| 881 |
Orthodonti lepas ( Rawat Inap Spesialis Gigi & Mulut) |
Rp1.079.000 |
Prosedur Bedah |
| 882 |
Labiopasty Unilateral inkomplit ( Rawat Jalan Spesialis Bedah Mulut) |
Rp1.030.000 |
Prosedur Bedah |
| 883 |
Fistulektomi ( Rawat Jalan Spesialis Gigi & Mulut) |
Rp1.807.000 |
Prosedur Bedah |
| 884 |
Orthodonti cekat 1 rahang Kualitas II ( Rawat Jalan Spesialis Gigi & Mulut) |
Rp5.040.000 |
Prosedur Bedah |
| 885 |
Orthodonti cekat 1 rahang Kualitas I ( Rawat Jalan Spesialis Gigi & Mulut) |
Rp5.040.000 |
Prosedur Bedah |
| 886 |
Reparasi/retak ( Rawat Inap Umum/Spesialis Gigi & Mulut) |
Rp378.000 |
Prosedur Bedah |
| 887 |
Saddle ( Rawat Inap Umum/Spesialis Gigi & Mulut) |
Rp402.000 |
Prosedur Bedah |
| 888 |
Rebassing/relining ( Rawat Jalan Umum/Spesialis Gigi & Mulut) |
Rp268.000 |
Prosedur Bedah |
| 889 |
Crown & Bridengane 1 gigi |
Rp798.000 |
Prosedur Bedah |
| 890 |
Full dental per rahang ( Rawat Jalan Umum/Spesialis Gigi & Mulut) |
Rp1.320.000 |
Prosedur Bedah |
