LAMPIRAN VII PERATURAN G NOMOR 4 TAH TENTANG PERUBAHAN TA
TARIF RETRIBUSI RETRIB USI PELAYANAN PELAYANAN KESEHATAN KESEHATAN PROVINSI JAWA TENGAH BALAI LABORATORIUM KESEHATAN DAN PENGUJIAN ALAT K TA NO
I.
II.
III.
IV.
V.
JENIS PEMERIKSAAN
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SATUAN
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a.
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T./$#( S"(%&,*+ H$%+ TSH %.
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La$n-"a$n B#+") P,*+!"+ PME Mikroskopis BTA
B. KUL KULTUR TUR BIAK BIAKAN AN a. M$&o"o#$Ka+an#Kam$! M$&o"o#$Ka+an#Kam$! Candida Sp Cryptococcus sp Penicillium sp Aspergillus sp Rhizopus sp Mucor sp Monilllia sp Trichophyton sp Microsporum sp Epidermophyton sp Cladosporium sp Trichosporon sp %. Ba&*!$o" Ba&*!$o"o#$ o#$ Acinetobacter sp Aeromonas sp Bacillus sp Bacteriodes fragilis Bordetella sp Borrelia sp Branhamella sp Brucella sp Camphylobacter euni Citrobacter sp Clostridium sp Corynebacterium sp Escherichia coli Ed!asiella sp Enterobacter sp Enterococcus Erysipelothri" rusioppathalae #ransiella no$icada
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#usobacterium necrophorus %aemophilus sp %elicobacteri pylori &lebsiella sp 'egionella sp 'isteria sp Micrococcus sp Mycobacterium sp (eisseria gonorrhoea (eisseria meningitidis (ocardia sp Pesudomonas sp Proteus sp Pro$identia sp Salmonella sp Serratia sp Shigella sp Staphylococcus sp Streptococcus sp )ibrio (A* )ibrio parahaemolyticus )ibro cholerae +ersinia sp (. An#&a &umanAn#&a &umanAn#&a "m+n# "m+n# T"*, T"*, !&%*+ < -.&)&) < U%&% < A+!* -*'*+ -*%($
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). MPNJPT MPNJPT Coliform Coliform fecal Escherichia Coli . R'$'*n'$ T'* M(!$$*+()%# MO D)" L(+( 1 LJ D)" L(+( 2 LJ D)" L(+( 1 MGIT D)" L(+( 2 MGIT ,. Pa&* Ln#&a+ KLB -LB M* M*!*+*+%(+&%*+-#$*&+*+ -LB D(*$# -LB D('".#$( P*!#"L#+!*' 1 Mycobacterium tube rculosis,M-tbc. rculosis,M-tbc. *M(!$)!'() BTA SPS B(*!*+ -&,"&$
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2
3 4 5
6
7 8
9
10
11
Mycobacterium tuberculosis/tbc ,'0. Mycobacterium tuberculosis/tbc ,M*1T. U( -#'#!**+ OAT D)" L(+( 1 LJ D)" L(+( 2 LJ D)" L(+( 1 MGIT D)" L(+( 2 MGIT Mikroorganisme * M(!$)!'() G$*% MO B(*!*+-&,"&$ M(!$$*+()%# M MO R# R#)()"#+)( "#)" M( M(!$$*+()%# M MO U)*' V*(+* U$#".$* -&,"&$ J*%&$ A($ L#+!*' a-MP( Coliform b-MP( Coliform #ecal c-MP( Escherichia coli d-Escherichia coli A($ M(+&% a-MP( Coliform b-MP( Escherichia coli A($ B#$)(.@ A($ L(%*. RSD%#)"(!@ RSD%#)"(!@ A($ L*&" a-MP( Coliform A($ -,*% R#+*+ R#+*+ a-MP( Coliform A+!* !&%*+ &%&% A($ B**+ A($ ABA a-MP( Coliform b-MP( Coliform #ecal B*!"#$( U*$* N)!%(*, * A+!* !&%*+ &%&% Staphylococcus sp Streptococcus sp Shigella sp Escherichia coli Bacillus sp Clostridium sp -*'*+J*%&$ -*%($>#*)" :#,, M*!*+*+M(+&%*+ a-MP( Coliform b-MP( Coliform #ecal c-MP( Escherichia coli d-Escherichia coli e-Staphylococcus sp f-Streptococcus sp g-Bacillus sp h-Clostridium sp i-A'T/%itung &uman 2mum
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0- Angka &apang &hamir
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SSA A,&%(+(&% A, A$)#+A)
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KROMATOGRAFI KROMATOGRAFI GAS P#)"()(*
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GRAVIMETRI TITRIMETRI A& A($ L#%*! P$"#(+ -,$(* N*"$(&% -,$(* I(&% -*,(&% -,$*" -*$.($*" G,&!)* L*!")* F$&!")* S#$*" !*)*$
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SPEKTROFOTOMETRI A%+(*! B#*) :H3
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D*/* S#$*' P#%*!*$*+ S*%'*. (+#+#$*"$ GUBERNUR JAWA J AWA TENGAH "" GANJAR PRANOWO
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S*%'#, P#$ -(,$*%
BERNUR JAWA TENGAH N 2017 RIF RETRIBUSI DAERAH
ESEHATAN IF KETERANGAN
JUMLAH
15@000 25@000 10@000 25@000 25@000
7@000 5@000 20@000
55@000 70@000 55@000 70@000 95@000 55@000 70@000 95@000 55@000 70@000 95@000 55@000 70@000 95@000
30@000
45@000 108@500 40@000 110@000 23@000 117@500 136@000 95@000 122@000 117@500 109@000 121@000 94@000 220@000 182@000 162@000 131@500 131@500 40@000 145@000 140@000 140@000 165@000 47@000 117@500 117@500 131@600 131@600 131@600 131@600 54@000 1@200@000 131@600 131@600 35@000 77@000 77@000 131@600 131@600 35@000 135@000 54@000 61@500 20@000 90@000 117@500 117@500 117@500
117@500
6@000 6@000 7@000 7@000 6@000 10@000 12@000 8@000 16@500 4@000 10@000 8@500 25@000 30@000 10@000 7@500 7@500 7@500 7@000 180@000 240@000
17@000 17@000 17@000 20@000 20@000 20@000 20@000 20@000 42@000 20@000 20@000 20@000 20@000 20@000 22@000 60@000 20@000 28@000 55@000 20@000 20@000 25@000 25@000 27@500
40@000 170@000 162@500 70@000 42@000 72@000
45@000 15@000 30@000 20@000 20@000 20@000 20@000 20@000 20@000 20@000 20@000 20@000 20@000 20@000 20@000 10@000 17@000 55@000 22@500 22@500 22@500 22@500 22@500 22@500 22@500 25@000 75@000 750@000
24@000 24@000 24@000 24@000 24@000 24@000 24@000 18@000 18@000
18@000
18@000 18@000 18@000 18@000 18@000 18@000 18@000
63@000 71@000 REF
55@000 55@000 55@000 55@000 55@000 55@000 55@000 55@000 55@000 55@000 55@000 55@000
43@000 43@000 50@000 43@000 43@000 43@000 43@000 43@000 55@000 55@000 75@000 64@000 72@000 43@000 43@000 43@000 43@000 43@000
43@000 55@000 55@000 43@000 55@000 55@000 55@000 85@000 105@000 105@000 55@000 55@000 55@000 55@000 72@000 43@000 72@000 72@000 43@000 43@000 43@000 72@000 43@000
64@000 50@000 50@000
43@000 43@000 94@000
100@000 200@000 310@000 408@500 408@500
542@000 287@000 64@000
54@000
120@000 272@000 200@000 310@000 408@500 408@500 18@000 100@000 100@000 72@000 120@000 252@000 43@000 43@000 94@000 72@000 43@000 94@000 43@000 83@000 43@000 50@000 86@000 43@000 43@000 544@000 50@000 72@000 43@000 72@000 72@000 50@000 75@000 55@000 55@000 592@000 43@000 43@000 94@000 72@000 72@000 43@000 50@000 75@000 50@000
50@000
43@000 200@000 150@000 200@000 35@000 50@000 175@000
9@000 9@000 9@000 5@000 15@000 8@000 96@000 45@000 15@000 15@000 15@000 180@000 15@000 15@000 15@000 15@000 13@000 15@000 15@000 50@000 REF
4@000 4@000 5@000
7@000 7@000 7@000 4@000 5@000 7@000 5@000
4@000 5@000 9@000 7@000 4@000 10@000 7@000 7@000 4@000 5@000 10@000 4@000 12@000 24@000 10@000 30@000 10@000 17@000 10@000 6@000 22@000 15@000 12@000 15@000 30@000 20@000 15@000 15@000 14@000 30@000 15@000 11@000 13@000 14@000 15@000 5@000 5@000 40@000 12@000 17@000 20@000 10@000 10@000 14@000 13@000
42@000 42@000
42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000
200@000
30@000 8@000 8@000 9@000 8@000 9@000 40@000
40@000 20@000 20@000 20@000 20@000 20@000 20@000 20@000 20@000 35@000 30@000 20@000 12@000 15@000
20@000 15@000 13@000 30@000 30@000 30@000 30@000 30@000 40@000 40@000 40@000 40@000 50@000 50@000
40@000
60@000 50@000 50@000 50@000 50@000 50@000 50@000 50@000 50@000 50@000 60@000 50@000 60@000 60@000 60@000 240@000 60@000
50@000 50@000 50@000 50@000 50@000 50@000 50@000 50@000
8@000 6@000
6@000 12@000 6@000 12@000 6@000 6@000 13@000 13@000 10@000
30@000 30@000 34@000 50@000 20@000 20@000 26@000 24@000 40@000 40@000 40@000 40@000 30@000
24@000 10@000 30@000 40@000 40@000 40@000 14@000 14@000 13@000 15@000 24@000 23@000 13@000 14@000 20@000 35@000 20@000 10@000 21@000 25@000 23@000 23@000 40@000 13@000
14@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000 25@000
45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000
45@000 45@000 45@000 45@000 200@000 45@000 45@000 45@000 45@000 45@000 45@000 45@000
50@000 50@000 200@000 45@000 45@000
5@000 12@000 6@000 10@000 16@000 6@000 10@000 4@000 15@000 15@000 30@000 42@000 30@000 15@000 15@000 24@000 30@000 30@000 15@000 15@000 42@000 35@000 35@000 35@000 13@000 15@000 20@000 8@000 8@000
40@000 15@000 20@000 20@000 10@000 10@000 15@000 13@000
42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000 42@000
200@000 800@000
600@000 2@500@000 100@000 100@000
200@000
200@000 9@000
