. M. Maimun