LABORATORY
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| HEMATOLOGY | ||||
| a. CBC | 170.00 | 128.00 | 85.00 | FREE |
| b. Prothrombin time | 300.00 | 225.00 | 150.00 | FREE |
| c. APTT | 300.00 | 225.00 | 150.00 | FREE |
| d. Clotting time/bleeding time | 50.00 | 38.00 | 25.00 | FREE |
| e. Reticulocyte count | 80.00 | 60.00 | 40.00 | FREE |
| f. Malarial smear | 200.00 | 150.00 | 100.00 | FREE |
| Clinical Microscopy | ||||
| a. Urinalysis | 100.00 | 75.00 | 50.00 | FREE |
| b. Fecalysis | 100.00 | 75.00 | 50.00 | FREE |
| c. Pregnancy Test | 150.00 | 113.00 | 75.00 | FREE |
| d. Occult Fecal Blood | 220.00 | 165.00 | 110.00 | FREE |
| e. CSF Body Fluid | 1,000.00 | 750.00 | 100.00 | FREE |
| Microbiology | ||||
| a. Culture/Sensitivity Test | 1,000.00 | 750.00 | 500.00 | FREE |
| b. Blood Culture/Sensitivity Test (BACTEC) | 1,650.00 | 1,238.00 | 825.00 | FREE |
| c. Gram Stain | 120.00 | 90.00 | 60.00 | FREE |
| d. AFB Stain | 120.00 | 90.00 | 60.00 | FREE |
| e. KOH Stain | 120.00 | 90.00 | 60.00 | FREE |
| Serology | ||||
| a. Blood Typing including RH typing | 250.00 | 188.00 | 125.00 | FREE |
| b. Cross-matchiung including | 800.00 | 600.00 | 400.00 | FREE |
| c. Direct Coombs Test | 250.00 | 188.00 | 125.00 | FREE |
| d.Indirect Coombs Test | 100.00 | 75.00 | 50.00 | FREE |
| e. Coomb's Test | 250.00 | 188.00 | 125.00 | FREE |
| f. RTPCR | 3,800.00 | 2,850.00 | 1,900.00 | FREE |
| g. Rapid Antigen Test | 1,700.00 | 1,275.00 | 850.00 | FREE |
| Blood Chemistry | ||||
| a. FBS/RBS (Fasting/Random Blood Sugar) | 100.00 | 75.00 | 50.00 | FREE |
| b. OGCT (Oral Glucose Challenge Test) 50g | 150.00 | 113.00 | 75.00 | FREE |
| c. OGCT (Oral Glucose Challenge Test) 75g | 600.00 | 450.00 | 300.00 | FREE |
| d. Creatinine | 150.00 | 113.00 | 75.00 | FREE |
| e. Creatinine Clearance | 250.00 | 188.00 | 125.00 | FREE |
| f. 24 Hours Urine creatinine | 250.00 | 188.00 | 125.00 | FREE |
| g. Uric Acid | 150.00 | 113.00 | 75.00 | FREE |
| h. BUN | 150.00 | 113.00 | 75.00 | FREE |
| i. Cholesterol Only | 150.00 | 113.00 | 75.00 | FREE |
| j. Triglycerides Only | 250.00 | 118.00 | 125.00 | FREE |
| k. Lipid Profile (LDL, HDL, Chol, Trigy) | 700.00 | 525.00 | 350.00 | FREE |
| l. Albumin only | 150.00 | 113.00 | 75.00 | FREE |
| m. Total Protein only | 300.00 | 225.00 | 150.00 | FREE |
| n. Total Bilirubin | 250.00 | 188.00 | 125.00 | FREE |
| o. B1 (indirect Bilirubin) only | 250.00 | 188.00 | 125.00 | FREE |
| p. B2 (direct Bilirubin) only | 250.00 | 188.00 | 125.00 | FREE |
| q. CK MB | 800.00 | 225.00 | 150.00 | FREE |
| r. Troponin T | 700.00 | 525.00 | 350.00 | FREE |
| s. SGOT | 200.00 | 150.00 | 100.00 | FREE |
| t. SGPT | 200.00 | 150.00 | 100.00 | FREE |
| u. ALK Phosphatase | 200.00 | 150.00 | 100.00 | FREE |
| v. Amylase | 550.00 | 413.00 | 275.00 | FREE |
| w. Na+ (Sodium) | 250.00 | 188.00 | 125.00 | FREE |
| x. K+ (Potassium) | 250.00 | 188.00 | 125.00 | FREE |
| y. CH (Chloride) | 250.00 | 188.00 | 125.00 | FREE |
| z. Ca+ (Calcium) | 250.00 | 188.00 | 125.00 | FREE |
| aa Magnesium | 250.00 | 188.00 | 125.00 | FREE |
| bb Phosphorus | 150.00 | 113.00 | 75.00 | FREE |
| cc Blood Gas Analysis | 800.00 | 600.00 | 400.00 | FREE |
| dd TPAG | 300.00 | 225.00 | 150.00 | FREE |
| Immunology | ||||
| a. VORL | 250.00 | 188.00 | 125.00 | FREE |
| b. Hbsag (Surface Antigen) | 250.00 | 188.00 | 125.00 | FREE |
| c. Anti HCV Test | 300.00 | 225.00 | 150.00 | FREE |
| d. RF Rheumatoid Factor | 400.00 | 300.00 | 200.00 | FREE |
| e. CRP (C-Reactive Protein) | 400.00 | 300.00 | 200.00 | FREE |
| f. ASO (Titer) | 200.00 | 150.00 | 100.00 | FREE |
| g. RA LATEX RF | 400.00 | 300.00 | 200.00 | FREE |
| h. Salmonella Typhi | 800.00 | 600.00 | 400.00 | FREE |
| i. Dengue IgG/IgM Test | 300.00 | 225.00 | 150.00 | FREE |
| Tumor Markers & Hormone assays (Special Tests) | ||||
| a. PSA (Prostate Specific Ag) | 1,300.00 | 975.00 | 650.00 | FREE |
| b. CEA (Carcinoembryonic Ag) | 1,100.00 | 825.00 | 550.00 | FREE |
| c. Ca 125 (Ovarian Tumors) | 1,200.00 | 900.00 | 600.00 | FREE |
| d. AFP (a feto protein) | 650.00 | 488.00 | 325.00 | FREE |
| e. Free Beta HCG | 650.00 | 488.00 | 325.00 | FREE |
| f. Total HCG | 650.00 | 488.00 | 325.00 | FREE |
| g. Free T3 | 800.00 | 600.00 | 400.00 | FREE |
| h. Free T4 | 800.00 | 600.00 | 400.00 | FREE |
| i. TSH | 850.00 | 638.00 | 425.00 | FREE |
| j. GI-MA (ca19-9) | 1,300.00 | 975.00 | 650.00 | FREE |
| k. Ferritin | 700.00 | 525.00 | 350.00 | FREE |
| l. CK-MB | 500.00 | 375.00 | 250.00 | FREE |
| m. Troponin I | 700.00 | 525.00 | 350.00 | FREE |
| n. Anti-HBS | 800.00 | 600.00 | 400.00 | FREE |
| o. H Pylori | 400.00 | 300.00 | 200.00 | FREE |
| Histopathology section | ||||
| a. Surgical | ||||
| i) Small | 600.00 | 450.00 | 300.00 | FREE |
| ii) Medium | 700.00 | 525.00 | 350.00 | FREE |
| iii) Large | 900.00 | 675.00 | 450.00 | FREE |
| iv) X-Large | 1,100.00 | 825.00 | 550.00 | FREE |
| v) XX-Large | 1,600.00 | 1,200.00 | 800.00 | FREE |
| b. Cellblock Cytology | 1,100.00 | 825.00 | 550.00 | FREE |
| c. FNAB | 3,600.00 | 2,700.00 | 1,800.00 | FREE |
| f. Papsmear | 200.00 | 150.00 | 100.00 | FREE |
| e. Frozen Section | 3,400.00 | 2,550.00 | 1,700.00 | FREE |
| Immunohistochemistry | ||||
| a. ER/PR (Estrogen/Progesterone Receptor Assay) | 7,000.00 | 54,250.00 | 3,500.00 | FREE |
| Blood Service Facilites | ||||
| a. Fresh Whole Blood | 1,800.00 | 1,350.00 | 900.00 | FREE |
| b. Packed Red Cells | 1,500.00 | 1,125.00 | 750.00 | FREE |
| c. Platelet Concentrate | 1,000.00 | 750.00 | 500.00 | FREE |
| d. Fresh Frozen Plasma | 1,000.00 | 750.00 | 500.00 | FREE |
| Medical Gases | ||||
| Compressed Air | 1,100.00 | 825.00 | 550.00 | FREE |
| Oxygen Standard Type | 500.00 | 375.00 | 250.00 | FREE |
| Oxygen Flash Type | 330.00 | 248.00 | 165.00 | FREE |
| Oxygen Gp30 | 370.00 | 278.00 | 185.00 | FREE |
| Oxygen (lit/min) | 3.00 | 2.00 | 1.00 | FREE |
| Nitrous Oxide | 13,650.00 | 10,238.00 | 6,825.00 | FREE |
| Nitrous Oxide (lit/min) | 12.00 | 9.00 | 6.00 | FREE |
| CO2 (lit/min) | 20.00 | 15.00 | 10.00 | FREE |
RADIOLOGY
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| (X-RAY) | ||||
| 1. X-ray of Skull | ||||
| X-ray of Skull AP/Lateral | 450.00 | 338.00 | 225.00 | FREE |
| X-ray of Skull Nasal Bone | 340.00 | 255.00 | 170.00 | FREE |
| X-ray of Skull Paranasal sinus | 410.00 | 308.00 | 205.00 | FREE |
| X-ray of Skull Mastoid series | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Skull TMJ | 370.00 | 278.00 | 185.00 | FREE |
| X-ray of Skull Optic foramen (R/L) | 370.00 | 278.00 | 185.00 | FREE |
| X-ray of Skull Orbit (2 views) | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Skull Maxilla/Mandible (2 views) | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Skull Zygoma | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Skull Facial | 530.00 | 398.00 | 265.00 | FREE |
| X-ray of Skull Water's/Caldwell/Town's | 250.00 | 188.00 | 125.00 | FREE |
| X-ray of Soft Tissue | 195.00 | 146.00 | 98.00 | FREE |
| X-ray of Foreign Body | 195.00 | 146.00 | 98.00 | FREE |
| X-ray of Chest PA/AP/Lateral | 230.00 | 173.00 | 115.00 | FREE |
| X-ray of Chest PAL/APL | 300.00 | 225.00 | 150.00 | FREE |
| X-ray of Chest APL/PAL (2 views) PEDIA | 175.00 | 131.00 | 86.00 | FREE |
| X-ray of Apicolordotic view | 175.00 | 131.00 | 86.00 | FREE |
| X-ray Abdomen Plain and KUB | 330.00 | 248.00 | 165.00 | FREE |
| X-ray Abdomen Flat Plate & Upright | 450.00 | 338.00 | 225.00 | FREE |
| X-ray Abdomen Invertogram | 750.00 | 563.00 | 375.00 | FREE |
| X-ray Abdomen Babygram | 300.00 | 225.00 | 150.00 | FREE |
| X-ray Vertebral column Cervical Spine | 370.00 | 278.00 | 185.00 | FREE |
| X-ray Vertebral column Cervico-Thoracic Spine | 770.00 | 578.00 | 385.00 | FREE |
| X-ray Vertebral column Thoracic Spine | 430.00 | 323.00 | 215.00 | FREE |
| X-ray Vertebral column Thoracolumbar Spine | 770.00 | 578.00 | 385.00 | FREE |
| X-ray Vertebral column Cervico-Thoraco-Lumbar Spine | 800.00 | 800.00 | 400.00 | FREE |
| X-ray Vertebral column Sacrum/COCCYX | 195.00 | 146.00 | 98.00 | FREE |
| X-ray Vertebral column Scoliotic Series | 930.00 | 698.00 | 465.00 | FREE |
| X-ray Digestive Barium Swallow | 730.00 | 548.00 | 365.00 | FREE |
| X-ray Digestive UGIS | 2,600.00 | 1,950.00 | 1,300.00 | FREE |
| X-ray Digestive Small Intestinal Series | 1,050.00 | 788.00 | 525.00 | FREE |
| X-ray Digestive Barium Enema | 2,300.00 | 1,725.00 | 1,150.00 | FREE |
| X-ray Digestive Oral Chole-GI | 650.00 | 488.00 | 325.00 | FREE |
| Cholangiography | 350.00 | 263.00 | 175.00 | FREE |
| T-tube cholangiography | 360.00 | 285.00 | 190.00 | FREE |
| PTC | 2,000.00 | 1,500.00 | 100.00 | FREE |
| ERCP | 1,900.00 | 1,425.00 | 950.00 | FREE |
| IVU | 1,300.00 | 975.00 | 650.00 | FREE |
| Pelvimetry | 500.00 | 375.00 | 250.00 | FREE |
| Fetography | 500.00 | 375.00 | 250.00 | FREE |
| Cardiac Studies with Barium | 35,000.00 | 2,625.00 | 1,750.00 | FREE |
| Myelography | 35,000.00 | 2,625.00 | 1,750.00 | FREE |
| X-ray of Shoulder | 290.00 | 218.00 | 145.00 | FREE |
| X-ray of Thoracic Cage | 290.00 | 218.00 | 145.00 | FREE |
| X-ray of Clavicle | 380.00 | 285.00 | 190.00 | FREE |
| X-ray of Scapula | 370.00 | 278.00 | 185.00 | FREE |
| X-ray of Sternum | 430.00 | 323.00 | 215.00 | FREE |
| X-ray of Humerus | 320.00 | 240.00 | 160.00 | FREE |
| X-ray of Elbow | 310.00 | 233.00 | 155.00 | FREE |
| X-ray of Forearm | 290.00 | 218.00 | 145.00 | FREE |
| X-ray of wrist | 300.00 | 225.00 | 150.00 | FREE |
| X-ray of Hand | 300.00 | 225.00 | 150.00 | FREE |
| X-ray of Pelvis | 275.00 | 206.00 | 138.00 | FREE |
| X-ray of Hip Joint | 420.00 | 315.00 | 210.00 | FREE |
| X-ray of Femur | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Knee/Platella | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Leg | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Ankle | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of OS Calcis | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Foot | 350.00 | 263.00 | 175.00 | FREE |
| X-ray of Skeletal Survey | 3,500.00 | 2,625.00 | 1,750.00 | FREE |
| UTZ of Abdomen, Upper (HBT, Spleen, Kidneys, Pancreas) | 950.00 | 713.00 | 475.00 | FREE |
| UTZ of Abdomen Lower | 700.00 | 525.00 | 350.00 | FREE |
| UTZ of Abdomen, Whole (Upper & Pelvis) | 1,200.00 | 900.00 | 600.00 | FREE |
| UTZ of Hepatobiliary Tree | 750.00 | 563.00 | 375.00 | FREE |
| UTZ of KUB (kidneys, Ureters, Bladder) | 750.00 | 563.00 | 375.00 | FREE |
| UTZ of KUBP (KUB + Prostate) | 750.00 | 563.00 | 375.00 | FREE |
| UTZ of Thyroid | 650.00 | 488.00 | 325.00 | FREE |
| UTZ of Breast | 900.00 | 675.00 | 450.00 | FREE |
| UTZ of Chest | 550.00 | 413.00 | 275.00 | FREE |
| UTZ of Liver | 500.00 | 375.00 | 250.00 | FREE |
| UTZ of Kidneys | 500.00 | 375.00 | 250.00 | FREE |
| UTZ of Umbilical Area | 500.00 | 375.00 | 250.00 | FREE |
| UTZ of Pelvis (Non-Pregnant) | 550.00 | 413.00 | 275.00 | FREE |
| UTZ of Inguinal Area | 500.00 | 375.00 | 250.00 | FREE |
| UTZ of Scroto-Inguinal Area | 750.00 | 562.00 | 375.00 | FREE |
| UTZ of Biophysical Scoring (BPS) | 800.00 | 600.00 | 400.00 | FREE |
| UTZ of TAS (Transabdominal) | 550.00 | 413.00 | 275.00 | FREE |
| UTZ of TVS (Transvaginal) | 800.00 | 6,000.00 | 400.00 | FREE |
| UTZ of TRS (Transrectal) | 600.00 | 450.00 | 300.00 | FREE |
| UTZ of Cranial | 550.00 | 413.00 | 275.00 | FREE |
| UTZ of Any Single Organ | 590.00 | 443.00 | 295.00 | FREE |
| UTZ of Additional Organ | 250.00 | 188.00 | 125.00 | FREE |
| 2D-Echo | 2,500.00 | 1,875.00 | 1,250.00 | FREE |
| CT-Scan Cranium Plain | 4,000.00 | 3,000.00 | 2,000.00 | FREE |
| CT-Scan Cranium with Contrast | 6,000.00 | 4,500.00 | 3,000.00 | FREE |
| CT-Scan Paranasal Sinuses Plain | 6,500.00 | 4,875.00 | 3,250.00 | FREE |
| CT-Scan Paranasal Sinuses Plain with Contrast | 8,000.00 | 6,000.00 | 4,000.00 | FREE |
| CT-Scan Cranio-Facial Plain | 600.00 | 4,500.00 | 300.00 | FREE |
| CT-Scan Cranio-Facial Plain with Contrast | 8,000.00 | 6,000.00 | 4,000.00 | FREE |
| CT-Scan Neck/Cervical Plain | 5,500.00 | 4,125.00 | 2,750.00 | FREE |
| CT-Scan Neck/Cervical Plain with Contrast | 7,000.00 | 5,250.00 | 3,500.00 | FREE |
| CT-Scan Plain | 5,000.00 | 3,750.00 | 2,500.00 | FREE |
| CT-Scan Stella with Contrast | 6,500.00 | 4,875.00 | 3,250.00 | FREE |
| CT-Scan Extremities Plain | 5,400.00 | 4,050.00 | 2,700.00 | FREE |
| CT-Scan Extremities with Contrast | 6,600.00 | 4,950.00 | 3,300.00 | FREE |
| CT-Scan Lumbar Plain | 4,600.00 | 3,450.00 | 2,300.00 | FREE |
| CT-Scan Lumbar with Contrast | 6,600.00 | 4,950.00 | 3,300.00 | FREE |
| CT-Scan Whole Abdomen Plain | 9,000.00 | 6,750.00 | 4,500.00 | FREE |
| CT-Scan Whole Abdomen with Contrast | 11,000.00 | 8,250.00 | 5,500.00 | FREE |
| CT-Scan Upper Abdomen Plain | 6,000.00 | 4,500.00 | 3,000.00 | FREE |
| CT-Scan Upper Abdomen with Contrast | 8,000.00 | 6,000.00 | 4,000.00 | FREE |
| CT-Scan Lower Abdomen Plain | 5,000.00 | 3,750.00 | 2,500.00 | FREE |
| CT-Scan Lower Abdomen with Contrast | 7,000.00 | 5,250.00 | 3,500.00 | FREE |
| CT-Scan Chest Plain | 5,200.00 | 3,900.00 | 2,600.00 | FREE |
| CT-Scan Chest with Contrast | 7,200.00 | 5,400.00 | 3,600.00 | FREE |
| CT-Scan Upper/Lower Thoracic Plain | 6,000.00 | 4,500.00 | 3,000.00 | FREE |
| CT-Scan Upper/Lower Thoracic Plain Contrast | 7,000.00 | 5,250.00 | 3,500.00 | FREE |
| CT-Scan Guided Biopsy | 7,000.00 | 5,250.00 | 3,500.00 | FREE |
| CT-Scan Angiogram | 15,000.00 | 11,250.00 | 7,500.00 | FREE |
| MRI Head/Cranial | 7,700.00 | 5,775.00 | 3,850.00 | FREE |
| MRI Cervical Spine | 8,200.00 | 6,150.00 | 4,100.00 | FREE |
| MRI Thoracic Spine | 8,200.00 | 61,500.00 | 4,100.00 | FREE |
| MRI Lumbar Spine | 7,600.00 | 5,700.00 | 3,800.00 | FREE |
| MRI Upper Extremities (each) | 7,700.00 | 5,775.00 | 3,850.00 | FREE |
| MRI Lower Extremities (each) | 7,700.00 | 5,775.00 | 3,850.00 | FREE |
| MRI Angiogram/MRA/MRV | 9,600.00 | 7,200.00 | 4,800.00 | FREE |
HOSPITAL EQUIPMENT
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| 1. Cardiac Monitor (per hour of use) | 45.00 | 34.00 | 25.00 | FREE |
| 2. Ventilator (per hour of use) | 60.00 | 45.00 | 30.00 | FREE |
| 3. Nebulizer (per use) | 75.00 | 56.00 | 38.00 | FREE |
| 4. Pulse Oximeter | 30.00 | 23.00 | 15.00 | FREE |
| 5. Infusion Pump | 20.00 | 15.00 | 10.00 | FREE |
| 6. Syringe Pump | 20.00 | 15.00 | 10.00 | FREE |
| 7. Incubator | 20.00 | 15.00 | 10.00 | FREE |
| 8. Drop Light/Spot Light | 10.00 | 8.00 | 5.00 | FREE |
| 9. Suction Machine | 10.00 | 8.00 | 5.00 | FREE |
| 10. Phototheraphy | 5.00 | 4.00 | 3.00 | FREE |
| 11. CPAP (per day) | 3,000.00 | 2,250.00 | 1,500.00 | FREE |
| 12. Infant Radiant Warmer (per hour) | 100.00 | 75.00 | 50.00 | FREE |
| 13. Anesthesia Machine | 100.00 | 75.00 | 50.00 | FREE |
| 14. Transcutaneous bilirubinometer | 30.00 | 23.00 | 15.00 | FREE |
| 15. Endoscopy Machine | 6,000.00 | 4,500.00 | 3,000.00 | FREE |
| 16. Dialysis (per session) | 3,000.00 | 2,250.00 | 1,500.00 | FREE |
ROOM RATES
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| 1. Service Ward | 400.00 | 300.00 | 200.00 | FREE |
| 2. Private Ward | 600.00 | 450.00 | 300.00 | FREE |
| 3. Private Room | 1,000.00 | 750.00 | 500.00 | FREE |
| 4. CCU Room | 3,000.00 | 2,250.00 | 1,500.00 | FREE |
| 5. NICU Room | 2,300.00 | 1,725.00 | 1,150.00 | FREE |
| 6. PACU Room | 2,000.00 | 1,500.00 | 1,000.00 | FREE |
| 7. Isolation Ward | 500.00 | 375.00 | 250.00 | FREE |
USE OF AMBULANCE
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| 1. Within the City | ||||
| a. Level 1 | 500.00 | 375.00 | 250.00 | FREE |
| b. Level 2 | 100.00 | 750.00 | 500.00 | FREE |
| c. PTV | 200.00 | 150.00 | 100.00 | FREE |
| 2. Outside of the City | add:P50/km | add:P38/km | add:P25/km | |
MEDICAL FORMS
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| 1. Health Examination Record: | ||||
| i) Employment (Local or Abroad) | 100.00 | 75.00 | 50.00 | FREE |
| ii) School | 100.00 | 75.00 | 50.00 | FREE |
| 2. Outpatient Record with ID Card | ||||
| i) New | 50.00 | 38.00 | 25.00 | FREE |
| 3. Medical Certificates | ||||
| i) Non-medico-legal | 100.00 | 75.00 | 50.00 | FREE |
| ii) Medico-legal | 150.00 | 113.00 | 75.00 | FREE |
| iii) Dental Certificate | 100.00 | 75.00 | 50.00 | FREE |
OUT PATIENT PROCEDURE
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| a. 12-lead ECG | 200.00 | 150.00 | 100.00 | FREE |
| b. Chest Tube Insertion | 670.00 | 502.00 | 335.00 | FREE |
| c. Enema | 100.00 | 75.00 | 50.00 | FREE |
| d. Gastric Lavage | 200.00 | 150.00 | 100.00 | FREE |
| e. Incision & Drainage | 700.00 | 525.00 | 350.00 | FREE |
| f. Internal Examination | 50.00 | 38.00 | 25.00 | FREE |
| g. Intramascular (IM) injection | 75.00 | 56.00 | 38.00 | FREE |
| h. IV Cutdown | 670.00 | 503.00 | 335.00 | FREE |
| i. IV Insertion | 160.00 | 120.00 | 80.00 | FREE |
| j. NGT-OGT Insertion | 150.00 | 113.00 | 75.00 | FREE |
| k. Oxygen/Nebulization | 750.00 | 563.00 | 375.00 | FREE |
| l. Rectal Examination | 50.00 | 38.00 | 25.00 | FREE |
| m. Removal of Cast | 200.00 | 150.00 | 100.00 | FREE |
| n. Removal of Suture | 80.00 | 60.00 | 40.00 | FREE |
| o. Suturing | 670.00 | 503.00 | 335.00 | FREE |
| p. Urethral Catheter Insertion/Removal | 150.00 | 112.50 | 75.00 | FREE |
| q. Wound Drebridement | 1,100.00 | 825.00 | 550.00 | FREE |
| r. Wound Irrifation | 250.00 | 187.50 | 125.00 | FREE |
| s. Wound Dressing | ||||
| i. Small | 25.00 | 19.00 | 13.00 | FREE |
| ii) Medium | 50.00 | 38.00 | 25.00 | FREE |
| iii) Large | 100.00 | 75.00 | 50.00 | FREE |
| t. TTIG | 100.00 | 75.00 | 50.00 | FREE |
| Consultation: | ||||
| OPD | 150.00 | 113.00 | 75.00 | FREE |
| Dental | 150.00 | 113.00 | 75.00 | FREE |
| Emergency Room | 150.00 | 113.00 | 75.00 | FREE |
| Minor O.R Fee | 150.00 | 113.00 | 75.00 | FREE |
| Other Fess (Package) | ||||
| O.R Fee (good for 4 hours, additional 1000/ succeeding hours) | 4,000.00 | 3,000.00 | 2,000.00 | FREE |
| O.R /CS | 3,300.00 | 2,475.00 | 1,650.00 | FREE |
| D.R Fee | 1,500.00 | 1,125.00 | 750.00 | FREE |
DENTAL SERVICES
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| H. Dental Services | ||||
| 1. Oral prophylaxis | ||||
| a. Mild | 500.00 | 375.00 | 250.00 | FREE |
| b. Moderate | 800.00 | 600.00 | 400.00 | FREE |
| c. Heavy | 1,100.00 | 825.00 | 550.00 | FREE |
| d. Severe Stains (per quadrant) | 1,400.00 | 1,050.00 | 700.00 | FREE |
| e. Fluoride Application (Per quadrant) | 250.00 | 188.00 | 125.00 | |
| 2. Radiographs | ||||
| a. Panoramic | 800.00 | 600.00 | 400.00 | FREE |
| b. Lateral | 500.00 | 375.00 | 250.00 | FREE |
| 3. Preventive and Restorative dentistry | ||||
| a. Pit and fissure sealant application | 300.00 | 225.00 | 150.00 | FREE |
| b. Temporary Filling (per cavity) | 75.00 | 58.00 | 38.00 | FREE |
| c. Permanent Filling (light Cure) | ||||
| i) All Cases of Cavity | 500.00 | 375.00 | 250.00 | FREE |
| 4. Dental Surgery | ||||
| a. Decidious Tooth Removal | 175.00 | 131.00 | 88.00 | FREE |
| b. Permanent Tooth Extraction | 300.00 | 225.00 | 150.00 | FREE |
| c. Alveoloplasty | 1,000.00 | 750.00 | 500.00 | FREE |
| d. Impacted Tooth (any) odontectomy | ||||
| i) 3rd Molar Upright | 1,200.00 | 900.00 | 600.00 | FREE |
| ii) Class I Position B | 25,000.00 | 1,875.00 | 1,250.00 | FREE |
| iii) Class II Position B | 3,500.00 | 2,625.00 | 1,750.00 | FREE |
| iv) Class III Positiob B | 4,500.00 | 3,375.00 | 2,250.00 | FREE |
| v) Linguoverted/buccoverted/distoverted | 5,500.00 | 4,125.00 | 2,750.00 | FREE |
| E. Gingivectomy | 670.00 | 503.00 | 335.00 | FREE |
| F. Incision and Drainage | 670.00 | 503.00 | 335.00 | FREE |
| G. Post Extraction and Bleeding Management | 670.00 | 503.00 | 335.00 | FREE |
| 5. Miscellaneous Fee (PPE's) | ||||
| a. Level 1 | 500.00 | 375.00 | 250.00 | FREE |
| b. Level 2 | 800.00 | 600.00 | 400.00 | FREE |
| c. Level 3 | 1,000.00 | 750.00 | 500.00 | FREE |
SPECIAL SERVICES
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| a. ABTC | ||||
| i) Category 1 | 1,000.00 | 750.00 | 500.00 | FREE |
| ii) Category 2 | 3,000.00 | 2,250.00 | 1,500.00 | FREE |
| iii) Category 3 | 5,000.00 | 3,750.00 | 2,500.00 | FREE |
MEDICAL SUPPLIES
| CATEGORY OF PATIENT | ||||
| A | B | C | D | |
| Medical Supplies | 5% markup unit cost | FREE | ||
| Drugs and Medicine | 5% markup unit cost | FREE | ||
| a. Paperlab (per lab) | 3.00 | 2.00 | 1.00 | FREE |
