Perbedaan Tarif Hosana Medica Group 15032013

7/25/2019 Perbedaan Tarif Hosana Medica Group 15032013

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PERBANDINGAN TARIF HOSANA MEDICA GROUP

TARIF RUANG PERAWATAN

KETERANGAN HM LIPPO Usulan BEKASI Usulan HCB

BIAYA ADM :

LAMA RJ 7,500 7,500 7,500

BARU RJ 15,000 15,000 15,000

ADM RI 5% 5% 5%

TARIF JASA MEDIS RAWAT JALAN

JASA MEDIS RAWAT JALAN

Dokter Umum 40,000 40,000 35,000

Konsul Bid n ! ! !

Dokter "#e$i lis 75,000 0,000 70,000

J s Ke&id n n'd(n U") inti#* ! ! 0

Dokter "u&"#esi lis 100,000 100,000 100,000

J s Dokter )i(i '+U* 30,000 30,000 30,000

J s Dokter )i(i "#esi lis d n Mulut ! ! 0

J s Dokter mer(en$- . U)D 'Dr/ Umum* 50,000 50,000 45,000

J s Dokter mer(en$- . U)D 'Dr/ "#esi lis*' kti * 75,000 0,000 70,000

J s Dokter mer(en$- . U)D 'Dr/ "#esi lis*'# si * 35,000 40,000 35,000

J s Konsul A li )i2i 30,000 30,000 30,000

J s isum et Re#ertum r n( idu# 75,000 75,000 75,000

J s isum et Re#ertum r n( M ti 150,000 150,000 150,000


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J s Dokter n 6 ll 1 75,000 75,000 75,000

J s Dokter n 6 ll 100,000 100,000 100,000

J s Dokter n 6 ll ' ks# tri t * 150,000 150,000 150,000

J s Dokter Aku#untur 75,000 75,000 75,000

TARIF RUANG PERAWATAN RAWAT INAP

I+ 00,000 ! 0

I+ 850,000 850,000 550,000

K LA" 1 450,000 400,000 350,000

K LA" 50,000 50,000 00,000

K LA" 3A '5 Bed* 1 0,000 110,000 110,000

K LA" 3B '8 Bed* 110,000 ! 95,000

RUA:) BA;I " A< "esu i kel s "esu i kel s "esu i Kel s

I" LA"I 450,000 400,000 350,000

+ RI:A< L )I 400,000 350,000 300,000

I/ 6/ U 750,000 800,000 500,0006U 500,000 500,000 400,000

:/ I/ 6/ U. +/I/6/U 750,000 800,000 500,000

TARIF RUANG OBSER ASI UGD DAN KAMAR BERSALIN

U:I< )A=A< DARURA< >

1 ! 3 JAM 50,000 50,000 50,000

100,000 100,000 100,000

?8 JAM s . d 1 ri 00,000 00,000 00,000

K >

3 ! 8 JAM


3/322

K I+ 800,000

K BIA"A 400,000 400,000 400,000

TARIF JASA MEDIS RAWAT INAPisite dokter s#esi lis '$ r(e m @ 1@ . ri*

I+ 1 5,000

I+ 100,000 100/000 90,000

I 90,000 90,000 0,000

II 0,000 0,000 70,000

III 75,000 75,000 85,000

I" LA"I 90,000 90,000 0,000

6U 100,000 100,000 100,000

I6U.+I6U.:I6U 150,000 1 5,000 1 5,000

+erin 100,000 100,000 100,000

Dokter ru n( n #er ri

"U+ R I+

I+ 45,000 45,000 40,000

I 40,000 40,000 35,000

II 37,500 37,500 3 ,500

III 35,000 35,000 30,000

I" LA"I 40,000 40,000 35,000I6U.+I6U.:I6U 150,000 50,000 50,000

+ RI:A 50,000 50,000 50,000

Administr si R t In # 5 % d ri tot l t (i n

TARIF TINDAKAN MEDIS RAWAT INAP

KELAS III!II KELAS III!II KELAS III!II KELAS III!IIen "eksi.


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In l si . :e&uli2er.


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"-rin(e #um# . In us +um# . ri . 1 l t 100,000

"u$tion 'm @ 5@ . ri* 30,000

"B


6/322

#er si K usus 3,000,000 ,000,000

TARIF TINDAKAN FISIOTERAPI


7/322

E 5 it n di itun( #er it n ,000 3,500 ,000e$tin( 5 ! 10 it ne$tin( 10 ! 15 it ne$tin( 18 ! 0 it ne$tin( 1 ! 5 it ne$tin( ? 5 it n

An(k t J it n 1!5 5,000 30,000 5,000? 5 it n di itun( #er it n ,000 ,500 ,000

A e$tin( 5 ! 10 it n A e$tin( 10 ! 15 it n A e$tin( 18 ! 0 it n A e$tin( 1 ! 5 it n

A e$tin( ? 5 it n

kstir# si >

Li#om !4 $m 'ke$il* 00,000 00,000 00,000

Li#om 5!7 $m 300,000 300,000 300,000

Li#om ?7 $m '&es r* 450,000 450,000 450,000

kstir# si 6l us 00,000 00,000 00,000

kstir# si eruk 00,000 00,000 00,000@#lor si luk 100,000 100,000 100,000kstir# si )r m 150,000 150,000 150,000

@tr si 6or#us Allienum ten((orok n. telin( . idun( 100,000 100,000 100,000Roser#l st- '$ &ut kuku se& (i n* 150,000 150,000 150,000

kstr ksi kuku '$ &ut kuku keseluru n* 100,000 100,000 100,000:ekrotom- > 75,000 75,000 75,000

6om&ustio 75,000 75,000 75,000

Am#ut si 1 ru s 50,000 50,000 50,000) nti er& n ') * ke$il 35,000 35,000 35,000) nti er& n ') * sed n( 40,000 40,000 40,000) nti er& n ') * &es r 45,000 45,000 45,000

=< Ke$il 30,000 30,000 30,000

=< "ed n( 35,000 35,000 35,000

=< Bes r 40,000 40,000 40,000"irkumsisi An k 'dr umum* 400,000 400,000 400,000"irkumsisi De s 'dr umum* 300,000 300,000 300,000

Klism 50,000 50,000 50,000

Insisi A&ses ke$il 75,000 75,000 75,000


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Insisi A&ses &es r 1 5,000 1 5,000 1 5,000

Iri( si m t 50,000 50,000 50,000

In us t li #us t 75,000 75,000 75,000

Um&ili$ l $ t eter 100,000 100,000 100,000

+ s n( in us 35,000 35,000 35,000

en seksi 500,000 500,000 500,000

:e&uli2er 45,000 40,000 40,000+er t n #ert m luk & k r >

E 5% 75,000 75,000 75,000? 5% 1 5,000 1 5,000 1 5,000

Ci@ @i + t

/ + s n( "# lk 'len( n* 5,000 5,000 5,000

+ s n( )i&s 400,000 400,000 400,000Re#osisi Dislok si "eder n 1 5,000 50,000 50,000Bil s L m&un( 100,000 100,000 100,000Corm lin di Rum 1,000,000 1,000,000 1,000,000Corm lin di Rum " kit 1,000,000 1,000,000 1,000,000

K) 50,000 50,000 50,000Monitor. 8 m 50,000 50,000 50,000Monitor. 1 m 75,000 75,000 75,000Monitor. 4 m 100,000 100,000 100,000

ksi(en . m 0,000 0,000 0,000

At erom 50,000 50,000 50,000

) n(lion 300,000 300,000 300,000+ ket ) #er 1@ kun un( n '1@ suntik* 100,000 100,000

+ s n( $oll r ne$k 10,000 10,000 10,000

+ s n( l stik +er& n 10,000 10,000 10,000


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Intr sseu2 250,000 250,000 250,000+ s n( in us 50,000 50,000 50,000Resusit si J ntun( + ru.dr/ umum 00,000 00,000 00,000Monitorin( Arteline . ri 100,000 100,000 100,000Monitorin( . ri 100,000 100,000 100,000

en "e$tie 750,000 750,000 750,000:)< 50,000 50,000 50,0006 t eter 50,000 50,000 50,000

entil tor . ri 500,000 500,000 500,000

. ri 140,000 140,000 140000$# # 00,000 175,000 175,000:e&uli2er 45,000 40,000 40,000

Intu& si 50,000 50,000 50,000

D6 s o$k 150,000 150,000 150,000


10/322

Usulan Su#an$ Usulan KLINIK BPJS MEDIKA ANNISA AMANDA HK SILOAM

17,000 5,000 8,000 10,000 15,000

,500 10,000 1 ,000

375/000, Isol si F I6U > 80/000, ! 5 %

50,000 30,000 40,000 30,000 5,000 5,000 50,000

! 15,000

11 ,500 80,000 75,000 85,000 85,000 55,000 95,000

0 0 10,000 15,000

! 0

50,000 30,000 40,000 7,500 5,000 75,000

0 0 100,00

81, 75 0 45,000 40,000 40,000 35,000 80,000

! 0 5,000 85,000

! 0

0 0 30,000 15,000 5,000

! 75,000

100,000 150,000


11/322

! 85,000

! 75,000

! 100,000

! 75,000

0 0 890,000

505,000 0 500,000 475,000 450,000 700,000

390,000 0 350,000 75,000 300,000 375,000

0,000 0 1 5,000 85,000 00,000 150,000 50,000

11 ,000 0 ,000 90,000 90,000 5,000 1 0,0000 0

"esu i Kel s 0 75,000

450,000 0 385,000 5,000 75,000 300,000

1 3,000 0 75,000 190,000 75,0001,01 ,000 0 535,000 450,000 400,000 550,000 750,000

! 0 450,000

! 0 535,000 350,000 350,000 550,000 550,000

7 ,750 30,000

0 50,000

0 75,000


12/322

1,184,375

15,000

183,000 90,000 5,000 115,000

130,000

100,000

95,000

130,000 0,000!

190,000 10 ,000 5,000 1 5,000

! 115,000

70,000 80,000

isite dr/ umum 40,000 3 ,500

0

8 ,000 3,000

50,000

50,000

45,000

8 ,000 1,000

8 ,000 33,000 35,000

! 3 ,500

19,000 30,000

17,000 7,500

15,000 5,0005 % DARI <


13/322

47,500 50,000

1 5,000 150,000

1 5,000 150,000

00,000 50,000

35,000 40,00035,000 40,000

40,000 45,000

45,000 50,000

55,000 80,000

900,000


14/322


15/322

1 9,375


16/322

,500 30,000191, 50 48,000 70,000 49,500 75,00

5 ,750 80,000 115,000 77,000 9 ,5155,000 110,000 9 ,5175,000 13 ,000

7,500 185,00045,000 75,000 0,00018, 75 1 ,000 45,000 ,00058, 50 ,0007 ,750 85,000 30, 00 75

0,000 49,500

83, 0077,000

110,000

108, 75 75,000

80,000 70,000 88,000

95,000 137,500

1 0,000 180,000 110,000 178,000

11 ,500

11 ,500183,1 5183,1 5 9 ,000 110,000108, 75 1 5,000 55,000

79,500 110,000

380,00045,00058, 50 4,000 0,000 30,000 7,500 50,0073,1 5 37,500 5,000 37,000 3 ,500 55,00

73,1 5 88,000 30,000 45,000 49,500 80,00

108, 75

198, 7595,000 0,000 507,

7,500 300,000

95,000 400,000 400,000

7 ,750 4 ,000 35,000 50,000 33,000


17/322

1 0,000 79,000 89,000 70,000

73,1 5 158,000 1 5,000 135,000 137,500

38,000 34,500 50,000

81, 75 7,500

50,8 5 0,000

380,000 30,000 1 5,000 00,000 0,00

108, 75 173,000 0,000 0,000

4 ,000 83,000 75,000 49,500

105,000 103,500 130,000 110,00047,000 40,000

! 110,000

450,000 4,0003 3,43 35,00011 ,500 1 ,500 80,000 110,000

! 317,000 17 ,500 00,000 0,000! 7 5,000

90,0000 ,500 58,000 3 ,500

10,000

!

! 19 ,500350,000 10,000 75,000

0 40,000

3 3,43488, 75 79,500 34,500 55,000

110,000

70,0000 19 ,000

11 ,500 80,000!


18/322

!7 ,000

1000.90000155000155000 80,000380000

8 000 0,00047000 80,000 0,000

0 8 ,000 475,000

73,1 5

!45000

75,000 50,000

108 75

3 08 5 135,000

55,000

40,000


19/322

MITRA TMR RA HARAP HERMINA BELLA

10,000 5,000

17,000

5 % MAG 800/000

85,000 30,000 59,000 40,000

75,000 110,000 75,000

0,000

70/000!100/000

95,000 30,000

110,000


20/322

BELLA

1,195,000 5 0,000 10,000 750,000

850,000 4 5,000 400,000

375,000 00,000 55,000 10,000

150,000 95,000 110,000 110,000

7 0,000 3 5,000 4 5,000 500,000

4 5,000

1,005,000 4 5,000 450,000

! !

595,000 550,000 400,000

80,000 ,000

80,000 85,000


21/322

180,000 190,000

1 5,000

1 5,000

130,000

90,000 90,000


22/322


23/322


24/322

85,000

85,000

85,000

85,000

70,000

85,000

85,000

90,000

78,000

78,000

78,000

85,00085,000

1,000


25/322

133,000 1 0,000 170,000 HHH

0,000

330,000

100,000 85,000 75,000 75,000

5000

17,000 170,000

17,000 80,0008,000

44,000

350,000

101,000 110,000


26/322

1,000

39,000 70,000

140,000

735,000 370,000

145,000

1 0,000

100,00040,000

1 0,000

1,000,000

5,0001 ,000

13 ,000 175,000,000


27/322

195,00050000

79 ,00080,000

50,000

110,000 85000


28/322

TINDAKAN DI POLI

KETERANGAN HM LIPPO

TARIF TINDAKAN POLI UMUMIn eksi 15,000) 50,000

TARIF TINDAKAN POLI BEDAH UMUM) 50,000:e$rotome 75,000"irkumsisi 750,000

ACC 6


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R +AIR JARI:)A: !I:"I"I AKUA"I MA< M !+ MA"A:)A: KA=A< CIK"A"I !6IR6UM"I"I 'A: "< "I L KAL* !

:A " K"I !6


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+U:)"I I:J K"I " :DI K 6IL+U:)"I I:J K"I " :DI B "AR

TARIF JASA DOKTER BEDAH TULANG ! ORTOPEDI

#er si Ke$il !#er si "ed n( !#er si Bes r !#er si K usus !

"e l t ort o !

POLI PENYAKIT DALAMM ntou@


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? 10(in l


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&/ Du


33/322

< IL < < LI:)A 15,000 ACC 6


34/322

A:)KA< B :DA A"I:) MA


35/322

GA:< LA"MAR +AIR +AL+ BRAR +AIR 6 :JU:6


36/322


37/322

+ MA"A:)A: R< II 5,500,000K :


38/322

R< D :


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USULAN LIPPO HM BEKASI HM SUBANG SENTRA MEDIKA

15,000 15000 50,000 58000

50,000 58,00075,000

750,000 !75,000 45,000

5,000 58000 50,000

! 000 5,000

350,000 00,000 150,000

50,000 5000 1 0,000

! 150,000500,000 150,000 51 000

750,000 50,000

5,000 58000 300,000

30,000 45000 40,000

35,000 58000 70,000

40,000 73000 100,000100,000

10,000

00,000350,000

50,000 5000

0

0,000 5000


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00,000150,000150,000800,000

300,000 50,000100,000 130000

150,000 450000 50,000 3 000

BEKASI850,000 7 7,500

1, 00,000 1, 37,5001,700,000 ,09 ,500

,100,000

50,000 98000 0,000

100,000 190000 500,000 450000 50,000

5,00075,00075,000

350,00050,000

500,000 106,875

750,000 180,000

50,000

5,000

40,000

70,000

100,000

100,000

50,000

5 0,00050,000


41/322

1 0,000

850,0001,750,000

,500,0004,000,000

50,000

50,000

75,000 0000 35,000 35000 50,000

100,000 190000 15,000

75,000 75,000 0000 145,000

35,000 35,000 35000 0,000

1 5,000 175,000 19 ,00050,00050,000 80,000

1 5,000 0,000 40,000

175,000 100,000 40,000

50,000 13 ,000

75000 80,000

150,000 310000

1 5,000

100,000 310000

750,00030,00035,000 88,000

5,000,500


42/322

0,0004 ,000

1 0,000150,000

340000 1 5,000

5000 40,000

KELAS III 3,000,000 900,000 55,000

Dit m& 5% d ri r( # rtus norm l 1185000.10 8750.1184375500,000 543,000

3,000,000 900,000 3, 35,0007,000,000 1,400,000 9,703,000

,413,000!

400,000400,000

50,000

500,00080,000

! 500,000

500,000

150,000 8 000 88,000


43/322

90,000

35,000 0,000 50000 35,000 0,000 50000 45,000 80,000

0,000

80000 4 ,000

5000 4 ,000

55,000 95000 40,000

35,000 95000 80,000

!!

!! 11 500

5,000 8 000 50,000

35,000

! 5,000 8 000

40,000

5,00050,000

0,000 40,000


44/322

0,000 95000 40,000

30,00050,00075,000

!!

5,0005,000

70,000

1 0,000

88,000

1 0,000

1 5,000 10 ,000100,000

4 ,000

7 ,000

80,000

13 ,000

500,0001, 00,0001,750,000

,500,000

750,0001,000,000


45/322

35,000 80,00030,000 75,00050,000 35,000

35,000 75,000 33,000

50,000 ! 75,000 1 0,000

80,000 !

100,000 150,000

40,000 HHH 33,000

30,000 50,000 19 ,000

50,000 ! 75,000 HHH 5,000 HHH 33,000

0,000 5,000 33,000

100,000

30,000 45,000 88,00050,00075,000

150,00040,00040,000 19 ,000

! 88,000

!

!!!

80,00035,000 48,500

! 5,000 33,000

15,000 0,000


46/322

750,0001,100,0001,700,000

!

30,000 ! 50000 40,00075,000 80,000 79,000 88,000

,000,000150,000 100,000

13 ,000

150,000

180,000

40,000

180,000150,000 150,000 3 0,000

00,000 00,000 183,00075,000 98,000 75,000

75,000 183,000 9 ,500

75,000 98,000 79,500

100,000 130,000 99,000

100,000150,000

100,000 100,000


47/322

13 ,000

180,000

108,000

119,00045,000

1,000,000

0,000

100,000

150,000

50,00050,00075,000

398,000

00,000 00,000

1,000,000 !1,1 0,000 1,500,000

500,000 40,000

95,0000,000

450,000

75,00040,000

100,0000,000

! 11 000.R )I500,000

150,0005,000

75,000100,000 100,000150,000100,000150,000300,000450,000

,000,00075,000


48/322

5,500,000100,000

75,00075,000

1,300,0003,000,000

150,00075,000

400,000

00,000 450,000100,000 183,000

1,000,000 1,1 1,000100,000 183,000

1,500,000100,000

1,000,000 1,1 1,000750,000 848,000750,000 7 7,000

,000,000

300,00075,00075,00050,00075,00030,00040,00050,000

5,00075,000

150,0004, 00

150,000 40,000


49/322


50/322

BEKASI ANNISA AMANDA HARAPAN KELUARGA SILOAM MITRA TMR

15,000

50,000

50,00075,000

750,00075,000

30,000 45,000

40,000 85,000

350,00050,000 140,000 5,000

!500,000750,000

9,000 45,000 50,000

34,500 55,000

48,000 80,000

110,000 180,000

1 5,000 180,000

110,000 3 0,000

140,000 180,000

55,000 75,000


51/322

145,00050,000

55,000

1,3 ,000 1,440,000 800,000 770,000

3,051,000 ,770,000 1,000,000 143,0003,799,000 3,900,000 1,500,000 ,530,000

4,543,000 4,810,000 ,000,000 3,830,000

30,000

0,000

100,000500,000

50,0005,000

75,00075,000

350,00050,000

500,000

750,000

3 0,000


52/322

1,455,000 800,000 1, 00,000

3,07 ,000 1,000,000 ,300,000

4,04 ,000 1,500,000 3,800,000

4,9 5,000 ,500,000 4,800,000

30,000

75,00035,00050,000

100,00015,000

1 5,000 130,000 18 ,000

50,000 85,000 130,000

1 5,000 185,000 3 4,000597,000

HHH

50,000

00,000

90,000 90,000 100,000 147,000

40,000

1,000

150,00070,000

15,000

150,000

70,000

5,000 5,000

5,000

35,00045,000


53/322

85,000

30,000 35,000

1 ,500

150,0005,000 100,000

00,000 100,000

5,000

35,000

00,000

0,000

35,000

30,000

40,000

1,3 ,000 ,14 ,500 1,100,000

1,505,000 1,375,000

915,000 550,000

1,100,0003,150,000 1,500,000

1, 00,0001,375,000

30,000 0,000 0,000

500,000 140,00080,000 90,000 55,000

185,000

5,000

0,000

500,000500,000

150,000


54/322

0,000

0,000

45,000 55,000

00,000

85,000

50,000

5,000

1,000

35,000 75,000 89,000

58,000

89,0005,000

89,000

80,000

5,000

87,500 5,000

5,000

0,000

45,000

1 4,000

155,000

187,000

1 0,000

50,0005,000

5,000

40,000

85,000

5,000 8,000

85,000

0,0001,000


55/322

30,000

50,000

75,000

80,000

155,000 155,000

55,000 85,000

185,000 155,000

5,000 1 4,000

143,000

155,000

1 0,000

89,00089,000

140,000

5,000 0,000

30,000

45,000

1 0,000

90,000

55,000

1, 35,000 1,7 0,000 800,000 850,000

,731,000 3,050,000 1,000,000 1, 50,000

3,108,000 4,1 0,000 1,500,000 1,750,000

3, 14,000 4, 90,000 ,000,000 ,500,000

750,0001,000,000


56/322

35,00030,000 40,000 1 9,000

50,00075,000

150,00035,000 30,000

50,00075,000

80,0001 9,000

100,000 457,000457,000

40,0008,000

115,000

30,000 104,000

50,00075,000

5,000 59,000

0,000 104,000158,000

30,00030,000

55,000

300,000

70,000

104,000

5,000 104,000

185,000

150,000

30,000

30,000 41,000

30,000 54,000


57/322

457,000

457,000

555,000

75,000

75,000104,000

30,000 104,000

45,000

5,000

30,000

300,000

300,000

1, 10,000 800,000 750,000

,3 7,000 1,000,000 1,350,000

,9 0,000 1,500,000 1,850,000

3,000,000

5,000 75,000 5,00050,000 80,000 50,000

90,000 90,000 300,000

110,000 1 0,000 500,000

90,000 380,000

90,000 70,000 0,000

105,000 1 0,000 90,000

70,000 80,000


58/322

90,000 0,000

135,000 105,000 110,000

155,000 180,000 150,000

105,000 95,000 0,000

115,500 140,000 90,00050,000 300,000

00,000 300,000

45,000 35,000

55,000 45,000

150,000

00,000

730,000 800,000 1, 50,000

,500,000

180,000 150,000 150,000 750,000

150,000

40,000

350,0005,000


59/322

100,000

300,000

5,000

45,0001 0,000

90,000

1 5,000

350,000 3 5,000 500,0009 ,000 100,000 130,000

935,000 1,300,000

1 5,000 150,000

1,000,000

00,000

975,000 50,000

500,000 750000!900000

875,000 1, 50,000

1,000,000 3,000,000 ,500,000

90,000 50,000

95,000 75,000 100,000 150,000

00,000 150,000 0,000 150,000

00,000 0,000

1,050,000 ,500,000 1,000,000

10,000,000

11,000,000

14,000,000

,000,000


60/322

9,000,000

10,000,000

1 ,000,000

13,000,000

175,00090,000 100,000

,000,000

1 5,000

3 0,000

510,000

150,000

50,000

5 5,000 40,000

45,000

835,000

05,000

15,000

835,000

05,000

835,000

05,000150,000

3, 00,000

,975,000

835,000

415,000

35,000


61/322

CITRA HARAPAN HERMINA BELLA

55000

7 000

80000

1 5000300000

580000

910000

1 0000

300000


62/322

850000

500000

75000

50000

170,000


63/322

135000

35000


64/322

40,000


65/322

90,000

80,000


66/322

80,000


67/322

155,000


68/322

70,000100,000

300,000

00,000

150,000

150,000150,000


69/322

1,000,000

100,000

1, 50,000


70/322

50,000


71/322


72/322

TARIF PER JENIS OPERASI

KETERANGAN HM LIPPO

:o Jenis #er si KELAS

I+ I+

OPERASI KECIL

1


73/322

OPERASI KHUSUS

1 "#lenektomi ### ###K olesistektomi sulit ### ###

3 1 Bi - terse&ut dilu r rese# dokter, r t in #, isite dokter d n #emeriks n #enun n(

#er si 6ito k sus, s dokter dit m& 5%

3 Jik d kesulit n d n tind k n l in, m k &i - k n &eru& / Jik o4 Bi - terse&ut d l untuk #er t n &i s '&uk n 6U*5 Bi - dministr si 5% d ri tot l &i -8 + d (emeli, untuk & -i &erikutn- &i - dit m& 50% #er & -i

7 Dokter An stesi 40% d ri s dokter o#er tor < ri k m r o#er si sud term suk l t ! l t st nd ris si o#er si


74/322

9 Jik o#er si le&i d ri s tu ktu d n d l m &ed l # n( n o#er si m10 Bil o#er si dil kuk n ole dokter s#esi lis - n( &er&ed m k s o#er tor n- m

OPERASI KECIL1 Bio#si tumor den( n )ener l An stesi ')A* 1,050,000 1,050,000

ks#lor si n so rin( den( n )ener l An stesi ')A* 1,050,000 1,050,0003 kstr ksi &end sin( di idun( . telin( den( n )A 1,000,000 1,000,000

OPERASI SEDANG1 kstr ksi $erumen sulit 1,500,000 1,500,000

kstr ksi &end sin( sulit


75/322

1 Cess 'Cun$tion r- ndos$o#- "inus "ur(er-* ,500,000 ,500,000An(io o&rom n so rin( ,500,000 ,500,000

3 Dekom#resi $i lis ,500,000 ,500,0004


76/322

13 Re# ir istel 3,300,000 3,300,00014 "istosko#i den( n tind k n 3,300,000 3,300,000

OPERASI KHUSUS1


77/322

1 Ciks si intern - n( kom#leks , 50,000 , 50,000

Ciks si le&i d ri s tu tul n( , 50,000 , 50,0003 Dis rtikul si , 50,000 , 50,0004 Multi#le re# ir tendon , 50,000 , 50,0005 Am#ut si tul n( &es r , 50,000 , 50,0008 #en reduksi r ktur , 50,000 , 50,000

OPERASI KHUSUS 1 M $rosur(er- 3,750,000 3,750,000

Artros$o#- 3,750,000 3,750,0003 ) nti sendi 'tot l knee i# el&o * 1 sendi 3,750,000 3,750,0004 Cr ktur - n( kom#lek ' r ktur $et &ulum, tul n( &el k 3,750,000 3,750,0005 "eoliosis 3,750,000 3,750,0008 "#ondilitis 3,750,000 3,750,0007 Kel in n $on(enit l se#erti 6D 3,750,000 3,750,000

Am#ut si Mind u ter 1 sisi 3,750,000 3,750,000

9 Am#ut si Core u ter 1 sisi 3,750,000 3,750,00010 Reseksi tumor mus$uloskelet l F rekontruksi 1 tul n( 3,750,000 3,750,00011 Artros$o#- 3,750,000 3,750,0001 6< 3,750,000 3,750,00013 :e(le$ted r $ture 'non union . m l union* 1 tul n( 3,750,000 3,750,00014 Dislok si l m 1 tul n( 3,750,000 3,750,000

Keter n( n >1 Bil le&i d ri 1 's tu* tul n( t u sisi &i - t m& 50%

OPERASI KECIL1 ktir# si #oli#+l $ent m nu l 1, 00,000 1, 00,000

3 M$ Don ld . " irodk r 1, 00,000 1, 00,0004 +en it n ro&ek n ser iks 00,000 00,0005 idrotu& si 1,050,000 1,050,000

OPERASI SEDANG &s(-n1 kstir# si M-om )e&urt 1,700,000 1,700,000

M = '


78/322

1


79/322

Ru#tur 6orne 4,050,000 4,050,0003 D $r-o$-ste$tom- 'D6R* 4,400,000 4,400,0004 Re# ir #tosis 3, 00,000 3, 00,0005 "tr &ismus 4,300,000 4,300,0008 nu$le si &ul&i 4,500,000 4,500,0007 K t r k den( n #en-ulit F # s n( I L 'Intr $uler Le 3, 00,000 3, 00,000


80/322

USULAN LIPPO USULAN BEKASI

KELASI II III I+ I II

Rp950,000 Rp 850,000 Rp 750,000 ### ### Rp 850,000### ### Rp1,000,000 ### ### Rp1,100,000

Rp950,000 Rp 850,000 Rp 750,000 ### ### Rp 850,000Rp950,000 Rp 850,000 Rp 750,000 ### ### Rp 850,000Rp950,000 Rp 850,000 Rp 750,000 ### ### Rp 850,000

### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000

### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000### ### Rp1,400,000 ### ### Rp1,500,000

### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000

### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp2,000,000 ### ### Rp2,100,000### ### Rp2,000,000 ### ### Rp2,100,000### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000

### ### Rp1,800,000 ### ### Rp1,900,000### ### Rp1,800,000 ### ### Rp1,900,000

BedahUmum

BedahUmum

BedahUmum


81/322

### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000

### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000### ### Rp3,000,000 ### ### Rp3,200,000

### ### Rp2,500,000 ### ### Rp3,500,000

BedahUmum

BedahUmum


82/322

sin( ! m sin(

950,000 50,000 750,000 1,050,000 950,000 50,000950,000 50,000 750,000 1,050,000 950,000 50,000900,000 00,000 700,000 1,000,000 900,000 00,000

1,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,000

1,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,0001,400,000 1,300,000 1, 00,000 1,700,000 1,500,000 1,400,000

1,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,000

, 00,000 ,100,000 ,000,000 ,300,000 , 00,000 ,100,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,000


83/322

,400,000 ,300,000 , 50,000 3, 00,000 ,900,000 ,700,000,400,000 ,300,000 , 50,000 3, 00,000 ,900,000 ,700,000,400,000 ,300,000 , 50,000 3, 00,000 ,900,000 ,700,000,400,000 ,300,000 , 50,000 3, 00,000 ,900,000 ,700,000,400,000 ,300,000 , 50,000 3, 00,000 ,900,000 ,700,000,400,000 ,300,000 , 50,000 3, 00,000 ,900,000 ,700,000,400,000 ,300,000 , 50,000 3, 00,000 ,900,000 ,700,000

50%

Urologi 1,500,000 1, 00,000 1,000,000 1,900,000 1,500,000 1, 00,0001,500,000 1, 00,000 1,000,000 1,900,000 1,500,000 1, 00,0001,500,000 1, 00,000 1,000,000 1,900,000 1,500,000 1, 00,0001,500,000 1, 00,000 1,000,000 1,900,000 1,500,000 1, 00,0001,500,000 1, 00,000 1,000,000 1,900,000 1,500,000 1, 00,0001,500,000 1, 00,000 1,000,000 1,900,000 1,500,000 1, 00,0001,500,000 1, 00,000 1,000,000 1,900,000 1,500,000 1, 00,0001,500,000 1, 00,000 1,000,000 1,900,000 1,500,000 1, 00,000

Urologi ,150,000 1,950,000 1,750,000 ,550,000 ,150,000 1,950,000

,150,000 1,950,000 1,750,000 ,550,000 ,150,000 1,950,000,150,000 1,950,000 1,750,000 ,550,000 ,150,000 1,950,000,150,000 1,950,000 1,750,000 ,550,000 ,150,000 1,950,000,150,000 1,950,000 1,750,000 ,550,000 ,150,000 1,950,000,450,000 ,350,000 , 50,000 ,550,000 ,450,000 ,350,000,150,000 1,950,000 1,750,000 ,550,000 ,150,000 1,950,000, 00,000 ,100,000 ,000,000 ,300,000 , 00,000 ,100,000,150,000 1,950,000 1,750,000 ,550,000 ,150,000 1,950,000, 00,000 ,100,000 ,000,000 ,300,000 , 00,000 ,100,000,150,000 1,950,000 1,750,000 ,550,000 ,150,000 1,950,000,700,000 ,800,000 ,500,000 , 00,000 ,700,000 ,800,000

Urolo(i3, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 3,100,000 3,000,000 3,300,000 3, 00,000 3,100,000

,950,000 , 50,000 ,750,000 3,050,000 ,950,000 , 50,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,000

3, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,000


84/322

3, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,0003, 00,000 , 00,000 ,800,000 3,300,000 3, 00,000 , 00,000

Urologi 4,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,000

4,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,000

4,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,0004,050,000 3,585,000 3, 35,000 4, 50,000 4,050,000 3,585,000

(/

50% d ri t ri tind k n o#er tor se&elumn- /#er tor #ert m

Bedah Tulang / Ort 950,000 50,000 750,000 1,150,000 950,000 50,000

950,000 50,000 750,000 1,150,000 950,000 50,000

Bed


85/322

,450,000 ,350,000 , 50,000 , 50,000 ,450,000 ,350,000,450,000 ,350,000 , 50,000 , 50,000 ,450,000 ,350,000,450,000 ,350,000 , 50,000 , 50,000 ,450,000 ,350,000,450,000 ,350,000 , 50,000 , 50,000 ,450,000 ,350,000,450,000 ,350,000 , 50,000 , 50,000 ,450,000 ,350,000,450,000 ,350,000 , 50,000 , 50,000 ,450,000 ,350,000

Bed


86/322

,700,000 ,800,000 ,500,000 , 00,000 ,700,000 ,800,000,900,000 , 00,000 ,700,000 3,000,000 ,900,000 , 00,000,700,000 ,800,000 ,500,000 , 00,000 ,700,000 ,800,000,400,000 ,300,000 , 00,000 ,500,000 ,400,000 ,300,000,450,000 ,350,000 , 50,000 ,550,000 ,450,000 ,350,000,700,000 ,800,000 ,500,000 , 00,000 ,700,000 ,800,000

Bedah Syaraf Bedah1, 00,000 1,100,000 9,000,000 1,400,000 1, 00,000 1,100,000

1,100,000 1,000,000 ,000,000 1,300,000 1,100,000 1,000,000

1, 00,000 1,100,000 9,000,000 1,400,000 1, 00,000 1,100,000

15,000,000 14,000,000 1 ,000,000 17,000,000 15,000,000 14,000,00011,500,000 10,500,000 ,500,000 13,500,000 11,500,000 10,500,000

d n isite dokter d n #emeriks n #enun n(/

50% d ri t ri tind k n o#er tor se&elumn-

Bedah Mulut Beda,700,000 ,800,000 ,500,000 , 00,000 ,700,000 ,800,000,950,000 , 50,000 ,750,000 3,050,000 ,950,000 , 50,000

Bed Mulut

3,700,000 3,800,000 3,500,000 3, 00,000 3,700,000 3,800,000

Bedah Mata Beda, 00,000 ,100,000 ,000,000 ,300,000 , 00,000 ,100,000

Bed M t

1,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,000, 00,000 ,100,000 ,000,000 ,300,000 , 00,000 ,100,000

1,700,000 1,800,000 1,500,000 1, 00,000 1,700,000 1,800,0001,950,000 1, 50,000 1,750,000 ,050,000 1,950,000 1, 50,000

, 00,000 ,100,000 ,000,000 ,300,000 , 00,000 ,100,000

Bed M t


87/322

3,950,000 3, 50,000 3,750,000 4,050,000 3,950,000 3, 50,0004,300,000 4, 00,000 4,100,000 4,400,000 4,300,000 4, 00,0003,700,000 3,800,000 3,500,000 3, 00,000 3,700,000 3,800,0004, 00,000 4,100,000 4,000,000 4,300,000 4, 00,000 4,100,0004,400,000 4,300,000 4, 00,000 4,500,000 4,400,000 4,300,0003,700,000 3,800,000 3,500,000 3, 00,000 3,700,000 3,800,000


88/322

SUBANG

KELAS KELASIII I+ I II III IP

1,9 5,000

Rp 750,000 ### ### Rp2,566,000 Rp2,149,500Rp1,000,000Rp 750,000Rp 750,000Rp 750,000

3, 45,000

Rp1,400,000 ### ### Rp4,275,500 Rp3,437,000Rp1,400,000Rp1,400,000Rp1,400,000Rp1,400,000Rp1,400,000Rp1,400,000Rp1,400,000

Rp1,400,000Rp1,400,000Rp1,400,000

5,005,000

Rp1,800,000 ### ### Rp6,649,000 Rp5,653,500Rp1,800,000Rp1,800,000Rp1,800,000

Rp1,800,000Rp1,800,000Rp1,800,000Rp1,800,000Rp1,800,000Rp2,000,000Rp2,000,000Rp1,800,000Rp1,800,000Rp1,800,000

Rp1,800,000Rp1,800,000

BedahUmum

BedahUmum

Be aUmum

BedahUmum

Be aUmum

BedahUmum


89/322

8,180,000

Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000

Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000Rp3,000,000

Rp3,000,000

Be aUmum

BedahUmum

Be aUmum

BedahUmum


90/322

180,000

750,000750,000700,000

3,000,000

1,300,0001,300,0001,300,0001,300,0001,300,0001,300,000

1,300,0001,300,0001,300,0001,300,0001,300,0001,300,0001,300,0001,300,0001,300,0001,300,0001,300,0001,300,000

4,500,000

1,750,0001,750,0001,750,0001,750,000

,000,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,0001,750,000

5, 50,000

Telinga HidungTenggorokan




91/322

,500,000,500,000,500,000,500,000,500,000,500,000,500,000

rologi Urologi 1,000,0001,000,0001,000,0001,000,0001,000,0001,000,0001,000,0001,000,000

rologi Urologi 1,750,000

1,750,0001,750,0001,750,0001,750,000

, 50,0001,750,000

,000,0001,750,000

,000,0001,750,000

,500,000

Urolo(i,800,000,800,000,800,000,800,000,800,000,800,000,800,000

3,000,000,750,000,800,000

,800,000,800,000


92/322

,800,000,800,000

rologi 3, 35,000

3, 35,0003, 35,0003, 35,0003, 35,0003, 35,0003, 35,0003, 35,0003, 35,0003, 35,0003, 35,0003, 35,0003, 35,000

3, 35,0003, 35,0003, 35,0003, 35,0003, 35,0003, 35,000

hopedi Bedah Tulang / Orthopedi 3,400,000750,000 1,150,000 950,000 50,000 750,000750,000 1,150,000 950,000 50,000 750,000

ul n( . rt o#edi Bed


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, 50,000 , 50,000 ,450,000 ,350,000 , 50,000, 50,000 , 50,000 ,450,000 ,350,000 , 50,000, 50,000 , 50,000 ,450,000 ,350,000 , 50,000, 50,000 , 50,000 ,450,000 ,350,000 , 50,000, 50,000 , 50,000 ,450,000 ,350,000 , 50,000, 50,000 , 50,000 ,450,000 ,350,000 , 50,000

ul n( . rt o#edi Bed


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,500,000 , 00,000 ,700,000 ,800,000 ,500,000,700,000 3,000,000 ,900,000 , 00,000 ,700,000,500,000 , 00,000 ,700,000 ,800,000 ,500,000, 00,000 ,500,000 ,400,000 ,300,000 , 00,000, 50,000 ,550,000 ,450,000 ,350,000 , 50,000,500,000 , 00,000 ,700,000 ,800,000 ,500,000

Syaraf Bedah Syaraf 9,000,000 1,400,000 1, 00,000 1,100,000 9,000,000

,000,000 1,300,000 1,100,000 1,000,000 ,000,000

9,000,000 1,400,000 1, 00,000 1,100,000 9,000,000

1 ,000,000 17,000,000 15,000,000 14,000,000 1 ,000,000,500,000 13,500,000 11,500,000 10,500,000 ,500,000

Mulut Bedah Mulut ,500,000 , 00,000 ,700,000 ,800,000 ,500,000

,750,000 3,050,000 ,950,000 , 50,000 ,750,000

Bed Mulut Bed Mulut

3,500,000 3, 00,000 3,700,000 3,800,000 3,500,000

h Mata Bedah Mata 1,750,000,000,000 ,300,000 , 00,000 ,100,000 ,000,000

Bed M t Bed M t,500,000

1,750,000 ,050,000 1,950,000 1, 50,000 1,750,000,000,000 ,300,000 , 00,000 ,100,000 ,000,000

1,500,000 1, 00,000 1,700,000 1,800,000 1,500,0001,750,000 ,050,000 1,950,000 1, 50,000 1,750,000

,000,000 ,300,000 , 00,000 ,100,000 ,000,000

Bed M t Bed M t3, 00,000


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3,750,000 4,050,000 3,950,000 3, 50,000 3,750,0004,100,000 4,400,000 4,300,000 4, 00,000 4,100,0003,500,000 3, 00,000 3,700,000 3,800,000 3,500,0004,000,000 4,300,000 4, 00,000 4,100,000 4,000,0004, 00,000 4,500,000 4,400,000 4,300,000 4, 00,0003,500,000 3, 00,000 3,700,000 3,800,000 3,500,000


96/322

SILOAM MITRA TMR CITRA HARAPANKELAS

I II III

1,430,000 1,100,000 770,000

1,9 0,000 1,705,000 1,430,000

3,905,000 3,0 0,000 ,530,000


97/322

5,810,000 4,510,000 3,830,000


98/322

1,100,000 900,000 850,000

1,750,000 1,500,000 1, 50,000

,750,000 , 50,000 1,750,000

4,000,000 3, 50,000 ,500,000


99/322


100/322

, 50,000 1,750,000 1, 00,000

4,500,000 3,400,000 ,300,000

3,905,000 3,0 0,000 ,530,000

3,905,000 3,0 0,000 ,530,000


101/322

5,810,000 4,510,000 3,830,000


102/322

1,500,000 1, 00,000 750,000

00,000 1,750,000 1,350,000

,500,000 , 00,000 1,850,000


103/322


104/322

RAPAN KELUAR AMANDA MITRA TMR CITRA HARAPAN HERMINA


105/322


106/322


107/322


108/322


109/322


110/322


111/322


112/322

BELLA


113/322


114/322


115/322


116/322


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119/322


120/322

TARIF PENUNJANG MEDIS

KETERANGAN HM LIPPO USULAN LIPPO

TARIF RADIOLOGI

6RA:IUM 140,000 140,0006 R I6AL +"" 150,000 150,0006 R I6AL 4 +"" 1 0,000 1 0,000

" :A"AL 140,000 140,000MA:DIBULA 140,000 140,000MA"< ID 135,000 135,000"+: 1 0,000 1 0,000MA:U" 135,000 135,000=RI"< J I:< 135,000 135,000

A:< BRA6 I 140,000 140,000LB = J I:< 135,000 135,000UM RU" 140,000 140,000

A:KL J I:< 135,000 135,000+ DI" 140,000 140,0006RURI" 140,000 140,000K: J I:< 140,000 140,000

ABD M : 3 + "I"I 330,000 330,000C MUR 140,000 140,000

6ALKA: U" 140,000 140,000< RAG A+.+A 1 0,000 1 0,000< RAG A+ LA< RAL 1 0,000 1 0,000< RAG LA< RAL 1 0,000 1 0,000< + L RD


121/322

MD 500,000 500,000UR


122/322

6RURI" D G . "I:LB = J I:< D G F "I:LB = J I:< D G . "I: 85,000

C MUR D G ."I: 75,000

C MUR D G F "I:UM RU" 85,000UM RU" D G F "I:UM RU" D G . "I:

MA:U" A+ 85,000MA:U" BILA< RALMA:U" D G F "I:MA:U" D G . "I:MA"< ID 85,000

RBI


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" ULD R J I:< 85,000" ULD R BILA< RAL"+: 85,000

R


124/322

!!

TARIF RADIOLOGI UNTUK RAWAT INAP KELAS / :

ABD M : 3 + "I"I A:KL J I:< KA F KI A:KL J I:< KA . KI A:< BRA6 I KA F KI A:< BRA6 I KA . KI AR< BA U KA F KI AR< BA U KA . KI AR< ) :U KA F KI AR< ) :U KA.KI

ABD M : + L " 'B: *B : "UR ;6LA IKULA KA F KI6LA IKULA KA . KI6 LL R< 6 R IKALI" + "I"I6 R A:AL"6RA:IUM 6RURI" KA F KI

6RURI" KA . KI

LB = J I:< KA.KIC MUR KA.KI

I+ J I:< KA.KIUM RU" J I:< KA.KI

MA:DIBULA KA.KIMA:U" KA.KIMA"< ID:A"AL

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125/322

=RI"< J I:< KA F KI=RI"< J I:< KA . KI

;) MA


126/322

)olon( n D r 1 ,000R C ktor 4,000L D

HEMATOLOGI0COAGULASIM s +end r n 10,000 10,000M s +em&eku n 10,000 10,000Ci&rono(en +R 198,000 198,000D r Rutin 40,000 40,000

6ross M t$ 7,000 7,0006oom&s


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As m m#edu 19 ,000LA+ 31 ,000LD

KIMIA0Fun$s& G&n2alUreum D r ,000 ,0006re tinin D r ,000 ,000

As m Ur t D r ,000 ,000Ureum Urine 18,5006re tinin urine 18,500

As m Ur t Urine 18,500Ureum 6le r n$e 30,000

KIMIA0D&a#,+,s)ul D r +u s ,000 ,000)ul D r ++ ,000 ,000)ul D r "e ktu ,000 ,000Kur ri n 4 ,000


128/322

Anti B$


129/322

6 romMet nol

KIMIA0L,.a*C6 olesterol


130/322

TORC


131/322


132/322

+"A '+rost t* 37,000"66 '"er iks* 330,000

MIKROBIOLOGI

Kultur 40,000Resistensi 40,000)AL Kultur 150,000Kultur B


133/322

+ LI


134/322

HM BEKASI HM SUBANG HM PILAR SENTRA MEDIKA ANNISA

19000175000

00000000000000000000

45000000000

11 50059000

11 500

175000175000175000140000

94000

140000508000


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450,000 ! 08,50075,000 153,000

175,000 153,0000,000 153,000

119,000153,000

119,000

153,000

119,000

150,00085,000 ,000

! 140000 ! 99,000 114,000809,500

75,00090,000 119,000

1 0,000 153,000119,000

171,500

138,500

0 ,000

138,5000 ,000

138,500

0 ,000

80,000 131,000109,000

1 0,000 14,000

! 5,000 7,000

0,000 7,000 119,000

119,0000,000 0 ,000 151,000

140/00075/000

0/000

1 0/000150/000

75/00090/000

1 0/000

80/000

1 0/000

0/000

0/000


136/322

138,500

153,000

75,000 119,000

0,000 138,500 151,000

0 ,000175,000 0,000

153,000

119,000

75,000

153,000

119,000

0,000 119,000 114,000

0,000 119,000 107,0000,000 153,000

119,000

140,000 70,000 119,000 10 ,0007,000

119,000

138,000 950,000

11 ,500 80,000 7,000 89,000

59,000 80,000 147,000

119,000138,500

100,00080,000

153,000

0,000 113,000

1 0,00075,000 153,000 114,000

119,00035,000

114,000

80,0000,0000,000 114,000

0,000 113,000

! 175,000 0,000

75/0000/000

0/000

75/000

0/000

0/0000/000

70/000

80/000100/000

80/00080/000

0/0001 0/000

70/000

35/000

0/0000/0000/0000/000

3 5/0000/000


137/322

175,000 0,000

0,000 131,000

! 100,000 135,000

100,000!

! ! ,370,000

100,000 1,050,000

00,0000,000

100,000 187,000

5 ,000 ! 490,000 1,3 5,000

1, 75,000

119,000

508,000 50,000 194,000

550,000 87 ,000 7 ,00073 ,000

838,000

475,000 500,000

3 5,000 838,000 535,000

851,000350,000 443,000

400,000 405,000 518,000

375,000 573,000 413,00083 ,000

9,000

704,000

347,000

583,000

400,000 4 3,000 535,000857,000

! 3 5,000

! 1,041,000

!! 5 7,000 800,000

! 84 ,000!

0/000

0/000

100/000100/000

100/00000/000

0/000100/000100/000

50/000550/000

475/0003 5/000

350/000400/000375/000

400/000

1/333/5001/385/000

750/000

50/0000/000


138/322

!!

10 ,000

197,000

109,000

114,000

114,000

10 ,000

107,000

/83 / 00750/000


139/322

1 5,000 30,000

5,000195,000

170,000195,000

0,0001 ,000 0,00040,000 5,000 70,000

7,000 0,0001 ,000 0,000

40,000 !1 ,000 0,00050,000 5,000

5,000 0,000 5,000 1 ,000 ,000

15,000 17,000

18,5000,000

1 5/000

5/000195/000

170/000195/000


140/322

19,000 33,000 0,000

9,000

10,000 19,00010,000 19,000

158,0007 ,000

103,00087,500

150,000

88,00080,90085,000

30,000 39,000

,000 39,000

,000 39,000,000 39,000

,000 39,000 57,501

,000 39,000 30,000

39,000,000 39,000 30,000

,000 39,000 30,000

30,000

8,000


141/322

,000 39,000 3,000

,000 39,000 3,000

,000 39,000,000 39,000,000 39,000,000 39,000

57,750

,000 39,000,000 39,000,000 39,000 3,000

109,000

90,000 310,00090,000 310,00050,000 70,000

55,000

50,000

85,000 7 ,000


142/322

5,000 47,00038,000 39,000

39,000

5,000 39,000

55,000 50,00039,800

50,000!

45,00045,00045,00045,000

7 ,000


143/322

8,000 39,000,500 47,000,500 47,000

7,000 54,00057,800

30,00030,00030,0004 ,500

80,000

33,000

149, 00


144/322

310,000

310,000

100,000114,000


145/322

55,000


146/322

30,000

7 ,000 115,000 135000


147/322


148/322

AMANDA HARAPAN KELUARGA SILOAM MITRA TMR RA HARAP HERMINA BELLA


149/322

0,000173,000 ,8 5,000 3 5,000 84,000

1,000 30,000154,000185,000

1,000 50,000

975,000

7,000805,000

115,000 ,000

179,000

179,000

179,000

179,000

70,000

1,000

149,000

5,000

143,000

19 ,0001,000 80,000


150/322

175,000

115,000 189,000

1,000 185,000

1,000 154,000

181,000 30,000

9 ,000 178,000

9 ,0001,000 55,000

170,000

9 ,000 148,000

183,000

1,3 , 00 00,000

150,000 157, 00

1 7,000 1 ,000

157, 00

1,593,900

183,000

45,000

1,000 40,000

180,0003,000

181,000

13 ,000

104,000 178,000

7,000 143,000

13 ,000


151/322

1,000 185,000

50,000

9 ,000

,000

115,000

115,000 9 9,700 ,000

395,000

115,000 4 ,000

115,000

0,000181,000 , 5 ,000

193,000

300,000 50,000

400,000

1,150,000

80,000 550,000

50,000

350,000 385, 00

950,000

850,000

800,000

575,000

450,000

884,100

884,000

998,100


152/322

05, 00119,500

8,300

119,500

8,300

9 ,400

83,500

9 ,400

83,500

79,800531,300

9 ,900

79,800

99,800

13 , 00

99,800

159,300

99,500

8,30099,800 180,000

8,300 178,000

1,000 8,300

75,000

8,300

99,800

79,700

79,700

119,500119,500

8,300

79,700

79,700

150,900

8,800

159,400

11 ,900

180,000 10 ,8000,000 7 ,400


153/322

119,500

8,300

99,800

88,400

45 ,800 385000

85,800 300,000

453, 00

33 ,000

341,800

453, 00

85,800 300,000 3 1,000

300,000 573,000

453, 00 385,000

5, 00 300,000

300,000 3 4,000

453, 00

5, 00

199, 00

385,000

15,100

55,000 75,000 3,500

1 ,000 15,100 ,500

1 ,000 15,100 33,000

1 ,000 54,300 3 ,500

15,100 5,000

50,800

5,000 0, 00

1 ,000 15,100 5,000 HHH

5,000 30,000

30,000

0, 00 31,000


154/322

1 ,300 31,000 30,000

0,000

1 ,000 15,100 5,000

5,000 8,500

5,000 8,500

153,000 19 ,000

3,000

1 0,000 131,000131,000

180,000 19 ,000

189,000 50,000

19,000

75,000 314,000

79,000

97,500

110,000 1 0,000

1,000

05,000

7,500 180,000

57,500 4,000 88,000 43,500

4,000 41,50045,500 40,000

11 , 00 1 9,000

4,000 70,000 4 ,000

4,000 70,000 4 ,000

4,000 70,000 3 ,500

7,500 4,000 3 ,000 43,500

7,500 4,000 3 ,000 43,500

50,000 48,100 53,000 84,000

90,400 104,000 134,00053,900 37,900 55,000 80,000


155/322

90,900 375,000

330,000

9 ,000 4,700 9 ,000

3,400 31,000 43,500

3,400 33,000

3 ,500 3,400 3 ,000 4 ,500

3,400 89,000

3,400 89,000

3,400 89,000

13 ,000 107,000

,000 0, 00 5,000 3 ,000

,000 0, 00 5,000 3 ,000

,000 0, 00 5,000 3 ,000

83,000 113,000

91,700 139,000

195,000

15,800 11,000,700

4 0,000 1 5,000

31 ,400 4 0,000 1 5,000

57,500 58,900 5,000 97,500

197,800 130,000 17 ,000

197,800 1 0,000 1 5,000

197,800 5,0004 ,500 55,300 55,000 71,500

90,000 9 ,500

55,000

78,500 9 ,000 1 1,500

151, 00 110,000 133,500

330,400 0,000 309,50044 ,000 411,100 3 3,000 358,500


156/322

1 4,000

470,400 359,000

45 , 00 1,9 5,000

1,400 15,000 91,000

354, 00 17,500 55,000 3 0,000

3,000 4,800 43,000 5 ,000

0,000 4,000

0,000 4,000

8,000 30,000

30,900 78,000 77,000

0,000

80,000 44,000 187,000

77,000 3 ,500

31,000

84,000

110,000

33,000

4 5,000

81,800 53,700 110,000

53,700

53,700

110,000

110,000

110,000110,000

118,000

97,000

97,000

97,000

97,000

97,000

97,00010 ,000


157/322

10 ,000

330,000

7,500 4,000 43,500

33,000 4,000 59,000

33,000 4,000 59,000

4,000 43,500

55,300

199, 00

18 , 00

83,100

19 ,700

333,800

4,700

78,500

18,800

18,800

78,700

50,000 1 0, 00 50,000 59,000

50,000 HHH 59,000

50,000 59,000

57,700 50,000 5 ,000

53,700 50,000 8 ,000

50,000 58,900 50,000

75,000135,000

33,000

75,000

15 ,100 140,000 178,500

174,000 15 ,100 187,000 178,500

0 ,400 400,000


158/322

31,000

31,00031,000 199, 00 175,000

175,000

54, 00 1 4,000

10,000

195,000

195,000

1 0,000

1 0,000

7 ,100

4,000

4,000

45,500

14,000

140,000 180,000 178,000

140,000 180,000 178,000

50,000 174,000

358,00039,000 30,500


159/322

178,000 194,000

18,300 15,000 5 ,500

80,900 15,000 5 ,50080,900 10,000 5 ,500

347, 00 4 ,000 330,500

33 ,000 84,000 330,000

33 ,000 5 ,000 343,000

80,000

3 7, 00 313,000 358,000

9, 00 4 ,500

3 1,500

3 1,500

534,500

540,000

3 1,500

3 1,5003 1,500

3 1,500

348,500

3 1,500

3 1,500

3 1,500

3 1,500

3 1,500

540,000348,500

15,000

15,000

488,400

49 ,000

414, 00347, 00


160/322

40,000 58,700

78,700

00,000 7,70030,000

150, 00

00,000 0 ,700

7,500 49,000

49,000

1 ,000

15 ,000 08,500

1 7,000

171,000

171,000

355,000

15 ,000

134,000

1,430,000, 00,000

143,000

147,000

3 ,900

318, 00

11 , 00

71,900133,100

174,500

371,900

90,900

0,000 90,000

0,000 ,500

0,000 50,0000,000


161/322

0,000 5,000

0,000 30,000


162/322

TARIF SEWA ALAT

KETERANGAN HM LIPPO USULAN LIPPO

RUANGANI+ 400,000 400,000

K LA" I U


163/322

K U"U" +A"I : JAMK "DA " =A ALA< 750,000 750,000K U"U" +A"I : JAMK "DA " =A ALA< 750,000 750,000

RUJUKA: BIDA:" =A K'KUR


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SENTRA MEDIKA ANNISA AMANDA HARAPAN KELUARGA SILOAM


165/322


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MITRA TMR CITRA HARAPAN HERMINA BELLA


167/322


168/322

KETERANGAN M LIPPO

JASA PERAWATJA"A M DI" + RA=A


169/322

U") < RAGU")


170/322

1/ A A/


171/322

#er si Ke$il#er si "ed n(#er si Bes r #er si K usus

TARIF JASA DOKTER BEDAH UROLOGI

#er si Ke$il !#er si "ed n( !#er si Bes r !#er si k usus !"=L !

TARIF JASA DOKTER BEDAH MULUT

dentektomi d(n Dr(/ "# BMdentektomi d(n Dr(/ Umum

TARIF OPERASI SYARAF

#er si Ke$il#er si "ed n(#er si Bes r #er si K usus


172/322

LIPPO

TARIF TINDAKAN DIRUANGAN PERAWATAN BIASAen seksi 00,000

"u$tion 18,500+u(si >1/ +leur 100,000

/ A$ies ' &domen* !

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/ Ke$il 5,000

&/ sed n( 30,000$/ &es r 40,000


173/322

USULAN LIPPO HM BEKASI HM PILAR NTRA MEDI ANNISA AMANDA APAN KELUA

15,000 5,000 !

75,000 5,000 !

750,000 750,000! 100,000! 100,000

75,000 ! 00,000 ! 70,000 ! 70,000 ! 70,000 !

! !

! 500,000! 800,000! 750,000

40,000 40,000 45,000 80,000 44,00000,000

150,000 ! 05,000 150,000

0,000 00,000

05,000 150,000

195,000 150,000


174/322

5,000 150,000

150,000

5,000 1 5,000

150,000

150,00050,000

158,000

195,000

195,000 ! 50,000 50,000 85,000 80,000 75,000

100,000 137,500

50,000 ! 375,000 ! 50,000 75,000

00,000

00,000

00,000

00,000

00,000

00,000

00,000

150,000

1 5,000

50,000

50,000

50,000

50,000

137,500

,500

50,000

50,000


175/322

185,000

5,000

99,000

80,000

150,00050,000

800,000

450,000

900,000

850,000

1,100,000

50,000

0,000

80,00080,000

KELAS III500,000 300,000 750,000

00,000 750,000 1,050,0001, 00,000 900,000 1, 50,000

,000,000 1,400,000,500,000 ! 1,550,000

BEKASIK LA" III

1,000,000


176/322

800,000

3,410,000 3,350,000 1,000,000

3,5 5,000 3,770,000 1,500,000

4, 00,000 ,000,000

850,000 ! 1,473,000 1,440,000 1,500/000 ! 3,395,000 ,770,000 1, 00,000 , 00,000 ! 4,459,000 3,900,000 1, 00,000 3,000,000 ! 5,09 ,000 4,810,000 ,500,000 4,900/000 ! 8,000,000

3,840,000 ,000,000

1,800,000

1,100,000


177/322

BEKASIKELAS III

40,000 00,00018,500 18,500

1 5,000 100,000 1 0,000

1 5,000 !

5,000 5,0005,000 5,0005,000 5,000

00,000 00,0005,000 5,0005,000 35,000

30,000 5,000

35,000 30,00040,000 40,000


178/322

SILOAM MITRA TMR RA HARA HERMINA BELLA

1,479,000

80,000

15,000

150,000

1,14 ,000

1,14 ,000

1,397,000

1,479,000

1,198,000

1,479,000

1,479,000

9,000

114,000

3 1,000

3 4,000

573,000


179/322

108,000

94,000

,000

89,000

100,000


180/322

870,000

790,000

1,000,000

1,1 0,000


181/322

9 0,000

1, 50,000

,100,000

,450,000

750,0001,500,000

,500,000

3,500,000

750,0001,500,000

,500,000

3,500,000


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Perbedaan Tarif Hosana Medica Group 15032013

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Transcript of Perbedaan Tarif Hosana Medica Group 15032013