ST.

STEPHEN'S HOSPITAL
TIS HAZARI, DELHI - 110 401
SCHEDULE OF CHARGES W.E.F 01-04-2011

INDEX
SL. No. 1 Particulars O.P.D. SERVICES : - Registration ... - Clinics - Comprehensive Check-up.. ADMISSION FEE ................................................................................ ACCOMMODATION CHARGES ICU, CCU . CONSULTATION CHARGES .. THERAPEUTIC DIET SERVICES PROCEDURE & DRESSING - Dressing, Injection, etc . LABORATORY SERVICES - Haematology - Microbiology ................................... - Serology ......................................... - Blood Bank . ................................... - Biochemistry . ................................. - Clinical Pathology ........................... - Histopathology & Cytology ............ - Immuno Assay ............................... RADIOLOGY SERVICES - X-Ray ... - CT Scan..... .. - Ultrasound. - MRI.......................... - Interventional Radiology . PHYSIOTHERAPY SERVICES .. OCCUPATIONAL SERVICES .......................................................... A.L.C. SERVICES .......................................................................... CARDIOLOGY SERVICES ................................ PACKAGE CHARGES FOR C T S . RHEUMATOLOGY SERVICES . ENDOCRINOLOGY SERVICES GASTROENTROLOGY SERVICES ................................................. DERMATOLOGY SERVICES .......................................................... RESPIRATORY MEDICINE SERVICES ......................................... PSYCHIATRIC SERVICES ............................................................... NEUROLOGY SERVICES .. NEPHROLOGY SERVICES ............................................................. PEADIATRIC SERVICES .............................................................. OPHTHALMOLOGY SERVICES E.N.T. & AUDIOLOGY SERVICES ....... DENTAL SERVICES .. MATERNITY SERVICES . REPRODUCTIVE AND FOETAL MEDICINE UNIT (RFM UNIT) . MINOR OT PROCEDURES ............................................................. OPERATION CHARGES ................................................................ OXYGEN CHARGES ..... IN PATIENT PACKAGE CHARGES FOR GENERAL SURGERY ... MISCELLANEOUS CHARGES - Certificate Fee . - Ambulance Services .. - Mortuary Services . 4 4 4 5 5 5 5 5 6 7 7 8 8 9 10 10 11 12 13 13 14 15 17 18 18 21 22 22 23 23 24 25 25 25 26 27 27 28 29 30 31 32 33 34 35 36 36 36 Page No.

2 3 4 5 6 7 8

10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33

GENERAL INFORMATIONS:
1.

This schedule will apply to all patients including those belonging to the Institutions who have St. Stephen's Hospital on their panel for treatment of their referred patients, except for those who are offered CGHS/DGEHS rates.

2.

a) For O.P.D. Services there are two categories of charges only i.e. GENERAL and PRIVATE. For private OPD, the charges @ semi private rates would be applicable. b) For in-patients, the charges are determined with reference to the type of accommodation chosen by the patients as given below: GENERAL, CUBICLE, SEMI-PVT NON A.C., SEMI-PVT A.C., PRIVATE NON A.C., PRIVATE A.C., SPECIAL ROOMS and DELUXE.

3.

Change of Accommodation: a) If a higher type of accommodation is desired by a patient during the hospital stay, i.e. if a general ward patient wishes to be transferred to a private/semi private ward, he/she will pay general ward charges for all services up to the time of transfer and private ward charges as per category chosen for all services from the date of transfer to higher accommodation.

However, in the case of a person operated or who has undergone a delivery who is subsequently desiring a higher category of accommodation, the operation fees/delivery charges will be as per the highest category of accommodation availed.

b)

If a patient wishes to change to lower accommodation (from private/semi private to

general ward) the decision to transfer will depend on the availability of bed and evaluation by Medical social worker as to his/her eligibility to go to a subsidized bed. If transfer is effect, the patient will pay all the charges up to the date of transfer as per private schedule of charges and at the general ward schedule from the date of transfer.

4.

a) ICU/CCU etc. are treatment areas and not the accommodation areas. Any patient admitted directly in these areas will decide about the type of accommodation at the time

of admission in these areas and charges will be made accordingly irrespective of whether or not they have actually utilized such an accommodation for whatever reason. No charges of stay in the treatment areas up to 2 hours. b) Labour charges will apply fully irrespective of the duration of stay in the Labour

Room. c) Accommodation Charges:

Duration of stay for 24 hours will be counted as one full day. Upon discharge, the fractions thereof will be calculated as follows:

i. 4 hours of stay
ii. 4 hours to 12 hours of stay iii. More than 12 hours of stay

No charges
Half day charge Full day charge

5.

Service Charges: The patient will be charged for all services provided from the time of admission till the time of discharge.

6.

VAT, Service Tax etc. will be applicable wherever it applies. Checkout Time is within 6 hours from the time of billing and if not settled such bills will be modified accordingly.

7.

8.

An attendant is allowed to stay with the patient free of charge in Cubicle/ SemiPrivate/Private Non A.C./Private A.C, Special and Deluxe rooms. permitted to stay with the patient in General Ward. No attendant is

9.

Visitors should strictly observe visiting hours of the hospital.

Dr. Sudhir C. Joseph DIRECTOR

ST STEPHEN'S HOSPITAL, TIS HAZARI, DELHI - 110 401.

SCHEDULE OF CHARGES FOR O.P.D.
New Registration I. OPD CONSULTATION 1. Registration - General O.P.D. 2. Registration - Private O.P.D. 3. Registration- Private O P D (Evening) 4. Casualty 5. Child Health Card II. CLINICS 1. Well Baby Clinic-General 2. All sub-specialties and super- specialty Clinic-General 80 80 80 80 80 400 500 150 20 70 350 450 Revisit

NOTE : No Registration fee will be charged for the Cards issued to the New Born Babies
III. ANTI NATAL CLINIC 1. Pregnancy Clinic (Per Visit) 2. High Risk Pregnancy Clinic ( per Visit) 3. For entire duration of Pregnancy (Unlimited Visit) 4. Special Scheme for entire duration of Pregnancy (Unlimited Visit) New Registration 500 500 1500 3000* Revisit 200 250 -

* Rs.2000/- rebate will be given on delivery in St. Stephens Hospital

V.

COMPREHENSIVE CHECK-UP: 1. Comprehensive check-up a) Basic Preventive Health check-up b) Executive Health check-up c) Preventive Heart check-up d) Whole Body check-up e) Well woman check-up 850 2000 3500 4400 2000

SCHEDULE OF CHARGES FOR INPATIENTS

General 225 Private 450

ADMISSION FEE

ACCOMMODATION CHARGES (Per day)

SL. No. 1 2 3 4 5 6 7 8 10 Category of Accommodation General Ward * (Subsidized Charges) Cubicle Semi Private Non A.C. Semi Private A.C. Room Semi Private A.C. Room (Delux) Non A.C. Single Room A.C. Single Room (Small) A.C. Single Room- Special Room Delux Room Amount 1100 1200 1500 1750 2400 2600 2900 3500 4200

* Note: Deserving patients will be given a subsidy of Rs.350/- to those admitted in General Ward and Rs.50/- in Cubicle Ward.

I.C.U. & C.C.U. CHARGES

(per day for all Catagories) SL. No. 1 2 3 3 4 5 I C U care High Dependency Unit (Medicine) Post Operative Care Ventilator Charges Monitoring charges in Wards. Invasive Ventilation-Bippapp machine Amount 3500 1800 1300 3500 425 1600

CONSULTATION FEE & VISITING CHARGES

Consultation charge per day Rs. 460 375 300 150

Category of Accommodation 1 2 3 4 A.C. Rooms Non A.C. Rooms and A.C. Semi Private Rooms Semi-Private (non-A.C. Rooms) Cubicle
NOTE:

1. The charges as noted above will apply when the specialist visit the patients in the ICU/CCU and Nursery. 2. Surgeon's fees include visiting charges for the first seven days starting from and including day of operation.

THERAPEUTIC DIET CHARGES

I. CO01 THERAPEUTIC DIET DIET COUNSELING CHARGES Gen./ Cub. 50 S Pvt. 90 Private 125

PROCEDURE & DRESSING/ TREATMENT CHARGES

I. ICU05 PD01 PD02 PD03 PD04 PD05 PD06 PD07 PD08 PD09 PD10 PD11 PD12 PD13 PD14 PD15 PD16 PD17 PD18 PD19 PD20 PT01 PT02 PT03 PT04 PT05 PT06 PT07 PT08 PT09 PT10 PT11 PT12 PT13 PT14 PT15 PT16 PT17 PT18 PT19 PT20 PT21 PT23 PT24 PT25 PT26 PT27 PT28 PT29 PT30 PT31 PROCEDURES& DRESSING/TREATMENT MONITORING CHARGES IN WARDS DRESSING SMALL DRESSING LARGE SPECIAL DRESSING(PLASTIC SURGERY) CHEMOTHERAPY (I V INJECTION) INJECTION INOCULATION 15% TO 30% BURNS FIRST DRESSING SUBSEQUENT DRESSING (15-30 %) 30% TO 50% BURNS FIRST DRESSING SUBSEQUENT DRESSING (30-50%) EXTENSIVE BURN ABOVE 50% SUBSEQUENT DRESSING (ABOVE 50%) NEBULIZATION THERAPY D.C. SHOCK RBS (BY GLUCOMETERS) BLOOD GAS ANALYSER BLOOD GAS ANALYSER WITH ELECTROLYTE INFUSION PUMPS SYRINGE PUMPS SUTURE REMOVAL OT DRESSING LUMBAR PUNCTURE CUT DOWN CHEST ASPIRATION INTER COSTAL DRAINAGE LIVER BIOPSY KIDNEY BIOPSY LIVER ASPIRATION BONE MARROW SUBDURAL TAP TAP THERAPEUTIC (ASCITIC) TAP DIAGNOSTIC (ASCITIC) VENTRICULAR TAP UMBILICAL CANULATION EXCHANGE TRANSFUSION BLOOD TRANSFUSION PULSE OXIMETER IMAGE INTENSIFIER PLASTER APPLICATION CHARGES FLOW RATE (UROLOGY) URODYNAMICS CATHETERISATION URINE ALBUMIN TRACHEOSTOMY INTUBATION FLUID/BLOOD WARMER BODY WARMER OPERATING MICROSCOPE ARGON COAGULATOR INVASIVE MONITORING HARMONIC SCALPEL Gen./ Cub. 460 70 130 130 750 10 130 90 220 150 220 150 50 150 80 300 400 150 150 50 130 310 190 190 500 310 1150 300 300 300 150 150 310 150 1500 220 170 700 200 330 800 150 50 1300 430 1050 1050 700 700 1050 8500 S .Pvt. 460 90 160 160 1100 10 150 110 280 200 280 200 70 200 90 370 450 220 220 70 160 390 240 240 600 390 1750 400 400 400 220 220 390 220 1800 350 230 1050 280 450 1150 220 70 4150 580 1400 1400 1050 1050 1400 9700 Private 460 110 250 230 1550 10 230 170 370 280 370 280 90 230 110 430 550 280 280 90 230 550 310 310 700 550 2300 550 550 550 280 280 550 280 2300 460 290 1400 370 550 1520 280 90 4600 700 2100 2100 1400 1400 2100 10870

PT32 PT33 PT34 PT35

ISOFLURIN SERVO FLURANE THERAPEUTIC ARTHOSCOPY- SHAVER CHARGES W/O IMPLANT THERAPEUTIC ARTHOSCOPY- SHAVER CHARGES WITH IMPLANT

450 600 1000 3000

450 600 1200 3200

450 600 1500 3500

LABORATORY SERVICE CHARGES

I. HM01 HM02 HM03 HM04 HM05 HM06 HM07 HM08 HM09 HM10 HM11 HM12 HM13 HM14 HM15 HM16 HM17 HM18 HM19 HM20 HM21 HM22 HM23 HM24 HM25 HM26 HM27 HM28 HM29

HAEMATOLOGY Hb (HAEMOGLOBIN) CBC (HB,TC,DC,PLTS,Cell Indi PS) ESR RETICULOCYTE COUNT ABSOLUTE EOSINOPHIL COUNT MP (MALARIA PARASITE SMEAR) MICROFILARIA BT PT/INR APTT COAGULATION WORK UP FACTOR ASSAY BETHESDA ASSAY INHIBITOR SCREENING LUPUS ANTICOAGULANT PANEL FDP/D-DIMER FIBRINOGEN HAMS TEST H PREPARATION G6 PD SCREENING SICKLE CELL PREPARATION Hb A2 AND Hb F (THAL SCREENING TEST OSMOTIC FRAGILITY TEST BONE MARROW WITH IRON CYTOCHEMISTRY FOR LEUKEMIA LE CELLS RAPID TEST FOR MALARIA TEG ANALYSIS SPLENIC ASPIRATE FOR L.D. BODIES

General 60 260 90 175 100 90 100 75 260 350 3000 1500 2000 1500 1800 850 225 225 75 350 75 600 250 550 360 175 450 1250 125

Private. 70 270 100 200 125 100 120 100 275 370 3500 1750 2500 1750 2000 900 250 250 100 400 100 650 300 600 440 200 500 1500 150

II. MB01 MB02 MB03 MB08 MB10 MB11 MB12 MB22 MB05

MICROBIOLOGY GRAMS STAIN AFB STAIN ALBERTS STAIN FUNGAL CULTURE INDIA INK PREPARATION KOH PREPARATION HANGING DROP PREPARATION CULTURE IDENTIFICATION AND SENSITIVITY ANAEROBIC CULTURE

General 125 150 125 550 110 125 100 520 650

Private. 150 180 150 600 120 150 125 620 700

MB24 III. SE01 SE02 SE03 SE04 SE06 SE13 SE14 SE15 SE16 SE17 SE18 SE20 SE21 SE22 SE23 SE29 SE32 SE33 SE34 SE35 SE36 SE37 SE38 SE40 SE41 SE42 SE43 SE44 IV. BB01 BB02 BB03 BB04 BB05 BB06 BB07 BB08 BB09 BB10 BB11 BB12 BB13 BB14 BB15 BB16 BB17 BB18 BB19 BB20 BB21

CULTURE- QUANTITATIVE SEROLOGY WIDAL CRP ASO RA FACTOR VDRL./RPR HIV SPOT HIV ELISA HBs Ag SPOT HBs Ag ELISA HCV SPOT HCV ELISA DENGUE IgM IgG CRYPTOCOCCUS TB IgG (ELISA) TB IgM (ELISA) NCC TOXO IgG HEPATITIS C PCR QUALITATIVE HEPATITIS C PCR QUANTITATIVE HEPATITIS B PCR QUALITATIVE HEPATITIS B PCR QUANTITATIVE HUMAN PAPILLOMA VIRUS (HYBRID CAP.) HLA B-24- PCR DENGUE NS 1 ANTIGEN ENTEROCHECK (S. typhi IgM) HEV-IgM LEPTOSPIRA-IgM CHIKUNGUNIA-IgM BLOOD BANK ABO Rh [BLOOD GROUP] SUB GROUPS Rho PHENOTYPE DIRECT COOMBS INDIRECT COOMBS (FOR ANTI D) RHO ANTI BODY TITER AUTOANTIBODY COLD AGGLUTININS CROSS MATCH WHOLE BLOOD PACKED CELLS FRESH FROZEN PLASMA (FFP) PLATELETS CONCENTRATE BANK PLASMA VENESECTION - THALASSEMIA PLT APHEREIS DONOR SCREENING FOR APHERESIS VENESECTION TRIPLE BAG CROSS MATCH FOR THALASEEMIA PATIENTS ONLY ANTIBODY SCREEN- FOR B.T Rh PHENOTYPE

1000 General 160 250 350 250 80 300 300 200 300 300 600 1000 500 350 350 300 300 2700 6250 2500 6500 1300 1300 1300 300 1100 900 650 General 175 125 300 250 300 650 125 300 300 850 850 850 750 750 300 10000 500 500 100 300 300

1200 Private. 180 300 400 300 90 350 350 250 350 350 650 1200 650 450 450 350 350 3000 6500 3000 7000 1500 1500 1400 350 1200 1000 700 Private. 200 150 350 300 350 700 150 350 350 850 850 850 750 750 300 10000 500 500 100 350 350

V. BC01 BC02 BC03 BC04 BC05 BC06 BC07 BC09 BC10 BC11 BC12 BC13 BC14 BC16 BC17 BC18 BC19 BC20 BC21 BC22 BC23 BC24 BC25 BC26 BC27 BC30 BC31 BC33 BC34 BC35 BC36 BC37 BC38 BC40 BC41 BC42 BC43 BC44 BC45 BC46 BC47 BC48 BC49 BC50 BC51 BC52 BC53 BC54 BC55 BC56 BC58 BC61 BC62 BC63 BC64

BIOCHEMISTRY FBS PPBS RBS GCT GTT (GLUCOSE TOLERANCE TEST) GLYCOSYLATED Hb (Hb,A1c) ACETONE BUN (BLOOD UREA NITROGEN) CREATININE URIC ACID SODIUM POTASSIUM CHLORIDE URINE PROTEIN 24 HRS URINE CREATININE CREATININE CLEARANCE UREA CLEARANCE TEST CALCIUM PHOSPHOROUS MAGNESIUM LFT BILIRUBIN SGPT SGOT ALKALINE PHOSPHATASE TOTAL PROTEIN ALBUMIN AMYLASE LIPASE LDH CPK CK MB LIPID PROFILE CHOLESTEROL TRIGLYCERIDES HDL LDL Iron & TIBC KFT URINE AMYLASE URINE CALCIUM URINE CHLORIDE URINE BICARBONATE URINE CREATININE URINE POTASSIUM URINE MAGNISIUM URINE PHOSPHOROUS URINE PROTEIN RANDOM QUANTITATIVE URINE SODIUM URINE HEMOSEDERINE URINARY URIC ACID 24HR A.D.A. RENAL PROFILE (BUN,CR,UA,NA,K) CYSCTATIN-C QUANTIFERON TB GOLD

General 75 75 75 75 275 350 40 85 85 95 120 120 120 110 85 250 250 120 120 350 550 170 120 120 120 120 100 300 400 250 250 310 700 100 200 180 180 300 265 300 120 120 200 85 120 350 120 110 120 175 95 450 630 900 2250

Private. 80 80 80 80 330 400 50 90 90 100 130 130 130 120 90 300 300 130 130 370 600 180 130 130 130 130 110 320 450 260 260 320 750 110 220 190 190 320 280 320 130 130 250 90 130 370 130 120 130 200 100 460 640 1000 2500

VI. CP01 CP02 CP03 CP04 CP05 CP06 CP07 CP08 CP09 CP10 CP11 CP12 CP13 CP14 CP15 CP16 CP17 CP18 CP19 CP20 CP21 CP22 CP23 CP24 CP25

CLINICAL PATHOLOGY STOOL ROUTINE STOOL OCCULT BLOOD STOOL REDUCING SUBSTANCE URINE ROUTINE URINE BILLIRUBIN URINE UROBILINOGEN URINE ACETONE (KETONE) URINE SPECIFIC GRAVITY URINE pH URINE GLUCOSE URINE PROTEIN URINE NITRATE URINE BENCE JONES PROTEIN URINE PREGNANCY TEST BODY FLUIDS EXAM.(CSF,AF,PF,PC) SEMEN ANALYSIS PCT (Post Coital Test) APT TEST ASPIRATE FOR POLYMORPHS STOOL pH STOOL FATGLOBULES URINE OCCULT BLOOD BODY FLUID AMYLASE BODY FLUID LDH BODY FLUID BILIRUBIN

General 60 40 40 60 40 40 40 40 40 40 40 40 125 110 350 200 80 60 75 40 40 40 350 250 170

Private. 70 50 50 70 50 50 50 50 50 50 50 50 150 120 400 250 100 70 100 50 50 50 400 270 180

VII. HP01 HP25 HP03 HP26 HP04 HP05 HP06 HP16 HP08 HP17 HP09 HP18 HP11 HP12 HP13 HP14 HP15 HP19 HP20 HP21 HP22 HP23 HP24 HP27 HP29 HP28

HISTOPATHOLOGY & CYTOLOGY HISTOPATHOLOGY SMALL (UPTO 3 CONTAINERS) ADDITIONAL CONTAINER (SMALL BIOPSY) HISTOPATHOLOGY - LARGE ADDITIONAL CONTAINER (LARGE BIOPSY) FNA C PAP SMEAR INTRA OPERATIVE PATHOLOGY (IOP) (UPTO TWO) ADDITIONAL CONTAINER (IOP) BODY FLUIDS CYTOLOGY (UPTO TWO SITES) ADDITIONAL SITE (BODY FLUIDS) IMMUNO HISTO CHEMISTRY (FIRST) ADDITIONAL TEST (IMMUNO HISTOCHEMISTRY) IMMUNO HISTOCHEMISTRY LCA IMMUNO HISTOCHEMISTRY CYTOKERATIN IMMUNO HISTOCHEMISTRY ER IMMUNO HISTOCHEMISTRY PR IMMUNO HISTOCHEMISTRY HER-2 NEU IMMUNO HISTOCHEMISTRY VIMENTIN DUPLICATE SLIDE CHARGES (PER SLIDE) BLOCK CHARGES (PER BLOCK) CD3 CD20 Ki67 IMMUNOFLUOROSCENCE FOR KIDNY BIOPSY ONCOLOGY SPECIMEN HUMAN PAPILLOMA VIRU (HYBRID CAP. ASSAY)

General 600 100 800 200 500 350 900 250 400 125 1250 900 1250 1250 1250 1250 1250 1250 20 20 1250 1250 1250 1500 1300 1700

Private. 700 125 900 250 600 450 1000 300 500 150 1500 1000 1500 1500 1500 1500 1500 1500 20 20 1500 1500 1500 1800 1500 2000

10

HP30

F N A C SLIDE REVIEW

300

400

VIII. IA01 IA02 IA03 IA04 IA05 IA06 IA07 IA08 IA09 IA10 IA11 IA12 IA13 IA14 IA15 IA17 IA19 IA20 IA22 IA23 IA24 IA25 IA26 IA27 IA28 IA29 IA30 IA33 IA34 IA38 IA39 IA41 IA44 IA45 IA46 IA54 IA56 IA57 IA58 IA59 IA60 IA61 IA62 IA66 IA67 IA70 IA71

IMMUNO ASSAYS T3 FREE T3 T4 FREE T4 TSH LH FSH PROLACTIN ESTRADIOL (E2) PROGESTRONE B-HCG TESTOSTERONE CORTISOL INSULIN C-PEPTIDE ANTI DS DNA ANTI CARDIOLIPIN ANTIBODY IgG- IgM PSA AFP CEA CA 125 SERUM FERRITIN VIT B12 SERUM FOLATE IgE TFT ACTH OSTEOCALCIN INTACT PTH hGH IGF-1 ANTI HBc ANTI HBs ANDROSTENEDIONE DHEA-SO4 THYROGLOBULIN ANTI TPO Ab HOMOCYSTEINE URINE CORTISOL ESTRIOL (FE3) ANA PROFILE ANA FT CA-19.9 CA 15.3 PROCALCITONIN (PCT) EBV IgM DERECT RENIN

General 270 270 270 270 270 420 420 420 420 420 420 460 460 600 700 550 1000 550 600 550 800 450 750 750 400 1250 900 1250 900 500 3000 800 800 1300 700 1200 900 600 460 400 1750 900 800 900 1800 1000 700

Private. 300 300 300 300 300 430 430 430 430 430 430 470 470 630 750 600 1100 600 630 600 850 500 800 800 500 1450 1000 1500 1000 550 3050 830 830 1400 750 1300 950 650 470 420 2000 1000 850 1000 2000 1200 800

11

RADIOLOGY SERVICE CHARGES

Gen./ Cub. 120 120 180 180 360 180 180 360 180 180 250 180 180 180 250 250 360 180 180 250 180 180 180 250 500 1100 900 1800 880 1800 2100 2100 2100 2100 180 180 180 250 2400 1450 1450 1200 2400 2100 2300 2600 900 2100 250

I. PORT XR01 XR04 XR05 XR07 XR08 XR09 XR10 XR11 XR12 XR13 XR14 XR15 XR16 XR17 XR18 XR19 XR20 XR21 XR22 XR23 XR24 XR25 XR26 XR27 XR28 XR29 XR30 XR31 XR33 XR35 XR36 XR38 XR42 XR43 XR44 XR45 XR46 XR48 XR49 XR50 XR51 XR52 XR54 XR55 XR56 XR57 XR58 XR60

X-RAY PORTABLE CHARGES FLUROSCOPY CHEST ABDOMEN A P OR ERECT ABDOMEN FOR LAT. VIEW ABDOMEN ERECT & SUPINE CHEST P A CHEST OBLIQUE OR LATERAL CHEST P A & RIGHT OR LEFT LATERAL MASTOIDS EXTREMITIES,BONES&JOINTS-1 EXPOSURE EXTREMITIES,BONES&JOINTS-2 EXPOSURES PELVIS PARA-NASAL SINUSES T M JOINTS ONE EXPOSURE T M JOINTS (TWO EXPOSURE) K.U.B.(ABDOM. & PELVIS) 2 EXPOSURES SKULL A P & LATERAL SKULL A P / LAT. SKULL LAT OR OBLIQUE OR TOWNES SPINE A P & LATERAL (2 EXPOSURES) SPINE A P / LAT. (1 EXPOSURE) SPINE LEFT OR RIGHT LATERAL SPINE LEFT OR RIGHT OBLIQUE SPINE BOTH OBLIQUE SPINE A P, LATERAL & OBLIQUE BARIUM SWALLOW/GASTROGRAFIN SINOGRAPHY/SIALOGRAPHY CYSTOGRAPHY/URETHROGRAPHY HYSTERO-SALPINGOGRAPHY RETROGRADE PYELOGRAPHY BARIUM ENEMA BARIUM MEAL UPPER OR LOWER I V UROGRAPHY CEREBRAL/FEMORAL ANGIOGRAPHY APICOGRAM (CHEST) CHEST DECUBITUS VIEW K.U.B.(ABD & PELVIS) 1 FILM EXTREMITIES, BONES & JOINTS 2 EXPOSURE SPLENO-PORTOGRAPHY T-TUBE CHOLANGIOGRAPHY INTRA-OPERATIVE CHOLANGIOGRAPHY PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY BILIARY DRAINAGE UNDER GUIDANCE CENTRAL VENOGRAPHY BARIUM MEAL FOLLOW THROUGH PERCT. TRANSHEPATIC BILIARY DRAINAGE MAMMOGRAPHY SMALL BOWEL ENEMA PARA NASAL SINUSES TWO EXPOSURE

S. Pvt. 150 155 220 220 430 220 220 420 220 220 300 220 220 220 300 300 430 220 220 300 220 220 220 300 600 1450 1200 2100 1100 2100 2500 2500 2500 2500 220 220 220 300 2900 1820 1820 1500 2900 2500 2700 3100 1200 2500 300

Private 200 200 270 270 520 270 270 520 270 270 350 270 270 270 350 350 520 270 270 350 270 270 270 350 700 1820 1500 2400 1320 2400 3000 3000 3000 3000 270 270 270 350 3400 2200 2200 1800 3400 3000 3100 3600 1500 3000 350

12

XR61 XR62 XR63 XR64 XR65 XR66 XR67 XR68

TM JOINTS TWO EXPOSURES EXTREMITIES, BONES, JOINTS 3 EXPOSURES MASTOID BI-LATERAL SOFT TISSUE NECK LATERAL ERCP PERCUTANEOUS NEPHROSTOMY NASO JEJUNAL TUBE INSERTION FLUROSCOPY NASAL BONE LAT. VIEW

250 300 220 200 800 900 280 200 Gen./ Cub. 1520 1820 2420 2420 2420 1820 1820 1820 600 300 1500 220 1220 4400 6050 6050 1820 2420 6050 6050 3630 6050 6050 3020 2420 6050 6050 3630 6050 1100 1820 600 370 Gen./ Cub. 580 460 800 650 1250 580

300 350 290 220 950 1050 380 220

350 400 340 270 1100 1200 480 270

II. CT01 CT02 CT03 CT04 CT05 CT06 CT07 CT08 CT09 CT11 CT12 CT13 CT14 CT21 CT22 CT23 CT24 CT25 CT26 CT27 CT28 CT29 CT30 CT31 CT32 CT33 CT34 CT35 CT36 CT37 CT38 CT39 CT40

CT SCAN CT HEAD BASIC BRAIN SCAN CT PNS,ORBIT,PITUTARY FOSSA,TEMPORAL BONE, CT CHEST CT UPPER ABDOMEN CT LOWER ABDOMEN CT SPINE (FOR 3 LEVELS) CT LIMBS & JOINTS CT NECK SPINE ADDITIONAL 1 LEVEL CT SCANOGRAM CT GUIDED BIOPSY, FNAC, ASPIRATION EMERGENCY SCAN CHARGE FOR CT CT FOR P.N.S LIMITED CUTS CT WHOLE ABDOMEN CT HEAD INTRACRANIAL ANGIOGRAPHY CT HEAD PERFUSION STUDIES LARYNX THORAX HRCT THORACIC AORTA ANGIOGRAPHY CORONARY ANGIOGRAPHY + CA SCORING CT BRONCHOSCOPY UPPER ABDOMEN SINGLE,DUAL,TRIPHASIC SPLENO-PORTAL,MESENTRIC, VENOUS UPPER ABDOMEN HEPATIC VOLUME UPPER ABDOMEN HEPATIC PERFUSION UPPER ABDOMINAL AORTA ANGIOGRAPHY UPPER ABDOMEN RENAL ANGIOGRAPHY LOWER ABDOMEN + COLONOSCOPY CT PERIPHERAL ANGIOGRAPHY CT DENTA SCAN (ORTHOPANTOMOGRAM) CT BONE MINERAL ANALYSIS 3-D RECONSTRUCTIONS ANAESTHETIST CHARGES

S. Pvt. 1700 2120 3020 3020 3020 2120 2120 2120 720 390 1900 360 1520 5060 7260 7260 2120 3020 7260 7260 4570 7260 7260 3960 3020 7260 7260 4570 7260 1320 2120 900 600

Private 1950 2530 3630 3630 3630 2530 2530 2530 850 480 2200 500 1820 5830 8470 8470 2530 3630 8470 8470 5500 8470 8470 4840 3630 8470 8470 5500 8470 1650 2530 1200 600

III. US01 US02 US03 US04 US05 US06

ULTRA SOUND OBSTETRICS FIRST SCAN OBSTETRICS FOLLOW UP (2ND VISIT) OBSTETRICS DOPLER STUDY BIOPHYSICAL PROFILE OBSTETRICS DOPLER AND BIOPHYSICAL PROFILE PELVIC SCAN

S. Pvt. 760 690 1275 950 1750 750

Private 950 890 1760 1250 2150 950

13

US07 US08 US09 US10 US11 US13 US15 US16 US17 US18 US19 US20 US21 US22 US23 US24 US25 US26 US27 US28 US29 US32 US33 US34 US35 US36 US41 US42 US43 US44 US45 US47 US48

TRANSVAGINAL SCAN FOLLICULAR STUDY Ist SITTING FOLLICULAR STUDY SUBSEQUENT SITTING LEVEL II SCAN FOR FOETAL ANOMALIES FOETAL ECHO NEONATAL SKULL NEONATAL HIP ABDOMINAL SCANS UPPER ABDOMEN GENERAL SCAN LOWER ABDOMEN GENERAL SCAN WHOLE ABDOMEN GENERAL SCAN KUB GENERAL SCAN TRANSRECTAL GENERAL SCAN SMALL PARTS (BREAST,EYE,TESTIS,THYROID, JOINT) VEINS UPPER OR LOWER EXTREMITIES ARTERIES VASCULAR STUDY RENAL DOPPLER AND PORTAL VEIN STUDY WITH ABDOMINAL SCAN FNAC USG INTERVENTIONS DIAGNOSTIC PLEURAL ASCETIC TAP LUNG/ LIVER ABSCESS DRAINAGE/ PELVIC ABSCESS DRAINAGE WITH INDWELLING CATHETERS (Pig Tail) Excluding cost of consumables. TRANSRECTAL BIOPSIES BIOPSY NEEDLE CHARGES USG CHEST,PVR,MATERNAL KIDNEYS ECV RENAL INTERVENTION (PC NEPHROSTOMY) EMERGENCIES ULTRASOUND PORTABLE CHARGES VENOUS DOPPLER STUDY BOTH LIMBS CAROTID DOPPLER STUDY ARTERIAL DOPPLER STUDY BOTH LIMBS SINGLE LOOK USG USG FOR PVR

650 650 150 1500 840 500 660 500 550 550 800 500 750 800 1200 1700 1100 1000 875 1050 1125 1800 850 150 230 1800 165 80 1850 1700 1850 200 200

900 900 230 1900 1330 725 900 725 725 725 1050 725 1100 1275 1925 2300 1450 1250 1000 1500 1800 2500 1700 180 350 2500 165 80 2950 2300 2950 250 250

1150 1150 300 2300 1840 1000 1150 1000 950 950 1275 1000 1460 1760 2640 2900 1825 1500 1300 2000 2400 3300 1700 220 460 3300 165 80 4050 2900 4050 300 300

IV. MRI01 MRI02 MRI03 MRI04 MRI05 MRI06 MRI07 MRI08 MRI09 MRI10 MRI11 MRI12 MRI13 MRI14 MRI15 MRI16 MRI17

MRI MRI BRAIN MRI SPINE MRI ABDOMEN MRI THORAX MRI PELVIS MRI JOINTS MRI EXTREMITIES MRCP MR UROGRAPHY MRI CSF FLOW STUDY MRI ANGIOGRAPHY ONE PART MRI BRAIN+ANGIOGRAPHY(CIRCLE OF WILLIS) MRI BRAIN+ANGIOGRAPHY (NECK+CIRCLE OF WILLIS) MRI ANGIOGRAPHY(NECK+CIRCLE OF WILLIS) MRI MARROW SCREENING MRI SPINE ONE PART + SCREENING WHOLE SPINE MRI PELVIMETRY/PLACENTA LOCALISATION

Gen./ Cub. 5200 5200 5200 5200 5200 5200 5200 5200 5200 5200 5200 8000 9350 8000 2650 6400 2000

S. Pvt. 5700 5700 5700 5700 5700 5700 5700 5700 5700 5700 5700 8700 10000 8700 3300 7370 2600

Private 6300 6300 6300 6300 6300 6300 6300 6300 6300 6300 6300 9400 10700 9400 4000 8250 3300

14

MRI18 MRI19 MRI20 MRI23 MRI24 MRI25 MRI26 MRI27 MRI28 MRI29 MRI30 MRI31 MRI32 MRI33 MRI34 MRI35 MRI36 MRI37 MRI38

MRI ARTHOGRAPHY+1 FILM CONVENTIONAL MRI LUMBER SPINE & SI JOINTS MRI LTD STUDY OF IAM MRI ANAESTHESIA CHARGES MRI BRAIN-PITUITARY FOSSA MRI ORBIT MRI PNS MRI T.M. JOINTS (SPECIFY SIDE) MRI ANGIOGRAPHY-CIRCLE OF WILLIS MRI BRAIN-VENOGRAPHY MRI ANGIOGRAPHY-NECK MRI ANGIOGRAPHY-RENAL ANGIOGRAPHY MRI NASOPHARYNX MRI NECK MRI FISTULOGRAPHY MRI BOTH HIPS-DYNAMIC STUDY MRI EXTREMITY/JOINT- DOUBLE MRI EMERGENCY CHARGES MRI BRAIN SCREENING

6600 6600 2000 375 5200 5200 5200 5200 5200 5200 5200 5200 5200 5200 5200 5200 10100 250 1700

7400 7400 2600 600 5700 5700 5700 5700 5700 5700 5700 5700 5700 5700 5700 5700 11400 400 2200

8000 8000 3300 600 6300 6300 6300 6300 6300 6300 6300 6300 6300 6300 6300 6300 12600 500 2700

V. INR01 INR02 INR03 INR04 INR05 INR06 INR07 INR08 INR09 INR10 INR11 INR12 INR13 INR14 INR15 INR16 INR17 INR18 INR19 INR20 INR21 INR22 INR23 INR24 INR25 INR26 INR27 INR28 INR29 INR30

INTERVENTIONAL RADIOLOGY PERIPHERAL ANGIOGRAPHY (DIAGNOSTIC) (ONE LIMB PERIPHERAL TRAUMA INTERVENTIONAL PERIPHERAL ARTERIAL ANGIOPLASTY WITHOUT STENT RT/LT PERIPHERAL ARTERIAL ANGIOPLASTY WITH STENT RT/LT ILAIC ANGIOPLASTY/STENTING PERIPHERAL ARTERIAL THROMBOLYSIS RT/LT PERIPHERAL HEMANGIOMA SCLEROTHERAPY (DIRECT) PERIPHERAL HEMANGIOMA SCLERO/EMBOLISATION (TRANSARTERIAL) UTERINE ART EMBOL FOR FIBROIDS-PRE MYOMECTOMY UTERINE ARTERY EMBOLIZATION FOR FIBROIDS UTERINE ART/PELVIC ANGIO- POST PART HRAGE-OTHERS UTERINE ARTERY/PELVIC EMBOLIZATION FOR POST PARTUM PELVIC CONGESTION SYNDROME (OVARIAN VEIN) EMBOLISATION FALLOPIAN TUBE CATHETERIZATION ( FOR BLOCKED TUBE PRE/POST PROCEDURE USG EVALUATION FOR FIBROIDS/ADENOMYOSIS/UTERUS/BODY PUDENDAL ARTERY EVALUATION VERICOSEAL EVALUATION VERICOSEAL INTERVENTIONAL RENAL ARTERY ANGIOGRAPHY RENAL ARTERY ANGIOPLASTY RENAL ARTERY STENTING RENAL ARTERY EMBOLIZATION (ONE SIDE) PERCUTANOUS NEPHROSTOMY & DRAINAGE (RT/LT) URETRIC STENT (DOUBLE PIGTAIL/J) RT/LT INTERVENT FOLLOW UP FOR NEPHROSTOMY DRAINAGE CATHETER GUIDED PERIPHERAL INSERTION OF CENTRAL CATH-PICC DIALYSIS CATH INSERT IJ,SUBCLAV,FEMORAL-NON TUNNEL DIALYSIS CATH INSERT (IJ,FEMORAL)TUNNELLED/ EXCHANGE CHEST PORT INSERTION FOR CHEMOTHERAPY CENTRAL VENOGRAM/ARM VENOGRAM (DIAGNOSTIC)

General 12200 23400 23400 23400 26300 28900 1600 23400 17800 17800 15000 18750 26300 13100 750 13750 17800 23400 14000 23000 23000 10300 10300 13100 1875 4700 2250 4700 8900 4700

Private 16300 31300 31300 31300 35000 37500 2100 31300 23800 23800 20000 25000 35000 17500 1000 18800 23800 31300 18800 30600 30600 13800 13800 17500 2500 5600 3100 6300 11900 5600

15

INR31 INR32 INR33 INR34 INR35 INR36 INR37 INR38 INR39 INR40 INR41 INR42 INR43 INR44 INR45 INR46 INR47 INR48 INR49 INR50 INR51 INR52 INR53 INR54 INR55 INR56 INR57 INR58 INR59 INR60 INR61 INR62 INR63 INR64 INR65 INR66 INR67 INR68 INR69 INR70 INR71 INR72 INR73 INR74 INR75 INR76 INR77 INR79 INR80 INR81 INR82 INR83 INR84 INR85

CENTRAL VENOGRAM/ARM VENOGRAM INTERVENTIONAL MEDIASTINAL SYNDROMES INTERVENTIONAL VENOUS SAMPLING (ADRENAL & RENAL VEIN) I V C MEMBRANOTOMY AND ANGIOPLASTY/STENTING PORTAL VEIN EMBOLISATION AORTOGRAM/SPECIFIC SINGLE AORTOGRAM AORTIC ANGIOPLASTY/STENTING AORTIC STENT GRAFT ENDOLEAK EMBOLIZATION ABDOMINAL AORTIC ANEURYSM GRAFT BRONCHIAL ARTERY EVALUATION BRONCHIAL ARTERY EMBOLIZATION INTRA VASCULAR CATHETER/ FOREIGN BODY REMOVAL PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAM POST PTBD CHECK CHOLANGIOGRAM PRE/INTRA/POST PROCD PTBD- POST OPERATIVE/BILIARY LEAK PTBD EXTERNAL DRAINAGE(SINGLE) PTBD-EXTERNO-INTERNALISATION PTBD--INTERNALISATION PCN/PTBD WITH STENTING TRANSJUGLAR LIVER BIOPSY TIPS (TRANS-JUGULAR PORTO-SYSTIMIC SHUNT) INTERVEN ARTERIO-PORTOGRAM GI BLEED AND ISCHEMIA (TRIPLE VESSEL) EVALUATION GI BLEED EMBOLISATION GI ISCHEMIA INTERVENTION (ANGIOPLATY/STENTING) PARTIAL SPLENIC EMBOLIZATION EMPERICAL ANY ARTERY EMBOLISATION USG GUIDED ANEURYSM EMBOLISATION CHEMOEMBOLIZATION OF HEPATIC TUMOUR/METS TRANS ARTERIAL CHEMOTHERAPY INFUSION RADIOFREQUENCY ABLATION OF HEPATIC TUMOURS/ METS NASO JEJUNAL INTUBATION CEREBRAL ANGIOGRAM CAROTID ANGIOGRAM VESSELS EVAL CEREBRAL+CAROTID+ SUBCLAVIAN+ VERTEBRAL SPINAL ANGIOGRAM EVALUATION FOR NASAL BLEEDING / NASAL MASS EMBOLIZATION FOR NASAL BLEEDING / SINUS MASS EMBOL OF EXTERNAL CAROTID ARTERY/SINGLE VESSEL EMBOLIZATION OF TUMOURS FED BY BOTH ICA & ECA EMBOLIZATION OF TUMOURS FED BY VA OR/AND BA GLUE EMBOLIZATION OF TUMOURS EMBOLIZATION OF SPINAL TUMOURS EMBOLIZATION FOR VERTEBRAL BODY HEMANGIOMA/METS VERTEBROPLASTY (VERTERAL BODY/PELVIC BONE VENOUS SINUS SAMPLING (PETROSAL SINUS) CCF OCCLUSION PROXIMAL OCCLUSION OF INTERNAL CAROTID ARTERY CEREBRAL AVM EMBOLIZATION (BESIDES VB TERRITORY) AVM EMBOLIZATION IN THE VERTEBROBASILAR TERRITORY SPINAL AVM EMBOLIZATION/AVF EMBOLIZATION COILING OF INTRACRANIAL ANEURYSM COILING OF MULTIPLE ANEURYSMS GDC COILING OF INTRACRANIAL ANEURYSMS WITH SPASM

13100 15000 9400 23400 23400 9400 32800 32800 37500 10300 22500 4700 6600 2800 13100 9400 13100 7500 21600 7800 35600 16900 13100 19700 19700 32800 32800 8400 32800 26300 26300 3750 15000 9400 17800 18750 11250 17800 27200 53100 49700 49700 34700 26300 34700 34700 56250 51500 52500 52500 59000 46900 52500 56250

17500 20000 12500 31300 31300 12500 43800 43800 50000 13800 30000 5600 8800 3800 17500 12500 17500 10000 28800 11300 46300 22500 17500 26300 26300 43800 43800 11300 43800 35000 35000 5000 20000 12500 23800 25000 15000 23800 36300 70000 66300 66300 46300 35000 46300 46300 75000 68800 70000 70000 78800 62500 70000 75000

16

INR86 INR87 INR88 INR89 INR90 INR91 INR92 INR93 INR94

COILING OF INTRACRANIAL ANEURYSM ATTEMPTED POST SAH INTRACRANIAL ANGIOPLASTY FOR SPASM INTRACRANIAL DRUG THERAPY FOR POST SAH VASOSPASAM INTRA ARTERIAL THROMBOLYSIS MANAGEMENT OF DURAL SINUS THROMBOSIS ANGIOGPLASTY FOR CAROTID/VERTEBRAL ARTERY STENOSIS STENTING FOR CAROTID/VERTEBRAL ARTERY STENOSIS INTRACRANIAL ANGIOPLASTY INTRACRANIAL STENTING

28100 52500 32800 44400 52500 52500 40300 52500 52500

37500 70000 43800 56800 70000 70000 53800 70000 70000

Extra Costs: Contrast Charges.

PHYSIOTHERAPY SERVICES

I. PHY01 PHY02 PHY03 PHY04 PHY05 PHY06 PHY07 PHY08 PHY09 PHY10 PHY11 PHY12 PHY13 PHY14 PHY15 PHY16 PHY17 PHY18 PHY19 PHY20 PHY21 PHY22 PHY23 PHY24 PHY25 PHY26 PHY27 PHY28 PHY29 PHY30 PHY31 PHY32 PHY33 PHY34

PHYSIOTHERAPY SERVICES EXERCISE/HOME PROGRAM MUSCLE ASSESSMENT FUNCTIONAL MOBILIZATION MANUAL THERAPY GAIT TRAINING ANC (3 SITTINGS) POSTNATAL (3 SITTINGS) EXERCISE/DAY FOR PMR PATIENT ICU CARE(PHYSIO) EXERCISE FOR CTS CLOSED HEART (7 DAYS) EXERCISE FOR CTS OPEN HEART (7 DAYS) PULMONARY PHYSIOTHERAPY SHORT WAVE DIATHERMY ULTRASOUND INFRA RED RAYS/ULTRAVIOLET HYDRO COLLATOR THERAPY PARAFFIN WAX BATH INTERFERENTIAL THERAPY MUSCLE STIMULATION LUMBER TRACTION CERVICAL TRACTION TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION McKENZIE EXERCISE PROGRAMME MULLIGANS MOBILIZATION CPM CRYO THERAPY TRACTION/S W D TRACTION U S T TRACTION/I F T S W D/U S T WAX BATH/EXERCISE HOT PACKS/EXERCISE C P M/EXERCISE FUNCTIONAL MOBILIZATION AND CHEST CARE

General 90 110 120 120 110 150 150 190 150 1150 1300 120 110 110 110 90 90 110 110 110 110 110 110 110 110 110 150 150 150 150 150 150 150 150

Private 130 190 190 190 190 250 250 325 150 1900 2500 200 190 190 190 130 130 190 190 190 190 190 190 190 190 190 250 250 250 250 250 250 250 250

17

PHY35 PHY36 PHY37 PHY38 PHY39 PHY40 PHY41 PHY42 PHY43 PHY44 PHY45 PHY46 PHY47 PHY48 PHY49 PHY50 PHY51 PHY52 II. OCC01 OCC02 OCC03 OCC04 OCC05 OCC06 OCC07

PULMONARY PT (NIGHT) US & PWB SWD & IFT US & IFT ICT & HP CPM & HP PWB & CPM PT CONSULTATION PRE-OPERATIVE ASSESSMENT ANY TWO MODULE TREATMENT PACKAGE (5 Days) MANUAL MOBILIZATION + ELECTROTHERAPY (5 Days) SPECIAL PHYSIOTHERAPY CARE NEURO MUSCULAR DYSFUNCTION MANAGEMENT RENAL TRANSPLANT- RECEIPENT (10 DAYS) RENAL TRANSPLANT DONOR (5 DAYS) ASSESSMENT AND PRESCRIPTION & DOCUMENTATION HOT PACKS/MOBILISATION HOT PACKS/IFT OCCUPATIONAL THERAPY ASSESSMENT ASSESSMENT & THERAPY 1 HOUR ASSESSMENT & THERAPY 3 HOURS ASSESSMENT & THERAPY MORE THAN 3 HRS ASSESSMENT & THERAPY FOR SMALL PARTS THERAPY FOR ICU PATIENTS REHAB. MED. PATIENTS THERAPY/DAY

150 150 150 150 150 150 150 120 120 650 650 180 180 1725 920 120 150 150 General 90 125 200 250 100 150 180

250 250 250 250 250 250 250 200 200 1250 1250 180 250 2300 1380 200 250 250 Private 180 250 400 500 200 150 360

III. ALC001 ALC002 ALC003 ALC004 ALC005 ALC006 ALC007 ALC008 ALC009 ALC010 ALC011 ALC012 ALC013 ALC014 ALC015 ALC016 ALC017 ALC018 ALC019 ALC020 ALC021 ALC022 ALC023 ALC024

ARTIFICIAL LIMB CENTRE SYM S SIZE I SYM S SIZE II SYM S SIZE III PTB PROTHESIS SIZE I PTB PROTHESIS SIZE II PTB PROTHESIS SIZE III ABOVE KNEE PROTHESIS SIZE I ABOVE KNEE PROTHESIS SIZE II ABOVE KNEE PROTHESIS SIZE III COSMETIC HAND SIZE I COSMETIC HAND SIZE II COSMETIC HAND SIZE III BELOW ELBOW & MECH. HAND SIZE I BELOW ELBOW & MECH. HAND SIZE II BELOW ELBOW & MECH. HAND SIZE III AE PROTHESIS MECH. HAND SIZE I AE PROTHESIS MECH. HAND SIZE II AE PROTHESIS MECH. HAND SIZE III EXTENSION PROTHESIS SIZE I EXTENSION PROTHESIS SIZE II7500 EXTENSION PROTHESIS SIZE III CHOPART PROTHESIS SIZE I CHOPART PROTHESIS SIZE II CHOPART PROTHESIS SIZE III

General 4000 5000 5500 6000 6200 11000 7500 8500 16500 2000 2500 3200 4500 6000 8500 6000 7500 8800 4500 7500 10500 3800 4500 5200

Private 4500 5500 6000 6500 8000 13800 8200 9200 19500 2500 2900 3800 5000 6700 9500 7000 8000 9500 5500 8200 12300 4500 5000 5700

18

ALC025 ALC026 ALC027 ALC028 ALC029 ALC030 ALC031 ALC032 ALC033 ALC034 ALC035 ALC036 ALC037 ALC038 ALC039 ALC040 ALC041 ALC042 ALC043 ALC044 ALC045 ALC046 ALC047 ALC048 ALC049 ALC050 ALC051 ALC052 ALC053 ALC054 ALC055 ALC056 ALC057 ALC058 ALC059 ALC060 ALC061 ALC062 ALC063 ALC064 ALC065 ALC066 ALC067 ALC068 ALC069 ALC070 ALC071 ALC072 ALC073 ALC074 ALC075 ALC076 ALC077

FINGER SPLINT SIZE I FINGER SPLINT SIZE II FINGER SPLINT SIZE III LONG OPPONENS SIZE I LONG OPPONENS SIZE II LONG OPPONENS SIZE III SHORT OPPONENS SIZE I SHORT OPPONENS SIZE II SHORT OPPONENS SIZE III STATIC COCK UP SPLINT SIZE I STATIC COCK UP SPLINT SIZE II STATIC COCK UP SPLINT SIZE III DYNAMIC COCK UP SPLINT SIZE I DYNAMIC COCK UP SPLINT SIZE II DYNAMIC COCK UP SPLINT SIZE III TURN BUCKLE COCK UP SPLINT SIZE I TURN BUCKLE COCK UP SPLINT SIZE II TURN BUCKLE COCK UP SPLINT SIZE III E ARM BRACE SIZE I E ARM BRACE SIZE II E ARM BRACE SIZE III ELBOW BRACE WITH ELBIT SIZE I ELBOW BRACE WITH ELBIT SIZE II ELBOW BRACE WITH ELBIT SIZE III SHOULDER CAPSULE BRACE SIZE I SHOULDER CAPSULE BRACE SIZE II SHOULDER CAPSULE BRACE SIZE III SHOULDER ABDUCTION SPLINT SIZE I SHOULDER ABDUCTION SPLINT SIZE II SHOULDER ABDUCTION SPLINT SIZE III TLSO (TAYLOR S BRACE) SIZE I TLSO (TAYLOR S BRACE) SIZE II TLSO (TAYLOR S BRACE) SIZE III TLSO (MOULDED SPL. JACKET) SIZE I TLSO (MOULDED SPL. JACKET) SIZE II TLSO (MOULDED SPL. JACKET) SIZE III LS FRAME SIZE I LS FRAME SIZE II LS FRAME SIZE III LS BELT SIZE II LS BELT SIZE III KT BRACE SIZE II KT BRACE SIZE III ASH BRACE SIZE I ASH BRACE SIZE II ASH BRACE SIZE III SOMI BRACE SIZE II SOMI BRACE SIZE III TWO POST MOULDED COLLER SIZE I TWO POST MOULDED COLLER SIZE II TWO POST MOULDED COLLER SIZE III FOUR POST COLLER SIZE I FOUR POST COLLER SIZE II

250 300 350 500 550 700 500 550 700 650 750 900 650 750 900 950 1050 1200 1250 1400 1800 1800 2100 2800 1800 2100 2800 1800 2300 2600 1100 1500 1800 2600 3000 4200 1100 1500 1800 550 750 1800 2300 900 1400 1700 1900 2300 1500 1800 2500 1400 1800

350 400 450 550 650 800 550 650 800 750 850 950 750 850 950 1050 1150 1350 1400 1550 2050 2050 2400 3500 2000 2400 3200 2000 2500 2900 1400 1900 2100 3000 3600 4500 1300 1800 2100 650 850 2100 2500 1100 1500 2000 2100 2500 1800 2200 2800 1650 2350

19

ALC078 ALC079 ALC080 ALC081 ALC082 ALC083 ALC084 ALC085 ALC086 ALC087 ALC088 ALC089 ALC090 ALC091 ALC092 ALC093 ALC094 ALC095 ALC096 ALC097 ALC098 ALC099 ALC100 ALC101 ALC102 ALC103 ALC104 ALC105 ALC106 ALC107 ALC108 ALC110 ALC111 ALC112 ALC113 ALC114 ALC115 ALC116 ALC117 ALC118 ALC119 ALC120 ALC121 ALC122 ALC123 ALC124 ALC125 ALC126 ALC127 ALC128 ALC129 ALC130 ALC131

FOUR POST COLLER SIZE III SOFT COLLER SIZE I SOFT COLLER SIZE II SOFT COLLER SIZE III LS MOULDED SIZE I LS MOULDED SIZE II LS MOULDED SIZE III AFO SIZE I AFO SIZE II AFO SIZE III KAFOAK PVC SPLINT SIZE I KAFO WITHOUT JOINT SIZE I KAFO U/L JOINT SIZE I KAFO U/L JOINT SIZE II KAFO U/L JOINT SIZE III HKAFO U/L JOINT SIZE I HKAFO U/L JOINT SIZE II HKAFO U/L JOINT SIZE III HKAFO B/L JOINT SIZE I HKAFO B/L JOINT SIZE II HKAFO B/L JOINT SIZE III KNEE BRACE WITH JOINT SIZE I KNEE BRACE WITH JOINT SIZE II KNEE BRACE WITH JOINT SIZE III KNEE BRACE WITHOUT JOINT SIZE I KNEE BRACE WITHOUT JOINT SIZE II KNEE BRACE WITHOUT JOINT SIZE III AFO WITH HINGE SIZE I AFO WITH HINGE SIZE II AFO WITH HINGE SIZE III CDH SIZE I KAFO WITH PLASTIC THIGH SIZE I KAFO WITH PLASTIC THIGH SIZE II KAFO WITH PLASTIC THIGH SIZE III GAITERS B/L SIZE I GAITERS B/L SIZE II GAITERS B/L SIZE III MERMAID SPLINT B/L SIZE I MERMAID SPLINT B/L SIZE II FRO SIZE I FRO SIZE II FRO SIZE III PTB BRACE SIZE I PTB BRACE SIZE II PTB BRACE SIZE III AK CAST BRACE U/L SIZE I AK CAST BRACE U/L SIZE II AK CAST BRACE U/L SIZE III ARCH SUPPORT SIZE I ARCH SUPPORT SIZE II ARCH SUPPORT SIZE III HEEL PAD SIZE I HEEL PAD SIZE II

2500 400 450 550 2100 2500 3200 850 1050 1400 1500 1600 3200 3500 4200 3500 4200 4800 7000 7700 9500 2300 3000 3500 1500 2000 2500 1050 1400 1700 1600 3800 4000 4800 1000 1400 1800 1500 1800 2000 2500 3000 2200 2600 3200 3600 4200 4500 250 300 400 300 350

2800 450 500 650 2500 2800 3500 950 1200 1500 1800 1900 3500 4000 4500 4000 4500 5200 7500 8200 10500 2800 3500 4000 1900 2300 2800 1200 1500 1900 1900 4000 4500 5200 1200 1600 2100 1800 2100 2200 2800 3500 2500 3000 3500 4200 4500 5000 300 400 450 350 375

20

ALC132 ALC133 ALC134 ALC135 ALC136 ALC137 ALC138 ALC139 ALC140 ALC141 ALC142 ALC143 ALC144 ALC145 ALC146

HEEL PAD SIZE III CRUTCH ELBOW ADJUSTABLE (AL) SIZE I CRUTCH ELBOW ADJUSTABLE (AL) SIZE II CRUTCH AXILLA ADJUSTABLE (AL) EXTRA SMALL CRUTCH AXILLA ADJUSTABLE (AL) SMALL CRUTCH AXILLA ADJUSTABLE (AL) MEDIU CRUTCH AXILLA ADJUSTABLE (AL) LARGE WALK STICK WHEEL CHAIR FOLDING STANDARD ADULT TRICYCLE CONVENTIONAL CANE WALKING TETRAPOD SIZE I CANE WALKING TETRAPOD SIZE II WHEEL CHAIR FOLDING CHILD SIZE WALKER REPAIR CHARGE

375 500 550 400 450 500 550 350 7500 5500 550 600 6200 1800 250

400 500 550 400 450 500 550 350 7500 5500 550 600 6200 1800 250

CARDIOLOGY SERVICE CHARGES

I. CPR01 CPR02 CPR03 CPR04 CPR05 CPR07 CPR09 CPR11 II. ECG III. ACT ECHO EVR HOLT STEC TEE TMT

CARDIOLOGY PROCEDURE
TEMPORARY PACEMAKER IMPLANTATION PERMANENT PACEMAKER IMPLANTATION SINGLE CHAMBER PERMANENT PACEMAKER IMPLANTATION DUEL CHAMBER PERMANENT PACEMAKER IMPLANTATION TRIPLE CHAMBER PERI-CARDIAL TAPPING NON IONIC DYE PER VIAL INVASIVE PRESSURE MONITORING PERICARDIACTOMY

Gen./ Cub. 2500 10500 13800 23000 1900 2500 2500 57500 Gen./Cub. 130 Gen./Cub. 350 1250 380 1900 1500 2100 1150

S. Pvt. 3800 13800 17250 35000 3150 2500 3800 70000 S. Pvt. 150 S. Pvt. 430 1750 600 2230 2000 2450 1700

Private 6300 17250 20700 46000 5100 2500 5000 80000 Private 200 Private 500 2200 850 2500 2500 2800 2200

ECG E.C.G. CARDIOLOGY INVESTIGATION ACT TEST ECHO DOPPLER EVENT RECORDING (PER DAY) HOLTER CHARGES (PER DAY) STRESS ECHO TRANS ESOPHAGEAL ECHO STRESS TEST(TMT TREAD MILL TEST)

PACKAGE CHARGES FOR CARDIOLOGY PROCEDURES Code I. ABMV ACC ACAG Service Name CATH-LAB PROCEDURES: ANGIOPLASTY/BALOON MITRAL VALVOTOMY CARDIAC CATHETERISATION CORONARY/RENAL ANGIOGRAPHY 30000 7000 9000 40000 9000 11000 50000 11000 13000 02 01 01 Gen./Cub. S. Pvt. Private No. of days

21

ACAWS ACPA ADSA AEPS APA ARFA ARHS A3DM

CORONARY/RENAL ANGIOPLASTY CORONORY PERIPHERAL ANGIOGRAPHY CERIBRAL ANGIOGRAPHY ELECTRO PHYSIOLOGY STUDY PERIPHERAL ANGIOPLASTY RADIO FREQUENCY ABLATION RIGHT HEART STUDY 3D MAPPING

76500 9000 9000 9000 75000 30000 7000 45000

85000 11000 11000 10000 85000 40000 9000 55000

100000 13000 13000 11000 95000 50000 11000 65000

02 01 01 01 02 01 01 01

Extra Cost:
1. Stent a) Drug Eluting Stent b) Mounted Stent . 2. Pharmacy 3. Non- Ionic Dye 4. Extended Stay

Note:
a. Any Cardiology procedure done in emergency shall be charged as per higher category, ie minimum Semi- Private Category will be charged. b. When two or more procedures are performed 50% of the minor procedure will be charged extra. PACKAGE CHARGES FOR C T S Code II. AVSD AOHS AOHSE Service Name CARDIO-THORACIC SURGERIES ASD/VSD/OHS AVR/MVR/CABG AVR/MVR/CABG EMERGENCY 100000 120000 130000 120000 140000 150000 138000 161000 172500 148000 170000 182500 170000 195000 210000 10 10 10 General S Pvt. Non AC S Pvt. AC Pvt. Non AC PVT AC (S) No. of days

Note:
a. Package is for 10 days. b. Valve will be charged extra. c. Extended stay will be charged extra for all services. d. IABP charges and permanent pace maker implant shall be charged extra. e. Patient to pay an advance at the time of admission equivalent to the approximate amount of bill.

RHEUMATOLOGY SERVICE CHARGES

I. RHEU01 RHEU02 RHEU03

RHEUMATOLOGY SOFT TISSUE(TENNIS ELBOW, TENDINITIS, BURSITS) SMALL/MEDIUM JOINTS (MCP/PIP, WRIST, ELBOW, ANKLE) LARGE JOINTS(KNEE, SHOULDER WITH ASPIRATION ON JOINT)

General 70 80 130

Private 230 280 350

22

ENDOCRINOLOGY SERVICE CHARGES

I. ENDOCRINOLOGY END01 END02 END03 SCREENING DOPPLER (DIABETIC) BIOTHESIOMETER TOTAL DIABETIC FOOT STUDY General 450 230 600 Private 700 350 900

GASTROENTEROLOGY SERVICE CHARGES

Gen./ Cub. 920 2300 2300 2900 1700 2400 2100 2000 2300 2300 1150 1150 3450 2900 2900 2900 1700 3300 3500 2300 2300 2300 4600 4600 4600 2900 1700 4000 1700 8000 5300 3500 Gen./ Cub. 1700 2500

I. GENT10 GENT11 GENT12 GENT13 GENT14 GENT15 GENT16 GENT17 GENT18 GENT19 GENT20 GENT21 GENT22 GENT23 GENT24 GENT25 GENT26 GENT27 GENT28 GENT29 GENT30 GENT31 GENT32 GENT33 GENT34 GENT35 GENT36 GENT37 GENT39 GENT40 GENT42 GENT43 II. GENT01 GENT03

GASTROENTEROLOGY EMERGENCY ENDOSCOPY CHARGES ESOPHAGEAL DILATION GASTRIC STRICTURE DILATION ESOPHAGEAL VARICEAL GLUE INJECTION TUMOR ABLATION BY ALCOHOL INJECTION PLACEMENT OF FEEDING TUBES WITH ENDOSCOPY FOREIGN BODY REMOVAL INJECTION BLEEDING ULCER SPHINCTEROTOMY STONE EXTRACTION STENTING NASOBILARY DRAINAGE ESOPHAGEAL PROSTHESIS INSERTION GASTRIC POLYPECTOMY GASTRIC VARICES GLUE INJECTION COLONOSCOPIC POLYPECTOMY DECOMPRESSION OF COLON ENDOSCOPIC MUCOSAL RESECTION TUMOR ABLATION BY ELECTROCAUTERY/LA VARICEAL LIGATION BY ENDOSCOPY COLONIC STRICTURE DILATION ENDOSCOPIC FISTULA CLOSURE PRECUTANEAS ENDOSCOPIC GASTROSTOMY DRAINAGE OF PSEUDOCYST ACHALASIA DIALATION COLONOSCOPY LEFT SIDE COLONOSCOPY EVL SET EVL SET(VIEW MAX) BILARY DIALATATION INTRA OPERATIVE ENDOSCOPIC METALIC STENT INSERTION IN CBD GASTROENTEROLOGY INVESTIGATION UPPER G.I. ENDOSCOPY ESOPHAGEAL SCLERO THERAPY: st a. VARICES - 1 SITTING

S. Pvt. 1380 2900 2900 4100 2300 3250 2900 2900 3500 2900 1750 1750 5200 4100 4100 4100 2300 4900 4600 3450 4100 3450 7500 7500 7500 3700 2000 4100 1700 10600 6600 5200 S. Pvt. 2300 3300

Private 1700 3700 3700 4600 3500 4100 4100 3500 4100 4100 2300 2300 6900 5200 5200 5200 3500 6600 5750 4600 5200 4600 9200 9200 9200 4800 2300 4100 1700 13250 8100 5750 Private 2700 4100

23

GENT04 GENT05 GENT06 GENT07 GENT08 GENT09 GENT41 GENT44 GENT45 GENT46 GENT47

ESOPHAGEAL SCLERO THERAPY: b. VARICES SUBSEQUENT SITTING SIGMOIDOSCOPY (RIGID) SIGMOIDOSCOPY (FLEXIBLE) ESOPHAGOSCOPY BIOPSY CHARGES FOR GASTRO PROCEDURE ERCP (EXCLUDING STENT) VARICEAL INJECTION ENDOSCOPIC BRUSH CYTOLOGY CBD STENT REMOVAL SIDE VIEWING DUODENOSCOPY MECHANICAL LITHOTRIPSY

1750 1600 1600 700 600 5300 1150 600 3500 2700 8100

2650 1950 1950 950 700 6600 1750 700 4600 2900 9200

3350 2300 2300 1150 800 8000 2100 800 5800 3500 11500

DERMATOLOGY SERVICE CHARGES

I. SKN01 SKN02 SKN03 SKN04 SKN05 SKN06 SKN07 SKN08 SKN09 SKN11 SKN13 SKN14 SKN15 SKN16 SKN17 SKN18 SKN19 SKN20 SKN21 SKN22 SKN23 SKN24 SKN25 SKN26 SKN27 SKN28 SKN29

SKIN PROCEDURE SKIN BIOPSY EXCISION MOLES EXCISION WARTS EXCISION - SAB CYST CAUTERIZATION & SCRAPING WARTS CAUTERIZATION SCRAPING MOLLUS CUM CONTRA- SINGLE CAUTERIZATION & SCRAPING VENERAL WARTS CAUTERIZATION & SCRAPING CORNS CHEMICAL PEELING- GLYCOLIC PEEL INTRALESIONAL INJECTIONS- SINGLE LESION CAUTERIZATION SCRAPING MOLLUS CUM CONTRA- DOUBLE CHEMICAL PEELING- ACNE PEEL CHEMICAL PEELING- LACTIC PEEL CRYO SURGERY- SINGLE LESION CRYO SURGERY- DOUBLE LESION CRYO SURGERY- MULTIPLE LESION MILIA EXTRACTION ELECTRIC CAUTERIZATION (WARTS,SKIN)- SINGLE LESION ELECTRIC CAUTERIZATION (WARTS,SKIN)- DOUBLE LESION ELECTRIC CAUTERIZATION (WARTS,SKIN)- MULTI LESIONS DERMAROLLER FOR ACNE SCAR TCA APPLICATION- SINGLE LESION TCA APPLICATION- DOUBLE LESIONS TCA APPLICATION- MULTIPLE LESIONS COSMO PEEL FOR HYPER PIGMENTATION NEORONOX INJECTION (PER UNIT) NBUVB COMB THERAPY FOR SCALP PSORIASIS- PER SITTING

General 550 170 170 170 170 200 170 170 620 300 360 720 720 320 550 720 360 170 320 800 3000 80 130 180 1200 100 100

Private 1100 340 340 340 340 400 340 340 1240 600 720 1440 1440 640 1100 1440 720 340 640 1600 6000 160 260 360 2400 200 200

24

RESPIRATORY MEDICINE SERVICE CHARGES

I. RES01 RES02 RES05 RES06 RES07 RES08 RES09 RES11 RES12 RES13

RESPIRATORY LAB BRONCHOSCOPY PULMONARY FUNCTION TESTING (PRE &POST NEBULISATION) PLEURODESIS PLEURAL TAP SMOKING CESSATION CLINIC BRONCHOSCOPY WITH BIOPSY SLEEP STUDY PERCUTANEOUS PLEURAL BIOPSY BRONCHOSCOPIC GLUE INJECTION 0.50ML BRONCHOSCOPIC GLUE INJECTION 1 ML

Gen./Cub. 5000 650 2000 600 200 6000 8500 800 6750 7250

S. Pvt. 6000 950 2250 1000 250 7000 10000 1150 8000 8500

Private 7000 1300 2900 1100 300 8000 11500 1600 9250 9750

PSYCHIATRY SERVICE CHARGES

I. PSY01 PSY02 PSY03 PSY04 PSY05 PSY06 PSY07 PSY08 PSY09 PSY10 PSY11 PSY12 PSY13 PSY14

PSYCHOLOGY SERVICES COUNSELING PSYCHOTERAPY PLAY THERAPY RELAXATION TRAINING ASSESSMENT OF CHILDHOOD DISORDERS ASSESSMENT OF DEVELOPMENT AND SOCIAL QUOTIENT IQ TEST THEMATIC APPERCEPTION TEST RORSCHACH TEST BEHAVIOUR THERAPY OR PSYCHOTHERAPY ( 6 SESSION) NEUROPSYCHOLOGICAL BATTERY PERSONALITY TEST COMPLETE PSYCHODIAGNOSTIC TEST MEMORY TEST RELAXATION TRAINING ( 6 SESSION)

General 200 150 200 300 500 500 500 500 1200 1400 800 1200 900 900

Private 400 300 400 600 1100 1000 1000 1000 2000 2500 1500 2500 1400 1500

NEUROLOGY SERVICE CHARGES

I. NEPHY01 NEPHY02 NEPHY03 NEPHY04 NEPHY05 NEPHY06

NEUROPHYSIOLOGY SERVICES E.E.G NERVE CONDUCTION STUDY NERVE CONDUCTION STUDY AND EMG VISUAL EVOKED RESPONSE BRAINSTEM AUDITORY EVOKED RESPONSE SOMATOSENSORY EVOKED RESPONSE

Gen. / Cub. 750 1200 2500 1200 1200 1200

S. Pvt. 1000 1600 2900 1600 1600 1600

Private 1200 1900 3500 1900 1900 1900

25

NEPHY07 NEPHY08 NEPHY09 NEPHY10 NEPHY11 NEPHY12 NEPHY13 NEPHY14 NEPHY15

DECREMENTAL RESPONSE E.M.G OVERNIGHT POLYSOMNOGRAPHY MULTIPLE SLEEP LATENCY TEST (MSLT) CPAP TITRATION STUDY SHORT TIME VIDIO EEG LONG TIME VIDIO EEG BRACHIAL PLEXUS STUDY FACIAL N.C. STUDY

1200 1400 3500 2300 1750 1400 4000 1300 1200

1600 1800 4600 3750 3200 1700 5500 1600 1600

1900 2200 4600 3750 3200 2000 6000 1900 1900

NEPHROLOGY SERVICE CHARGES

I. DIA01 DIA02 DIA03 DIA04 DIA05 DIA06 DIA07

NEPHROLOGY CHARGES PERITONEAL DIALYSIS HAEMODIALYSIS FEMORAL CATHETERISATION SUB CLAVIAN CATHETERISATION VASCULAR ACCESS KIDNEY BIOPSY ADD CHG FOR BEDSIDE HEMODIALYSIS

Gen./ Cub. 1650 1650 1200 1500 1500 1500 350

S. Pvt. 2100 2100 1400 1700 1700 1700 350

Private 2500 2500 1600 1900 1900 2300 350

Note:
I. Haemodialysis includes all consumables and professional charges but it does not include dialyser charges. II. Charges for procedures to be done in O T. 1. A V Shunt Category II 2. A V Fistula Category II 3. CAPD placement Category IB

PACKAGE CHARGES FOR NEPHROLOGY S Pvt. Non AC S Pvt. AC Pvt. Non AC PVT AC (S) No. of days

Code

Service Name RENAL TRANSPLANTATION RENAL TRANSPLANTATION DONOR RENAL TRANSPLANTATION RECIPIENT

General

ARTD ARTR

50000 200000

70000 330000

70000 330000

70000 330000

70000 330000

12 12

Note:
a. The package is for 12 days and starts one day before the operation. Any extra stay and services beyond the package will be charged. b. Package includes the charges for surgery and stay in the hospital for the donor. c. Donor opting for the special accommodation than allowed in the package shall be charged for the difference in accommodation. d. Pharmacy to be charged extra.

26

PEADIATRIC SERVICE CHARGES

I. PAED01 PAED02 PAED03 PAED04 PAED05 PAED06 PAED07 PAED08 PAED09 PAED10 PAED13 PAED14 PAED15 PAED16 PAED18 PAED19

PEADIATRICS SERVICE CHARGES PEADIATRIC CARE FOR NEW BORN (7 to12 days) GENERAL NURSERY CARE PER DAY PREMATURE BABY CARE PER DAY INCUBATOR/OPEN CARE SYSTEM PER DAY INTENSIVE CARE PER DAY PHOTOTHERAPY RESUSCITATION RESUSCITATION WITH INCUBATION(BY SP) EXCHANGE TRANSFUSION OT CHARGES FOR EXCHANGE TRANSFUSION MULTICHANNEL MONITOR INFUSION PUMPS & SYRINGE PUMPS NON INVASIVE/ BP MONITOR APNOEA MONITOR ROP SCREENING CHARGES MILK

Gen./ Cub. 350 350 350 550 700 250 350 700 1300 100 460 160 160 160 300 40

S. Pvt. 550 700 450 650 700 325 700 1050 1725 150 650 260 260 260 400 50

Private 850 1050 575 700 700 460 1050 1400 2100 200 775 360 360 360 500 60

OPTHALMOLOGY SERVICE CHARGES

I. BUT1 OPTHA01 OPTHA02 OPTHA03 OPTHA04 OPTHA08 OPTHA09 OPTHA10 OPTHA11 OPTHA12 OPTHA13 OPTHA14 OPTHA15 OPTHA16 OPTHA17 OPTHA18 OPTHA19 OPTHA20 OPTHA21 OPTHA22 OPTHA23 OPTHA24 OPTHA26 OPTHA27 OPTHA28 OPTHA30

OPTHALMOLOGY SERVICE CHARGES BUTOX INJECTION PER UNIT SAC SYRINGING REFRACTION FUNDUS EXAMINATION(DIRECT OPTHALMOS FUNDUS EXAMINATION (INDIRECT OPTHAL GLAUCOMA INVESTIGATION GONIOSCOPY ORTHOPTIC EXERCISES FIELD CHARTING WITH FIELD MACHINE B INCISION OF ABSCESS CORNEAL F.B REMOVAL CHALOZION EXCISION WART EXCISION APPLICATION OF THE LIMBAL RING CONJUNCTIVAL RESUTURING ELECTROLYTIC EPLATION A SCAN BIOMETRY ROP SCREENING CHARGES FLUROSCENE ANGIOGRAPHY(LASER THERAPY) ARGON LASER PHOTOCOAGULATION YAG LASER CAPSULOTOMY YAG LASER IRODOTOMY CORNEA PROCESSING CHARGES PER CORNE * LASIK LASER TREATMENT BOTH EYES COSTOMUVE LASIK LASER BOTH EYES FIELD CHARTING WITH FIELD MACHINE ONE EYE LASIK LASER TREATMENT ONE EYE

General 325 80 80 80 80 80 200 650 200 200 250 250 250 250 250 250 250 1400 2300 1500 2300 2200 24000 29000 350 14000

Private 325 160 160 160 160 160 400 900 400 400 500 500 500 500 500 500 500 1900 2900 1900 2700 2200 24000 29000 550 14000

27

OPTHA31 OPTHA32 OPTHA33 OPTHA34 OPTHA36 OPTHA37 OPTHA38

COSTOMUVE LASIK LASER ONE EYE IOL ORDINARY IOL INDIAN FOLDABLE HYDROPHOBIC FOLDABLE IOL HYDROPHILIC ACRYLIC LENS ASPHERIC LENS LASIK WORK UP

17000 900 2000 5000 5800 8000 1000

17000 900 2000 5000 5800 8000 1000

PACKAGE CHARGES FOR OPHTHALMOLOGY No. of days

Code

Service Name CATARACT WITH IOL IMPLANTATION

Gen./Cub.

S Pvt.

Private

ACTIO

CATARACT WITH IOL IMPLANTATION (WITHOUT IOL) IOL Charges will be extra as follows: Ordinary IOL - Rs.900/Indian Foldable Lens - Rs.2000 Hydrophobic Foldable Lens - Rs.5000 Hydrophilic Acrylic Lens - Rs.5800/Aspheric Lens - Rs.8000/-

8500

9375

10800

01

Note:

ENT AUDIOLOGY SERVICE CHARGES

I. ENT01 ENT02 ENT03 ENT04 ENT05 ENT06 ENT07 ENT08 ENT09 ENT10 ENT11 ENT12 ENT13 ENT14 ENT15 ENT16 ENT17 ENT18 ENT19 ENT20 ENT21 ENT22 ENT23 ENT24 ENT25 ENT26

ENT & AUDIOLOGY PURE TONE AUDIOGRAM SISI, TONE DECAY & DIFFERENCE LIMEA MULTIPLE HEARING ASSESSMENT TEST/AD HEARING AID SELECTION SPEECH DISCRIMINATION SCORE SPEECH ASSESSMENT SPEECH THERAPY PER SESSION 30-40 Min. DELAYED SPEECH: AUDIOMETRY & SPEECH & BEHAVIOUR COLD CARORIC TEST FOR VESTIBULAR FUNCTION SPECIAL TEST TYMPANOMETRY TYMPANOMETRY & STAPE DIAL REFLEX SPECIAL TEST ARLT, DE, CAY TYMPANOMETRY STAPE DIAL REFLEX, ARL HEARING TEST FOR NEW BORN BABIES(OA) MYRINGO PLASTY MYRINGOTOMY MYRINGOTOMY WITH GROMMET EXAMINATION UNDER MICROSCOPE BIOPSY (ENT) FIBRO OPTIC LARYNGOSCOPY DIAGNOSTIC NASAL ENDOSCOPY ENDOSCOPY SUCTION CLEANING BRONCHOSCOPY LARYNGOSCOPY (FLEXIBLE) BRONCHOSCOPY WITH BIOPSY

General 230 180 400 180 100 130 200 380 230 180 150 200 180 460 150 2000 300 800 180 270 880 530 350 3450 700 4600

Private 460 350 800 350 210 280 300 660 460 350 300 400 350 920 200 4000 660 1100 300 400 1150 1000 460 4000 1400 5750

28

DENTAL SERVICE CHARGES

I. DENT01 DENT02 DENT04 DENT06 DENT07 DENT08 DENT09 DENT10 DENT11 DENT12 DENT13 DENT14 DENT15 DENT16 DENT17 DENT18 DENT19 DENT20 DENT21 DENT22 DENT23 DENT24 DENT25 DENT26 DENT27 DENT28 DENT29 DENT30 DENT31 DENT32 DENT33 DENT34 DENT35 DENT36 DENT39 DENT40 DENT41 DENT42 DENT43 DENT44 DENT45 DENT46 DENT47 DENT49 DENT50 DENT52

DENTAL AMALGAM ONE SURFACE(FILLING PER TOOTH) AMALGAM TWO SURFACE(FILLING PER TOOTH) COMPOSITE FILLING-LIGHT CURE GLASS IONOMER RCT ANTERIORS(ENDONTICS) RCT POSTERIORS(ENDODONTICS) PULPOTOMY (ENDODONTICS) APICAL CURETTAGE (ENDODONTICS) ORATEKE AND LUCITONE-COMPLETE DENTURES ACRYLIC & PREMA DENTURES-COMPLETE DENTURES RELINING COMPLETE DENTURES (PROSTHETICS) DENTURE REPAIR (PROSTHETICS) SINGLE TOOTH PARTIAL DENTURES(ACRYLIC) EACH ADDITIONAL TOOTH-PARTIAL DENTURE CAST PARTIAL DENTURE JACKET CROWN (ACRYLIC PER UNIT) CROWN(CHROME COBALT PER UNIT)WITHOUT FACING CROWN(CHROME COBALT PER UNIT)ACRYLIC FACING CROWN(CHROME COBALT PER UNIT) PORCELAIN FACING DOWEL CROWN(ACRYLIC PER UNIT) POST AND CORE OBTURATOR FOR CLEFT PALATE COST OF APPLIANCES(ORTHODONTICS) COST OF EACH VISIT FOR ADJUSTMENT(ORTHODONT) EACH BREAKAGE/LOSS(ORTHODONTICS) ACTIVATOR/BIONATOR (ORTHODONTICS) EXPANSION PLATE
COST OF APPLIANCE (FIXED, ORTHODONTICS)

General 380 530 700 430 1800 2150 530 1500 7000

Private 520 700 950 580 2200 3000 700 2000 10000

6000 8000 1000 1500 330 500 850 1150 270 400 Charges will be determined by Doctor 1500 2000 1600 3000 1900 2400 2300 3200 1700 2400 3200 5200 3200 5200 3500 5000 350 550 Charges will be determined by Doctor 9000 12500 7600 11500 15000 20000 850 1600 Charges will be determined by Doctor 1500 2000 700 800 850 1000 1050 1300 800 1100 200 250 650 800 Charges will be determined by Doctor 330 500 450 580 250 350 1500 2300 2000 3000 1200 1800 550 650 150 200

COST OF EACH VISIT FOR ADJUSTMENT (FIXED ORTH.) EACH BREAKAGE/LOSS OF BAND(FIXED ORTHODONTICS) EXTRA ORAL APPLIANCE HEAD GEAR(KLOENS TYPE) SCALING AND POLISHING OR TEETH (I) SCALING AND POLISHING OF TEETH (II) SCALING AND POLISHING OF TEETH (III GINGIVECTOMY PER QUADRANT PERIO CORONOTOMY (PER TOOTH) FRENECTOMY FLOURIDE APPLICATION (PEDODONTICS) SPACE MAINTAINER FUNCTIONAL(PER UNIT SPACE MAINTAINER NON FUNCTIONAL EXTRACTION PER TOOTH EXTRACTION ALL TEETH IN A JAW DISIMPACTION TOOTH REPLANTATION ALVEOLECTOMY ABCESS INCISION(PER TOOTH)

29

DENT53 DENT54 DENT57 DENT58 DENT59 DENT60 DENT61 DENT62 DENT63 DENT64 DENT65 DENT67 DENT68 DENT69 DENT70

GROWTH REMOVAL BIOPSY FLAP OPERATION FIXATION OF FRACTURED JAW I.M.F IMPRESSIONS FOR STUDY MODELS COST OF APPLIANCE (FIXED, ORTHODONTICS SINGLE) COST OF EACH VISIT FOR ADJUSTMENT SINGLE COST OF APPLIANCE (FIXED, ORTHODONTICS SEGM.) DENTAL X-RAY ORATEKE AND LUCITONE DENTURE ONE JAW ACRYLIC & PREMA DENTURES ONE JAW RCT (PREMOLARS) EXTRACTION OF RCT TOOTH BLEACHING OF SINGLE TEETH BLEACHING OF ALL TEETH

550 550 1200 5000 280 7500 430 3500 150 3500 3000 1800 1500 1500 4500

700 650 1800 10000 330 10000 800 5000 200 5100 3800 2300 2000 2000 6000

MATERNITY SERVICE CHARGES

I. MAT01 MAT04 MAT05 MAT06 MAT07 MAT11 MAT13 MAT15 MAT16 MAT19 MAT20 MAT23 IVF51 MAT25 MAT26 MAT27 IVF02 IVF16 IVF17 MAT28

MATERNITY CHARGES COLPOSCOPY END. ASPIRATION CERVICAL CAUTERISATION (ELECTRICAL) Cx PUNCH BIOPSY VAGINAL VULVAL/PUNCH BIOPSY CARDIO TOCOGRAPH(CTG) CRYO CAUTERY Cx VASECTOMY CHEMOTHERAPY AFI AFI + NST UNBOOKED DELIVERY CASES (EXTRA CHARGES) EPIDURAL ANALGESIA CHARGES MONITORING CHARGE IN LABOUR WARD ECLAMPSIA PATIENTS CHARGES SPECIAL LABOUR ROOM CHARGES ECV NST BIOPHYSICAL PROFILE PAINLESS DELIVERY CHARGES

Gen./Cub. 500 230 330 160 160 300 500 1900 750 160 600 1150 950 160 460 800 230 500 650 2600

S. Pvt. 850 380 580 320 320 580 950 1900 1100 300 1050 2300 1275 200 460 800 350 780 950 2900

Private 950 500 760 380 380 860 1250 1900 1550 350 1150 3000 1900 230 460 800 460 1000 1250 3200

II. DELIVERY CHARGES Code MAT30 MAT31 MAT32 MAT33 Service Name NORMAL DELIVERY FORCEPS DELIVERY BREECH DELIVERY TWINS DELIVERY General 2750 4200 4600 5400 Cubicle 4850 6900 7500 8000 S Pvt. 7150 9000 9700 10500 Pvt. Non AC 7600 9800 10500 10800 PVT AC 8600 11300 12000 13100

30

III. LABOUR ROOM CHARGES Code MAT34 MAT35 MAT36 MAT37 Service Name NORMAL DELIVERY FORCEPS DELIVERY BREECH DELIVERY TWINS DELIVERY General 1000 1100 1100 1200 Cubicle 1600 1800 1800 1900 S Pvt. 2350 2500 2500 2650 Pvt. Non AC 2500 2800 2800 3000 PVT AC 2900 3000 3000 3200

REPRODUCTIVE AND FOETAL MEDICINE UNIT

I. IVF01 IVF03 IVF04 IVF05 IVF06 IVF07 IVF08 IVF09 IVF10 IVF11 IVF14 IVF15 IVF18 IVF19 IVF20 IVF21 IVF22 IVF23 IVF24 IVF25 IVF26 IVF27 IVF28 IVF29 IVF30 IVF31 IVF32 IVF33 IVF34 IVF36 IVF35 IVF37 IVF38 IVF39 IVF40 IVF41 IVF44 IVF45 IVF46 IVF47

REPRODUCTIVE AND FOETAL MEDICINE UNIT (RFMU) CYST ASPIRATION TAS CVS(CHORIONIC VILLUS SAMPLING) AMNIOCENTESIS CORDOCENTESIS FOETOSCOPY FOLLICULAR STUDY I SITTING FOLLICULAR STUDY SUBSEQUENT SITTING MALE INFERTILITY SCAN SEMEN ANALYSIS IUI (INTRA UTERINE INSEMINATION) PELVIC SCAN FOETAL SCAN ROUTINE FOETAL DOPPLER FOETAL ECHO OBSTETRIC DOPLER & BIOPHYSICAL PROFILE LEVEL II SCAN FOR FOETAL ANOMALIES Cx SCORE FOETAL BIOPSY FOETAL DOPPLER & FOETAL ECHO FOETAL SCAN ROUTINE & FOETAL ECHO FOETAL SCAN ROUTINE & FOETAL DOPPLER FOETAL SCAN ROUTINE & BIOPHYSICAL SCORE CYST ASPITATION TVS SPERM FUNCTION FOETAL INTERVENTIONAL ADDITIONAL TVS FOETAL SCAN ROUTINE + DOPPLER + ECHO SONO HYSTEROSALPINGOGRAM SPERM WASH st 1 INSTALLMENT AT THE TIME OF REGISTRATION nd 2 INSTALLMENT AT THE TIME OF OOCYTE RETRIEVAL SPERM FREEZING-INITIAL CHARGE OOCYTE/EMBRYO FREEZING INITIAL CHARGE OOCYTE/EMBRYO FREEZING EVERY SIX MONTHS PESA/TESA/MESA ETC EMBRYO THAWING AND TRANSFER AFI AFI + NST ECV NST

Gen./Cub. 750 2200 750 2200 2200 650 150 800 200 1900 580 520 840 840 1250 1500 130 2150 1200 1250 1250 1250 2200 320 2500 130 1250 750 320 5000 55000 1280 11500 3500 1750 17250 160 600 230 500

S. Pvt. 1150 3150 1150 3150 3150 900 230 1280 250 3800 750 750 1330 1330 1750 1900 250 2750 1700 1750 1750 1750 3150 630 3450 200 1750 950 630 10000 60000 1500 13800 3500 3450 17250 300 1050 350 780

Private 1550 4000 1550 4000 4000 1150 300 1800 330 5100 950 980 1840 1840 2150 2300 380 4000 2000 2200 2200 2200 4000 950 4000 250 2200 1150 950 10000 60000 1500 13800 3500 3450 17250 350 1150 460 1000

31

IVF48 IVF50 IVF51 IVF52 MAT03 IVF53 IVF54 MAT08 MAT09 MAT10 MAT12 MAT14 MAT17 MAT18 MAT21 MAT22 IVF55 IVF56 IVF57

BIOPHYSICAL SCORE PAINLESS DELIVERY CHARGES EPIDURAL ANALGESIA CHARGES SPERM FREEZING EVERY SIX MONTHS END. BIOPSY st LOW COST IVF-ICSI 1 INSTALMENT nd LOW COST IVF-ICSI 2 INSTALMENT OBSTETRIC ULTRASOUND I VISIT OBSTETRIC ULTRASOUND FOLLOW UP GYNAE ULTRASOUND (PELVIC SCAN) HSG(HYSTEROSALINOGRAM) HYDROTUBATION (3 SITTINGS) TRANSVAGINAL SCAN HEGARS TEST FOETAL THERAPY SINGLE LOOK ULTRASOUND IUD INSERTION PROCEDURE CHARGES FOR MINOR SURGERIES (I B) PROCEDURE CHARGES FOR MINOR SURGERIES (I A)

650 2600 950 350 580 5000 30000 580 460 580 1150 500 650 460 2500 200 130 2100 1400

950 2900 1275 580 750 10000 30000 760 690 750 1280 950 900 700 3900 250 200 3000 2800

1250 3200 1900 580 950 10000 30000 950 890 950 1400 1300 1150 920 4750 300 250 3000 2800

PACKAGE CHARGES FOR OBS & GYNAE S Pvt. Non AC Pvt. Non AC No. of da ys

Code I. ALOC ALOO ALAVH AEA

Service Name

General

Cubicle

S Pvt. AC

PVT AC (S)

LAPAROSCOPIC SURGERIES IN OBS & GYNAE DEPARTMENT: LAPAROSCOPIC OVARIAN CYSTECTOMY 14700 19600 26000 LAPAROSCOPIC OVARIOTOMY OOPHRECTOMY 14700 19600 26000 LAPAROSCOPICALLY ASST.VAGINAL HYSTERECTOMY 19600 24200 32200 ENDOMETRIAL ABLATION 10500 12700 15600

27900 27900 35700 15600

31700 31700 39100 19600

38000 38000 46000 23000

03 03 05 02

Note:
a. Pharmacy to be charged extra. b. Any Lab test done will be charged extra. c. Any service provided beyond the package days will be extra.

MINOR OT PROCEDURE CHARGES

I. MOT001 MOT002 MOT003 MOT004 MOT005 MOT006 MOT040 MOT007 MOT008 MOT009 MOT010

MINOR OT PROCEDURES I&D SUTURING INTERCOSTAL DRAINAGE CHEST TUBE INSERTION NASAL PACKING REMOVAL OF FOREIGN BODY-NASAL/EAR REMOVAL OF FOREIGN BODY- HAND/ FOOT BIOPSY URETHRAL DILATATION CYSTOSCOPY DJ STENT REMOVAL

General 520 380 1000 1000 600 300 450 370 340 830 1380

Private 690 540 1250 1250 840 500 600 540 520 920 1840

32

MOT011 MOT012 MOT013 MOT014 MOT015 MOT016 MOT017 MOT018 MOT019 MOT020 MOT021 MOT022 MOT023 MOT024 MOT025 MOT026 MOT027 MOT028 MOT029 MOT030 MOT031 MOT032 MOT033 MOT034 MOT035 MOT036 MOT037 MOT038 MOT039 MOT041

CIRCUMCISION SUPRA-PUBIC CYSTOSTOMY CLOSED REDUCTION IN DISLOCATION ELB. CLOSED REDUCTION + POP LEG CLOSED REDUCTION + POP H TRACHEOSTOMY K WIRE FIXATION NAIL REMOVAL EAR LOBE REPAIR EXCISION OF CYST POP CHARGES SUTURE REMOVAL BLADDER IRRIGATION B C G INSTALLATION DORSAL SLIT KNEE ASPIRATION MINOR AMPUTATION CARDIAC MONITORING OXYGEN THERAPY (per hour) ARTERIAL BLOOD GAS MORTURY SHEETS AIRWAY SPC SKIN BIOPSY RANDOM BLOOD SUGAR ECG BLOOD KETONE CASUALTY MINOR PROCEDURE A CASUALTY MINOR PROCEDURE B N/G TUBE INSERTION

1380 1380 830 1380 830 1380 350 1380 830 400 250 200 310 260 1380 600 300 480 80 400 90 80 1150 250 80 130 180 110 350 50

1840 1840 920 1840 920 1840 500 1840 920 550 350 250 380 380 1840 950 380 480 110 450 90 80 1150 450 100 150 200 180 600 100

OPERATION CHARGES
Non AC Pvt. 900 1000 1530 4700 6000 7800 10500 13200 14500 18800 7100

I. OPER1 OPER1A OPER1B OPER2 OPER3A OPER3B OPER4A OPER4B OPER5 OPER6 OPER7

OPERATION CHARGES OPERATION CATEGORY 1 OPERATION CATEGORY 1A OPERATION CATEGORY 1B OPERATION CATEGORY 2 OPERATION CATEGORY 3A OPERATION CATEGORY 3B OPERATION CATEGORY 4A OPERATION CATEGORY 4B OPERATION CATEGORY 5 OPERATION CATEGORY 6 LAPAROSCOPY CHARGES

General 210 240 550 1100 1380 1500 2450 3000 4000 5300 3700

Cubicle 380 440 950 2200 2500 3000 3900 5350 5700 6600 4500

S. Pvt. 800 870 1320 4400 5100 6500 9100 11300 12600 15400 6400

Pvt. AC 1050 1240 1850 5900 8400 10000 13000 18900 20800 23100 8900

II. OT1 OT1A OT1B

THEATRE/LABOUR ROOM CHARGES OT CATEGORY 1 OT CATEGORY 1A OT CATEGORY 1B

General 180 220 500

Cubicle 350 400 720

S. Pvt. 530 610 890

Pvt. 630 730 1000

Pvt. AC 800 900 1220

33

OT2 OT3A OT3B OT4A OT4B OT5 OT6 OTC001

OT CATEGORY 2 OT CATEGORY 3A OT CATEGORY 3B OT CATEGORY 4A OT CATEGORY 4B OT CATEGORY 5 OT CATEGORY 6 THEATRE ADDITIONAL CHARGES

800 1150 1150 1400 2000 2600 3130 300

1300 1700 2200 2300 3600 3800 4400 420

3000 3600 4200 5900 7600 8000 10000 540

3300 4100 4600 6800 8800 9400 11900 600

3800 4600 6000 7600 12200 12700 13800 660

Note: For Emergency Surgery the next higher category rate will be charged from category 3A onwaeds.

III. ANA1 ANA1A ANA1B ANA2 ANA3A ANA3B ANA4A ANA4B ANA5 ANA6 ANA07

ANAESTHESIA CHARGES ANAESTHESIA CATEGORY 1 ANAESTHESIA CATEGORY 1A ANAESTHESIA CATEGORY 1B ANAESTHESIA CATEGORY 2 ANAESTHESIA CATEGORY 3A ANAESTHESIA CATEGORY 3B ANAESTHESIA CATEGORY 4A ANAESTHESIA CATEGORY 4B ANAESTHESIA CATEGORY 5 ANAESTHESIA CATEGORY 6 IV SEDATION

General 110 130 250 400 575 575 700 1000 1300 1500 480

Cubicle 190 210 390 700 850 1150 1200 1700 1900 2100 540

S. Pvt. 280 330 460 1500 1850 2100 2900 3700 4000 4700 700

Pvt. 330 380 520 1650 2100 2350 3450 4500 4900 6000 850

Pvt. AC 400 450 660 1900 2350 3050 3900 6200 6700 7000 970

IV ANA08 ANA16 ANA17 ANA18

PAIN CLINIC NERVE BLOCKS FOR CHRONIC PAIN COELIAC PLEXUS BLOCK SCAR/LOCAL INFILTRATION FLUROSCOPY a) Pharmacy b) Disposables

General 1150 1725 850 300

Cubicle 1150 1725 850 300

S. Pvt. 1725 2300 1150 575

Pvt. 1725 2300 1150 575

Pvt. AC 1725 2300 1150 575

Extra Charges:

OXYGEN CHARGES
I. OXY01 OXY02 OXY03 OXY04 OXY05 OXY06 OXY07 OXY08 OXYGEN OXYGEN CHARGES PER HOUR ADULT OXYGEN CHARGES PER HOUR PAED. OXYGEN CHARGES PER DAY PAED. OXYGEN CHARGES PER DAY ADULT OXYGEN CHARGES PER HR. IN ICU ADULT OXYGEN CHARGES PER DAY ICU OXYGEN CHARGES PER HR IN ICU PAED OXYGEN CHARGES PER DAY IN ICU PAED General 90 70 660 860 90 860 70 700 Private 120 120 1380 1380 90 860 70 700

NOTE: 1) These rates apply for supply of Oxygen whether piped or cylinder. 2) In the Operation Theater and ICU charges at the above rates will for apply for the entire period for which oxygen is supplied Note:
1. Charges for Multiple Operation: When 2 or more operations are performed in one sitting by the same surgeon, the following

34

shall be the basis of the charges: 1. Operation Fee: Full fee for the main operation plus 50% of the fee for Other operation.

2. OT Room Charges / Anaesthesia Charges: Full charges in respect of the main operation up to 1 hour and thereafter extra charges according to the duration. 2. Package Charge for Anaesthesia (Gases and Drugs): Up to half an hour Half an hour to one and half hour Each subsequent hour General Anaesthesia for Minor Procedures Spinal Epidural/Brachial Block Combined Spinal/Epidural CSE Any other block Labour Analgesia 3. 575 430 530 700 375 950 Rs.630/Rs.1050/Rs.400/Semi Pvt. 575 700 800 1150 570 1250 Private 575 920 1100 1500 630 1900

PAC Charges

200

300

460

PACKAGE CHARGES FOR GENERAL SURGERY S Pvt. General Cubicle Non AC S Pvt. AC Pvt. Non AC PVT AC (S) No. of days

Code

Service Name

GENERAL/UROLOGY/PAEDIATRIC SURGERY: ALC LAPAROSCOPIC CHOLECYSTECTOMY 19000 25100 33600 38600 43400 49800 04

APCNB

P C N L BILATERAL

26000

36500

45900

52600

55700

65200

08

APCNL ATURP

P.C.N.L. TRANSURETHRA RESECTION OF PROSTATE (T.U.R.P)

21100 17100

29700 21500

37000 31000

42900 36100

46800 40100

55100 47500

06 06

AURSD

URS + DJ STENTING

18100

23800

32000

37000

41200

47500

03

AURSB

URS + DJ STENTING BILATERAL

23500

31100

39200

45500

48300

56600

03

35

APSB APSBO

HERNIOTOMY BILATERAL ORCHIOPEXY BILATERAL HERNIOTOMY- UNILATERAL

10000 11000 6500

14100 15000 10500

18500 19000 14700

21000 22000 16900

22500 23000 18100

25000 26000 21400

01 01 01

ORCHIDOPEXY- UNILATERAL

7500

11500

15700

17900

19100

22400

01

CIRCUMCESION RE-LOOK SURGERY FOR KIDNEY STONE

5500

9000

12500

14000

15000

18000

01

ARKS

7300

10000

12500

14500

15100

17800

--

Note:
a. Pharmacy to be charged extra. b. Any Service provided beyond the package days shall be charged extra. c. The package starts one day before the operation/procedure.

MISCELLANEOUS CHARGES
I. CERTIFICATE FEE: 1. Fitness Certificate 2. Other Certificates 3. Birth time certificate - up to 5 Yrs - 5 - 10 Yrs - above 10 Yrs 4. Correction of letters II. Room Booking charges - Rs.400/120 120 120 150 180 60

III.

Ambulance charges: Rs.15/- per km. subject to a minimum of - Rs.300/- up to 11 km. Waiting charges after 1/2 an hour will be - Rs.100/- per hour If a Doctor or a Nurse accompanies the patient at the patients request, additional charge - Rs.500/During the NIGHT: from 8 p.m. to 6 a.m. extra charge - Rs.250/Ambulance will not be used for transporting the dead body.

IV.

Mortuary charges: Any inpatient who has expired in Hospital - Rs.300/- per day. Dead Bodies brought from outside - Rs.1500/- per day.

36