E Gmina cc + oe MARY JOHNSTON HOSPITAL FOLOQY) 1221 J Nolasco, Tondo, Manila Se Phone No. 531-86-600 Immuno AK TIN; 000-630-104-000 to“ LABORATORY From January 01, 2022 to December 31, 2022 2 | DESCRIPTION ay TOTAL a IN-PATIENT. PAY SARORUMEP OE 1.00 466.00 el 64.00 10,835.60 B 61.00 28,739.80 AFB C/S 1.00 7,424.00 AFP 11.00/ 27,342.00 eo! 6 525.06 182,909.02 & “ER OC yoo 247.20 . ° /1.00 253.60 & /205.00 79,943.20 a “1.00 2,075.20 . 86.00 53,947.60 ‘ANA 3.00 4,576.00 ‘ANA (NKTD) 5.00 20,771.00 ‘Anti - DSDNA 4.00 15,136.00 Ran DSDNA 1.00 2,204.00 ‘Anti HAV 1GG_ 10.00 7,676.60 160 ananavicn 13.00 7,702.20 al od ‘Anti HBC 1GG_ 14.00 8,005.80 ate ‘Anti HBC 1GM 11.00 7,438.60 cs ‘Anti HBE 5,00 3,417.00 grea 2 Ant HES 56.00 54,423.60 ee) PAT 490.00 337,838.00 ae uid Analysis 2.00 1118.40 oe 8.00 4,259.60 apt 29.00 27,881.80 a 8.00 45,719.00 UI sa 4,684.00 : ‘ , 75,496.30 BE bon ote ase) 58.00 138,535.80 18 Fe Biopsy (Large) 76.00 78,780.6017 guste Se Bip (edu 399.00 351,613.20! Fr tS Biopsy (Small) 461.00 341,111.20 fh Bleeding Time 35.00 4,887.20 yf 12 Blood Culture with ARD One Ste 96.00 341,138.2083 mg 1 Blood Culture with ARD Two Sites 192.00 1,003,281.80!2 | Blood Reseevation Fee 2.00 i “00. 00H | € Blood Typng = 1,227.00 698,162,500 q. 7.00 4,316.20 acd ‘ 172.00 56)840.90 Rol 7! ' 41,627.00 545,186,574 (catiss: 18.00 31,556:40 ' CA 15-3 8.00 21,406.00 cA 19-9 1.00 2,113.60 é 18.00 ‘53,399.40 2 i 120.00 49,893.00 eianeen 4,884.00 sf 2,803,203,28 Page 1 of8 Scanned with CamScanner——————— ee —t™S MARY JOHNSTON HOSPITAL 1221] Nolasco, Tonge, Manila Phone No.: 531-86-600 Fray ebb sano 000 LABORATORY ‘From January 01, 2022 to December 31, 2022 ay TOTAL eo 15,492.60 1 4.00 492 2 27.00 51,719.60- 43.00 30,824.72 Cell Block and Cytology Prd oma 8.00 2,454.60 a 1.00 2,400.00 ‘ iting Tine 29.00 5,497.20 Cate hPatage 9.00 7,902.00 jl Complete Hepatitis Profile 4,00 21,017.80 "| Coombs Direct 27.00 10,974.80 4 ‘Coombs Indirect 27.00 10,974.80 @ 4.00 3,388.20 D 19 PCR 458.00 (3 1,247,320.00 13 | Covid Antigen Test 145.00 104,168.00 + OK 14.00 10,484.00 | coeme 25.00 35,094.40 BPMN 9.00 14,594.60 2 seo @ 2,064.00 676,676.52 18 23 atching 502.00 Bp 511,885.00+¢ + 2ut % Crossmatching + Blood Typing 347.00 88,460.80 70 2cp al CRP 26.00 325,018.00 2/ 26, CSF Analysis 40.00 7,270.00 '7p1-22/Culture (Urine/Stool/Fuids/etc) 483.00 791,348.40 23 “pj 32 Cytology (alone) 8 slides 2.00 1/564.00 25 Py a D-Dimer 120.00 509,998.80 > Pre.” Dengue Card Test 22.00 59,072.20 Pro 26 Dengue Duo (NSI, IGG, IGM) 67.00 263,236.80 2 Ora, 199.00 68,819.90 rot apie Cory 28.00 838.20 x 59.00 14,931.80 450.00 127,361.60, BF ogee romae 212.00 40,024.90 il WS Ferritin 90.00 269,404,601 g FNAB (6 slides) ey 5000 BS). heels (13) 114.00 150,729.00!” Sc W FreeT4 (Fra) : 2 135.00 181,189.60 1 e 1.00 1,065.00 12.00 7,041.60 418.00 134,410.10 340.00 325,971.00 316.00 F 395,742.80 6.00 3,891.00 89.00 39,625.60 27.00 27,125.60 = Hematocrit 57.00 83,444.40 = Hemoglobin 260.00 43,712.00 3.00 518.00 Page 2 of 8 Scanned with CamScanner+ Onamidhny = wonton, MARY JOHNSTON HOSPITAL 1221 3 Nolasco, Tondo, Mani Poneto: Sneeeny ania egy “TIN: 000-630-104000 LABORATORY From January Of, 2022 to December 31, 2022 DESCRIPTION a cal Hepatitis Pree 4.00 uai760 | 2 eae 3 nal 12.00 18,060.20 © 2,594.00 ona7i93 + 32.00 8845.00 107.00 315,712.22 4 « (0 LDH (serum or fluids) 155.00 96,312.60 I 1 Lepto-mat 8.00 13,447.40 1! Lut 1.00 41,065.00 py + 13 Lipase 112.00 78,498.20 13 [ystipid Profle 386.00 653,343.90) Magnesium 639.00 763,946.45 1S Malarial / Peripheral Smear 2.00 '534,00/¢ 19 MTB Gene Expert (sputum) 7.00 41,312.8017 + 2,170.00 820,974.5318 JaNSL AG 59.00 120,509.00 19 (20 NT-proBNP Test 143.00 579,431.00 af Occult Blood 44.00 gg7i.602! +52 OGTT (3 sample) 2.00 1,713.60 2 23 PAPSmear with kit 5.00 735.6023 24Peripheral Blood Smear 69.00 17,623,804 ‘2€ Phlebotomy 13.00 6,265.80 + 26Phosphorous 111.00 62,596.60 2b —23Platelet Count 270.00 65,782.2027 & Pleural Fluid Analysis 3.00 1,963.20 28 ‘29 Pregnancy Test 73.00 28,706.0024 + Procalcitonin 235.00 1,076,425.80 20 2! Processing Fee FWB 358.00 606,806.60 3! + gz Prolactin Assay 1.00 1,167.00 3 33 Protime 596.00 823,149.00 33 FEPSA 22.00 38,146.60 24 36°TH 2.00 7,892.00 36 Reticulocyte Count 54.00 32,276.204L 37 RF 3.00 859.2037 58 RF/RA Quanti 1.00 932.00 2 37 RPR 3,00 1,011.00 39 “SARS COV-2 Neutralizing Antibody 1.00 1,634.00 4° 2 SARSCOV 2 IGG IGM 1.00 2,600.00 yf yp Serum Ferritin (Send-out) 2.00 4,838.00 4 ‘Serum Osmolality 10.00. 13,307.60 43 « gy Serum Protein Electrophoresis 1.00 4,120.24 gO 1§ Service Charge - Laboratory (FWB - PRBC) 273.00 194,194.00 45 {o Service Charge - Others 107.00 76,818.00 gxscoT 408.00 168,917.20 YT qe SGPT 631.00 261,578.80 48 Page 3 of 8 Scanned with CamScannerMARY JOHNSTON HOSPITAL 1221 J Nolasco, Tondo, Manila Phone No.: 531-86-600 TIN: 000-630-104-000 LABORATORY From January O1, 2022 to December 31, 2022 DESCRIPTION oy TOTAL ‘Anti HAV 166 3.00 2,116.00 ‘Anti HAV 16M 10.00 4,932.00 ‘Anti HBC 166 20.00 9,990.00 ‘Anti HBC 16M 7.00 3,835.20 Anti HBE 8.00 4,360.00 Anti HBS 381.00 +355,943.20 APT 283.00 180,058.90 ASO 8.00 4,087.00 ‘ASOw/ titer 90.00 76,112.40 B.Braun - Albumin (serum) 1.00 7.60 B.Braun - BUN 2.00 170.00 B.Braun - Calcium 1,00 102.40 B.Braun - CBC 16.00 3,182.80 B.Braun - Creatinine 5.00 465.60 B.Braun - K 9.00 1,256.00 “B.Braun - Nat 4.00 ‘565.20 B.Braun - Phosphorus 3.00 488.80 Beta HCG Titer 78.00 118,279.40 B-HCG 7.00 9,012.00 + Bilirubin Total 214.00 57,443.35, Biopsy (Extra Large) 1.00 1,091.00 Biopsy (Large) 3.00 2,547.00 Biopsy (Medium) 19.00 12,610.00 Biopsy (Small) 118.00 65,467.60 — Bleeding Time 95.00 10,812.35 — Blood Culture with ARD One Site 7.00 20,648.00 = Blood Culture with ARD Two Sites 23.00 92,057.60 = _ Blood Reseevation Fee 26.00 12,700.00 = Blood Typing 520.00 738,180.45 + BUA 2,999.00 887,949.80 «BUN / Urea 3,161.00 877,710.24 a 43.00 48,598.00 ca 125 33.00 69,658.40 cA15-3 1.00 1,921.60 A199 9.00 19,912.00 + Calum / Ca4+ 298.00 93,886.60 —k oC 12,186.00 5,260,683.40 A 30.00 ‘99,000.00 CEN 30.00 49,537.60 Cell Block and Cytology 7.00 4,521.00 + Chloride / Cl 346.00 134,077.40 Cholesterol Total 171.00 49,806.40 — Clotting Time 92.00 14,357.40 Code A Package 428.00 + 301,016.40 Complete Hepatitis Profile 8.00 39,584.40 Coombs Direct 13.00 3,942.50 _ Coombs Indirect 13.00 3,942.50 Cortisol 1.00 758.00 Page 5 of 8 Scanned with CamScannerc= MARY JOHNSTON HOSPITAL AnH Serotg'y — 1221 J Nolasco, Tondo, Manila ant Prone No 31-86-600 AntiH —tmmans 10-630-104-000 ai AnH and LABORATORY fea ‘From January 01, 2022 to December 31, 2022 ssn, L TOR a a — Bora SatFee Ute Waucr 15,692.00 7353,63940 | Bir > storage fee 1.00 220,00 2 Bibra ¢ Sugar / Glucose 3.00 465.00 > Bae 473 3.00 3,932.40 B.Bra’ tn 3.00 3,932,405 @ Testosterone 1.00 441440 ¢ Total Protein. © 292.00 99,115.00 > Bra Triglycerides C 3.00 1,683.00 & Beta, Troponin I (Qualitative) ¢ 5.00 11,149.80 Bue (@Troponin I (Quantitative) © 340.00 1,362,460,33 12 * Biliry TSH 157.00 211,584.80 I! Biopsy Typhidot 30.00 39,658.80 12. Biops 2X Urinalysis 1,749.00 345,573.74 13 Biops, 2 NUrine Albumin / Creatinine Ratio © 11.00 7,786.80 1Y Biopsy At 1S Urine Calcium & 1.00 “953.00 IS eed Z [Urine Crea € 3.00, 199800 1 Blood ¢ A 17 Urine CS with ARD. 37.00 619.20 1? pat Be Buns 123,619.20 | Blood R 11 Urine Micral Test 12.00 11,122.80 18 OOS Cotte é im 4,396.0019 BUN “Agr ine Oaalty 3.00 3021 DUNT aarti Prete 2.00 2,707.00 >> 125 apa 3.00 41,060.00 +3 A125 _ 3yWbe & Di. count 23.00 5.276.602. A 19-8 T2ADA SS akium —_QuT-PATIENT . Pay D4 a 9 thas 29.00 11,160.00 ! | 4.00 = 1672.00 2 Blox 3 24 Gre, Clearance 2.00 1,103.00 3 crit 4° g. 24 Hour Urine Protein 2% § Acetone / Ketone 4.00 = 9,242.004 ing Se 8.00 1,105.60 ¢ eM. oes 78 DOTS 322.00 124,141.806 ple! AFB C/S 74.00 8.712.007 os Arp 5.00 33,745.00 ¢ PS _ 1p Albumin (Serum) eo 17 A7B.80 9 = 1 Albumin (Serum) - ER 207.00 60,051.40 10 - 4% Albumin (Urine) 1.00 247.20 , 78 Alkaline Phosphatase 2.00 428.00} ‘1 Alkaline Phosphatase - ER a oe ae GAmylase 3.00 963.00 1% fa 243,00 + 133,529.60, 73 ANA (NKTI) 18,00 17,567.60 1b ys Anti - DSDNA 10.00 31,106.00 17 Fant cop 5.00 18,600.00 1 “IGAnt DSDNA 1.00 7,008.00 (4 1.00 1,903.00 20 Page 4 of 8 Scanned with CamScannerMARY JOHNSTO! 1221 J Nolasco, Tondo} Phone No. $31-86-600 "TIN: 000-630-104-000 LABORATORY ‘From January 01, 2022 to December 31, 2022 DESCRIPTION ay TOTAL Anti HAV 1GG_ 3.00 2,116.00 Anti HAV 1GM 10.00 4,932.00 Anti HBC 1GG 20.00 9,990.00 Anti HBC 1GM 7.00 3,835.20 Anti HBE 8.00 4,360.00 Anti HBS 381.00 + 355,943.20 APT 283.00 180,058.90 ASO 8.00 4,087.00 ASOw/ titer 90.00 76,112.40 B.Braun - Albumin (serum) 1.00 77.60 B.Braun - BUN 2.00 170.00 B.Braun - Calcium, 1.00 102.40 B.Braun - CBC 16.00 3,182.80 B.Braun - Creatinine 5.00 465.60 B.Braun-K 9.00 1,256.00 “Braun - Nat 4.00 565.20 B.Braun - Phosphorus 3.00 488.80 Beta HCG Titer 78.00 118,279.40 BHCG 7.00 9,012.00 + Bilirubin Total 214.00 57,443.35 Biopsy (Extra Large) 1.00 1,091.00 Biopsy (Large) 3.00 2,547.00 Biopsy (Medium) 19.00 12,610.00 Biopsy (Small) 118.00 65,467.60 — Bleeding Time 95.00 10,812.35 — Blood Culture with ARD One Site 7.00 20,648.00 — Blood Culture with ARD Two Sites 23.00 92,057.60 — Blood Reseevation Fee 26.00 12,700.00 = Blood Typing 520.00 238,180.45 BUA 2,999.00 887,949.80, «BUN / Urea 3,161.00 87,710.24 a 43.00 48,598.00 cans 33.00 69,658.40 A153 1.00 1,921.60 cA19-9 9.00 19,912.00 Calcium / Ca++ 298.00 93,886.60 —f oc 12,186.00 5,260,683.40 4 30.00 99,000.00 CEA 30.00 49,537.60 #® Call Block and Cytology 7.00 4,521.00 + Chloride / cl 346.00 134,077.40 Cholesterol Total 171.00 49,806.40 — Clotting Time 92.00 14,357.40 Code A Package 428.00 «301,016.40 Complete Hepatitis Profile 8.00 39,584.40 Coombs Direct 13.00 3,942.50 ‘Coombs Indirect 13.00 3,942.50 — Cortisol 1.00 758.00 Page 5 of 8 Scanned with CamScannerMARY JOHNSTON HOSPITAL Tondo, Manila 42211 rene Saeed "in: e00-630-104-000 LABORATORY ‘From January 01, 2022 to December 3, 2022 DESCRIFTION oy wo 2,280.00 6,532,120.00 congas rect 2/822.00 ¥2445,216.00 OPK 18.00 11,077.80 PK-MB 41,00 48,376.40 (CPK-MM 2.00 2,856.00 Ge Creatinine 5,716.00 + v'1,562,333.64 ‘Crossmatching 32.00 24,101.50 _ Crossmatching + Blood Typing 18,00 24,399.40 cRP 143.00 116,416.60 19 Culture (Urine/Stool/Fuids/etc) 428.00- 0575,473.60 1? Gytology (alone) 8 slides 1,00 612,00 — Dimer 36.00 123,384.00 — Dengue Card Test 108.00 234,140.40 — 14 Dengue Duo (NS1, IGG, IGM) 234.00 + 799,854.00: ¥ Direct Bilirubin: 202.00 55,502.80: Duplicate Copy 91.00 2,904.00 + ESR 200.00 39,188.60 Estrogen 1.00 2,002.40 199 FBS / PPBS / RBS. 3,920.00 991,004.20 14 Fecalysis 1,812.00 272,645.40 Ferritin 44.00 112,764.60 aT 3.00 3,000.00 FNAB (6 slides) 60.00 24,568.00 24 Free T3 (FT3) 357.00 + 400,892.00 2¥, 28 Free T4 (FT4) 518.007 6 595,177.60 28 » FSH 30.00 29,610.00 - GGT 56.00 27,912.40 Gram Stain 141.00 37,183.30 H. Pylori 5.00 6,604.00 3° Handling Fee 691.00 * 673,440.00, 3¢ 3 te HBAIC 2,936.00 — 3,217,123.80 2) HBE-Antigen 19.00 10,292.00 « HBSAG (Qualitative) 446.00 165,250.00 * HBsAG (quantitative) 44.00 37,998.40 HBV DNA 1.00 9,232.00 HCV 36.00 45,532.60 # HDL - Cholesterol 14.00 7,697.00 — Hematocrit 9.00 980.00 — Hemoglobin 3.00 420.00 Hepatitis Profile 12.00 31,186.20 «Hab & Het 2.00 281.60 4 HS Troponin 1 155.007 *508,410.00 ¢ 4> Tonized Calcium 715.00 # 600,530.20 ¢. + Tren 10.00 29,983.20 YS K 4,581.00 + 1,413,117.20 4 « KOH 46.00 10,065.60 LE. Cell Preparation 2.00 700.00 gb LABORATORY 209.00 348,063.40, 4 Page 6 of 8 v Scanned with CamScannersifojoyped —__2t668!"=N94d_MARY JOHNSTON HOSPITAL “asa \do, Manzi ‘aw-vivny it raway nwoit222 9 Nolasco, Toney ZT -ig ZL, TIN: 000-630-104-000 astBojouyoo,, PO1Ppy LABORATORY From January 01, 2022 to December Ht, 2022 C DESCRIPTION ay TOTAL, Te LDH (serum or fluids) 68.00 35,688.20 | 2 Lepto-mat 2.00 2,992.00 > Be LH 24.00 19,914,003 4 lipase 365.00 223,852.804 ‘Lipid Profile 3,003.00 4,588,700.00 te egrsium - 381.00 200,237,406 7 Malarial / Peripheral Smear 807 & MTB Gene Expert (sputum) ae 8 Gypvuxa any jaf Noe quNat 3,763.00 +1,216,995.309 IONSL AG : 645.00 + 1,011,824.60 jo NT-proBNP Test 00F - ost Wevol oz 76.00 no S718 09 Occult Blood o1-00 % 45.00 se1t4do32680,00 OGTT(3sample) —o'h- 011 % 1 285.00 sodas) 347.80 PapSmear with kit gg gy % L 2,083.00 sovi26BQ78.20 — Peripheral Blood Smear, 57.00 12,869.00 ‘or - oz % % sauvooydlgcp9: Phlebotomy ce 10.00 7.20 = Phosphorous 099 0'9¢ % ” 118.00 28H 849 90 Platelet Count 13,00 MO TENE HETEO % Pregnancy Test OOl-o's Tevol ws 797.00 swno3 2149667802.40 Procalcitonin o'se-o1e wa ree 60.00 29R944.00 Processing Fee FWB 9.67 -o:¢¢ 34 vie 15.00 40 Progesterone bs 1.00 .00 Prolactin Assay «L608 v st 14.00 3,259.20 Protime vs-8e TN/9vOr v9 408.00 w¥°95OGY.20 PSA Ozr-oLe % urs H 285.00 ‘PeESHBHL.60 2 PTH s91- Sz wa FLU 2.00 igo (806)343.60 = Reticulocyte Count 19.00)un05 pooia 298800320 RF 20.00 aaa: 200 REN Qua a 17,686,60 4 Rubela Tog 400 SP OTOLNSAGHon 4K SARS COV-2 Neutralizing Antibod 1,00 1,350.00 -K SARSCOV 2 1GGUGHla>u9.0)9Rf wen arasee 1,00 SWEN_350d1,756.00 Seoth Tape Swab 1.00 133.00 ~ Serum Ferritin (Send-out) a oetco000ee égizon, “10 = Serum Preg Test Hoo a oo Service Charge - Laboratory (FWB - PRBC) 700, rene ‘4,774.00, + Service Charge - Others sh'zz €c07-S1-10 ljowiachaen! 16.00 Ast eid » SGOT vee ewesT-10 pearoooy seq] 1,433.00 $100,803.81 SGPT i 5,004.58, r Spar raids we ‘wont207 vtSRE PR ann frit ae cea if Stat Fee erat 19,622.00 £71318 49,479 NK Stone Analysis 7.00 3,312.00 LYOdTA ADOTOLVWIH 8.00 672.00 5.00 fp | 522.80 Izopsvz : oN ouoydopeL zo ae EL XOG ‘O'd PIIMEWY “OPUOLL “IS ODSEON WERE 1ZZL ul es 00) ‘1V.LIdSOH NOLSNHOr ANVW Scanned with CamScannerMARY JOHNSTON HOSPITAL 1221 J Nolasco, Tondo, Manila Phone No.: 531-86-600 ‘TIN: 000-630-104-000 LABORATORY From January 01, 2022 to December 31, 2022 DESCRIPTION oy ‘TOTAL TBC 5.00 11,104.80 Total Protein 147.00 41,815.40 « Triglycerides 121.00 56,501.20 — Triple Smear 12,00 5,198.00 += Troponin I (Qualitative) 4,00 7,592.40 YW Troponin I (Quantitative) 324.00 > 1,065,883.90 TSH 661.00 "3 *748,909.40 “Typhidot 44.00 48,202.20 4 Urinalysis 11,564.00 + 9f 1,933,924.24 Urine Albumin / Creatinine Ratio 88.00 57,919.00 ve Urine Calcium 3.00 2,440.00 2 Urine Crea 10.00 5,804.40 + Urine CS with ARD 10.00 28,408.40 + Urine K 5.00 4,214.00 Urine Micral Test 79.00 74,765.00 Urine Nat 7.00 4,958.60 ‘Urine Protein 3.00 2,976.00 VORL. 260.00 71,740.20 + Viral Load 18.00 128,700.00 —_Whe & Diff. Count 5.00 946.80 '51099,448.65 ________78,391,87026 Page 8 of 8 Scanned with CamScanner