C.P.

Reyes Hospital Inc

Summary of Proposed OB Package

Clean Cases CS
Proposed New Package Ward Semi-Private Private
Proposed Price 28,650.00 30,600.00 32,950.00
Infection Control Fee OR 2,500.00 2,500.00 2,500.00
 NSD Infectious Cases
Ward Semi-Private Private Proposed New Package
22,650.00 24,600.00 26,500.00 Proposed Price
2,500.00 2,500.00 2,500.00 Infection Control Fee
 CS NSD
Private Private
35,050.00 27,400.00
2,500.00 2,500.00
C.P. Reyes Hospital Inc
OB Package 2020
NSD Ward
Total Hospital Package:
PHP 22,650.00

OR Package
Item Type Item Description QTY
Medical Supplies 1CC (OB PACKAGE) 1.00
Medical Supplies 3CC SYRINGE "TERUMO" 2.00
Medical Supplies 5 CC SYRINGE "TERUMO" 1.00
Medical Supplies CHERRIES W/ BETADINE 6.00
Medical Supplies CHROMIC 2.0 HR 38 (DOUBLE NEEDLE) (29405HF) 1.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 6.5 2.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 7 1.00
Medical Supplies KY SACHET "ORMED" 2.00
Medical Supplies O2 CANNULA ADULT(OB PACKAGE) 1.00
Medical Supplies OS 2/3 (5) 1.00
Medical Supplies RAZOR "KAI" 1.00
Medical Supplies Cord Clamp 1.00
Medical Supplies Straight Cath Fr. 16 1.00
Medical Supplies NEEDLE GA.27 "TERUMO" 1.00
Medicines NALBUPHINE 10MG/ML AMPULE (NUBAIN 10MG/ML AMPULE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines LIDOCAINE HCL (XYLOCAINE 2% 5ML POLYAMP) 1.00
ORDR use of suction machine 1.00
ORDR USE OF OR 1.00
ORDR USE OF OR - assist fee 1.00
ORDR Use of Minor Set 1.00
ORDR Use of Minor Pack 1.00
Medicines DIAZEPAM 10MG/2ML AMPULE(VALIUM 10MG/2ML AMPULE) 1.00
ORDR use of Doppler 1.00
ORDR Use of Pulse Oxymeter 1.00
ORDR Use of oxygen (2 hours) 2.00
ORDR Use of Labor Room 1.00

Pharmacy Package
Item Type Item Description QTY
Medical Supplies MACROSET NEEDLELESS(OB PACKAGE) 1.00
Medical Supplies MICROPORE 1(OB PACKAGE) 1.00
Medical Supplies SUPERCATH GAUGE 18(OB PACKAGE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines D5LR 1L (OB Package) 1.00
Medicines METHYLERGOMETRINE MALEATE NF (Ampule) 1.00

NICU Package
Item Type Item Description QTY
NICU NEWBORN 1.00
NICU Use of Infant Warmer 1.00
NICU Hearing Test 1.00
Medical Supplies Bonet 1.00
Medical Supplies Towel 1.00
Supplies Birth Certificate 1.00
Medicine Erythromycin 0.5% Opthalmic 3G Ointment 1.00
Medicine Vitamin K 1.00
NICU BCG 1.00
NICU Hepa B 1.00
Medical Supplies Gloves Gammex 1.00

Other Charges
Item Type Item Description QTY
Billing Room and Board 2.00
Billing CSR 1.00
Billing Miscellaneous 1.00
Billing Admission 1.00

Prepared by:

Princess Irish G. Saludo, CPA

Finance Director

Approved By:

Mary Carla Christine R. Sia,MBA,MHA,CHA,FPCHA

Chief Operating Officer
C.P. Reyes Hospital Inc
OB Package 2020
NSD Ward
Total Hospital Package:
PHP 22,650.00

OR Package Supplies/Meds OR
Item Type Item Description QTY
Medical Supplies 1CC (OB PACKAGE) 1.00
Medical Supplies 3CC SYRINGE "TERUMO" 2.00
Medical Supplies 5 CC SYRINGE "TERUMO" 1.00
Medical Supplies CHERRIES W/ BETADINE 6.00
Medical Supplies CHROMIC 2.0 HR 38 (DOUBLE NEEDLE) (29405HF) 1.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 6.5 2.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 7 1.00
Medical Supplies KY SACHET "ORMED" 2.00
Medical Supplies O2 CANNULA ADULT(OB PACKAGE) 1.00
Medical Supplies OS 2/3 (5) 1.00
Medical Supplies RAZOR "KAI" 1.00
Medical Supplies Cord Clamp 1.00
Medical Supplies Straight Cath Fr. 16 1.00
Medical Supplies NEEDLE GA.27 "TERUMO" 1.00
Medicines NALBUPHINE 10MG/ML AMPULE (NUBAIN 10MG/ML AMPULE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines LIDOCAINE HCL (XYLOCAINE 2% 5ML POLYAMP) 1.00
Medicines DIAZEPAM 10MG/2ML AMPULE(VALIUM 10MG/2ML AMPULE) 1.00
Medical Supplies MACROSET NEEDLELESS(OB PACKAGE) 1.00
Medical Supplies MICROPORE 1(OB PACKAGE) 1.00
Medical Supplies SUPERCATH GAUGE 18(OB PACKAGE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines D5LR 1L (OB Package) 1.00
Medicines METHYLERGOMETRINE MALEATE NF (Ampule) 1.00

OR Package OR
Item Type Item Description QTY

ORDR use of suction machine 1.00

ORDR USE OF OR 1.00
ORDR USE OF OR - assist fee 1.00
ORDR Use of Minor Set 1.00
ORDR Use of Minor Pack 1.00
ORDR use of Doppler 1.00
ORDR Use of Pulse Oxymeter 1.00
ORDR Use of oxygen (2 hours) 2.00
ORDR Use of Labor Room 1.00

NICU Package
Item Type Item Description QTY
NICU NEWBORN 1.00
NICU Use of Infant Warmer 1.00
NICU Hearing Test 1.00
Medical Supplies Bonet 1.00
Medical Supplies Towel 1.00
Supplies Birth Certificate 1.00
Medicine Erythromycin 0.5% Opthalmic 3G Ointment 1.00
Medicine Vitamin K 1.00
NICU BCG 1.00
NICU Hepa B 1.00
Medical Supplies Gloves Gammex 1.00

Other Charges
Item Type Item Description QTY
Billing Room and Board 2.00
Billing CSR 1.00
Billing Miscellaneous 1.00
Billing Admission 1.00
 22650

Price

2632.5

Price

275
4400
230
429
440
209
 423.5
314
605

7325.5

Price
1800
295
687
38
53
50
332
124
1672
3975
96

9122

Price
1500
270
300
1500

3570
C.P. Reyes Hospital Inc
OB Package 2020
NSD Semi-Private
Total Hospital Package:
PHP 24,600.00

OR Package
Item Type Item Description QTY
Medical Supplies 1CC (OB PACKAGE) 1.00
Medical Supplies 3CC SYRINGE "TERUMO" 2.00
Medical Supplies 5 CC SYRINGE "TERUMO" 1.00
Medical Supplies CHERRIES W/ BETADINE 6.00
Medical Supplies CHROMIC 2.0 HR 38 (DOUBLE NEEDLE) (29405HF) 1.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 6.5 2.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 7 1.00
Medical Supplies KY SACHET "ORMED" 2.00
Medical Supplies OS 2/3 (5) 1.00
Medical Supplies RAZOR "KAI" 1.00
Medical Supplies Cord Clamp 1.00
Medical Supplies Straight Cath Fr. 16 1.00
Medical Supplies NEEDLE GA.27 "TERUMO" 1.00
Medicines NALBUPHINE 10MG/ML AMPULE (NUBAIN 10MG/ML AMPULE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines LIDOCAINE HCL (XYLOCAINE 2% 5ML POLYAMP) 1.00
ORDR use of suction machine 1.00
ORDR USE OF OR 1.00
ORDR USE OF OR - assist fee 1.00
ORDR Use of Minor Set 1.00
ORDR Use of Minor Pack 1.00
Medicines DIAZEPAM 10MG/2ML AMPULE(VALIUM 10MG/2ML AMPULE) 1.00
ORDR use of Doppler 1.00
ORDR Use of Pulse Oxymeter 1.00
ORDR Use of oxygen (2 hours) 2.00
ORDR Use of Labor Room 1.00

Pharmacy Package
Item Type Item Description QTY
Medical Supplies MACROSET NEEDLELESS(OB PACKAGE) 1.00
Medical Supplies MICROPORE 1(OB PACKAGE) 1.00
Medical Supplies SUPERCATH GAUGE 18(OB PACKAGE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines D5LR 1L (OB Package) 1.00
Medicines METHYLERGOMETRINE MALEATE NF (Ampule) 1.00

NICU Package
Item Type Item Description QTY
NICU NEWBORN 1.00
NICU Use of Infant Warmer 1.00
NICU Hearing Test 1.00
Medical Supplies Bonet 1.00
Medical Supplies Towel 1.00
Supplies Birth Certificate 1.00
Medicine Erythromycin 0.5% Opthalmic 3G Ointment 1.00
Medicine Vitamin K 1.00
NICU BCG 1.00
NICU Hepa B 1.00
Medical Supplies Gloves Gammex 1.00

Other Charges
Item Type Item Description QTY
Billing Room and Board 2.00
Billing CSR 1.00
Billing Miscellaneous 1.00
Billing Admission 1.00

Prepared by:

Princess Irish G. Saludo, CPA

Finance Director

Approved By:

Mary Carla Christine R. Sia,MBA,MHA,CHA,FPCHA

Chief Operating Officer
C.P. Reyes Hospital Inc
OB Package 2020
NSD Private
Total Hospital Package:
PHP 26,500.00

OR Package
Item Type Item Description QTY
Medical Supplies 1CC (OB PACKAGE) 1.00
Medical Supplies 3CC SYRINGE "TERUMO" 2.00
Medical Supplies 5 CC SYRINGE "TERUMO" 1.00
Medical Supplies CHERRIES W/ BETADINE 6.00
Medical Supplies CHROMIC 2.0 HR 38 (DOUBLE NEEDLE) (29405HF) 1.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 6.5 2.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 7 1.00
Medical Supplies KY SACHET "ORMED" 2.00
Medical Supplies OS 2/3 (5) 1.00
Medical Supplies RAZOR "KAI" 1.00
Medical Supplies Cord Clamp 1.00
Medical Supplies Straight Cath Fr. 16 1.00
Medical Supplies NEEDLE GA.27 "TERUMO" 1.00
Medicines NALBUPHINE 10MG/ML AMPULE (NUBAIN 10MG/ML AMPULE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines LIDOCAINE HCL (XYLOCAINE 2% 5ML POLYAMP) 1.00
ORDR use of suction machine 1.00
ORDR USE OF OR 1.00
ORDR USE OF OR - assist fee 1.00
ORDR Use of Minor Set 1.00
ORDR Use of Minor Pack 1.00
Medicines DIAZEPAM 10MG/2ML AMPULE(VALIUM 10MG/2ML AMPULE) 1.00
ORDR use of Doppler 1.00
ORDR Use of Pulse Oxymeter 1.00
ORDR Use of oxygen (2 hours) 2.00
ORDR Use of Labor Room 1.00

Pharmacy Package
Item Type Item Description QTY
Medical Supplies MACROSET NEEDLELESS(OB PACKAGE) 1.00
Medical Supplies MICROPORE 1(OB PACKAGE) 1.00
Medical Supplies SUPERCATH GAUGE 18(OB PACKAGE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines D5LR 1L (OB Package) 1.00
Medicines METHYLERGOMETRINE MALEATE NF (Ampule) 1.00

NICU Package
Item Type Item Description QTY
NICU NEWBORN 1.00
NICU Use of Infant Warmer 1.00
NICU Hearing Test 1.00
Medical Supplies Bonet 1.00
Medical Supplies Towel 1.00
Supplies Birth Certificate 1.00
Medicine Erythromycin 0.5% Opthalmic 3G Ointment 1.00
Medicine Vitamin K 1.00
NICU BCG 1.00
NICU Hepa B 1.00
Medical Supplies Gloves Gammex 1.00

Other Charges
Item Type Item Description QTY
Billing Room and Board 2.00
Billing CSR 1.00
Billing Miscellaneous 1.00
Billing Admission 1.00

Prepared by:

Princess Irish G. Saludo, CPA

Finance Director

Approved By:

Mary Carla Christine R. Sia,MBA,MHA,CHA,FPCHA

Chief Operating Officer
C.P. Reyes Hospital Inc Carboprost +1 -Meds
OB Package 2020
CS Ward
Total Hospital Package:
PHP 28,650.00

OR Package
Item Type Item Description QTY
Medical Supplies 1CC (OB PACKAGE) 2.00
Medical Supplies 1CC SYRINGE "TERUMO" 2.00
Medical Supplies 3CC SYRINGE "TERUMO" 5.00
Medical Supplies 5 CC SYRINGE "TERUMO" 1.00
Medical Supplies BLADE 10 " FEATHER" 1.00
Medical Supplies CHERRIES W/ BETADINE 12.00
Medical Supplies CHROMIC 1 RN HR 40 REF 340N 2.00
Medical Supplies CHROMIC 2.0 HR 38 (DOUBLE NEEDLE) (29405HF) 1.00
Medical Supplies FOLEY CATH FR 16- 2WAY "RUSH" 1.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 6.5 5.00
Medical Supplies KY SACHET "ORMED" 1.00
Medical Supplies O2 CANNULA ADULT(OB PACKAGE) 1.00
Medical Supplies OS 2/3 (5) 1.00
Medical Supplies OS 4/4 (1) 1.00
Medical Supplies SPINAL NEEDLE GA.23 "TOP" 1.00
Medical Supplies URINE BAG (ADULT) ORDINARY (SECURE) 1.00
Medical Supplies VICRYL 1 RN (9431) / SKIN STAPLER WIDE PMW 35 / MONOCRYL + REVERSE CUTTING Y426 1.00
Medical Supplies VICRYL 4-0 CUTTING W9570 1.00
Medical Supplies SUCTION SET YANKUER 1.00
Medical Supplies Cord Clamp 1.00
Medical Supplies Straight Cath Fr. 16 1.00
Medical Supplies NEEDLE GA.27 "TERUMO" 1.00
Medical Supplies Dressing Set 1.00
Medicines NALBUPHINE 10MG/ML AMPULE (NUBAIN 10MG/ML AMPULE) 1.00
Medicines CEFUROXIME 750MG VIAL(ZOLTAX 750MG VIAL) 2.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines STERILE WATER FOR INJECTION 5ML (DH2O POLYAMPULE 5ML) 2.00
Medicines LIDOCAINE HCL (XYLOCAINE 2% 5ML POLYAMP) 1.00
Medicines TRAMADOL HYDROCHLORIDE 50MG/ML 2ML AMPULE (TDL 50MG/ML 2ML AMPULE) 3.00
Medicines BUPIVACAINE HCL 4ML AMPULE (SENSORCAINE HEAVY 4ML AMPULE) 1.00
ORDR use of suction machine 1.00
ORDR USE OF OR 1.00
ORDR USE OF OR - assist fee 1.00
ORDR Recovery Room/2HRS 1.00
ORDR Use of Pulse Oxymeter 1.00
ORDR Use of oxygen (2 hours) 2.00
ORDR Use of Major pack 1.00
ORDR Use of Major set 1.00

Pharmacy Package
Item Type Item Description QTY
Medical Supplies MACROSET NEEDLELESS(OB PACKAGE) 1.00
Medical Supplies MICROPORE 1(OB PACKAGE) 1.00
Medical Supplies SUPERCATH GAUGE 18(OB PACKAGE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines CARBOPROST (EVAPROST) 250MCG/1ML SOLN FOR INJECTION 1.00
Medicines D5LR 1L (OB Package) 3.00

NICU Package
Item Type Item Description QTY
NICU NEWBORN 1.00
NICU Use of Infant Warmer 1.00
NICU Hearing Test 1.00
Medical Supplies Bonet 1.00
Medical Supplies Towel 1.00
Supplies Birth Certificate 1.00
Medicine Erythromycin 0.5% Opthalmic 3G Ointment 1.00
Medicine Vitamin K 1.00
NICU BCG 1.00
NICU Hepa B 1.00
Medical Supplies Gloves Gammex 1.00

Other Charges
Item Type Item Description QTY
Billing Room and Board 3.00
Billing CSR 1.00
Billing Miscellaneous 1.00
Billing Admission 1.00

Prepared by:

Princess Irish G. Saludo, CPA

Finance Director

Approved By:

Mary Carla Christine R. Sia,MBA,MHA,CHA,FPCHA

Chief Operating Officer
C.P. Reyes Hospital Inc
OB Package 2020
CS Semi-Private
Total Hospital Package:
PHP 30,600.00

OR Package
Item Type Item Description QTY
Medical Supplies 10CC SYRINGE "TERUMO" 1.00
Medical Supplies 1CC (OB PACKAGE) 2.00
Medical Supplies 1CC SYRINGE "TERUMO" 2.00
Medical Supplies 3CC SYRINGE "TERUMO" 5.00
Medical Supplies 5 CC SYRINGE "TERUMO" 1.00
Medical Supplies BLADE 10 " FEATHER" 1.00
Medical Supplies CHERRIES W/ BETADINE 12.00
Medical Supplies CHROMIC 1 RN HR 40 REF 340N 2.00
Medical Supplies CHROMIC 2.0 HR 38 (DOUBLE NEEDLE) (29405HF) 1.00
Medical Supplies FOLEY CATH FR 16- 2WAY "RUSH" 1.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 6.5 5.00
Medical Supplies KY SACHET "ORMED" 1.00
Medical Supplies O2 CANNULA A. "ALLEGIANCE" 1.00
Medical Supplies OS 2/3 (5) 1.00
Medical Supplies OS 4/4 (1) 1.00
Medical Supplies SPINAL NEEDLE GA.23 "TOP" 1.00
Medical Supplies URINE BAG (ADULT) ORDINARY (SECURE) 1.00
Medical Supplies VICRYL 1 RN (9431) / SKIN STAPLER WIDE PMW 35 / MONOCRYL + REVERSE CUTTING Y426 1.00
Medical Supplies VICRYL 4-0 CUTTING W9570 1.00
Medical Supplies SUCTION SET YANKUER 1.00
Medical Supplies Cord Clamp 1.00
Medical Supplies Straight Cath Fr. 16 1.00
Medical Supplies NEEDLE GA.27 "TERUMO" 1.00
Medical Supplies Dressing Set 1.00
Medicines NALBUPHINE 10MG/ML AMPULE (NUBAIN 10MG/ML AMPULE) 1.00
Medicines CEFUROXIME 750MG VIAL(ZOLTAX 750MG VIAL) 2.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines STERILE WATER FOR INJECTION 5ML (DH2O POLYAMPULE 5ML) 2.00
Medicines LIDOCAINE HCL (XYLOCAINE 2% 5ML POLYAMP) 1.00
Medicines TRAMADOL HYDROCHLORIDE 50MG/ML 2ML AMPULE (TDL 50MG/ML 2ML AMPULE) 3.00
Medicines BUPIVACAINE HCL 4ML AMPULE (SENSORCAINE HEAVY 4ML AMPULE) 1.00
ORDR use of suction machine 1.00
ORDR USE OF OR 1.00
ORDR USE OF OR - assist fee 1.00
ORDR Recovery Room/2HRS 1.00
ORDR Use of Pulse Oxymeter 1.00
ORDR Use of oxygen (2 hours) 2.00
ORDR Use of Major pack 1.00
ORDR Use of Major set 1.00

Pharmacy Package
Item Type Item Description QTY
Medical Supplies MACROSET NEEDLELESS(OB PACKAGE) 1.00
Medical Supplies MICROPORE 1(OB PACKAGE) 1.00
Medical Supplies SUPERCATH GAUGE 18(OB PACKAGE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines CARBOPROST (EVAPROST) 250MCG/1ML SOLN FOR INJECTION 1.00
Medicines D5LR 1L (OB Package) 3.00

NICU Package
Item Type Item Description QTY
NICU NEWBORN 1.00
NICU Use of Infant Warmer 1.00
NICU Hearing Test 1.00
Medical Supplies Bonet 1.00
Medical Supplies Towel 1.00
Supplies Birth Certificate 1.00
Medicine Erythromycin 0.5% Opthalmic 3G Ointment 1.00
Medicine Vitamin K 1.00
NICU BCG 1.00
NICU Hepa B 1.00
Medical Supplies Gloves Gammex 1.00

Other Charges
Item Type Item Description QTY
Billing Room and Board 3.00
Billing CSR 1.00
Billing Miscellaneous 1.00
Billing Admission 1.00

Prepared by:

Princess Irish G. Saludo, CPA

Finance Director

Approved By:

Mary Carla Christine R. Sia,MBA,MHA,CHA,FPCHA

Chief Operating Officer
C.P. Reyes Hospital Inc
OB Package 2020
CS Private
Total Hospital Package:
PHP 32,950.00

OR Package
Item Type Item Description QTY
Medical Supplies 10CC SYRINGE "TERUMO" 1.00
Medical Supplies 1CC (OB PACKAGE) 2.00
Medical Supplies 1CC SYRINGE "TERUMO" 2.00
Medical Supplies 3CC SYRINGE "TERUMO" 5.00
Medical Supplies 5 CC SYRINGE "TERUMO" 1.00
Medical Supplies BLADE 10 " FEATHER" 1.00
Medical Supplies CHERRIES W/ BETADINE 12.00
Medical Supplies CHROMIC 1 RN HR 40 REF 340N 2.00
Medical Supplies CHROMIC 2.0 HR 38 (DOUBLE NEEDLE) (29405HF) 1.00
Medical Supplies FOLEY CATH FR 16- 2WAY "RUSH" 1.00
Medical Supplies DERMAPRENE HYPO-ALLERGENIC GLOVES SIZE 6.5 5.00
Medical Supplies KY SACHET "ORMED" 1.00
Medical Supplies O2 CANNULA A. "ALLEGIANCE" 1.00
Medical Supplies OS 2/3 (5) 1.00
Medical Supplies OS 4/4 (1) 1.00
Medical Supplies SPINAL NEEDLE GA.23 "TOP" 1.00
Medical Supplies URINE BAG (ADULT) ORDINARY (SECURE) 1.00
Medical Supplies VICRYL 1 RN (9431) / SKIN STAPLER WIDE PMW 35 / MONOCRYL + REVERSE CUTTING Y426 1.00
Medical Supplies VICRYL 4-0 CUTTING W9570 1.00
Medical Supplies SUCTION SET YANKUER 1.00
Medical Supplies Cord Clamp 1.00
Medical Supplies Straight Cath Fr. 16 1.00
Medical Supplies NEEDLE GA.27 "TERUMO" 1.00
Medical Supplies Dressing Set 1.00
Medicines NALBUPHINE 10MG/ML AMPULE (NUBAIN 10MG/ML AMPULE) 1.00
Medicines CEFUROXIME 750MG VIAL(ZOLTAX 750MG VIAL) 2.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines STERILE WATER FOR INJECTION 5ML (DH2O POLYAMPULE 5ML) 2.00
Medicines LIDOCAINE HCL (XYLOCAINE 2% 5ML POLYAMP) 1.00
Medicines TRAMADOL HYDROCHLORIDE 50MG/ML 2ML AMPULE (TDL 50MG/ML 2ML AMPULE) 3.00
Medicines BUPIVACAINE HCL 4ML AMPULE (SENSORCAINE HEAVY 4ML AMPULE) 1.00
ORDR use of suction machine 1.00
ORDR USE OF OR 1.00
ORDR USE OF OR - assist fee 1.00
ORDR Recovery Room/2HRS 1.00
ORDR Use of Pulse Oxymeter 1.00
ORDR Use of oxygen (2 hours) 2.00
ORDR Use of Major pack 1.00
ORDR Use of Major set 1.00

Pharmacy Package
Item Type Item Description QTY
Medical Supplies MACROSET NEEDLELESS(OB PACKAGE) 1.00
Medical Supplies MICROPORE 1(OB PACKAGE) 1.00
Medical Supplies SUPERCATH GAUGE 18(OB PACKAGE) 1.00
Medicines OXYTOCIN 10IU/ML AMPULE (ESTIMA 10 I.U./ML AMPULE) 1.00
Medicines CARBOPROST (EVAPROST) 250MCG/1ML SOLN FOR INJECTION 1.00
Medicines D5LR 1L (OB Package) 3.00

NICU Package
Item Type Item Description QTY
NICU NEWBORN 1.00
NICU Use of Infant Warmer 1.00
NICU Hearing Test 1.00
Medical Supplies Bonet 1.00
Medical Supplies Towel 1.00
Supplies Birth Certificate 1.00
Medicine Erythromycin 0.5% Opthalmic 3G Ointment 1.00
Medicine Vitamin K 1.00
NICU BCG 1.00
NICU Hepa B 1.00
Medical Supplies Gloves Gammex 1.00

Other Charges
Item Type Item Description QTY
Billing Room and Board 3.00
Billing CSR 1.00
Billing Miscellaneous 1.00
Billing Admission 1.00

Prepared by:

Princess Irish G. Saludo, CPA

Finance Director

Approved By:

Mary Carla Christine R. Sia,MBA,MHA,CHA,FPCHA

Chief Operating Officer