| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1221 | Reaksi LE | Rp62.000 | Laboratorium |
| 1222 | Golongan darah | Rp45.000 | Laboratorium |
| 1223 | Rhesus Factor | Rp15.000 | Laboratorium |
| 1224 | Test None | Rp15.000 | Laboratorium |
| 1225 | Test Pandi | Rp15.000 | Laboratorium |
| 1226 | Rivalta | Rp28.000 | Laboratorium |
| 1227 | Differential Count | Rp22.000 | Laboratorium |
| 1228 | Pemeriksaan Niesseria | Rp26.000 | Laboratorium |
| 1229 | Pemeriksaan Dipteria | Rp26.000 | Laboratorium |
| 1230 | Morfologi Darah Tepi (MDT) | Rp31.000 | Laboratorium |