| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 1301 | SGOT | Rp40.000 | Laboratorium |
| 1302 | SGPT | Rp40.000 | Laboratorium |
| 1303 | Alkali Fosfatase | Rp37.000 | Laboratorium |
| 1304 | Protein Total | Rp37.000 | Laboratorium |
| 1305 | Albumin | Rp37.000 | Laboratorium |
| 1306 | Bilirubin Total | Rp41.000 | Laboratorium |
| 1307 | Bilirubin Direct / Indirect | Rp41.000 | Laboratorium |
| 1308 | Ureum | Rp41.000 | Laboratorium |
| 1309 | Creatinin | Rp41.000 | Laboratorium |
| 1310 | Uric Acid / Asam Urat | Rp45.000 | Laboratorium |
