6.

500 Jam Kerja 15% Diluar Jam Kerja 50%

Harga Harga
BOP BHP Sharing Sharing
No NAMA TINDAKAN MEDIS TOTAL c = (a+b) Homecare Margin % Homecare Margin %
(a) (b) Fee Nakes Fee Nakes
2023 2023

1 Visit dokter umum 75.500 0 75.500 100.000 300.000 124.500 42% 150.000 300.000 74.500 25%
2 Visit perawat (8 JAM) 91.500 0 91.500 61.275 500.000 347.225 69% 204.250 500.000 204.250 41%
3 Visit Perawat / jam 57.900 0 57.900 3.315 80.000 18.785 23% 11.050 80.000 11.050 14%
4 Injeksi Vitamin B 63.500 21.200 84.700 9.795 150.000 55.505 37% 32.650 150.000 32.650 22%
5 Injeksi Vitamin C 500 mg 65.900 32.300 98.200 12.270 180.000 69.530 39% 40.900 180.000 40.900 23%
6 Injeksi Vitamin B plus C 71.500 53.500 125.000 18.750 250.000 106.250 43% 62.500 250.000 62.500 25%
7 Infus RL (pasang) 69.100 48.500 117.600 15.360 220.000 87.040 40% 51.200 220.000 51.200 23%
8 Infus Nacl (pasang) 69.100 48.500 117.600 15.360 220.000 87.040 40% 51.200 220.000 51.200 23%
9 Infus (lepas) 67.500 1.500 69.000 19.650 200.000 111.350 56% 65.500 200.000 65.500 33%
10 Perawatan Infus 67.500 33.500 101.000 14.850 200.000 84.150 42% 49.500 200.000 49.500 25%
11 Rawat Luka Gangren Kecil 72.300 70.138 142.438 17.634 260.000 99.928 38% 58.781 260.000 58.781 23%
12 Rawat Luka Gangren Sedang 79.500 81.627 161.127 28.331 350.000 160.542 46% 94.437 350.000 94.437 27%
13 Rawat Luka Gangren Besar 91.500 116.094 207.594 43.861 500.000 248.545 50% 146.203 500.000 146.203 29%
14 Rawat Luka Kecil
15 Rawat Luka Sedang
16 Rawat Luka Besar
17 Rawat Luka Post Op Kecil
CONFIDENTIAL
75.500
79.500
83.500
71.500
70.138
81.627
116.094
68.000
145.638
161.127
199.594
139.500
23.154
28.331
30.061
16.575
300.000
350.000
400.000
250.000
131.208
160.542
170.345
93.925
44%
46%
43%
38%
77.181
94.437
100.203
55.250
300.000
350.000
400.000
250.000
77.181
94.437
100.203
55.250
26%
27%
25%
22%
18 Rawat Luka Post Op Sedang 79.500 75.500 155.000 29.250 350.000 165.750 47% 97.500 350.000 97.500 28%
19 Rawat Luka Post-Op Besar 91.500 77.500 169.000 49.650 500.000 281.350 56% 165.500 500.000 165.500 33%
20 Kateter Uretra (lepas) 71.500 13.000 84.500 24.825 250.000 140.675 56% 82.750 250.000 82.750 33%
21 Kateter Uretra (pasang) 71.500 62.000 133.500 17.475 250.000 99.025 40% 58.250 250.000 58.250 23%
22 Kateter (Spoeling) 71.500 23.000 94.500 23.325 250.000 132.175 53% 77.750 250.000 77.750 31%
23 Nasogatric Tube (NGT) (lepas) 71.500 13.000 84.500 24.825 250.000 140.675 56% 82.750 250.000 82.750 33%
24 Nasogatric Tube (NGT) (pasang) 71.500 51.500 123.000 19.050 250.000 107.950 43% 63.500 250.000 63.500 25%
25 Perawatan NGT 71.500 55.160 126.660 18.501 250.000 104.839 42% 61.670 250.000 61.670 25%
26 Nebulizer Anak (non-obat) 67.500 6.000 73.500 18.975 200.000 107.525 54% 63.250 200.000 63.250 32%
27 Nebulizer Dewasa (non-obat) 67.500 25.000 92.500 16.125 200.000 91.375 46% 53.750 200.000 53.750 27%
a. 1 - 2 jenis obat 67.500 21.000 88.500 16.725 200.000 94.775 47% 55.750 200.000 55.750 28%
b. >2 jenis obat 79.500 66.000 145.500 30.675 350.000 173.825 50% 102.250 350.000 102.250 29%
28 Pemasangan Oksigenasi 67.500 30.000 97.500 15.375 200.000 87.125 44% 51.250 200.000 51.250 26%
29 Perawatan Oksigenasi 67.500 30.000 97.500 15.375 200.000 87.125 44% 51.250 200.000 51.250 26%
30 Rawat Luka Decubitus Kecil 75.500 70.138 145.638 23.154 300.000 131.208 44% 77.181 300.000 77.181 26%
31 Rawat Luka Decubitus Sedang 82.700 81.627 164.327 33.851 390.000 191.822 49% 112.837 390.000 112.837 29%
32 Rawat Luka Decubitus Besar 91.500 116.094 207.594 43.861 500.000 248.545 50% 146.203 500.000 146.203 29%
33 Gundul Bayi 60.620 12.000 72.620 6.207 114.000 35.173 31% 20.690 114.000 20.690 18%
34 Pijat Bayi 63.500 12.500 76.000 11.100 150.000 62.900 42% 37.000 150.000 37.000 25%
35 Pijat Anak 65.100 12.500 77.600 13.860 170.000 78.540 46% 46.200 170.000 46.200 27%
36 Pijat Hamil 68.300 28.300 96.600 17.010 210.000 96.390 46% 56.700 210.000 56.700 27%
37 Pijat Tradisional 66.380 28.300 94.680 13.698 186.000 77.622 42% 45.660 186.000 45.660 25%
38 Pijat Laktasi Head to Toe 70.700 28.300 99.000 21.150 240.000 119.850 50% 70.500 240.000 70.500 29%
39 Paket Pasca Bersalin (Pijat Laktasi Head to Toe+Pijat Bayi) 79.820 40.800 120.620 35.007 354.000 198.373 56% 116.690 354.000 116.690 33%
40 Paket Mom & Baby (Pijat Tradisional + Pijat Bayi) 75.500 40.800 116.300 27.555 300.000 156.145 52% 91.850 300.000 91.850 31%
41 Paket Mom & Kid (Pijat Tradisional + Pijat Anak) 76.460 40.800 117.260 29.211 312.000 165.529 53% 97.370 312.000 97.370 31%
42 Paket Pemasangan dan Pelepasan Infus 75.500 50.000 125.500 26.175 300.000 148.325 49% 87.250 300.000 87.250 29%
43 Paket Infus Vitamin C 71.500 65.800 137.300 16.905 250.000 95.795 38% 56.350 250.000 56.350 23%
44 Paket Infus Vitamin B 71.500 54.700 126.200 18.570 250.000 105.230 42% 61.900 250.000 61.900 25%
45 Paket Infus Immune Booster C & B 75.500 87.000 162.500 20.625 300.000 116.875 39% 68.750 300.000 68.750 23%
46 Paket Pemasangan dan Pelepasan NGT 83.500 64.500 148.000 37.800 400.000 214.200 54% 126.000 400.000 126.000 32%
47 Paket Pemasangan dan Pelepasan Kateter 83.500 75.000 158.500 36.225 400.000 205.275 51% 120.750 400.000 120.750 30%
48 Injeksi IV/IM/SC/IC Kanamycin 2 Gram 73.100 62.600 135.700 20.145 270.000 114.155 42% 67.150 270.000 67.150 25%
49 Injeksi IV/IM/SC/IC Metampiron + Diphenhidramin
50 Injeksi IV/IM/SC/IC Metochlorpramide
51 Injeksi IV/IM/SC/IC Ondancetron
CONFIDENTIAL
63.500
65.100
63.500
25.600
33.800
23.800
89.100
98.900
87.300
9.135
10.665
9.405
150.000
170.000
150.000
51.765
60.435
53.295
35%
36%
36%
30.450
35.550
31.350
150.000
170.000
150.000
30.450
35.550
31.350
20%
21%
21%
52 Injeksi IV/IM/SC/IC Hyoscine 64.300 30.800 95.100 9.735 160.000 55.165 34% 32.450 160.000 32.450 20%
53 Injeksi IV/IM/SC/IC Ketoprofen 63.500 25.400 88.900 9.165 150.000 51.935 35% 30.550 150.000 30.550 20%
54 Injeksi IV/IM/SC/IC Cyanocobalamin 61.900 18.000 79.900 7.515 130.000 42.585 33% 25.050 130.000 25.050 19%
55 Injeksi IV/IM/SC/IC Dexametason + Diphenhidramine 65.100 23.800 88.900 12.165 170.000 68.935 41% 40.550 170.000 40.550 24%
56 Injeksi IV/IM/SC/IC Metilprednisolon 65.900 36.800 102.700 11.595 180.000 65.705 37% 38.650 180.000 38.650 21%
57 Injeksi IV/IM/SC/IC Pehacain 63.500 23.800 87.300 9.405 150.000 53.295 36% 31.350 150.000 31.350 21%
58 Injeksi IV/IM/SC/IC Lidocain 63.500 18.800 82.300 10.155 150.000 57.545 38% 33.850 150.000 33.850 23%
59 Injeksi IV/IM/SC/IC Ranitidin 63.500 19.800 83.300 10.005 150.000 56.695 38% 33.350 150.000 33.350 22%
60 Injeksi IV/IM/SC/IC Tetagam 95.500 255.600 351.100 29.835 550.000 169.065 31% 99.450 550.000 99.450 18%
61 Injeksi IV/IM/SC/IC Anti Tetanus Serum 95.500 131.800 227.300 48.405 550.000 274.295 50% 161.350 550.000 161.350 29%
62 Sirkumsisi /Khitan Manual 91.500 109.000 200.500 44.925 500.000 254.575 51% 149.750 500.000 149.750 30%
63 Sirkumsisi /Khitan Manual (komplikasi penyulit) 99.500 109.000 208.500 58.725 600.000 332.775 55% 195.750 600.000 195.750 33%
64 Sirkumsisi /Khitan Smart Klamp 147.500 109.000 256.500 141.525 1.200.000 801.975 67% 471.750 1.200.000 471.750 39%
65 Sirkumsisi /Khitan Smart Klamp (komplikasi penyulit) 155.500 109.000 264.500 155.325 1.300.000 880.175 68% 517.750 1.300.000 517.750 40%
66 Sirkumsisi /Khitan Electric Couter 115.500 109.000 224.500 86.325 800.000 489.175 61% 287.750 800.000 287.750 36%
67 Sirkumsisi /Khitan Electric Couter (komplikasi penyulit) 123.500 109.000 232.500 100.125 900.000 567.375 63% 333.750 900.000 333.750 37%
68 Sirkumsisi/Khitan Lem (Klamp Sealer) 187.500 200.000 387.500 196.875 1.700.000 1.115.625 66% 656.250 1.700.000 656.250 39%
69 Injeksi Cernevit 119.500 435.121 554.621 44.307 850.000 251.072 30% 147.690 850.000 147.690 17%
70 Fisioterapi Stroke 52.500 455.000 507.500 650.000 142.500 22% 650.000 142.500 22%
71 Fisioterapi Cedera Olahraga 52.500 455.000 507.500 650.000 142.500 22% 650.000 142.500 22%
72 Fisioterapi Muskuloskeletal 52.500 455.000 507.500 650.000 142.500 22% 650.000 142.500 22%
73 Fisioterapi Carpal Tunnel Syndrome 52.500 455.000 507.500 650.000 142.500 22% 650.000 142.500 22%
74 Fisioterapi Frozen Shoulder 52.500 455.000 507.500 650.000 142.500 22% 650.000 142.500 22%
75 Fisioterapi HNP 52.500 455.000 507.500 650.000 142.500 22% 650.000 142.500 22%
76 Fisioterapi PPOK 52.500 455.000 507.500 650.000 142.500 22% 650.000 142.500 22%
77 Fisioterapi Pediatric 52.500 455.000 507.500 650.000 142.500 22% 650.000 142.500 22%
78 Paket Fisioterapi 3x 130.500 1.137.500 1.268.000 1.625.000 357.000 22% 1.625.000 357.000 22%
79 Pake Fisioterapit 6x 260.500 2.275.000 2.535.500 3.250.000 714.500 22% 3.250.000 714.500 22%
80 Paket Fisioterapi 10x 416.500 3.640.000 4.056.500 5.200.000 1.143.500 22% 5.200.000 1.143.500 22%

CONFIDENTIAL
 Perawat dijam Dinas Perawat diluar Jam Dinas
Harga Vaksin KFA (HPP BPP FEE HOMECARE BPP Homecare MARGIN FEE HOMECARE BPP Homecare MARGIN
Merek Dagang Kemasan BPP Total JASA HARGA MARGIN
&PPn+Cost Structure 1,15) OPERASIONAL (JASA) Total HOMECARE 2022 (JASA) Total HOMECARE

Vaksinasi Biofarma 15% 50%

Polio Injeksi (IPV) Paket 1 orang 190.087 60.500 250.587 54.413 305.000 18% 8.162 258.749 15% 27.207 277.794 9%
Polio Injeksi (IPV) Paket 3 orang Vial 2.5 mL (5 ds) 126.725 60.500 187.225 117.775 305.000 39% 17.666 204.891 33% 58.888 246.112 19%
Polio Injeksi (IPV) Paket 5 orang 76.035 60.500 136.535 168.465 305.000 55% 25.270 161.805 47% 84.233 220.767 28%
BCG Paket 1 - 5 orang 135.365 60.500 195.865 104.135 300.000 35% 15.620 211.485 30% 52.068 247.932 17%
BCG Paket 6 - 10 orang Amp 20 ds 54.146 60.500 114.646 155.354 270.000 58% 23.303 137.949 49% 77.677 192.323 29%
BCG Paket > 10 orang 38.676 60.500 99.176 150.824 250.000 60% 22.624 121.799 51% 75.412 174.588 30%
Polio Oral (OPV) Paket 1 - 3 orang 41.474 45.625 87.099 42.902 130.000 33% 6.435 93.534 28% 21.451 108.549 17%
Polio Oral (OPV) Paket 4 - 6 orang Vial 1 mL (10 ds) 20.737 45.625 66.362 63.638 130.000 49% 9.546 75.907 42% 31.819 98.181 24%
Polio Oral (OPV) Paket > 6 orang 11.850 45.625 57.475 72.525 130.000 56% 10.879 68.353 47% 36.263 93.737 28%
TT Paket 1 - 3 orang 63.484 52.000 115.484 84.517 200.000 42% 12.677 128.161 36% 42.258 157.742 21%
TT Paket 4 - 6 orang Vial 5 ml (10 ds) 31.742 52.000 83.742 86.258 170.000 51% 12.939 96.680 43% 43.129 126.871 25%
TT Paket > 6 orang 18.138 52.000 70.138 84.862 155.000 55% 12.729 82.867 47% 42.431 112.569 27%
Tetanus Difteri (Td) Vial 5 ml (10 ds) 42.242 45.200 87.442 32.558 120.000 27% 4.884 92.325 23% 16.279 103.721 14%
Cervarix PFS 663.248 111.500 774.748 135.252 910.000 15% 20.288 795.036 13% 67.626 842.374 7%
Varicela Vial 1 ds 339.549 81.750 421.299 133.701 555.000 24% 20.055 441.354 20% 66.851 488.150 12%
Havrix Dewasa PFS 333.170 81.750 414.920 90.080 505.000 18% 13.512 428.432 15% 45.040 459.960 9%
Measles Rubella Paket 1 - 3 orang 181.901 60.500 242.401 57.599 300.000 19% 8.640 251.041 16% 28.799 271.201 10%
Measles Rubella Paket 4 - 6 orang Vial 10 ds 136.426 60.500 196.926 73.074 270.000 27% 10.961 207.887 23% 36.537 233.463 14%
Measles Rubella Paket > 6 orang 77.958 60.500 138.458 116.542 255.000 46% 17.481 155.939 39% 58.271 196.729 23%
Campak 1 - 3 orang 118.842 56.250 175.092 74.908 250.000 30% 11.236 186.328 25% 37.454 212.546 15%
Campak 4 - 6 orang Vial 10 ds 59.421 56.250 115.671 124.329 240.000 52% 18.649 134.320 44% 62.165 177.836 26%
Campak > 6 orang
Bio Td
Flubio
Hepatitis Rekombinan anak
Hepatitis Rekombinan dewasa
Amp 0,5 mL (1 ds)
Vial 0,5 mL (1 ds)
Pouch 0,5 mL (1 ds)
Pouch 1 mL (1 ds)
CONFIDENTIAL
29.711
53.479
108.922
45.950
72.033
56.250
47.750
71.250
52.000
52.000
85.961
101.229
180.172
97.950
124.033
149.040
53.771
69.828
102.050
75.967
235.000
155.000
250.000
200.000
200.000
63%
35%
28%
51%
38%
22.356
8.066
10.474
15.308
11.395
108.316
109.295
190.646
113.258
135.428
54%
29%
24%
43%
32%
74.520
26.886
34.914
51.025
37.984
160.480
128.115
215.086
148.975
162.017
32%
17%
14%
26%
19%
Menivax Vial 1 ds 148.828 74.750 223.578 126.422 350.000 36% 18.963 242.541 31% 63.211 286.789 18%
Pentabio 1 ds Vial 0,5 mL (1 ds) 138.245 64.750 202.995 147.005 350.000 42% 22.051 225.046 36% 73.503 276.498 21%
Bio TT Amp 0,5 mL (1 ds) 28.013 47.750 75.763 79.237 155.000 51% 11.886 87.649 43% 39.619 115.382 26%
Vaksin JE Vial 5 ds 223.496 64.750 288.246 61.754 350.000 18% 9.263 297.509 15% 30.877 319.123 9%

Perawat dijam Dinas Perawat diluar Jam Dinas

JASA Fee 15 % (jasa) BPP Homecare Margin Fee 50 % (jasa) BPP Homecare Margin
Vaksin Non Biofarma
Synflorix Syringe 0,5 mL 648.963 88.125 737.088 187.912 925.000 20% 28.187 765.275 17% 93.956 831.044 10%
Prevenar 13 Syringe 0,5 mL 820.704 115.750 936.454 263.546 1.200.000 22% 39.532 975.986 19% 131.773 1.068.227 11%
MMR (II) Vial 0,5 mL 406.976 77.500 484.476 125.524 610.000 21% 18.829 503.304 17% 62.762 547.238 10%
Hexaxim PFS 802.280 115.750 918.030 331.970 1.250.000 27% 49.795 967.826 23% 165.985 1.084.015 13%
Varivax Vial 0,5 mL 622.216 98.750 720.966 179.034 900.000 20% 26.855 747.821 17% 89.517 810.483 10%
Verorab Syringe 0,5 mL 271.639 64.750 336.389 113.611 450.000 25% 17.042 353.431 21% 56.805 393.195 13%
Fluquadri 0,5 ml Prefilled syringe 0,5 mL 227.131 60.500 287.631 112.369 400.000 28% 16.855 304.486 24% 56.185 343.816 14%
Dengvaxia Vial 0,5 mL 1.181.401 154.000 1.335.401 364.599 1.700.000 21% 54.690 1.390.091 18% 182.300 1.517.700 11%
Pentaxim Vial 0,5 mL 636.974 100.875 737.849 212.152 950.000 22% 31.823 769.671 19% 106.076 843.924 11%
Tetraxim Syringe 0,5 mL 471.029 86.000 557.029 142.972 700.000 20% 21.446 578.474 17% 71.486 628.514 10%
Avaxim Dewasa Syringe 0,5 mL 422.831 81.750 504.581 145.419 650.000 22% 21.813 526.394 19% 72.710 577.291 11%
Gardasil Syringe 0,5 mL 1.044.951 145.500 1.190.451 309.549 1.500.000 21% 46.432 1.236.883 18% 154.775 1.345.225 10%
Avaxim Anak syringe 0,5 mL 337.508 73.250 410.758 114.242 525.000 22% 17.136 427.895 18% 57.121 467.879 11%
Vaxigrip tetra Prefilled syringe 0,5 mL 254.662 64.750 319.412 105.588 425.000 25% 15.838 335.250 21% 52.794 372.206 12%
Infanrix Hexa Vial 0,5 mL 750.659 115.750 866.409 233.591 1.100.000 21% 35.039 901.448 18% 116.795 983.205 11%
Stamaril Vial 0,5 mL 389.230 79.625 468.855 131.145 600.000 22% 19.672 488.527 19% 65.572 534.428 11%
Adacel Vial 0,5 mL 402.098 81.750 483.848 141.153 625.000 23% 21.173 505.020 19% 70.576 554.424 11%
Menactra Vial 0,5 mL 676.545 111.500 788.045 161.955 950.000 17% 24.293 812.338 14% 80.978 869.023 9%
Twinrix Syringe 1 mL 438.786 86.000 524.786 150.214 675.000 22% 22.532 547.318 19% 75.107 599.893 11%
Havrix Anak Syringe 0,5 mL 316.138 73.250 389.388 160.612 550.000 29% 24.092 413.480 25% 80.306 469.694 15%
Menveo Vial 0,5 mL 510.600 98.750 609.350 290.650 900.000 32% 43.598 652.948 27% 145.325 754.675 16%
Thypim vi Syringe 0,5 mL 255.140 69.000 324.140 115.860 440.000 26% 17.379 341.519 22% 57.930 382.070 13%
Boostrix Prefilled syringe 0,5 mL 273.171 73.250 346.421 128.579 475.000 27% 19.287 365.708 23% 64.290 410.711 14%
Euvax Dewasa Vial 1 mL 101.023 52.000 153.023 66.977 220.000 30% 10.047 163.070 26% 33.489 186.512 15%
Engerix Dewasa Syringe 1 mL 137.999 58.375 196.374 103.626 300.000 35% 15.544 211.918 29% 51.813 248.187 17%
Vaxigrip Dewasa Syringe 0,5 mL 170.355 64.750 235.105 114.895 350.000 33% 17.234 252.339 28% 57.447 292.553 16%
Euvax Anak Vial 0,5 mL 67.209 49.875 117.084 82.916 200.000 41% 12.437 129.521 35% 41.458 158.542 21%
Engerix Anak Syringe 0,5 mL 109.887 56.250 166.137 83.863 250.000 34% 12.579 178.717 29% 41.931 208.069 17%
Typherix Prefilled syringe 0,5 mL 108.309 56.250 164.559 85.441 250.000 34% 12.816 177.375 29% 42.720 207.280 17%
Imojev Vial 0,5 mL 223.496 77.500 300.996 199.004 500.000 40% 29.851 330.847 34% 99.502 400.498 20%

CONFIDENTIAL
 Sharing Sharing
Sharing Sharing Sharing
Sharing Fee Di Sharing Fee Di Sharing Fee Fee Di
BHP Reagent BHP Price per BPP Normal Sharing Fee Di BPP Price After Fee Di Luar BPP Price After Fee Di BPP Price After Fee Di
Status Category Package Name Test Name Luar Jam Kerja Margin % Fee Di Jam Margin % Luar Jam Margin % Provider Luar Jam Margin %
per Test Reagen Test Operasional Package Price Jam Kerja 15% Operasional Disc. 20% Jam Kerja Operasional Disc. 25% Jam Kerja Operasional Disc. 30% Jam Kerja
50% Kerja 15% Kerja Online (10%) Kerja
50% 15% 15%
50% 50%
Hematologi Lengkap 37.828 150.000
Gula Darah Puasa 6.090 48.000
1 NEW PACKAGE MEDICAL CHECK UP Let'sFIT Package 66.119 66.400 332.000 199.481 60,08% 53.120 265.600 21.954 73.181 146.361 55,11% 49.800 249.000 19.962 66.541 133.081 53,45% 46.480 23.240 232.400 17.970 59.901 119.801 51,55%
Kolesterol Total 7.446 71.000
Asam Urat 14.755 80.000 29.922 99.741
Hematologi Lengkap 37.828 150.000
Kolesterol Total 7.446 71.000
Kolesterol HDL Direk 29.195 99.000
RENEWAL
2 MEDICAL CHECK UP BeFIT Package Kolesterol LDL Direk 25.158 128.233 145.000 127.000 635.000 56.965 189.884 379.767 59,81% 101.600 508.000 41.725 139.084 278.167 54,76% 95.250 476.250 37.915 126.384 252.767 53,07% 88.900 44.450 444.500 34.105 113.684 227.367 51,15%
PACKAGE
Trigliserida 7.761 75.000
Gula Darah Puasa 6.090 48.000
Asam Urat 14.755 80.000
Hematologi Lengkap 37.828 150.000
Urine Lengkap 9.365 77.000
Kolesterol Total 7.446 71.000
Kolesterol HDL Direk 29.195 99.000
Kolesterol LDL Direk 25.158 145.000
RENEWAL Trigliserida 7.761 75.000
3 MEDICAL CHECK UP GetFIT Package 219.031 238.400 1.192.000 110.185 367.285 734.569 61,62% 190.720 953.600 81.577 271.925 543.849 57,03% 178.800 894.000 74.425 248.085 496.169 55,50% 166.880 83.440 834.400 67.273 224.245 448.489 53,75%
PACKAGE Gula Darah Puasa 6.090 48.000
Apo B 34.046 285.000
Kreatinin 18.255 75.000
Asam Urat 14.755 80.000
SGOT (AST) 14.566 75.000
SGPT (ALT) 14.566 75.000
Hematologi Lengkap 37.828 150.000
Urine Lengkap 9.365 77.000
Kolesterol Total 7.446 71.000
Kolesterol HDL Direk 29.195 99.000
Kolesterol LDL Direk 25.158 145.000
Trigliserida 7.761 75.000
Gula Darah Puasa 6.090 48.000
RENEWAL
4 MEDICAL CHECK UP StayFIT Package Cystatin C 155.992 767.864 435.000 515.000 2.575.000 193.820 646.068 1.292.136 50,18% 412.000 2.060.000 132.020 440.068 880.136 42,73% 386.250 1.931.250 116.570 388.568 777.136 40,24% 360.500 180.250 1.802.500 101.120 337.068 674.136 37,40%
PACKAGE
Asam Urat 14.755 80.000
SGOT (AST) 14.566 75.000
SGPT (ALT) 14.566 75.000
hsCRP 54.423 380.000
Vitamin D 25 OH 285.079 505.000
Apo B 34.046 285.000
HbA1c 71.594 210.000

CONFIDENTIAL
Hematologi Lengkap 37.828 150.000
SGOT (AST) 14.566 75.000
RENEWAL SGPT (ALT) 14.566 75.000
6 MEDICAL CHECK UP Healthy Liver Package 88.922 134.000 670.000 67.062 223.539 447.078 66,73% 107.200 536.000 50.982 169.939 339.878 63,41% 100.500 502.500 46.962 156.539 313.078 62,30% 93.800 46.900 469.000 42.942 143.139 286.278 61,04%
PACKAGE HBsAg Rapid Test (Screening) 7.152 170.000
Gamma GT 6.336 140.000
Bilirubin Total 8.474 95.000
Anti HAV Total 224.029 640.000
Basic Screening SGPT (ALT) 14.566 75.000
7 NEW PACKAGE PENYAKIT MENULAR 506.628 274.600 1.373.000 88.766 295.886 591.772 43,10% 219.680 1.098.400 55.814 186.046 372.092 33,88% 205.950 1.029.750 47.576 158.586 317.172 30,80% 192.220 96.110 961.100 39.338 131.126 262.252 27,29%
Hepatitis HBsAg ELFA/ECLIA 79.780 230.000
Anti HCV total Kualitatif 188.253 500.000
Hematologi Lengkap 37.828 150.000
Anti HAV Total 224.029 640.000
SGOT (AST) 14.566 75.000
Premium Screening SGPT (ALT) 14.566 75.000
8 NEW PACKAGE PENYAKIT MENULAR 856.804 524.000 2.620.000 185.879 619.598 1.239.196 47,30% 419.200 2.096.000 122.999 409.998 819.996 39,12% 393.000 1.965.000 107.279 357.598 715.196 36,40% 366.800 183.400 1.834.000 91.559 305.198 610.396 33,28%
Hepatitis HBsAg ELFA/ECLIA 79.780 230.000
Anti HCV total Kualitatif 188.253 500.000
Anti Hbs (Titer) 171.091 450.000
Anti HBc Total 126.691 500.000
Urine Lengkap 9.365 77.000
RENEWAL PENYAKIT TIDAK
9 Diabetic Basic Package Gula Darah Sewaktu 6.090 87.049 48.000 63.600 318.000 25.103 83.676 167.351 52,63% 50.880 254.400 17.471 58.236 116.471 45,78% 47.700 238.500 15.563 51.876 103.751 43,50% 44.520 22.260 222.600 13.655 45.516 91.031 40,89%
PACKAGE MENULAR
HbA1c 71.594 210.000
Hematologi Lengkap 37.828 150.000
Urine Lengkap 9.365 77.000
SGPT (ALT) 14.566 75.000
PENYAKIT TIDAK Diabetic Premium
10 NEW PACKAGE Cystatin C 155.992 352.136 435.000 246.000 1.230.000 94.780 315.932 631.864 51,37% 196.800 984.000 65.260 217.532 435.064 44,21% 184.500 922.500 57.880 192.932 385.864 41,83% 172.200 86.100 861.000 50.500 168.332 336.664 39,10%
MENULAR Package
Gula Darah Sewaktu 6.090 48.000
Mikro Albumin Kuantitatif 56.701 300.000
HbA1c 71.594 210.000
Hematologi Lengkap 37.828 150.000
Urine Lengkap 9.365 77.000
RENEWAL CRP Kuantitatif 58.497 375.000
11 MEDICAL CHECK UP Fever Package 570.796 423.000 2.115.000 168.181 560.602 1.121.204 53,01% 338.400 1.692.000 117.421 391.402 782.804 46,27% 317.250 1.586.250 104.731 349.102 698.204 44,02% 296.100 148.050 1.480.500 92.041 306.802 613.604 41,45%
PACKAGE Dengue NS-1 133.931 530.000
Anti Salmonella IgM 150.815 435.000
Anti Dengue IgG IgM 180.360 660.000
Free T4 176.606 465.000
12 NEW PACKAGE MEDICAL CHECK UP Thyroid Package 327.204 159.600 798.000 46.679 155.598 311.196 39,00% 127.680 638.400 27.527 91.758 183.516 28,75% 119.700 598.500 22.739 75.798 151.596 25,33% 111.720 55.860 558.600 17.951 59.838 119.676 21,42%
TSH Sensitif 150.598 375.000
Kolesterol Total 7.446 71.000
EXISTING Kolesterol HDL Direk 29.195 99.000
13 MEDICAL CHECK UP Lipid Basic Package 69.560 74.000 370.000 33.966 113.220 226.440 61,20% 59.200 296.000 25.086 83.620 167.240 56,50% 55.500 277.500 22.866 76.220 152.440 54,93% 51.800 25.900 259.000 20.646 68.820 137.640 53,14%
PACKAGE Kolesterol LDL Direk 25.158 145.000
Trigliserida 7.761 75.000
Kolesterol Total 7.446 71.000
Kolesterol HDL Direk 29.195 99.000
Lipid Premium Kolesterol LDL Direk 25.158 145.000
14 NEW PACKAGE MEDICAL CHECK UP 158.029 200.000 1.000.000 96.296 320.986 641.971 64,20% 160.000 800.000 72.296 240.986 481.971 60,25% 150.000 750.000 66.296 220.986 441.971 58,93% 140.000 70.000 700.000 60.296 200.986 401.971 57,42%
Package Trigliserida 7.761 75.000
hsCRP 54.423 380.000
Apo B 34.046 285.000
 Hematologi Lengkap 37.828 150.000
PENYAKIT TIDAK Ferritin 115.591 390.000
15 NEW PACKAGE Thalassemia Package 448.907 287.000 1.435.000 104.864 349.547 699.093 48,72% 229.600 1.148.000 70.424 234.747 469.493 40,90% 215.250 1.076.250 61.814 206.047 412.093 38,29% 200.900 100.450 1.004.500 53.204 177.347 354.693 35,31%
MENULAR Analisis Hb 232.868 705.000
Gambaran Darah Tepi 62.620 265.000
Hematologi Lengkap 37.828 150.000
Urine Lengkap 9.365 77.000
EXISTING Healthy Kidney Basic
16 MEDICAL CHECK UP Ureum 8.546 88.749 70.000 85.800 429.000 38.168 127.226 254.451 59,31% 68.640 343.200 27.872 92.906 185.811 54,14% 64.350 321.750 25.298 84.326 168.651 52,42% 60.060 30.030 300.300 22.724 75.746 151.491 50,45%
PACKAGE Package
Kreatinin 18.255 75.000
Asam Urat 14.755 80.000
Hematologi Lengkap 37.828 150.000
Urine Lengkap 9.365 77.000
Healthy Kidney Ureum 8.546 70.000
17 NEW PACKAGE MEDICAL CHECK UP 298.080 194.200 971.000 71.808 239.360 478.720 49,30% 155.360 776.800 48.504 161.680 323.360 41,63% 145.650 728.250 42.678 142.260 284.520 39,07% 135.940 67.970 679.700 36.852 122.840 245.680 36,15%
Premium Package Cystatin C 155.992 435.000
Asam Urat 14.755 80.000
HbA1c 71.594 210.000
HIV Monitoring HIV RNA 482.416 1.800.000
18 NEW PACKAGE PENYAKIT MENULAR 698.758 417.000 2.085.000 145.386 484.621 969.242 46,49% 333.600 1.668.000 95.346 317.821 635.642 38,11% 312.750 1.563.750 82.836 276.121 552.242 35,32% 291.900 145.950 1.459.500 70.326 234.421 468.842 32,12%
Therapy Package CD4 216.342 395.000
Anti Toksoplasma Ig G 109.358 425.000
Anti Toksoplasma Ig M 109.358 425.000
Anti Rubella Ig G 104.883 455.000
EXISTING Anti Rubella Ig M 212.075 575.000
19 FERTILITAS TORCH Package 1.035.300 734.400 3.672.000 285.345 951.150 1.902.300 51,81% 587.520 2.937.600 197.217 657.390 1.314.780 44,76% 550.800 2.754.000 175.185 583.950 1.167.900 42,41% 514.080 257.040 2.570.400 153.153 510.510 1.021.020 39,72%
PACKAGE Anti CMV Ig G 109.614 430.000
Anti CMV Ig M 165.968 585.000
Anti HSV II Ig G 108.888 485.000
Anti HSV II Ig M 115.156 485.000
Hematologi Lengkap 37.828 150.000
Goldar & Rhesus Factor 14.140 95.000
Gambaran Darah Tepi 62.620 265.000
Gula Darah Puasa 6.090 48.000
Urine Lengkap 9.365 77.000
RENEWAL Pre Marital Man
20 MEDICAL CHECK UP Anti HIV 139.840 668.737 555.000 511.400 2.557.000 206.529 688.432 1.376.863 53,85% 409.120 2.045.600 145.161 483.872 967.743 47,31% 383.550 1.917.750 129.819 432.732 865.463 45,13% 357.980 178.990 1.789.900 114.477 381.592 763.183 42,64%
PACKAGE Package
VDRL 11.706 145.000
TPHA 20.652 236.000
Anti Hbs (Titer) 171.091 450.000
HBsAg Rapid Test (Screening) 7.152 170.000
Anti HCV total Kualitatif 188.253 500.000
Hematologi Lengkap 37.828 150.000
Goldar & Rhesus Factor 14.140 95.000
Gambaran Darah Tepi 62.620 265.000
Gula Darah Puasa 6.090 48.000
Urine Lengkap 9.365 77.000
Anti HIV 139.840 555.000

CONFIDENTIAL
RENEWAL Pre Marital Woman VDRL 11.706 145.000
21 MEDICAL CHECK UP 992.592 760.000 3.800.000 307.111 1.023.704 2.047.408 53,88% 608.000 3.040.000 215.911 719.704 1.439.408 47,35% 570.000 2.850.000 193.111 643.704 1.287.408 45,17% 532.000 266.000 2.660.000 170.311 567.704 1.135.408 42,68%
PACKAGE Package TPHA 20.652 236.000
Anti Hbs (Titer) 171.091 450.000
HBsAg Rapid Test (Screening) 7.152 170.000
Anti HCV total Kualitatif 188.253 500.000
Anti Toksoplasma Ig G 109.358 425.000
Anti Rubella Ig G 104.883 455.000
Anti CMV Ig G 109.614 430.000
AMH 702.866 950.000
FSH 116.530 530.000
LH 116.530 515.000
Fertility Woman
23 NEW PACKAGE FERTILITAS Progesteron 196.706 1.520.388 650.000 781.800 3.909.000 241.022 803.406 1.606.812 41,11% 625.440 3.127.200 147.206 490.686 981.372 31,38% 586.350 2.931.750 123.752 412.506 825.012 28,14% 547.260 273.630 2.736.300 100.298 334.326 668.652 24,44%
Package
TSH Sensitif 150.598 375.000
Prolaktin 124.983 475.000
Estradiol 112.175 620.000
ANA IF 238.260 890.000
PENYAKIT TIDAK ANA Profile 780.072 1.415.000
24 NEW PACKAGE Autoimmune Package 1.341.239 562.400 2.812.000 136.254 454.181 908.361 32,30% 449.920 2.249.600 68.766 229.221 458.441 20,38% 421.800 2.109.000 51.894 172.981 345.961 16,40% 393.680 196.840 1.968.400 35.022 116.741 233.481 11,86%
MENULAR Vitamin D 25 OH 285.079 505.000
Hematologi Lengkap 37.828 150.000
ACA IgG 309.899 990.000
ACA IgM 309.899 990.000
TSH Sensitif 150.598 375.000
25 NEW PACKAGE FERTILITAS Keguguran Package 1.517.180 665.600 3.328.000 171.783 572.610 1.145.220 34,41% 532.480 2.662.400 91.911 306.370 612.740 23,01% 499.200 2.496.000 71.943 239.810 479.620 19,22% 465.920 232.960 2.329.600 51.975 173.250 346.500 14,87%
AMH 702.866 950.000
Gula Darah Puasa 6.090 48.000
Hematologi Lengkap 37.828 150.000
CEA 200.121 450.000
Colon & Pancreas CA 19 - 9 253.060 890.000
26 NEW PACKAGE KANKER 507.752 322.000 1.610.000 117.037 390.124 780.248 48,46% 257.600 1.288.000 78.397 261.324 522.648 40,58% 241.500 1.207.500 68.737 229.124 458.248 37,95% 225.400 112.700 1.127.000 59.077 196.924 393.848 34,95%
Cancer Package Darah Samar 47.501 230.000
Faeces Rutin 7.070 125.000
Hematologi Lengkap 37.828 150.000
B-HCG kuantitatif 113.883 755.000
Woman Cancer
27 NEW PACKAGE KANKER CEA 200.121 774.275 450.000 589.000 2.945.000 237.259 790.863 1.581.725 53,71% 471.200 2.356.000 166.579 555.263 1.110.525 47,14% 441.750 2.208.750 148.909 496.363 992.725 44,95% 412.300 206.150 2.061.500 131.239 437.463 874.925 42,44%
Package
CA 125 176.214 870.000
CA 15-3 246.229 875.000
Hematologi Lengkap 37.828 150.000
B-HCG kuantitatif 113.883 755.000
28 NEW PACKAGE KANKER Man Cancer Package 496.549 364.800 1.824.000 144.398 481.326 962.651 52,78% 291.840 1.459.200 100.622 335.406 670.811 45,97% 273.600 1.368.000 89.678 298.926 597.851 43,70% 255.360 127.680 1.276.800 78.734 262.446 524.891 41,11%
CEA 200.121 450.000
PSA 144.717 565.000
Hematologi Lengkap 37.828 150.000
PENYAKIT TIDAK
29 NEW PACKAGE Anemia Package Gambaran Darah Tepi 62.620 111.337 265.000 108.400 542.000 48.339 161.132 322.263 59,46% 86.720 433.600 35.331 117.772 235.543 54,32% 81.300 406.500 32.079 106.932 213.863 52,61% 75.880 37.940 379.400 28.827 96.092 192.183 50,65%
MENULAR
Retikulosit 10.889 155.000
Hematologi Lengkap 37.828 150.000
Analisa Faeces Lengkap 50.500 400.000
Urine Lengkap 9.365 77.000
Gula Darah Puasa 6.090 48.000
RENEWAL Vitamin D 25 OH 285.079 505.000
30 FERTILITAS Pregnancy Package 568.212 434.400 2.172.000 175.408 584.694 1.169.388 53,84% 347.520 1.737.600 123.280 410.934 821.868 47,30% 325.800 1.629.000 110.248 367.494 734.988 45,12% 304.080 152.040 1.520.400 97.216 324.054 648.108 42,63%
PACKAGE Anti HIV 139.840 555.000
 RENEWAL
30 FERTILITAS Pregnancy Package 568.212 434.400 2.172.000 175.408 584.694 1.169.388 53,84% 347.520 1.737.600 123.280 410.934 821.868 47,30% 325.800 1.629.000 110.248 367.494 734.988 45,12% 304.080 152.040 1.520.400 97.216 324.054 648.108 42,63%
PACKAGE
VDRL 11.706 145.000
TPHA 20.652 236.000
HBsAg Rapid Test (Screening) 7.152 170.000
Pemeriksaan Tekanan Darah 0 0
Hematologi Lengkap 37.828 150.000
Urine Lengkap 9.365 77.000
SGPT (ALT) 14.566 75.000
Child Wellness
31 NEW PACKAGE MEDICAL CHECK UP Gula Darah Sewaktu 6.090 378.629 48.000 190.000 950.000 57.206 190.686 381.371 40,14% 152.000 760.000 34.406 114.686 229.371 30,18% 142.500 712.500 28.706 95.686 191.371 26,86% 133.000 66.500 665.000 23.006 76.686 153.371 23,06%
Package
Kolesterol Total 7.446 71.000
Kreatinin 18.255 75.000
Vitamin D 25 OH 285.079 505.000
Vitamin D 25 OH 285.079 505.000
RENEWAL
32 MEDICAL CHECK UP Healthy Bone Package Calcium Total 5.079 314.803 150.000 158.800 794.000 48.060 160.199 320.397 40,35% 127.040 635.200 29.004 96.679 193.357 30,44% 119.100 595.500 24.240 80.799 161.597 27,14% 111.160 55.580 555.800 19.476 64.919 129.837 23,36%
PACKAGE
RF Kualitatif 24.645 180.000
N-Mid Osteocalcin 175.330 645.000
33 NEW PACKAGE MEDICAL CHECK UP Osteoporosis Package 360.799 240.400 1.202.000 90.120 300.400 600.801 49,98% 192.320 961.600 61.272 204.240 408.481 42,48% 180.300 901.500 54.060 180.200 360.401 39,98% 168.280 84.140 841.400 46.848 156.160 312.321 37,12%
Beta Crosslaps (CTx Telopeptide) 185.469 620.000
Testosteron 229.494 595.000
34 NEW PACKAGE FERTILITAS PCOS Package FSH 116.530 462.554 530.000 311.600 1.558.000 117.577 391.923 783.846 50,31% 249.280 1.246.400 80.185 267.283 534.566 42,89% 233.700 1.168.500 70.837 236.123 472.246 40,41% 218.120 109.060 1.090.600 61.489 204.963 409.926 37,59%
LH 116.530 515.000
CEA 200.121 450.000
35 NEW PACKAGE KANKER Breast Cancer Package 446.350 251.600 1.258.000 84.008 280.025 560.050 44,52% 201.280 1.006.400 53.816 179.385 358.770 35,65% 188.700 943.500 46.268 154.225 308.450 32,69% 176.120 88.060 880.600 38.720 129.065 258.130 29,31%
CA 15-3 246.229 875.000
CEA 200.121 450.000
36 NEW PACKAGE KANKER Liver Cancer Package 322.190 175.600 878.000 57.032 190.105 380.210 43,30% 140.480 702.400 35.960 119.865 239.730 34,13% 131.700 658.500 30.692 102.305 204.610 31,07% 122.920 61.460 614.600 25.424 84.745 169.490 27,58%
AFP 122.069 475.000
Hematologi Lengkap 37.828 150.000
EXISTING
37 MEDICAL CHECK UP Fever Dengue Package Dengue NS-1 133.931 352.119 530.000 254.600 1.273.000 99.942 333.141 666.281 52,34% 203.680 1.018.400 69.390 231.301 462.601 45,42% 190.950 954.750 61.752 205.841 411.681 43,12% 178.220 89.110 891.100 54.114 180.381 360.761 40,48%
PACKAGE
Anti Dengue IgG IgM 180.360 660.000
EXISTING Hematologi Lengkap 37.828 150.000
38 MEDICAL CHECK UP Fever Typhoid Package 218.188 111.000 555.000 33.872 112.906 225.812 40,69% 88.800 444.000 20.552 68.506 137.012 30,86% 83.250 416.250 17.222 57.406 114.812 27,58% 77.700 38.850 388.500 13.892 46.306 92.612 23,84%
PACKAGE Anti Salmonella IgM 180.360 435.000

CONFIDENTIAL