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| Supreme Court of the Philippines Library Services, Padre Faura, Ermita, Manila, Philippines 1000 |
| (632) 8524-2706 |
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(NAR) VOL. 13 NOS. 1-4 / OCTOBER-DECEMBER 2002
[ DOTC DEPARTMENT ORDER NO. 2002-57, November 15, 2002 ]
AN ORDER REVISING CERTAIN FEES AND CHARGES OF THE AIR TRANSPORTATION OFFICE (ATO) FOR MEDICAL, DENTAL AND LABORATORY SERVICE UNDER D.O. #94-762.
MEDICAL, LABORATORY AND DENTAL FEES
A. MEDICAL
1. Consultation |
P100.00 |
2. Treatments (dressing, injection, etc.) |
100.00 |
3. Minor Surgery |
|
a) Circumcision |
400.00 |
b) Incision and Drainage, Suturing |
200.00 |
c) Removal of Cyst |
300.00 |
4. Physical Examination with Issuance of Medical Certificate |
50.00 |
5. Ambulance conduction fee within Metro Manila |
500.00 |
6. Nebulization with kit and medicine |
180.00 |
7. Nebulization without kit and medicine |
30.00 |
8. Optical examination (refraction and visual acuity) |
50.00 |
9. Neuro-Psychiatric Examination |
150.00 |
10. Annual fee for designation of Aviation Medical Examiners |
200.00 |
11. Treadmill/Stress Test |
700.00 |
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B. LABORATORY |
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1. ECG |
200.00 |
2. Chest X-ray |
|
14 x 17 |
150.00 |
11 x 14 |
120.00 |
3. Complete Blood Count |
95.00 |
4. Hemoglobin |
50.00 |
5. Hematocrit |
50.00 |
6. White cell count |
50.00 |
7. Red cell count |
50.00 |
8. Blood typing |
100.00 |
9. Platelet count |
65.00 |
10. ESR |
80.00 |
11. Differential count |
50.00 |
12. Occult blood |
85.00 |
13. Pregnancy test |
145.00 |
14. Routine urinalysis |
70.00 |
15. Urine albumin and sugar |
60.00 |
16. Stool exam |
60.00 |
17. Blood chemistry |
|
a) Glucose |
120.00 |
b) BUN |
120.00 |
c) Creatinine |
120.00 |
d) Uric Acid |
120.00 |
e) Cholesterol |
120.00 |
f) Triglycerides |
130.00 |
g) HDL |
180.00 |
h) SGOT |
140.00 |
i) SGPT |
140.00 |
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C. DENTAL |
|
|
|
1. Treatment |
35.00 |
2. Filling per tooth |
100.00 |
3. Extraction per tooth |
50.00 |
4. Prophylaxis (light) |
100.00 |
REPEALING CLAUSE
All previous administrative/department orders, rules and regulations, or part thereof inconsistent with or contrary to any prevision of this order are hereby repealed or modified accordingly.
EFFECTIVITY DATE
This Order shall be published once a week for two (2) consecutive weeks in two (2) newspapers of general circulation in the Philippines and the same shall be effective fifteen (15) days after the last publication.
RECOMMENDING APPROVAL:
M/Gen. ADELBERTO F. YAP (Ret.)
Assistant Secretary
APPROVED:
(SGD.) LEANDRO R. MENDOZA
Secretary
Attachment
Rates for Medical, Laboratory and Dental Services
Examination/Procedure |
Pay Rates – Class A |
Charity Rates |
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Outpatients/Ward/Semi-Private/Private/ Deluxe./Suite |
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Ward/Semi-Priv. |
Private |
Suite Deluxe |
Class D |
Class B |
Class C |
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A. Medical |
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1. Consultation (ER Only) |
200.00 |
200.00 |
200.00 |
- |
- |
- |
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2. Treatment (dressing, Injection, etc.) |
- |
- |
- |
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3. Minor Surgery |
390.00 |
500.00 |
855.00 |
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435.00 |
695.00 |
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a. Circumcision |
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b. Incision & drainage, Suturing |
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c. removal of cyst |
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4. Physical Examination w/ Issuance of Medical Certificate |
NA |
NA |
NA |
NA |
NA |
NA |
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5. Ambulance Conduction Fee |
600.00- |
600.00 |
|
600.00 |
|
600.00 |
w./in Metro Manila |
800.00 |
800.00 |
800.00 |
800.00 |
800.00 |
800.00 |
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6. Nebulization w/Kit & Medicine |
NA |
NA |
NA |
NA |
NA |
NA |
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7. Nebulization w/o Kit & Medicine |
35.00/day |
35.00/day |
35.00/day |
- |
- |
- |
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8. Optical Examination (Refraction & Visual Acuity) |
NA |
NA |
NA |
NA |
NA |
NA |
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9. Neuro-Psychiatry Examination |
NA |
NA |
NA |
NA |
NA |
NA |
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10. Annual fee for designation of Aviation Medical examiners NA |
NA |
NA |
NA |
NA |
NA |
NA |
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B. Laboratory |
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1. ECG- Regular |
200.00 |
240.00 |
350.00 |
- |
70.00 |
40.00 |
- Bedside/Emer. |
260.00 |
310.00 |
- |
- |
- |
- |
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2. Chest X-ray |
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PA |
285.00 |
285.00 |
345.00 |
- |
100.00 |
100.00 |
PA and lateral |
345.00 |
345.00 |
415.00 |
- |
130.00 |
140.00 |
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3. Complete Blood Count |
95.00 |
115.00 |
115.00 |
- |
40.00 |
60.00 |
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4. Hemoglobin |
50.00 |
50.00 |
60.00 |
- |
15.00 |
30.00 |
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5. Hematocrit |
50.00 |
50.00 |
60.00 |
- |
15.00 |
30.00 |
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6. White Cell Count |
50.00 |
50.00 |
60.00 |
- |
15.00 |
30.00 |
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7. Differential Count |
70.00 |
70.00 |
75.00 |
- |
20.00 |
40.00 |
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8. Hemoglobin only |
50.00 |
50.00 |
60.00 |
- |
15.00 |
30.00 |
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9. Red Blood Cell/Count/ WBC Morpitology |
65.00 |
65.00 |
70.00 |
- |
20.00 |
35.00 |
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10. Blood Typing |
125.00 |
160.00 |
160.00 |
- |
35.00 |
70.00 |
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11. Platelet Count |
65.00 |
65.00 |
80.00 |
- |
20.00 |
40.00 |
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12. ESR |
100.00 |
100.00 |
100.00 |
- |
50.00 |
55.00 |
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13. Occult Blood |
90.00 |
100.00 |
100.00 |
- |
40.00 |
45.00 |
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14. Pregnancy Test |
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Qualitative: Slide Test |
100.00 |
110.00 |
110.00 |
- |
40.00 |
45.00 |
Card Test |
145.00 |
160.00 |
160.00 |
- |
105.00 |
115.00 |
Quantitative: 24 hrs. |
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HCG |
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15. Urinalysis (Routine) |
70.00 |
75.00 |
75.00 |
- |
35.00 |
40.00 |
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16. Urine Albumin |
70.00 |
90.00 |
90.00 |
- |
30.00 |
35.00 |
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17. Sugar |
45.00 |
50.00 |
50.00 |
- |
30.00 |
35.00 |
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18. Stool Exam (Routine) |
70.00 |
75.00 |
75.00 |
- |
20.00 |
25.00 |
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19. Blood Chemistry |
|
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Glucose |
350.00 |
350.00 |
385.00 |
- |
95.00 |
195.00 |
BUN |
85.00 |
100.00 |
100.00 |
- |
25.00 |
50.00 |
Creatinine |
90.00 |
90.00 |
105.00 |
- |
25.00 |
55.00 |
Uric Acid |
85.00 |
95.00 |
95.00 |
- |
25.00 |
50.00 |
Cholesterol |
105.00 |
115.00 |
115.00 |
- |
30.00 |
60.00 |
Triglycerides |
185.00 |
215.00 |
215.00 |
- |
55.00 |
110.00 |
HDL |
195.00 |
210.00 |
210.00 |
- |
115.00 |
135.00 |
SGOT |
115.00 |
125.00 |
125.00 |
- |
30.00 |
65.00 |
SGPT |
115.00 |
125.00 |
125.00 |
- |
30.00 |
65.00 |
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C. Dental |
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1. Treatment (Preventive periodontal therapy) |
50.00 |
50.00 |
50.00 |
- |
30.00 |
30.00 |
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2. Filing per tooth |
NA |
NA |
NA |
NA |
NA |
NA |
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3. Extraction per tooth |
32.00 |
32.00 |
32.00 |
- |
18.00 |
18.00 |
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4. Prophylaxis |
50.00 |
50.00 |
50.00 |
50.00 |
50.00 |
50.00 |