Tarif
Tarif
31,500
AYANAN estimasi harga sp konser
Total
180,000 250.000-300.000
180,000 250.000-300.000
188,000
200,000
180,000
180,000
125,000
125,000
200,000 1,3 juta/3x
170,500 1,3 juta/3x
241,000
125,000 125,000
50,000
650,000
800,000
75,000
200,000
250,000
350,000
700,000
900,000
75,000
120,000
150,000
35,000
30,000
300,000
JASA PELAYANAN
No JENIS PERAWATAN
JASA SARANA DAN PRASARANA BAHAN MEDIS PAKAI HABIS TARIF drg
1a Konsultasi 6,000 0 14,875
1b pemeriksaan/ kontrol tanpa perawatan (dengan atau 25,000 0 25,750
tanpa resep)
2 Tumpatan Sementara (ROP,Sterilisasi) 25,000 7,500 40,500
3
Bongkar tumpatan, open bur kamar pulpa, trepanasi 25,000 4,500 65,000
4 oklusal adjustment 25,000 5,500 34,500
5 aplikasi seal and protect (per gigi) 25,000 15,000 35,000
6 TUMPATAN GIC
a Type II 25,000 12,000 140,000
b Type IX 25,000 20,500 140,000
7 TUMPATAN KOMPOSIT
a Tumpatan Komposit kecil 50,000 20,000 120,000
b Tumpatan Komposit sedang 50,000 25,000 155,000
c Tumpatan komposit besar 50,000 35,000 200,000
8 veener direct, komposit crown form 50,000 45,000 250,000
9 TUMPATAN AMALGAM (silverfill argentum)
a Tumpatan Amalgam kecil 50,000 45,000 135,000
b Tumpatan Amalgam sedang 50,000 45,000 140,000
c Tumpatan Amalgam besar 50,000 45,000 165,000
10 TUMPATAN SANDWICH
a Tumpatan sandwich kecil 50,000 23,000 127,000
b Tumpatan sandwich sedang 50,000 25,000 210,000
c Tumpatan sandwich besar 50,000 30,000 270,000
11 Devitalisasi Pulpa 25,000 20,000 50,000
12 Pulp Caping 25,000 25,000 50,000
13 Pulpectomy (3x kunjungan)
a Perawatan Saluran Akar Tunggal (Per kunjungan) 50,000 22,500 115,000
b Perawatan Saluran Akar Ganda (Per kunjungan) 50,000 30,000 175,000
14 Endo Intrakanal (3x kunjungan)
a Perawatan Saluran Akar Tunggal (Per kunjungan) 50,000 10,500 98,000
b Perawatan Saluran Akar Ganda (Per kunjungan) 50,000 15,500 162,500
15 PSA dengan penyulit (obturasi SA)
a akar tunggal BMPH + 5.000 Tarif PSA + 75.000
b akar ganda BMPH + 10.000 Tarif PSA + 150.000
16 PSA one visit SA tunggal 50,000 40,000 425,000
17 PSA one visit SA ganda 50,000 50,000 650,000
18 splinting (komposit Per gigi) 50,000 25,000 40,000
19 Bleaching in office (sinar) 50,000 250,000 500,000
20 Apeks reseksi 75,000 70,500 693,500
21 Preparasi
a Jaket crown (logam,porselen) 50,000 10,500 250,000
b inlay (logam,porselen) 50,000 10,500 140,000
c onlay (logam,porselen) 50,000 10,500 175,000
d pasak (inti logam cor) 50,000 10,500 145,000
d pasak (inti jadi) 50,000 20,500 145,000
e veener 50,000 10,500 200,000
22 Cetak Alginat 30,000 11,250 30,500
23 Cetak polikarbonat 30,000 45,000 60,500
KET :
73,000 215,000
94,500 215,000
65,000
75,000
177,000 298,000
185,500 298,000
190,000 298,000
230,000 298,000
285,000 298,000
345,000 298,000
230,000 298,000
235,000 298,000
260,000 298,000
200,000 298,000
285,000 298,000
350,000 298,000
95,000 215,000
100,000 215,000
187,500 298,000
255,000 298,000
158,500 298,000
228,000 298,000
298,000
298,000
515,000
750,000
115,000
800,000
839,000
310,500 DT
200,500 DT
235,500 DT
205,500 DT
215,500
260,500 DT
71,750
135,500