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Daftar Harga Pemeriksaan Radiologi Rsud Awet Muda Narmada

The document lists the prices for radiology examinations and consumable medical supplies at RSUD Awet Muda Narmada hospital in Lombok Barat Regency. It includes over 30 types of radiology exams such as chest x-rays, abdominal x-rays, and bone x-rays, priced between 75,000 - 300,000 rupiah each. Ultrasound exams and contrast radiology exams are also listed. An appendix provides prices of various disposable medical supplies like syringes, gloves, and bandages. The source is cited as the local government regulation setting the new health service fee tariffs for two public hospitals.

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RADIOLOGI RSHK
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467 views4 pages

Daftar Harga Pemeriksaan Radiologi Rsud Awet Muda Narmada

The document lists the prices for radiology examinations and consumable medical supplies at RSUD Awet Muda Narmada hospital in Lombok Barat Regency. It includes over 30 types of radiology exams such as chest x-rays, abdominal x-rays, and bone x-rays, priced between 75,000 - 300,000 rupiah each. Ultrasound exams and contrast radiology exams are also listed. An appendix provides prices of various disposable medical supplies like syringes, gloves, and bandages. The source is cited as the local government regulation setting the new health service fee tariffs for two public hospitals.

Uploaded by

RADIOLOGI RSHK
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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PEMERINTAH KABUPATEN LOMBOK BARAT

RSUD AWET MUDA NARMADA


Jl. Ahmad Yani No. 69 Narmada Kode Pos 83371
E-mail : rsudam.lombokbarat@gmail.com

DAFTAR HARGA PEMERIKSAAN RADIOLOGI


RSUD AWET MUDA NARMADA

No. JENIS PEMERIKSAAN TARIF


1 Thorax AP/PA 75.000
2 Thorax AP+Lateral 150.000
3 Thorax Top Lordotik 75.000
4 Abdomen 1 Posisi 80.000
5 Abdomen 2 Posisi 160.000
6 Abdomen 3 Posisi 240.000
7 Manus 1 Side (AP-Oblique) 105.000
8 Wrist Joint 1 Side (AP-Lateral) 105.000
9 Antebrahi / Radius-Ulna 1 Side (AP-Lateral) 105.000
10 Elbow Joint 1 Side (AP-Lateral) 105.000
11 Humerus 1 Side (AP-Lateral) 105.000
12 Shoulder Joint 1 Side (AP) 75.000
13 Shoulder Joint 1 Side (Endo-Exo Rotation) 105.000
14 Clavicula 1 Side (AP) 75.000
15 Scapula 1 Side (AP) 75.000
16 Pedis 1 Side (AP-Oblique) 105.000
17 Ankle Joint 1 Side (AP-Lateral) 105.000
18 Calcaneus 1 Side (AP-Tangensial) 105.000
19 Cruris / Tibia Fibula 1 Side (AP-Lateral) 105.000
20 Genu / Knee Joint 1 Side (AP-Lateral) 105.000
21 Femur 1 Side (AP-Lateral) 105.000
22 Hip Joint 1 side (AP) 75.000
23 Pelvis (AP) 75.000
24 Columna Vertebralis Cervicalis (AP-Lateral) 105.000
25 Columna Vertebralis Cervicalis (AP-Lateral-Oblique Kanan Kiri) 210.000
26 Columna Vertebralis Thoracal (AP-Lateral) 150.000
27 Columna Vertebralis Lumbosacral (AP-Lateral) 150.000
28 Columna Vertebralis Thoracolumbal (AP-Lateral) 300.000
29 Scoliosis Program 300.000
30 Cranium / Kepala (AP-Lateral) 105.000
31 Waters 75.000
32 Nasal 180.000
33 Mastoid (AP-Lateral Kanan Kiri) 75.000
34 Print Ulang Film (20x25) Tanpa Bacaan 50.000
35 Print Ulang Film (26x36) Tanpa Bacaan 75.000
36 Print Ulang Film (35x43) Tanpa Bacaan 100.000

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PEMERINTAH KABUPATEN LOMBOK BARAT
RSUD AWET MUDA NARMADA
Jl. Ahmad Yani No. 69 Narmada Kode Pos 83371
E-mail : rsudam.lombokbarat@gmail.com

(Pemeriksaan Radiologi Dengan Media Kontras)


1 OMD 700.000
2 BNO IVP 1.000.000
3 Appendicografi 500.000
4 Barium Follow Through 800.000
5 Colon In Loop 800.000
6 Fistulografi 500.000
7 HSG 800.000
8 Uretrocystografi 500.000
9 Retrograde / Antegrade Pyelografi 700.000
10 Lopogragi 500.000
11 Angiografi 3.000.000
12 Plebografi 2.000.000
13 Cholangiografi 2.000.000
14 Bipolar Uretrocystografi 1.000.000
15 Genitografi 1.000.000
16 Sialografi 800.000
17 Esofagografi 700.000
USG
1 USG Whole Abdomen 350.000
2 USG Urologi 250.000
3 USG Payudara 1 Side 200.000
4 USG Testis/Scrotum 200.000
5 USG thyroid/Colli 300.000
6 USG Muskuloskeletal 400.000
7 USG Soft Tissue 200.000
8 USG Doppler Extremitas 1 Side 500.000
9 USG Doppler Carotis 350.000
10 USG 4D 400.000
11 USG Guide Biopsi 500.000
12 USG Marker 350.000
13 Abses Drainage With USG Guide 500.000

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PEMERINTAH KABUPATEN LOMBOK BARAT
RSUD AWET MUDA NARMADA
Jl. Ahmad Yani No. 69 Narmada Kode Pos 83371
E-mail : rsudam.lombokbarat@gmail.com

Lampiran Harga Bahan Habis Pakai (BHP) :

NO NAMA BARANG SATUAN HARGA


1 ALAT SUNTIK SEKALI PAKAI - 1 CC PCS Rp 1,771
2 ALAT SUNTIK SEKALI PAKAI - 3 CC PCS Rp 1,725
3 ALAT SUNTIK SEKALI PAKAI - 5 CC PCS Rp 1,984
4 ALAT SUNTIK SEKALI PAKAI - 10 CC PCS Rp 2,803
5 ALAT SUNTIK SEKALI PAKAI - 20 CC PCS Rp 2,475
6 ALAT SUNTIK SEKALI PAKAI - 50 CC PCS Rp 11,000
7 HANDSCOON STERIL 6.5 PCS Rp 10,588
8 HANDSCOON STERIL 8 PCS Rp 10,588
9 HANDSCOON STERIL 7 PCS Rp 11,825
10 DULCOLAX SUPP 10MG SUPPO Rp 33,075
11 PLESTER DERMAVIQ 10X8 PCS Rp 5,294
12 ALKOHOL SWAB Pcs Rp 440
13 KASA STERIL 16X16 (ONEMED) Pieces Rp 756
14 FOLEY CATH 24 EC UC Pieces Rp 11,000
15 WING NEEDLE NO. 21, 23, 25G Pieces Rp 1,925
16 BARIUM SULFATE
17 KONTRAS WATER SOLUBLE
18 IRRIGATOR WITH RECTAL CANULA
19 CLEANSING ENEMA SET

3
PEMERINTAH KABUPATEN LOMBOK BARAT
RSUD AWET MUDA NARMADA
Jl. Ahmad Yani No. 69 Narmada Kode Pos 83371
E-mail : rsudam.lombokbarat@gmail.com

Catatan: Untuk Pemeriksaan Radiologi dengan Media Kontras Belum Bisa Dilakukan Pemeriksaan
di Radiologi Awet Muda (Hanya Kisaran Biaya Saja)

Sumber : Peraturan Bupati Lombok Barat Nomor II Tahun 2018, Mengenai Perubahan Tarif Retribusi
Pelayanan Kesehatan Pada Badan Layanan Umum Daerah Rumah Sakit Umum Daerah Patut Patuh Patju
Gerung Dan Rumah Sakit Umum Daerah Awet Muda Narmada Kabupaten Lombok Barat.

Mengetahui :

Direktur Rumah Sakit Umum Daerah


Awet Muda Narmada Dokter Penanggung Jawab Pelayanan Radiologi
RSUD Awet Muda Narmada

dr. A.A.N Putra Suryanatha


NIP. 19641224 199803 1 007
dr. RR. Eka Purwaningsih, Sp.Rad
NIP. 19830705 200901 2 011

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