[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-id-113":3,"doc-seo-294069-113":53,"doc-detail-294069-id":128},{"code":4,"msg":5,"data":6},0,"success",[7,13,17,21,25,29,33,37,41,45,49],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},55,"Document","Agama & Spiritualitas",60,"religion-spirituality",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":11,"slug":16},48,"Cerita & Novel","story-novel",{"id":18,"doc_module":4,"doc_module_name":9,"category_name":19,"show_sort_weight":11,"slug":20},56,"Gaya Hidup","lifestyle",{"id":22,"doc_module":4,"doc_module_name":9,"category_name":23,"show_sort_weight":11,"slug":24},51,"Komik","comic",{"id":26,"doc_module":4,"doc_module_name":9,"category_name":27,"show_sort_weight":11,"slug":28},53,"Layanan Kesehatan","healthcare",{"id":30,"doc_module":4,"doc_module_name":9,"category_name":31,"show_sort_weight":11,"slug":32},54,"Penelitian & Laporan","research-report",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":11,"slug":36},49,"Sastra","literature",{"id":38,"doc_module":4,"doc_module_name":9,"category_name":39,"show_sort_weight":11,"slug":40},52,"Teknologi","technology",{"id":42,"doc_module":4,"doc_module_name":9,"category_name":43,"show_sort_weight":11,"slug":44},50,"Ujian","exam",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":47,"show_sort_weight":11,"slug":48},57,"Umum","general",{"id":50,"doc_module":4,"doc_module_name":9,"category_name":51,"show_sort_weight":4,"slug":52},181,"Formulir","formulir",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":121,"head_meta":123,"extra_data":125,"updated_unix":127},113,"id","general-service-fees-health-services-fee-structure-for-puskesmas-outpatient-services","Retribusi Jasa Umum - Pelayanan Kesehatan - Struktur Besaran Tarif Retribusi Pelayanan Puskesmas","","Lampiran I memuat ketentuan Retribusi Jasa Umum untuk layanan kesehatan di Puskesmas Kota Surabaya. Rincian disajikan sebagai struktur besaran tarif berdasarkan jenis pelayanan, biaya, satuan, dan keterangan. Materi mencakup pelayanan pengobatan umum, tindakan medik operatif, pelayanan kegawatdaruratan, serta pelayanan pengobatan gigi, termasuk pemeriksaan, tindakan seperti infus, injeksi, skin test, pemasangan drain, ECG, home care, prosedur operatif, serta layanan penanganan luka dan prosedur gigi.",{"@graph":63,"@context":120},[64,81,103],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,72,75,78],{"item":68,"name":69,"@type":70,"position":71},"https://docshare.wps.com","Home","ListItem",1,{"item":73,"name":9,"@type":70,"position":74},"https://docshare.wps.com/id/document/",2,{"item":76,"name":27,"@type":70,"position":77},"https://docshare.wps.com/id/document/layanan-kesehatan/",3,{"item":79,"name":59,"@type":70,"position":80},"https://docshare.wps.com/id/document/general-service-fees-health-services-fee-structure-for-puskesmas-outpatient-services/294069/",4,{"url":79,"name":59,"@type":82,"image":83,"author":88,"headline":59,"publisher":91,"fileFormat":94,"inLanguage":57,"description":61,"dateModified":95,"datePublished":96,"encodingFormat":94,"isAccessibleForFree":97,"interactionStatistic":98},"DigitalDocument",{"url":84,"@type":85,"width":86,"height":87},"https://docshare.wps.com/thumbnails/general-service-fees-health-services-fee-structure-for-puskesmas-outpatient-services/294069.png","ImageObject",300,407,{"name":89,"@type":90},"Marry","Person",{"url":68,"name":92,"@type":93},"DocShare","Organization","application/pdf","2026-10-03","2026-09-17",true,{"@type":99,"interactionType":100,"userInteractionCount":102},"InteractionCounter",{"@type":101},"ViewAction",6,{"@type":104,"mainEntity":105},"FAQPage",[106,112,116],{"name":107,"@type":108,"acceptedAnswer":109},"Apa saja lingkup layanan kesehatan yang tercantum dalam lampiran ini?","Question",{"text":110,"@type":111},"Lampiran memuat pelayanan pengobatan umum, tindakan medik operatif, pelayanan kegawatdaruratan, dan pelayanan pengobatan gigi di Puskesmas.","Answer",{"name":113,"@type":108,"acceptedAnswer":114},"Bagaimana format penentuan tarif pelayanan ditampilkan?",{"text":115,"@type":111},"Tarif disajikan dalam tabel dengan kolom jenis pelayanan, biaya, satuan, dan keterangan untuk masing-masing tindakan.",{"name":117,"@type":108,"acceptedAnswer":118},"Apakah lampiran ini memuat tindakan untuk kondisi kegawatdaruratan?",{"text":119,"@type":111},"Ya. Termasuk pemeriksaan kegawatdaruratan, observasi UGD, perawatan luka (ringan-sedang-berat), perawatan luka bakar, pemasangan kateter, resusitasi jantung paru, serta terapi oksigen.","https://schema.org",{"og:url":79,"og:type":122,"og:title":59,"og:site_name":92,"og:description":61},"article",{"robots":124,"canonical":79},"index,follow",{"doc_id":126,"site_id":56},294069,1790410871,{"code":4,"msg":5,"data":129},{"doc_id":126,"user_id":130,"nickname":89,"user_avatar":131,"doc_module":4,"category_id":26,"category_name":27,"doc_title":59,"doc_description":61,"doc_content":132,"file_id":133,"file_url":134,"file_type":135,"file_size":136,"view_count":102,"is_deleted":4,"is_public":71,"is_downloadable":71,"audit_status":71,"page_count":137,"language":138,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":139,"faqs":140,"seo_title":141,"seo_description":61,"update_tm":142,"read_time":143},5909892079670,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","LAMPIRAN I PERATURAN DAERAH KOTA SURABAYANOMOR : 7 TAHUN 2023  \nTANGGAL: 27 DESEMBER 2023  \nRETRIBUSI JASA UMUM  \nA . Pelayanan Kesehatan  \n1. Struktur Besaran Tarif Retribusi Pelayanan Puskesmas  \na. Pelayanan Pengobatan Umum  \n\n| NO | JENIS PELAYANAN | BIAYA | SATUAN | KET |\n| --- | --- | --- | --- | --- |\n| 1 | Pemeriksaan dan Pengobatan Dasar | 20,000 | Pasien | Termasuk\u003Cbr>konsultasi\u003Cbr>medis danobat |\n| 2 | Pemeriksaan dan Pengobatan Dasar Kunjungan Sore | 25,000 | Pasien | Termasuk\u003Cbr>konsultasi\u003Cbr>medis danobat |\n| 3 | Infus |  |  |  |\n|  | a. Pemasangan Infus | 30,000 | Tindakan |  |\n|  | b. Ganti cairan infus | 20,000 | Tindakan |  |\n| 4 | Injeksi Intravena | 20,000 | Tindakan |  |\n| 5 | Injeksi Intramuscular (IM) / Subcutaneous (SC) / Intracutaneus (IC) | 20,000 | Tindakan |  |\n| 6 | Skin test | 30,000 | Tindakan |  |\n| 7 | Pengambilan sampel darah | 20,000 | Tindakan |  |\n| 8 | Bandaging / pemasangan bandage | 20,000 | Tindakan |  |\n| 9 | Pelepasan / pemasangan drain | 25,000 | Tindakan |  |\n| 10 | Pemeriksaan untuk penerbitan Surat Keterangan / Surat Pengantar” |  |  |  |\n|  | a. Sehat | 20,000 | Orang |  |\n|  | b. Kelahiran | 20,000 | Orang |  |\n|  | c. Visum hidup | 20,000 | Orang |  |\n| 11 | ECG | 25,000 | Pasien |  |\n| 12 | Home Care (Home Visit) | 50,000 | Pasien |  |\n| 13 | Pelayanan kesehatan Mata |  |  |  |\n|  | a.Pemeriksaan visus mata | 20,000 | Pasien |  |\n|  | b.Tindakan irigasi mata (trauma kimia) | 30,000 | Tindakan |  |\n|  | c.Pengambilan Corpus alienum (benda asing) | 35,000 | Tindakan |  |\n| 14 | Pelayanan kesehatan THT |  |  |  |\n|  | Ekstraksi serumen | 25,000 | Pasien |  |\n|  | Ekstraksi benda asing THT | 40,000 | Pasien |  |\n\nb. Tindakan Medik Operatif  \n\n| NO | JENIS PELAYANAN | BIAYA | SATUAN | KET |\n| --- | --- | --- | --- | --- |\n| 1 | Sirkumsisi | 150,000 | Tindakan |  |\n| 2 | Sirkumsisi dengan alat | 215,000 | Tindakan | Alat Cauter |\n| 3 | Insisi Abses | 30,000 | Tindakan |  |\n| 4 | Ekstraksi Kuku | 40,000 | Tindakan |  |\n| 5 | Stump plasty | 30,000 | Tindakan |  |\n\n2  \n\n| NO | JENIS PELAYANAN | BIAYA | SATUAN | KET |\n| --- | --- | --- | --- | --- |\n| 6 | Ekstirpasi Mata Ikan (Eksisi clavus) | 70,000 | Tindakan |  |\n| 7 | Hecting/jahit luka : |  |  |  |\n|  | a. 1-3 per luka | 28,000 | Luka |  |\n|  | b. Lebih dari 4 per luka | 40,000 | Luka |  |\n|  | c. Angkat / lepas jahitan | 20,000 | Luka |  |\n| 8 | Ekstirpasi lipoma | 85,000 | Tindakan |  |\n| 9 | Bulektomi | 100,000 | Tindakan |  |\n| 10 | Pasang Naso Gastric Tube (NGT) | 25,000 | Tindakan | termasuk AMHP |\n| 11 | Jahit 1 Telinga dawir | 50,000 | Telinga |  |\n| 12 | Cross insisi | 30,000 | Tindakan |  |\n\nc. Pelayanan Kegawatdaruratan  \n\n| NO | JENIS PELAYANAN | BIAYA | SATUAN | KET |\n| --- | --- | --- | --- | --- |\n| 1 | Pelayanan Kegawat daruratan |  |  |  |\n|  | a.Pemeriksaan Kegawat daruratan | 20,000 | Pasien |  |\n|  | b.Observasi UGD (per jam) maks 6 jam | 20,000 | Pasien |  |\n| 2 | Tindakan Medik Gawat Darurat |  |  |  |\n|  | a. Perawatan Luka Luar : |  |  |  |\n|  | - Rawat luka ringan (Kecil \u003C 5 cm) | 20,000 | Luka |  |\n|  | - Rawat luka sedang (5-10 cm) | 25,000 | Luka |  |\n|  | - Rawat luka berat (> 10 cm) | 30,000 | Luka |  |\n|  | - Rawat luka gangren | 30,000 | Luka |  |\n|  | b. Perawatan Luka Bakar : |  |  |  |\n|  | - Rawat luka bakar derajat I/regio (kecil) | 40,000 | Luka |  |\n|  | - Rawat luka bakar derajat II/regio (sedang) | 50,000 | Luka |  |\n|  | c. Pelayanan Kateter : |  |  |  |\n|  | - Pasang kateter / dower kateter | 20,000 | Tindakan |  |\n|  | - Lepas kateter | 20,000 | Tindakan |  |\n|  | d.Pemasangan fiksasi dada | 50,000 | Tindakan |  |\n|  | e.Resusitasi Jantung Paru | 30,000 | Tindakan |  |\n| 3 | Pemeriksaan/Tindakan Kegawatdaruratan dengan Alat |  |  |  |\n|  | a. Pemakaian nebulizer (tanpa obat) | 25,000 | Pasien |  |\n|  | b. Pelayanan pemakaian infus pump | 21,000 | Pasien |  |\n|  | c. Pelayanan pemakaian syringe pump | 20,000 | Pasien |  |\n|  | d. Pelayanan pemakaian suction pump | 21,000 | Pasien |  |\n|  |","cbCaipMi6msE1rzm","https://ap.wps.com/l/cbCaipMi6msE1rzm","pdf",797967,80,"Indonesian","# Retribusi Jasa Umum\n## A. Pelayanan Kesehatan\n### 1. Struktur Besaran Tarif Retribusi Pelayanan Puskesmas\n#### a. Pelayanan Pengobatan Umum\n#### b. Tindakan Medik Operatif\n#### c. Pelayanan Kegawatdaruratan\n#### d. Pelayanan Pengobatan Gigi","[{\"question\":\"Apa saja lingkup layanan kesehatan yang tercantum dalam lampiran ini?\",\"answer\":\"Lampiran memuat pelayanan pengobatan umum, tindakan medik operatif, pelayanan kegawatdaruratan, dan pelayanan pengobatan gigi di Puskesmas.\"},{\"question\":\"Bagaimana format penentuan tarif pelayanan ditampilkan?\",\"answer\":\"Tarif disajikan dalam tabel dengan kolom jenis pelayanan, biaya, satuan, dan keterangan untuk masing-masing tindakan.\"},{\"question\":\"Apakah lampiran ini memuat tindakan untuk kondisi kegawatdaruratan?\",\"answer\":\"Ya. Termasuk pemeriksaan kegawatdaruratan, observasi UGD, perawatan luka (ringan-sedang-berat), perawatan luka bakar, pemasangan kateter, resusitasi jantung paru, serta terapi oksigen.\"}]","Retribusi Jasa Umum - Pelayanan Kesehatan - Struktur Besaran Tarif Retribusi Pelayanan Puskesmas | PDF",1789674708,123]