Latest Packages Ayushman Bharat and HIMCARE 3-Compressed

Health Benefit Package 2.
0 under Ayushman Bharat and HIMCARE
SL# ode PackageDescription PackageId urgical Amount ays Status Reserved Documents - Documents - LOS
Pre Claim Processing
Authorization
1 BM (Burns Thermal burns–% Total Body Surface BM001A S 7,000 3 Y N Clinical Notes, Post Treatment NA
Management) Area Burns (TBSA) - any % MLC copy with clinical photograph,
(not requiring admission). number, Extent lab tests or other
Needs at least 5-6 dressing of burns visible diagnostic
on photograph procedures done as
(with rule of 9 a part of treatment.
chart) Detailed clinical
notes.
2 BM (Burns Thermal burns–% Total Body Surface BM001B S 40,000 4 Y N Clinical Notes, Post Treatment 19
Management) Area Burns (TBSA): Upto 40 %; MLC copy with clinical photograph,
Includes % TBSA skin grafted, flap number, Extent lab tests, X-rays or
cover, follow-up dressings etc. as of upto 40% other diagnostic
deemed necessary; Surgical burns visible on procedures done as
procedures are required for deep photograph a part of treatment.
burns that are not amenable to heal (with rule of 9 Detailed discharge
with dressings alone. chart) summary.
3 BM (Burns Thermal burns–% Total Body Surface BM001C S 50,000 2 Y N Clinical Notes, Post Treatment 19
Management) Area Burns (TBSA): 40% - 60 %; MLC copy with clinical photograph,
cover, follow-up dressings etc. as of upto 40% - other diagnostic
deemed necessary; Surgical 60% burns procedures done as
procedures are required for deep visible on a part of treatment.
burns that are not amenable to heal photograph Detailed discharge
with dressings alone. (with rule of 9 summary.
chart)
4 BM (Burns Thermal burns–% Total Body Surface BM001D S 80,000 2 Y N Clinical Notes, Post Treatment 19
Management) Area Burns (TBSA): > 60 %; Includes MLC copy with clinical photograph,
% TBSA skin grafted, flap cover, number, Extent lab tests, X-rays or
follow-up dressings etc. as deemed > 60% burns other diagnostic
necessary; Surgical procedures are visible on procedures done as
required for deep burns that are not photograph a part of treatment.
amenable to heal with dressings (with rule of 9 Detailed discharge
alone. chart) summary.
5 BM (Burns Scald burns–% Total Body Surface BM002A S 7,000 3 Y N Clinical Notes, Post Treatment NA
(not requiring admission). number, Extent lab tests or other
Needs at least 5-6 dressing of burns visible diagnostic
chart) Detailed clinical
notes.
6 BM (Burns Scald burns–% Total Body Surface BM002B S 40,000 3 Y N Clinical Notes, Post Treatment 19
7 BM (Burns Scald burns–% Total Body Surface BM002C S 50,000 3 Y N Clinical Notes, Post Treatment 19
Management) Area Burns (TBSA): 40% - 60 %; MLC copy with clinical photograph,
chart)
8 BM (Burns Scald burns–% Total Body Surface BM002D S 80,000 5 Y N Clinical Notes, Post Treatment 19
9 BM (Burns Flame burns–% Total Body Surface BM003A S 7,000 5 Y N Clinical Notes, Post Treatment NA
(not requiring admission). number, Extent lab tests, X-rays or
Needs at least 5-6 dressing of burns visible other diagnostic
chart) Detailed discharge
summary.
10 BM (Burns Flame burns–% Total Body Surface BM003B S 40,000 3 Y N Clinical Notes, Post Treatment 19
11 BM (Burns Flame burns–% Total Body Surface BM003C S 50,000 3 Y N Clinical Notes, Post Treatment 19
Management) Area Burns (TBSA): 40 % - 60 %; MLC copy with clinical photograph,
chart)
12 BM (Burns Flame burns–% Total Body Surface BM003D S 80,000 2 Y N Clinical Notes, Post Treatment 19
13 BM (Burns Electrical contact burns–Electrical BM004A S 30,000 2 Y N Circumstances Post Treatment 19

Management) contact burns: Low voltage - without that led to low clinical photograph,
part of limb / limb loss; Includes % voltage lab tests, X-rays or
TBSA skin grafted, flap cover, follow- electrical other diagnostic
up dressings etc. as deemed contact burns, procedures done as
necessary; Surgical procedures are MLC copy with a part of treatment.
required for deep burns that are not number. % Detailed discharge
amenable to heal with dressings burns visible on summary. Detailed
alone. clinical Procedure /
photograph Operative Notes if
(with rule of 9 surgery done.
chart)
14 BM (Burns Electrical contact burns–Electrical BM004B S 40,000 2 Y N Circumstances Post Treatment 19

Management) contact burns: Low voltage - with part that led to low clinical photograph,
of limb / limb loss; Includes % TBSA voltage lab tests, X-rays or
skin grafted, flap cover, follow-up electrical other diagnostic
dressings etc. as deemed necessary; contact burns, procedures done as
Surgical procedures are required for MLC copy with a part of treatment.
deep burns that are not amenable to number. % Detailed discharge
heal with dressings alone. burns visible on summary. Detailed
clinical Procedure /
chart)
15 BM (Burns Electrical contact burns–Electrical BM004C S 60,000 4 Y N Circumstances Post Treatment 19
Management) contact burns: High voltage - with part that led to High clinical photograph,
of limb / limb loss; Includes % TBSA voltage lab tests, X-rays or
skin grafted, flap cover, follow-up electrical other diagnostic
dressings etc. as deemed necessary; contact burns, procedures done as
Surgical procedures are required for MLC copy with a part of treatment.
deep burns that are not amenable to number. % Detailed discharge
heal with dressings alone. burns visible on summary. Detailed
chart)
16 BM (Burns Electrical contact burns–Electrical BM004D S 50,000 1 Y N Circumstances Post Treatment 19

Management) contact burns: High voltage - without that led to High clinical photograph,
part of limb / limb loss; Includes % voltage lab tests, X-rays or
TBSA skin grafted, flap cover, follow- electrical other diagnostic
up dressings etc. as deemed contact burns, procedures done as
necessary; Surgical procedures are MLC copy with a part of treatment.
required for deep burns that are not number. % Detailed discharge
amenable to heal with dressings burns visible on summary. Detailed
alone. clinical Procedure /
chart)
17 BM (Burns Chemical burns–Chemical burns: BM005A S 40,000 4 Y N Circumstances Post Treatment 19

Management) Without significant facial scarring that led to clinical photograph
and/or loss of function; Includes % chemical burns, showing treated
TBSA skin grafted, flap cover, follow- MLC copy with burns, lab tests, X-
up dressings etc. as deemed number, % and rays or other
necessary; Surgical procedures are area burnt diagnostic
required for deep burns that are not visible on procedures done as
amenable to heal with dressings clinical a part of
alone. photograph treatment.Detailed
(with rule of 9 discharge summary.
chart) Detailed Procedure
/ Operative Notes if
surgery done.
18 BM (Burns Chemical burns–Chemical burns: BM005B S 60,000 1 Y N Circumstances Post Treatment 19
Management) With significant facial scarring and/or that led to clinical photograph
loss of function; Includes % TBSA chemical burns, showing treated
skin grafted, flap cover, follow-up MLC copy with burns, lab tests, X-
dressings etc. as deemed necessary; number, % and rays or other
Surgical procedures are required for area burnt diagnostic
deep burns that are not amenable to visible on procedures done as
heal with dressings alone. clinical a part of
photograph treatment.Detailed
(with rule of 9 discharge summary.
chart) Detailed Procedure
/ Operative Notes if
surgery done.
19 BM (Burns Post Burn Contracture surgeries for BM006A S 50,000 1 Y N Clinical history Post Treatment 10
Management) Functional Improvement–Post Burn detailing the clinical photograph,
Contracture surgeries for Functional burns - etiology, Detailed discharge
Improvement (Package including treatment given summary. Detailed
splints, pressure garments, silicone - and resultant Procedure /
gel sheet and physiotherapy): contractures Operative Notes.
Excluding Neck contracture; left. Functional
Contracture release with - Split disability to be
thickness Skin Graft (STSG) / Full detailed and
Thickness Skin Graft (FTSG) / Flap expected
cover is done for each joint with post - functional
operative regular dressings for STSG improvement to
/ FTSG / Flap cover. be shared. Pre-
op clinical
photograph.
20 BM (Burns Post Burn Contracture surgeries for BM006B S 50,000 1 Y N Clinical history Post Treatment 10
Management) Functional Improvement–Post Burn detailing the clinical photograph,
Contracture surgeries for Functional burns - etiology, Detailed discharge
Improvement (Package including treatment given summary. Detailed
splints, pressure garments, silicone - and resultant Procedure /
gel sheet and physiotherapy): Neck contractures Operative Notes.
contracture; Contracture release with - left. Functional
Split thickness Skin Graft (STSG) / disability to be
Full Thickness Skin Graft (FTSG) / detailed and
Flap cover is done for each joint with expected
post-operative regular dressings for functional
STSG / FTSG / Flap cover. improvement to
be shared. Pre-
op clinical
photograph.
21 ER (Emergency Laceration - Suturing / ER001A M 2,000 1 N N Clinical notes Clinical notes / NA

Room Packages) Dressing–Laceration - Suturing / with planned discharge summary
Dressing line of with planned line of
treatment with treatment & post
pre-clinical clinical photograph
photograph
22 ER (Emergency Cardiopulmonary ER002A M 2,000 1 N N Clinical notes Clinical notes / NA
Room Packages) emergency–Emergency with stable with planned discharge summary
cardiopulmonary status line of with planned line of
treatment, ECG treatment
23 ER (Emergency Cardiopulmonary ER002B M 10,000 2 N N Clinical notes Clinical notes / NA

Room Packages) emergency–Emergency with unstable with planned discharge summary
cardiopulmonary status with line of with planned line of
resuccitation treatment, ECG treatment
24 ER (Emergency Animal bites (Excluding Snake ER003A M 1,700 3 N N Classification of Beneficiary NA
Room Packages) Bite)–Animal bites (Excluding Snake bites with pre- signature / thumb
Bite) clinical impession; invoice /
photograph bar code sticker of
the vaccine, Clinical
Notes with complete
treatment details
given
25 IN (Interventional Dural AVMs / AVFs–Dural AVMs (per IN001A M 70,000 5 Y N Clinical notes Detailed Procedure 5
Neuroradiology) sitting) with glue and CT/MRI/ / Operative Notes.
DSA confirming Radiographic stills
the diagnosis photograph/CT/MRI/
Angio, Invoice / bar
code of glue used,
Detailed Discharge
Summary
26 IN (Interventional Dural AVMs / AVFs–Dural AVFs (per IN001B M 70,000 5 Y N Clinical notes Detailed Procedure 5
Neuroradiology) sitting) with glue and CT/MRI/ / Operative Notes.
code of glue used,
Detailed Discharge
Summary
27 IN (Interventional Dural AVMs / AVFs–Dural AVMs (per IN001C M 150,000 5 Y N Clinical notes Detailed Procedure 5
Neuroradiology) sitting) with onyx and CT/MRI/ / Operative Notes.
code of Onyx used,
Detailed Discharge
Summary
28 IN (Interventional Dural AVMs / AVFs–Dural AVFs (per IN001D M 150,000 5 Y N Clinical notes Detailed Procedure 5
Neuroradiology) sitting) with onyx and CT/MRI/ / Operative Notes.
code of Onyx used,
Detailed Discharge
Summary
29 IN (Interventional Cerebral & Spinal AVM embolization - IN002A M 100,000 2 Y N Clinical notes Detailed Procedure 5
Neuroradiology) Using Histoacryl (per sitting)–Cerebral and CT/MRI/ / Operative Notes.
AVM embolization - Using Histoacryl DSA confirming Radiographic stills
(per sitting) the diagnosis photograph/CT/MRI/
code of histoacryl
used, Detailed
Discharge
Summary
30 IN (Interventional Cerebral & Spinal AVM embolization - IN002B M 100,000 3 Y N Clinical notes Detailed Procedure 5
Neuroradiology) Using Histoacryl (per sitting)–Spinal and CT/MRI/ / Operative Notes.
AVM embolization - Using Histoacryl DSA confirming Radiographic stills
(per sitting) the diagnosis photograph/CT/MRI/
code of histoacryl
used, Detailed
Discharge
Summary
31 IN (Interventional Coil embolization for aneurysms IN003A M 124,000 2 Y N Clinical notes Post procedure x- 7
Neuroradiology) (includes cost of first 3 coils + balloon and CT ray showing coils;
and / or stent if used)–Coil Angio/MRA/ Detailed Procedure
embolization for aneurysms DSA confirming / Operative Notes.
(includes cost of first 3 coils + balloon the diagnosis Invoice / bar code of
and / or stent if used) for which the used coil / balloon /
procedure is stent, detailed
done discharge summary
32 IN (Interventional Carotico-cavernous Fistula (CCF) IN004A M 150,000 1 Y N Clinical notes Post procedure x- 7
Neuroradiology) embolization–Carotico-cavernous and CT/MRI/ ray showing coils;
Fistula (CCF) embolization with coils. DSA confirming Detailed Procedure
[includes 5 coils, guide catheter, micro the diagnosis / Operative Notes.
catheter, micro-guidewire, general Invoice / bar code of
items] used coil / catheter
and other
accessories,
detailed discharge
summary
33 IN (Interventional Carotico-cavernous Fistula (CCF) IN004B M 75,000 2 Y N Clinical notes Post procedure x- 7
Neuroradiology) embolization–Carotid-cavernous and CT/MRI/ ray showing balloon;
Fistula (CCF) embolization with DSA confirming Detailed Procedure
balloon the diagnosis / Operative Notes.
(includes one balloon, guide catheter, Invoice / bar code of
micro-catheter, micro-guidewire, used coil / catheter
general items) and other
accessories,
detailed discharge
summary
34 IN (Interventional Pre-operative tumour embolization IN005A M 40,000 5 Y N Clinical notes Intra procedure 5
Neuroradiology) (per session)–Pre-operative tumour and CT/MRI/ clinical photograph,
embolization DSA confirming Detailed discharge
(per session) the diagnosis summary, Detailed
Procedure /
Operative Notes.
Invoices / bar code
of embolic agent
used.
35 IN (Interventional Intracranial balloon angioplasty with IN006A M 160,000 1 Y N Clinical notes Intra procedure 3
Neuroradiology) stenting–Intracranial balloon and CT/MRI/ clinical photograph,
angioplasty with stenting DSA confirming Detailed discharge
the diagnosis summary, Detailed
Procedure /
Operative Notes.
Invoices / bar code
of balloon and stent
36 IN (Interventional Intracranial thrombolysis / clot IN007A M 160,000 3 Y N Clinical notes Intra procedure 3
Neuroradiology) retrieval–Intracranial thrombolysis / and CT/MRI/ clinical photograph,
clot retrieval DSA confirming Detailed discharge
Procedure /
Operative Notes.
Invoices / bar code
of thrombolytic
agentused.
37 IN (Interventional Balloon test occlusion–Balloon test IN008A M 70,000 3 Y N Clinical notes Intra procedure 3
Neuroradiology) occlusion and CT/MRI/ clinical photograph,
DSA confirming Detailed discharge
Procedure /
Operative Notes.
38 IN (Interventional Parent vessel occlusion - IN009A M 30,000 2 Y N Clinical notes Intra procedure still 3
Neuroradiology) Basic–Parent vessel occlusion - Basic and CT/MRI/ photograph showing
DSA confirming coil, Detailed
the diagnosis Procedure /
Operative Notes
with procedure
deployed; detailed
discharge summary;
invoice / bar code of
coil used
39 IN (Interventional Vertebroplasty –Vertebroplasty IN010A M 40,000 3 Y N Clinical notes Intra procedure 3
Neuroradiology) and CT/MRI clinical photograph,
confirming the Detailed discharge
diagnosis and summary, Detailed
need of Procedure /
procedure; Operative Notes.
MLC/ FIR if Invoices of cement
traumatic used.
40 MC (Cardiology) Right / Left Heart MC001A S 5,000 2 Y N Clinical notes Discharge 2

Catheterization–Right Heart with planned summary,
Catheterization line of Procedure /
treatment, Operative Notes.
ECG, ECHO Invoices of catherter
and other
accesories used.
41 MC (Cardiology) Right / Left Heart Catheterization–Left MC001B S 5,000 5 Y N Clinical notes Discharge 2
Heart Catheterization with planned summary,
line of Procedure /
treatment, Operative Notes.
ECG, ECHO Invoices of catherter
and other
accesories used.
42 MC (Cardiology) Catheter directed Thrombolysis–For MC002A S 30,800 1 Y N Clinical notes Post procedure 2
Deep vein thrombosis (DVT) and doppler Colour Doppler of
establishing affected limb/part,
presence of invoice of catheter
DVT used, invoice of the
thrombolytic drug
(tPA) used, Detailed
Discharge
Summary.
43 MC (Cardiology) Catheter directed Thrombolysis–For MC002B S 30,800 4 Y N Clinical notes Post procedure 2
Mesenteric Thrombosis and doppler Colour Doppler of
mesentric used, invoice of the
thrombosis thrombolytic drug
(tPA) used, Detailed
Discharge
Summary.
44 MC (Cardiology) Catheter directed Thrombolysis–For MC002C S 30,800 1 Y N Clinical notes Post procedure 2
Peripheral vessels and doppler Colour Doppler of
peripheral used, invoice of the
vessel thrombolytic drug
thrombosis (tPA) used, Detailed
Discharge
Summary.
45 MC (Cardiology) Balloon Dilatation–Coartication of MC003A S 71,600 2 Y N ECHO & CT Procedure / 2
Aorta angiogram Operative Notes
report & stills with images, Post
Procedure images /
Angiogram, barcode
of balloon used,
Detailed Discharge
Summary
46 MC (Cardiology) Balloon Dilatation–Pulmonary Artrey MC003B S 71,600 2 Y N ECHO & CT Procedure / 2

Stenosis angiogram Operative Notes
report & stills with images, Post
Procedure images /
Angiogram, barcode
of balloon used,
Detailed Discharge
Summary
47 MC (Cardiology) Balloon Pulmonary / Aortic MC004A S 56,400 2 Y N Clinical notes Procedure / 2
Valvotomy–Balloon Pulmonary with planned Operative notes
Valvotomy line of with still images,
treatment and Post procedure stills
ECHO report of Echo with report;
with stills. Invoice of blade /
balloon used,
Detailed Discharge
Summary .
48 MC (Cardiology) Balloon Pulmonary / Aortic MC004B S 56,400 2 Y N Clinical notes Procedure / 2

Valvotomy–Balloon Aortic Valvotomy with planned Operative notes
line of with still images,
balloon used,
Detailed Discharge
Summary .
49 MC (Cardiology) Balloon Mitral Valvotomy–Balloon MC005A S 90,700 2 Y N Clinical notes Procedure / 2

Mitral Valvotomy with planned Operative notes
line of with still images,
balloon used,
Detailed Discharge
Summary .
50 MC (Cardiology) Balloon Atrial Septostomy–Balloon MC006A S 24,400 2 Y N Clinical notes Procedure / 2

Atrial Septostomy and ECHO / Operative notes
and doppler with still images,
stills + reports Post procedure stills
showing the of ECHO with
transposition of report; Invoice of
the great blade / balloon
arteries (TGA) used, Detailed
& need of Discharge
septostomy Summary .
51 MC (Cardiology) ASD Device Closure–ASD Device MC007A S 98,900 2 Y N Clinical notes Procedure / 2
Closure and ECHO Operative notes
report showing with still images,
ASD Post procedure stills
of ECHO with
report; Invoice of
blade / device used,
Detailed Discharge
Summary .
52 MC (Cardiology) VSD Device Closure–VSD Device MC008A S 109,900 2 Y N Clinical notes Procedure / 2
VSD Post procedure stills
of ECHO with
report; Invoice of
Detailed Discharge
Summary .
53 MC (Cardiology) PDA Device Closure–PDA Device MC009A S 55,000 2 Y N Clinical notes Procedure / 2
PDA Post procedure stills
of ECHO with
report; Invoice of
Detailed Discharge
Summary .
54 MC (Cardiology) PDA stenting–PDA stenting MC010A S 71,860 2 Y N Clinical notes Procedure / 2
and ECHO Operative notes
report / Angio with still images,
showing PDA Post procedure stills
of ECHO with
report; Invoice of
blade / barcode of
stent used, barcode
of the stent used,
Detailed Discharge
Summary .
55 MC (Cardiology) PTCA, inclusive of diagnostic MC011A S 72,200 3 Y N ECG, ECHO, Procedure / 2

angiogram–PTCA, inclusive of CAG stills Operative notes
diagnostic angiogram showing blocks with still images,
& Reports Angiogram report,
showing stent &
post Stent flow +
barcode of the
stents used,
Detailed Discharge
Summary
56 MC (Cardiology) Electrophysiological MC012A S 66,000 5 Y N Clinical notes Discharge 1
Study–Electrophysiological Study with planned summary, EP study
line of report
treatment,
ECG, ECHO,
Serum
Elctrolytes
57 MC (Cardiology) Electrophysiological MC012B S 96,000 1 Y N Clinical notes Discharge 1
Study–Electrophysiological Study with planned summary, EP study
with Radio Frequency Ablation line of report, Procedure /
treatment, Operative Notes
ECG, ECHO,
Serum
Elctrolytes
58 MC (Cardiology) Percutaneous Transluminal Septal MC013A S 34,000 4 Y N Clinical notes Angiogram report 2
Myocardial Ablation–Percutaneous and ECG, with stills, showing
Transluminal Septal Myocardial ECHO, CAG stent & post Stent
Ablation stills showing flow + barcode /
blaocks Invoice of the stent
justifying the used
procedure
59 MC (Cardiology) Temporary Pacemaker MC014A S 19,200 4 Y N Clinical notes X Ray showing the 2
implantation–Temporary Pacemaker and ECG + pacemaker in situ;
implantation Report by detailed discharge
cardiologist summary, Detailed
necessitating Procedure /
procedure Operative Notes;
Invoice / barcode of
pacemaker
60 MC (Cardiology) Single Chamber Permanent MC015A S 69,500 5 Y N Clinical notes X Ray showing the 2
Pacemaker Implantation–Permanent and ECG + pacemaker in situ,
Pacemaker Implantation - Report by Invoice / Barcode of
Single Chamber cardiologist designated
necessitating pacemaker.
procedure; Detailed Procedure
Angiogram if / Operative Notes,
done detailed discharge
summary
61 MC (Cardiology) Double Chamber Permanent MC016A S 108,000 1 Y N Clinical notes X Ray showing the 2
Pacemaker Implantation –Permanent and ECG + pacemaker in situ,
Pacemaker Implantation - Report by Invoice / Barcode of
Double Chamber cardiologist designated
necessitating pacemaker.
procedure; Detailed Procedure
Angiogram if / Operative Notes,
done detailed discharge
summary
62 MC (Cardiology) Peripheral Angioplasty–Peripheral MC017A S 55,500 3 Y N ECHO, Post op. Angiogram 2
Angioplasty Doppler, Angio report/ stills,
stills showing showing stent;
blocks & Implant / barcode of
Reports stent used
63 MC (Cardiology) Bronchial artery Embolisation MC018A S 32,800 7 Y N Clinical notes Check Angiography 3
(for Haemoptysis)–Bronchial artery and Chest X- of same bronchial
Embolisation Ray / HRCT artery after the
(for Haemoptysis) chest with CT procedure. Detailed
Pulmonary discharge summary;
Angiogram & Detailed Procedure
other / Operative Notes,
investigations Hb, Serum
Creatinine
64 MC (Cardiology) Pericardiocentesis–Pericardiocentesis MC019A S 12,100 2 Y N Clinical notes Intra procedure 1

and ECHO clinical photograph,
report justifying post procedure
need of ECHO report;
procedure Analysis of fluid
removed.
65 MC (Cardiology) Systemic Thrombolysis (for MC020A S 17,900 3 Y N Serial ECGs ECHO, ECG, Lab 3
MI)–Systemic Thrombolysis (for MI) showing MI, Investigation (TROP
Cardiac - T report); invoice /
markers - CPK- barcode of
MB, TROP I or thrombolytic agent
TROP T used
66 MG (General Acute febrile illness–Acute febrile MG001A M Package 3 N N Clinical notes Detailed ICPs, NA
Medicine) illness Amount per detailing history Treatment details,
day (drop and Admission detailed discharge
down) for notes showing summary, All
admission vitals and investigations
type: Routine examination reports.
ward (Rs findings; any
1800)/ HDU investigations
(Rs (Rs 2700)/ done; planned
ICU (without line of
ventilator) (Rs management
3600)/ ICU
(with
ventilator)(Rs
4500)
67 MG (General Severe sepsis–Severe sepsis MG002A M Package 3 N N Clinical notes Detailed ICPs, NA
Medicine) Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
68 MG (General Severe sepsis–Septic shock MG002B M Package 2 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
69 MG (General Malaria–Malaria MG003A M Package 3 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
70 MG (General Malaria–Complicated malaria MG003B M Package 2 N N Clinical notes Detailed ICPs, NA

3600)/ ICU
(with
ventilator)(Rs
4500)
71 MG (General Dengue fever–Dengue fever MG004A M Package 5 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
72 MG (General Dengue fever–Dengue hemorrhagic MG004B M Package 3 N N Clinical notes Detailed ICPs, NA
Medicine) fever Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
73 MG (General Dengue fever–Dengue shock MG004C M Package 2 N N Clinical notes Detailed ICPs, NA
Medicine) syndrome Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
74 MG (General Chikungunya fever–Chikungunya MG005A M Package 2 N N Clinical notes Detailed ICPs, NA

Medicine) fever Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
75 MG (General Enteric fever–Enteric fever MG006A M Package 5 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
76 MG (General HIV with complications–HIV with MG007A M Package 1 N N Clinical notes Detailed ICPs, NA
Medicine) complications Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
77 MG (General Leptospirosis–Leptospirosis MG008A M Package 2 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
78 MG (General Acute gastroenteritis with MG009A M Package 5 N N Clinical notes Detailed ICPs, NA
Medicine) dehydration–Acute gastroenteritis with Amount per detailing history Treatment details,
moderate dehydration day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
79 MG (General Acute gastroenteritis with MG009B M Package 5 N N Clinical notes Detailed ICPs, NA
Medicine) dehydration–Acute gastroenteritis with Amount per detailing history Treatment details,
severe dehydration day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
80 MG (General Diarrohea–Chronic diarrohea MG010A M Package 6 N N Clinical notes Detailed Discharge NA

Medicine) Amount per with planned Summary, any other
day (drop line of investigations done
down) for treatment
admission
type: Routine
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
81 MG (General Diarrohea–Persistent diarrohea MG010B M Package 5 N N Clinical notes Detailed Discharge NA
Medicine) Amount per with planned Summary summary,
day (drop line of any other
down) for treatment; stool investigations done
admission examintaion
type: Routine
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
82 MG (General Dysentery–Dysentery MG011A M Package 5 N N Clinical notes Detailed ICPs, NA

3600)/ ICU
(with
ventilator)(Rs
4500)
83 MG (General Acute viral hepatitis–Acute viral MG012A M Package 5 N N Clinical notes Detailed ICPs, NA
Medicine) hepatitis Amount per with planned Treatment details,
day (drop line of detailed discharge
down) for treatment, LFT, summary, All
admission USG - Whole investigations
type: Routine Abdomen reports.
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
84 MG (General Chronic Hepatitis–Chronic Hepatitis MG013A M Package 5 N N Clinical notes Detailed ICPs, NA
Medicine) Amount per with planned Treatment details,
down) for treatment, LFT, summary, All
admission USG - Whole investigations
type: Routine Abdomen reports.
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
85 MG (General Liver abscess–Liver abscess MG014A M Package 5 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
86 MG (General Visceral leishmaniasis–Visceral MG015A M Package 3 N N Clinical notes Detailed ICPs, NA

Medicine) leishmaniasis Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
87 MG (General Pneumonia–Pneumonia MG016A M Package 4 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
88 MG (General Severe pneumonia–Severe MG017A M Package 1 N N Clinical notes Detailed ICPs, NA

Medicine) pneumonia Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
89 MG (General Empyema–Empyema MG018A M Package 4 N N Clinical notes Post Treatment X- NA
Medicine) Amount per with planned ray chest, Detailed
day (drop line of Discharge
down) for treatment, Summary
admission CBC, X ray
type: Routine chest
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
90 MG (General Lung abscess–Lung abscess MG019A M Package 2 N N Clinical notes Post Treatment X- NA
Medicine) Amount per with planned ray chest, CBC,
day (drop line of Detailed Discharge
down) for treatment , X- summary.
admission ray chest, CBC
type: Routine and any other
ward (Rs investigations
1800)/ HDU done, planned
(Rs (Rs 2700)/ line of
ICU (without management
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
91 MG (General Pericardial / Pleural MG020A M Package 3 N N Clinical notes Detailed ICPs, NA
Medicine) tuberculosis–Pericardial tuberculosis Amount per detailing history Treatment details,
ward (Rs findings;
(Rs (Rs 2700)/ done
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
92 MG (General Pericardial / Pleural MG020B M Package 5 N N Clinical notes Detailed ICPs, NA

Medicine) tuberculosis–Pleural tuberculosis Amount per detailing history Treatment details,
ward (Rs findings;
(Rs (Rs 2700)/ done
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
93 MG (General Urinary Tract Infection–Urinary Tract MG021A M Package 1 N N Clinical notes Detailed ICPs, NA
Medicine) Infection Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
94 MG (General Viral encephalitis–Viral encephalitis MG022A M Package 5 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
95 MG (General Septic Arthritis –Septic Arthritis MG023A M Package 5 Y N Clinical notes Post treatment X- NA
Medicine) Amount per with planned ray / Radiological
day (drop line of evidence, CBC,
down) for treatment, Detailed Discharge
admission CBC, X-ray of Summary
type: Routine the affected
ward (Rs joint
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
96 MG (General Skin and soft tissue infections –Skin MG024A M Package 4 Y N Clinical notes Detailed ICPs, NA
Medicine) and soft tissue infections Amount per with planned Treatment details,
down) for treatment, CBC summary, All
admission investigations
type: Routine reports including
ward (Rs CBC
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
97 MG (General Recurrent vomiting with MG025A M Package 6 N N Clinical notes Detailed ICPs, NA
Medicine) dehydration–Recurrent vomiting with Amount per detailing history Treatment details,
dehydration day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
98 MG (General Pyrexia of unknown origin–Pyrexia of MG026A M Package 7 N N Clinical notes Detailed ICPs, NA
Medicine) unknown origin Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
99 MG (General Bronchiectasis–Bronchiectasis MG027A M Package 2 Y N X ray-Chest, Post treatment X- NA
Medicine) Amount per Clinical notes ray / Radiological
day (drop with planned evidence, Detailed
down) for line of Discharge
admission treatment Summary, Detailed
type: Routine ICPs, Treatment
ward (Rs details, All
(Rs (Rs 2700)/ reports.
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
100 MG (General Acute bronchitis–Acute bronchitis MG028A M Package 2 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
101 MG (General Acute excaberation of COPD–Acute MG029A M Package 1 N N Clinical notes Detailed ICPs, NA
Medicine) excaberation of COPD Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
102 MG (General Acute excaberation of Interstitial Lung MG030A M Package 5 N N Clinical notes Detailed ICPs, NA
Medicine) Disease–Acute excaberation of Amount per detailing history Treatment details,
Interstitial Lung Disease day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
103 MG (General Endocarditis–Bacterial Endocarditis MG031A M Package 4 N N Clinical notes Blood culture NA
Medicine) Amount per with planned reports, Post
day (drop line of treatment ECHO,
admission ECHO, CBC Summary, Detailed
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
104 MG (General Endocarditis–Fungal Endocarditis MG031B M Package 2 N N Clinical notes Blood culture NA
Medicine) Amount per with planned reports, Post
day (drop line of treatment ECHO,
admission ECHO, CBC Summary, Detailed
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
105 MG (General Vasculitis–Vasculitis MG032A M Package 6 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
106 MG (General Pancreatitis–Acute pancreatitis MG033A M Package 3 N N Cliical notes, Sr Post treatment Sr NA
Medicine) Amount per Amylase, Amylase, Lipase,
day (drop Lipase, LFT, LFT, USG-
down) for CBC, USG- abdomen Detailed
admission abdomen Discharge
type: Routine Summary
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
107 MG (General Pancreatitis–Chronic pancreatitis MG033B M Package 1 N N Cliical notes, Sr Post treatment Sr NA
Medicine) Amount per Amylase, Amylase, Lipase,
day (drop Lipase, LFT, LFT, USG-
down) for CBC, USG- abdomen Detailed
admission abdomen Discharge
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
108 MG (General Ascites–Ascites MG034A M Package 2 Y N Clinial notes, Ascitic Fluid NA

Medicine) Amount per LFT, CBC, Analysis and
day (drop USG- abdomen Culture Report,
down) for Detailed Discharge
admission Summary,
type: Routine
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
109 MG (General Acute transverse myelitis–Acute MG035A M Package 3 N N Clinical notes Detailed ICPs, NA
Medicine) transverse myelitis Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
110 MG (General Atrial Fibrillation –Atrial Fibrillation MG036A M Package 3 N N Clinical notes Post treatment NA
Medicine) Amount per with planned ECG, Detailed
day (drop line of Discharge
down) for treatment, Summary, Detailed
admission ECG, Sr ICPs, Treatment
type: Routine Electrolytes details, All
1800)/ HDU reports.
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
111 MG (General Cardiac Tamponade –Cardiac MG037A M Package 7 N N Clincal notes, Post treatment 2D NA
Medicine) Tamponade Amount per 2D echo echo, Fluid
day (drop Aspirated report,
down) for Procedure notes,
admission Detailed Discharge
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
112 MG (General Congestive heart failure–Congestive MG038A M Package 7 N N Clinical notes Detailed ICPs, NA
Medicine) heart failure Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
113 MG (General Asthma–Acute asthmatic attack MG039A M Package 5 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
114 MG (General Asthma–Status asthmaticus MG039B M Package 2 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
115 MG (General Respiratory failure–Type 1 respiratory MG040A M Package 3 N N Clinical notes Detailed ICPs, NA
Medicine) failure Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
116 MG (General Respiratory failure–Type 2 respiratory MG040B M Package 3 N N Clinical notes Detailed ICPs, NA
Medicine) failure Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
117 MG (General Respiratory failure–Due to any cause MG040C M Package 2 N N Clinical notes Detailed ICPs, NA
Medicine) (pneumonia, asthma, COPD, ARDS, Amount per detailing history Treatment details,
foreign body, poisoning, head injury day (drop and Admission detailed discharge
etc.) down) for notes showing summary, All
ventilator) (Rs management,
3600)/ ICU Copy of MLC /
(with FIR (if required)
ventilator)(Rs
4500)
118 MG (General Upper GI bleeding–Upper GI bleeding MG041A M Package 6 N N Clinical notes Detailed ICPs, NA
Medicine) (conservative) Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
119 MG (General Upper GI bleeding–Upper GI bleeding MG041B M Package 5 N N Clinical notes Detailed ICPs, NA
Medicine) (endoscopic) Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
120 MG (General Lower GI hemorrhage–Lower GI MG042A M Package 2 N N Clinical notes Detailed ICPs, NA
Medicine) hemorrhage Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
121 MG (General Addison’s disease –Addison’s disease MG043A M Package 2 Y N Clincal notes, Post treatment NA
Medicine) Amount per Sr. Cortisol cortisol levels,
day (drop levels, USG- Detailed Discharge
down) for abdomen Summary
admission
type: Routine
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
122 MG (General Renal colic–Renal colic MG044A M Package 6 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
123 MG (General AKI / Renal failure–AKI / Renal failure MG045A M Package 2 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
124 MG (General Seizures–Seizures MG046A M Package 5 N N Clinical notes Detailed ICPs, NA

3600)/ ICU
(with
ventilator)(Rs
4500)
125 MG (General Status epilepticus–Status epilepticus MG047A M Package 1 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
126 MG (General Cerebrovascular MG048A M Package 6 N N Clinical notes Detailed ICPs, NA

Medicine) accident–Cerebrovascular accident Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
127 MG (General Cerebral sino-venous thrombosis / MG049A M Package 6 N N Clinical notes Detailed ICPs, NA
Medicine) Stroke–Cerebral sino-venous Amount per detailing history Treatment details,
thrombosis day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
128 MG (General Cerebral sino-venous thrombosis / MG049B M Package 6 N N Clinical notes Detailed ICPs, NA
Medicine) Stroke–Acute stroke Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
129 MG (General Cerebral sino-venous thrombosis / MG049C M Package 6 N N Clinical notes Detailed ICPs, NA
Medicine) Stroke–Acute ischemic stroke Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
130 MG (General Cerebral sino-venous thrombosis / MG049D M Package 2 N N Clinical notes Detailed ICPs, NA
Medicine) Stroke–Acute heamorrhagic stroke Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
131 MG (General Immune mediated CNS MG050A M Package 3 N N Clinical notes Detailed ICPs, NA
Medicine) disorders–Immune mediated CNS Amount per detailing history Treatment details,
disorders day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
132 MG (General Hydrocephalus–Hydrocephalus MG051A M Package 3 N N Clinical notes Detailed ICPs, NA

3600)/ ICU
(with
ventilator)(Rs
4500)
133 MG (General Myxedema coma –Myxedema coma MG052A M Package 4 Y N Clinical notes Post treatment NA
Medicine) Amount per with planned Thyroid Profile,
down) for treatment, Summary
admission Throid profile,
type: Routine USG- Thyroid
ward (Rs Gland
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
134 MG (General Thyrotoxic crisis –Thyrotoxic crisis MG053A M Package 2 N N Clinical notes Radionuclide Iodine NA
Medicine) Amount per with planned uptake study, Post
day (drop line of treatment Thyroid
down) for treatment, Profile, Detailed
admission Throid profile, Discharge
type: Routine USG- Thyroid Summary
ward (Rs Gland
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
135 MG (General Gout –Gout MG054A M Package 2 Y N Clinical notes Detailed Discharge NA
Medicine) Amount per with planned Summary
day (drop line of
down) for treatment,
admission Sr.Uric acid
type: Routine
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
136 MG (General Pneumothroax–Pneumothroax MG055A M Package 5 N N Clinical notes Detailed ICPs, NA

3600)/ ICU
(with
ventilator)(Rs
4500)
137 MG (General Neuromuscular MG056A M Package 0 N N Clinical notes Detailed ICPs, NA
Medicine) disorders–Neuromuscular disorders Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
138 MG (General Hypoglycemia–Hypoglycemia MG057A M Package 0 N N Clincal notes, Post treatment NA

Medicine) Amount per Blood sugar Blood sugar levels,
day (drop level Hba1C, Detailed
down) for Discharge
admission Summary
type: Routine
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
139 MG (General Diabetic Foot–Diabetic Foot MG058A M Package 0 Y N Clincal profile, Post treatment NA
Medicine) Amount per Blood sugar Blood sugar levels,
day (drop level,CBC, Hba1C, Photograph
down) for Photograph of of the affected foot,
admission the affected Detailed Discharge
type: Routine foot Summary
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
140 MG (General Diabetic ketoacidosis–Diabetic MG059A M Package 0 N N Clinical notes Detailed ICPs, NA
Medicine) ketoacidosis Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
141 MG (General Electrolyte Imbalance–Hypercalcemia MG060A M Package 0 N N Clinical notes Post treatment NA
Medicine) Amount per with planned Serum Calcium,
admission Serum Calcium ICPs, Treatment
type: Routine details, All
1800)/ HDU reports.
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
142 MG (General Electrolyte Imbalance–Hypocalcemia MG060B M Package 6 N N Clinical notes Post treatment NA
Medicine) Amount per with planned Serum Calcium,
admission Serum Calcium ICPs, Treatment
type: Routine details, All
1800)/ HDU reports.
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
143 MG (General Electrolyte Imbalance–Hyponatremia MG060C M Package 6 N N Clinical notes Post treatment NA
Medicine) Amount per with planned Serum Electrolytes,
admission Serum ICPs, Treatment
1800)/ HDU reports.
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
144 MG (General Electrolyte Imbalance–Hypernatremia MG060D M Package 0 N N Clinical notes Post treatment NA
Medicine) Amount per with planned Serum Electrolytes,
admission Serum ICPs, Treatment
1800)/ HDU reports.
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
145 MG (General Hyperosmolar Non-Ketotic MG061A M Package 0 N N Clinical notes Detailed ICPs, NA
Medicine) coma–Hyperosmolar Non-Ketotic Amount per detailing history Treatment details,
coma day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
146 MG (General Accelerated MG062A M Package 0 N N Clinical notes Detailed ICPs, NA

Medicine) hypertension–Accelerated Amount per detailing history Treatment details,
hypertension day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
147 MG (General Hypertensive MG063A M Package 0 N N Clinical notes Detailed ICPs, NA
Medicine) emergencies–Hypertensive Amount per detailing history Treatment details,
emergencies day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
148 MG (General Severe anemia–Severe anemia MG064A M Package 0 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
149 MG (General Sickle cell Anemia–Sickle cell Anemia MG065A M Package 1 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
150 MG (General Anaphylaxis –Anaphylaxis MG066A M Package 0 N N Clinical notes Detailed ICPs, NA
Medicine) Amount per with planned Treatment details,
down) for treatment, CBC summary, All
admission investigations
type: Routine reports.
ward (Rs
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
151 MG (General Heat stroke–Heat stroke MG067A M Package 0 N N Clinical notes Detailed ICPs, NA
day (drop leading to this detailed discharge
down) for hospitalization summary, All
admission and Admission investigations
type: Routine notes showing reports.
ward (Rs vitals and
1800)/ HDU examination
(Rs (Rs 2700)/ findings; any
ICU (without investigations
ventilator) (Rs done; planned
3600)/ ICU line of
(with management
ventilator)(Rs
4500)
152 MG (General Systematic lupus MG068A M Package 0 N N Clinical notes Detailed ICPs, NA
Medicine) erythematosus–Systematic lupus Amount per detailing history Treatment details,
erythematosus day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
153 MG (General Guillian Barre Syndrome–Guillian MG069A M Package 1 N N Clinical notes Report of test NA
Medicine) Barre Syndrome Amount per and Admission blocked.
day (drop notes detailed
down) for the need for
admission High end
type: Routine histopathology
ward (Rs (Biopsies) and
1800)/ HDU advanced
(Rs (Rs 2700)/ serology
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
154 MG (General Snake bite–Snake bite MG070A M Package 1 N N Clinical notes Detailed ICPs, NA
type: Routine neurological reports.
ward (Rs examination
1800)/ HDU findings; any
(Rs (Rs 2700)/ investigations
ICU (without done; planned
ventilator) (Rs line of
3600)/ ICU management
(with
ventilator)(Rs
4500)
155 MG (General Poisoning–Acute organophosphorus MG071A M Package 1 N N Clinical notes Detailed ICPs, NA
Medicine) poisoning Amount per detailing history Treatment details,
3600)/ ICU management,
(with Copy of MLC /
ventilator)(Rs FIR
4500)
156 MG (General Poisoning–Other poisonings MG071B M Package 0 N N Clinical notes Detailed ICPs, NA
3600)/ ICU management,
(with Copy of MLC /
ventilator)(Rs FIR
4500)
157 MG (General Haemodialysis / Peritoneal MG072A M 1,500 0 Y N Clinical notes Detailed ICPs, Daycare
Medicine) Dialysis–Haemodialysis Dialysis detailing history Treatment details,
and Admission detailed discharge
notes showing summary, All
vitals and investigations
examination reports.
findings; any
investigations
done; planned
line of
management
158 MG (General Haemodialysis / Peritoneal MG072B M 1,500 0 Y N Clinical notes Detailed ICPs, Daycare
Medicine) Dialysis–Peritoneal Dialysis detailing history Treatment details,
findings; any
investigations
done; planned
line of
management
159 MG (General Plasmapheresis–Plasmapheresis MG073A M 2,000 3 N N Clinical notes Detailed ICPs, Daycare
Medicine) detailing history Treatment details,
findings; any
investigations
done; planned
line of
management
160 MG (General Blood transfusion–Whole Blood MG074A M 2,000 5 N N Clinical notes Detailed ICPs, Post Daycare
Medicine) transfusion with planned treatment Complete
line of hemogram, Detailed
treatment, Discharge
Complete Summary
Hemogram,
Blood Group,
Planned line of
treatment
161 MG (General Blood transfusion–Blood component MG074B M 2,000 5 N N Clinical notes Detailed ICPs, Post Daycare
Medicine) including platelet transfusion (RDP, with planned treatment Complete
PC, SDP) line of hemogram, Detailed
treatment, Discharge
Complete Summary
Hemogram,
Blood Group,
Planned line of
treatment
162 MG (General High end radiological diagnostic MG075A M 5,000 3 Y N Clinical notes Detailed ICPs, NA
Medicine) (CT, MRI, Imaging including nuclear detailing history Treatment details,
imaging)–High end radiological and Admission detailed discharge
diagnostic notes showing summary, All
(CT, MRI, Imaging including nuclear vitals and investigations
imaging) (Only for ABPMJAY) examination reports.
findings; any
investigations
done; planned
line of
management
163 MG (General High end histopathology (Biopsies) MG076A M 5,000 5 Y N Clinical notes Detailed ICPs, NA
Medicine) and advanced serology detailing history Treatment details,
investigations–High end and Admission detailed discharge
histopathology (Biopsies) and notes showing summary, All
advanced serology investigations vitals and investigations
findings; any
investigations
done; planned
line of
management
164 MG (General Unspecified Medical MG077A M to be 0 Y N Clinical Notes Detailed treatment NA

Medicine) negotiated notes; all
investigations done;
detailed discharge
summary.
165 MM (Mental Disorder Mental Retardation–Mental MM001A M Package 3 Y Y Detailed history Detailed treatment NA
Packages) Retardation (Reserved for Public Amount per with chronicity; notes; all
Hospital Only) day (drop need for investigations done;
down) for hospitalization. detailed discharge
admission Admission summary.
type: Routine under
ward (Rs empanneled
1500)/ HDU Psychiatrist is a
(Rs (Rs 2500) must.
166 MM (Mental Disorder Mental disorders - Organic, including MM002A M Package 5 Y Y Detailed history Detailed treatment NA
Packages) symptomatic–Mental disorders - Amount per with chronicity; notes; all
Organic, including symptomatic day (drop need for investigations done;
(Reserved for Public Hospital Only) down) for hospitalization. detailed discharge
type: Routine under
ward (Rs empanneled
(Rs (Rs 2500) must.
167 MM (Mental Disorder Schizophrenia, schizotypal and MM003A M Package 5 Y Y Detailed history Detailed treatment NA
Packages) delusional disorders–Schizophrenia, Amount per with chronicity; notes; all
schizotypal and delusional disorders day (drop need for investigations done;
(Reserved for Public Hospital Only) down) for hospitalization. detailed discharge
type: Routine under
ward (Rs empanneled
(Rs (Rs 2500) must.
168 MM (Mental Disorder Neurotic, stress-related and MM004A M Package 5 Y Y Detailed history Detailed treatment NA
Packages) somatoform disorders–Neurotic, Amount per with chronicity; notes; all
stress-related and somatoform day (drop need for investigations done;
disorders (Reserved for Public down) for hospitalization. detailed discharge
Hospital Only) admission Admission summary.
type: Routine under
ward (Rs empanneled
(Rs (Rs 2500) must.
169 MM (Mental Disorder Mood (affective) disorders–Mood MM005A M Package 3 Y Y Detailed history Detailed treatment NA
Packages) (affective) disorders (Reserved for Amount per with chronicity; notes; all
Public Hospital Only) day (drop need for investigations done;
down) for hospitalization. detailed discharge
type: Routine under
ward (Rs empanneled
(Rs (Rs 2500) must.
170 MM (Mental Disorder Behavioural syndromes associated MM006A M Package 5 Y Y Detailed history Detailed treatment NA
Packages) with physiological disturbances and Amount per with chronicity; notes; all
physical factors–Behavioural day (drop need for investigations done;
syndromes associated with down) for hospitalization. detailed discharge
physiological disturbances and admission Admission summary.
physical factors (Reserved for Public type: Routine under
Hospital Only) ward (Rs empanneled
(Rs (Rs 2500) must.
171 MM (Mental Disorder Mental and Behavioural disorders due MM007A M Package 5 Y Y Detailed history Detailed treatment NA
Packages) to psychoactive substance use– Amount per of psychoactive notes; all
Mental and Behavioural disorders day (drop substanec with investigations done;
due to psychoactive substance use down) for chronicity; need detailed discharge
(Reserved for Public Hospital admission for summary.
Only) type: Routine hospitalization.
ward (Rs Admission
1500)/ HDU under
(Rs (Rs 2500) empanneled
Psychiatrist is a
must.
172 MM (Mental Disorder Pre - Electro Convulsive Therapy MM008A M 10,000 5 Y Y Detailed history Detailed treatment NA
Packages) (ECT) and Pre - Transcranial with chronicity; notes; all
Magnetic Stimulation (TMS) Package need for investigations done;
(Cognitive Tests, Complete specific detailed discharge
Haemogram, Liver Function Test, treatment and summary.
Renal Function Test, Serum expected
Electrolytes, Electro Cardiogram results.
(ECG), CT / MRI Brain, Admission
Electroencephalogram, Thyroid under
Function Test, VDRL, HIV Test, empanneled
Vitamin B12 levels, Folate levels, Psychiatrist is a
Lipid Profile, Homocysteine levels)– must.
Pre - Electro Convulsive
Therapy (ECT) and Pre - Transcranial
Magnetic Stimulation (TMS) Package
(Cognitive Tests, Complete
Haemogram, Liver Function Test,
Renal Function Test, Serum
Electrolytes, Electro Cardiogram
(ECG), CT / MRI Brain,
Electroencephalogram, Thyroid
Function Test, VDRL, HIV Test,
Vitamin B12 levels, Folate levels,
Lipid Profile, Homocysteine levels)
(Reserved for Public Hospital Only)
173 MM (Mental Disorder Electro Convulsive Therapy (ECT) - MM009A M 3,000 5 Y Y Detailed history Detailed treatment 1
Packages) per session–Electro Convulsive with chronicity; notes; all
Therapy (ECT) - per session need for investigations done;
(Reserved for Public Hospital Only) specific detailed discharge
treatment and summary.
expected
results.
Admission
under
empanneled
Psychiatrist is a
must.
174 MM (Mental Disorder Transcranial Magnetic Stimulation MM010A M 1,000 5 Y Y Detailed history Detailed treatment 1
Packages) (TMS) - per session–Transcranial with chronicity; notes; all
Magnetic Stimulation (TMS) - per need for investigations done;
session (Reserved for Public specific detailed discharge
Hospital Only) treatment and summary.
expected
results.
Admission
under
empanneled
Psychiatrist is a
must.
175 MN (Neo-Natal Care Basic neonatal care package: Babies MN001A M 500 5 Y N Detailed clinical Detailed ICPs (daily 4
Packages) that can be managed by side of notes (incl Treatment details),
mother in postnatal ward without trigger for detailed discharge
requiring admission in SNCU/NICU: hospitalization summary, All
• Any newborn needing feeding and investigations
support examiantion reports.
• Babies requiring closer monitoring or findings),
short-term care for conditions like: supporting
o Birth asphyxia (need for positive investigations.
pressure ventilation; no HIE) Admission
o Moderate jaundice requiring under
phototherapy neonatologist in
o Large for dates (>97 percentile) NICU (in major
Babies locations) and
o Small for gestational age (less than under
3rd centile) –Basic neonatal care Pediatrician in
package: Babies that can be smaller
managed by side of mother in locations is a
postnatal ward without requiring must.
admission in SNCU/NICU:
• Any newborn needing feeding
support
• Babies requiring closer monitoring or
short-term care for conditions like:
o Birth asphyxia (need for positive
pressure ventilation; no HIE)
o Moderate jaundice requiring
phototherapy
o Large for dates (>97 percentile)
Babies
o Small for gestational age (less than
3rd centile)
176 MN (Neo-Natal Care Special Neonatal Care Package: MN002A M 3,000 5 Y N Clinical notes Detailed ICPs (daily 6
Packages) Babies that required admission to with planned Treatment details),
SNCU or NICU: line of Procedure /
Babies admitted for short term care treatment (incl Operative Notes (if
for conditions like: birth & past applicable), Detailed
• Mild Respiratory Distress/tachypnea history), Discharge
• Mild encephalopathy Investigation Summary, All
• Severe jaundice requiring intensive Reports investigations
phototherapy supporting reports.
• Haemorrhagic disease of newborn diagnosis,
• Unwell baby requiring monitoring Planned line of
• Some dehydration treatment
• Hypoglycaemia
Mother's stay and food in the hospital
for breastfeeding, family centred care
and (Kangaroo Mother Care) KMC is
mandatory and included in the
package rate
–Special Neonatal Care Package:
Babies that required admission to
SNCU or NICU:
Babies admitted for short term care
for conditions like:
• Mild Respiratory Distress/tachypnea
• Mild encephalopathy
• Severe jaundice requiring intensive
phototherapy
• Haemorrhagic disease of newborn
• Unwell baby requiring monitoring
• Some dehydration
• Hypoglycaemia
177 MN (Neo-Natal Care Intensive Neonatal Care Package MN003A M 5,000 5 Y N Detailed clinical Detailed ICPs (daily 7
Packages) Babies with birthweight 1500-1799 g notes (incl Treatment details),
or trigger for detailed discharge
Babies of any birthweight and at least hospitalization summary, All
one of the following conditions: and investigations
• Need for mechanical ventilation for examiantion reports.
less than 24 hours or non-invasive findings),
respiratory support (CPAP, HFFNC) supporting
• Sepsis / pneumonia without investigations.
complications Admission
• Hyperbilirubinemia requiring under
exchange transfusion neonatologist in
• Seizures NICU (in major
• Major congenital malformations (pre- locations) and
surgical stabilization, not requiring under
ventilation) Pediatrician in
• Cholestasis significant enough smaller
requiring work up and in-hospital locations is a
management must.
• Congestive heart failure or shock
package rate
–Intensive Neonatal Care Package
Babies with birthweight 1500-1799 g
or
Babies of any birthweight and at least
one of the following conditions:
• Need for mechanical ventilation for
less than 24 hours or non-invasive
178 MN (Neo-Natal Care Advanced Neonatal Care Package: MN004A M 6,000 5 N N Detailed clinical Detailed ICPs (daily 7
Packages) Babies with birthweight of 1200-1499 notes (incl Treatment details),
g trigger for detailed discharge
or hospitalization summary, All
Babies of any birthweight with at least and investigations
one of the following conditions: examiantion reports.
• Any condition requiring invasive findings),
ventilation longer than 24 hours supporting
• Hypoxic Ischemic encephalopathy investigations.
requiring Therapeutic Hypothermia Admission
• Cardiac rhythm disorders needing under
intervention (the cost of cardiac neonatologist in
surgery or implant will be covered NICU (in major
under cardiac surgery packages) locations) and
• Sepsis with complications such as under
meningitis or bone and joint infection, Pediatrician in
DIC or shock smaller
• Renal failure requiring dialysis locations is a
• Inborn errors of metabolism must.
package rate
–Advanced Neonatal Care Package:
Babies with birthweight of 1200-1499
g
or
Babies of any birthweight with at least
• Any condition requiring invasive
ventilation longer than 24 hours
179 MN (Neo-Natal Care Critical Care Neonatal Package: MN005A M 7,000 5 N N Detailed clinical Detailed ICPs (daily 21
Packages) Babies with birthweight of <1200 g notes (incl Treatment details),
or trigger for detailed discharge
Babies of any birthweight with at least hospitalization summary, All
one of the following conditions: and investigations
• Severe Respiratory Failure requiring examiantion reports.
High Frequency Ventilation or inhaled findings),
Nitric Oxide (iNO) supporting
• Multisystem failure requiring multiple investigations.
organ support including mechanical Admission
ventilation and multiple inotropes under
• Critical congenital heart disease neonatologist in
Mother's stay and food in the hospital NICU (in major
for breastfeeding, family centred care locations) and
and (Kangaroo Mother Care) KMC is under
mandatory and included in the Pediatrician in
package rate smaller
–Critical Care Neonatal Package: locations is a
Babies with birthweight of <1200 g must.
or
Babies of any birthweight with at least
• Severe Respiratory Failure requiring
High Frequency Ventilation or inhaled
Nitric Oxide (iNO)
• Multisystem failure requiring multiple
organ support including mechanical
ventilation and multiple inotropes
• Critical congenital heart disease
180 MN (Neo-Natal Care Chronic Care Package: If the baby MN006A M 3,000 3 Y N Claim number Detailed ICPs (daily NA
Packages) requires stay beyond the upper limit of of having Treatment details),
usual stay in Package no MN004A or utilized detailed discharge
MN005A for conditions like severe Package no summary, All
BPD requiring respiratory support, MN004A or investigations
severe NEC requiring prolonged TPN MN005A and reports.
support–Chronic Care Package: If the Notes
baby requires stay beyond the upper mentioning
limit of usual stay in Package no need for stay
MN004A or MN005A for conditions beyond
like severe BPD requiring respiratory prescribed
support, severe NEC requiring upper limit
prolonged TPN support
181 MN (Neo-Natal Care High Risk Newborn Post Discharge MN007A M 2,400 3 Y N Need of Detailed ICP with NA
Packages) Care Package (Protocol Driven)–High planned care daily notes, vitals,
Risk Newborn Post Discharge Care and details of drugs given,
Package planned post investigation reports
(Protocol Driven) discharge care Card with pre and
post admission
general conditions
and vital
parameters. Details
of
procedures/operatio
ns required for any
congenital heart
conditions if any.
182 MN (Neo-Natal Care Laser Therapy for Retinopathy of MN008A S 1,500 5 Y N Clinical notes Details of Laser Daycare
Packages) Prematurity (Irrespective of no. of and therapy done.
eyes affected) - per session–Laser Fundoscope
Therapy for Retinopathy of reports / stills
Prematurity showing extent
(Irrespective of no. of eyes affected) - of ROP and
per session need for
procedure.
183 MN (Neo-Natal Care Advanced Surgery for Retinopathy of MN009A S 15,000 0 Y N Clinical notes Detailed discharge 5
Packages) Prematurity–Advanced Surgery for and summary, Detailed
Retinopathy of Prematurity Fundoscope Procedure /
reports / stills Operative Notes,
showing extent Intra procedure
of ROP and clinical photograph
need for
surgery.
184 MN (Neo-Natal Care Ventriculoperitoneal Shunt Surgery MN010A S 5,000 7 Y N Clinical history Detailed discharge 2
Packages) (VP) or Omaya Reservoir or External and CT/ MRI; summary, Detailed
Drainage for Hydrocephalus– pre-op clinical Procedure /
Ventriculoperitoneal Shunt Surgery photograph Operative Notes,
(VP) or Omaya Reservoir or External Intra procedure
Drainage for Hydrocephalus clinical photograph
185 MO (Medical CT for CA Breast–Cyclophosphamide MO001A M 7,200 5 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) + Epirubcin Biopsy report or THE DRUGS,
surgical REPORTS OF THE
pathology TESTS
report of (PATHOLOGY,
Modified radical RADIOLOGY,
mastectomy or MICROBIOLOGY,
breast HEMATOLOGY,
conservation BIOCHEMISTRY,E
surgery,ECG, TC.) DISCHARGE
2D-ECHO, USG SUMMARY OF
abdomen and INPATIENT
pelvis, CXR PA DEPARTMENT,
view or CECT DISCHARGE
chest+abdomen SUMMARY OF
and pelvis in DAY CARE
case of DEPARTMENT,
metastatic CHARTS OF
disease CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
186 MO (Medical CT for CA Breast–Weekly Paclitaxel MO001B M 5,800 6 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) for Adjuvant Therapy Biopsy report or THE DRUGS,
pathology report TESTS
of Modified (PATHOLOGY,
radical RADIOLOGY,
breast HEMATOLOGY,
surgery, USG TC.) DISCHARGE
abdomen and SUMMARY OF
pelvis, CXR PA INPATIENT
view or CECT DEPARTMENT,
chest+abdomen DISCHARGE
and pelvis in SUMMARY OF
case of DAY CARE
metastatic DEPARTMENT,
disease CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
187 MO (Medical CT for CA Breast–Weekly Paclitaxel MO001C M 5,800 6 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) in metastatic setting Biopsy report or THE DRUGS,
radical RADIOLOGY,
breast HEMATOLOGY,
case of DAY CARE
disease CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
188 MO (Medical CT for CA Breast–Cyclophosphamide MO001D M 3,200 6 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) + Methotrexate + 5 - FU Biopsy report or THE DRUGS,
radical RADIOLOGY,
breast HEMATOLOGY,
case of DAY CARE
disease CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
189 MO (Medical CT for CA Breast–Docetaxel + MO001E M 19,800 5 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) Cyclophosphamide Biopsy report or THE DRUGS,
radical RADIOLOGY,
breast HEMATOLOGY,
case of DAY CARE
disease CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
190 MO (Medical CT for CA Breast–Trastuzumab MO001F M 21,200 0 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) Biopsy report or THE DRUGS,
radical RADIOLOGY,
breast HEMATOLOGY,
surgery, Her-2 TC.) DISCHARGE
neu IHC - 3+ or SUMMARY OF
Her 2-neu INPATIENT
positive DEPARTMENT,
FISH,ECG,2D- DISCHARGE
ECHO,USG SUMMARY OF
abdomen and DAY CARE
view or CECT CHARTS OF
chest+abdomen CHEMOTHERAPY
and pelvis in REGIMEN,
case of TRANFUSION
metastatic SLIPS
disease
191 MO (Medical CT for CA Breast–Tamoxifen MO001G M 1,200 0 Y N CBC, LFT,RFT, BAR CODE OF Daycare
radical RADIOLOGY,
breast HEMATOLOGY,
surgery, ER or TC.) DISCHARGE
PR positive , SUMMARY OF
mammography, INPATIENT
USG abdomen DEPARTMENT,
and pelvis, CXR DISCHARGE
PA view or SUMMARY OF
CECT DAY CARE
chest+abdomen DEPARTMENT,
and pelvis in CHARTS OF
case of CHEMOTHERAPY
metastatic REGIMEN,
disease TRANFUSION
SLIPS
192 MO (Medical CT for CA Breast–Letrozole MO001H M 3,900 0 Y N CBC, LFT,RFT, BAR CODE OF Daycare
radical RADIOLOGY,
breast HEMATOLOGY,
CECT DAY CARE
chest+abdomen DEPARTMENT,
and pelvis in CHARTS OF
case of CHEMOTHERAPY
metastatic REGIMEN,
disease TRANFUSION
SLIPS
193 MO (Medical CT for CA Breast–Carboplatin + MO001I M 14,900 0 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) Paclitaxel Biopsy report or THE DRUGS,
radical RADIOLOGY,
breast HEMATOLOGY,
surgery, , TC.) DISCHARGE
mammography, SUMMARY OF
USG abdomen INPATIENT
and pelvis, CXR DEPARTMENT,
PA view or DISCHARGE
CECThest+abd SUMMARY OF
omen and DAY CARE
pelvis in case of DEPARTMENT,
REGIMEN,
TRANFUSION
SLIPS
194 MO (Medical CT for CA Breast–Capecitabine MO001J M 7,400 0 Y N CBC, LFT,RFT, BAR CODE OF Daycare
radical RADIOLOGY,
breast HEMATOLOGY,
CECT SUMMARY OF
chest+abdomen DAY CARE
and pelvis in DEPARTMENT,
case of CHARTS OF
metastatic CHEMOTHERAPY
disease REGIMEN,
TRANFUSION
SLIPS
195 MO (Medical CT for CA Breast–Carboplatin + MO001K M 13,900 0 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) Gemcitabine Biopsy report or THE DRUGS,
radical RADIOLOGY,
breast HEMATOLOGY,
CECT SUMMARY OF
chest+abdomen DAY CARE
and pelvis in DEPARTMENT,
case of CHARTS OF
metastatic CHEMOTHERAPY
disease REGIMEN,
TRANFUSION
SLIPS
196 MO (Medical CT for CA Breast–Cyclophosphamide MO001L M 4,500 5 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) + Adriamycin Biopsy report or THE DRUGS,
pathology TESTS
report of (PATHOLOGY,
Modified radical RADIOLOGY,
breast HEMATOLOGY,
surgery,ECG, TC.) DISCHARGE
2D-ECHO, USG SUMMARY OF
abdomen and INPATIENT
view or CECT DISCHARGE
chest+abdomen SUMMARY OF
and pelvis in DAY CARE
case of DEPARTMENT,
REGIMEN,
TRANFUSION
SLIPS
197 MO (Medical CT for CA Breast–Fulvestrant MO001M M 11,000 0 Y N CBC, LFT,RFT, BAR CODE OF Daycare
radical RADIOLOGY,
breast HEMATOLOGY,
CECT chest DAY CARE
abdomen and DEPARTMENT,
pelvis CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
198 MO (Medical CT for CA Breast–Paclitaxel MO001N M 11,800 5 Y N CBC, LFT,RFT, BAR CODE OF Daycare
radical RADIOLOGY,
breast HEMATOLOGY,
CECT chest SUMMARY OF
abdomen and DAY CARE
pelvis DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
199 MO (Medical CT for CA Breast–Exemestane MO001O M 10,400 0 Y N CBC, LFT,RFT, BAR CODE OF Daycare
radical RADIOLOGY,
breast HEMATOLOGY,
CECT chest DAY CARE
abdomen and DEPARTMENT,
pelvis CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
200 MO (Medical CT for Metastatic bone malignancy MO002A M 4,500 5 Y N RFT, skeletal BAR CODE OF Daycare
Oncology) and multiple myeloma–Zoledronic survey/bone THE DRUGS,
Acid scan/PET-CT REPORTS OF THE
showing bone TESTS
metastasis (PATHOLOGY,
histopathology RADIOLOGY,
showing MICROBIOLOGY,
myeloma, lung HEMATOLOGY,
cancer,Breast BIOCHEMISTRY,E
cancer, renal TC.) DISCHARGE
cancer or other SUMMARY OF
cancer INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
201 MO (Medical CT for CA Ovary–Cisplatin + MO003A M 10,200 0 Y N CBc, LFT, RFT, BAR CODE OF Daycare
Oncology) Irinotecan RBS, CA-125, THE DRUGS,
CECT Thorax, REPORTS OF THE
abdomen and TESTS
Pelvis, HPR or (PATHOLOGY,
cytology RADIOLOGY,
suggestive of MICROBIOLOGY,
ovarian HEMATOLOGY,
adenocarcinom BIOCHEMISTRY,E
a TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
202 MO (Medical CT for CA Ovary–Lipodox + MO003B M 17,200 7 Y N CBc, LFT, RFT, BAR CODE OF Daycare
Oncology) Carboplatin RBS, CA-125, THE DRUGS,
abdomen and TESTS
cytology RADIOLOGY,
ovarian HEMATOLOGY,
a TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
203 MO (Medical CT for CA Ovary–Etoposide MO003C M 3,400 1 Y N CBc, LFT, RFT, BAR CODE OF Daycare
Oncology) RBS, CA-125, THE DRUGS,
abdomen and TESTS
cytology RADIOLOGY,
ovarian HEMATOLOGY,
a TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
204 MO (Medical CT for CA Ovary–Irinotecan MO003D M 8,400 0 Y N CBc, LFT, RFT, BAR CODE OF Daycare
abdomen and TESTS
cytology RADIOLOGY,
ovarian HEMATOLOGY,
a TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
205 MO (Medical CT for CA Ovary–Lipodox MO003E M 14,800 0 Y N CBc, LFT, RFT, BAR CODE OF Daycare
abdomen and TESTS
cytology RADIOLOGY,
ovarian HEMATOLOGY,
a TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
206 MO (Medical CT for CA Ovary–Carboplatin + MO003F M 13,900 0 Y N CBc, LFT, RFT, BAR CODE OF Daycare
Oncology) Gemcitabine RBS, CA-125, THE DRUGS,
abdomen and TESTS
cytology RADIOLOGY,
ovarian HEMATOLOGY,
a TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
207 MO (Medical CT for CA Ovary–Carboplatin + MO003G M 14,700 0 Y N CBc, LFT, RFT, BAR CODE OF Daycare
Oncology) Paclitaxel RBS, CA-125, THE DRUGS,
abdomen and TESTS
cytology RADIOLOGY,
ovarian HEMATOLOGY,
a TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
208 MO (Medical CT for Germ Cell Tumor–Carboplatin MO004A M 5,800 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) (AUC 7) RFT, RBS, THE DRUGS,
Beta- HCG, REPORTS OF THE
AFP, TESTS
LDH,CECT (PATHOLOGY,
Thorax, RADIOLOGY,
abdomen and MICROBIOLOGY,
Pelvis, ECG, HEMATOLOGY,
Histopathology - BIOCHEMISTRY,E
testicular TC.) DISCHARGE
seminoma SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
209 MO (Medical CT for Germ Cell Tumor–Bleomycin + MO004B M 11,600 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Etoposide + Cisplatin RFT, RBS, THE DRUGS,
Beta-HCG, REPORTS OF THE
AFP, TESTS
Thorax, RADIOLOGY,
Pelvis, HEMATOLOGY,
ECG,PFT BIOCHEMISTRY,E
DLCo, TC.) DISCHARGE
Histopathology - SUMMARY OF
Ovarian, INPATIENT
testicular, DEPARTMENT,
mediastinal DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
210 MO (Medical CT for Germ Cell Tumor–Etoposide + MO004C M 10,000 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Cisplatin RFT, RBS, THE DRUGS,
AFP, TESTS
Thorax, RADIOLOGY,
Ovarian, TC.) DISCHARGE
testicular, SUMMARY OF
mediastinal INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
211 MO (Medical CT for Germ Cell MO004D M 17,500 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Tumor–Gemcitabine + Oxaliplatin RFT, RBS, THE DRUGS,
AFP, TESTS
Thorax, RADIOLOGY,
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
212 MO (Medical CT for Germ Cell MO004E M 17,500 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Tumor–Gemcitabine + Paclitaxel RFT, RBS, THE DRUGS,
AFP, TESTS
Thorax, RADIOLOGY,
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
213 MO (Medical CT for Germ Cell Tumor–Paclitaxel + MO004F M 24,400 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Ifosfamide + Cisplatin RFT, RBS, THE DRUGS,
AFP, TESTS
Thorax, RADIOLOGY,
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
214 MO (Medical CT for Germ Cell Tumor–Vinblastin + MO004G M 12,600 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Ifosfamide + Cisplatin RFT, RBS, THE DRUGS,
AFP, TESTS
Thorax, RADIOLOGY,
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
215 MO (Medical CT for Gestational Trophoblastic MO005A M 11,400 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Neoplasia–EMA - CO RFT, RBS, THE DRUGS,
CECT Thorax, TESTS
abdomen and (PATHOLOGY,
Pelvis RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
216 MO (Medical CT for Gestational Trophoblastic MO005B M 12,200 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Neoplasia–EMA - EP RFT, RBS, THE DRUGS,
CECT Thorax, TESTS
Pelvis RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
217 MO (Medical CT for Gestational Trophoblastic MO005C M 1,100 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Neoplasia–Methotrexate RFT, RBS, THE DRUGS,
CECT Thorax, TESTS
Pelvis RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
218 MO (Medical CT for Cervical Cancer–Carboplatin + MO006A M 14,900 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Paclitaxel RFT, THE DRUGS,
RBS,CECT REPORTS OF THE
Thorax, TESTS
Pelvis,histopath RADIOLOGY,
ology MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
219 MO (Medical CT for Cervical Cancer–Cisplatin MO006B M 2,200 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) RFT, THE DRUGS,
Thorax, TESTS
ology MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
220 MO (Medical CT for Endometrial MO007A M 14,900 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Cancer–Carboplatin + Paclitaxel RFT, THE DRUGS,
Thorax, TESTS
ology MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
221 MO (Medical CT for Endometrial Cancer–Cisplatin MO007B M 4,200 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) + Doxorubicin RFT, THE DRUGS,
Thorax, TESTS
ology , ECG,2D MICROBIOLOGY,
ECHO HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
222 MO (Medical CT for Vulvar Cancer–Cisplatin + 5 MO008A M 7,600 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) FU RFT, RBS, THE DRUGS,
MRI REPORTS OF THE
pelvis,histopath TESTS
ology (PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
223 MO (Medical CT for Vulvar Cancer–Cisplatin MO008B M 2,200 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) RFT, RBS, THE DRUGS,
MRI REPORTS OF THE
pelvis,histopath TESTS
ology (PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
224 MO (Medical CT for Ewing Sarcoma–VTC + ITMZ MO009A M 22,400 0 Y N CBC, BAR CODE OF Daycare
Oncology) for Relapsed Ewing Sarcoma Biochemistry, THE DRUGS,
PET CT or CT REPORTS OF THE
CHEST/BONE TESTS
SCAN, Bone (PATHOLOGY,
marrow studies, RADIOLOGY,
Biopsy, ECG, MICROBIOLOGY,
2D-ECHO HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
225 MO (Medical CT for Ewing Sarcoma–EFT 2001 MO009B M 9,700 0 Y N CBC, BAR CODE OF Daycare
Oncology) Biochemistry, THE DRUGS,
CHEST/BONE TESTS
2D-ECHO HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
226 MO (Medical CT for Ewing Sarcoma–VAC + IE MO009C M 12,500 0 Y N CBC, BAR CODE OF Daycare
CHEST/BONE TESTS
2D-ECHO HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
227 MO (Medical CT for Osteogenic MO010A M 21,800 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Sarcoma–Methotrexate + Doxorubicin RFT, RBS, THE DRUGS,
+ Cisplatin DTPA GFR, REPORTS OF THE
NCCT chest, TESTS
MRI of the (PATHOLOGY,
involved site,2D RADIOLOGY,
ECHO, Pure MICROBIOLOGY,
tone HEMATOLOGY,
audiometry,hist BIOCHEMISTRY,E
opathology TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
228 MO (Medical CT for Osteogenic MO010B M 27,000 0 Y N CBC, BAR CODE OF Daycare
Oncology) Sarcoma–Methotrexate + Doxorubicin Biochemistry, THE DRUGS,
+ Cisplatin for Relapsed Osteogenic CT CHEST, REPORTS OF THE
Sarcoma BONE SCAN, TESTS
Biopsy, ECG, (PATHOLOGY,
2D-ECHO, RADIOLOGY,
AUDIOMETRY, MICROBIOLOGY,
GFR HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
229 MO (Medical CT for Osteogenic Sarcoma–OGS - MO010C M 29,600 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) 12 RFT, RBS, THE DRUGS,
DTPA GFR, REPORTS OF THE
NCCT chest, TESTS
MRI of the (PATHOLOGY,
involved site,2D RADIOLOGY,
ECHO, Pure MICROBIOLOGY,
tone HEMATOLOGY,
audiometry,hist BIOCHEMISTRY,E
opathology TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
230 MO (Medical CT for Osteogenic Sarcoma–OGS - MO010D M 36,200 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) 12 RFT, RBS, THE DRUGS,
DTPA GFR,2D REPORTS OF THE
ECHO, Pure TESTS
tone,histopathol (PATHOLOGY,
ogy RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
231 MO (Medical CT for Soft Tissue MO011A M 30,900 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Sarcoma–Gemcitabine + Docetaxel ECHO, MRI of THE DRUGS,
the involved REPORTS OF THE
part, CECT TESTS
Thorax, (PATHOLOGY,
abdomen and RADIOLOGY,
Pelvis,histopath MICROBIOLOGY,
ology HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
232 MO (Medical CT for Soft Tissue MO011B M 13,700 0 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Sarcoma–Ifosfamide+ Adriamycin ECHO, MRI of THE DRUGS,
the involved REPORTS OF THE
part, CECT TESTS
Thorax, (PATHOLOGY,
Pelvis,histopath MICROBIOLOGY,
ology HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
233 MO (Medical CT for Metastatic MO012A M 7,100 0 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Melanoma–Dacarbazine + Cisplatin LFT, RBS, THE DRUGS,
abdomen and TESTS
Pelvis,histopath (PATHOLOGY,
ology RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
234 MO (Medical CT for Metastatic MO012B M 23,100 0 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Melanoma–Temozolamide LFT, RBS, THE DRUGS,
abdomen and TESTS
Pelvis (PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
235 MO (Medical CT for Anal Cancer–5 FU + Mitomycin MO013A M 10,500 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) C RBS, CECT THE DRUGS,
Thorax , REPORTS OF THE
abdomen , MRI TESTS
Pelvis, CEA, (PATHOLOGY,
Histopathology RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
236 MO (Medical CT for Anal Cancer–Capecitabine + MO013B M 13,800 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Mitomycin C RBS, CECT THE DRUGS,
abdomen , MRI TESTS
Pelvis, CEA, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
237 MO (Medical CT for Anal Cancer–Cisplatin + 5 FU MO013C M 7,600 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) RBS, CECT THE DRUGS,
abdomen TESTS
,Pelvis, CEA, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
238 MO (Medical CT for Anal Cancer–Carboplatin + MO013D M 14,900 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Paclitaxel RBS, CECT THE DRUGS,
abdomen TESTS
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
239 MO (Medical CT for Anal Cancer–Cisplatin + MO013E M 13,300 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Paclitaxel RBS, CECT THE DRUGS,
abdomen TESTS
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
240 MO (Medical CT for Colorectal Cancer–5 FU + MO014A M 4,700 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Leucovorin RBS, CECT THE DRUGS,
abdomen TESTS
,Colonoscopy MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
241 MO (Medical CT for Colorectal MO014B M 12,500 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Capecitabine + Irinotecan RBS, CECT THE DRUGS,
abdomen TESTS
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
242 MO (Medical CT for Colorectal Cancer–Folfox MO014C M 11,100 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
243 MO (Medical CT for Colorectal Cancer–Folfiri MO014D M 8,700 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
abdomen TESTS
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
244 MO (Medical CT for Colorectal MO014E M 16,500 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Capecitabine + Oxaliplatin RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
245 MO (Medical CT for Colorectal MO014F M 7,200 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Capecitabine RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
246 MO (Medical CT for Colorectal MO014G M 7,300 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
247 MO (Medical CT for Colorectal Cancer–Folfirinox MO014H M 15,100 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
248 MO (Medical CT for Esophageal MO015A M 14,900 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Carboplatin + Paclitaxel RBS, CECT THE DRUGS,
abdomen TESTS
,Pelvis, (PATHOLOGY,
,UGI MICROBIOLOGY,
endoscospy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
249 MO (Medical CT for Esophageal Cancer–Cisplatin MO015B M 9,600 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) + 5 FU RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
250 MO (Medical CT for Esophageal Cancer–Cisplatin MO015C M 9,600 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) + 5 FU RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
251 MO (Medical CT for Esophageal Cancer–Paclitaxel MO015D M 25,100 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) + Carboplatin for definitive Non - RBS, CECT THE DRUGS,
metastatic Thorax , REPORTS OF THE
(With RT) abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
252 MO (Medical CT for Esophageal Cancer–Paclitaxel MO015E M 25,100 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) + Carboplatin for metastatic RBS, CECT THE DRUGS,
(Without RT) Thorax , REPORTS OF THE
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
253 MO (Medical CT for Esophageal / Stomach MO016A M 12,100 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Cisplatin + Docetaxel RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
254 MO (Medical CT for Esophageal / Stomach MO016B M 8,300 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Irinotecan RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
255 MO (Medical CT for Esophageal / Stomach MO016C M 8,000 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–5 FU RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
256 MO (Medical CT for Esophageal / Stomach MO016D M 7,200 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
257 MO (Medical CT for Esophageal / Stomach MO016E M 16,500 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–CAPOX RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
258 MO (Medical CT for Esophageal / Stomach MO016F M 16,400 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Docetaxel + Cisplatin + 5 FU RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
259 MO (Medical CT for Esophageal / Stomach MO016G M 19,700 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Docetaxel + Cisplatin + RBS, CECT THE DRUGS,
Xeloda Thorax , REPORTS OF THE
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
260 MO (Medical CT for Esophageal / Stomach MO016H M 20,400 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Docetaxel + Oxaliplatin + 5 RBS, CECT THE DRUGS,
FU Thorax , REPORTS OF THE
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
261 MO (Medical CT for Esophageal / Stomach MO016I M 24,900 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Docetaxel + Oxaliplatin + RBS, CECT THE DRUGS,
Xeloda Thorax , REPORTS OF THE
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
262 MO (Medical CT for Esophageal / Stomach MO016J M 8,700 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Folfiri RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
263 MO (Medical CT for Esophageal / Stomach MO016K M 11,100 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Folfox RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
264 MO (Medical CT for Esophageal / Stomach MO016L M 5,800 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Paclitaxel RBS, CECT THE DRUGS,
abdomen TESTS
,UGI MICROBIOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
265 MO (Medical CT for Hepatocellular MO017A M 10,000 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Carcinoma–Doxorubicin RBS, Triphasic THE DRUGS,
CECT Thorax , REPORTS OF THE
abdomen TESTS
Histopathology , RADIOLOGY,
AFP,MRI MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
266 MO (Medical CT for Hepatocellular MO017B M 7,400 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Carcinoma–Sorafenib RBS, Triphasic THE DRUGS,
CECT Thorax , REPORTS OF THE
abdomen TESTS
Histopathology , RADIOLOGY,
AFP, Lipid MICROBIOLOGY,
Profile, Urine HEMATOLOGY,
R/M, 2D ECHO BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
267 MO (Medical CT for Panceratic MO018A M 23,500 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Gemcitabine + RBS, CECT THE DRUGS,
Nanopaclitaxel Thorax , REPORTS OF THE
abdomen TESTS
Histopathology/ RADIOLOGY,
FNAC, CA19.9, MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
268 MO (Medical CT for Panceratic MO018B M 9,000 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Gemcitabine RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
269 MO (Medical CT for Panceratic MO018C M 9,000 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Gemcitabine RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
270 MO (Medical CT for Panceratic Cancer–Folfirinox MO018D M 15,500 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
271 MO (Medical CT for Panceratic MO018E M 7,400 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
272 MO (Medical CT for Panceratic MO018F M 31,500 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cancer–Capecitabine + Gemcitabine RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
273 MO (Medical CT for Gall Bladder Cancer / MO019A M 7,300 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cholangiocarcinoma–Capecitabine RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
274 MO (Medical CT for Gall Bladder Cancer / MO019B M 10,900 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cholangiocarcinoma–Cisplatin + RBS, CECT THE DRUGS,
Gemcitabine Thorax , REPORTS OF THE
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
275 MO (Medical CT for Gall Bladder Cancer / MO019C M 8,900 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cholangiocarcinoma–Folfiri RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
276 MO (Medical CT for Gall Bladder Cancer / MO019D M 9,000 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cholangiocarcinoma–Gemcitabine RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
277 MO (Medical CT for Gall Bladder Cancer / MO019E M 8,900 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cholangiocarcinoma–Gemcitabine RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
278 MO (Medical CT for Gall Bladder Cancer / MO019F M 17,100 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cholangiocarcinoma–Oxaliplatin + RBS, CECT THE DRUGS,
Gemcitabine Thorax , REPORTS OF THE
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
279 MO (Medical CT for Gall Bladder Cancer / MO019G M 12,600 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cholangiocarcinoma–CAPIRI RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
280 MO (Medical CT for Gall Bladder Cancer / MO019H M 11,300 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) Cholangiocarcinoma–Folfox RBS, CECT THE DRUGS,
abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
281 MO (Medical CT for Gastointestinal stromal MO020A M 19,400 0 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) tumor–Imatinib RBS, CECT THE DRUGS,
abdomen TESTS
FNAC, Ckit- MICROBIOLOGY,
mutation (not HEMATOLOGY,
mandatory) BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
282 MO (Medical CT for Gastointestinal stromal tumor MO020B M 24,400 1 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) –Sunitinib RBS, CECT THE DRUGS,
abdomen TESTS
FNAC, Ckit- MICROBIOLOGY,
mutation (not HEMATOLOGY,
mandatory) BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
283 MO (Medical CT for CA Brain–Temozolamide MO021A M 13,000 2 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) RBS, MRI THE DRUGS,
brain, REPORTS OF THE
Histopathology TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
284 MO (Medical CT for CA Brain–Temozolamide MO021B M 67,600 2 Y N CBC,LFT, RFT, BAR CODE OF Daycare
Oncology) RBS, MRI THE DRUGS,
brain, REPORTS OF THE
Histopathology TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
285 MO (Medical CT for Mesothelioma–Gemcitabine + MO022A M 11,100 2 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
286 MO (Medical CT for Mesothelioma–Pemetrexed + MO022B M 9,200 2 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
287 MO (Medical CT for Mesothelioma–Pemetrexed + MO022C M 10,000 2 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Carboplatin RFT, RBS, THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
288 MO (Medical CT for Thymic Carcinoma–Cisplatin + MO023A M 5,300 2 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Etoposide RFT, RBS, THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
histopathology , RADIOLOGY,
ECHO MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
289 MO (Medical CT for Thymic Carcinoma–Cisplatin + MO023B M 5,000 2 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Adriamycin RFT, RBS, THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
histopathology , RADIOLOGY,
ECHO MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
290 MO (Medical CT for CA Head & Neck–Cisplatin + MO024A M 12,400 2 Y N CBC, BAR CODE OF Daycare
Oncology) Docetaxel LFT,RFT,RBS, THE DRUGS,
CECT/MR Face REPORTS OF THE
and neck, TESTS
histopathology - (PATHOLOGY,
squamous RADIOLOGY,
carcinoma, MICROBIOLOGY,
Nasopharyngea HEMATOLOGY,
l carcinoma BIOCHEMISTRY,E
Pure tone TC.) DISCHARGE
audiometry SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
291 MO (Medical CT for CA Head & Neck–Cisplatin MO024B M 9,800 2 Y N CBC, BAR CODE OF Daycare
Oncology) LFT,RFT,RBS, THE DRUGS,
and neck, TESTS
squamous RADIOLOGY,
nasopharyngeal HEMATOLOGY,
carcinoma,Pure BIOCHEMISTRY,E
tone audiometry TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
292 MO (Medical CT for CA Head & Neck–Carboplatin MO024C M 14,300 2 Y N CBC, BAR CODE OF Daycare
Oncology) + Gemcitabine LFT,RFT,RBS, THE DRUGS,
histopathology- REPORTS OF THE
squamous TESTS
carcinoma,naso (PATHOLOGY,
pharyngeal RADIOLOGY,
salivary gland HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
293 MO (Medical CT for CA Head & Neck–Docetaxel + MO024D M 16,500 2 Y N CBC, BAR CODE OF Daycare
Oncology) Cisplatin + 5 FU LFT,RFT,RBS, THE DRUGS,
squamous TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
294 MO (Medical CT for CA Head & Neck–Docetaxel MO024E M 15,000 1 Y N CBC, BAR CODE OF Daycare
squamous TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
295 MO (Medical CT for CA Head & Neck–Docetaxel MO024F M 14,400 3 Y N CBC, BAR CODE OF Daycare
and neck, TESTS
squamous RADIOLOGY,
carcinoma MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
296 MO (Medical CT for CA Head & Neck–Etoposide + MO024G M 7,100 3 Y N CBC, BAR CODE OF Daycare
Oncology) Carboplatin LFT,RFT,RBS, THE DRUGS,
histopathology - REPORTS OF THE
esthesioneurobl TESTS
astoma, (PATHOLOGY,
Neuroendocrine RADIOLOGY,
, MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
297 MO (Medical CT for CA Head & Neck–Etoposide + MO024H M 9,200 3 Y N CBC, BAR CODE OF Daycare
Oncology) Cisplatin LFT,RFT,RBS, THE DRUGS,
histopathology - REPORTS OF THE
esthesioneurobl TESTS
astoma, (PATHOLOGY,
Neuroendocrine RADIOLOGY,
, MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
298 MO (Medical CT for CA Head & Neck–Gemcitabine MO024I M 9,200 3 Y N CBC, BAR CODE OF Daycare
squamous TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
299 MO (Medical CT for CA Head & Neck–Gemcitabine MO024J M 11,100 3 Y N CBC, BAR CODE OF Daycare
Oncology) + Cisplatin LFT,RFT,RBS, THE DRUGS,
squamous TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
300 MO (Medical CT for CA Head & Neck–Paclitaxel + MO024K M 7,700 1 Y N CBC, BAR CODE OF Daycare
squamous TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
301 MO (Medical CT for CA Head & Neck–Paclitaxel + MO024L M 15,100 1 Y N CBC, BAR CODE OF Daycare
squamous TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
302 MO (Medical CT for CA Head & Neck–Paclitaxel MO024M M 5,700 1 Y N CBC, BAR CODE OF Daycare
squamous TESTS
carcinoma, (PATHOLOGY,
salivary gland RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
303 MO (Medical CT for CA Head & Neck–Paclitaxel MO024N M 12,200 2 Y N CBC, BAR CODE OF Daycare
squamous TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
304 MO (Medical CT for CA Head & Neck–Carboplatin MO024O M 2,400 3 Y N CBC, BAR CODE OF Daycare
and neck, TESTS
squamous RADIOLOGY,
nasopharyngeal HEMATOLOGY,
carcinoma BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
305 MO (Medical CT for CA Head & Neck–Cisplatin MO024P M 2,200 3 Y N CBC, BAR CODE OF Daycare
and neck, TESTS
squamous RADIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
306 MO (Medical CT for Renal Cell Cancer–Sunitinib MO025A M 26,400 2 Y N CBC, RFT, BAR CODE OF Daycare
Thorax, REPORTS OF THE
abdomen and TESTS
Pelvis,lipid (PATHOLOGY,
profile, 2 D RADIOLOGY,
ECHO, TFT, 24 MICROBIOLOGY,
hour urine HEMATOLOGY,
protein BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
307 MO (Medical CT for Ureter / Bladder / MO026A M 6,000 1 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Cisplatin + Methotrexate + LFT, CECT THE DRUGS,
Vinblastin Thorax, REPORTS OF THE
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
308 MO (Medical CT for Ureter / Bladder / MO026B M 14,300 3 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Carboplatin + Gemcitabine LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MRI,histopathol RADIOLOGY,
ogy MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
309 MO (Medical CT for Ureter / Bladder / MO026C M 11,100 3 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Cisplatin + Gemcitabine LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, MRI, (PATHOLOGY,
ECG, 2D- RADIOLOGY,
ECHO,Histopat MICROBIOLOGY,
hology HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
310 MO (Medical CT for Ureter / Bladder / MO026D M 7,800 3 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Cisplatin + 5 FU LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
311 MO (Medical CT for Ureter / Bladder / MO026E M 13,500 3 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Cisplatin + Paclitaxel LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
312 MO (Medical CT for Ureter / Bladder / MO026F M 14,400 1 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Docetaxel LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
313 MO (Medical CT for Ureter / Bladder / MO026G M 17,500 3 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Gemcitabine + Paclitaxel LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
314 MO (Medical CT for Ureter / Bladder / MO026H M 9,200 2 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Gemcitabine LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
315 MO (Medical CT for Ureter / Bladder / MO026I M 6,600 2 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Methotrexate + Vinblastin + LFT, CECT THE DRUGS,
Doxorubicin + Cisplatin Thorax, REPORTS OF THE
abdomen and TESTS
Pelvis, MRI, (PATHOLOGY,
histopathology, RADIOLOGY,
ECG, ECHO MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
316 MO (Medical CT for Ureter / Bladder / MO026J M 15,100 1 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Paclitaxel + Carboplatin LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
317 MO (Medical CT for Ureter / Bladder / MO026K M 5,700 2 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Urethra–Paclitaxel LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
318 MO (Medical CT for CA Penis–Cisplatin + MO027A M 13,500 1 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Paclitaxel LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
319 MO (Medical CT for CA Penis–5 FU + Cisplatin MO027B M 7,800 1 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
320 MO (Medical CT for CA Penis–Capecitabine MO027C M 7,400 1 Y N CBC, RFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
321 MO (Medical CT for CA Penis–Paclitaxel + MO027D M 15,100 2 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Carboplatin LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
322 MO (Medical CT for CA Penis–Paclitaxel MO027E M 5,700 1 Y N CBC, RFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
323 MO (Medical CT for CA Penis–Paclitaxel MO027F M 12,200 1 Y N CBC, RFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
324 MO (Medical CT for CA Penis–Paclitaxel + MO027G M 7,900 1 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Carboplatin LFT, CECT THE DRUGS,
abdomen and TESTS
Pelvis, (PATHOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
325 MO (Medical CT for CA Prostate–Docetaxel MO028A M 11,700 1 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) LFT, PSA, THE DRUGS,
ECG, REPORTS OF THE
CECTThorax, TESTS
Pelvis,bone RADIOLOGY,
scan,histopatho MICROBIOLOGY,
logy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
326 MO (Medical CT for CA Prostate–Docetaxel MO028B M 14,100 5 Y N CBC, RFT, BAR CODE OF Daycare
ECG, REPORTS OF THE
CECTThorax, TESTS
logy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
327 MO (Medical CT for CA Prostate–Etoposide + MO028C M 7,100 3 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Carboplatin LFT, PSA, THE DRUGS,
ECG, REPORTS OF THE
CECTThorax, TESTS
logy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
328 MO (Medical CT for CA Prostate–LHRH Agonist MO028D M 15,300 1 Y N CBC, RFT, BAR CODE OF Daycare
ECG, REPORTS OF THE
CECTThorax, TESTS
logy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
329 MO (Medical CT for CA Prostate–Mitoxantrone + MO028E M 4,200 1 Y N CBC, RFT, BAR CODE OF Daycare
Oncology) Prednisolone LFT, PSA, THE DRUGS,
ECG, REPORTS OF THE
CECTThorax, TESTS
logy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
330 MO (Medical CT for CA Prostate–Paclitaxel + MO028F M 7,700 3 Y N CBC, RFT, BAR CODE OF Daycare
ECG, REPORTS OF THE
CECTThorax, TESTS
logy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
331 MO (Medical CT for CA Prostate–Paclitaxel + MO028G M 15,100 2 Y N CBC, RFT, BAR CODE OF Daycare
ECG, REPORTS OF THE
CECTThorax, TESTS
logy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
332 MO (Medical CT for CA Prostate–Docetaxel MO028H M 14,700 1 Y N CBC, RFT, BAR CODE OF Daycare
ECG, REPORTS OF THE
CECTThorax, TESTS
logy HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
333 MO (Medical CT for B - Cell NHL - High Grade MO029A M 26,200 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) (Except Burkitt's & PCNSL)–R - try,PET CT or THE DRUGS,
CEOP CECT Chest REPORTS OF THE
abdomen and TESTS
pelvis, Bone (PATHOLOGY,
Biopsy or fluid MICROBIOLOGY,
flow/PB HEMATOLOGY,
cytometry,ECG, BIOCHEMISTRY,E
2D-ECHO TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
334 MO (Medical CT for B - Cell NHL - High Grade MO029B M 27,000 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) (Except Burkitt's & PCNSL)–R - try,PET CT or THE DRUGS,
CHOP CECT Chest REPORTS OF THE
abdomen and TESTS
flow HEMATOLOGY,
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
335 MO (Medical CT for High - Grade NHL - B MO030A M 34,900 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Cell–Rituxmab + Dexamethasone + try,PET CT or THE DRUGS,
High Dose Cytarabine + Cisplatin CECT Chest REPORTS OF THE
abdomen and TESTS
flow cytometry. HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
336 MO (Medical CT for Relapsed B - Cell NHL - High MO031A M 35,300 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Grade try,PET CT or THE DRUGS,
(Except Burkitt's & PCNSL)–GDP - R CECT Chest REPORTS OF THE
abdomen and TESTS
flow cytometry, HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
337 MO (Medical CT for Relapsed B - Cell NHL - High MO031B M 31,900 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Grade try,PET CT or THE DRUGS,
(Except Burkitt's & PCNSL)–ICE - R CECT Chest REPORTS OF THE
abdomen and TESTS
flow cytometry HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
338 MO (Medical CT for PMBCL / Burkitt's Lymphoma / MO032A M 31,700 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Seropositive try,PET CT or THE DRUGS,
B - Cell NHLR–EPOCH CECT Chest REPORTS OF THE
abdomen and TESTS
flow HEMATOLOGY,
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
339 MO (Medical CT for Burkitt's NHL–Codox - M - MO033A M 34,500 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) IVAC / GMALL / BFM / Hyper CVAD try,PET CT or THE DRUGS,
CECT Chest REPORTS OF THE
abdomen and TESTS
flow HEMATOLOGY,
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
340 MO (Medical CT for Low Grade B - Cell MO034A M 30,700 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) NHL–Bendamustine + Rituximab try,PET CT or THE DRUGS,
abdomen and TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
341 MO (Medical CT for Low Grade B - Cell MO034B M 27,500 3 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) NHL–Lenalidomide + Rituximab try,PET CT or THE DRUGS,
abdomen and TESTS
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
342 MO (Medical CT for Low Grade NHL –Rituximab MO035A M 24,800 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) try,CECT Chest THE DRUGS,
abdomen and REPORTS OF THE
pelvis, Bone TESTS
marrow studies, (PATHOLOGY,
Biopsy or fluid RADIOLOGY,
flow cytometry. MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
343 MO (Medical CT for Low Grade NHL –Rituximab + MO035B M 25,800 3 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Cyclophosphamide + Vincristine + try,USG THE DRUGS,
Prednisolone abdmen and REPORTS OF THE
Pelvis CECT TESTS
Chest abdomen (PATHOLOGY,
and pelvis, RADIOLOGY,
Bone marrow MICROBIOLOGY,
studies, Biopsy HEMATOLOGY,
or fluid flow BIOCHEMISTRY,E
cytometry. TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
344 MO (Medical CT for Chronic Lymphocytic MO036A M 18,100 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Leukemia–Fludarabine + try,Chest X ay THE DRUGS,
Cyclophosphamide and USG REPORTS OF THE
abdomen/pelvis TESTS
or CECT Chest (PATHOLOGY,
pelvis, Bone MICROBIOLOGY,
marrow studies, HEMATOLOGY,
Biopsy or fluid BIOCHEMISTRY,E
flow cytometry. TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
345 MO (Medical CT for Chronic Lymphocytic MO036B M 24,900 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Leukemia–Rituxmab + Chlorambucil try,Chest X ay THE DRUGS,
and USG REPORTS OF THE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
346 MO (Medical CT for Chronic Lymphocytic MO036C M 40,700 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Leukemia–Rituximab + Fludarabine + try,Chest X ay THE DRUGS,
Cyclophosphamide and USG REPORTS OF THE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
347 MO (Medical CT for Chronic Lymphocytic MO036D M 4,800 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Leukemia–Lenalidomide try,Chest X ay THE DRUGS,
and USG REPORTS OF THE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
348 MO (Medical CT for Peripheral T - Cell MO037A M 5,000 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–CHOEP try,LDH,PET THE DRUGS,
CECT or CECT REPORTS OF THE
chest abdomen TESTS
and pelvis, (PATHOLOGY,
Bone marrow RADIOLOGY,
studies, Biopsy MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
349 MO (Medical CT for Peripheral T - Cell MO037B M 4,000 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–CHOP try,LDH,PET THE DRUGS,
chest abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
350 MO (Medical CT for Peripheral T - Cell MO037C M 19,300 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–SMILE try,LDH,PET THE DRUGS,
chest abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
351 MO (Medical CT for NK - T Cell MO038A M 18,900 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–GELOX try,LDH,PET THE DRUGS,
chest abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
352 MO (Medical CT for NK - T Cell Lymphoma–LVP MO038B M 7,600 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) try,LDH,PET THE DRUGS,
chest abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
353 MO (Medical CT for Hodgkin's Lymphoma–COPP MO039A M 3,600 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) try,PET CT or THE DRUGS,
abdomen and TESTS
node Biopsy. MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
354 MO (Medical CT for Hodgkin's Lymphoma–ABVD MO039B M 10,200 2 Y N CBC,Biochemis BAR CODE OF Daycare
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
355 MO (Medical CT for Hodgkin's Lymphoma–AEVD MO039C M 10,200 1 Y N CBC,Biochemis BAR CODE OF Daycare
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
356 MO (Medical CT for Relapsed Hodgkin MO040A M 9,700 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–ICE try,LDH,PET THE DRUGS,
chest abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
357 MO (Medical CT for Relapsed Hodgkin MO040B M 9,700 4 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–MINE try,LDH,PET THE DRUGS,
chest abdomen TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
358 MO (Medical CT for Relapsed Hodgkin MO040C M 12,500 2 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–PTCL - GDP try,PET CT or THE DRUGS,
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
359 MO (Medical CT for Relapsed NHL & HL–DHAP MO041A M 11,500 4 Y N CBC,Biochemis BAR CODE OF Daycare
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
360 MO (Medical CT for MM / Amyloidosis / MO042A M 6,000 3 Y N CBC, BAR CODE OF Daycare
Oncology) POEMS–LD Biochemistry, THE DRUGS,
Serum protein REPORTS OF THE
electrophoresis, TESTS
Immunofixation, (PATHOLOGY,
Serum free light RADIOLOGY,
chain assay, MICROBIOLOGY,
Bone marrow HEMATOLOGY,
studies, BIOCHEMISTRY,E
Skeletal survey, TC.) DISCHARGE
Urine BJP SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
361 MO (Medical CT for MM / Amyloidosis / MO042B M 6,800 3 Y N CBC, BAR CODE OF Daycare
Oncology) POEMS–POM DEX Biochemistry, THE DRUGS,
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
362 MO (Medical CT for MM / Amyloidosis–CTD MO043A M 4,000 3 Y N CBC, BAR CODE OF Daycare
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
363 MO (Medical CT for MM / Amyloidosis–MPT MO043B M 4,100 3 Y N CBC, BAR CODE OF Daycare
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
364 MO (Medical CT for MM / Amyloidosis–VCD MO043C M 14,600 3 Y N CBC, BAR CODE OF Daycare
Bone marrow (PATHOLOGY,
studies, skeletal RADIOLOGY,
survey, Urine MICROBIOLOGY,
BJP. HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
365 MO (Medical CT for MM / Amyloidosis–VD MO043D M 13,300 3 Y N CBC, BAR CODE OF Daycare
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
366 MO (Medical CT for MM / Amyloidosis–VMP MO043E M 12,600 2 Y N CBC, BAR CODE OF Daycare
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
367 MO (Medical CT for MM / Amyloidosis–VRD MO043F M 17,800 3 Y N CBC, BAR CODE OF Daycare
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
368 MO (Medical CT for MM / Amyloidosis–VTD MO043G M 15,000 3 Y N CBC, BAR CODE OF Daycare
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
369 MO (Medical CT for Chronic Myeloid MO044A M 19,400 3 Y N CBC,RFT,LFT, BAR CODE OF Daycare
Oncology) Leukemia–Imatinib MDC,BONE THE DRUGS,
MARROW, REPORTS OF THE
BIOPSY,CYTO TESTS
GENETICS, (PATHOLOGY,
RQ PCR BCR RADIOLOGY,
ABL MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
370 MO (Medical CT for Myeloproliferative MO045A M 2,200 3 Y N CBC,RFT,LFT, BAR CODE OF Daycare
Oncology) Neoplasm–Hydroxurea MDC,BONE THE DRUGS,
MARROW REPORTS OF THE
,CYTOGENETI TESTS
CS (PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
371 MO (Medical CT for Acute Myeloid MO046A M 60,000 4 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) Leukemia–Consolidation RBS, Bone THE DRUGS,
marrow REPORTS OF THE
aspiration, flow TESTS
cytometry or (PATHOLOGY,
Peripheral RADIOLOGY,
blood flow MICROBIOLOGY,
cytometry, HEMATOLOGY,
cytogenetics, BIOCHEMISTRY,E
Molecular TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
372 MO (Medical CT for Acute Myeloid MO046B M 96,000 4 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) Leukemia–Induction RBS, Bone THE DRUGS,
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
373 MO (Medical CT for Acute Lymphoblastic MO047A M 160,000 4 Y N CBC BIOCHEM BAR CODE OF Daycare
Oncology) Leukemia–Consolidation THE DRUGS,
(Phase II, CNS Therapy Reinduction) REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
374 MO (Medical CT for Acute Lymphoblastic MO047B M 80,000 4 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) Leukemia–Induction HBSAG,HCV,2 THE DRUGS,
D ECHO,NCCT REPORTS OF THE
CHEST,BONE TESTS
MARROW or (PATHOLOGY,
bloodFLOW MICROBIOLOGY,
CYTOMETRY, HEMATOLOGY,
CYTOGENETI BIOCHEMISTRY,E
CS,Molecular,B TC.) DISCHARGE
IOPSY, PET- SUMMARY OF
CT or CECT INPATIENT
chest abdomen DEPARTMENT,
and Pelvis(if DISCHARGE
LBL) SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
375 MO (Medical CT for Acute Lymphoblastic MO047C M 4,000 0 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) Leukemia–Maintenance HBSAG,HCV,BI THE DRUGS,
OCHEM,CSF REPORTS OF THE
CYTOMORPH TESTS
OLOGY,FLOW (PATHOLOGY,
CYTOMETRY, RADIOLOGY,
BONE MICROBIOLOGY,
MARROW HEMATOLOGY,
FLOW BIOCHEMISTRY,E
CYTOMETRY, TC.) DISCHARGE
CYTOGENETI SUMMARY OF
CS,NGS,BIOPS INPATIENT
Y DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
376 MO (Medical CT for Lymphoblastic MO048A M 160,000 0 Y N CBC BIOCHEM BAR CODE OF Daycare
Oncology) Lymphoma–Consolidation THE DRUGS,
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
377 MO (Medical CT for Lymphoblastic MO048B M 80,000 0 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) Lymphoma–Induction HBSAG,HCV,2 THE DRUGS,
CHEST,BONE TESTS
LBL) SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
378 MO (Medical CT for Lymphoblastic MO048C M 4,000 0 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) Lymphoma–Maintenance HBSAG,HCV,BI THE DRUGS,
CYTOMORPH TESTS
BONE MICROBIOLOGY,
MARROW HEMATOLOGY,
FLOW BIOCHEMISTRY,E
Y DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
379 MO (Medical CT for Acute Promyelocytic Leukemia MO049A M 32,000 0 Y N CBC BIOCHEM BAR CODE OF Daycare
Oncology) (High Risk)–High Risk Consolidation ECG THE DRUGS,
BONEMARRO REPORTS OF THE
W RQPCR TESTS
PML RARA (PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
380 MO (Medical CT for Acute Promyelocytic Leukemia MO049B M 96,000 0 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) (High Risk)–High Risk Induction HBSAG,HCV,BI THE DRUGS,
OCHEM,PT,AP REPORTS OF THE
TT,FIBRINOGE TESTS
N,2D (PATHOLOGY,
ECHO,NCCT RADIOLOGY,
CHEST,BONE MICROBIOLOGY,
MARROW HEMATOLOGY,
FLOW BIOCHEMISTRY,E
CS,RQPCR INPATIENT
PML DEPARTMENT,
RARA,BIOPSY DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
381 MO (Medical CT for Acute Promyelocytic Leukemia MO049C M 8,000 0 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) (High Risk)–High Risk Maintenance HBSAG,HCV,BI THE DRUGS,
TT,FIBRINOGE TESTS
N,2D (PATHOLOGY,
MARROW HEMATOLOGY,
FLOW BIOCHEMISTRY,E
CS,RQPCR INPATIENT
PML DEPARTMENT,
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
382 MO (Medical CT for Acute Promyelocytic Leukemia MO050A M 12,000 0 Y N CBC LFT BAR CODE OF Daycare
Oncology) (Low Risk)–Low Risk Consolidation THE DRUGS,
REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
383 MO (Medical CT for Acute Promyelocytic Leukemia MO050B M 80,000 0 Y N CBC BIOCHEM BAR CODE OF Daycare
Oncology) (Low Risk)–Low Risk Induction THE DRUGS,
REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
384 MO (Medical Febrile Neutopenia–First Line MO051A M 28,000 0 Y N CBC, BAR CODE OF Daycare
Oncology) Antibiotics BIOCHEM, THE DRUGS,
ECG, BONE REPORTS OF THE
MARROW, RQ TESTS
PCR, PML (PATHOLOGY,
RARA RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
385 MO (Medical Febrile Neutopenia–Second Line MO051B M 60,000 1 Y N CBC, LFT, RQ BAR CODE OF Daycare
Oncology) Antibiotics and Antifungals PCR, PML THE DRUGS,
RARA REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
386 MO (Medical Chemotherapy Complications - Tumor MO052A M 24,000 1 Y N CBC, LFT, BAR CODE OF Daycare
Oncology) Lysis Syndrome–Chemotherapy Serum THE DRUGS,
Complications - Tumor Lysis Electrolytes, REPORTS OF THE
Syndrome Blood TESTS
Phosphate (PATHOLOGY,
levels, Uric RADIOLOGY,
Acid, BUN MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
387 MO (Medical Granulocyte Colony Stimulating MO053A M 12,800 1 Y N CBC, Bone BAR CODE OF Daycare
Oncology) Factor Use–Granulocyte Colony marrow, RFT, THE DRUGS,
Stimulating Factor Use LFT REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
388 MO (Medical CT for Langerhans Cell MO054A M 22,400 1 Y N CBC,RFT,LFT, BAR CODE OF Daycare
Oncology) Histiocytosis–Langerhans Cell MDC,BONE THE DRUGS,
Histiocytosis MARROW, REPORTS OF THE
(Histiocytosis Protocol - Induction) BIOPSY, TESTS
SKELETAL (PATHOLOGY,
SURVEY OR RADIOLOGY,
PET CECT MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
389 MO (Medical CT for Langerhans Cell MO054B M 17,000 1 Y N CBC,RFT,LFT, BAR CODE OF Daycare
Oncology) Histiocytosis–Langerhans Cell MDC,BONE THE DRUGS,
Histiocytosis MARROW, REPORTS OF THE
(Histiocytosis Protocol - Maintenance) SKELETAL TESTS
SURVEY OR (PATHOLOGY,
PET CECT RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
390 MO (Medical CT for Low Grade Glioma–Vincristine MO055A M 5,600 1 Y N CBC, BAR CODE OF Daycare
Oncology) + Carboplatin Biochemistry, THE DRUGS,
MRI, Biopsy REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
391 MO (Medical CT for Low Grade Glioma–Vinblastin MO055B M 1,900 1 Y N CBC, BAR CODE OF Daycare
MRI, Biopsy REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
392 MO (Medical CT for Medulloblastoma / Brain MO056A M 4,900 1 Y N CBC, BAR CODE OF Daycare
Oncology) PNET–PACKER Biochemistry, THE DRUGS,
MRI (BRAIN REPORTS OF THE
AND SPINE), TESTS
Biopsy, CSF (PATHOLOGY,
CYTOLOGY, RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
393 MO (Medical CT for Medulloblastoma / CNS MO056B M 8,300 1 Y N CBC, BAR CODE OF Daycare
Oncology) PNET–CET Biochemistry, THE DRUGS,
MRI (BRAIN REPORTS OF THE
AND SPINE), TESTS
Biopsy, CSF (PATHOLOGY,
CYTOLOGY, RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
394 MO (Medical CT for Neuroblastoma–Cabroplatin + MO057A M 7,900 1 Y N CBC, BAR CODE OF Daycare
Oncology) Etoposide + Cyclophosphamide + Biochemistry, THE DRUGS,
Doxorubicin CECT/MRI, REPORTS OF THE
BONE TESTS
MARROW (PATHOLOGY,
STUDIES, RADIOLOGY,
MIBG OR MICROBIOLOGY,
BONE OR PET HEMATOLOGY,
CT SCAN, BIOCHEMISTRY,E
BIOPSY, FISH TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
395 MO (Medical CT for Neuroblastoma–RAPID MO057B M 6,800 1 Y N CBC, BAR CODE OF Daycare
Oncology) COJEC Biochemistry, THE DRUGS,
CECT/MRI, REPORTS OF THE
BONE TESTS
MARROW (PATHOLOGY,
STUDIES, RADIOLOGY,
MIBG OR MICROBIOLOGY,
BONE OR PET HEMATOLOGY,
CT SCAN, BIOCHEMISTRY,E
BIOPSY, FISH TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
396 MO (Medical CT for Neuroblastoma–RETINOID MO057C M 2,000 1 Y N CBC, BAR CODE OF Daycare
Oncology) Biochemistry THE DRUGS,
REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
397 MO (Medical CT for Retinoblastoma–JOE / COPE MO058A M 7,100 1 Y N CBC, BAR CODE OF Daycare
MRI/CT (BRAIN REPORTS OF THE
AND ORBITS), TESTS
ULTRASONOG (PATHOLOGY,
RAPHY, BONE RADIOLOGY,
MARROW AND MICROBIOLOGY,
CSF STUDIES HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
398 MO (Medical CT for Rhabdomyosarcoma–VCD MO059A M 4,800 1 Y N CBC, BAR CODE OF Daycare
MRI OR CECT, REPORTS OF THE
BONE TESTS
MARROW (PATHOLOGY,
STUDIES, RADIOLOGY,
BONE SCAN MICROBIOLOGY,
OR PET CT, HEMATOLOGY,
Biopsy BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
399 MO (Medical CT for Rhabdomyosarcoma–VIE MO059B M 16,200 1 Y N CBC, BAR CODE OF Daycare
BONE TESTS
MARROW (PATHOLOGY,
STUDIES, RADIOLOGY,
Biopsy BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
400 MO (Medical CT for Relapse MO060A M 12,200 1 Y N CBC, BAR CODE OF Daycare
Oncology) Rhabdomyosarcoma–VTC + VAC Biochemistry, THE DRUGS,
BONE TESTS
MARROW (PATHOLOGY,
STUDIES, RADIOLOGY,
Biopsy, 2D BIOCHEMISTRY,E
ECHO TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
401 MO (Medical CT for Wilms Tumor–VINC + ACTIN. MO061A M 3,000 1 Y N CBC, BAR CODE OF Daycare
Oncology) D Biochemistry, THE DRUGS,
CT CHEST REPORTS OF THE
ABDOMEN, TESTS
RAPHY, RADIOLOGY,
BIOPSY MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
402 MO (Medical CT for Wilms Tumor–VINC + ACTIN. MO061B M 4,200 2 Y N CBC, BAR CODE OF Daycare
Oncology) D + DOX Biochemistry, THE DRUGS,
ABDOMEN, TESTS
RAPHY, RADIOLOGY,
BIOPSY, 2D MICROBIOLOGY,
ECHO HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
403 MO (Medical CT for Wilms Tumor–Cyclo + Dox + MO061C M 12,300 1 Y N CBC, BAR CODE OF Daycare
Oncology) Etop + Vinc + Actino . D Biochemistry, THE DRUGS,
ABDOMEN, TESTS
RAPHY, RADIOLOGY,
BIOPSY, 2D MICROBIOLOGY,
ECHO HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
404 MO (Medical CT for Pediatric Acute Lymphoblastic MO062A M 208,600 1 Y N CBC BIOCHEM BAR CODE OF Daycare
Oncology) Leukemia–Consolidation THE DRUGS,
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
405 MO (Medical CT for Pediatric Acute Lymphoblastic MO062B M 72,000 2 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) Leukemia–Induction HBSAG,HCV,2 THE DRUGS,
CHEST,BONE TESTS
LBL) SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
406 MO (Medical CT for Pediatric Acute Lymphoblastic MO062C M 2,500 1 Y N CBC,MDC,HIV,BAR CODE OF Daycare
Oncology) Leukemia–Maintenance HBSAG,HCV,BITHE DRUGS,
CYTOMORPH TESTS
BONE MICROBIOLOGY,
MARROW HEMATOLOGY,
FLOW BIOCHEMISTRY,E
CS,NGS,BIOPSINPATIENT
Y DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
407 MO (Medical CT for Pediatric Lymphoblastic MO063A M 208,600 1 Y N CBC BIOCHEM BAR CODE OF Daycare
Oncology) Lymphoma–Consolidation THE DRUGS,
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
408 MO (Medical CT for Pediatric Lymphoblastic MO063B M 72,000 1 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) Lymphoma–Induction HBSAG,HCV,2 THE DRUGS,
CHEST,BONE TESTS
LBL) SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
409 MO (Medical CT for Pediatric Lymphoblastic MO063C M 2,500 1 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) Lymphoma–Maintenance HBSAG,HCV,BI THE DRUGS,
CYTOMORPH TESTS
BONE MICROBIOLOGY,
MARROW HEMATOLOGY,
FLOW BIOCHEMISTRY,E
Y DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
410 MO (Medical CT for Pediatric Acute Myeloid MO064A M 57,600 1 Y N CBC, LFT,RFT, BAR CODE OF Daycare
Oncology) Leukemia–Consolidation - High Dose RBS, Bone THE DRUGS,
Cytarabine marrow REPORTS OF THE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
411 MO (Medical CT for Pediatric Acute Myeloid MO064B M 94,400 1 Y N CBC, LFT,RFT, BAR CODE OF Daycare
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
412 MO (Medical CT for Pediatric Acute Myeloid MO064C M 92,800 1 Y N CBC, LFT,RFT, BAR CODE OF Daycare
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
413 MO (Medical CT for Pediatric Acute Promyelocytic MO065A M 36,800 1 Y N CBC BIOCHEM BAR CODE OF Daycare
Oncology) Leukemia–Consolidation ECG THE DRUGS,
BONEMARRO REPORTS OF THE
W RQPCR TESTS
PML RARA (PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
414 MO (Medical CT for Pediatric Acute Promyelocytic MO065B M 97,600 1 Y N CBC BIOCHEM BAR CODE OF Daycare
Oncology) Leukemia–Induction THE DRUGS,
REPORTS OF THE
TESTS
(PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
415 MO (Medical CT for Pediatric Acute Promyelocytic MO065C M 39,300 0 Y N CBC,MDC,HIV, BAR CODE OF Daycare
Oncology) Leukemia–Maintenance HBSAG,HCV,BI THE DRUGS,
TT,FIBRINOGE TESTS
N,2D (PATHOLOGY,
MARROW HEMATOLOGY,
FLOW BIOCHEMISTRY,E
CS,RQPCR INPATIENT
PML DEPARTMENT,
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
416 MO (Medical CT for Pediatric Hodgkins MO066A M 7,800 0 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–COPDAC try,PET CT or THE DRUGS,
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
417 MO (Medical CT for Pediatric Hodgkins MO066B M 13,000 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–OPEA try,PET CT or THE DRUGS,
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
418 MO (Medical CT for Pediatric Hodgkins Lymphoma MO067A M 21,500 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Relapse–ICE try,PET CT or THE DRUGS,
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
419 MO (Medical CT for Pediatric Hodgkins Lymphoma MO067B M 17,800 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Relapse–DECA try,PET CT or THE DRUGS,
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
420 MO (Medical CT for Pediatric Hodgkins Lymphoma MO067C M 34,000 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Relapse–IGVD try,PET CT or THE DRUGS,
abdomen and TESTS
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
421 MO (Medical CT for Pediatric Non Hodgkins MO068A M 33,500 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–LMB 89 - 96 - try,PET CT or THE DRUGS,
Consolidation CECT Chest REPORTS OF THE
abdomen and TESTS
flow HEMATOLOGY,
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
422 MO (Medical CT for Pediatric Non Hodgkins MO068B M 33,100 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–LMB 89 - 96 - Induction - try,PET CT or THE DRUGS,
COPADAM CECT Chest REPORTS OF THE
abdomen and TESTS
flow HEMATOLOGY,
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
423 MO (Medical CT for Pediatric Non Hodgkins MO068C M 15,400 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–LMB 89 - 96 - try,PET CT or THE DRUGS,
Maintenance CECT Chest REPORTS OF THE
abdomen and TESTS
flow HEMATOLOGY,
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
424 MO (Medical CT for Pediatric Non Hodgkins MO068D M 13,200 1 Y N CBC,Biochemis BAR CODE OF Daycare
Oncology) Lymphoma–MCP - 842 try,PET CT or THE DRUGS,
abdomen and TESTS
flow HEMATOLOGY,
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN
425 MO (Medical PEDIATRIC-GCT/JEB–PEDIATRIC- MO069A M 10,000 2 Y N CBC, BAR CODE OF Daycare
Oncology) GCT/JEB Biochemistry, THE DRUGS,
TUMOR REPORTS OF THE
MARKERS, TESTS
CECT CHEST (PATHOLOGY,
AND RADIOLOGY,
ABDOMEN, MICROBIOLOGY,
Biopsy, HEMATOLOGY,
AUDIOMETRY, BIOCHEMISTRY,E
GFR TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
426 MO (Medical CT for Pediatric MO070A M 4,900 0 Y N CBC, BAR CODE OF Daycare
Oncology) Hepatoblastoma–Carboplatin + Biochemistry, THE DRUGS,
Cisplatin + Doxorubicin CECT CHEST REPORTS OF THE
AND TESTS
ABDOMEN, (PATHOLOGY,
Biopsy, ECG, RADIOLOGY,
2D-ECHO, MICROBIOLOGY,
AUDIOMETRY, HEMATOLOGY,
GFR BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
427 MO (Medical CT for Pediatric MO070B M 5,600 0 Y N CBC, BAR CODE OF Daycare
Oncology) Hepatoblastoma–Cisplatin Biochemistry, THE DRUGS,
S.AFP, CECT REPORTS OF THE
CHEST AND TESTS
ABDOMEN, (PATHOLOGY,
Biopsy, RADIOLOGY,
AUDIOMETRY, MICROBIOLOGY,
GFR HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
428 MO (Medical CT for CA Lung–Docetaxel MO071A M 16,200 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis (PATHOLOGY,
RADIOLOGY,
MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
429 MO (Medical CT for CA Lung–Erlotinib MO071B M 13,000 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, EGFR (PATHOLOGY,
mutation RADIOLOGY,
positive MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
430 MO (Medical CT for CA Lung–Gefitnib MO071C M 11,000 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, EGFR (PATHOLOGY,
mutation RADIOLOGY,
positive MICROBIOLOGY,
HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
431 MO (Medical CT for CA Lung–Paclitaxel + MO071D M 15,100 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
(non small cell MICROBIOLOGY,
carcinoma) HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
432 MO (Medical CT for CA Lung–Pemetrexed + MO071E M 10,000 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
(non small cell - MICROBIOLOGY,
adenocarcinom HEMATOLOGY,
a or BIOCHEMISTRY,E
adenosquamou TC.) DISCHARGE
s carcinoma) SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
433 MO (Medical CT for CA Lung–Topotecan MO071F M 24,600 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
histopathology - RADIOLOGY,
Small Cell Lung MICROBIOLOGY,
Carcinoma HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
434 MO (Medical CT for CA Lung–Docetaxel MO071G M 14,600 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
histopathology- RADIOLOGY,
Non Small cell MICROBIOLOGY,
Lung cancer HEMATOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
435 MO (Medical CT for CA Lung–Etoposide + MO071H M 7,100 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
436 MO (Medical CT for CA Lung–Etoposide + Cisplatin MO071I M 5,500 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
437 MO (Medical CT for CA Lung–Gemcitabine MO071J M 8,900 0 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
438 MO (Medical CT for CA Lung–Gemcitabine + MO071K M 14,300 5 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
439 MO (Medical CT for CA Lung–Gemcitabine + MO071L M 11,100 5 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
440 MO (Medical CT for CA Lung–Paclitaxel MO071M M 5,800 5 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
441 MO (Medical CT for CA Lung–Paclitaxel MO071N M 12,000 5 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
442 MO (Medical CT for CA Lung–Paclitaxel + MO071O M 7,900 1 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
443 MO (Medical CT for CA Lung–Paclitaxel + Cisplatin MO071P M 13,500 3 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
444 MO (Medical CT for CA Lung–Pemetrexed + MO071Q M 9,200 5 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
adenocarcinom MICROBIOLOGY,
a and HEMATOLOGY,
adenosquamou BIOCHEMISTRY,E
s carcinoma TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
445 MO (Medical CT for CA Lung–Pemetrexed MO071R M 7,600 5 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
(non small cell - MICROBIOLOGY,
adenocarcinom HEMATOLOGY,
a or BIOCHEMISTRY,E
adenosquamou TC.) DISCHARGE
s carcinoma) SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
446 MO (Medical CT for CA Lung–Vinorelbine + MO071S M 22,800 4 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
447 MO (Medical CT for CA Lung–Vinorelbine + MO071T M 20,600 5 Y N CBC, LFT, BAR CODE OF Daycare
abdomen and TESTS
Pelvis, (PATHOLOGY,
BIOCHEMISTRY,E
TC.) DISCHARGE
SUMMARY OF
INPATIENT
DEPARTMENT,
DISCHARGE
SUMMARY OF
DAY CARE
DEPARTMENT,
CHARTS OF
CHEMOTHERAPY
REGIMEN,
TRANFUSION
SLIPS
448 MP (Paediatric Febrile seizures / other MP001A M Package 5 N N Clinical notes Detailed ICPs, NA
Madical seizures–Febrile seizures Amount per detailing history Treatment details,
Management) day (drop and Admission detailed discharge
admission vitals; planned investigations
type: Routine line reports.
ward (Rs management;
1800)/ HDU 1st seizure or
(Rs (Rs 2700)/ past history
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
449 MP (Paediatric Febrile seizures / other seizures–Flury MP001B M Package 7 N N Clinical notes Detailed ICPs, NA
Madical of seizures Amount per detailing history Treatment details,
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
450 MP (Paediatric Febrile seizures / other MP001C M Package 3 N N Clinical notes Detailed ICPs, NA
Madical seizures–Neurocysticercosis Amount per detailing history Treatment details,
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
451 MP (Paediatric Febrile seizures / other MP001D M Package 3 N N Clinical notes Detailed ICPs, NA
Madical seizures–Epilepsy Amount per detailing history Treatment details,
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
452 MP (Paediatric Epileptic encephalopathy–Epileptic MP002A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical encephalopathy Amount per detailing history Treatment details,
1800)/ HDU past h/o
(Rs (Rs 2700)/ epilpesy
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
453 MP (Paediatric Acute encephalitis–Infectious - MP003A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical uncomplicated Amount per detailing history Treatment details,
ward (Rs findings (incl
1800)/ HDU neurological
(Rs (Rs 2700)/ examination);
ICU (without any
ventilator) (Rs investigations
3600)/ ICU done; planned
(with line of
ventilator)(Rs management
4500)
454 MP (Paediatric Acute encephalitis–Immune-mediated MP003B M Package 1 N N Clinical notes Detailed ICPs, NA
Madical - uncomplicated Amount per detailing history Treatment details,
ICU (without any
(with line of
4500)
455 MP (Paediatric Acute encephalitis syndrome–Acute MP004A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical encephalitis syndrome Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
456 MP (Paediatric Acute meningo encephalitis / aseptic MP005A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical meningitis / febrile encephalopathy / Amount per detailing history Treatment details,
Management) hypertensive encehalopathy / day (drop and Admission detailed discharge
metabolic encephalopathy / hepatic down) for notes showing summary, All
encephalopathy / brain abcess –Acute admission vitals and investigations
meningo encephalitis type: Routine examination reports.
3600)/ ICU
(with
ventilator)(Rs
4500)
457 MP (Paediatric Acute meningo encephalitis / aseptic MP005B M Package 3 N N Clinical notes Detailed ICPs, NA
encephalopathy / brain abcess admission vitals and investigations
–Aseptic meningitis type: Routine examination reports.
3600)/ ICU
(with
ventilator)(Rs
4500)
458 MP (Paediatric Acute meningo encephalitis / aseptic MP005C M Package 3 N N Clinical notes Detailed ICPs, NA
–Febrile encephalopathy type: Routine examination reports.
3600)/ ICU
(with
ventilator)(Rs
4500)
459 MP (Paediatric Acute meningo encephalitis / aseptic MP005D M Package 3 N N Clinical notes Detailed ICPs, NA
–Hypertensive encehalopathy type: Routine examination reports.
3600)/ ICU
(with
ventilator)(Rs
4500)
460 MP (Paediatric Acute meningo encephalitis / aseptic MP005E M Package 5 N N Clinical notes Detailed ICPs, NA
–Metabolic encephalopathy type: Routine examination reports.
3600)/ ICU
(with
ventilator)(Rs
4500)
461 MP (Paediatric Acute meningo encephalitis / aseptic MP005F M Package 3 N N Clinical notes Detailed ICPs, NA
–Hepatic encephalopathy type: Routine examination reports.
3600)/ ICU
(with
ventilator)(Rs
4500)
462 MP (Paediatric Acute meningo encephalitis / aseptic MP005G M Package 5 N N Clinical notes Detailed ICPs, NA
encephalopathy / brain abcess –Brain admission vitals and investigations
abcess type: Routine examination reports.
3600)/ ICU
(with
ventilator)(Rs
4500)
463 MP (Paediatric Meningitis–Chronic meningitis MP006A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical Amount per detailing history Treatment details,
ICU (without any
(with line of
4500)
464 MP (Paediatric Meningitis–Partially treated pyogenic MP006B M Package 1 N N Clinical notes Detailed ICPs, NA
Madical meningitis Amount per detailing history Treatment details,
ICU (without any
(with line of
4500)
465 MP (Paediatric Meningitis–Neuro tuberculosis MP006C M Package 3 N N Clinical notes Detailed ICPs, NA
ICU (without any
(with line of
4500)
466 MP (Paediatric Meningitis–Complicated bacterial MP006D M Package 1 N N Clinical notes Detailed ICPs, NA
Madical meningitis Amount per detailing history Treatment details,
ICU (without any
(with line of
4500)
467 MP (Paediatric Meningitis–Acute meningitis MP006E M Package 1 N N Clinical notes Detailed ICPs, NA
ICU (without any
(with line of
4500)
468 MP (Paediatric Optic neuritis–Optic neuritis MP007A M Package 1 N N Clinical notes Detailed ICPs, NA
type: Routine fundus findings reports.
ward (Rs & photograph;
1800)/ HDU planned line
(Rs (Rs 2700)/ management;
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
469 MP (Paediatric Medical Management for Raised MP008A M Package 2 N N Clinical notes Detailed ICPs, NA
Madical intracranial pressure–After Amount per detailing history Treatment details,
Management) Decompressive craniotomy / day (drop and Admission detailed discharge
After Shunt procedure / down) for notes showing summary, All
After other emergency neuro surgical admission vitals and investigations
procedures / type: Routine examination reports.
For ICP monitoring ward (Rs findings (incl
ICU (without any
(with line of
4500)
470 MP (Paediatric Intracranial hemorrhage–Intracranial MP009A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical hemorrhage Amount per detailing history Treatment details,
ICU (without any
(with line of
4500)
471 MP (Paediatric Intracranial space occupying MP010A M Package 5 N N Clinical notes Detailed ICPs, NA
Madical lesion–Intracranial space occupying Amount per detailing history Treatment details,
Management) lesion day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
472 MP (Paediatric Intracranial ring enhancing lesion with MP011A M Package 5 N N Clinical notes Detailed ICPs, NA
Madical complication (tuberculoma)– Amount per detailing history Treatment details,
Management) Intracranial ring enhancing lesion day (drop and Admission detailed discharge
with complication (tuberculoma) down) for notes showing summary, All
ICU (without any
(with line of
4500)
473 MP (Paediatric Cerebral herniation–Cerebral MP012A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical herniation Amount per detailing history Treatment details,
ICU (without any
(with line of
4500)
474 MP (Paediatric Acute neuroregression / Acute MP013A M Package 3 N N Clinical notes Detailed ICPs (daily NA
Madical worsening in neuro metabolic and Amount per with planned Treatment details),
Management) neurodegenerative conditions–Acute day (drop line of Procedure /
neuroregression / Acute worsening in down) for treatment (incl Operative Notes (if
neuro metabolic and admission birth & past applicable), Detailed
neurodegenerative conditions type: Routine history), Discharge
ward (Rs Investigation Summary, All
1800)/ HDU Reports investigations
(Rs (Rs 2700)/ supporting reports.
ICU (without diagnosis
ventilator) (Rs (including CT
3600)/ ICU head), Planned
(with line of
ventilator)(Rs treatment
4500)
475 MP (Paediatric Acute demyelinating MP014A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical myelopathy–Acute demyelinating Amount per detailing history Treatment details,
Management) myelopathy day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
476 MP (Paediatric Juvenile myasthenia–Juvenile MP015A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical myasthenia Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
477 MP (Paediatric Acute ataxia–Acute ataxia MP016A M Package 3 N N Clinical notes Detailed ICPs, NA
ICU (without any
(with line of
4500)
478 MP (Paediatric Acute ischemic stroke–Acute MP017A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical ischemic stroke Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
479 MP (Paediatric Wheezing–Wheezing MP018A M Package 3 N N Clinical notes Detailed ICPs, NA
ward (Rs management
1800)/ HDU
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
480 MP (Paediatric Chronic cough–Chronic cough MP019A M Package 2 N N Clinical notes Detailed ICPs, NA
Management) day (drop and earlier detailed discharge
down) for Treatment done summary, All
admission and Admission investigations
ward (Rs vitals; planned
1800)/ HDU line
(Rs (Rs 2700)/ management
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
481 MP (Paediatric Acute urticaria / Anaphylaxis acute MP020A M Package 5 N N Clinical notes Detailed ICPs, NA
Madical asthma–Acute urticaria Amount per detailing history Treatment details,
1800)/ HDU specify the
(Rs (Rs 2700)/ trigger
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
482 MP (Paediatric Acute urticaria / Anaphylaxis acute MP020B M Package 1 N N Clinical notes Detailed ICPs, NA
Madical asthma–Anaphylaxis acute asthma Amount per detailing history Treatment details,
1800)/ HDU specify the
(Rs (Rs 2700)/ trigger
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
483 MP (Paediatric Acute abdomen–Acute abdomen MP021A M Package 1 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
484 MP (Paediatric Celiac disease–Celiac disease MP022A M Package 1 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
485 MP (Paediatric Unexplained MP023A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical hepatosplenomegaly–Unexplained Amount per detailing history Treatment details,
Management) hepatosplenomegaly day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
486 MP (Paediatric Infantile cholestasis–Infantile MP024A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical cholestasis Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
487 MP (Paediatric Acute glomerulonephritis–Acute MP025A M Package 5 N N Clinical notes Detailed ICPs, NA
Madical glomerulonephritis Amount per detailing history Treatment details,
(Rs (Rs 2700)/ done
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
488 MP (Paediatric Nephrotic syndrome with MP026A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical peritonitis–Nephrotic syndrome with Amount per detailing history Treatment details,
Management) peritonitis day (drop including past detailed discharge
down) for history, summary, All
admission examination investigations
type: Routine findindgs, reports.
1800)/ HDU done and
(Rs (Rs 2700)/ Admission
ICU (without notes showing
ventilator) (Rs vitals; planned
3600)/ ICU line
(with management
ventilator)(Rs
4500)
489 MP (Paediatric Haemolytic uremic MP027A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical syndrome–Haemolytic uremic Amount per detailing history Treatment details,
Management) syndrome day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
490 MP (Paediatric CRRT–CRRT MP028A M 8,000 5 Y N Clinical notes Detailed ICPs, Daycare
Madical detailing history Treatment details,
Management) and Admission detailed discharge
findings; any
investigations
done; planned
line of
management
491 MP (Paediatric Global developmental delay / MP029A M Package 2 N N Clinical notes Detailed ICPs, NA
Madical Intellectual disability of unknown Amount per detailing birth Treatment details,
Management) etiology–Global developmental delay day (drop and subsequent detailed discharge
down) for history and summary, All
admission Admission investigations
1800)/ HDU line
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
492 MP (Paediatric Global developmental delay / MP029B M Package 2 N N Clinical notes Detailed ICPs, NA
Madical Intellectual disability of unknown Amount per detailing birth Treatment details,
Management) etiology–Intellectual disability of day (drop and subsequent detailed discharge
unknown etiology down) for history and summary, All
1800)/ HDU line
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
493 MP (Paediatric Rickets - requiring admission for MP030A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical Work Up–Rickets - requiring Amount per detailing Treatment details,
Management) admission for Work Up day (drop history, detailed discharge
down) for investigations summary, All
admission done and investigations
type: Routine Admission reports.
ward (Rs notes showing
1800)/ HDU vitals; planned
(Rs (Rs 2700)/ line
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
494 MP (Paediatric Acute severe malnutrition–Acute MP031A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical severe malnutrition Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
495 MP (Paediatric Developmental and behavioral MP032A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical disorders–Developmental and Amount per detailing history Treatment details,
Management) behavioral disorders day (drop and detailed discharge
down) for examination summary, All
admission findings. investigations
(Rs (Rs 2700)/ examination;
ICU (without any
3600)/ ICU done, planned
(with line
4500)
496 MP (Paediatric Short stature–Short stature MP033A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical Amount per detailing histor, Treatment details,
Management) day (drop parent's height detailed discharge
down) for and Admission summary, All
admission notes showing investigations
type: Routine vitals; planned reports.
ward (Rs line
1800)/ HDU management
(Rs (Rs 2700)/
ICU (without
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
497 MP (Paediatric Dysmorphic children–Dysmorphic MP034A M Package 3 N N Clinical notes Detailed ICPs, NA
Madical children Amount per detailing Treatment details,
Management) day (drop history, detailed discharge
down) for investigations summary, All
admission done and investigations
1800)/ HDU vitals; planned
(Rs (Rs 2700)/ line
ventilator) (Rs
3600)/ ICU
(with
ventilator)(Rs
4500)
498 MP (Paediatric Floppy infant–Floppy infant MP035A M Package 1 N N Clinical notes Detailed ICPs, NA
ICU (without any
(with line of
4500)
499 MP (Paediatric Inborn errors of metabolism–Inborn MP036A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical errors of metabolism Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
500 MP (Paediatric Wilson’s disease–Wilson’s disease MP037A M Package 1 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
501 MP (Paediatric Rheumatoid arthritis–Rheumatoid MP038A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical arthritis Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
502 MP (Paediatric Rheumatic fever–Rheumatic fever MP039A M Package 3 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
503 MP (Paediatric Cyanotic spells–Cyanotic spells MP040A M Package 5 N N Clinical notes Detailed ICPs (daily NA
Madical Amount per with planned Treatment details),
Management) day (drop line of Detailed Discharge
down) for treatment (incl Summary, All
admission birth & past investigations
type: Routine history), reports.
ward (Rs Investigation
1800)/ HDU Reports
(Rs (Rs 2700)/ supporting
ventilator) (Rs (including
3600)/ ICU ABG), Planned
(with line of
4500)
504 MP (Paediatric Cyanotic spells–Cyanotic spells with MP040B M Package 1 N N Clinical notes Detailed ICPs (daily NA
Madical CHD Amount per with planned Treatment details),
Management) day (drop line of Detailed Discharge
down) for treatment (incl Summary, All
admission birth & past investigations
type: Routine history), reports (including
ward (Rs Investigation 2D echo).
1800)/ HDU Reports
ventilator) (Rs (including
3600)/ ICU ECHO, ABG),
(with Planned line of
4500)
505 MP (Paediatric Cyanotic spells–Cyanotic spells with MP040C M Package 0 N N Clinical notes Detailed ICPs (daily NA
Madical Chest infection Amount per with planned Treatment details),
Management) day (drop line of Post treatment CBC
down) for treatment (incl and X-ray chest,
admission birth & past Detailed Discharge
type: Routine history) summary
ward (Rs Investigation
1800)/ HDU Reports
ventilator) (Rs (including CBC,
3600)/ ICU X-ray chest),
(with Planned line of
4500)
506 MP (Paediatric Cyanotic spells–Cyanotic spells with MP040D M Package 1 N N Clinical notes Detailed ICPs (daily NA
Madical Sepsis Amount per with planned Treatment details),
Management) day (drop line of Post treatment
down) for treatment (incl CBC, and
admission birth & past Radiological
type: Routine history), investigations,
ward (Rs Investigation Detailed Discharge
1800)/ HDU Reports summary
ventilator) (Rs (including CBC,
3600)/ ICU ABG,
(with Radiological
ventilator)(Rs investigations),
4500) Planned line of
treatment
507 MP (Paediatric Immune haemolytic anemia–Immune MP041A M Package 0 N N Clinical notes Detailed ICPs, NA
Madical haemolytic anemia Amount per detailing history Treatment details,
3600)/ ICU
(with
ventilator)(Rs
4500)
508 MP (Paediatric Idiopathic Thrombocytopenic MP042A M Package 5 N N Clinical notes Detailed ICPs, NA
Madical Purpura–Idiopathic Thrombocytopenic Amount per detailing history Treatment details,
Management) Purpura day (drop and Admission detailed discharge
3600)/ ICU
(with
ventilator)(Rs
4500)
509 MP (Paediatric Kawasaki Disease–Kawasaki Disease MP043A M Package 1 N N Clinical notes Detailed ICPs, NA
3600)/ ICU
(with
ventilator)(Rs
4500)
510 MP (Paediatric Steven Johnson syndrome–Steven MP044A M Package 2 N N Clinical notes Detailed ICPs, NA
Madical Johnson syndrome Amount per detailing history Treatment details,
Management) day (drop (incl drug intake detailed discharge
down) for history) and summary, All
ward (Rs vitals and
1800)/ HDU examination
(Rs (Rs 2700)/ findings; any
ventilator) (Rs done; planned
3600)/ ICU line of
(with management
ventilator)(Rs
4500)
511 MP (Paediatric Trauma –Trauma MP045A M Package 1 N N Clinical notes Detailed ICPs, NA
Management) day (drop / examination detailed discharge
down) for findings summary, All
admission describing investigations
type: Routine trauma; MLC/ reports.
ward (Rs FIR; and
1800)/ HDU Admission
(Rs (Rs 2700)/ notes showing
ICU (without vitals; planned
ventilator) (Rs line
3600)/ ICU management
(with
ventilator)(Rs
4500)
512 MP (Paediatric Ketogenic diet initiation in refractory MP046A M Package 1 N N Clinical notes Detailed ICPs, NA
Madical epilepsy–Ketogenic diet initiation in Amount per detailing history Treatment details,
Management) refractory epilepsy day (drop and Admission detailed discharge
ICU (without any
(with line of
4500)
513 MR (Radiation 2D External Beam Radiotherapy (6 MR001A M 11,000 1 Y N HPE report, Detailed Discahrge Daycare
Oncology) Fractions) (Inclusive of Simulation & Clinical notes Summary (with RT
Planning Cost)–Radical with planned treatment and
line of doses given)
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
514 MR (Radiation 2D External Beam Radiotherapy (6 MR001B M 11,000 1 Y N HPE report, Detailed Discahrge Daycare
Planning Cost)–Adjuvant with planned treatment and
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
515 MR (Radiation 2D External Beam Radiotherapy (6 MR001C M 11,000 1 Y N HPE report, Detailed Discahrge Daycare
Planning Cost)–Neoadjuvant with planned treatment and
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
516 MR (Radiation 2D External Beam Radiotherapy - MR002A M 10,000 1 Y N HPE report, Detailed Discahrge Daycare
Oncology) Palliative Clinical notes Summary (with RT
(Upto 10 Fractions) with planned treatment and
(Inclusive of Simulation & Planning line of doses given)
Cost)–Palliative treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
517 MR (Radiation 2D External Beam Radiotherapy (25 MR003A M 20,000 0 Y N HPE report, Detailed Discahrge Daycare
Planning Cost)–Radical with planned treatment and
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
518 MR (Radiation 2D External Beam Radiotherapy (25 MR003B M 20,000 0 Y N HPE report, Detailed Discahrge Daycare
Planning Cost)–Adjuvant with planned treatment and
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
519 MR (Radiation 2D External Beam Radiotherapy (25 MR003C M 20,000 5 Y N HPE report, Detailed Discahrge Daycare
Planning Cost)–Neoadjuvant with planned treatment and
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
520 MR (Radiation Linear Accelerator, External Beam MR004A M 21,000 5 Y N HPE report, Detailed Discahrge Daycare
Oncology) Radiotherapy 3D CRT (6 Fractions) Clinical notes Summary (with RT
(Inclusive of Simulation & Planning with planned treatment and
Cost)–Radical line of doses given)
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
521 MR (Radiation Linear Accelerator, External Beam MR004B M 21,000 1 Y N HPE report, Detailed Discahrge Daycare
Cost)–Adjuvant line of doses given)
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
522 MR (Radiation Linear Accelerator, External Beam MR004C M 21,000 4 Y N HPE report, Detailed Discahrge Daycare
Cost)–Neoadjuvant line of doses given)
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
Cost)–Radical line of doses given)
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
Cost)–Adjuvant line of doses given)
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
Cost)–Neoadjuvant line of doses given)
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
Oncology) Radiotherapy IMRT (Intensity Clinical notes Summary (with RT
Modulated Radiotherapy) with planned treatment and
(20 Fractions) line of doses given)
(Inclusive of Simulation & Planning treatment
Cost)–Radical (documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
Cost)–Adjuvant (documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
Cost)–Neoadjuvant (documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
confirming the
Procedure
indicated and
details of RT
treatment plan).
confirming the
Procedure
indicated and
details of RT
treatment plan).
confirming the
Procedure
indicated and
details of RT
treatment plan).
532 MR (Radiation Linear Accelerator External Beam MR008A M 90,000 10 Y N HPE report, Detailed Discahrge Daycare
Oncology) Radiotherapy IGRT (Image Guided Clinical notes Summary (with RT
radiotherapy) with 3D CRT or IMRT with planned treatment and
confirming the
Procedure
indicated and
details of RT
treatment plan).
533 MR (Radiation Linear Accelerator External Beam MR008B M 90,000 0 Y N HPE report, Detailed Discahrge Daycare
confirming the
Procedure
indicated and
details of RT
treatment plan).
534 MR (Radiation Linear Accelerator External Beam MR008C M 90,000 6 Y N HPE report, Detailed Discahrge Daycare
confirming the
Procedure
indicated and
details of RT
treatment plan).
535 MR (Radiation Linear Accelerator External Beam MR009A M 55,000 0 Y N HPE report, Detailed Discahrge Daycare
confirming the
Procedure
indicated and
details of RT
treatment plan).
536 MR (Radiation Linear Accelerator External Beam MR009B M 55,000 0 Y N HPE report, Detailed Discahrge Daycare
confirming the
Procedure
indicated and
details of RT
treatment plan).
537 MR (Radiation Linear Accelerator External Beam MR009C M 55,000 0 Y N HPE report, Detailed Discahrge Daycare
confirming the
Procedure
indicated and
details of RT
treatment plan).
538 MR (Radiation SRT / SBRT with IGRT MR010A M 82,000 1 Y N HPE report, Detailed Discahrge Daycare
Oncology) (Stereotacatic radiotherapy) Clinical notes Summary (with RT
(4 Fractions) with planned treatment and
(Inclusive of Simulation & Planning line of doses given)
Cost)–SRT / SBRT with IGRT treatment
(Stereotacatic radiotherapy) (documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
539 MR (Radiation SRS with IGRT (Stereotacatic MR011A M 70,000 3 Y N Biopsy/ HPE Detailed Discahrge Daycare
Oncology) radiotherapy) report of Summary (with RT
(Inclusive of Simulation & Planning malignancy; treatment and
Cost)–SRS with IGRT (Stereotacatic justification of doses given)
radiotherapy) SRS?
540 MR (Radiation Respiratory Gating along with Linear MR012A M 65,000 2 Y N Clinical notes Detailed Discahrge Daycare
Oncology) Accelerator planning (5 Fractions) and Summary (with RT
(Inclusive of Simulation & Planning Documentary treatment and
Cost)–Respiratory Gating along with evidence doses given)
Linear Accelerator planning confirming the
need of
Respiratory-
gated
radiotherapy
(tumours that
move with
respiration
during
radiotherapy
(lung, breast
and upper
abdominal
tumpurs)
541 MR (Radiation Brachytherapy High Dose MR013A M 3,500 1 Y N HPE report, Detailed Discahrge Daycare
Oncology) Radiation–Intracavitory Clinical notes Summary (with RT
with planned treatment and
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
542 MR (Radiation Brachytherapy High Dose MR013B M 3,500 5 Y N HPE report, Detailed Discahrge Daycare
Oncology) Radiation–Intraluminal Clinical notes Summary (with RT
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
543 MR (Radiation Brachytherapy High Dose MR013C M 3,500 5 Y N HPE report, Detailed Discahrge Daycare
Oncology) Radiation–Endobiliary Clinical notes Summary (with RT
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
544 MR (Radiation Brachytherapy High Dose MR013D M 3,500 5 Y N HPE report, Detailed Discahrge Daycare
Oncology) Radiation–Endobronchial Clinical notes Summary (with RT
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
545 MR (Radiation Brachytherapy High Dose MR013E M 3,500 5 Y N HPE report, Detailed Discahrge Daycare
Oncology) Radiation–CVS Clinical notes Summary (with RT
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
546 MR (Radiation Brachytherapy High Dose Radiation (5 MR014A M 42,000 2 Y N HPE report, Detailed Discahrge Daycare
Oncology) doses) Clinical notes Summary (with RT
(Inclusive of Simulation, Planning with planned treatment and
Cost, OT & other charges )–Interstitial line of doses given)
treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
547 MR (Radiation Brachytherapy High Dose Radiation (5 MR014B M 42,000 2 Y N HPE report, Detailed Discahrge Daycare
Oncology) doses) Clinical notes Summary (with RT
(Inclusive of Simulation, Planning with planned treatment and
Cost, OT & other charges )–Surface line of doses given)
Mould treatment
(documents
confirming the
Procedure
indicated and
details of RT
treatment plan).
548 SB (Orthopaedics) Fracture - Conservative Management - SB001A S 2,000 2 N N Clinical notes Procedure / Daycare
Without plaster–Fracture - with planned Operation notes,
Conservative Management - line of Post procedure X-
Without plaster treatment ray films with
including reports, Detailed
planned line of Discharge
treatment, X- Summary
ray films with
reports
549 SB (Orthopaedics) Application of Traction–Skeletal SB002A S 2,000 1 N N Clinical notes Post Procedure Daycare
Tractions with pin and X-ray clinical photgraph
showing the with pins, detailed
need of Procedure /
procedure, Operative Notes.
clinical Detailed discharge
photograph of summary
affected part
550 SB (Orthopaedics) Application of Traction–Skin Traction SB002B S 700 1 N N Clinical notes Post Procedure Daycare
and X-ray clinical photgraph,
showing the detailed Procedure /
need of Operative Notes.
procedure, Detailed discharge
clinical summary
photograph of
affected part
551 SB (Orthopaedics) Application of P.O.P. casts–Upper SB003A S 3,000 5 N N Clinical notes Post Procedure Daycare
Limbs and X-ray clinical photgraph
showing the with POP cast,
need of detailed Procedure /
affected part
552 SB (Orthopaedics) Application of P.O.P. casts–Lower SB003B S 3,000 4 N N Clinical notes Post Procedure Daycare
Limbs and X-ray clinical photgraph
showing the with POP cast,
affected part
553 SB (Orthopaedics) Application of P.O.P. Spikas & SB004A S 3,500 4 N N Clinical notes Post Procedure Daycare
Jackets–Spikas and X-ray clinical photgraph
showing the with POP spika,
affected part
554 SB (Orthopaedics) Application of P.O.P. Spikas & SB004B S 3,500 2 N N Clinical notes Post Procedure Daycare
Jackets–Jackets and X-ray clinical photgraph
showing the with POP Jacket,
affected part
555 SB (Orthopaedics) External fixation of Fracture–Long SB005A S 19,000 5 N N Clinical notes Post Procedure 4
bone and X-ray clinical photgraph,
confirming the detailed Procedure /
diagnosis, Operative Notes.
photograph of summary Invoice
affected part and barcode of
implant
556 SB (Orthopaedics) External fixation of Fracture–Small SB005B S 14,500 2 N N Clinical notes Post Procedure 3
bone and X-ray clinical photgraph,
implant
557 SB (Orthopaedics) External fixation of Fracture–Pelvis SB005C S 19,000 7 N N Clinical notes Post Procedure 5
implant
558 SB (Orthopaedics) External fixation of Fracture–Both SB005D S 20,000 7 N N Clinical notes Post Procedure 4
bones - forearms and X-ray clinical photgraph,
implant
559 SB (Orthopaedics) Percutaneous - Fixation of SB006A S 5,000 4 N N Clinical notes Procedure / 4
Fracture–Percutaneous - Fixation of with planned Operation notes,
Fracture line of Post procedure X-
treatment ray films with
including reports, Stickers of
planned line of implants used,
treatment, X- Detailed Discharge
ray films with Summary
reports
560 SB (Orthopaedics) Elastic nailing for fracture SB007A S 16,000 7 N N Clinical notes Procedure / 4
fixation–Femur with planned Operation notes,
line of Post procedure X-
reports
561 SB (Orthopaedics) Elastic nailing for fracture SB007B S 16,000 7 N N Clinical notes Procedure / 4
fixation–Humerus with planned Operation notes,
reports
562 SB (Orthopaedics) Elastic nailing for fracture SB007C S 16,000 2 N N Clinical notes Procedure / 4
fixation–Forearm with planned Operation notes,
reports
563 SB (Orthopaedics) Internal Fixation of Small Bones SB008A S 10,000 2 N N Clinical notes Post Procedure 3
–Internal Fixation of Small Bones and X-ray clinical photgraph,
confirming the Post procedure X-
diagnosis, rayshowing implant;
clinical detailed Procedure /
photograph of Operative Notes.
affected part Detailed discharge
summary Invoice
and barcode of
implant.
564 SB (Orthopaedics) Fracture - Long Bones - Metaphyseal - SB009A S 26,700 4 N N Clinical notes Procedure / 4
ORIF–Fracture - Long Bones - with planned Operation notes,
Metaphyseal - ORIF line of Post procedure X-
reports
565 SB (Orthopaedics) Fixation of Diaphyseal Fracture - Long SB010A S 20,900 4 N N Clinical notes Post procedure 4
Bone–Open Reduction Internal and radiological imaging study (X
Fixation investigations Ray), Post
confirming the Procedure clinical
diagnosis (X- photograph,
ray), clinical detailed Procedure /
affected part invoice and barcode
of implant
566 SB (Orthopaedics) Fixation of Diaphyseal Fracture - Long SB010B S 25,000 3 N N Clinical notes Post procedure 4
Bone–Closed Reduction & Fixation and radiological imaging study (X
investigations Ray), Post
diagnosis (X- photograph,
ray), clinical detailed Procedure /
affected part invoice and barcode
of implant
567 SB (Orthopaedics) Surgery for Comminuted Fracture - SB011A S 19,800 5 N N Clinical notes Post Procedure 3
Olecranon of Ulna–Plating and X-ray clinical photgraph,
diagnosis, ray; detailed
summary, Invoice
and barcode of
implant
568 SB (Orthopaedics) Fracture Head radius–Fixation SB012A S 15,000 4 N N Clinical notes Post procedure 4
and X-ray imaging study (X
confirming the Ray), Post
diagnosis, Procedure clinical
clinical photgraph, detailed
photograph of Procedure /
affected part Operative Notes.
Detailed discharge
summary, Invoice
and barcode of
implant
569 SB (Orthopaedics) Fracture Head radius–Excision SB012B S 9,200 3 N N Clinical notes Post procedure 3
and X-ray imaging study (X
Detailed discharge
summary
570 SB (Orthopaedics) Fracture - Single Bone - Forearm - SB013A S 12,400 10 N N Clinical notes Post Procedure 4
ORIF - Plating / Nailing–Fracture - and X-ray clinical photgraph,
Single Bone - Forearm - ORIF - confirming the Post procedure X-
Plating / Nailing diagnosis, rayshowing implant;
summary Invoice
and barcode of
implant.
571 SB (Orthopaedics) Fracture - Both Bones - Forearm - SB014A S 19,700 6 N N Clinical notes Post Procedure 4
ORIF - Plating / Nailing–Fracture - and X-ray clinical photgraph,
Both Bones - Forearm - ORIF - confirming the Post procedure X-
Plating / Nailing diagnosis, rayshowing implant;
summary Invoice
and barcode of
implant.
572 SB (Orthopaedics) Fracture Condyle - Humerus - SB015A S 10,000 5 N N Clinical notes Post Procedure 3
ORIF–Lateral Condyle and X-ray clinical photgraph,
summary Invoice
and barcode of
implant.
573 SB (Orthopaedics) Fracture Condyle - Humerus - SB015B S 10,000 6 N N Clinical notes Post Procedure 3
ORIF–Medial Condyle and X-ray clinical photgraph,
summary Invoice
and barcode of
implant.
574 SB (Orthopaedics) Fracture intercondylar Humerus + SB016A S 26,100 6 N N Clinical notes Post Procedure X- 5
olecranon osteotomy–Fracture and X-ray ray showing
intercondylar Humerus + olecranon showing the osteotomy as well
osteotomy need of as frature maneged;
procedure, detailed Procedure /
clinical Operative Notes.
photograph of Detailed discharge
affected part summary, Invoice
and barcode of
implant
575 SB (Orthopaedics) Displaced Clavicle Fracture–Open SB017A S 20,000 3 N N Clinical notes Procedure / 4
Reduction Internal Fixation with planned Operation notes,
reports
576 SB (Orthopaedics) Fracture - Acetabulum–Single SB018A S 38,000 6 N N Clinical notes Procedure / 7
Approach with planned Operation notes,
treatment, X- Summary, Invoice
ray films with and barcode of
reports implant
577 SB (Orthopaedics) Fracture - Acetabulum–Combined SB018B S 48,500 7 N N Clinical notes Procedure / 7
Approach with planned Operation notes,
reports implant
578 SB (Orthopaedics) Fracture - Neck Femur–Closed SB019A S 15,000 1 N N Clinical notes Post procedure 2
Reduction and Percutaneous Screw and X-ray imaging study (X
Fixation confirming the Ray), Post
Invoice and barcode
of implant
579 SB (Orthopaedics) Fracture - Neck SB019B S 20,800 3 N N Clinical notes Post procedure 5
Femur–Intertrochanteric Fracture with and X-ray imaging study (X
Dynamic Hip Screw confirming the Ray), Post
Invoice and barcode
of implant
580 SB (Orthopaedics) Fracture - Neck SB019C S 24,100 5 N N Clinical notes Post procedure 5
Femur–Intertrochanteric Fracture with and X-ray imaging study (X
Proximal Femoral Nail confirming the Ray), Post
Invoice and barcode
of implant
581 SB (Orthopaedics) Ankle Fractures–Open Reduction SB020A S 19,000 7 N N Clinical notes Detailed discharge 5
Internal Fixation and X-ray of summary Post
ankle joint, Procedure clinical
affected part Operative Notes,
Invoice and barcode
of implant
582 SB (Orthopaedics) Cervical spine fixation including SB021A S 40,000 7 N N Clinical notes Procedure / 7
odontoid –Cervical spine fixation with planned Operation notes,
including odontoid line of Post procedure X-
reports implant
583 SB (Orthopaedics) Dorsal and lumber spine SB022A S 50,000 10 N N Clinical notes Procedure / 7
fixation–Anterior with planned Operation notes,
reports implant
584 SB (Orthopaedics) Dorsal and lumber spine SB022B S 40,000 2 N N Clinical notes Procedure / 7
fixation–Posterior with planned Operation notes,
reports implant
585 SB (Orthopaedics) Bone grafting for Non union –Bone SB023A S 10,000 3 Y N Clinical notes Post procedure 3
grafting for Non union detailing earlier imaging study (X
surgery that Ray), Post
resulted in non- Procedure clinical
union and photgraphof donor
radiological and recipient sites,
investigations detailed Procedure /
confirming the Operative Notes.
diagnosis (X- Detailed discharge
ray of affected summary
joint), clinical
photograph
586 SB (Orthopaedics) Arthorotomy of any joint–Arthorotomy SB024A S 14,000 7 Y N Clinical notes Post op clinical 7
of any joint and X-ray photgraph, detailed
confirming the Procedure /
clinical Detailed Discharge
affected part
587 SB (Orthopaedics) Arthrolysis of joint–Elbow SB025A S 15,000 2 Y N Clinical notes Post Procedure 4
diagnosis, Operative Notes.,
clinical Post procedure
photograph of imaging study (X
affected part Ray)
588 SB (Orthopaedics) Arthrolysis of joint–Knee SB025B S 15,000 2 Y N Clinical notes Post Procedure 4
affected part Ray)
589 SB (Orthopaedics) Arthrolysis of joint–Ankle SB025C S 15,000 2 Y N Clinical notes Post Procedure 4
affected part Ray)
590 SB (Orthopaedics) Arthrodesis–Ankle / Triple with SB026A S 20,000 2 Y N Clinical notes Post procedure X- 5
implant detailing ray, Post Procedure
indication and X- clinical photgraph,
ray of ankle and detailed Procedure /
foot, clinical Operative Notes,
photograph of Detailed Discharge
affected part summary, Invoice
and barcode of
implant
591 SB (Orthopaedics) Arthrodesis–Shoulder SB026B S 20,000 3 Y N Clinical notes Post procedure X- 3

detailing ray, Post Procedure
photograph of Invoice and barcode
affected part of implant
592 SB (Orthopaedics) Arthrodesis–Wrist SB026C S 20,000 1 Y N Clinical notes Post procedure X- 3
593 SB (Orthopaedics) Arthrodesis–Knee SB026D S 25,000 1 Y N Clinical notes Post procedure X- 4

594 SB (Orthopaedics) Arthrodesis–Hand SB026E S 27,000 1 Y N Clinical notes Post procedure X- 3

foot, clinical Operative Notes.
photograph of
affected part
595 SB (Orthopaedics) Arthrodesis–Foot SB026F S 27,000 1 Y N Clinical notes Post procedure X- 3

affected part summary.
596 SB (Orthopaedics) Arthrodesis–Ankle / Triple without SB026G S 15,000 3 Y N Clinical notes Post procedure X- 3
implant detailing ray, Post Procedure
597 SB (Orthopaedics) Disarticulation–Hind quarter SB027A S 25,000 5 Y N Clinical notes Post Procedure 10
justifying clinical photgraph,
surgery with X detailed Procedure /
Ray of affected Operative Notes.
limb, clinical Detailed Discharge
affected part
showing the
gangrene/
injury/ severe
anatomical
deformity
598 SB (Orthopaedics) Disarticulation–Fore quarter SB027B S 25,000 5 Y N Clinical notes Post Procedure 10
justifying clinical photgraph,
surgery with X detailed Procedure /
Ray of affected Operative Notes.
limb, clinical Detailed Discharge
affected part
showing the
gangrene/
injury/ severe
anatomical
deformity
599 SB (Orthopaedics) Closed reduction of joint SB028A S 7,400 1 N N Clinical notes Post procedure Daycare
dislocation–Hip and X-ray imaging study (X
Detailed discharge
summary,
600 SB (Orthopaedics) Closed reduction of joint SB028B S 5,500 3 N N Clinical notes Post procedure 7
dislocation–Shoulder and X-ray imaging study (X
Detailed discharge
summary,
601 SB (Orthopaedics) Closed reduction of joint SB028C S 5,500 7 N N Clinical notes Post procedure Daycare
dislocation–Elbow and X-ray imaging study (X
Detailed discharge
summary,
602 SB (Orthopaedics) Closed reduction of joint SB028D S 5,500 7 N N Clinical notes Post procedure Daycare
dislocation–Knee and X-ray imaging study (X
Detailed discharge
summary,
603 SB (Orthopaedics) Open Reduction of Small Joint–Open SB029A S 10,000 7 N N Clinical and Post procedure 2
Reduction of Small Joint radiological imaging study (X
diagnosis (X- photgraph, detailed
ray of affected Procedure /
joint), clinical Operative Notes.
child summary, Invoice
and barcode of
implant
604 SB (Orthopaedics) Tension Band Wiring–Tension Band SB030A S 15,000 7 N N Clinical notes Procedure / 3
Wiring with planned Operation notes,
reports implant
605 SB (Orthopaedics) Hemiarthroplasty–Unipolar SB031A S 18,000 7 Y N Clinical notes Post Procedure 5
and X-ray/ CT clinical photgraph,
justifying the detailed discharge
surgery, summary, detailed
Procedure /
Operative Notes.
Post op X-ray
showing the implant
& invoice / bar code
of implant.
606 SB (Orthopaedics) Hemiarthroplasty–Bipolar (Non - SB031B S 22,000 7 Y N Clinical notes Post Procedure 7
Modular) and X-ray/ CT clinical photgraph,
Procedure /
Operative Notes.
Post op X-ray
showing the implant
of implant.
607 SB (Orthopaedics) Hemiarthroplasty–Bipolar (Modular) SB031C S 35,000 7 Y N Clinical notes Post Procedure 7
and X-ray/ CT clinical photgraph,
Procedure /
Operative Notes.
Post op X-ray
showing the implant
of implant.
608 SB (Orthopaedics) AC Joint reconstruction / SB032A S 30,500 7 Y N Clinical notes Post-op X-ray of 4
Stabilization–Rockwood Type - I detailing operated limb, Post
Rockwood type Procedure clinical
of fracture, X- photgraph, detailed
ray/ MRI and Procedure /
justification of Operative Notes,
surgery done Detailed Discharge
summary, Invoice
and barcode of
implant
609 SB (Orthopaedics) AC Joint reconstruction / SB032B S 30,500 7 Y N Clinical notes Post-op X-ray of 4
Stabilization–Rockwood Type - II detailing operated limb, Post
summary, Invoice
and barcode of
implant
610 SB (Orthopaedics) AC Joint reconstruction / SB032C S 30,500 7 Y N Clinical notes Post-op X-ray of 4
Stabilization–Rockwood Type - III detailing operated limb, Post
summary, Invoice
and barcode of
implant
611 SB (Orthopaedics) AC Joint reconstruction / SB032D S 30,500 0 Y N Clinical notes Post-op X-ray of 4
Stabilization–Rockwood Type - IV detailing operated limb, Post
summary, Invoice
and barcode of
implant
612 SB (Orthopaedics) AC Joint reconstruction / SB032E S 30,500 0 Y N Clinical notes Post-op X-ray of 4
Stabilization–Rockwood Type - V detailing operated limb, Post
summary, Invoice
and barcode of
implant
613 SB (Orthopaedics) AC Joint reconstruction / SB032F S 30,500 0 Y N Clinical notes Post-op X-ray of 4
Stabilization–Rockwood Type - VI detailing operated limb, Post
summary, Invoice
and barcode of
implant
614 SB (Orthopaedics) Excision Arthoplasty of Femur SB033A S 17,500 0 Y N Clinical notes Post Procedure 5
head–Excision Arthoplasty of Femur detailing clinical photgraph,
head indication and X- detailed Procedure /
ray, clinical Operative Notes.
affected part summary
615 SB (Orthopaedics) Open Reduction of CDH–Open SB034A S 20,000 0 N N Clinical and Post procedure 5
Reduction of CDH radiological imaging study (X
diagnosis (X- photgraph, detailed
ray of both Procedure /
hips), clinical Operative Notes.
photograph Detailed discharge
summary
616 SB (Orthopaedics) Patellectomy–Patellectomy SB035A S 11,000 0 N N Clinical notes Post procedure 5
and X-ray of the imaging study (X
patella justifying Ray), Post
the procedure, Procedure clinical
Detailed discharge
summary
617 SB (Orthopaedics) Arthroscopic Meniscus Repair / SB036A S 12,000 0 Y N Clinical notes Intra operative still 2
Meniscectomy–Arthroscopic and MRI image, post
Meniscus Repair / Meniscectomy justifying procedure clinical
procedure photgraph, detailed
Procedure /
Operative Notes,
Detailed Discharge
summary.
618 SB (Orthopaedics) Elbow replacement–Elbow SB037A S 45,100 0 Y N Clinical notes Post Procedure 5
replacement and X-ray/ CT clinical photgraph,
surgery summary, detailed
Procedure /
Operative Notes.
Post op X-ray
showing the implant
of implant.
619 SB (Orthopaedics) Total Hip Replacement–Cemented SB038A S 70,000 0 Y N Clinical notes Post Procedure X- 7
and X-ray/ CT ray showing
justifying the implant, detailed
surgery Procedure /
Operative Notes.
Bar code of implant
& cement used,
Detailed discharge
summary
620 SB (Orthopaedics) Total Hip Replacement–Cementless SB038B S 97,000 0 Y N Clinical notes Post Procedure X- 7
surgery Procedure /
Operative Notes.
Bar code of implant
used, Detailed
discharge summary
621 SB (Orthopaedics) Total Hip Replacement–Hybrid SB038C S 77,000 0 Y N Clinical notes Post Procedure X- 7
surgery Procedure /
Operative Notes.
Bar code of implant
/ cement used,
Detailed discharge
summary
622 SB (Orthopaedics) Total Hip Replacement–Revision - SB038D S 140,000 0 Y N Clinical notes Post Procedure X- 7
Total Hip Replacement and X-ray/ CT ray showing
surgery Procedure /
Operative Notes.
Bar code of implant
/ cement used,
Detailed discharge
summary
623 SB (Orthopaedics) Total Knee Replacement–Primary - SB039A S 80,000 0 Y N Clinical notes Post Procedure 5
Total Knee Replacement and X-ray/ CT clinical photgraph,
Procedure /
Operative Notes.
Post op X-ray
showing the implant
of implant.
624 SB (Orthopaedics) Total Knee Replacement–Revision - SB039B S 130,000 0 Y N Clinical notes Post Procedure 5
Total Knee Replacement and X-ray/ CT clinical photgraph,
Procedure /
Operative Notes.
Post op X-ray
showing the implant
of implant.
625 SB (Orthopaedics) Bone Tumour Excision (malignant) SB040A S 177,000 0 Y N Clinical notes Post procedure 7
including GCT + Joint replacement justifying need imaging study (X
(depending upon type of joint and of this surgery Ray), Post
implant)–Bone Tumour Excision and X-ray/ MRI Procedure with
(malignant) including GCT + Joint of affected part, implant; invoice and
replacement Biopsy, clinical barcode of implant.
(depending upon type of joint and photograph of detailed Procedure /
implant) affected part Operative Notes.
Histopathology of
excised tissue,
Detailed Discharge
summary
626 SB (Orthopaedics) Bone Tumour Excision + SB041A S 40,000 0 Y N Clinical notes Post procedure 6
reconstruction–Bone Tumour Excision justifying need imaging study (X
+ reconstruction of this surgery Ray), Post
and X-ray/ MRI procedure clinical
of affected part, photgraph, detailed
Biopsy, clinical Procedure /
summary, invoice
and barcode of
implant
627 SB (Orthopaedics) Bone Tumour (benign) curettage / SB042A S 20,000 0 Y N Clinical notes Post procedure 4
Excision justifying need imaging study (X
and bone grafting–Bone Tumour of this surgery Ray), Post
(benign) curettage / Excision and and X-ray/ MRI Procedure clinical
bone grafting of affected part, photgraph of both
Biopsy, clinical donor and recipient
photograph of sites, detailed
affected part Procedure /
Operative Notes.
Histopathology of
curreted tissue,
Detailed Discharge
summary
628 SB (Orthopaedics) Single Stage Amputation–Above SB043A S 15,000 0 N N X Ray of Post Procedure 5
Elbow affected limb, clinical photgraph,
clinical notes detailed Procedure /
and clinical Operative Notes.
justifying the
indication; MLC/
FIR if traumatic
629 SB (Orthopaedics) Single Stage Amputation–Below SB043B S 15,000 0 N N X Ray of Post Procedure 5
Elbow affected limb, clinical photgraph,
justifying the
indication; MLC/
FIR if traumatic
630 SB (Orthopaedics) Single Stage Amputation–Above Knee SB043C S 15,000 0 N N X Ray of Post Procedure 5
affected limb, clinical photgraph,
justifying the
indication; MLC/
FIR if traumatic
631 SB (Orthopaedics) Single Stage Amputation–Below Knee SB043D S 15,000 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
632 SB (Orthopaedics) Single Stage Amputation–Foot SB043E S 15,000 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
633 SB (Orthopaedics) Single Stage Amputation–Hand SB043F S 15,000 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
634 SB (Orthopaedics) Single Stage Amputation–Wrist SB043G S 15,000 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
635 SB (Orthopaedics) Two Stage Amputation–Above Elbow SB044A S 23,200 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
636 SB (Orthopaedics) Two Stage Amputation–Below Elbow SB044B S 23,200 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
637 SB (Orthopaedics) Two Stage Amputation–Above Knee SB044C S 23,200 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
638 SB (Orthopaedics) Two Stage Amputation–Below Knee SB044D S 23,200 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
639 SB (Orthopaedics) Two Stage Amputation–Foot SB044E S 23,200 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
640 SB (Orthopaedics) Two Stage Amputation–Hand SB044F S 23,200 0 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
641 SB (Orthopaedics) Two Stage Amputation–Wrist SB044G S 23,200 10 N N X Ray of Post Procedure 5
justifying the
indication; MLC/
FIR if traumatic
642 SB (Orthopaedics) Amputation - Fingers / Toes–Finger(s) SB045A S 10,400 10 N N X Ray of Post Procedure 2
justifying the
indication; MLC/
FIR if traumatic
643 SB (Orthopaedics) Amputation - Fingers / Toes–Toe(s) SB045B S 10,400 10 N N X Ray of Post Procedure 2
justifying the
indication; MLC/
FIR if traumatic
644 SB (Orthopaedics) Tendon Grafting / Repair–Tendon SB046A S 15,000 10 Y N Clinical notes Post Procedure 3
Grafting detailing clinical photgraph of
jusification of donor and receipent
surgery, clinical sites; detailed
Detailed discharge
summary
645 SB (Orthopaedics) Tendon Grafting / Repair–Tendon SB046B S 15,000 10 Y N Clinical notes Post Procedure 3
Repair detailing clinical photgraph;
jusification of detailed Procedure /
surgery, clinical Operative Notes.
646 SB (Orthopaedics) Tendon Release / Tenotomy–Tendon SB047A S 5,000 10 Y N Clinical notes Post Procedure Daycare
Release / Tenotomy and justifying clinical photgraph,
surgery, clinical Operative Notes.
647 SB (Orthopaedics) Tenolysis–Tenolysis SB048A S 5,000 10 Y N Clinical notes Post Procedure Daycare
and justifying clinical photgraph,
surgery, clinical Operative Notes
photograph of including agent
affected part used for lysis of
tendon. Detailed
discharge summary
648 SB (Orthopaedics) Reconstruction of Cruciate Ligament SB049A S 42,700 10 Y N Clinical notes Post Procedure 3
with implant and brace–Anterior and MRI scan clinical photgraph,
of affected detailed Procedure /
knee, Clinical Operative Notes.
photograph of Post proedure X-ray
affected part showing implant;
ensure brace is
provided in package
cost, Detailed
Discharge summary
649 SB (Orthopaedics) Reconstruction of Cruciate Ligament SB049B S 42,700 10 Y N Clinical notes Post Procedure 3
with implant and brace–Posterior and MRI scan clinical photgraph,
of affected detailed Procedure /
knee, Clinical Operative Notes.
photograph of Post proedure X-ray
affected part showing implant;
ensure brace is
provided in package
cost, Detailed
Discharge summary
650 SB (Orthopaedics) Fasciotomy–Fasciotomy SB050A S 10,500 10 Y N Clinical Detailed discharge 2

documents summary, Post
justifying Procedure clinical
surgery with photgraph, detailed
USG Evidence, Procedure /
photograph of
affected part
651 SB (Orthopaedics) Duputryen’s Contracture release + SB051A S 8,500 10 Y N Clinical notes Detailed discharge 4
rehabilitation–Duputryen’s and clinical summary Post
Contracture release + rehabilitation photograph of Procedure clinical
affected part photgraph, detailed
diagnosis Operative Notes.
652 SB (Orthopaedics) Debridement & Closure of injuries - SB052A S 10,900 10 N N Clinical notes +/- Post Procedure 6
contused lacerated wounds–Anti- X-ray clinical photgraph,
biotic + dressing - minimum of 5 confirming the detailed Procedure /
sessions diagnosis, Operative Notes.
photograph of summary Evidence
affected part of 5 sessions
dressing
653 SB (Orthopaedics) Debridement & Closure of injuries - SB052B S 3,000 7 N N Clinical notes +/- Post Procedure Daycare
contused lacerated wounds–Anti- X-ray clinical photgraph,
biotic + dressing - minimum of 2 confirming the detailed Procedure /
sessions diagnosis, Operative Notes.
photograph of summary Evidence
affected part of 2 sessions
dressing
654 SB (Orthopaedics) Sequestectomy / SB053A S 10,000 3 Y N Clinical notes Procedure / 4
Curettage–Sequestectomy / with planned Operation notes,
Curettage line of Post procedure X-
ray films with
reports
655 SB (Orthopaedics) Spine deformity correction–Spine SB054A S 40,000 7 Y N Clinical notes Procedure / 7
deformity correction with planned Operation notes,
reports implant
656 SB (Orthopaedics) Osteotomy–Long Bone SB055A S 23,000 5 Y N Clinical notes Post procedure 5
affected bone Ray), Post
justifying the procedure clinical
procedure, photgraph, detailed
summary, invoice
and barcode of
implant
657 SB (Orthopaedics) Osteotomy–Small Bone SB055B S 10,000 0 Y N Clinical notes Post procedure 4
affected bone Ray), Post
justifying the Procedure clinical
procedure, photgraph, detailed
summary
658 SB (Orthopaedics) Pelvic Osteotomy and fixation–Pelvic SB056A S 20,000 5 Y N Clinical notes Post procedure 7
Osteotomy and fixation and X-ray of the imaging study (X
patella justifying Ray) showing the
the procedure, implant, Post
clinical Procedure clinical
photograph of photgraph, detailed
affected part Procedure /
Operative Notes.
Invoice and barcode
of implant used.
Detailed discharge
summary
659 SB (Orthopaedics) High Tibial Osteotomy–High Tibial SB057A S 23,000 3 Y N Clinical notes Post procedure 5
Osteotomy and X-ray imaging study (X
diagnosis, procedure clinical
Detailed discharge
summary, invoice
and barcode of
implant
660 SB (Orthopaedics) Ilizarov Fixation–Ilizarov Fixation SB058A S 25,000 5 Y N Clinical and Post Procedure 6
radiological clinical photgraph /
investigations Post procedure X-
confirming the ray showing
indication, implant; detailed
summary Invoice
and barcode of
implant.
661 SB (Orthopaedics) Limb Lengthening / Bone Transport by SB059A S 35,700 3 Y N Clinical and Post procedure 8
Ilizarov–Limb Lengthening / Bone radiological clinical photograph;
Transport by Ilizarov investigations Intra procedure still
confirming the pictures; Detailed
diagnosis, discharge summary
clinical Detailed Procedure
photograph of / Operative Notes,
affected part Invoice and barcode
showing short of implant
limb as
compared to
other limb
662 SB (Orthopaedics) Growth Modulation and SB060A S 10,000 5 Y N Clinical notes Procedure / 6
fixation–Growth Modulation and with planned Operation notes,
fixation line of Post procedure X-
reports implant
663 SB (Orthopaedics) Corrective Surgery for foot SB061A S 15,000 5 Y N Clinical notes Procedure / 5
deformities–Vertical Talus with planned Operation notes,
ray films with
reports
664 SB (Orthopaedics) Corrective Surgery for foot SB061B S 15,000 5 Y N Clinical notes Procedure / 5
deformities–Other foot deformities with planned Operation notes,
ray films with
reports
665 SB (Orthopaedics) Correction of club foot per SB062A S 3,000 3 Y N Clinical notes Post Procedure Daycare
cast–Correction of club foot per cast and X-ray clinical photgraph
confirming the with cast, detailed
diagnosis, Procedure /
clinical Operative Notes,
666 SB (Orthopaedics) Corrective Surgery in Club Foot / SB063A S 20,000 5 Y N Clinical notes Procedure / Daycare
JESS Fixator–Corrective Surgery in with planned Operation notes,
Club Foot / JESS Fixator line of Post procedure X-
reports implant
667 SB (Orthopaedics) Excision of Osteochondroma / SB064A S 10,000 3 Y N Clinical notes Post Procedure 3
Exostosis–Osteochondroma justifying clinical photgraph,
surgery with detailed Procedure /
evidence from Operative
X-ray / MRI Notes.Detailed
scan of affected Discharge summary
part, clinical Histopath of
photograph of removed tissue
affected part
668 SB (Orthopaedics) Excision of Osteochondroma / SB064B S 10,000 3 Y N Clinical notes Post Procedure 3
Exostosis–Exostosis justifying clinical photgraph,
surgery with detailed Procedure /
evidence from Operative
X-ray / MRI Notes.Detailed
scan of affected Discharge summary
part, clinical Histopath of
photograph of removed tissue
affected part
669 SB (Orthopaedics) Excision of Bursa–Excision of Bursa SB065A S 3,000 2 Y N Clinical notes Detailed discharge Daycare
detailing summary, Post
findings Procedure clinical
confirming the photgraph, detailed
diagnosis, Procedure /
photograph of
affected part
670 SB (Orthopaedics) Nerve Transposition / Release / SB066A S 13,000 1 Y N Clinical notes Intra Procedure still 3
Neurolysis–Nerve Transposition justifying images, detailed
surgery with Procedure /
evidence of Operative Notes.
MRI / EMG/ Detailed Discharge
NCV summary
671 SB (Orthopaedics) Nerve Transposition / Release / SB066B S 13,000 2 Y N Clinical notes Intra Procedure still 3
Neurolysis–Nerve Release justifying images, detailed
NCV summary
672 SB (Orthopaedics) Nerve Transposition / Release / SB066C S 13,000 5 Y N Clinical notes Intra Procedure still 3
Neurolysis–Nerve Neurolysis justifying images, detailed
NCV summary
673 SB (Orthopaedics) Nerve Repair Surgery–Nerve Repair SB067A S 13,800 3 Y N Clinical notes Intra procedure still 4
Surgery justifying images, Post
surgery with Procedure clinical
evidence of photgraph, detailed
MRI / EMG/ Procedure /
NCV Operative Notes.
Detailed discharge
summary
674 SB (Orthopaedics) Nerve root block–Nerve root block SB068A S 3,000 3 Y N Clinical notes Procedure / Daycare
with planned Operation notes,
ray films with
reports
675 SB (Orthopaedics) Exploration and Ulnar nerve SB069A S 9,800 3 Y N Clinical +/- and Detailed discharge 4
Repair–Exploration and Ulnar nerve radiological summary, Post
Repair investigations Procedure clinical
confirming the photgraph, detailed
need of Procedure /
surgery; +/- Operative Notes.
NCV report
676 SB (Orthopaedics) Implant Removal under LA–K - Wire SB070A S 5,000 3 Y N Clinical notes Procedure / Daycare
ray films with
reports
677 SB (Orthopaedics) Implant Removal under LA–Screw SB070B S 5,000 3 Y N Clinical notes Procedure / Daycare
ray films with
reports
678 SB (Orthopaedics) Implant Removal under RA / GA–Nail SB071A S 15,000 1 Y N Clinical notes Procedure / 2
ray films with
reports
679 SB (Orthopaedics) Implant Removal under RA / SB071B S 15,000 1 Y N Clinical notes Procedure / 2
GA–Plate with planned Operation notes,
ray films with
reports
680 SC (Surgical Glossectomy–Hemiglossectomy SC001A S 24,000 3 Y N Clinical notes Procedure / 6
Oncology) with planned Operative Notes,
line of Post Procedure
treatment and Photographs of
FNAC/ surgical site, HPE
BIOPSY, CECT report, Detailed
Discharge
Summary
681 SC (Surgical Glossectomy–Total Glossectomy SC001B S 30,000 2 Y N Clinical notes Procedure / 11
Discharge
Summary
682 SC (Surgical Palatectomy–Soft palate SC002A S 20,000 3 Y N Clinical notes, detailed Procedure / 4
Oncology) Biopsy and Operative Notes,
clinical Clinical photgraph
photograph +/- showing scar,
CT/ MRI detailed discharge
summary, HPE
683 SC (Surgical Palatectomy–Hard palate SC002B S 20,000 5 Y N Clinical notes, detailed Procedure / 6
Oncology) Biopsy and Operative Notes,
clinical Clinical photgraph
photograph +/- showing scar,
CT/ MRI detailed discharge
summary, HPE
684 SC (Surgical Maxillectomy–Partial SC003A S 27,000 2 Y N Clinical notes detailed Procedure / 6
Oncology) and Biopsy, Operative Notes,
CECT Clinical Photograph
showing scar, HPE
report, Detailed
discharge summary
685 SC (Surgical Maxillectomy–Radical SC003B S 33,000 3 Y N Clinical notes detailed Procedure / 8

showing scar, HPE
report, Detailed
Discharge summary
686 SC (Surgical Maxillectomy–Total SC003C S 30,000 3 Y N Clinical notes detailed Procedure / 8

showing scar, HPE
report, Detailed
Discharge summary
687 SC (Surgical Composite resection (Oral SC004A S 40,000 3 Y N Clinical notes, detailed Procedure / 8
Oncology) Cavity)–Composite resection (Oral Biopsy, CT Operative Notes,
Cavity) reports and Clinical Photograph
clinical showing scar, HPE
photograph report, detailed
discharge summary
688 SC (Surgical Oesophageal / Tracheal SC005A S 45,000 1 Y N Clinical notes Barcode of Stent; 4
Oncology) stenting–Oesophageal stenting and CECT, Detailed Procedure
OGD Scopy / Operative Notes,
Detailed Discharge
summary.
689 SC (Surgical Oesophageal / Tracheal SC005B S 45,000 3 Y N Clinical notes Barcode of Stent; 4
Oncology) stenting–Tracheal stenting and CECT, Detailed Procedure
OGD Scopy / Operative
Notes,Detailed
Discharge summary
690 SC (Surgical Transthoracic esophagectomy: 2F / SC006A S 60,000 3 Y N Clinical notes Procedure / 7

Oncology) 3F–Open with planned Operative Notes,
Discharge
Summary
691 SC (Surgical Transthoracic esophagectomy: 2F / SC006B S 60,000 1 Y N Clinical notes Procedure / 7
Oncology) 3F–MIS with planned Operative Notes,
Discharge
Summary
692 SC (Surgical Gastric pull-up / Jejunal Graft–Gastric SC007A S 36,000 1 Y N Clinical notes Procedure / 11
Oncology) pull-up / Jejunal Graft with planned Operative Notes,
Discharge
Summary
693 SC (Surgical Radical Small Bowel Resection–Open SC008A S 33,000 1 Y N Clinical notes Procedure / 7
Discharge
Summary
694 SC (Surgical Radical Small Bowel Resection–Lap. SC008B S 33,000 2 Y N Clinical notes Procedure / 7
Discharge
Summary
695 SC (Surgical Intersphincteric resection–Open SC009A S 40,200 1 Y N Clinical notes Procedure / 6
line of HPE report,
treatment and Detailed Discharge
FNAC/ Summary
BIOPSY, CECT
696 SC (Surgical Intersphincteric resection–Lap. SC009B S 40,200 3 Y N Clinical notes Procedure / 6

line of HPE report,
treatment and Detailed Discharge
FNAC/ Summary
BIOPSY, CECT
697 SC (Surgical Surgery for Abdominal wall SC010A S 25,000 3 Y N Clinical notes detailed Procedure / 3
Oncology) tumour–Abdominal wall tumour and CT Operative Notes,
resection abdomen Clinical Photograph
reports; biopsy showing scar, HPE
report; detailed
discharge summary
698 SC (Surgical Surgery for Abdominal wall SC010B S 39,000 3 Y N Clinical notes detailed Procedure / 6
Oncology) tumour–Abdominal wall tumour and CT Operative Notes,
resection with reconstruction abdomen Clinical Photograph
reports; biopsy showing scar, HPE
report; detailed
discharge summary
699 SC (Surgical Exploratory laparotomy f / b diversion SC011A S 30,000 3 Y N Clinical notes Procedure / 8
Oncology) stoma / bypass–Exploratory with planned Operative Notes,
laparotomy f / b diversion stoma line of Post Procedure
treatment, Photographs of
CECT surgical site, HPE
report, Detailed
Discharge
Summary
700 SC (Surgical Exploratory laparotomy f / b diversion SC011B S 30,000 3 Y N Clinical notes Procedure / 8
Oncology) stoma / bypass–Exploratory with planned Operative Notes,
laparotomy f / b diversion bypass line of Post Procedure
CECT surgical site, HPE
report, Detailed
Discharge
Summary
701 SC (Surgical Abdominoperineal resection–Open SC012A S 39,600 3 Y N Clinical notes Procedure / 6
line of HPE report,
treatment, HPE Detailed Discharge
Summary
702 SC (Surgical Abdominoperineal resection–Lap. SC012B S 39,600 3 Y N Clinical notes Procedure / 6
line of HPE report,
treatment, HPE Detailed Discharge
Summary
703 SC (Surgical Omentectomy–Omentectomy SC013A S 21,000 3 Y N Clinical notes Procedure / 6
treatment, HPE Photographs of
surgical site, HPE
report, Detailed
Discharge
Summary
704 SC (Surgical Procedures Requiring Bypass SC014A S 35,000 3 Y N Clinical notes Procedure / 4
Oncology) Techniques–Procedures Requiring with planned Operative Notes,
Bypass Techniques line of Post Procedure
surgical site, HPE
report, Detailed
Discharge
Summary
705 SC (Surgical Segmentectomy - hepatobiliary SC015A S 50,000 3 Y N Clinical notes detailed Procedure / 5
Oncology) system–Segmentectomy - and Biopsy, Operative Notes,
hepatobiliary system CECT/ MRI Clinical Photograph
showing scar, HPE
report; detailed
discharge summary
706 SC (Surgical Radical / Revision SC016A S 39,600 5 Y N Clinical notes detailed Procedure / 6
Oncology) Cholecystectomy–Radical and CECT/MRI Operative Notes,
reports; biopsy Clinical Photograph
showing scar, HPE
report; detailed
discharge summary
707 SC (Surgical Radical / Revision SC016B S 39,600 1 Y N Clinical notes detailed Procedure / 6
Oncology) Cholecystectomy–Revision and CECT/MRI Operative Notes,
reports; biopsy Clinical Photograph
showing scar, HPE
report; detailed
discharge summary
708 SC (Surgical Enucleation of pancreatic SC017A S 39,600 1 Y N Clinical notes detailed Procedure / 6
Oncology) neoplasm–Enucleation of pancreatic and CECT/ MRI Operative Notes,
neoplasm & biopsy and Clinical Photograph
IHC report showing scar, HPE
report, detailed
discharge summary
709 SC (Surgical Hepatoblastoma SC018A S 52,200 1 Y N Clinical notes Procedure / 8
Oncology) Excision–Hepatoblastoma Excision with planned Operative Notes,
treatment, HPE, Photographs of
CT surgical site, HPE
report, Detailed
Discharge
Summary
710 SC (Surgical Hemipelvectomy - SC019A S 54,000 1 Y N Clinical notes Procedure / 11
Oncology) Internal–Hemipelvectomy - Internal with planned Operative Notes,
report, Detailed
Discharge
Summary
711 SC (Surgical Pelvic Exenteration–Anterior - Open SC020A S 58,800 2 Y N Clinical notes Procedure / 15
line of HPE report,
treatment, HPE, Detailed Discharge
CT Summary
712 SC (Surgical Pelvic Exenteration–Anterior - Lap. SC020B S 58,800 2 Y N Clinical notes Procedure / 15
line of HPE report,
CT Summary
713 SC (Surgical Pelvic Exenteration–Total - Open SC020C S 58,800 1 Y N Clinical notes Procedure / 15
line of HPE report,
CT Summary
714 SC (Surgical Pelvic Exenteration–Total - Lap. SC020D S 58,800 2 Y N Clinical notes Procedure / 15
line of HPE report,
CT Summary
715 SC (Surgical Wilms tumors: surgery–Wilms SC021A S 33,000 2 Y N Clinical notes Procedure / 8
Oncology) tumors: surgery with planned Operative Notes,
Biopsy/HPE, surgical site, HPE
CT abdomen report, Detailed
Discharge
Summary
716 SC (Surgical Ureteric end to end anastomosis SC022A S 24,000 1 Y N CT KUB, Procedure / 6
Oncology) –Ureteric end to end anastomosis Clinical notes Operative Notes,
with planned Post Procedure
line of Photographs of
treatment surgical site, HPE
report, Detailed
Discharge
Summary
717 SC (Surgical Distal ureterectomy with SC023A S 30,000 1 Y N CT KUB, Procedure / 6
Oncology) reimplantation–Distal ureterectomy Clinical notes Operative Notes,
with reimplantation with planned Post Procedure
report, Detailed
Discharge
Summary
718 SC (Surgical Radical cystectomy–With continent SC024A S 98,000 1 Y N HPE, Clinical Procedure / 8
Oncology) diversion - Open notes with Operative Notes,
planned line of Post Procedure
treatment, CT Photographs of
surgical site, HPE
report, Detailed
Discharge
Summary
719 SC (Surgical Radical cystectomy–With Ileal SC024B S 88,000 1 Y N HPE, Clinical Procedure / 8
Oncology) Conduit - Open notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
720 SC (Surgical Radical cystectomy–With Ileal SC024C S 88,000 1 Y N HPE, Clinical Procedure / 8
Oncology) Conduit - Lap. notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
721 SC (Surgical Radical cystectomy–With neobladder - SC024D S 98,000 5 Y N HPE, Clinical Procedure / 11
Oncology) Open notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
722 SC (Surgical Radical cystectomy–With neobladder - SC024E S 98,000 3 Y N HPE, Clinical Procedure / 11
Oncology) Lap notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
723 SC (Surgical Radical cystectomy–With SC024F S 75,000 2 Y N HPE, Clinical Procedure / 8
Oncology) ureterosigmoidostomy - Open notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
724 SC (Surgical Radical cystectomy–With SC024G S 75,000 5 Y N HPE, Clinical Procedure / 8
Oncology) ureterosigmoidostomy - Lap notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
725 SC (Surgical Radical cystectomy–With SC024H S 70,000 3 Y N HPE, Clinical Procedure / 8
Oncology) ureterostomy -Open notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
726 SC (Surgical Radical cystectomy–With SC024I S 70,000 3 Y N HPE, Clinical Procedure / 8
Oncology) ureterostomy -Lap. notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
727 SC (Surgical Channel TURP–Channel TURP SC025A S 22,800 7 Y N Clinical notes Procedure / 4
line of HPE report,
treatment, PSA, Detailed Discharge
USG- prostate Summary
728 SC (Surgical Radical Urethrectomy –Radical SC026A S 30,000 7 Y N CT KUB, Procedure / 5

Oncology) Urethrectomy Clinical notes Operative Notes,
with planned Post Procedure
report, Detailed
Discharge
Summary
729 SC (Surgical Penile preserving surgery SC027A S 25,000 7 Y N HPE, Clinical Procedure / 5
Oncology) (WLE, Glansectomy, Laser)–Penile notes with Operative Notes,
preserving surgery planned line of HPE report,
(WLE, Glansectomy, Laser) treatment Detailed Discharge
Summary
730 SC (Surgical Excision of undescended testicular SC028A S 24,000 7 Y N CT, Clinical Procedure / 5
Oncology) mass –Excision of undescended notes with Operative Notes,
testicular mass planned line of HPE report,
treatment Detailed Discharge
Summary
731 SC (Surgical Germ Cell Tumour Excision–Germ SC029A S 30,000 7 Y N Beta HCG, Procedure / 6
Oncology) Cell Tumour Excision AFP, USG, CT, Operative Notes,
Clinical notes HPE report,
with planned Detailed Discharge
line of Summary
treatment
732 SC (Surgical Bilateral salpingoophorectomy–Open SC030A S 21,000 2 Y N Clinical notes Procedure / 5
surgical site, HPE
report, Detailed
Discharge
Summary
733 SC (Surgical Bilateral salpingoophorectomy–Lap. SC030B S 21,000 1 Y N Clinical notes Procedure / 5
surgical site, HPE
report, Detailed
Discharge
Summary
734 SC (Surgical Leiomyoma excision–Open SC031A S 42,000 1 Y N Clinical notes Procedure / 6
treatment, USG Photographs of
surgical site, HPE
report, Detailed
Discharge
Summary
735 SC (Surgical Leiomyoma excision–MIS SC031B S 42,000 5 Y N Clinical notes Procedure / 6
treatment, USG Photographs of
surgical site, HPE
report, Detailed
Discharge
Summary
736 SC (Surgical Radical Hysterectomy–Class I radical SC032A S 27,000 5 Y N Clinical notes Procedure / 11
Oncology) hysterectomy + bilateral with planned Operative Notes,
salpingoophorectomy + BPLND - Lap. line of Post Procedure
Biopsy, CECT/ surgical site, HPE
MRI report, Detailed
Discharge
Summary
737 SC (Surgical Radical Hysterectomy–Class I radical SC032B S 27,000 5 Y N Clinical notes Procedure / 11
Oncology) hysterectomy + bilateral with planned Operative Notes,
salpingoophorectomy + BPLND - line of Post Procedure
Open treatment and Photographs of
Discharge
Summary
738 SC (Surgical Radical Hysterectomy–Class I radical SC032C S 27,000 0 Y N Clinical notes Procedure / 6
Oncology) Hysterectomy +/- bilateral with planned Operative Notes,
salpingoophorectomy - Lap. line of Post Procedure
Discharge
Summary
739 SC (Surgical Radical Hysterectomy–Class I radical SC032D S 27,000 3 Y N Clinical notes Procedure / 6
Oncology) Hysterectomy +/- bilateral with planned Operative Notes,
salpingoophorectomy - Open line of Post Procedure
Discharge
Summary
740 SC (Surgical Radical Hysterectomy–Class II radical SC032E S 27,000 5 Y N Clinical notes Procedure / 11
Oncology) hysterctomy + BPLND with planned Operative Notes,
Discharge
Summary
741 SC (Surgical Radical Hysterectomy–Class III SC032F S 27,000 5 Y N Clinical notes Procedure / 11
Oncology) radical hysterctomy + BPLND with planned Operative Notes,
Discharge
Summary
742 SC (Surgical Radical Hysterectomy–Hysterectomy SC032G S 34,000 5 Y N Clinical notes Procedure / 13
Oncology) + bilateral salpingoophorectomy + with planned Operative Notes,
omentectomy + peritonectomy and line of Post Procedure
organ resections treatment and Photographs of
Discharge
Summary
743 SC (Surgical Radical vaginectomy–Radical SC033A S 30,000 3 Y N Clinical notes HPE report, detailed 6
Oncology) vaginectomy and CECT, Procedure /
biopsy Operative Notes.
Detailed discharge
summary
744 SC (Surgical Vulvectomy + reconstruction SC034A S 36,000 3 Y N Clinical notes Procedure / 11
Oncology) procedures–Vulvectomy + with planned Operative Notes,
reconstruction procedures line of HPE report,
treatment, Detailed Discharge
Biopsy/HPE Summary
745 SC (Surgical Radical Trachelectomy–Radical SC035A S 40,000 2 Y N Clinical notes HPE report, detailed 11
Oncology) Trachelectomy and CECT, Procedure /
biopsy Operative Notes.
Detailed discharge
summary , Post
procedure Clinical
photgraph showing
scar
746 SC (Surgical Sacral Tumour Excision–Anterior + SC036A S 60,000 2 Y N Clinical notes Procedure / 13
Oncology) Posterior approach with planned Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
747 SC (Surgical Sacral Tumour Excision–Posterior SC036B S 54,000 2 Y N Clinical notes Procedure / 11
Oncology) approach with planned Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
748 SC (Surgical Resection of nasopharyngeal SC037A S 40,000 2 Y N Clinical notes detailed Procedure / 8
Oncology) tumour–Resection of nasopharyngeal and Biopsy of Operative Notes,
tumour primary, Clinical Photograph
CECT/MRI showing scar, HPE
report, detailed
discharge summary
749 SC (Surgical Total Pharyngectomy–Total SC038A S 36,000 2 Y N Clinical notes Procedure / 8

Oncology) Pharyngectomy with planned Operative Notes,
CT / MRI surgical site, HPE
report, Detailed
Discharge
Summary
750 SC (Surgical Parapharyngeal Tumour SC039A S 31,200 2 Y N Clinical notes Procedure / 6
Oncology) Excision–Parapharyngeal Tumour with planned Operative Notes,
Excision line of Post Procedure
report, Detailed
Discharge
Summary
751 SC (Surgical Laryngectomy–Partial laryngectomy SC040A S 69,000 2 Y N Clinical notes detailed Procedure / 6
Oncology) (voice preserving) and Biopsy, Operative Notes,
CECT film and Clinical Photograph
report showing scar, HPE
report, Detailed
Discharge summary
752 SC (Surgical Laryngectomy–Total Laryngectomy SC040B S 36,000 2 Y N Clinical notes detailed Procedure / 11
CECT film and Clinical Photograph
report showing scar, HPE
report
753 SC (Surgical Tracheal resection–Tracheal SC041A S 36,000 2 Y N Clinical notes detailed Procedure / 8
Oncology) resection and CECT/ Operative Notes,
Biopsy Clinical Photograph
confirming showing scar, HPE
diagnosis report, Detailed
discharge summary
754 SC (Surgical Tracheal / Carinal resection–Tracheal SC042A S 58,800 2 Y N Clinical notes Procedure / 8
Oncology) / Carinal resection with planned Operative Notes,
report, Detailed
Discharge
Summary
755 SC (Surgical Tracheal Stenosis (End to end SC043A S 36,000 2 Y N Clinical notes Procedure / 6
Oncology) Anastamosis) (Throat)–Tracheal with planned Operative Notes,
Stenosis (End to end Anastamosis) line of Post Procedure
(Throat) treatment, HPE, Photographs of
report, Detailed
Discharge
Summary
756 SC (Surgical Central airway tumour SC044A S 22,800 2 Y N Clinical notes Procedure / 5
Oncology) debulking–Central airway tumour with planned Operative Notes,
debulking line of Post Procedure
treatment, HPE,Photographs of
report, Detailed
Discharge
Summary
757 SC (Surgical Diagnostic thoracoscopy–Diagnostic SC045A S 15,000 2 Y N Cinical notes, Procedure / 3
Oncology) thoracoscopy radiological Operative Notes,
evidence for Post Procedure
indication Photographs of
surgical site, HPE
report, Detailed
Discharge
Summary
758 SC (Surgical Sleeve resection of lung SC046A S 70,000 5 Y N Clinical notes detailed Procedure / 7
Oncology) cancer–Sleeve resection of lung and FNAC/ Operative Notes,
cancer BIOPSY, CECT Clinical Photograph
showing scar, HPE
report, detailed
discharge summary
759 SC (Surgical Mediastinoscopy–Diagnostic SC047A S 22,200 5 Y N Cinical notes, Procedure / 2

Oncology) radiological Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
760 SC (Surgical Mediastinoscopy–Staging SC047B S 22,200 0 Y N Cinical notes, Procedure / 2
Oncology) radiological Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
761 SC (Surgical Removal of Chest Wall SC048A S 36,000 1 Y N Clinical notes Procedure / 6
Oncology) Tumour–Chest Wall Tumour Excision with planned Operative Notes,
HPE, CT surgical site, HPE
report, Detailed
Discharge
Summary
762 SC (Surgical Removal of Chest Wall SC048B S 51,000 1 Y N Clinical notes Procedure / 6
Oncology) Tumour–Removal of chest wall with planned Operative Notes,
tumour with reconstruction line of Post Procedure
report, Detailed
Discharge
Summary
763 SC (Surgical Pleurectomy SC049A S 39,000 1 Y N Clinical notes Procedure / 5
Oncology) Decortication–Pleurectomy with planned Operative Notes,
Decortication line of Post Procedure
report, Detailed
Discharge
Summary
764 SC (Surgical Chamberlain procedure–Chamberlain SC050A S 22,200 1 Y N Clinical notes Procedure / 2
Oncology) procedure with planned Operative Notes,
CT Thorax surgical site, HPE
report, Detailed
Discharge
Summary
765 SC (Surgical Extrapleural SC051A S 66,000 1 Y N Clinical notes Procedure / 7
Oncology) pneumonectomy–Extrapleural with planned Operative Notes,
pneumonectomy line of Post Procedure
report, Detailed
Discharge
Summary
766 SC (Surgical Pneumonectomy–Pneumonectomy SC052A S 54,000 3 Y N Clinical notes Procedure / 6
CT Thorax, surgical site, HPE
biopsy report, Detailed
Discharge
Summary
767 SC (Surgical Lung metastectomy–Open SC053A S 30,000 5 Y N Clinical notes detailed Procedure / 4
Oncology) and FNAC/ Operative Notes,
BIOPSY, CECT Clinical Photograph
showing scar, HPE
report, detailed
discharge summary
768 SC (Surgical Lung metastectomy–VATS SC053B S 30,000 5 Y N Clinical notes detailed Procedure / 4
BIOPSY, CECT Clinical Photograph
showing scar, HPE
report, detailed
discharge summary
769 SC (Surgical Thoracostomy–Thoracostomy SC054A S 19,800 5 Y N Clinical notes Procedure / 2

clinical surgical site, HPE
photograph report, Detailed
Discharge
Summary
770 SC (Surgical Mediastinal lymphadenectomy–Open SC055A S 36,000 5 Y N Clinical notes Procedure / 4
surgical site, HPE
report, Detailed
Discharge
Summary
771 SC (Surgical Mediastinal lymphadenectomy–Video - SC055B S 36,000 2 Y N Clinical notes Procedure / 4
Oncology) assisted with planned Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
772 SC (Surgical Mediastinal mass excision with lung SC056A S 60,000 6 Y N Clinical notes Procedure / 6
Oncology) resection–Mediastinal mass excision with planned Operative Notes,
with lung resection line of Post Procedure
Discharge
Summary
773 SC (Surgical Segmental resection of lung–Open SC057A S 42,000 1 Y N Clinical notes Procedure / 6
Discharge
Summary
774 SC (Surgical Segmental resection of SC057B S 42,000 1 Y N Clinical notes Procedure / 6
Oncology) lung–Thoracoscopic with planned Operative Notes,
Discharge
Summary
775 SC (Surgical Wedge resection lung–Open SC058A S 36,000 1 Y N Clinical notes Procedure / 6
Discharge
Summary
776 SC (Surgical Wedge resection lung–Thoracoscopic SC058B S 36,000 3 Y N Clinical notes Procedure / 6
Discharge
Summary
777 SC (Surgical Breast conserving surgery–Breast SC059A S 22,800 3 Y N Clinical notes detailed Procedure / 3
Oncology) conserving surgery and Operative Notes,
(lumpectomy + axillary surgery) Mammography, HPE report; detailed
FNAC/ discharge summary
BIOPSY; CT/
MRI
778 SC (Surgical Breast conserving surgery–Breast SC059B S 24,600 2 Y N Clinical notes detailed Procedure / 4
Oncology) conserving surgery with Oncoplasty and Operative Notes,
Mammography, HPE report; detailed
FNAC/ discharge summary
BIOPSY; CT/
MRI
779 SC (Surgical Axillary Sampling / Sentinel Node SC060A S 16,200 2 Y N FNAC, Clinical Procedure / 3
Oncology) Biopsy–Axillary Sampling / Sentinel notes with Operative Notes,
Node Biopsy planned line of Post Procedure
treatment Photographs of
surgical site, HPE
report, Detailed
Discharge
Summary
780 SC (Surgical Axillary dissection–Axillary dissection SC061A S 19,800 2 Y N Clinical notes detailed Procedure / 3
BIOPSY, Clinical Photograph
CECT/ Chest X- showing scar, HPE
ray report; detailed
discharge summary
781 SC (Surgical Scalp tumour excision with skull bone SC062A S 30,000 2 Y N HPE, Clinical Procedure / 6
Oncology) excision–Scalp tumour excision with notes with Operative Notes,
skull bone excision planned line of Post Procedure
surgical site, HPE
report, Detailed
Discharge
Summary
782 SC (Surgical Neuroblastoma SC063A S 60,000 4 Y N HPE, Clinical Procedure / 8
Oncology) Excision–Neuroblastoma Excision notes with Operative Notes,
surgical site, HPE
report, Detailed
Discharge
Summary
783 SC (Surgical Excision of Pinna for Growths / SC064A S 21,600 4 Y N HPE, Clinical Procedure / 2
Oncology) Injuries - Total Amputation & Excision notes with Operative Notes,
of External Auditory Meatus–Growth - planned line of Post Procedure
Squamous treatment Photographs of
surgical site, HPE
report, Detailed
Discharge
Summary
784 SC (Surgical Excision of Pinna for Growths / SC064B S 21,600 3 Y N HPE, Clinical Procedure / 2
Oncology) Injuries - Total Amputation & Excision notes with Operative Notes,
of External Auditory Meatus–Growth - planned line of Post Procedure
Basal treatment Photographs of
surgical site, HPE
report, Detailed
Discharge
Summary
785 SC (Surgical Excision of Pinna for Growths / SC064C S 21,600 2 Y N Clinical notes Procedure / 2
Oncology) Injuries - Total Amputation & Excision with planned Operative Notes,
of External Auditory Meatus–Injury line of Post Procedure
Clinical surgical site, HPE
photograph report, Detailed
Discharge
Summary
786 SC (Surgical Neck dissection - SC065A S 16,000 2 Y N Clinical notes, detailed Procedure / 4
Oncology) comprehensive–Neck dissection - USG/ CT neck Operative Notes,
comprehensive and Clinical Photograph
Biopsy/FNAC showing scar, HPE
report, detailed
discharge summary
787 SC (Surgical Benign Soft Tissue Tumour - SC066A S 12,000 3 Y N HPE, Clinical Procedure / 3
Oncology) Excision–Benign Soft Tissue Tumour - notes with Operative Notes,
Excision planned line of Post Procedure
surgical site, HPE
report, Detailed
Discharge
Summary
788 SC (Surgical Malignant Soft Tissue Tumour - SC067A S 24,000 3 Y N HPE, Clinical Procedure / 5
Oncology) Excision–Malignant Soft Tissue notes with Operative Notes,
Tumour - Excision planned line of Post Procedure
surgical site, HPE
report, Detailed
Discharge
Summary
789 SC (Surgical Regional flap–Myocutaneous flap SC068A S 30,600 3 Y N Clinical notes detailed Procedure / 5
Oncology) and Biopsy of Operative Notes,
primary Clinical photgraph
showing scar,
detailed discharge
summary
790 SC (Surgical Regional flap–Fasciocutaneous flap SC068B S 30,600 3 Y N Clinical notes detailed Procedure / 5
Oncology) and Biopsy of Operative Notes,
primary Clinical photgraph
showing scar,
detailed discharge
summary
791 SC (Surgical Rotationplasty–Rotationplasty SC069A S 45,000 1 Y N Clinical notes Procedure / 7
surgical site,
Detailed Discharge
Summary
792 SC (Surgical Bone tumors / soft tissue sarcomas: SC070A S 30,000 1 Y N HPE, Clinical Procedure / 6
Oncology) surgery–Bone tumors / soft tissue notes with Operative Notes,
sarcomas: surgery planned line of Post Procedure
surgical site, HPE
report, Detailed
Discharge
Summary
793 SC (Surgical Endoprosthesis Revision–Complete SC071A S 39,000 1 Y N Clinical notes Procedure / 7
radiological surgical site,
evidence for Detailed Discharge
indication Summary
794 SC (Surgical Endoprosthesis Revision–Partial SC071B S 24,000 3 Y N Clinical notes Procedure / 4
radiological surgical site,
evidence for Detailed Discharge
indication Summary
795 SC (Surgical Vertebral Tumour Excision and SC072A S 54,000 3 Y N Clinical notes Procedure / 11
Oncology) Reconstruction–Vertebral Tumour with planned Operative Notes,
Excision and Reconstruction line of Post Procedure
radiological surgical site, HPE
evidence for report, Detailed
indication Discharge
Summary
796 SC (Surgical Microvascular reconstruction (free SC073A S 60,000 1 Y N Clinical notes detailed discharge 7
Oncology) flaps)–Microvascular reconstruction and Biopsy of summary, detailed
(free flaps) primary with Procedure /
details of earlier Operative Notes,
surgery done Clinical Photograph
and showing scar
establishing
need of
microvascular
reconstruction
797 SC (Surgical Vascular reconstruction –Vascular SC074A S 57,600 1 Y N Clincal notes Detailed Discharge 9
Oncology) reconstruction Summary
798 SC (Surgical Curopsy / Sclerotherapy–Curopsy / SC075A S 19,200 1 Y N Clincal notes Detailed Discharge 3
Oncology) Sclerotherapy Summary
799 SC (Surgical Chemo Port Insertion–Chemo Port SC076A S 33,000 1 Y N Clinical notes Procedure / 2
Oncology) Insertion with planned Operative Notes,
line of discharge summary,
treatment Invoice of Chemo
port used
800 SE (Opthalmology) Ptosis Surgery–Ptosis Surgery SE001A S 8,000 1 Y N Clinical Still image of the Daycare
Photograph of the procedure with
affected eye pt. ID and date,
(Photographic Detailed discharge
record of the summary, detailed
patient should operative notes.
be maintained
for comparison.
Photographs
should have be
taken in primary
position as well
as in lateral
gazes)
801 SE (Opthalmology) Entropion correction–Entropion SE002A S 6,600 1 Y N Clinical notes Detailed discharge Daycare
correction and Clinical summary, Still
Photograph image of the the
procedure with pt.
ID and
date,operative
notes.
802 SE (Opthalmology) Ectropion correction –Ectropion SE003A S 6,500 1 Y N Clinical notes Detailed discharge Daycare
correction and Clinical summary, Still
Photograph image of the the
procedure with pt.
ID and
date,operative
notes.
803 SE (Opthalmology) Lid Tear Repair–Lid Tear Repair SE004A S 5,000 1 N N Clinical notes; Still image of the Daycare
FIR/MLC in the procedure with
case of pt. ID and
accident, date,operative
Clinical notes. Detailed
Photograph discharge summary
804 SE (Opthalmology) Lid Abscess Drainage–Lid Abscess SE005A S 3,000 3 N N Patient details, Discharge notes, Daycare
Drainage diagnosis, microbiology
doctors notes, report,Still image of
photo the patient
undergoing the
procedure with date
stamp
805 SE (Opthalmology) Lid Tumor excision + Lid SE006A S 10,000 2 Y N Clinical notes Still image of the Daycare
Reconstruction–Lid Tumor excision + and Clinical the procedure with
Lid Reconstruction Photograph of pt. ID and date, HP
affected part, report, Procedure /
stated plan for Operative Notes.
lab investigation Detailed discharge
of host tissue summary
(HP/
Microbiology/ot
her)
806 SE (Opthalmology) Chalazion Removal–Chalazion SE007A S 2,000 0 Y N Patient details, Discharge notes, Daycare
Removal diagnosis, pathology report,
doctors notes, Still image of the
photo patient undergoing
the procedure with
date stamp
807 SE (Opthalmology) Squint correction–Minor - upto 2 SE008A S 4,000 0 Y N Clinical notes Still image of the Daycare
muscles detailing which the procedure with
muscles pt. ID and
affected; date,Procedure /
indication Operative Notes.
justifying the Detailed discharge
need for GA (if summary
required),
Clinical
Photograph
808 SE (Opthalmology) Squint correction–Major - 3 or more SE008B S 14,000 0 Y N Clinical notes Still image of the Daycare
muscles (complex surgery involving detailing which the procedure with
four muscles or oblique muscles) muscles pt. ID and
affected; date,Procedure /
indication Operative Notes.
justifying the Detailed discharge
need for GA (if summary
required),
Clinical
Photograph
809 SE (Opthalmology) Conjunctival tumour excision including SE009A S 7,000 7 Y N Clinical notes , Still image of the Daycare
Amniotic Membrane Graft– Clinical the procedure with
Conjunctival tumour excision Photograph of pt. ID and date, HP
including Amniotic Membrane Graft affected part report, detailed
discharge summary,
detailed Procedure /
Operative Notes.
810 SE (Opthalmology) Dacryocystorhinostomy–Canaliculo SE010A S 10,000 3 Y N Dye Still image of the 1
Dacryocystorhinostomy with Silicon disappearance the procedure with
Tube / Stent test , Tear pt. ID and date,
meniscus operative notes
height
measurement,
Probing and
irrigation
811 SE (Opthalmology) Dacryocystorhinostomy–Canaliculo SE010B S 8,000 0 Y N Dye Still image of the 1
Dacryocystorhinostomy without Silicon disappearance the procedure with
Tube / Stent test , Tear pt. ID and date,
meniscus operative notes
height
measurement,
Probing and
irrigation
812 SE (Opthalmology) Dacryocystorhinostomy–Dacryocystor SE010C S 10,000 5 Y N Clinical notes Still image of the Daycare
hinostomy with Silicon Tube / Stent and the procedure with
establishing pt. ID and
lacrimal cancer date,operative
with Evidence notes. Detailed
of biopsy. Pre- discharge summary
op clinical Invoice of implants
photograph.
813 SE (Opthalmology) Dacryocystorhinostomy–Dacryocystor SE010D S 8,000 5 Y N Clinical notes Still image of the Daycare
hinostomy without Silicon Tube / Stent and the procedure with
establishing pt. ID and
lacrimal cancer date,operative
with Evidence notes. Detailed
of biopsy. Pre- discharge summary
op clinical Invoice of implants
photograph.
814 SE (Opthalmology) Corneal Ulcer Management–Corneal SE011A S 4,000 0 N N clinical Still image of the 5
Ulcer Management presentation patient undergoing
photo the procedure with
date stamp
815 SE (Opthalmology) Corneal Grafting–Corneal Grafting SE012A S 8,500 0 Y N Clinical notes Still image of the Daycare
detailing the procedure with
Indication for pt. ID and
corneal grafting date,operative
and supporting notes. Detailed
investigation, discharge summary
Clinical
Photograph;
details of donor
cornea, stated
plan for lab
investigation of
host tissue
(HPE/
Microbiology/ot
her)
816 SE (Opthalmology) Corneal Grafting–Corneal Graft - SE012B S 2,000 0 N N clinical notes Still image of the Daycare
Follow Up patient undergoing
the procedure with
date stamp
817 SE (Opthalmology) Corneal Collagen SE013A S 9,000 8 Y N PENTACAM Still image of the Daycare
Crosslinking–Corneal Collagen PROGRESSIO patient undergoing
Crosslinking N MAPS 3 to 6 the procedure with
months apart date stamp
818 SE (Opthalmology) Pterygium + Conjunctival SE014A S 5,000 2 Y N Clinical notes Still image of the Daycare
Autograft–Pterygium + Conjunctival and the procedure with
Autograft Retinoscopy, pt. ID and date,
Corneal detailed discharge
topography (not summary, detailed
mandatory), operative notes.
keratometry,
Clinical
Photograph
819 SE (Opthalmology) Corneo / Scleral / Corneo scleral tear SE015A S 11,500 0 Y N Clinical notes Still image of the 2
repair–Corneo / Scleral / Corneo and FIR/MLC the procedure with
scleral tear repair (since injury), pt. ID and date,
USG B scan, Detailed discharge
Clinical summary, barcode
Photograph of Intraocular Lens
used,operative
notes.
820 SE (Opthalmology) Corneal / Scleral Patch Graft–Corneal SE016A S 3,000 3 N N preoperative operative notes, Still 3
/ Scleral Patch Graft clinical photo image of the patient
undergoing the
procedure with date
stamp
821 SE (Opthalmology) Scleral buckling surgery–Scleral SE017A S 15,000 7 N N Clinical notes operative notes. 1
buckling surgery Detailed discharge
summary,Still image
of the the
procedure with pt.
ID and date
822 SE (Opthalmology) Scleral Buckle Removal–Scleral SE018A S 5,500 5 N N Clinical notes Still image of the Daycare
Buckle Removal with, Indication the procedure with
for removal, pt. ID and date,
stated plan for operative notes.
lab investigation Detailed discharge
of host tissue summary,
(Microbiology) microbiological
report
823 SE (Opthalmology) Limbal Dermoid Removal–Limbal SE019A S 4,000 7 Y N Clinical notes Still image of the Daycare
Dermoid Removal and Indication the procedure with
for Limbal pt. ID and date,
Dermoid Detailed discharge
Removal like summary, detailed
increase in operative notes.
dermoid size/
increasing
astigmatism/vis
ual
deterioration/ce
ntral
opacification of
the cornea)
Clinical
Photograph
824 SE (Opthalmology) Cataract surgery–Phaco SE020A S 7,500 7 Y N Clinical notes Detailed discharge Daycare
emulsification with foldable detailing visual summary, operative
hydrophobic acrylic IOL impairment notes. Barcode of
(Best corrected IOL used. Still
visual acquity- image of the the
BCVA) of procedure with pt.
cataract and , ID and date
Ocular Biometry
(A scan and
ketometry) and
Clinical photo of
affected part
825 SE (Opthalmology) Cataract surgery–SICS with non- SE020B S 5,000 7 Y N Clinical notes Detailed discharge Daycare
foldable IOL detailing visual summary, operative
impairment notes. Barcode of
(Best corrected IOL used. Still
visual acquity- image of the the
BCVA) of procedure with pt.
cataract and , ID and date
Ocular Biometry
(A scan and
ketometry) and
Clinical photo of
affected part
826 SE (Opthalmology) Surgery for Pediatric SE021A S 12,200 5 Y N Clinical notes Still image of the Daycare
Cataract–Paediatric lensectomy detailing the procedure with
Indication for pt. ID and date,
Lensectomy Detailed discharge
/pediatric lens summary, detailed
aspiration/ operative notes with
membranectom visual outcomes.
y and Barcode of IOL
supporting used
investigation,
Clinical
Photograph
827 SE (Opthalmology) Surgery for Pediatric SE021B S 12,200 5 Y N Clinical notes Still image of the Daycare
Cataract–Pediatric lens aspiration with detailing the procedure with
posterior capsulotomy & anterior Indication for pt. ID and date,
vitrectomy Lensectomy Detailed discharge
supporting used
investigation,
Clinical
Photograph
828 SE (Opthalmology) Surgery for Pediatric SE021C S 12,200 8 Y N Clinical notes Still image of the Daycare
Cataract–Paediatric Membranectomy detailing the procedure with
& anterior vitrectomy Indication for pt. ID and date,
Lensectomy Detailed discharge
supporting used
investigation,
Clinical
Photograph
829 SE (Opthalmology) Capsulotomy (YAG)–Capsulotomy SE022A S 1,500 8 Y N Clinical notes procedure notes, Daycare
(YAG) detailing when Detailed discharge
was cataract summary, Still
surgery was image of the the
done and notes procedure with pt.
mentioning ID and date
indication for
this procedure
with vision and
fundus. Clinical
photo of patient
before
procedure
830 SE (Opthalmology) SFIOL (inclusive of SE023A S 18,000 10 Y N Clinical notes Still image of the Daycare
Vitrectomy)–SFIOL (inclusive of with planned patient undergoing
Vitrectomy) line of the procedure with
treatment, Pre date stamp
operative operative notes.
Clinical Detailed discharge
Photograph of summary, Barcode
affected part of SFIOL.
831 SE (Opthalmology) Secondary IOL / IOL Exchange / SE024A S 5,000 0 Y N Clinical notes, Still image of the Daycare
Explant–Secondary IOL / IOL pre operative patient undergoing
Exchange / Explant documentation the procedure with
of indication for date stamp,
intervention and operative notes.
Photograph of summary; Barcode
affected part of IOL
832 SE (Opthalmology) IRIS Prolapse – Repair–IRIS Prolapse SE025A S 4,000 6 N N Clinical notes, Still image of the Daycare
– Repair pre operative patient undergoing
documentation the procedure with
of indication for date stamp,
intervention and operative notes.
Photograph of summary
affected part
833 SE (Opthalmology) Iridectomy–Iridectomy SE026A S 2,000 5 Y N Clinical notes Still image of the Daycare
showing the procedure with
Indication for pt. ID and date,
Iridectomy(Lase procedure notes.
r), Tonometry, Detailed discharge
Gonioscopy,an summary
d clinical photo
834 SE (Opthalmology) Glaucoma Surgery –Cyclocryotherapy SE027A S 3,700 5 Y N Clinical notes Detailed Procedure Daycare
/ Cyclophotocoagulation establishing / Operative Notes
long standing and discharge
history of summary.
Glaucoma with
recent
documentation
of vision and
reports of field
of vision.
835 SE (Opthalmology) Glaucoma Surgery–Glaucoma SE027B S 11,000 10 Y N Clinical notes Still image of the Daycare
Surgery (Trabeculectomy only) with or and IOP the procedure with
without Mitomycin C, including measurement, pt. ID and date
postoperative medications for 12 documentary ,operative notes.
weeks evidence Detailed discharge
(and wherever surgical or laser supporting summary; ensure
procedures required for bleb chronicity that post op
augmentation and anterior chamber medicine for 12
maintenance) weeks is given
836 SE (Opthalmology) Glaucoma Surgery –Glaucoma Shunt SE027C S 20,000 10 Y N Clinical notes Still image of the 3
Surgery and IOP patient undergoing
measurement, the procedure with
documentary date stamp,
evidence operative notes.
supporting Detailed discharge
chronicity/ summary
Failed
Trabeculectomy
837 SE (Opthalmology) Glaucoma Surgery –Pediatric SE027D S 15,000 10 Y N Clinical notes Still image of the 4
Glaucoma Surgery and IOP patient undergoing
measurement, the procedure with
documentary date stamp,
evidence of operative notes.
paediatric Detailed discharge
glaucoma with summary
confirmation of
diagnosis under
GA/Examinatio
n under
anaesthesia
(EUA)
838 SE (Opthalmology) EUA for Confirmation of Pediatric SE028A S 3,000 10 Y N Clinical notes Still image of the Daycare
Glaucoma–EUA for Confirmation of and/or patient undergoing
Pediatric Glaucoma documentary the procedure with
evidence date stamp,
operative notes.
Detailed discharge
summary with
IOP,Fundus,Cornea
l diameter
839 SE (Opthalmology) Retinal Laser Photocoagulation –For SE029A S 1,500 10 Y N clinical notes discharge summary, Daycare
retinal tear repair Per Eye Per Sitting and or clinical notes, Still
supportive image of the the
documents procedure with pt.
ID and date
840 SE (Opthalmology) Retinal Laser Photocoagulation –Pan SE029B S 8,500 7 Y N clinical notes Still image of the Daycare
Retinal Photocoagulation (PRP) - and or the procedure with
Retinal Laser including 3 sittings / supportive pt. ID and date;
package of retino laser documents discharge summary,
photocoagulation clinical notes
(3 sittings per eye for both eyes)
841 SE (Opthalmology) ROP Laser - Per Eye–ROP Laser - SE030A S 5,000 7 N N Clinical notes Discharge Daycare
Per Eye summary, Still
image of the patient
undergoing the
procedure with date
stamp
842 SE (Opthalmology) Retinal Cryopexy–Retinal Cryopexy SE031A S 3,800 4 Y N Clinical notes Detailed Procedure Daycare
with Indication notes and discharge
for procedure summary,Still image
of the the
procedure with pt.
ID and date
843 SE (Opthalmology) Vitreoretinal Surgery (with Silicon Oil SE032A S 23,900 6 Y N Clinical notes Detailed discharge Daycare
Insertion)–Vitreoretinal Surgery (with and or Clinical summary, operative
Silicon Oil Insertion) documents, B notes, IOL sticker,
Scan (optional) Still image of the
the procedure with
pt. ID and date
844 SE (Opthalmology) SOR (Silicon Oil Removal)–SOR SE033A S 9,300 6 Y N Clinical notes Detailed discharge Daycare
(Silicon Oil Removal) and or Clinical summary, operative
documents, B notes., sticker of
Scan IOL,Still image of
the the procedure
with pt. ID and date
845 SE (Opthalmology) Endophthalmitis (excluding SE034A S 8,000 0 N N Clinical notes Still image of the 5
Vitrectomy)–Endophthalmitis with planned patient undergoing
(excluding Vitrectomy) line of the procedure with
treatment, Pre date stamp,
operative operative notes.
affected part
846 SE (Opthalmology) Enucleation–Without implant SE035A S 8,400 7 Y N Clinical notes Intra procedure 2
establishing clinical photograph,
Indication and detailed discharge
justifying summary, ,operative
enucleation and notes, confirmation
supporting that specimen was
investigation, sent for
Clinical histopathology.
Photograph;
Recommendati
on/opinion of 2
ophthalmologist
s for the
procedure
847 SE (Opthalmology) Enucleation–With implant SE035B S 9,000 0 Y N Clinical notes Still image of the 2
establishing the procedure with
Indication and pt. ID and date,
justifying detailed discharge
enucleation and summary, ,operative
supporting notes. Invoice of
investigation, implant,
Clinical confirmation/
Photograph, declaration that the
Recommendati specimen has been
on/opinion of 2 sent for
ophthalmologist histopathology and
s for the report will be sent
procedure for filing later
848 SE (Opthalmology) Evisceration–Evisceration SE036A S 4,800 7 Y N Indication for Detailed discharge Daycare
Evisceration summary, Still
and supporting image of the the
investigation procedure with pt.
report, Clinical ID and
Photograph, date,operative
Recommendati notes,
on/opinion of 2 Confirmation/declar
ophthalmologist ation that specimen
s for the sent for lab
procedure, investigationmicrobi
stated plan for o/path and report
lab investigation will be submitted
of host tissue
(HP/
Microbiology/ot
her)
849 SE (Opthalmology) Exenteration–Exenteration SE037A S 15,000 0 Y N Indication for Still image of the Daycare
Exenteration the procedure with
and supporting pt. ID and
investigation, date,operative
(Biopsy / CT / notes.
MRI Histopathological
establishing exam report.
indication for Detailed discharge
Exenteration) summary,
Clinical confirmation/
Photograph, declaration that the
Recommendati specimen has been
on/opinion of 2 sent for
ophthalmologist histopathology and
s for the report will be sent
procedure for filing later
850 SE (Opthalmology) Socket Reconstruction including SE038A S 11,200 7 Y N Clinical notes Still image of the 1
Amniotic Membrane Graft–Socket and showing the procedure with
Reconstruction including Amniotic Indication for pt. ID and
Membrane Graft socket date,operative
reconstruction, notes. Detailed
Clinical discharge summary
Photograph of
affected part
851 SE (Opthalmology) Orbitotomy–Orbitotomy SE039A S 14,000 0 Y N Clinical notes Still image of the Daycare
detailing the procedure with
indication and pt. ID and date, HP
CT Scan, Report of actual
Clinical surgery, operative
Photograph, notes, Lab
stated plan for (Histopath) report
lab investigation
of host tissue
(HP/
Microbiology/ot
her)
852 SE (Opthalmology) GA / EUA separate add on SE040A S 3,000 7 Y N Clinical Notes Clinical Notes for Daycare
package–GA / EUA separate add on justifying the the associated
package need for GA in surgery / disease
the associated along with Pre OP,
surgery Operative and
Anesthesia, Post
OP notes
853 SG (General Oesophagectomy–Oesophagectomy SG001A S 28,300 0 N N Clinical notes Histopath, Intra 5
Surgery) and procedure clinical
USG/CT/MRI/ photograph,
Biopsy report detailed discharge
confirming the summary, Detailed
diagnosis for Operative notes
which the
surgery is done
854 SG (General Operations for Replacement of SG002A S 30,500 7 N N Clinical notes Picture of removed 10
Surgery) Oesophagus by Colon–Operations for and X-ray, esopahgus (Intra
Replacement of Oesophagus by CT/MRI/ UGIE procedure clinical
Colon findings photograph), Scar
confirming the photo (should be
diagnosis for two scars or one
which the huge thoracolumbar
surgery is done, scar coverin both
Biospy, colon removal &
esopagus
replacement)
Detailed discharge
summary, Detailed
Operative notes
855 SG (General Gastrectomy–Bleeding Ulcer - Partial SG003A S 25,000 0 N N Clinical notes, Intra Operative 5
Surgery) Gastrectomy without Vagotomy UGI Endoscopy Photograph,
confirming the Histopathology
Operative notes &
detailed discharge
summary.
856 SG (General Gastrectomy–Bleeding Ulcer - Partial SG003B S 25,000 6 N N Clinical notes,Intra Operative 5
Surgery) Gastrectomy with Vagotomy UGI Endoscopy Photograph,
confirming the Histopathology
Operative notes &
detailed discharge
summary.
857 SG (General Gastrectomy–Partial Gastrectomy for SG003C S 27,800 7 N N Clinical notes Intra procedure 6
Surgery) Carcinoma and mandatory clinical photograph,
Biopsy + Histopathology
Endoscopy/ CT report, post
Scan procedure clinical
confirming the photograph,
diagnosis, Detailed Operative
Clinical notes, Detailed
photograph discharge summary
858 SG (General Gastrectomy–Subtotal Gastrectomy SG003D S 27,800 7 N N Clinical notes Intra procedure 6
Surgery) for Carcinoma and mandatory clinical photograph,
Biopsy + Histopathology
Endoscopy/ CT report, post
diagnosis, Detailed Operative
Clinical notes, Detailed
859 SG (General Gastrectomy–Total Gastrectomy - SG003E S 51,600 7 N N Clinical notes Intra procedure 5
Surgery) Lap. and Endoscopy clinical photograph,
report +/- Video Histopathology
/Biopsy/ CT report, post
diagnosis for Detailed Operative
which this notes, Detailed
surgery is done discharge summary
860 SG (General Gastrectomy–Total Gastrectomy - SG003F S 51,600 3 N N Clinical notes Intra procedure 5
Surgery) Open and Endoscopy clinical photograph,
861 SG (General Operative Gastrostomy–Operative SG004A S 15,000 3 N N Clinical notes Intra procedure 5
Surgery) Gastrostomy and Endoscopy clinical photograph,
862 SG (General Vagotomy–G J Vagotomy SG005A S 23,500 5 N N Clinical notes Endoscopic intra 5
Surgery) and Endoscopy operative
report with Photograph,Histopa
confirming the thology report,
which this notes, detailed
863 SG (General Vagotomy–Vagotomy + Pyloroplasty SG005B S 23,500 7 N N Clinical notes Endoscopic intra 5
Surgery) and Endoscopy operative
report with Photograph,Histopa
confirming the thology report,
which this notes, detailed
864 SG (General Operation for Bleeding Peptic SG006A S 22,500 2 N N Clinical notes Intra procedure 5
Surgery) Ulcer–Operation for Bleeding Peptic and Endoscopy clinical Photograph,
Ulcer confirming the Detailed discharge
diagnosis, summary, Detailed
Operative notes
865 SG (General Operation for Gastric / Duodenal SG007A S 18,500 5 N N Clinical notes Intra procedure 6
Surgery) Perforation–Gastric Perforation and X Ray clinical photograph,
Erect/USG/ CT Detailed Operative
Abdomen notes, detailed
confirming the discharge summary
diagnosis,
FIR/MLC in
case of
traumatic
aetiology
866 SG (General Operation for Gastric / Duodenal SG007B S 18,500 3 N N Clinical notes Intra procedure 6
Surgery) Perforation–Duodenal Perforation and X Ray clinical photograph,
Erect/USG/ CT Detailed Operative
Abdomen notes, detailed
diagnosis,
FIR/MLC in
case of
traumatic
aetiology
867 SG (General Pyloroplasty–Pyloroplasty SG008A S 14,000 2 N N Clinical notes Intra procedure 5
Surgery) and Endoscopy clinical photograph,
confirming the detailed discharge
diagnosis for summary, Detailed
which the Operative notes
surgery is done
868 SG (General Pyloromyotomy–Pyloromyotomy SG009A S 15,000 10 N N Clinical notes Endoscopic still 5
Surgery) and Endoscopy Photograph,
report Detailed discharge
diagnosis of Operative notes
nfantile
hypertrophic
pyloric stenosis
869 SG (General Gastrojejunostomy–Gastrojejunostom SG010A S 18,500 10 N N Clinical notes intra operative 5

Surgery) y and Endoscopy photograph Detailed
report OR Operative notes,
Biopsy OR CT detailed discharge
Scan summary
confirming the
diagnosis for
which this
surgery is done
870 SG (General CystoJejunostomy / SG011A S 20,000 10 N N Clinical notes Detailed discharge 6

Surgery) Cystogastrostomy–CystoJejunostomy and USG / CT summary, post
Open confirming the procedure clinical
diagnosis for photograph,
which Detailed Operative
procedure is notes, scar photo
needed
871 SG (General CystoJejunostomy / SG011B S 20,000 10 N N Clinical notes Detailed discharge 6
Surgery) Cystogastrostomy–CystoJejunostomy and USG / CT summary, post
Lap. confirming the procedure clinical
needed
872 SG (General CystoJejunostomy / SG011C S 20,000 10 N N Clinical notes Detailed discharge 6
Surgery) Cystogastrostomy–Cystogastrostomy - and USG / CT summary, post
Open confirming the procedure clinical
needed
873 SG (General CystoJejunostomy / SG011D S 20,000 7 N N Clinical notes Detailed discharge 6
Surgery) Cystogastrostomy–Cystogastrostomy - and USG / CT summary, post
Lap. confirming the procedure clinical
needed
874 SG (General Feeding Jejunostomy–Feeding SG012A S 10,000 7 N N Clinical notes Intra procedure 6
Surgery) Jejunostomy and Endoscopy clinical photograph
report +/- Video detailed discharge
/Biopsy/ CT summary, Detailed
Scan Operative notes
confirming the
diagnosis for
which this
surgery is done
875 SG (General Ileostomy–Ileostomy SG013A S 14,000 0 N N Clinical notes Histopath, Post 6

Surgery) and Endoscopy procedure clinical
/ Biopsy/ CT photograph,
Scan Detailed Operative
confirming the notes, detailed
diagnosis for discharge summary
which this
surgery is done
876 SG (General Congenital Atresia & Stenosis of SG014A S 23,000 12 N N Clinical notes Intra procedure 6
Surgery) Small Intestine–Congenital Atresia & and X ray, clinical stills,
Stenosis of Small Intestine CT/MRI Abd Detailed Operative
confirming the notes, Detailed
diagnosis discharge summary
877 SG (General Operation for Duplication of SG015A S 18,000 0 N N Clinical notes USG, Intra 7
Surgery) Intestine–Operation for Duplication of and USG Abd/ operative clinical
Intestine CT/MRI photograph,
/Endoscopic Detailed Operative
Ultrasound - notes, Detailed
any one test discharge summary,
confirming the histopath of
diagnosis. removed part.
878 SG (General Diverticulectomy–Excision Duodenal SG016A S 20,000 0 N N Clinical notes Intra operative 5
Surgery) Diverticulum and CT clinical photograph,
Scan/Endoscop Detailed Operative
y/Double notes, scar photo
balloon Detailed discharge
enteroscopy summary
confirming the
diagnosis
879 SG (General Diverticulectomy–Excision Meckel's SG016B S 15,000 0 N N Clinical notes Histopath, Intra 3
Surgery) Diverticulum and operative clinical
USG/CT/MRI photograph,
report Detailed Operative
confirming the notes; detailed
880 SG (General Appendicectomy–Open SG017A S 11,000 10 N N Clinical notes Histopathology 3
Surgery) and USG report, Intra
confirming the procedure clinical
diagnosis photograph of
removed appendix,
post procedure
clinical photograph,
Detailed Operative
notes, Detailed
discharge summary
881 SG (General Appendicectomy–Lap. SG017B S 11,000 0 N N Clinical notes Histopathology 3

Surgery) and USG report, Intra
confirming the procedure clinical
diagnosis photograph of
removed appendix,
post procedure
Detailed Operative
notes, Detailed
discharge summary
882 SG (General Appendicular SG018A S 17,500 0 N N Clinical notes Histopath, Intra 5

Surgery) Perforation–Appendicular Perforation and X Ray procedure clinical
Abdomen photograph,
Erect/USG detailed discharge
confirming the summary and
diagnosis Detailed Operative
notes
883 SG (General Operative drainage of Appendicular SG019A S 12,000 0 N N Clinical notes, Intra Operative 3
Surgery) Abscess–Operative drainage of USG clinical photograph,
Appendicular Abscess Detailed Operative
notes & discharge
summary.
884 SG (General Total Colectomy–Open SG020A S 23,000 0 N N Clinical notes Histopathology, 7
Surgery) and CT Scan/ Intra procedure
Colonoscopy clinical photograph,
need of Operative notes
surgery; Biopsy
of the lsoion
885 SG (General Total Colectomy–Lap. SG020B S 23,000 0 N N Clinical notes Histopathology, 7

Surgery) and CT Scan/ Intra procedure
Colonoscopy clinical photograph,
need of Operative notes
surgery; Biopsy
of the lsoion
886 SG (General Hemi colectomy–Right - Open SG021A S 25,000 12 N N Clinical notes Histopathology 6
Surgery) and CT report and Intra
Scan/Colonosc procedure Clinical
opy confirming photograp of
the diagnosis removed colon,
for which the Detailed discharge
surgery is done, summary, Detailed
Biopsy Operative notes
887 SG (General Hemi colectomy–Right - Lap. SG021B S 25,000 0 N N Clinical notes Histopathology 6
888 SG (General Hemi colectomy–Left - Open SG021C S 25,000 0 N N Clinical notes Histopathology 6
889 SG (General Hemi colectomy–Left - Lap. SG021D S 25,000 0 N N Clinical notes Histopathology 6
890 SG (General Operative Management of Volvulus of SG022A S 25,000 0 N N Clinical notes Detailed discharge 4
Surgery) Large Bowel–Operative Management and X Ray summary, X Ray
of Volvulus of Large Bowel Abdomen / CT Abdomen, Detailed
Contrast Operative notes.
confirming the
diagnosis,
891 SG (General Colostomy–Colostomy SG023A S 14,000 0 N N Clinical notes Post procedure 7
Surgery) and CT/ MRI/ clinical photograph,
Colonoscopy Detailed Operative
evidence of notes & detailed
need of surgery notes.
surgery.
892 SG (General Closure of stoma–Closure of stoma SG024A S 14,500 5 N N Clinical notes Post procedure 4
Surgery) detailing why clinical photograph,
colostomy was Detailed Operative
done? Clinical notes, Detailed
893 SG (General Sigmoid Resection–Sigmoid SG025A S 21,500 3 N N Clinical notes Histopathology, 4
Surgery) Resection and Barium X- Intra procedure
rays / CT scan/ clinical photograph,
sigmoidoscopy, Detailed Operative
confirming the notes, detailed
894 SG (General Perineal Procedure for Rectal SG026A S 14,000 0 N N Clinical notes +/- Histopath, Intra 2
Surgery) Prolapse–Perineal Procedure for Colonoscopy / procedure clinical
Rectal Prolapse CT confirming photograph,
the diagnosis, detailed discharge
summary, Detailed
Operative notes
895 SG (General Abdominal Procedure for Rectal SG027A S 19,000 0 N N Clinical notes +/- Intra procedure 4
Surgery) Prolapse–Open Colonoscopy clinical photograph,
diagnosis of summary, Detailed
prolapse Operative notes,
896 SG (General Abdominal Procedure for Rectal SG027B S 19,000 0 N N Clinical notes +/- Intra procedure 4
Surgery) Prolapse–Lap. Colonoscopy clinical photograph,
diagnosis of summary, Detailed
prolapse Operative notes,
897 SG (General Rectal Polyp Excision–Rectal Polyp SG028A S 9,600 0 N N Clinical notes Histopath, Intra 1
Surgery) Excision and procedure clinical
Colonoscopy +/- photograph,
Biopsy justifying Detailed Operative
surgery, notes, detailed
discharge summary
898 SG (General Anterior Resection of rectum–Open SG029A S 28,500 0 N N Clinical notes, Histopathology 10
Surgery) Biopsy, report, post
Colonoscopy procedure clinical
photograph,
Detailed Operative
notes & detailed
discharge summary
899 SG (General Anterior Resection of rectum–Lap. SG029B S 28,500 0 N N Clinical notes, Histopathology 10
Surgery) Biopsy, report, post
Colonoscopy procedure clinical
photograph,
Detailed Operative
notes & detailed
discharge summary
900 SG (General Resection Anastomosis–Open SG030A S 25,000 0 N N Clinical notes Histopath of 7

Surgery) and X Ray resected part, Intra
Abdomen procedure clinical
Erect/USG / CT photograph,
diagnosis summary and
Detailed Operative
notes
901 SG (General Resection Anastomosis–Lap. SG030B S 25,000 0 N N Clinical notes Histopath of 7
Surgery) and X Ray resected part, Intra
Abdomen procedure clinical
Erect/USG / CT photograph,
diagnosis summary and
Detailed Operative
notes
902 SG (General Procedure for Fissure in SG031A S 8,000 0 N N Clinical notes Detailed Operative Daycare
Surgery) Ano–Procedure for Fissure in Ano and proctoscpic notes; detailed
findings discharge summary
confirming the
diagnosis for
which this
surgery is done,
903 SG (General Haemorroidectomy–without Stapler SG032A S 15,000 0 N N Clinical notes Post procedure Daycare
Surgery) and clinical photograph,
proctoscopy Detailed Operative
notes notes, detailed
diagnosis
904 SG (General Haemorroidectomy–with Stapler SG032B S 32,000 0 N N Clinical notes Post procedure Daycare
Surgery) and clinical photograph,
proctoscopy Detailed Operative
notes notes, detailed
diagnosis
905 SG (General Management of Pilonidal SG033A S 5,000 0 N N Clinical notes Histopath, Intra- Daycare
Surgery) Sinus–Management of Pilonidal Sinus and operative clinical
confirmation of photograph,
Pilonidal sinus Detailed Operative
on examination notes
906 SG (General Exicision of Sinus and SG034A S 5,000 0 N N Clinical notes post procedure Daycare
Surgery) Curettage–Exicision of Sinus and and some clinical photograph,
Curettage imaging to Detailed Operative
show tract of notes; detailed
sinus, discharge summary.
confirming the +/- Histopath of
diagnosis, surreted material
Clinical
Photograph
907 SG (General Exploratory Laparotomy–Exploratory SG035A S 10,000 0 N N Clinical notes Intra procedure 5
Surgery) Laparotomy detailing clinical photograph,
original Analysis of fluid
pathology that removed, Detailed
led to discharge summary,
peritonitis; Detailed Operative
supported by X notes describing
Ray/USG/CT management done
Scan Abdomen of pathology that led
to peritonitis;
cautious about OT
time; this should
take 2-3 hours.
908 SG (General Closure of Burst Abdomen–Closure of SG036A S 15,000 0 N N Clinical notes Intra procedure 6
Surgery) Burst Abdomen describing the clinical photograph,
original surgery Detailed Operative
that led to burst notes, detailed
abdomen and X discharge summary
Ray/USG/ CT
Abdomen
confirming the
diagnosis for
which the
surgery is done
909 SG (General Hepatic Resection–Open SG037A S 20,000 0 N N Clinical notes Histopath, Intra 7
USG/CT/MRI / photograph,
justification of Operative notes
surgery.
910 SG (General Hepatic Resection–Lap. SG037B S 20,000 0 N N Clinical notes Histopath, Intra 7
USG/CT/MRI / photograph,
justification of Operative notes
surgery.
911 SG (General Abdominal Hydatid Cyst (Single SG038A S 15,800 0 N N Clinical notes Histopath, Intra 3
Surgery) Organ)–Abdominal Hydatid Cyst and procedure clinical
(Single Organ) USG/CT/MRI photograph,
confirming the notes and detailed
diagnosis. discharge summary
912 SG (General Cholecystectomy–Without Exploration SG039A S 22,800 0 N N Clinical notes Intra procedure 6
Surgery) of CBD - Open and USG clinical photograph,
diagnosis summary, Detailed
Operative notes
913 SG (General Cholecystectomy–With Exploration of SG039B S 22,800 0 N N Clinical notes Intra procedure 6
Surgery) CBD - Open and USG clinical photograph,
Operative notes
914 SG (General Cholecystectomy–Without Exploration SG039C S 22,800 0 N N Clinical notes Intra procedure 6
Surgery) of CBD - Lap. and USG clinical photograph,
Operative notes
915 SG (General Cholecystectomy–With Exploration of SG039D S 22,800 5 N N Clinical notes Intra procedure 6
Surgery) CBD - Lap. and USG clinical photograph,
Operative notes
916 SG (General Operative Cholecystostomy–Open SG040A S 10,000 5 N N Clinical notes Intra procedure 4
Surgery) and USG/CT clinical photograph,
Scan Detailed discharge
which the
surgery is done,
917 SG (General Operative Cholecystostomy–Lap. SG040B S 10,000 3 N N Clinical notes Intra procedure 4
Surgery) and USG/CT clinical photograph,
Scan Detailed discharge
which the
surgery is done,
918 SG (General Operation of Choledochal SG041A S 24,500 4 N N Clinical notes Histopath, Detailed 5
Surgery) Cyst–Operation of Choledochal Cyst and USG/CT discharge summary,
Abdomen Scar photo, Detailed
Operative notes
919 SG (General Splenectomy–Open SG042A S 25,000 5 N N Clinical notes Detailed Operative 7

Surgery) and USG/CT notes, histopath,
Scan and Lab detailed discharge
investigations summary,
confirming the
diagnosis and
justifying the
surgery.
920 SG (General Splenectomy–Lap. SG042B S 25,000 5 N N Clinical notes Detailed Operative 7
Surgery) and USG/CT notes, histopath,
Scan and Lab detailed discharge
investigations summary,
confirming the
diagnosis and
justifying the
surgery.
921 SG (General Bypass - Inoperable SG043A S 23,500 3 N N Clinical and Histopathology 7
Surgery) Pancreas–Bypass - Inoperable radiological report, Intra
Pancreas evidence of operative clinical
inoperability photograph,
(biopsy, ERCP, Detailed Operative
MRCP) notes and discharge
summary.
922 SG (General Distal Pancreatectomy with SG044A S 25,000 3 N N Clinical notes Histopath, Intra 7
Surgery) Pancreatico Jejunostomy –Distal and Sr procedure clinical
Pancreatectomy with Amylase, CT/ photograph,
Pancreatico Jejunostomy USG, ERCP detailed discharge
justifying the summary, Detailed
surgery, Operative notes
923 SG (General PancreaticoDuodenectomy SG045A S 30,000 3 N N Clinical notes Histopath, Intra 7
Surgery) (Whipple's)–PancreaticoDuodenecto and CT/ USG, procedure clinical
my (Whipple's) ERCP photograph,
diagnosis, summary and
Detailed Operative
notes
924 SG (General Porto Caval Anastomosis–Porto SG046A S 31,500 1 N N Clinical notes Intra procedure 7
Surgery) Caval Anastomosis and USG- clinical photograph,
doppler detailed discharge
/CT/MRI report summary, Detailed
confirming the Operative notes
diagnosis for
which the
surgery is done
925 SG (General Mesenteric Caval SG047A S 28,500 14 N N Clinical notes Intra procedure 6
Surgery) Anastomosis–Mesenteric Caval and clinical photograph,
Anastomosis USG/CT/MRI/ detailed discharge
Endoscopy summary and
confirming the notes
diagnosis for
which the
anastomosis is
done
926 SG (General Mesenteric Cyst – SG048A S 15,000 14 N N Clinical notes Histopath, Intra 5
Surgery) Excision–Mesenteric Cyst – Excision and procedure clinical
USG/CT/MRI photograph,
report detailed discharge
confirming the summary and
notes
927 SG (General Retroperitoneal Tumor – SG049A S 23,000 14 N N Clinical notes Histopath, Intra 5
Surgery) Excision–Retroperitoneal Tumor – and X procedure clinical
Excision Ray/USG/CT photograph,
Abdomen detailed discharge
diagnosis Operative notes
928 SG (General Groin Hernia Repair–Inguinal - Open SG050A S 16,200 14 N N Clinical notes Post procedure 3
Surgery) and USG clinical photograph,
(specifying size detailed discharge
of defect), summary Detailed
Clinical Operative notes,
photograph Invoice of Mesh
used
929 SG (General Groin Hernia Repair–Inguinal - Lap. SG050B S 16,200 14 N N Clinical notes Post procedure 3
used
930 SG (General Groin Hernia Repair–Femoral - Open SG050C S 16,200 14 N N Clinical notes Post procedure 3
used
931 SG (General Groin Hernia Repair–Femoral - Lap SG050D S 16,200 14 N N Clinical notes Post procedure 3
used
932 SG (General Groin Hernia Repair–Obturator - Lap. SG050E S 35,000 14 N N Clinical notes Post procedure 2
used
933 SG (General Hernia - Ventral–Epigastric SG051A S 22,400 14 N N Clinical notes Post procedure 4
Clinical Operative notes +/-
used
934 SG (General Hernia - Ventral–Umbilical SG051B S 22,400 0 N N Clinical notes Post procedure 4
used
935 SG (General Hernia - Ventral–Paraumbilical SG051C S 22,400 0 N N Clinical notes Post procedure 4
used
936 SG (General Hernia - Ventral–Spigelian SG051D S 22,400 0 N N Clinical notes Post procedure 4
used
937 SG (General Repair of Incisional Hernia–Repair of SG052A S 35,000 0 N N Clinical notes Post procedure 3
Surgery) Incisional Hernia including info clinical photograph,
about previous detailed discharge
surgery in summary Detailed
whose incision Operative notes +/-
this hernia has Invoice of Mesh
occurred and used
USG
(specifying size
of defect),
Clinical
photograph
938 SG (General Hiatus Hernia Repair / SG053A S 23,500 0 N N Clinical notes Intra procedure 5
Surgery) Fundoplication–Hiatus Hernia Repair - and X-ray/ USG clinical photograph,
Open + UGI Detailed Operative
Endoscopy notes & discharge
summary
939 SG (General Hiatus Hernia Repair / SG053B S 23,500 0 N N Clinical notes Intra procedure 5
Surgery) Fundoplication–Hiatus Hernia Repair - and X-ray/ USG clinical photograph,
Lap. + UGI Detailed Operative
summary
940 SG (General Hiatus Hernia Repair / SG053C S 23,500 2 N N Clinical notes Intra procedure 5
Surgery) Fundoplication–Fundoplication - Open and X-ray/ USG clinical photograph,
+ UGI Detailed Operative
summary
941 SG (General Hiatus Hernia Repair / SG053D S 23,500 2 N N Clinical notes Intra procedure 5
Surgery) Fundoplication–Fundoplication - Lap. and X-ray/ USG clinical photograph,
+ UGI Detailed Operative
summary
942 SG (General Excision of cyst / Sebaceous Cysts SG054A S 2,000 2 N N Deailed Clinical Intra operative 1
Surgery) over scrotum–Single Cyst notes clinical photograph,
Detailed Operative
notes; detailed
discharge summary.
943 SG (General Excision of cyst / Sebaceous Cysts SG054B S 7,000 2 N N Deailed Clinical Intra operative 1
Surgery) over scrotum–Multiple Cysts notes clinical photograph,
Detailed Operative
notes; detailed
discharge summary.
944 SG (General Excision Filarial Scrotum–Excision SG055A S 6,500 2 N N Clinical notes +/- Histopath, detailed 3
Surgery) Filarial Scrotum USG report Operative notes,
diagnosis summary
945 SG (General Operation for Hydrocele SG056A S 5,000 2 N N Clinical notes Histopath, Intra Daycare
Surgery) (U/L)–Operation for Hydrocele (U/L) and +/- Scrotal procedure clinical
USG confirming photograph,
the diagnosis Detailed Operative
notes and detailed
discharge summary
946 SG (General Epididymal Cyst / Nodule SG057A S 4,600 2 N N Clinical notes Histopath, Intra Daycare
Surgery) Excision–Epididymal Cyst exision and USG report operative clinical
notes, Detailed
discharge summary
947 SG (General Epididymal Cyst / Nodule SG057B S 4,600 0 N N Clinical notes Histopath, Intra Daycare
Surgery) Excision–Epididymal Nodule excision and USG report operative clinical
notes, Detailed
discharge summary
948 SG (General Vasovasostomy–Vasovasostomy SG058A S 12,000 0 N N Clinical notes Detailed discharge 2

Surgery) detailing need summary, Detailed
of surgery after Operative notes.
vasectomy? Since this is
Evidence of microsurgery
When and evaluate time taken
where was (2 hours+)
vasectomy
done? Is the
EHCP equipped
for
microsurgery?
949 SG (General Orchidectomy–Orchidectomy SG059A S 11,200 0 N N Clinical notes Histopath, Intra 2
Surgery) and describing operative clinical
Swelling in photograph,
scrotum, USG Detailed Operative
of scrotum, notes, Detailed
FNAC, tumour discharge summary
markers (if
cancer of
prostate/testis,e
tc is the
indication);
justification of
orchidectmy
950 SG (General Inguinal Node (dissection) - SG060A S 16,000 0 N N Clinical notes Histopath, Intra 3
Surgery) U/L–Inguinal Node (dissection) - U/L and USG/ procedure clinical
Biopsy report photograph detailed
confirming the discharge summary,
which the notes
surgery is done
951 SG (General Estlander Operation (lip)–Estlander SG061A S 9,300 0 N N Clinical notes Post procedure 4
Surgery) Operation (lip) detailing the clinical photograph,
original Detailed Operative
pathology thet notes, Detailed
has led to this discharge summary
surgery with
suporting
investigation
reports.
FIR/MLC in
case of
traumatic
aetiology,
Clinical
Photograph
952 SG (General Operation for Carcinoma Lip–Wedge SG062A S 19,000 0 N N Clinical notes Histopath, Post 6
Surgery) Excision and Biopsy procedure clinical
report, Clinical photograph,
Photograph Detailed Operative
notes, Detailed
discharge summary
953 SG (General Operation for Carcinoma Lip–Wedge SG062B S 23,800 0 N N Clinical notes Histopath, Post 6
Surgery) Excision and Vermilionectomy and Biopsy procedure clinical
notes, Detailed
discharge summary
954 SG (General Operation for Carcinoma Lip–Cheek SG062C S 26,800 0 N N Clinical notes Histopath, Post 6
Surgery) advancement and Biopsy procedure clinical
notes, Detailed
discharge summary
955 SG (General Complete Excision of Growth from SG063A S 9,400 0 N N Clinical notes Histopath, Post Daycare
Surgery) Tongue only (inclusive of confirming the procedure clinical
Histopathology)–Complete Excision of diagnosis, photograph,
Growth from Tongue only Clinical Detailed Operative
(inclusive of Histopathology) Photograph; notes; detailed
FNAC if done discharge summary
956 SG (General Excision of Growth from Tongue with SG064A S 23,500 0 N N Clinical notes Histopath, Post 3
Surgery) neck node dissection–Excision of and procedure clinical
Growth from Tongue with neck node USG/CT/MRI photograph,
dissection report Detailed Operative
Clinical
Photograph
957 SG (General Microlaryngoscopic SG065A S 18,500 7 N N Clinical notes Post procedure 3
Surgery) Surgery–Microlaryngoscopic Surgery and Nasal Nasal Endoscopy
Endoscopy and post procedure
confirming the clinical photograph
diagnosis for OR Intra procedure
which this clinical photograph,
surgery is done detailed discharge
summary, Detailed
Operative notes
958 SG (General Submandibular Mass SG066A S 15,000 7 N N Clinical notes Histopath, Post 5
Surgery) Excision–Submandibular Mass and USG/CT procedure clinical
Excision Scan photograph,
confirming the Detailed Operative
diagnosis for notes, detailed
which the discharge summary
surgery is done
+/-
Biopsy/FNAC,
Clinical
Photograph
959 SG (General Radical Neck Dissection–Radical SG067A S 15,000 3 N N Clinical notes Histopath, Intra 6
Surgery) Neck Dissection and CT procedure clinical
Scan/MRI Neck photograph OR
confirming the Post procedure
diagnosis, clinical photograph,
Biopsy, Clinical detailed discharge
Photograph summary, Detailed
Operative notes
960 SG (General Surgical removal of Branchial SG068A S 15,000 3 N N Clinical notes Histopathology 2
Surgery) Cyst–Surgical removal of Branchial with USG or CT report, post
Cyst Scan procedure clinical
confirming photograph,
diagnosis; Pre- Detailed Operative
op Clinical notes & detailed
Photograph discharge summary.
961 SG (General Carotid Body tumour - SG069A S 20,000 0 N N Clinical notes Intra procedure 7
Surgery) Excision–Carotid Body tumour - and USG Neck/ clinical photograph,
Excision Colour doppler Detailed Operative
confirming the notes,
diagnosis Histopathology,
Detailed discharge
summary
962 SG (General Thyroidectomy–Hemi thyroidectomy SG070A S 17,000 3 N N Clinical notes Histopath report, 2
Surgery) and Thyroid Post procedure
Function Test, clinical photograph,
FNAC/USG Detailed Operative
diagnosis and discharge summary
justifying the
surgery.
963 SG (General Thyroidectomy–Total thyroidectomy SG070B S 20,000 0 N N Clinical notes Histopath report, 4
Surgery) and Thyroid Post procedure
Function Test, clinical photograph,
FNAC/USG Detailed Operative
diagnosis and discharge summary
justifying the
surgery.
964 SG (General Thyroidectomy–Total Thyroidectomy SG070C S 28,000 0 N N Clinical notes Histopath report, 5
Surgery) with Block Dissection and FNAC/ Post procedure
Biopsy/ Thyroid clinical photograph,
Function Scar Photo,
Test/USG Detailed discharge
diagnosis and Operative notes
need for
surgery
965 SG (General Excision of Parathyroid Adenoma / SG071A S 20,400 0 N N Clinical notes Histopathology, 4
Surgery) Carcinoma–Excision of Parathyroid and USG/CT Intra procedure
Adenoma Scan/Nuclear clinical photograph,
Imaging Detailed discharge
confirming the summary,, Detailed
diagnosis. Operative notes
966 SG (General Excision of Parathyroid Adenoma / SG071B S 20,400 0 N N Clinical notes Histopathology, 4
Surgery) Carcinoma–Excision of Parathyroid and USG/CT Intra procedure
Carcinoma Scan/Nuclear clinical photograph,
Imaging Detailed discharge
confirming the summary,, Detailed
diagnosis. Operative notes
967 SG (General Thymectomy–Thymectomy SG072A S 28,000 0 N N Clinical notes Histopath, Post 6
Investigation photograph,
need for discharge summary
surgery
(CT/MRI),
Single-fiber
electromyograp
hy in case of
myasthenia
gravis, Clinical
photograph
968 SG (General Sympathectomy–Sympathectomy SG073A S 15,000 0 N N Clinical notes Intra procedure 5
Surgery) and supporting clinical photograph,
Evidence of detailed discharge
need of surgery summary, Detailed
(EMG,Nerve Operative notes
conduction
study, CT/MRI)
Clinical
Photograph
969 SG (General Breast Lump Excision SG074A S 6,000 2 N N Clinical notes, Histopathology 1
Surgery) (Benign)–Breast Lump Excision Sono report, intra
(Benign) mammogram operative clinical
OR photograph,
Mamography Detailed Operative
showing breast notes & detailed
lump +/- FNAC discharge summary.
report
970 SG (General Mastectomy–Simple Mastectomy SG075A S 20,000 2 N N Clinical notes Histopath, Post 3
Mammography, photograph,
Biopsy Detailed Operative
Clinical
Photograph
971 SG (General Mastectomy–Radical / Modified SG075B S 25,000 2 N N Clinical notes Histopath, detailed 4
Surgery) Radical Mastectomy and discharge summary,
Mammography Detailed Operative
and Biopsy notes
justifying
surgery
972 SG (General Excision Mammary Fistula–Excision SG076A S 14,500 2 N N Clinical notes Histopath, Detailed Daycare
Surgery) Mammary Fistula and Operative notes,
sonomammogr Detailed discharge
am report summary
confirming the
diagnosis,
973 SG (General Intercostal drainage Only–Intercostal SG077A S 4,800 2 N N Clinical notes Analysis report of Daycare
Surgery) drainage Only and detailing drained fluid; post
need of ICD; procedure clinical
Clinical photograph,
photograph, Detailed Operative
Chest X-Ray notes; Detailed
PA discharge summary
974 SG (General Rib Resection & Drainage–Rib SG078A S 14,000 0 N N Clinical notes Pus C/S, Post 3
Surgery) Resection & Drainage and X Ray, CT/ procedure X Ray,
MRI confirming Post procedure
the diagnosis clinical photograph,
for which the Detailed Operative
surgery is done, notes, detailed
Clinical discharge summary
photograph
975 SG (General Thoracoplasty–Thoracoplasty SG079A S 20,000 0 N N Clinical notes Post procedure 6

Surgery) and X Ray, clinical photograph,
CT/MRI Chest Detailed Operative
confirming the notes, Intra
indication for procedure clinical
this surgery, photograph,
Photograph summary
976 SG (General Decortication SG080A S 28,000 0 N N Clinical notes Histopathology, 3
Surgery) (Pleurectomy)–Decortication and USG/CT Detailed discharge
(Pleurectomy) Scan summary and
diagnosis for notes
which the
surgery is done,
Biopsy
977 SG (General Lobectomy–Thoracoscopic SG081A S 27,500 0 N N Clinical notes Intra procedure 5
Surgery) and CT Thorax clinical photograph,
diagnosis, notes, histopath,
Biopsy +/- Detailed discharge
Cytology summary, Scar
Photo
978 SG (General Lobectomy–Open SG081B S 27,500 7 N N Clinical notes Intra procedure 5

Surgery) and CT Thorax clinical photograph,
diagnosis, notes, histopath,
Biopsy +/- Detailed discharge
Cytology summary, Scar
Photo
979 SG (General Thoracoscopic Segmental SG082A S 25,000 7 N N Clinical notes Intra procedure 5
Surgery) Resection–Thoracoscopic Segmental and CT Thorax clinical photograph,
Resection confirming the Detailed Operative
diagnosis, +/- notes, histopath,
Biopsy report Detailed discharge
summary, Scar
Photo
980 SG (General Lung Hydatid Cyst removal–Lung SG083A S 20,000 7 N N Clinical notes Post procedure 3
Surgery) Hydatid Cyst removal and X Ray, clinical photograph,
CT/MRI Chest Detailed Operative
confirming the notes, Intra
diagnosis, procedure clinical
Clinical photograph,
Photograph Detailed discharge
summary,
Histopathology
981 SG (General Incision & Drainage of SG084A S 5,000 7 N N Clinical notes C/S report of Daycare
Surgery) Abscess–Incision & Drainage of and USG report Wound or Pus, Intra
Abscess confirming large operative clinical
abscess. photograph,
Detailed Operative
notes & detailed
discharge summary.
982 SG (General Lipoma / Cyst / other cutaneous SG085A S 5,000 7 N N Clinical notes Histopath, Post Daycare
Surgery) swellings Excision–Lipoma Excision and clinical procedure clinical
photograph to photograph,
confirm Detailed Operative
diagnosis. notes, detailed
discharge summary
983 SG (General Lipoma / Cyst / other cutaneous SG085B S 5,000 7 N N Clinical notes Histopath, Post Daycare
Surgery) swellings Excision–Cyst Excision and clinical procedure clinical
photograph to photograph,
discharge summary
984 SG (General Lipoma / Cyst / other cutaneous SG085C S 5,000 7 N N Clinical notes Histopath, Post Daycare
Surgery) swellings Excision–Other cutaneous and clinical procedure clinical
swellings Excision photograph to photograph,
discharge summary
985 SG (General Debridement of Ulcer–Debridement of SG086A S 5,000 7 N N Clinical notes Post procedure Daycare
Surgery) Ulcer and Clinical clinical photograph,
photograph of Detailed Operative
affected part, notes, Detailed
Evidence of discharge summary
confirmed
diagnosis of
Leprosy
986 SG (General Flap Reconstructive Surgery–Flap SG087A S 20,000 7 N N Clinical notes Post procedure 4
Surgery) Reconstructive Surgery detailing the clinical photograph,
pathology thet notes, Detailed
has led to this discharge summary
surgery with
suporting
investigation
reports. Clinical
Photograph
987 SG (General Free Grafts - Wolfe Grafts–Free SG088A S 14,000 7 N N Clinical notes Post procedure Daycare
Surgery) Grafts - Wolfe Grafts detailing clinical photograph,
pathology, with notes, Detailed
suporting discharge summary
reports, Clinical
Photograph
988 SG (General Tissue Reconstruction Flap–Tissue SG089A S 25,000 7 N N Clinical notes Intra procedure 5
Surgery) Reconstruction Flap and Clinical clinical photograph,
photograph of Post procedure
affected part clinical photograph
justifying (if flap taken from
surgery. other site; even of
Evidence of donor site), Detailed
confirmed Operative notes,
diagnosis of Detailed discharge
Leprosy summary
989 SG (General Split thickness skin grafts–Small (< SG090A S 13,500 7 N N Clinical notes Post procedure Daycare
Surgery) 4% TBSA) detailing time of clinical photograph,
Burns,, Clinical Detailed Operative
Photograph notes, Detailed
discharge summary
990 SG (General Split thickness skin grafts–Medium (4 - SG090B S 13,500 7 N N Clinical notes Post procedure Daycare
discharge summary
991 SG (General Split thickness skin grafts–Large (> SG090C S 13,500 7 N N Clinical notes Post procedure Daycare
discharge summary
992 SG (General Skin Flaps - Rotation Flaps–Skin SG091A S 11,400 10 N N Clinical notes Post procedure Daycare
Surgery) Flaps - Rotation Flaps and Clinical clinical photograph,
Photograph, Detailed Operative
medical records notes, detailed
of previous discharge summary
surgeries and
indication of this
surgery
993 SG (General Tendon Transfer–Tendon Transfer SG092A S 15,000 10 N N Clinical notes Intra procedure 3
Surgery) and Clinical clinical photograph,
photograph of Post procedure
affected part, clinical photograph,
Evidence of Detailed Operative
confirmed notes, Detailed
diagnosis of discharge summary
Leprosy
994 SG (General Lymphatics Excision of Subcutaneous SG093A S 10,000 10 N N Clinical notes Histopathology 3
Surgery) Tissues In Lymphoedema– and detailing report, post
Lymphatics Excision of history, Clinical procedure clinical
Subcutaneous Tissues In Photograph photograph,
Lymphoedema Detailed Operative
notes, Detailed
discharge summary.
995 SG (General AV Fistula without prosthesis–AV SG094A S 6,000 10 N N Clinical notes Post Procedure Daycare
Surgery) Fistula without prosthesis detailing need clinical photograph,
for AV shunt Detailed Operative
with supporting notes, Detailed
Evidence of discharge summary
Creatinine/ RFT
996 SG (General Management of Varicose SG095A S 14,000 10 N N Clinical notes Detailed discharge 3
Surgery) Veins–Management of Varicose Veins and Duplex summary, Post
ultrasonography procedure clinical
/ Colour photograph,
Doppler Detailed Operative
confirming the notes
diagnosis, pre-
op clinical
photograph
997 SG (General Biopsy–Lymph Node SG096A S 5,000 10 N N Clinical notes Histopathology Daycare
Surgery) and Clinical report, post
Photograph of procedure clinical
Enlarged lymph photograph,
nodes +/- Detailed Operative
FNAC report notes
998 SG (General Biopsy–Endometrial Aspiration SG096B S 2,000 10 N N Clinical notes Pic of specimen, Daycare
Surgery) with supporting Histopathology
investigations report, discharge
summary
999 SG (General Biopsy–Cervix Cancer screening SG096C S 1,000 10 N N Clinical notes Pic of specimen, Daycare
Surgery) (PAP + Colposcopy) with supporting Histopathology
summary
1000 SG (General Biopsy–Cervical (Neck) SG096D S 1,500 10 N N Clinical notes Pic of specimen, Daycare
summary
1001 SG (General Biopsy–Vulval SG096E S 1,500 10 N N Clinical notes Pic of specimen, Daycare
summary
1002 SG (General Stoma Management–Stoma SG097A S 4,500 10 Y N Earlier Invoice / Receipt of NA
Surgery) Management follow up of Ileostomy discharge drugs and
summary, consumables
Clinical Notes
1003 SG (General Stoma Management–Stoma SG097B S 4,500 10 Y N Earlier Invoice / Receipt of NA
Surgery) Management follow up of Colostomy discharge drugs and
summary, consumables
Clinical Notes
1004 SG (General Foreign Body Removal–Foreign Body SG098A S 5,000 10 N N Clinical notes Post procedure Daycare
Surgery) Removal and X-ray/ USG clinical photograph,
report of the Detailed Operative
affected part notes, detailed
diagnosis, Still and relevant
Photograph of imaging study for
the imaging comparison
1005 SL Pinna surgery for tumour / SL001A S 8,600 10 Y N History, Pre-op Histopath report, Daycare
(Otorhinolaryngology trauma–Pinna surgery for tumour Clinical Post procedure
) photograph and clinical photograph
Biopsy of affected part,
Operative Notes,
detailed discharge
summary
1006 SL Pinna surgery for tumour / SL001B S 8,600 10 N N History, Pre-op Post procedure Daycare
(Otorhinolaryngology trauma–Pinna surgery for trauma Clinical clinical photograph
) photograph of affected part,
Operative Notes,
detailed discharge
summary
1007 SL Tympanoplasty–Tympanoplasty SL002A S 19,900 10 Y N Clinical notes Intra procedure 2
(Otorhinolaryngology and Audiogram/ clinical photograph,
) Tympanometry Post procedure
(or impedence clinical photograph
audiometry) as of affected part,
justification of detailed Procedure /
surgery Operative Notes.
Detailed discharge
summary Invoice of
graft used
1008 SL Stapedectomy / SL003A S 18,000 10 Y N Clinical notes Intra procedure 2

(Otorhinolaryngology tympanotomy–Stapedectomy and audiometry microscope clinical
) confirming photograph;
conductive detailed Procedure /
deafness Operative Notes,
detailed discharge
summary
1009 SL Stapedectomy / SL003B S 18,000 10 Y N Clinical notes Intra procedure 2
(Otorhinolaryngology tympanotomy–Tympanotomy and audiometry microscope clinical
) confirming photograph;
conductive detailed Procedure /
deafness Operative Notes,
detailed discharge
summary
1010 SL Mastoidectomy–Simple SL004A S 28,000 10 Y N Clinical notes Scar photo, Post 2
(Otorhinolaryngology confirming the procedure clinical
) indication for photograph,
the procedure Detailed Procedure
with imaging (X- / Operative Notes,
ray/ CT) Detailed discharge
Evidence, summary, Histopath
Audiometry
1011 SL Mastoidectomy–Radical SL004B S 28,000 10 Y N Clinical notes Scar photo, Post 2
(Otorhinolaryngology confirming the procedure clinical
) indication for photograph,
the procedure Detailed Procedure
with imaging (X- / Operative Notes,
ray/ CT) Detailed discharge
Evidence, summary, Histopath
Audiometry
1012 SL Myringotomy with or without SL005A S 5,000 10 Y N Clinical notes Photograph of Daycare
(Otorhinolaryngology Grommet–Unilateral and Audiogram patient while
) justifying undergoing the
surgery. procedure, detailed
Procedure /
Operative Notes,
detailed discharge
summary
1013 SL Myringotomy with or without SL005B S 5,000 10 Y N Clinical notes Photograph of Daycare
(Otorhinolaryngology Grommet–Bilateral and Audiogram patient while
) justifying undergoing the
surgery. procedure, detailed
Procedure /
Operative Notes,
detailed discharge
summary
1014 SL Endoscopic DCR–Endoscopic DCR SL006A S 19,300 10 Y N Clinical notes Endoscopic still Daycare
(Otorhinolaryngology and endoscopy images, Detailed
) findings, discharge summary,
Clinical Post procedure
photograph clinical photograph
of affected part,
Operative Notes.
1015 SL Epistaxis treatment - packing SL007A S 1,800 10 Y N Clinical notes Clinical photograph, NA
(Otorhinolaryngology –Epistaxis treatment - packing with planned Detailed Discharge
) line of Summary
treatment
1016 SL Functional septo SL008A S 21,800 10 Y N Clinical notes Post procedure 2
(Otorhinolaryngology rhinoplasty–Functional septo Indication for clinical photograph
) rhinoplasty this surgery of affected part;
with supporting Detailed Procedure
medical / Operative Notes;
records, X-ray, Detailed discharge
MLC/FIR for summary
traumatic
injuries and
circumstances
of the incident
which led to
disfigurement,
Clinical picture
1017 SL Septoplasty–Septoplasty SL009A S 12,000 10 Y N Indication for Post procedure 1
(Otorhinolaryngology this surgery clinical photograph
) with supporting of affected part,
medical Detailed Procedure
records, / Operative Notes.
MLC/FIR for Detailed discharge
traumatic summary
injuries,
Endoscopic
picture/ Clinical
picture
1018 SL Fracture - setting nasal SL010A S 8,000 10 N N MLC/FIR for Post procedure X- 2
(Otorhinolaryngology bone–Fracture - setting nasal bone traumatic ray, Post procedure
) injuries and clinical photograph
circumstances of affected part,
of the incident detailed Procedure /
which led to Operative Notes.
fracture, X Detailed discharge
Ray/CT summary
1019 SL Inferior turbinate reduction under SL011A S 5,700 10 Y N Clinical notes Intraoperative Stills, Daycare
(Otorhinolaryngology GA–Inferior turbinate reduction under and Post procedure
) GA EXAMINATION clinical photograph
FINDINGS, of affected part,
nasoendoscopy Detailed discharge
findings summary Detailed
Procedure /
Operative Notes
1020 SL Open sinus surgery–Open sinus SL012A S 15,000 10 Y N Clinical notes Post procedure 2
(Otorhinolaryngology surgery detailing Imaging, Post
) chronicity of procedure clinical
sinusitis . photograph of
indications for affected part.
surgery with Histopathology,,
supporting detailed Procedure /
CTpre- Operative Notes.
procedure Intra procedure
photograph clinical photograph
1021 SL Functional Endoscopic Sinus SL013A S 11,000 5 Y N Clinical notes Stills of procedure 2
(Otorhinolaryngology (FESS)–Functional Endoscopic Sinus and CT being done, post
) (FESS) confirming the procedure clinical
diagnosis photograph ,
Detailed Procedure
/ Operative Notes,
detailed discharge
summary
1022 SL Ant. Ethmoidal / sphenopalatine artery SL014A S 15,000 0 N N Indications of Intraoperative 2
(Otorhinolaryngology ligation–Ant. Ethmoidal artery ligation - this surgery photograph, X-ray
) Open with clinical of clips used, post
evidence (CT) procedure clinical
photograph of
affected part.
Detailed Procedure
/ Operative Notes
and discharge
summary.
1023 SL Ant. Ethmoidal / sphenopalatine artery SL014B S 15,000 0 N N Indications of Intraoperative 2
(Otorhinolaryngology ligation–Ant. Ethmoidal artery ligation - this surgery photograph, X-ray
) Endoscopic with clinical of clips used, post
photograph of
affected part.
Detailed Procedure
/ Operative Notes
and discharge
summary.
1024 SL Ant. Ethmoidal / sphenopalatine artery SL014C S 15,000 0 N N Indications of Intraoperative 2
(Otorhinolaryngology ligation–Sphenopalatine artery ligation this surgery photograph, X-ray
) - Open with clinical of clips used, post
photograph of
affected part.
Detailed Procedure
/ Operative Notes
and discharge
summary.
1025 SL Ant. Ethmoidal / sphenopalatine artery SL014D S 15,000 0 N N Indications of Intraoperative 2
(Otorhinolaryngology ligation–Sphenopalatine artery ligation this surgery photograph, X-ray
) - Endoscopic with clinical of clips used, post
photograph of
affected part.
Detailed Procedure
/ Operative Notes
and discharge
summary.
1026 SL Adenoidectomy–Adenoidectomy SL015A S 5,000 0 Y N Clinical notes Histopathology 1
(Otorhinolaryngology with supporting report, post
) investigation procedure clinical
reports,X Ray photograph of
Adenoids, affected part,
Clinical detailed Procedure /
Photograph Operative Notes.
Detailed discharge
summary
1027 SL Tonsillectomy–Tonsillectomy - U/L SL016A S 7,500 0 Y N Indication for Histopathology 2
(Otorhinolaryngology surgery from report, post
) treating doctor procedure clinical
with supporting photograph of
case history, affected part,
physical detailed Procedure /
examination Operative Notes
findings,
supporting
investigation
reports, Clinical
Photograph
1028 SL Tonsillectomy–Tonsillectomy - B/L SL016B S 7,500 0 Y N Indication for Histopathology 2

(Otorhinolaryngology surgery from report, post
) treating doctor procedure clinical
with supporting photograph of
case history, affected part,
physical detailed Procedure /
examination Operative Notes
findings,
supporting
investigation
reports, Clinical
Photograph
1029 SL Peritonsillar abscess drainage / SL017A S 5,800 0 N N Doctor's notes C/S of pus, post Daycare
(Otorhinolaryngology intraoral calculus removal– with presenting procedure clinical
) Peritonsillar abscess drainage complaints, photograph of
duration and affected part,
physicial detailed Procedure /
examination Operative Notes;
findings of oral detailed discharge
cavity and summary
tonsils, clinical
photograph if
possible
1030 SL Peritonsillar abscess drainage / SL017B S 5,800 0 N N Doctor's notes C/S of pus, post Daycare
(Otorhinolaryngology intraoral calculus removal–Intraoral with presenting procedure clinical
) calculus removal complaints, photograph of
duration and affected part,
physicial detailed Procedure /
examination Operative Notes;
findings of oral detailed discharge
cavity and summary
tonsils, clinical
photograph if
possible
1031 SL Thyroglossal / Branchial cyst / sinus / SL018A S 15,300 7 Y N Clinical notes Histopathology 2
(Otorhinolaryngology fistula excision–Thyroglossal cyst and pre- report, post
) excision operative procedure clinical
clincial photograph of
photograph affected part,
Operative Notes.
Detailed discharge
summary
1032 SL Thyroglossal / Branchial cyst / sinus / SL018B S 15,300 0 Y N Clinical notes Histopathology 2
(Otorhinolaryngology fistula excision–Thyroglossal sinus and pre- report, post
Operative Notes.
Detailed discharge
summary
1033 SL Thyroglossal / Branchial cyst / sinus / SL018C S 15,300 10 Y N Clinical notes Histopathology 2
(Otorhinolaryngology fistula excision–Thyroglossal fistula and pre- report, post
Operative Notes.
Detailed discharge
summary
1034 SL Thyroglossal / Branchial cyst / sinus / SL018D S 15,300 10 Y N Clinical notes Histopathology 2
(Otorhinolaryngology fistula excision–Branchial sinus and pre- report, post
Operative Notes.
Detailed discharge
summary
1035 SL Thyroglossal / Branchial cyst / sinus / SL018E S 15,300 10 Y N Clinical notes Histopathology 2
(Otorhinolaryngology fistula excision–Branchial fistula and pre- report, post
Operative Notes.
Detailed discharge
summary
1036 SL Uvulopalatopharyngoplasty SL019A S 18,600 10 Y N Clinical notes Post procedure 2
(Otorhinolaryngology (UPPP)–Uvulopalatopharyngoplasty and clinical photograph
) (UPPP) Polysomnograp of affected part,
hy (Sleep detailed Procedure /
Study) + Operative Notes;
CT/MRI detailed discharge
summary
1037 SL Excision of tumour of oral cavity / SL020A S 30,000 10 Y N CT Scan, Procedure / 5
(Otorhinolaryngology paranasal sinus / laryngopharynx with Biopsy, Clinical Operative
) or without reconstruction–Excision of notes with Notes,Post
tumour of oral cavity / paranasal sinus planned line of Procedure
/ laryngopharynx without treatment, Pre Photograph of
reconstruction operative affected part,
Clinical Histopathology
Photograph of report
affected part
1038 SL Excision of tumour of oral cavity / SL020B S 36,500 2 Y N CT Scan, Procedure / 6
) or without reconstruction–Excision of Photograph of Notes,Post
tumour of oral cavity / paranasal sinus affected part Procedure
/ laryngopharynx with pedicled flap Photograph of
reconstruction affected part,
Histopathology
report
1039 SL Excision of tumour of oral cavity / SL020C S 45,000 7 Y N CT Scan, Procedure / 7
) or without reconstruction–Excision of Photograph of Notes,Post
tumour of oral cavity / paranasal sinus affected part Procedure
/ laryngopharynx with free flap Photograph of
reconstruction affected part,
Histopathology
report
1040 SL Parotidectomy–Total Parotidectomy SL021A S 28,200 7 Y N CT Scan and Histopathology 3
(Otorhinolaryngology FNAC, Clinical report, post
) Photograph of procedure clinical
affected part photograph of
affected part,
Operative Notes and
detailed discharge
summary.
1041 SL Parotidectomy–Superficial SL021B S 23,800 0 Y N CT Scan, Histopathology 3

(Otorhinolaryngology Parotidectomy FNAC, Clinical report, post
) Photograph of procedure clinical
affected part photograph of
affected part,
Operative Notes and
detailed discharge
summary.
1042 SL Removal of Submandibular Salivary SL022A S 9,000 10 Y N Clinical notes to Histopathology 2
(Otorhinolaryngology gland–Removal of Submandibular establigh report, post
) Salivary gland indication; procedure clinical
Biopsy if photograph of
tumour, Clinical affected part,
Photograph of detailed Procedure /
affected part Operative Notes;
detailed discharge
summary
1043 SL Removal of Submandibular Salivary SL022B S 9,000 7 Y N Clinical notes Histopathology 2
(Otorhinolaryngology gland–Removal of Ranula and Clinical report, post
) photograph, procedure clinical
MLC/FIR for photograph of
traumatic affected part,
injuries and detailed Procedure /
circumstances Operative Notes;
of the incident detailed discharge
which led to summary
rupture of
salivary duct
1044 SL Removal of Submandibular Salivary SL022C S 9,000 0 Y N Clinical notes to Histopathology 2
(Otorhinolaryngology gland–Removal of Submandibular establigh report, post
) Lymph node indication; procedure clinical
Biopsy if photograph of
tumour, Clinical affected part,
Photograph of detailed operative
affected part notes; detailed
discharge summary
1045 SL Rigid laryngoscopy / bronchoscopy / SL023A S 7,000 7 Y N Clinical notes Procedure / Daycare
(Otorhinolaryngology oesophagoscopy - Diagnostic + / - with planned Operative
) biopsy–Rigid laryngoscopy - line of Notes,Post
Diagnostic + / - biopsy treatment Procedure
Photograph of
affected part,
Histopathology
report
1046 SL Rigid laryngoscopy / bronchoscopy / SL023B S 7,000 7 Y N Clinical notes Procedure / Daycare
) biopsy–Rigid bronchoscopy - line of Notes,Post
Photograph of
affected part,
Histopathology
report
1047 SL Rigid laryngoscopy / bronchoscopy / SL023C S 7,000 7 Y N Clinical notes Procedure / Daycare
) biopsy–Rigid oesophagoscopy - line of Notes,Post
Photograph of
affected part,
Histopathology
report
1048 SL Microlaryngeal surgery with or without SL024A S 17,000 7 Y N Indication for Procedure / 2
(Otorhinolaryngology laser–Microlaryngeal surgery with or surgery with Operative
) without laser supporting Notes,Post
investigation Procedure
reports, Photograph of
laryngoscopy affected part,
findings +/- Histopathology
Laryngeal report
electromyograp
hy
1049 SL Open laryngeal framework surgery / SL025A S 20,000 3 Y N Clinical notes to Histopathology 1
(Otorhinolaryngology Thyroplasty–Open laryngeal establish report in case of
) framework surgery / Thyroplasty indication and tumours, post
justification of procedure clinical
surgery; photograph of
Evidence affected part,
through CT/ detailed Procedure /
MRI/ Biopsy, Operative Notes;
Photograph summary
1050 SL Tracheostomy / SL026A S 6,000 10 Y N Clinical notes Procedure / NA
(Otorhinolaryngology Tracheotomy–Tracheostomy with planned Operative
) line of Notes,Post
treatment Procedure
justifying Photograph of
indication affected part,
Histopathology
report
1051 SL Tracheostomy / SL026B S 6,000 10 Y N Clinical notes Procedure / NA
(Otorhinolaryngology Tracheotomy–Tracheotomy with planned Operative
treatment Procedure
justifying Photograph of
indication affected part,
Histopathology
report
1052 SL Neck dissection–Selective Benign SL027A S 18,800 10 Y N Indication for Histopathology 3
(Otorhinolaryngology neck tumour excision surgery with report, Post
) supporting procedure Imaging,
investigation post procedure
reports (X-ray/ clinical photograph
CT/MRI), FNAC of affected part,
/ Biospy in case detailed Procedure /
of tumours, Operative Notes;
Clinical detailed discharge
Photograph summary
1053 SL Neck dissection–Comprehensive SL027B S 18,800 0 Y N Indication for Histopathology 3

(Otorhinolaryngology Benign neck tumour excision surgery with report, Post
Photograph summary
1054 SL Neck dissection–Selective Pharyngeal SL027C S 18,800 0 Y N Indication for Histopathology 3
(Otorhinolaryngology diverticulum excision surgery with report, Post
Photograph summary
1055 SL Neck dissection–Comprehensive SL027D S 18,800 0 Y N Indication for Histopathology 3

(Otorhinolaryngology Pharyngeal diverticulum excision surgery with report, Post
Photograph summary
1056 SL Deep neck abscess drainage/ Post SL028A S 16,800 7 N N Clinical notes C/S of pus, post 2
(Otorhinolaryngology trauma neck exploration–Deep neck and clinical procedure clinical
) abscess drainage photgraph/ photograph of
investigation affected part,
diagnosis, CT Operative Notes;
detailed discharge
summary
1057 SL Deep neck abscess drainage/ Post SL028B S 16,800 7 N N Clinical notes C/S of pus, post 2
(Otorhinolaryngology trauma neck exploration–Post trauma and clinical procedure clinical
) neck exploration photgraph/ photograph of
investigation affected part,
diagnosis, CT Operative Notes;
detailed discharge
summary
1058 SL Anterior skull base SL029A S 35,000 7 Y N Clinical notes Procedure / 6
(Otorhinolaryngology surgery–Endoscopic CSF Rhinorrhea with planned Operative
) Repair line of Notes,Post
treatment Procedure
detailing Photograph of
aetiology; MLC/ affected part
FIR if traumatic.
CT to confirm
need of surgery
1059 SL Anterior skull base surgery–Optic SL029B S 34,500 7 Y N Clinical notes Procedure / 6
(Otorhinolaryngology nerve decompression with planned Operative
treatment Procedure
FIR if traumatic.
CT to confirm
need of surgery
1060 SL Anterior skull base surgery–Orbital SL029C S 34,500 5 Y N Clinical notes Procedure / 6
(Otorhinolaryngology decompression with planned Operative
treatment Procedure
FIR if traumatic.
CT to confirm
need of surgery
1061 SL Anterior skull base SL029D S 34,500 7 Y N Clinical notes Procedure / 6
(Otorhinolaryngology surgery–Craniofacial resection with planned Operative
treatment Procedure
aetiology; MLC/ affected part,
FIR if traumatic. Histopathology
CT to confirm report
need of surgery
1062 SL Anterior skull base surgery–Maxillary SL029E S 34,500 7 Y N Clinical notes Procedure / 6
(Otorhinolaryngology swing with planned Operative
treatment Procedure
FIR if traumatic.
CT to confirm
need of surgery
1063 SL Advanced anterior skull base SL030A S 48,800 7 Y N Clinical notes Procedure / 7
(Otorhinolaryngology surgery–Endoscopic Hypophysectomy with planned Operative
treatment and Procedure
Coronal Photograph of
CT/MRI affected part,
establishing Histopathology
diagnosis and report
establishing
need of surgery
1064 SL Advanced anterior skull base SL030B S 48,800 7 Y N Clinical notes Procedure / 7
(Otorhinolaryngology surgery–Clival tumour excision with planned Operative
Coronal Photograph of
CT/MRI affected part,
establishing Histopathology
diagnosis and report
establishing
need of surgery
1065 SL Lateral skull base SL031A S 33,700 7 Y N Clinical notes Procedure / 6

(Otorhinolaryngology procedures–Subtotal petrosectomy with planned Operative
CT/MRI/ biopsy Photograph of
to establish the affected part,
indication and Histopathology
justify the report
surgery.
1066 SL Lateral skull base procedures–Post- SL031B S 33,700 7 Y N Clinical notes Procedure / 6
(Otorhinolaryngology traumatic facial nerve decompression with planned Operative
justify the report
surgery.
1067 SL Lateral skull base procedures–CSF SL031C S 33,700 7 Y N Clinical notes Procedure / 6
(Otorhinolaryngology Otorrhoea repair with planned Operative
justify the report
surgery.
1068 SL Advanced lateral skull base SL032A S 48,900 7 Y N Clinical notes Procedure / 7
(Otorhinolaryngology surgery–Fisch approach with planned Operative
Audiogram Photograph of
report justfying affected part,
surgery +/- CT- Histopathology
TEMPORAL report
BONE of
affected side /X-
RAY BOTH
MASTOIDS
1069 SL Advanced lateral skull base SL032B S 48,900 7 Y N Clinical notes Procedure / 7
(Otorhinolaryngology surgery–Translabyrinthine approach with planned Operative
TEMPORAL report
BONE of
affected side /X-
RAY BOTH
MASTOIDS
1070 SL Advanced lateral skull base SL032C S 48,900 0 Y N Clinical notes Procedure / 7
(Otorhinolaryngology surgery–Transcochlear approach with planned Operative
TEMPORAL report
BONE of
affected side /X-
RAY BOTH
MASTOIDS
1071 SL Advanced lateral skull base SL032D S 48,900 0 Y N Clinical notes Procedure / 7
(Otorhinolaryngology surgery–Temporal Bone resection with planned Operative
TEMPORAL report
BONE of
affected side /X-
RAY BOTH
MASTOIDS
1072 SL Closed reduction / intermaxillary SL033A S 9,200 0 N N MLC/FIR for Procedure / Daycare
(Otorhinolaryngology fixation for fracture of maxilla / traumatic Operative
) mandible / zygoma–Closed reduction injuries and Notes,Post
for fracture of maxilla circumstances Procedure
of the incident Photograph of
which led to affected part,
fracture, X Histopathology
Ray/CT report
1073 SL Closed reduction / intermaxillary SL033B S 9,200 0 N N MLC/FIR for Procedure / Daycare
for fracture of mandible circumstances Procedure
Ray/CT report
1074 SL Closed reduction / intermaxillary SL033C S 9,200 0 N N MLC/FIR for Procedure / Daycare
for fracture of zygoma circumstances Procedure
Ray/CT report
1075 SL Closed reduction / intermaxillary SL033D S 9,200 0 N N MLC/FIR for Procedure / Daycare
and Intermaxillary fixation for fracture circumstances Procedure
of mandible of the incident Photograph of
Ray/CT report
1076 SL Open reduction and internal fixation of SL034A S 18,000 0 N N MLC/FIR for Procedure / Daycare
(Otorhinolaryngology maxilla / mandible / zygoma–Open traumatic Operative
) reduction and internal fixation of injuries and Notes,Post
maxilla circumstances Procedure
Ray/CT report
1077 SL Open reduction and internal fixation of SL034B S 18,000 0 N N MLC/FIR for Procedure / Daycare
mandible circumstances Procedure
Ray/CT report
1078 SL Open reduction and internal fixation of SL034C S 18,000 0 N N MLC/FIR for Procedure / Daycare
zygoma circumstances Procedure
Ray/CT report
1079 SL Clinic based therapeutic interventions SL035A S 1,200 0 Y N Clinical notes Procedure / NA
(Otorhinolaryngology of ENT–Turbinate reduction with planned Operative
EXAMINATION Photograph of
FINDINGS, affected part,
nasoendoscopy Histopathology
findings report
1080 SL Clinic based therapeutic interventions SL035B S 1,200 0 Y N Clinical notes Procedure / NA
(Otorhinolaryngology of ENT–Biopsy with planned Operative
findings report
1081 SL Clinic based therapeutic interventions SL035C S 1,200 0 Y N Clinical notes Procedure / NA
(Otorhinolaryngology of ENT–Intratympanic injections with planned Operative
findings report
1082 SL Clinic based therapeutic interventions SL035D S 1,200 0 Y N Clinical notes Procedure / NA
(Otorhinolaryngology of ENT–Wide bore aspiration with planned Operative
findings report
1083 SM (Oral and Extraction of impacted tooth under SM001A S 500 0 Y N Dental X-ray / Post procedure X- NA
Maxillofacial LA –Extraction of impacted tooth OPG ray, extracted tooth,
Surgery) under LA (Orthopantomo Detailed Procedure
gram) showing / Operative Notes,
impacted tooth
Clinical
Photograph
1084 SM (Oral and Sequestrectomy –Sequestrectomy SM002A S 1,500 0 N N OPG showing Post procedure 7
Maxillofacial necrosed tissue clinical photograph;
Surgery) detailed discharge
summary, Detailed
Procedure /
Operative Notes,
HPE
1085 SM (Oral and TM joint ankylosis of both jaws - SM003A S 15,000 0 Y N Clinical Post procedure 3
Maxillofacial under GA –TM joint ankylosis of both Photograph, X- clinical photograph
Surgery) jaws - under GA Ray of affected with mouth open, X
area, CT; Ray, detailed
discharge summary
Detailed Procedure
/ Operative Notes
1086 SM (Oral and Fixation of fracture of jaw–Closed SM004A S 5,000 0 Y N Circumstances Detailed Discharge Daycare
Maxillofacial reduction (1 jaw) using wires - under that led to Summary, detailed
Surgery) LA fracture, MLC Procedure /
copy with Operative Notes,
number, Post procedure X
Clinical ray mandible
Photograph, X showing wires used
Ray Mandible,
1087 SM (Oral and Fixation of fracture of jaw–Open SM004B S 12,000 0 Y N Circumstances Detailed Discharge 2
Maxillofacial reduction (1 jaw) and fixing of plates / that led to Summary, detailed
Surgery) wire – under GA fracture, MLC Procedure /
copy with Operative Notes,
number, Post procedure X
Clinical ray mandible
Photograph, X showing wires used
Ray Mandible,
1088 SM (Oral and Surgery for Cyst & tumour of Maxilla / SM005A S 2,500 0 Y N OPG/ CT Scan detailed discharge Daycare
Maxillofacial Mandible–Enucleation / excision / confirming the summary, Detailed
Surgery) marsupialization for cyst & tumour of diagnosis; Procedure /
Maxilla under LA Biopsy/FNAC if Operative Notes,
tumour, Clinical Histopath, Post
Photograph procedure clinical
photograph; HPE
1089 SM (Oral and Surgery for Cyst & tumour of Maxilla / SM005B S 2,500 0 Y N OPG/ CT Scan detailed discharge Daycare
Maxillofacial Mandible–Enucleation / excision / confirming the summary, Detailed
Surgery) marsupialization for cyst & tumour of diagnosis; Procedure /
Mandible under LA Biopsy/FNAC if Operative Notes,
photograph; HPE
1090 SM (Oral and Mandible Tumour Resection and SM006A S 6,000 0 Y N OPG/ CT Scan detailed discharge 2
Maxillofacial reconstruction / Cancer surgery– confirming the summary, Detailed
Surgery) Mandible Tumour Resection and diagnosis; Procedure /
reconstruction / Cancer surgery Biopsy/FNAC if Operative Notes,
photograph; HPE
1091 SM (Oral and Release of fibrous bands & grafting - SM007A S 3,000 0 Y N Clinical notes Detailed Procedure Daycare
Maxillofacial in (OSMF) treatment under and Oral Biopsy / Operative Notes
Surgery) GA –Release of fibrous bands & confirming the detailing grafting,
grafting - in (OSMF) treatment under diagnosis, detailed discharge
GA Clinical summary, Post
photograph
1092 SN (Neurosurgery) Depressed Fracture–Depressed SN001A S 40,000 0 N N Clinical notes Post procedure 7
Fracture and CT Imaging with film
confirming (CT), Post
diagnosis procedure Clinical
photgraph showing
scar, detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1093 SN (Neurosurgery) CranioPlasty–CranioPlasty with SN002A S 20,000 0 Y N CT/MRI Post procedure 7

Endogenous graft Imaging wih film
(CT/Xray), Post
procedure Clinical
photgraph , Detailed
Procedure /
Operative Notes.
1094 SN (Neurosurgery) CranioPlasty–CranioPlasty with SN002B S 20,000 0 Y N CT/MRI Post procedure 7
Exogenous graft Imaging wih film
(CT/Xray), Post
procedure Clinical
photgraph , Detailed
Procedure /
Operative Notes.
1095 SN (Neurosurgery) Twist Drill Craniostomy–Twist Drill SN003A S 15,000 0 N N Clinical notes Post procedure 2
Craniostomy and CT Imaging with film
(CT/MRI), Post
procedure Clinical
photgraph showing
scar, Detailed
Procedure /
Operative Notes.
Discharge summary
1096 SN (Neurosurgery) Craniostenosis–Craniostenosis SN004A S 28,000 0 N N Clinical notes Post procedure 7

and CT/ MRI Imaging with film
establishing (CT), Post
need of surgery procedure Clinical
photgraph showing
Post procedure
Clinical photgraph
showing scar;
detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1097 SN (Neurosurgery) Meningocele–Anterior SN005A S 36,000 0 N N Clinical notes Post procedure 10
and CT/MRI Imaging with film
photgraph showing
scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1098 SN (Neurosurgery) Meningocele–Lumbar SN005B S 36,000 0 N N Clinical notes Post procedure 10
photgraph showing
scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1099 SN (Neurosurgery) Meningocele–Occipital SN005C S 50,000 0 N N Clinical notes Post procedure 10

photgraph showing
scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1100 SN (Neurosurgery) Surgery for tumour SN006A S 50,000 0 Y N Clinical notes Histopathology, 7
meninges–Gocussa and CT Post procedure
supporting Imaging with film
surgery (CT), Post
procedure Clinical
photgraph showing
scar , Detailed
Procedure /
Operative Notes.
Detailed discharge
summary
1101 SN (Neurosurgery) Surgery for tumour SN006B S 50,000 0 Y N Clinical notes Histopathology, 7
meninges–Posterior and CT Post procedure
surgery (CT), Post
procedure Clinical
photgraph showing
scar , Detailed
Procedure /
Operative Notes.
Detailed discharge
summary
1102 SN (Neurosurgery) Duroplasty–Duroplasty with SN007A S 12,500 0 N N Clinical notes Post procedure 5
Endogenous graft and CT/ MRI Imaging with film
photgraph showing
Post procedure
Clinical photgraph
showing scar;
detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1103 SN (Neurosurgery) Duroplasty–Duroplasty with SN007B S 12,500 0 N N Clinical notes Post procedure 5
Exogenous graft and CT/ MRI Imaging with film
photgraph showing
Post procedure
Clinical photgraph
showing scar;
detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1104 SN (Neurosurgery) Burr hole surgery–Burr hole SN008A S 7,000 0 N N Clinical notes Post procedure 2
photgraph showing
scar , Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1105 SN (Neurosurgery) Burr hole surgery–Burr hole surgery SN008B S 20,000 0 N N Clinical notes Post procedure 2
with chronic Sub Dural Haematoma and CT/MRI Imaging with film
photgraph showing
scar , Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1106 SN (Neurosurgery) Surgery for Haematoma - SN009A S 55,000 0 N N Clinical notes Post procedure 8
Intracranial–Head injuries and CT/ MRI Imaging with film
photgraph showing
scar , Detailed
Procedure /
Operative Notes.
Detailed discharge
summary
1107 SN (Neurosurgery) Surgery for Haematoma - SN009B S 50,000 0 N N Clinical notes Post procedure 8
Intracranial–Hypertensive and CT/ MRI Imaging with film
photgraph showing
scar , Detailed
Procedure /
Operative Notes.
Detailed discharge
summary
1108 SN (Neurosurgery) Surgery for Haematoma - SN009C S 50,000 0 N N Clinical notes Post procedure 10
Intracranial–Child - subdural and CT/ MRI Imaging with film
photgraph showing
scar , Detailed
Procedure /
Operative Notes.
Detailed discharge
summary
1109 SN (Neurosurgery) Excision of Brain Abscess–Excision of SN010A S 36,000 0 Y N Clinical notes Pus C/s, Post 7
Brain Abscess and CT procedure Imaging
with film (CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes
1110 SN (Neurosurgery) Abscess Tapping–Abscess Tapping SN011A S 20,000 0 N N Clinical notes Pus C/s, Post 7
and CT procedure Imaging
with film (CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes
1111 SN (Neurosurgery) Epilepsy Surgery–Epilepsy Surgery SN012A S 50,000 0 Y N Clinical notes Post procedure 10
and EEG, Imaging with film
Neurologist (CT), Post
report, CT/MRI procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1112 SN (Neurosurgery) Brain Biopsy–Brain Biopsy SN013A S 15,000 0 N N Clinical notes Histopathology, 3
and CT/MRI, Post procedure
suspected Clinical photgraph
differential showing scar,
diagnosis Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1113 SN (Neurosurgery) Excision of Orbital Tumour –Excision SN014A S 40,000 0 Y N Clinical notes Post procedure 7
of Orbital Tumour and CT/ MRI Imaging with film
report (CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
HPE report
1114 SN (Neurosurgery) Excision of Brain Tumor SN015A S 50,000 0 Y N Clinical notes Histopathology, 10
Supratentorial–Parasagital and CT/MRI Post procedure
Imaging with film
(CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1115 SN (Neurosurgery) Excision of Brain Tumor SN015B S 50,000 0 Y N Clinical notes Histopathology, 10
Supratentorial–Basal and CT/MRI Post procedure
Imaging with film
(CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1116 SN (Neurosurgery) Excision of Brain Tumor SN015C S 50,000 0 Y N Clinical notes Histopathology, 10
Supratentorial–Brainstem and CT/MRI Post procedure
Imaging with film
(CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1117 SN (Neurosurgery) Excision of Brain Tumor SN015D S 50,000 0 Y N Clinical notes Histopathology, 10
Supratentorial–C P Angle and CT/MRI Post procedure
Imaging with film
(CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1118 SN (Neurosurgery) Excision of Brain Tumor SN015E S 55,000 0 Y N Clinical notes Histopathology, 10
Supratentorial–Supratentorial & others and CT/MRI Post procedure
Imaging with film
(CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1119 SN (Neurosurgery) Stereotactic Lesioning–Stereotactic SN016A S 60,000 0 Y N Clinical notes Post procedure 10
Lesioning from Imaging with film
neuorlogist/ (CT), Post
psychiatriat / procedure Clinical
MRI photgraph showing
scar, Detailed
Procedure /
Operative Notes.
Detailed discharge
summary
1120 SN (Neurosurgery) Trans Sphenoidal Surgery–Trans SN017A S 50,000 0 N N Clinical notes Histopathology, 7
Sphenoidal Surgery and MRI Post procedure
surgery (MRI), Detailed
Procedure /
Operative Notes.
Detailed discharge
summary.
1121 SN (Neurosurgery) Trans oral Surgery–Trans oral SN018A S 40,000 0 N N X ray and MRI Post procedure 7
Surgery Spine Imaging with film (X-
ray), Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
HPE report
1122 SN (Neurosurgery) Transoral surgery (Anterior) and CV SN019A S 55,000 0 Y N X ray and MRI Post procedure 12
Junction (Posterior Sterilisation)– Spine Imaging with film (X-
Transoral surgery (Anterior) and CV ray), Detailed
Junction (Posterior Sterilisation) discharge summary,
Detailed Procedure
/ Operative Notes.
1123 SN (Neurosurgery) External Ventricular Drainage (EVD) SN020A S 30,000 0 Y N Clinical noteand Analysis/ C/S of 6
including antibiotics–External CT pus/ fluid removed,
Ventricular Drainage (EVD) Post procedure
including antibiotics Imaging with film
(CT), Post
procedure Clinical
photgraph showing
scar , Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1124 SN (Neurosurgery) Ventricular Puncture–Ventricular SN021A S 15,000 0 N N Clinical notes Post procedure 3
Puncture and CT Imaging with film
justifying (CT), Post
procedure procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1125 SN (Neurosurgery) Shunt Surgery–Ventriculo - peritoneal SN022A S 30,000 0 N N Clinical notes Detailed discharge 7
and CT/MRI summary, Detailed
Procedure /
Operative
Notes.Clinical
Photograph
1126 SN (Neurosurgery) Shunt Surgery–Ventriculo - pleural SN022B S 30,000 0 N N Clinical notes Detailed discharge 7
Procedure /
Operative
Notes.Clinical
Photograph
1127 SN (Neurosurgery) Shunt Surgery–Ventriculo - atrial SN022C S 30,000 0 N N Clinical notes Detailed discharge 7
Procedure /
Operative
Notes.Clinical
Photograph
1128 SN (Neurosurgery) Shunt Surgery–Theco - peritoneal SN022D S 30,000 0 N N Clinical notes Detailed discharge 7
Procedure /
Operative
Notes.Clinical
Photograph
1129 SN (Neurosurgery) Aneurysm Clipping including SN023A S 65,000 0 Y N Clinical notes Post procedure 12
angiogram–Aneurysm Clipping and CT- Imaging with film
including angiogram angio/MRA/DS (CT) showing clips,
A Post procedure
Clinical photgraph
showing scar,
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.,
invoice of all the
clip(s) used
1130 SN (Neurosurgery) Superficial Temporal Artery (STA): SN024A S 60,000 0 Y N Clinical notes Post procedure 10
middle cerebral artery (MCA) or (other and MRA/ DSA Imaging with film
EC - IC) Bypass procedure– report (CT), Post
Superficial Temporal Artery (STA): procedure Clinical
middle cerebral artery (MCA) or photgraph showing
(other EC - IC) Bypass procedure scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1131 SN (Neurosurgery) Arterio venous malformation (AVM) SN025A S 50,000 0 Y N Clinical notes Post procedure 10
excision–Intracranial and MRA/ DSA Imaging with film
report (CT), Post
procedure Clinical
photgraph showing
Post procedure
Clinical photgraph
showing scar,
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1132 SN (Neurosurgery) Arterio venous malformation (AVM) SN025B S 50,000 0 Y N Clinical notes Post procedure 10
excision–Intraspinal and MRA/ DSA Imaging with film
report (CT), Post
procedure Clinical
photgraph showing
Post procedure
Clinical photgraph
showing scar,
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1133 SN (Neurosurgery) Arterio venous malformation (AVM) SN025C S 25,000 0 Y N Clinical notes Post procedure 5
excision–Scalp and MRA/ DSA Imaging with film
report (CT), Post
procedure Clinical
photgraph showing
Post procedure
Clinical photgraph
showing scar,
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1134 SN (Neurosurgery) Foramen Magnum SN026A S 45,000 0 N N Clinical notes Post procedure 10
Decompression–Foramen Magnum and CT/MRI Clinical photgraph
Decompression showing scar,
detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1135 SN (Neurosurgery) Skull Traction–Skull Traction SN027A S 8,000 0 N N Clinical notes Clinical photgraph 4
and Indication with traction
for skull traction applied, Detailed
supporting Procedure /
radiological Operative Notes
evdience detailing weights
(CT/MRI). applied; Detailed
discharge summary
.
1136 SN (Neurosurgery) Posterior Cervical Discetomy without SN028A S 30,000 0 N N Clinical notes Post procedure 7
implant –Posterior Cervical Discetomy and MRI Clinical photgraph
without implant showing scar,
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1137 SN (Neurosurgery) Posterior Cervical Fusion with implant SN029A S 50,000 0 Y N Clinical notes Post procedure 7
(Lateral mass fixation) –Posterior and MRI Clinical photgraph
Cervical Fusion with implant showing scar,
(Lateral mass fixation) Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
Cervical spine X-ray
showing implant
1138 SN (Neurosurgery) Cervical Disc Multiple level without SN030A S 40,000 0 Y N Clinical notes Post procedure 7
Fusion –Cervical Disc Multiple level and MRI Clinical photgraph
without Fusion showing scar,
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
Cervical spine X-ray
1139 SN (Neurosurgery) Excision of Cervical Ribs –Excision of SN031A S 20,000 0 N N X-Ray Post procedure 7
Cervical Ribs chest/CT/MRI Imaging with film (X
confirming Ray) Detailed
Diagnosis. Procedure /
Operative Notes.
Post procedure scar
photo, Detailed
discharge summary
1140 SN (Neurosurgery) Thoracic / Lumbar Corpectomy with SN032A S 60,000 0 Y N Clinical notes Post procedure 7
fusion –Thoracic Corpectomy with and MRI Imaging with film (X
fusion ray) showing the
implants, Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary
, Detailed
Procedure /
Operative Notes
1141 SN (Neurosurgery) Thoracic / Lumbar Corpectomy with SN032B S 60,000 0 Y N Clinical notes Post procedure 7
fusion –Lumbar Corpectomy with and MRI Imaging with film (X
fusion ray) showing the
implants, Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary
, Detailed
Procedure /
Operative Notes
1142 SN (Neurosurgery) Lumbar Discectomy –Lumbar SN033A S 30,000 0 N N Clinical notes Post op MRI, Post 5
Discectomy and MRI procedure Clinical
establishing photgraph showing
need of surgery scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1143 SN (Neurosurgery) Laminectomy–Laminectomy with SN034A S 40,000 0 N N Clinical notes Post procedure X- 6
Fusion and MRI ray showing fixation
establishing & fusion, Post
photgraph showing
scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1144 SN (Neurosurgery) Laminectomy–Laminectomy with SN034B S 50,000 0 N N Clinical notes Post procedure X- 6
Fusion and fixation and MRI ray showing fixation
establishing & fusion, Post
photgraph showing
scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1145 SN (Neurosurgery) Neurectomy–Neurectomy SN035A S 16,000 0 N N Clinical notes Post procedure 5

justifying the Clinical photgraph
surgery, showing scar,
detailed discharge
summary Detailed
Procedure /
Operative Notes.
1146 SN (Neurosurgery) Neurectomy–Neurectomy - Trigeminal SN035B S 16,500 0 N N Clinical notes Post procedure 5
justifying the Clinical photgraph
surgery, showing scar,
detailed discharge
summary Detailed
Procedure /
Operative Notes.
1147 SN (Neurosurgery) Micro discectomy–Cervical SN036A S 40,000 0 N N Clinical notes Intra procedure still 10
and MRI photograph Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1148 SN (Neurosurgery) Micro discectomy–Lumbar SN036B S 40,000 0 N N Clinical notes Intra procedure still 10
and MRI photograph Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1149 SN (Neurosurgery) Surgery for Spinal Canal SN037A S 40,000 0 N N Clinical notes Post op X-ray with 6
Stenosis–Surgery for Spinal Canal and MRI film; Detailed
Stenosis supporting discharge summary;
surgery Detailed Procedure
/ Operative Notes;
1150 SN (Neurosurgery) Spine - Decompression & SN038A S 50,000 0 N N Clinical notes Post op X-ray with 6
Fusion–Spine - Decompression & and MRI film showing fusion;
Fusion supporting Detailed discharge
surgery summary; Detailed
Procedure /
Operative Notes;
1151 SN (Neurosurgery) Spine - Decompression & SN038B S 50,000 0 N N Clinical notes Post op X-ray with 6
Fusion–Spine - Decompression & and MRI film showing fusion;
Fusion with fixation supporting Detailed discharge
surgery summary; Detailed
Procedure /
Operative Notes;
1152 SN (Neurosurgery) Spine - Extradural Haematoma–Spine SN039A S 30,000 0 N N Clinical notes Post procedure 7
- Extradural Haematoma and MRI Clinical photgraph
supporting showing scar,
surgery detailed discharge
summary, Detailed
Procedure /
Operative Notes
1153 SN (Neurosurgery) Spine - Extradural Haematoma–Spine SN039B S 40,000 0 N N Clinical notes Post procedure 7
- Extradural Haematoma with fixation and MRI Clinical photgraph
summary, Detailed
Procedure /
Operative Notes
1154 SN (Neurosurgery) Spine - Intradural Haematoma–Spine SN040A S 40,000 0 N N Clinical notes Post procedure 7
- Intradural Haematoma and MRI Clinical photgraph
summary, Detailed
Procedure /
Operative Notes
1155 SN (Neurosurgery) Spine - Intradural Haematoma–Spine SN040B S 50,000 0 N N Clinical notes Post procedure 7
- Intradural Haematoma with fixation and MRI Clinical photgraph
summary, Detailed
Procedure /
Operative Notes
1156 SN (Neurosurgery) Spine - Extradural Tumour–Spine - SN041A S 30,000 0 N N Clinical notes Histopathology/ 7
Extradural Tumour and MRI Biopsy report, Post
supporting procedure Clinical
surgery photgraph showing
scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1157 SN (Neurosurgery) Spine - Extradural Tumour–Spine - SN041B S 40,000 0 N N Clinical notes Histopathology/ 7
Extradural Tumour with fixation and MRI Biopsy report, Post
scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1158 SN (Neurosurgery) Spine - Intradural Tumour–Spine - SN042A S 40,000 0 N N Clinical notes Biopsy & HPE 7
Intradural Tumour and MRI report; Post
scar, detailed
discharge summary,
Detailed Procedure
/ Operative Notes
1159 SN (Neurosurgery) Spine - Intradural Tumour–Spine - SN042B S 50,000 0 N N Clinical notes Biopsy & HPE 7
Intradural Tumour with fixation and MRI report; Post
scar, detailed
discharge summary,
Detailed Procedure
/ Operative Notes
1160 SN (Neurosurgery) Spine - Intramedullar Tumour–Spine - SN043A S 50,000 0 N N Clinical notes Histopathology, 7
Intramedullar Tumour and MRI Post procedure
supporting Imaging with film (X-
surgery ray/ CT), Post
procedure Clinical
photgraph showing
scar, Detailed
Procedure /
Operative Notes.
Detailed discharge
summary
1161 SN (Neurosurgery) Spine - Intramedullar Tumour–Spine - SN043B S 60,000 0 N N Clinical notes Histopathology, 7
Intramedullar Tumour with fixation and MRI Post procedure
supporting Imaging with film (X-
surgery ray/ CT), Post
procedure Clinical
photgraph showing
scar, Detailed
Procedure /
Operative Notes.
Detailed discharge
summary
1162 SN (Neurosurgery) R. F. Lesioning for Trigeminal SN044A S 16,500 0 N N Clinical notes Intra procedure 3
Neuralgia –R. F. Lesioning for establishing clinical CD/ series of
Trigeminal Neuralgia diagnosis of still photographs;
Trigeminal Detailed Procedure
neuralgia and / Operative Notes,
justification of detailed discharge
local summary; invoice of
neurectomy RF probe
with MRI / CT
1163 SN (Neurosurgery) Brachial Plexus – Repair–Brachial SN045A S 27,000 0 N N Clinical notes Detailed discharge 7
Plexus – Repair and MRI report summary, Post
procedure Clinical
photgraph showing
scar, Detailed
Procedure /
Operative Notes.
1164 SN (Neurosurgery) Carpal Tunnel Release–Carpal SN046A S 10,000 0 N N Clinical history, Post procedure 3
Tunnel Release MRI, NCV Clinical photgraph
showing scar,
Detailed discharge
summary , Detailed
Procedure /
Operative Notes &
MRI Report
1165 SN (Neurosurgery) Nerve Decompression–Nerve SN047A S 16,000 0 N N Clinical notes Detailed discharge 4
Decompression and NCV summary, Post
procedure Clinical
photgraph showing
scar, Detailed
Procedure /
Operative Notes.
1166 SN (Neurosurgery) Cranial Nerve Anastomosis–Cranial SN048A S 32,000 0 N N Clinical notes Post procedure 5
Nerve Anastomosis and MRI Imaging with film
justifying (CT), Post
surgery procedure Clinical
photgraph showing
scar, detailed
discharge summary,
Detailed Procedure
/ Operative Notes.
1167 SN (Neurosurgery) Peripheral Nerve Surgery–Minor SN049A S 15,000 0 Y N Clinical notes Detailed discharge 3
and Nerve summary, Post
Conduction procedure Clinical
Velocity (NCV) photgraph showing
and scar, Detailed
Electromyograp Procedure /
hy (EMG) Operative Notes.
reports
1168 SN (Neurosurgery) Peripheral Nerve Surgery–Major SN049B S 30,000 0 Y N Clinical notes Detailed discharge 5
and Nerve summary, Post
Conduction procedure Clinical
Velocity (NCV) photgraph showing
and scar, Detailed
Electromyograp Procedure /
hy (EMG) Operative Notes.
reports
1169 SN (Neurosurgery) Nerve Biopsy excluding SN050A S 7,000 0 N N Clinical notes HPE Report of 2
Hensens–Nerve Biopsy excluding and Reports of Nerve Biopsy:
Hensens previous Detailed Proedure
investigations notes; detailed
and treatment discharge summary
taken ruling out
Hensen's,
differentials
suspected,
need for Nerve
Biopsy
1170 SN (Neurosurgery) Muscle Biopsy with report–Muscle SN051A S 7,000 0 N N Clinical notes Histopathology, Daycare
Biopsy with report and Post procedure
Electromyograp Clinical photgraph
hy (EMG) showing scar
reports Detailed discharge
summary,, Detailed
Procedure /
Operative Notes.
1171 SN (Neurosurgery) Anterior Encephalocele–Anterior SN052A S 50,000 0 N N Clinical notes Post procedure 8
Encephalocele and CT/MRI as Imaging with film
Evidence (CT), Post
procedure Clinical
photgraph showing
scar, Detailed
discharge summary
Detailed Procedure
/ Operative Notes.
1172 SN (Neurosurgery) Spina Bifida Surgery–Spina Bifida SN053A S 36,000 0 N N Clinical notes Post procedure 10
Surgery and CT Clinical photgraph
showing scar,
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1173 SN (Neurosurgery) Gamma Knife radiosurgery (GKRS) / SN054A S 75,000 0 Y N Clinical notes Intra procedure 10
SRS for tumours / Arteriovenous and CT/ MRI clinical photograph,
malformation (AVM)–Gamma Knife report; Is the treating doctor's
radiosurgery (GKRS) / SRS for EHCP equipped consultation paper
tumours / Arteriovenous malformation with Gamma showing planning
(AVM) Knife? for RT treatment
and the RT chart,
detailed discharge
summary
1174 SO (Obstetrics & Lap. Salpingo-oophrectomy–Lap. SO001A S 14,000 0 Y N Clinical notes Detailed Operative 3
Gynaecology) Salpingo-oophrectomy establishing notes,HPE Pic of
indication, USG specimen. Intraop
Abdomen stills with date &
Pelvis/ CT/ MRI patient ID, Detailed
abdomen Pelvis discharge summary
1175 SO (Obstetrics & Laparotomy and proceed for Ovarian SO002A S 38,000 0 Y N Clinical notes Histopathology, 5
Gynaecology) Cancers. Omentomy with Bilateral and USG Detailed Operative
Salpingo-oophorectomy–Laparotomy Abdomen + notes, per op pic of
and proceed for Ovarian Cancers. Pelvis/ CT specimen removed,
Omentomy with Bilateral Salpingo- abdomen+ Detailed Discharge
oophorectomy Pelvis Summary.
establishing
indication
1176 SO (Obstetrics & Laparoscopic tubal surgeries SO003A S 13,900 0 N N Clinical notes Detailed Operative 3
Gynaecology) (for any indication including ectopic establishing notes, HPE if
pregnancy)–Laparoscopic tubal indication for ectopic pregnancy
surgeries the procedure, or salpingectomy for
(for any indication including ectopic USG uterus & any other indication,
pregnancy) adnexa, Beta Detailed discharge
HCG summary
1177 SO (Obstetrics & Procedure on Fallopian Tube for SO004A S 11,600 0 Y N Indication of the Detailed discharge 5
Gynaecology) establishing Tubal Patency– procedure summary; Detailed
Procedure on Fallopian Tube for preferably with Operative notes.
establishing Tubal Patency record of Intra procedure
previous clinical photograph
sterilization/
reason for non-
availability
1178 SO (Obstetrics & Laparotomy for broad ligament SO005A S 16,000 0 Y N Clinical notes Detailed discharge 3
Gynaecology) haematoma–Laparotomy for broad with physical summary; Detailed
ligament haematoma examination Operative notes.
findings Intra procedure
supported by clinical photograph
evidence of
hematoma
(USG)
1179 SO (Obstetrics & Abdominal Myomectomy–Abdominal SO006A S 20,000 0 Y N Clinical notes Detailed Operative 5
Gynaecology) Myomectomy establishing notes,HPE, Pic of
indication, USG specimen removed-
Abdomen Gross and
Pelvis/ MRI Histopathology,
abdomen. Pap Detailed discharge
smear summary
1180 SO (Obstetrics & Hysteroscopic SO007A S 9,900 0 Y N physical Detailed Operative 1
Gynaecology) myomectomies–Hysteroscopic examination notes, HPE, Intraop
myomectomies findings with stills with date &
indications for patient ID, Detailed
the procedure. discharge summary
USG pelvis /
MRI Pelvis
1181 SO (Obstetrics & Polypectomy–Polypectomy SO008A S 1,500 0 Y N Clinical notes Procedure / 1
Gynaecology) with planned Operative Notes,
line of Intraop. Stills,Pic of
treatment specimen,
(including Histopathology
System report, Detailed
Examination) Discharge
and Relavant Summary
Investigations
(USG Abdomen
+ Pelvis/ CT
abdomen+
Pelvis),
1182 SO (Obstetrics & Hysteroscopic SO009A S 7,200 0 Y N Admission Detailed Procedure 2

Gynaecology) polypectomy–Hysteroscopic Notes / Operative Notes
polypectomy comprising of together with
history and indication of
examination surgery, Intraop.
with indications stills with date &
for the patient ID, pic off
procedure, gross specimen
Relavant removed ,
Investigations HPE,Progress
(establishing notes,detailed
diagnosis),USG discharge summary.
showing polyp
1183 SO (Obstetrics & Hysterectomy–Abdominal SO010A S 20,000 0 Y N Clinical notes Histopathology, 5
Gynaecology) Hysterectomy with planned Detailed Discharge
line of Summary with
treatment Procedure /
(including Operative Notes
System
Examination)
and Relavant
Investigations
(USG Abdomen
+ Pelvis/ CT
abdomen+
Pelvis)
confirming the
indication
1184 SO (Obstetrics & Hysterectomy–Abdominal SO010B S 20,000 0 Y N Admission Detailed Procedure 5
Gynaecology) Hysterectomy + Salpingo- Notes / Operative Notes
oophorectomy comprising of together with
procedure,Clini gross specimen
cal notes with removed ,
planned line of HPE,Progress
treatment notes,detailed
(clearly discharge summary.
indicating
medical
management
tried and failed
or not indicated.
If failed
documents
proving duration
of treatment
and failure. The
medical
management
should have
been tried for
atleast 4-6
months
covering 1
course of
hormone cycle)
and USG
1185 SO (Obstetrics & Hysterectomy–Non descent vaginal SO010C S 20,000 0 Y N Clinical notes Detailed Procedure 4
Gynaecology) hysterectomy with planned / Operative Notes
line of together with
treatment indication of
(clearly surgery, Intraop.
indicating stills with date &
medical patient ID, pic off
management gross specimen
tried and failed removed , HPE,
or not indicated. Progress
If failed notes,detailed
documents discharge summary.
proving duration
of treatment
and failure. The
medical
management
should have
been tried for
atleast 4-6
months
covering 1
course of
hormone cycle),
USG Abdomen
+ Pelvis, Pap
smear, EB/EAC
1186 SO (Obstetrics & Hysterectomy–Vaginal hysterectomy SO010D S 20,000 0 Y N Clinical notes Detailed Procedure 5
Gynaecology) with anterior and posterior with planned / Operative Notes
colpoperineorrhaphy line of together with
treatment indication of
(clearly surgery, Intraop.
indicating stills with date &
or not indicated Progress
with reason. If notes,detailed
failed discharge summary.
documents
proving duration
of treatment
and failure. The
medical
management
should have
been tried for
atleast 4-6
months
covering 1
course of
hormone cycle),
Photographic
documentation
with patient’s
consent, Pap
smear (
EB/EAC is
optional )
1187 SO (Obstetrics & Hysterectomy–Laparoscopic SO010E S 20,000 0 Y N Clinical notes Histopathology, 5
Gynaecology) hysterectomy (TLH) with planned Detailed Discharge
line of Summary with
treatment and Detailed operative
USG Abdomen notes
+ Pelvis/ CT
abdomen+
Pelvis
confirming the
indication
1188 SO (Obstetrics & Hysterectomy–Laparoscopically SO010F S 20,000 0 Y N Admission Detailed Procedure 5
Gynaecology) assisted vaginal hysterectomy (LAVH) Notes / Operative Notes
comprising of together with
examination(cle surgery, Intraop.
arly indicating stills with date &
or not indicated, Progress
with reason. If notes,detailed
failed discharge summary.
documents
proving duration
of treatment
and failure. The
medical
management
should have
been tried for
atleast 4-6
months
covering 1
course of
hormone cycle)
, USG
Abdomen +
Pelvis/ MRI
abdomen+
Pelvis
confirming the
indication, Pap
1189 SO (Obstetrics & Caesarean hysterectomy–Caesarean SO011A S 20,000 2 N N Admission Detailed Procedure 5
Gynaecology) hysterectomy Notes / Operative Notes.
comprising of Histopath of uterus
history and removed, per op pic
examination of specimen
(clearly removed; status of
indicating the child at the time
medical of delivery and at
management the time of
tried and failed discharge; progress
or not indicated notes,Detailed
with reason. If discharge summary
failed
documents
proving duration
of treatment
and failure. The
medical
management
should have
been tried for
atleast 4-6
months
covering 1
course of
hormone cycle),
detailed Ante
natal care
records/
reasons for non-
availability of
ANC records.
1190 SO (Obstetrics & Manchester Repair–Manchester SO012A S 15,000 1 Y N Admission Detailed Procedure 5
Gynaecology) Repair Notes / Operative Notes,
comprising of Intraop. Stills,
history and Progress notes,
examination Detailed discharge
with indications summary
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
1191 SO (Obstetrics & Surgeries for Prolapse - Sling SO013A S 33,900 0 Y N Admission Detailed Procedure 5
Gynaecology) Surgeries–Surgeries for Prolapse - Notes / Operative Notes,
Sling Surgeries comprising of Intraop. stills
history and ,Barcode of sling
examination used; progress
with indications notes,Detailed
for the discharge summary
procedure,Rela
vant
Investigations
(establishing
diagnosis) ;
Photographic
documentation
of
degree/severity
of prolapse with
patient’s
consent,Pap
smear.
1192 SO (Obstetrics & Hysterotomy–Hysterotomy SO014A S 5,000 1 Y N Admission Detailed Procedure Daycare
Gynaecology) Notes / Operative Notes,
comprising of Intraop. stills with
history and date & patient ID,
examination HPE of
with indications specimen,Progress
for the notes, Detailed
procedure,Rela discharge summary
vant
Investigations
(establishing
diagnosis),
USG - Obstetric
confirming the
above package.
Has
medicolegal
compliance
been done?
1193 SO (Obstetrics & Lap. Surgery for Endometriosis SO015A S 11,200 0 Y N Admission Detailed Procedure 2
Gynaecology) (Other than Hysterectomy)–Lap. Notes / Operative Notes
Surgery for Endometriosis comprising of together with
(Other than Hysterectomy) history and indication of
examination, surgery, Intraop.
Relavant stills with date &
Investigations patient ID, pic off
(establishing gross specimen
diagnosis) removed , HPE,
USG/ CT/ MRI/ Progress
laparoscopy notes,detailed
findings discharge summary.
1194 SO (Obstetrics & Diagnostic hysteroscopy–With biopsy SO016A S 6,000 0 Y N Admission Detailed Procedure 1
Gynaecology) Notes / Operative Notes
Relavant removed , HPE of
Investigations biopsy
(establishing specimen,Progress
diagnosis),USG notes, Detailed
uterus & discharge summary
adnexa
1195 SO (Obstetrics & Diagnostic hysteroscopy–Without SO016B S 6,000 0 Y N Admission Detailed Procedure 1
Gynaecology) biopsy Notes / Operative Notes
Relavant removed , HPE of
Investigations biopsy
(establishing specimen,Progress
diagnosis),USG notes, Detailed
uterus & discharge summary
adnexa
1196 SO (Obstetrics & Hysteroscopic IUCD SO017A S 4,700 0 Y N Clinical notes Detailed Procedure 1
Gynaecology) removal–Hysteroscopic IUCD removal with details of / Operative Notes
IUCD insertion together with
(reason for non indication of
availability of surgery, Intraop.
details), stills with date &
indication for patient ID, pic off
removing IUCD, gross specimen
USG showing removed ,
misplaced IUD HPE,Progress
notes,detailed
discharge summary.
1197 SO (Obstetrics & D&C (Dilatation&curretage)–D&C SO018A S 3,000 0 N N Admission Detailed Procedure Daycare
Gynaecology) (Dilatation&curretage) Notes / Operative Notes,
history and Histopathology of
examination curetted material,
with indications Progress notes,
for the Detailed discharge
procedure,Rela summary
vant
Investigations
(establishing
diagnosis),
(USG Abdomen
+ Pelvis)-
optional
1198 SO (Obstetrics & Dilation and Evacuation SO019A S 5,000 0 N N Admission Detailed Procedure Daycare
Gynaecology) (D&E)–Dilation and Evacuation (D&E) Notes / Operative Notes,
comprising of Intraop.
history and Stills,Histopathology
examination of evacuated
with indications material, Progress
vant
Investigations
(establishing
diagnosis),USG
abdomen and
pelvis)
1199 SO (Obstetrics & Pyometra drainage–Pyometra SO020A S 5,000 0 Y N Admission Detailed Procedure 3
Gynaecology) drainage Notes / Operative Notes,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis)
1200 SO (Obstetrics & Intrauterine transfusions–Intrauterine SO021A S 11,000 0 Y N Admission Detailed Procedure Daycare
Gynaecology) transfusions Notes / Operative Notes,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis)
1201 SO (Obstetrics & Hysteroscopic SO022A S 6,900 0 Y N Admission Detailed Procedure 1

Gynaecology) adhesiolysis–Hysteroscopic Notes / Operative Notes
adhesiolysis comprising of together with
Relavant removed ,
Investigations HPE,Progress
diagnosis),USG discharge summary.
Abdomen
Pelvis / CT/MRI
Abdomen
Pelvis
1202 SO (Obstetrics & Laparoscopic SO023A S 6,000 0 Y N Admission Detailed Procedure 1
Gynaecology) adhesiolysis–Laparoscopic Notes / Operative Notes
adhesiolysis comprising of together with
diagnosis), removed , HPE,
USG Abdomen/ Progress
Pelvis (CT notes,detailed
abdomen- discharge summary.
Optional)
1203 SO (Obstetrics & Trans - vaginal tape / Trans-obturator SO024A S 15,200 0 Y N Admission Detailed Procedure Daycare
Gynaecology) tape–Trans-vaginal tape Notes / Operative Notes,
comprising of Barcode of
history and TVT/TOT tape
procedure,Rela
vant
Investigations
(establishing
diagnosis)
1204 SO (Obstetrics & Trans - vaginal tape / Trans-obturator SO024B S 15,200 0 Y N Admission Detailed Procedure Daycare
Gynaecology) tape–Trans-obturator tape Notes / Operative Notes,
comprising of Barcode of
history and TVT/TOT tape
procedure,Rela
vant
Investigations
(establishing
diagnosis)
1205 SO (Obstetrics & Sacrocolpopexy (Abdominal)–Open SO025A S 28,900 0 Y N Admission Detailed Procedure 7
examination Barcode of mesh
with indications used; progress
for the notes,Detailed
vant summary
Investigations
(establishing
diagnosis) ,
Photographic
documentation
with patient’s
consent.
1206 SO (Obstetrics & Sacrocolpopexy (Abdominal)–Lap. SO025B S 28,900 0 Y N Admission Detailed Procedure 7
examination Barcode of mesh
with indications used; progress
for the notes,Detailed
vant summary
Investigations
(establishing
diagnosis) ,
Photographic
documentation
with patient’s
consent.
1207 SO (Obstetrics & LLETZ (including PAP smear and SO026A S 9,900 0 N N Admission Detailed Procedure 3
Gynaecology) colposcopy)–LLETZ (including PAP Notes / Operative Notes,
smear and colposcopy) comprising of Intraop. stills with
examination HPE of
with indications specimen,Progress
vant
Investigations
(establishing
diagnosis) ,
Evidence of
cervical pre-
cancer (PAP
smear)
Colposcopiy.
Cervical Biopsy
is optional
1208 SO (Obstetrics & Vaginal Sacrospinus fixation with SO027A S 15,000 0 Y N Admission Detailed Procedure 5
Gynaecology) repair–Vaginal Sacrospinus fixation Notes / Operative Notes,
with repair comprising of Intraop. Stills,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
1209 SO (Obstetrics & Excision of Vaginal Septum (vaginal SO028A S 14,500 0 Y N Admission Detailed Procedure 1
Gynaecology) route)–Excision of Vaginal Septum Notes / Operative Notes,
(vaginal route) comprising of Intraop. Stills,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
need of
procedure
(USG Abdomen
+ Pelvis)
1210 SO (Obstetrics & Hymenectomy for imperforate SO029A S 3,000 0 Y N Admission Detailed Procedure 1
Gynaecology) hymen–Hymenectomy for imperforate Notes / Operative Notes,
hymen comprising of Intraop. Stills,
for the
procedure and
need of
procedure
1211 SO (Obstetrics & Anterior & Posterior SO030A S 8,000 0 Y N Admission Detailed Procedure 5
Gynaecology) Colpoperineorrhapy–Anterior & Notes / Operative Notes,
Posterior Colpoperineorrhapy comprising of Intraop. Stills,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
clinical pic if
feasible
1212 SO (Obstetrics & Vaginoplasty (McIndoe SO031A S 11,000 0 Y N Admission Detailed Procedure 3
Gynaecology) procedure)–Vaginoplasty (McIndoe Notes / Operative Notes,
procedure) comprising of Intraop. Stills,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
need of
procedure
(USG Abdomen
+ Pelvis)
1213 SO (Obstetrics & Vaginal repair for vesico-vaginal SO032A S 34,000 0 Y N Admission Detailed Procedure 5
Gynaecology) fistula–Vaginal repair for vesico- Notes / Operative Notes,
vaginal fistula comprising of Intraop. stills with
examination Progress
with indications notes,detailed
for the discharge
procedure,Rela summary.detailed
vant discharge summary.
Investigations
(establishing
diagnosis) and
Cystoscopy/
Cystourethrosc
opy. Voiding
Cystourethrogra
m is optional.
1214 SO (Obstetrics & Rectovaginal fistula SO033A S 24,000 0 Y N Admission Detailed Procedure 3
Gynaecology) repair–Rectovaginal fistula repair Notes / Operative Notes,
examination Progress
with indications notes,detailed
for the discharge summary.
procedure,Rela
vant
Investigations
(establishing
diagnosis)
1215 SO (Obstetrics & Vulval Hamatoma drainage–Vulval SO034A S 3,000 0 N N Admission Detailed Procedure Daycare
Gynaecology) Hamatoma drainage Notes / Operative Notes,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
1216 SO (Obstetrics & Vulvectomy simple–Vulvectomy SO035A S 15,000 0 Y N Admission Detailed Procedure 3
Gynaecology) simple Notes / Operative Notes,
comprising of Intra procedure
history and clinical photograph/
examination stills,
with indications histopathology;
for the progress
procedure,Rela notes,Detailed
vant discharge summary
Investigations
(establishing
diagnosis) with
Evidence
(biopsy).
Clinical pic if
patient permits
1217 SO (Obstetrics & Radical Vulvectomy with Inguinal and SO036A S 38,500 0 Y N Admission Detailed Procedure 3
Gynaecology) Pelvic lymph node disection–Radical Notes / Operative Notes
Vulvectomy with Inguinal and Pelvic comprising of together with
lymph node disection history and indication of
Relavant removed , HPE,
Investigations Progress
diagnosis),vulva discharge summary.
l biopsy,
CT/MRI for
staging
1218 SO (Obstetrics & Abdomino Perineal repair for SO037A S 20,000 0 Y N Admission Detailed Procedure 5
Gynaecology) Mullerian Anomaly–Abdomino Notes / Operative Notes,
Perineal repair for Mullerian Anomaly comprising of Intraop. Stills,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
(USG/ CT/ MRI)
1219 SO (Obstetrics & Pelvic Abscess Management SO038A S 1,200 0 N N Admission Detailed Procedure Daycare
Gynaecology) including Colpotomy–Pelvic Abscess Notes / Operative Notes,
Management including Colpotomy comprising of Intra procedure
examination stills; progress
procedure,Rela
vant
Investigations
(establishing
diagnosis) ,
USG Abdomen
& Pelvis
1220 SO (Obstetrics & Diagnostic / Staging SO039A S 9,700 0 Y N Admission Detailed Procedure 3
Gynaecology) laparoscopy–Diagnostic / Staging Notes / Operative Notes
laparoscopy comprising of together with
diagnosis) removed , HPE,
Progress
notes,detailed
discharge summary.
1221 SO (Obstetrics & Laparotomy for benign SO040A S 14,000 0 Y N Admission Detailed Procedure 5
Gynaecology) disorders–Ectopic Notes / Operative Notes
cal notes removed ,
establishing HPE,detailed
ruptured discharge summary.
ectopic with
Evidence of
beta hCG &
USG
1222 SO (Obstetrics & Laparotomy for benign disorders–PID SO040B S 14,000 0 Y N Admission Detailed Procedure 5
Gynaecology) Notes / Operative Notes
cal notes removed ,
establishing HPE,detailed
ruptured discharge summary.
ectopic with
Evidence of
beta hCG &
USG
1223 SO (Obstetrics & Laparoscopic SO041A S 15,000 0 Y N Admission Detailed Procedure 5
Gynaecology) cystectomy–Laparoscopic cystectomy Notes / Operative Notes
diagnosis), removed , HPE,
USG Abdomen Progress
Pelvis/ CT notes,detailed
abdomen. discharge summary.
1224 SO (Obstetrics & Cystocele - Anterior repair–Cystocele - SO042A S 6,000 0 Y N Admission Detailed Procedure 3
Gynaecology) Anterior repair Notes / Operative Notes,
with findings summary
establishing
Cystocoele .
Clinical pic if
feasible
1225 SO (Obstetrics & Burch–Abdominal SO043A S 30,000 0 Y N Admission Detailed Procedure 5
Gynaecology) Notes / Operative Notes;
comprising of Intraop. stills
history and ,progress
examination notes,Detailed
with indications discharge summary
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis) ;
Urodynamic
studies are
optional.
1226 SO (Obstetrics & Burch–Laparoscopic SO043B S 30,000 0 Y N Admission Detailed Procedure 5
Gynaecology) Notes / Operative Notes;
comprising of Intraop. stills
history and ,progress
examination notes,Detailed
with indications discharge summary
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis) ;
Urodynamic
studies are
optional.
1227 SO (Obstetrics & Electro Cauterisation / Cryo SO044A S 4,000 0 Y N Admission Detailed Procedure Daycare
Gynaecology) Surgery–Electro Cauterisation / Cryo Notes / Operative Notes,
Surgery comprising of Intraop. Stills,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis), pap
smear- optional
1228 SO (Obstetrics & EUA for (minor girls / unmarried SO045A S 2,000 0 Y N Admission Detailed Procedure Daycare
Gynaecology) sexually inactive / victims of sexual Notes / Operative Notes,
abuse) –EUA for (minor girls / comprising of Intraop. Stills,
unmarried sexually inactive / victims history and Progress notes,
of sexual abuse) examination Detailed discharge
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis), and
parental
consent (incase
of minor girls)
1229 SO (Obstetrics & Hospitalisation for Antenatal SO046A S 1,800 0 N N Admission Detailed Procedure NA
Gynaecology) Complications–Hospitalisation for Notes / Operative Notes,
Antenatal Complications comprising of Intraop. Stills,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
1230 SO (Obstetrics & Amniocentesis–Amniocentesis SO047A S 14,500 0 Y N Consulting Detailed Procedure Daycare
Gynaecology) notes giving the / Operative Notes,
indication for Intraop. Stills, ;
amniocentesis; Amniotic fluid
does the analysis report;
hospital have Progress notes,
fetal medicine Detailed discharge
expert? summary
1231 SO (Obstetrics & Chorionic villus sampling–Chorionic SO048A S 14,500 0 Y N Admission Procedure / Daycare
Gynaecology) villus sampling Notes Operative Notes
comprising of with report of
history and chorionic villi
examination sampling; Progress
with indications notes, Detailed
procedure,Rela
vant
Investigations
(establishing
diagnosis),
1232 SO (Obstetrics & Cordocentesis–Cordocentesis SO049A S 14,500 0 Y N Admission Detailed Procedure Daycare
comprising of Intraop. Stills, report
history and of cordocentesis;
examination Progress notes,
with indications Detailed discharge
for the summary
procedure,Rela
vant
Investigations
(establishing
diagnosis),
1233 SO (Obstetrics & McDonald's stitch–McDonald's stitch SO050A S 4,000 0 N N Admission Detailed Procedure Daycare
ANC findings Detailed discharge
justifying summary
cervical
incompetence
and the
procedure.
1234 SO (Obstetrics & Shirodkar's stitch–Shirodkar's stitch SO051A S 4,000 0 N N Admission Detailed Procedure Daycare
ANC findings Detailed discharge
justifying summary
cervical
incomptenecs
and the
procedure.
1235 SO (Obstetrics & Medical management of ectopic SO052A S 1,800 0 N N Admission Detailed Procedure 5
Gynaecology) pregnancy–Medical management of Notes / Operative Notes,
ectopic pregnancy comprising of Intraop. Stills,
for the
procedure,Rela
vant
Investigations
(establishing
diagnosis),
1236 SO (Obstetrics & Medical Termination of SO053A S 3,500 0 Y N Admission Detailed Procedure 1
Gynaecology) Pregnancy–MTP upto 8 weeks Notes / Operative Notes,
comprising of Intraop. stills , HPE
history and of
examination specimen,Progress
procedure,Rela
vant
Investigations
(establishing
diagnosis),
USG - Obstetric
confirming the
above package.
Has
medicolegal
compliance
been done?
1237 SO (Obstetrics & Medical Termination of SO053B S 5,000 0 Y N Admission Detailed Procedure 1
Gynaecology) Pregnancy–MTP 8 to 12 weeks Notes / Operative Notes,
history and of
procedure,Rela
vant
Investigations
(establishing
diagnosis),
USG - Obstetric
confirming the
above package.
Has
medicolegal
compliance
been done?
1238 SO (Obstetrics & Medical Termination of SO053C S 6,500 0 Y N Admission Detailed Procedure 1
Gynaecology) Pregnancy–MTP > 12 weeks Notes / Operative Notes,
history and of
procedure,Rela
vant
Investigations
(establishing
diagnosis),
USG - Obstetric
confirming the
above package.
Has
medicolegal
compliance
been done?
1239 SO (Obstetrics & High risk delivery–Pre-mature delivery SO054A S 11,500 0 N N Admission Detailed delivery 3
Gynaecology) Notes notes, PNC notes
comprising of along with relevant
history and investigation details;
detailed Ante status of the child at
natal care the time of delivery
records/ and at the time of
reasons for non- discharge; progress
availability of notes, Detailed
ANC records. discharge summary.
Obstetric USG.
All high risk
deliveries are to
be clubbed &
case specific
documents
required.
1240 SO (Obstetrics & High risk delivery–Mothers with SO054B S 11,500 0 N N Admission Detailed delivery 3
Gynaecology) eclampsia / imminent eclampsia / Notes notes, PNC notes
severe pre-eclampsia comprising of along with relevant
Obstetric USG.
All high risk
deliveries are to
be clubbed &
case specific
documents
required.
1241 SO (Obstetrics & High risk delivery–Major Fetal SO054C S 11,500 0 N N Admission Detailed delivery 3
Gynaecology) malformation requiring intervention Notes notes, PNC notes
immediately after birth comprising of along with relevant
Obstetric USG.
All high risk
deliveries are to
be clubbed &
case specific
documents
required.
1242 SO (Obstetrics & High risk delivery–Mothers with SO054D S 11,500 0 N N Admission Detailed delivery 3
Gynaecology) severe anaemia (<7 g/dL) Notes notes, PNC notes
comprising of along with relevant
Obstetric USG.
All high risk
deliveries are to
be clubbed &
case specific
documents
required.
1243 SO (Obstetrics & High risk delivery–Other maternal and SO054E S 11,500 0 N N Admission Detailed delivery 3
Gynaecology) fetal conditions as per guidelines-eg Notes notes, PNC notes
previous caesarean section, diabetes, comprising of along with relevant
severe growth retardation, etc that history and investigation details;
qualify for high risk delivery. detailed Ante status of the child at
records with and at the time of
special discharge; progress
reference to notes, Detailed
investigations discharge summary.
supporting the
diagnosis/
reasons for non-
availability of
ANC records.
Obstetric USG.
All high risk
deliveries are to
be clubbed &
case specific
documents
required.
1244 SO (Obstetrics & Manual removal of placenta–Manual SO055A S 8,500 0 N N Clinical notes Detailed Procedure 2
Gynaecology) removal of placenta documenting / Operative
need of manual Notes,stills of
removal of placenta, progress
placenta/ use of note Detailed
Active discharge summary;
Management of Post natal course
Third Stage of
Labor (AMTSL)
1245 SO (Obstetrics & Secondary suturing of SO056A S 2,500 0 Y N Admission Detailed Procedure 2
Gynaecology) episiotomy–Secondary suturing of Notes / Operative Notes,
episiotomy comprising of Intraop. Stills,
history Progress notes,
detailing when Detailed discharge
was first summary
surgery done?
and
examination
with indications
for the
procedure,
Physical
examination
findings with
indications for
the procedure.
1246 SO (Obstetrics & Caesarean Delivery–Caesarean SO057A S 11,500 0 N N Admission Detailed Procedure 5
Gynaecology) Delivery Notes / Operative Notes,
comprising of status of the child at
history and the time of delivery
examination and at the time of
with detailed discharge; progress
Ante natal care notes,Detailed
records/ discharge summary
reasons for non-
availability of
ANC records.
Indications for
the procedure.
USG Obstetrics
with Doppler is
case specific &
optional. Labor
charting, CTG if
available.
1247 SO (Obstetrics & Re exploration after laparotomy / SO058A S 14,000 0 N N Admission Detailed Procedure 5
Gynaecology) Caesarean Section–Re exploration Notes / Operative Notes,
after Caesarean Section comprising of Intra procedure
procedure,Rela
vant
Investigations
(establishing
diagnosis) ,
USG
1248 SO (Obstetrics & Re exploration after laparotomy / SO058B S 14,000 0 N N Admission Detailed Procedure 5
Gynaecology) Caesarean Section–Re exploration Notes / Operative Notes,
after laparotomy comprising of Intra procedure
procedure,Rela
vant
Investigations
(establishing
diagnosis) ,
USG
1249 SO (Obstetrics & Vulvo vaginal cyst enucleation / SO059A S 4,700 0 Y N Admission Detailed operative Daycare
Gynaecology) drainage–Vulvo vaginal cyst Notes notes, discharge
enucleation comprising of summary,
history and histopathology
examination report of tissue
with indications removed
for the
procedure,
Relavant
Investigations
(establishing
diagnosis)
1250 SO (Obstetrics & Vulvo vaginal cyst enucleation / SO059B S 4,700 0 Y N Admission Detailed operative Daycare
Gynaecology) drainage–Vulvo vaginal cyst drainage Notes notes, discharge
comprising of summary
history and
examination
with indications
for the
procedure,
Relavant
Investigations
(establishing
diagnosis)
1251 SP (Plastic & Pressure Sore – Surgery–Pressure SP001A S 30,000 0 Y N Clinical notes Post procedure 3
reconstructive Sore – Surgery detailing events clinical photograph;
Surgery) that led to Detailed Procedure
pressure sores; / Operative Notes,
clinical detailed discharge
photograph summary
1252 SP (Plastic & Diabetic Foot – Surgery–Diabetic Foot SP002A S 30,000 0 Y N Clinical notes Post procedure 3
reconstructive – Surgery with planned clinical photograph;
Surgery) line of Detailed Operative
treatment notes, detailed
detailing discharge summary
diabetic foot
extent of
damage;
clinical
photograph
1253 SP (Plastic & Revascularization of limb / SP003A S 25,000 0 Y N Clinical notes Intra procedure 5
reconstructive digit–Revascularization of limb / digit and Clinical clinical photograph,
Surgery) photograph, Detailed discharge
Doppler; If summary, Detailed
traumatic then Procedure /
MLC/FIR Operative Notes,
report.
1254 SP (Plastic & Ear Pinna Reconstruction with costal SP004A S 30,000 0 Y N Clinical notes Clinical photograph 5
reconstructive cartilage / Prosthesis and Clinical of donor and
Surgery) (including the cost of prosthesis / photograph in recipient sites, Intra
implants)–Ear Pinna Reconstruction case of injury, If operative clinical
with costal cartilage / Prosthesis traumatic then photograph Invoice
(including the cost of prosthesis / MLC/FIR of Prosthesis/
implants) report. Implant used.
Documents Detailed discharge
supporting if summary
indication is non
traumatic.
1255 SP (Plastic & Scalp avulsion reconstruction–Scalp SP005A S 50,000 0 Y N Clinical notes Intra procedure 5
reconstructive avulsion reconstruction detailing how clinical photograph
Surgery) avulsion and Post procedure
occurred; clinical photograph,
Clinical Detailed Procedure
Photograph, / Operative Notes,
MLC copy with detailed discharge
number since summary
traumatic
1256 SP (Plastic & Tissue Expander for disfigurement SP006A S 50,000 0 Y N Detailed Clinical Detailed discharge 5
reconstructive following burns / trauma / congenital notes of original summary, Detailed
Surgery) deformity clinical event Procedure /
(including cost of expander / having led to Operative Notes,
implant)–Tissue Expander for disfigurement Post procedure
disfigurement following burns or confirming clinical photograph,
details / Invoice of
invetsigations of expander/Implant
congenital used
event; Clinical
Photograph,
1257 SP (Plastic & Tissue Expander for disfigurement SP006B S 50,000 0 Y N Detailed Clinical Detailed discharge 5
disfigurement following trauma or confirming clinical photograph,
details / Invoice of
congenital used
event; Clinical
Photograph,
1258 SP (Plastic & Tissue Expander for disfigurement SP006C S 50,000 0 Y N Detailed Clinical Detailed discharge 5
disfigurement following congenital or confirming clinical photograph,
deformity details / Invoice of
congenital used
event; Clinical
Photograph,
1259 SP (Plastic & Hemangioma–Sclerotherapy under SP007A S 35,000 0 Y N Clinical notes Post procedure 3
reconstructive GA and Clinical clinical photograph,
Surgery) Photograph Invoice of sclerosing
agent used.
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1260 SP (Plastic & Hemangioma–Debulking SP007B S 35,000 0 Y N Clinical notes Post procedure 4
reconstructive and Clinical clinical photograph,
agent used.
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1261 SP (Plastic & Hemangioma–Excision SP007C S 35,000 0 Y N Clinical notes Post procedure 4
reconstructive and Clinical clinical photograph,
agent used.
Detailed discharge
summary, Detailed
Procedure /
Operative Notes.
1262 SP (Plastic & NPWT–NPWT SP008A M 2,000 0 Y N Clinical notes Post procedure 3
reconstructive detailing events clinical photograph
Surgery) that led to with tube and pump;
chronic/ non detailed discharge
healing woulds; summary, Detailed
photograph Operative Notes,
1263 SS (Paediatric Cleft Lip and Palate Surgery (per SS001A S 15,000 0 Y N Clinical notes Detailed discharge 3
Surgery) stage)–Cleft Lip and Palate Surgery and Clinical summary, detailed
(per stage) Photograph Procedure /
Operative Notes,
Post procedure
clinical photograph
1264 SS (Paediatric Ankyloglossia–Ankyloglossia Minor SS002A S 5,000 0 N N Clinical notes Detailed discharge Daycare
Surgery) and pre-op summary, detailed
photograph Procedure /
Operative Notes,
post procedure
clinical photograph
1265 SS (Paediatric Ankyloglossia–Ankyloglossia Major SS002B S 15,000 0 N N Clinical notes Detailed discharge 3
Surgery) and pre-op summary, detailed
photograph Procedure /
Operative Notes,
post procedure
clinical photograph
1266 SS (Paediatric Anti GERD Surgery–Anti GERD SS003A S 10,000 0 N N Clinical notes Intra procedure 2
Surgery) Surgery and UGI clinical photograph,
Endoscopy detailed Procedure /
report Operative Notes,
detailed discharge
summary
1267 SS (Paediatric Gastrostomy + Esophagoscopy + SS004A S 20,000 0 N N USG/CT Abd, detailed Procedure / 5
Surgery) Threading–Gastrostomy + Endoscopy, Operative Notes,
Esophagoscopy + Threading Biopsy Post procedure
clinical photograph
1268 SS (Paediatric Ladds Procedure–Ladds Procedure SS005A S 30,000 0 N N X Ray/ CT Scan Histopathology, 7
Surgery) Abdomen/ UGI detailed Procedure /
contrast study Operative Notes,
confirming the Post procedure
malrotation clinical photograph
of the operated
region
1269 SS (Paediatric Duplication Cyst Excision–Duplication SS006A S 20,000 0 N N Clinical notes Histopathology, 5
Surgery) Cyst Excision and USG/CT detailed Procedure /
Abd, +/- Operative Notes,
Endoscopic Intra procedure
USG clinical photograph,
detailed discharge
summary
1270 SS (Paediatric Intussusception–Non – Operative SS007A S 20,000 0 N N Clinical notes Detailed Procedure 3
Surgery) Reduction in infants and stills of: X- / Operative Notes,,
ray Detailed discharge
Abdomen/USG summary , Post
Abdomen procedure X Ray
Abdomen.
1271 SS (Paediatric Intussusception–Operative in infants SS007B S 25,000 0 N N Clinical notes Detailed Procedure 5
Surgery) and stills of: X-
/ Operative Notes,,
ray Detailed discharge
Abdomen/USG summary , Post
Abdomen procedure X Ray
Abdomen.
1272 SS (Paediatric Surgery for Hirschsprung’s SS008A S 25,000 0 N N Clinical notes Histopathology, 5
Surgery) Disease–Myectomy and USG/ Dye detailed Procedure /
test Operative Notes,
detailed discharge
summary
1273 SS (Paediatric Surgery for Hirschsprung’s SS008B S 20,000 0 N N Clinical notes Histopathology, 5
Surgery) Disease–Pull Through and USG/ Dye detailed Procedure /
detailed discharge
summary
1274 SS (Paediatric Surgery for Hirschsprung’s SS008C S 10,000 0 N N Clinical notes Histopathology, Daycare
Surgery) Disease–Rectal Biopsy - Punch and USG/ Dye detailed Procedure /
detailed discharge
summary
1275 SS (Paediatric Surgery for Hirschsprung’s SS008D S 10,000 0 N N Clinical notes Histopathology, 2
Surgery) Disease–Rectal Biopsy – Open and USG/ Dye detailed Procedure /
detailed discharge
summary
1276 SS (Paediatric Surgery for Hirschsprung’s SS008E S 15,000 0 N N Clinical notes Histopathology, 3
Surgery) Disease–Sphinecterotomy and USG/ Dye detailed Procedure /
detailed discharge
summary
1277 SS (Paediatric Rectal Polypectomy - Sigmoiescopic SS009A S 8,000 0 N N Clinical notes Histopathology, 2
Surgery) Under GA–Rectal Polypectomy - and detailed Procedure /
Sigmoiescopic Under GA sigmoidoscopy Operative Notes,
confirming Intra procedure
polyp clinical photograph
1278 SS (Paediatric Ano Rectal Malformation–Abd - SS010A S 20,000 0 N N Clinical notes detailed Procedure / 5
Surgery) Perineal PSARP and Clinical Operative Notes,
Photograph, Post procedure
Distal clinical
Cologram/ CT, photograph,
USG Abdomen, detailed discharge
Xray summary
Lumbosacral
spine (inverted
position)
1279 SS (Paediatric Ano Rectal Malformation–Anoplasty SS010B S 20,000 0 N N Clinical notes detailed Procedure / 5
Surgery) and Clinical Operative Notes,
Distal clinical
Xray summary
Lumbosacral
spine (inverted
position)
1280 SS (Paediatric Ano Rectal Malformation–Cutback SS010C S 20,000 0 N N Clinical notes detailed Procedure / 5
Distal clinical
Xray summary
Lumbosacral
spine (inverted
position)
1281 SS (Paediatric Ano Rectal Malformation–PSARP SS010D S 20,000 0 N N Clinical notes detailed Procedure / 5
Distal clinical
Xray summary
Lumbosacral
spine (inverted
position)
1282 SS (Paediatric Ano Rectal Malformation–Redo - SS010E S 15,000 0 N N Clinical notes detailed Procedure / 5
Surgery) Pullthrough and Clinical Operative Notes,
Distal clinical
Xray summary
Lumbosacral
spine (inverted
position)
1283 SS (Paediatric Ano Rectal SS010F S 15,000 0 N N Clinical notes detailed Procedure / 5
Surgery) Malformation–Transposition and Clinical Operative Notes,
Distal clinical
Xray summary
Lumbosacral
spine (inverted
position)
1284 SS (Paediatric Fecal Fistula Closure–Fecal Fistula SS011A S 25,000 0 N N Clinical notes Intra procedure 3
Surgery) Closure and USG / CT clinical photograph,
abdomen and detailed Procedure /
pelvis Operative Notes,
delineating Detailed discharge
fistula tract. summary
1285 SS (Paediatric GI Tumor Excision–GI Tumor SS012A S 30,000 0 N N Clinical notes HPR, detailed 7
Surgery) Excision and USG/ CT / Procedure /
biopsy Operative Notes,
Intra procedure
Detailed Procedure
/ Operative Notes,
detailed discharge
summary
1286 SS (Paediatric Congenital Diaphragmatic SS013A S 25,000 0 N N Clinical notes Detailed Procedure 5
Surgery) Hernia–Congenital Diaphragmatic and Chest X- / Operative Notes,
Hernia ray AP/Lat, detailed discharge
USG/CT scan summary, Foetal
stills Cardiogram, Xray
Chest AP/Lat stills
1287 SS (Paediatric Exomphalos / SS014A S 25,000 0 N N Clinical notes Detailed discharge 5
Surgery) Gastroschisis–Exomphalos and Clinical summary, detailed
Photograph Procedure /
Operative Notes,
Post procedure
clinical photograph
1288 SS (Paediatric Exomphalos / SS014B S 25,000 0 N N Clinical notes Detailed discharge 5
Surgery) Gastroschisis–Gastroschisis and Clinical summary, detailed
Photograph Procedure /
Operative Notes,
Post procedure
clinical photograph
1289 SS (Paediatric Hernia & Hydrocele–Hernia & SS015A S 20,000 0 N N Clinical notes detailed Procedure / 5
Surgery) Hydrocele and USG, Operative Notes,
Photograph clinical
photograph showing
scar, detailed
Procedure /
Operative Notes,
1290 SS (Paediatric Retro - Peritoneal Lymphangioma SS016A S 25,000 0 N N Clinical notes Histopathology, 5
Surgery) Excision–Retro - Peritoneal and USG/MRI detailed Procedure /
Lymphangioma Excision Abd Operative Notes,
Intra procedure
Detailed discharge
summary
1291 SS (Paediatric Surgery for Sacrococcygeal SS017A S 20,000 0 N N Clinical notes Histopathology, 5
Surgery) Teratoma–Surgery for and CT/MRI detailed Procedure /
Sacrococcygeal Teratoma confirming the Operative Notes,
diagnosis, Post procedure
Biopsy clinical photograph
showing scar
1292 SS (Paediatric Surgery for Congenital Lobar SS018A S 25,000 0 N N Clinical notes detailed Procedure / 7
Surgery) Emphysema–Surgery for Congenital and X Ray/CT Operative Notes,
Lobar Emphysema Scan stills Post procedure X-
confirming the ray stills, detailed
1293 SS (Paediatric Undescended Testis–Bilateral - SS019A S 15,000 0 N N Clinical notes detailed Procedure / 4
Surgery) Palpable + Nonpalpable and USG, Operative Notes,
Photograph clinical
photograph showing
scar, detailed
Procedure /
Operative Notes,
1294 SS (Paediatric Undescended Testis–Bilateral SS019B S 15,000 0 N N Clinical notes detailed Procedure / 4
Surgery) Palpable and USG, Operative Notes,
Photograph clinical
photograph showing
scar, detailed
Procedure /
Operative Notes,
Detailed Discharge
summary
1295 SS (Paediatric Undescended Testis–Bilateral Non - SS019C S 20,000 0 N N Clinical notes detailed Procedure / 4
Photograph clinical
photograph showing
scar, detailed
Procedure /
Operative Notes,
Detailed Discharge
summary
1296 SS (Paediatric Undescended Testis–Unilateral - SS019D S 15,000 0 N N Clinical notes detailed Procedure / 4
Photograph clinical
photograph showing
scar, detailed
Procedure /
Operative Notes,
Detailed Discharge
summary
1297 SS (Paediatric Undescended Testis–Reexploration / SS019E S 20,000 0 N N Clinical notes detailed Procedure / 4
Surgery) Second Stage and USG, Operative Notes,
Photograph clinical
photograph showing
scar, detailed
Procedure /
Operative Notes,
1298 ST (Polytrauma) Conservative Management of Head ST001A S 1,000 0 Y N Clinical notes Discharge summary 10
Injury–Severe with planned
line of
treatment
1299 ST (Polytrauma) Conservative Management of Head ST001B S 5,000 0 N N Clinical notes Discharge summary 10
Injury–Depressed Fracture with planned
line of
treatment
including
planned line of
treatment, X-
ray films with
reports
1300 ST (Polytrauma) Head injury with repair of Facio- ST002A S 35,000 0 N N Clinical notes Post- op Clinical 10
Maxillary Injury & fixations (including detailing the Photograph
implants)–Head injury with repair of injury and need showing implant for
Facio-Maxillary Injury & fixations of surgery. fixation and repairs;
(including implants) MLC/ FIR with detailed discharge
X-ray/ CT; pre- summary, Detailed
op clinical operatives notes
photograph
1301 ST (Polytrauma) Craniotomy and evacuation of ST003A S 60,000 0 N N Clinical notes Post- op Clinical 10
Haematoma with fixation of fracture of detailing the Photograph & X-
long bone–Subdural hematoma along injury and need rays showing
with fixation of fracture of single long of surgery. craniotomy
bone MLC/ FIR with evidence and
X-ray/ CT/ MRI implant for fixation;
(of both head & detailed discharge
affected long summary, Detailed
bone) operatives notes
1302 ST (Polytrauma) Craniotomy and evacuation of ST003B S 60,000 0 N N Clinical notes Post- op Clinical 10
long bone–Extradural hematoma injury and need rays showing
along with fixation of fracture of single of surgery. craniotomy
long bone MLC/ FIR with evidence and
1303 ST (Polytrauma) Craniotomy and evacuation of ST003C S 75,000 0 N N Clinical notes Post- op Clinical 10
long bone–Subdural hematoma along injury and need rays showing
with fixation of fracture of 2 or more of surgery. craniotomy
long bone. MLC/ FIR with evidence and
1304 ST (Polytrauma) Craniotomy and evacuation of ST003D S 75,000 0 N N Clinical notes Post- op Clinical 10
long bone–Extradural hematoma injury and need rays showing
along with fixation of fracture of 2 or of surgery. craniotomy
more long bone. MLC/ FIR with evidence and
1305 ST (Polytrauma) Management of Chest injury with ST004A S 35,000 0 N N Clinical notes Intra- op Clinical 5
fracture of Long bone–Management detailing the Photograph & X-
of Chest injury with fixation of Single injury and need rays showing chest
Long bone of surgery. injury repair and
MLC/ FIR with implant for fixation;
X-ray/ CT/ MRI detailed discharge
(of both chest & summary, Detailed
affected long operatives notes
bone)
1306 ST (Polytrauma) Management of Chest injury with ST004B S 45,000 0 N N Clinical notes Intra- op Clinical 5
fracture of Long bone–Management detailing the Photograph & X-
of Chest injury with fixation of 2 or injury and need rays showing chest
more Long bones of surgery. injury repair and
MLC/ FIR with implant for fixation;
X-ray/ CT/ MRI detailed discharge
(of both chest & summary, Detailed
affected long operatives notes
bone)
1307 ST (Polytrauma) Management of Visceral injury and ST005A S 30,000 0 N N Clinical notes Intra- op Clinical 10
fracture long bone–Surgical detailing the Photograph & X-
intervention for Visceral injury and injury and need rays showing
fixation of fracture of single long bone of surgery. visceral injury repair
MLC/ FIR with and implant for
X-ray/ CT/ MRI fixation; detailed
(of both discharge summary,
affected viscera Detailed operatives
& affected long notes
bone)
1308 ST (Polytrauma) Management of Visceral injury and ST005B S 45,000 0 N N Clinical notes Intra- op Clinical 10
fracture long bone–Surgical detailing the Photograph & X-
intervention for Visceral injury and injury and need rays showing
fixation of fracture of 2 or more long of surgery. visceral injury repair
bones MLC/ FIR with and implant for
X-ray/ CT/ MRI fixation; detailed
(of both discharge summary,
affected viscera Detailed operatives
& affected long notes
bone)
1309 ST (Polytrauma) Internal fixation of Pelviacetabular ST006A S 40,000 0 N N Clinical notes Post- op Clinical 10
fracture–Internal fixation of detailing the Photograph showing
Pelviacetabular fracture injury and need implant for fixation;
of surgery. detailed discharge
MLC/ FIR with summary, Detailed
X-ray/ CT; operatives notes
1310 ST (Polytrauma) Internal fixation with Flap cover ST007A S 40,000 0 N N Clinical notes Post- op Clinical 10
Surgery for wound in compound and PRE OP Photograph showing
fracture–Internal fixation with Flap CLINICAL implant for fixation
cover Surgery for wound in compound PICTURE and flap cover;
fracture +/- X-RAY/CT detailed discharge
summary, Detailed
operatives notes
1311 ST (Polytrauma) Emergency tendons repair ± ST008A S 30,000 0 N N Clinical notes Intra- op Clinical 10
Peripheral Nerve repair/ with planned Photograph
reconstructive surgery–Emergency line of showing tendon/
tendons repair ± Peripheral Nerve treatment nerve injury repair
repair/ reconstructive surgery detailing the and reconstruction;
injury and need detailed discharge
of surgery. summary, Detailed
MLC/ FIR with operatives notes
X-ray/ CT/ MRI
(of both chest &
affected long
bone)
1312 ST (Polytrauma) Management of Nerve Plexus / ST009A S 50,000 0 N N Clinical notes Intra operative still 10
Tendon injuries–Nerve Plexus injury detailing the photograph,
repair injury and need detailed discharge
MLC/ FIR +/- operatives notes
Nerve
conduction
velocity (NCV)
+/- MRI + /-
EMG(Electromy
ography)
1313 ST (Polytrauma) Management of Nerve Plexus / ST009B S 50,000 0 N N Clinical notes Intra operative still 10
Tendon injuries–Nerve Plexus injury detailing the photograph,
reconstruction injury and need detailed discharge
Nerve
conduction
velocity (NCV)
+/- MRI + /-
EMG(Electromy
ography)
1314 ST (Polytrauma) Management of Nerve Plexus / ST009C S 50,000 0 N N Clinical notes Intra operative still 10
Tendon injuries–Tendon injury repair detailing the photograph,
Nerve
conduction
velocity (NCV)
+/- MRI + /-
EMG(Electromy
ography)
1315 ST (Polytrauma) Management of Nerve Plexus / ST009D S 50,000 0 N N Clinical notes Intra operative still 10
Tendon injuries–Tendon injury detailing the photograph,
reconstruction injury and need detailed discharge
Nerve
conduction
velocity (NCV)
+/- MRI + /-
EMG(Electromy
ography)
1316 ST (Polytrauma) Management of Nerve Plexus / ST009E S 50,000 0 N N Clinical notes Intra operative still 10
Tendon injuries–Tendon Transfer detailing the photograph,
Nerve
conduction
velocity (NCV)
+/- MRI + /-
EMG(Electromy
ography)
1317 ST (Polytrauma) Plexus injury along with Vascular ST010A S 60,000 0 N N Clinical notes Intra operative still 10
injury repair / graft–Plexus injury along detailing the photograph,
with Vascular injury repair injury and need detailed discharge
Nerve
conduction
velocity (NCV)
+ /- MRI + /-
MRA + /- EMG
(Electromyogra
phy)
1318 ST (Polytrauma) Plexus injury along with Vascular ST010B S 60,000 0 N N Clinical notes Intra operative still 10
injury repair / graft–Plexus injury along detailing the photograph,
with Vascular injury graft injury and need detailed discharge
Nerve
conduction
velocity (NCV)
+ /- MRI + /-
MRA + /- EMG
(Electromyogra
phy)
1319 SU (Urology) Adrenalectomy–Open SU001A S 27,500 0 N N Clinical notes Histopathology, 5
confirming Detailed discharge
diagnosis with summary detailed
Evidence of Procedure /
/CT/MRI +/- Operative Notes
FNAC/Biopsy,
Sr. Cortisol, Sr.
electrolytes, 24
hr urinary
catacholamine
level / sr. or
urinary
metanephrine
normetanephrin
e, MIBG Scan/
DOTONOC
scan
1320 SU (Urology) Adrenalectomy–Lap. SU001B S 27,500 0 N N Clinical notes Histopathology, 4

confirming Detailed discharge
diagnosis with summary detailed
Evidence of Procedure /
/CT/MRI +/- Operative Notes
FNAC/Biopsy,
Sr. Cortisol, Sr.
electrolytes, 24
hr urinary
catacholamine
level / sr. or
urinary
metanephrine
normetanephrin
e, MIBG Scan/
DOTONOC
scan
1321 SU (Urology) Renal Cyst deroofing or SU002A S 25,000 0 Y N Clinical notes Intra procedure still 2
Marsupialization–Open and USG/CT photograph;
scan confirming detailed discharge
the renal cyst summary; detailed
and justification Procedure /
of the surgery Operative Notes
1322 SU (Urology) Renal Cyst deroofing or SU002B S 25,000 0 Y N Clinical notes Intra procedure still 2
Marsupialization–Lap. and USG/CT photograph;
scan confirming detailed discharge
the renal cyst summary; detailed
and justification Procedure /
of the surgery Operative Notes
1323 SU (Urology) Nephrectomy–For Benign pathology - SU003A S 27,500 0 N N Clinical notes Histopathology, 4
Open and USG/CT Intra operative
confirming the photograph.
need for Detailed discharge
surgery +/- summary, detailed
FNAC/Biopsy, Procedure /
Operative Notes
1324 SU (Urology) Nephrectomy–For Benign pathology - SU003B S 27,500 0 N N Clinical notes Histopathology, 3
Lap. and USG/CT Intra operative
surgery +/- summary, detailed
FNAC/Biopsy, Procedure /
Operative Notes
1325 SU (Urology) Nephrectomy–Radical (Renal tumor) - SU003C S 27,500 0 N N Clinical notes Histopathology, 4
Open and CT/MRI Intra operative
confirming the photograph/ Post
need for procedure X-ray.
surgery +/- Detailed discharge
FNAC/Biopsy, summary, detailed
Procedure /
Operative Notes
1326 SU (Urology) Nephrectomy–Radical (Renal tumor) - SU003D S 27,500 0 N N Clinical notes Histopathology, 3
Lap. and CT/MRI Intra operative
confirming the photograph/ Post
need for procedure X-ray.
surgery +/- Detailed discharge
FNAC/Biopsy, summary, detailed
Procedure /
Operative Notes
1327 SU (Urology) Nephrectomy - Partial or Hemi–Open SU004A S 42,000 0 N N Clinical notes Histopathology, 4
and CT/MRI Intra operative
Procedure /
Operative Notes
1328 SU (Urology) Nephrectomy - Partial or Hemi–Lap. SU004B S 42,000 0 N N Clinical notes Histopathology, 3
and CT/MRI Intra operative
Procedure /
Operative Notes
1329 SU (Urology) Nephrolithotomy–Open SU005A S 30,000 0 Y N Clinical notes Post procedure 4
and IVP / Imaging (X
NCCT+ CT-IVP Ray/USG), showing
confirming the stone removed;
indication Detailed discharge
summary, detailed
Procedure /
Operative Notes
1330 SU (Urology) Nephrolithotomy–Anatrophic SU005B S 30,000 0 Y N Clinical notes Post procedure 4

summary, detailed
Procedure /
Operative Notes
1331 SU (Urology) Open Nephrolithotomy - Follow SU006A S 1,000 0 Y N Earlier USG / Urine NA
Up–Open Nephrolithotomy - Follow Discharge Routine, Drugs
Up Summary
1332 SU (Urology) PCNL (Percutaneous SU007A S 35,000 0 Y N Clinical notes Intra operative 2
Nephrolithotomy)–PCNL and IVP / photograph.
(Percutaneous Nephrolithotomy) NCCT+ CT-IVP Detailed discharge
confirming the summary, detailed
indication and Procedure /
need for PCNL Operative Notes;
Post procedure
Imaging (X
Ray/USG),
1333 SU (Urology) Nephrostomy - Percutaneous SU008A S 14,000 0 Y N Clinical notes Intra procedure Daycare
ultrasound guided–Nephrostomy - and USG clinical photograph,
Percutaneous ultrasound guided confirming the detailed discharge
indication and summary, detailed
need of Procedure /
procedure. Operative Notes
1334 SU (Urology) Nephrostomy (PCN) - Follow SU009A S 1,200 0 Y N Earlier USG / X-RAY KUB NA
Up–Nephrostomy (PCN) - Follow Up Discharge
Summary
1335 SU (Urology) Nephro ureterectomy (Benign)–Open SU010A S 27,500 0 N N Clinical notes Histopathology, 4
and CT/ CT- Intra operative
IVP/MRI photograph.
need for summary, detailed
surgery, Procedure /
Operative Notes
1336 SU (Urology) Nephro ureterectomy (Benign)–Lap. SU010B S 27,500 0 N N Clinical notes Histopathology, 3
and /CT/ CT- Intra operative
IVP/MRI photograph.
need for summary, detailed
surgery, Procedure /
Operative Notes
1337 SU (Urology) Nephro ureterectomy with cuff of SU011A S 27,500 0 Y N Clinical notes Histopathology, 4
bladder–Open and CT/ CT- Intra operative
IVP/MRI/MRI photograph.
Urogram Detailed discharge
need for Procedure /
surgery, Operative Notes
1338 SU (Urology) Nephro ureterectomy with cuff of SU011B S 27,500 0 Y N Clinical notes Histopathology, 3
bladder–Lap. and CT/ CT- Intra operative
IVP/MRI/MRI photograph.
Urogram Detailed discharge
need for Procedure /
surgery, Operative Notes
1339 SU (Urology) Perinephric Abscess drainage–Open SU013A S 14,000 0 Y N Clinical notes Intra procedure still 2
and USG/CT photograph;
diagnosis of summary; detailed
perinephric Procedure /
abscess. Operative Notes
1340 SU (Urology) Perinephric Abscess SU013B S 14,000 0 Y N Clinical notes Intra procedure still 2
drainage–Percutaneous and USG/CT photograph;
diagnosis of summary; detailed
perinephric Procedure /
abscess. Operative Notes
1341 SU (Urology) Ureteroscopy + Stone removal with SU014A S 28,000 0 Y N Clinical notes Detailed discharge Daycare
lithotripsy–Lower Ureter and IVP / summary, Post
NCCT+ CT-IVP procedure Imaging
confirming the (X Ray/USG),
indication showing stone
removed detailed
Procedure /
Operative Notes
1342 SU (Urology) Ureteroscopy + Stone removal with SU014B S 28,000 0 Y N Clinical notes Detailed discharge Daycare
lithotripsy–Upper Ureter and IVP / summary, Post
removed detailed
Procedure /
Operative Notes
1343 SU (Urology) URSL / URSL - Laser - Follow SU015A S 1,000 0 Y N Earlier USG / Urine NA
Up–URSL / URSL - Laser - Follow Up Discharge Routine, Drugs
Summary
1344 SU (Urology) Extracoporeal shock - wave SU016A S 18,700 0 Y N Clinical notes Intra operative Daycare
Lithotripsy (ESWL)–Extracoporeal and IVP / photograph.
shock - wave Lithotripsy (ESWL) NCCT+ CT-IVP Detailed discharge
stone, with or without stent (one side) confirming the summary, detailed
need for ESWL, Operative Notes;
Is EHCP
registered for
ESWL?
1345 SU (Urology) ESWL - Follow Up–ESWL - Follow Up SU017A S 1,000 0 Y N Earlier USG / X-RAY KUB NA
Discharge
Summary
1346 SU (Urology) Ureterolithotomy–Open SU018A S 20,000 0 Y N Clinical notes Detailed discharge 3
and IVP / summary, detailed
NCCT+ CT-IVP Procedure /
confirming the Operative
indication Notes,Post
procedure Imaging
(X Ray/USG),
showing stone
removed
1347 SU (Urology) Ureterolithotomy–Lap. SU018B S 20,000 0 Y N Clinical notes Detailed discharge 2
and IVP / summary, Post
removed detailed
Procedure /
Operative Notes
1348 SU (Urology) Lap Ureterolithotomy - Follow Up–Lap SU019A S 1,000 0 Y N Earlier USG / Urine NA
Ureterolithotomy - Follow Up Discharge Routine, Drugs
Summary
1349 SU (Urology) Open Ureterolithotomy - Follow SU020A S 1,000 0 Y N Earlier USG / Urine NA
Up–Open Ureterolithotomy - Follow Discharge Routine, Drugs
Up Summary
1350 SU (Urology) Pyeloplasty / Pyeloureterostomy / SU021A S 27,500 0 Y N Clinical notes Intra operative 3
Pyelopyelostomy–Pyeloplasty - Open and IVP/CT/ CT- photograph.
IVP,+/-DTPA Detailed discharge
renal scan, summary, detailed
confirming Procedure /
indication and Operative Notes
the need for
surgery
1351 SU (Urology) Pyeloplasty / Pyeloureterostomy / SU021B S 27,500 0 Y N Clinical notes Intra operative 2
Pyelopyelostomy–Pyeloplasty - and IVP/CT/ CT- photograph.
Laparoscopic IVP,+/-DTPA Detailed discharge
the need for
surgery
1352 SU (Urology) Pyeloplasty / Pyeloureterostomy / SU021C S 27,500 0 Y N Clinical notes Intra operative 3
Pyelopyelostomy–Pyeloureterostomy - and IVP/CT/ CT- photograph.
Open IVP,+/-DTPA Detailed discharge
the need for
surgery
1353 SU (Urology) Pyeloplasty / Pyeloureterostomy / SU021D S 27,500 0 Y N Clinical notes Intra operative 2
Pyelopyelostomy–Pyeloureterostomy - and IVP/CT/ CT- photograph.
the need for
surgery
1354 SU (Urology) Pyeloplasty / Pyeloureterostomy / SU021E S 27,500 0 Y N Clinical notes Intra operative 3
Pyelopyelostomy–Pyelopyelostomy - and IVP/CT/ CT- photograph.
Open IVP,+/-DTPA Detailed discharge
the need for
surgery
1355 SU (Urology) Pyeloplasty / Pyeloureterostomy / SU021F S 27,500 0 Y N Clinical notes Intra operative 2
Pyelopyelostomy–Pyelopyelostomy - and IVP/CT/ CT- photograph.
the need for
surgery
1356 SU (Urology) Pyeloplasty–Pyeloplasty - Follow Up SU022A S 1,500 0 Y N Earlier USG / UFM / Urine NA
Discharge Routine
Summary
1357 SU (Urology) Ureterocalycostomy–Ureterocalycosto SU023A S 25,000 0 Y N Clinical notes Intra operative 4
my - Open and IVP/CT/ CT- photograph.
renal scan summary, detailed
Procedure /
Operative Notes
1358 SU (Urology) Ureterocalycostomy–Ureterocalycosto SU023B S 25,000 0 Y N Clinical notes Intra operative 3
my - Laparoscopic and IVP/CT/ CT- photograph.
Procedure /
Operative Notes
1359 SU (Urology) Pyelolithotomy–Open SU024A S 28,000 0 Y N Clinical notes Post procedure 3
summary, detailed
Procedure /
Operative Notes
1360 SU (Urology) Pyelolithotomy–Lap. SU024B S 28,000 0 Y N Clinical notes Post procedure 2

summary, detailed
Procedure /
Operative Notes
1361 SU (Urology) Internal Ureterotomy including SU025A S 10,000 0 Y N Clinical notes Endoscopic Intra Daycare
cystoscopy as an independent and procedure still
procedure–Internal Ureterotomy Investigation photograph,
including cystoscopy as an reports detailed discharge
independent procedure confirming summary, Detailed
urethral Procedure /
stricture Operative Notes
(RGU+/- MCU)
1362 SU (Urology) Ureterolysis for retroperitoneal fibrosis SU026A S 28,000 0 Y N Clinical notes Intra procedure still 3
(with or without omental and CT-IVP/ photograph,Detailed
wrapping)–Open MRI Urogram discharge summary,
diagnosis for Operative Notes
which the including details of
surgery is done, omental wrapping if
done
1363 SU (Urology) Ureterolysis for retroperitoneal fibrosis SU026B S 28,000 0 Y N Clinical notes Intra procedure still 2
(with or without omental and CT-IVP/ photograph,Detailed
wrapping)–Lap. MRI Urogram discharge summary,
diagnosis for Operative Notes
which the including details of
surgery is done, omental wrapping if
done
1364 SU (Urology) Ureterostomy–Ureterostomy SU027A S 20,000 0 Y N Clinical notes Post Procedure 2

(Cutaneous) and CT/MRI Clinical Photograph
confirming the stoma, Detailed
diagnosis for discharge summary,
ureterostomy detailed Procedure /
and need for Operative Notes
creating a
stoma for ureter
1365 SU (Urology) Uretero-ureterostomy–Open SU028A S 25,000 0 Y N Clinical notes Intra operative 3

and IVP/CT/ CT- photograph.
Procedure /
Operative Notes
1366 SU (Urology) Uretero-ureterostomy–Lap. SU028B S 25,000 0 Y N Clinical notes Intra operative 3
and IVP/CT/ CT- photograph.
Procedure /
Operative Notes
1367 SU (Urology) Uretero-vaginal / Uterine fistula SU029A S 25,000 0 Y N Clinical notes Intra procedure still 3
repair–Uretero - vaginal fistula repair - and IVP/ CT- photograph,Detailed
Open IVP + discharge summary,
cystoscopy and detailed Procedure /
vaginoscopy Operative Notes
Scopy
confirming the
diagnosis for
which the
surgery is done,
1368 SU (Urology) Uretero-vaginal / Uterine fistula SU029B S 25,000 0 Y N Clinical notes Intra procedure still 3
repair–Uretero - Uterine fistula repair - and IVP/ CT- photograph,Detailed
Open IVP + discharge summary,
Scopy
confirming the
diagnosis for
which the
surgery is done,
1369 SU (Urology) Uretero-vaginal / Uterine fistula SU029C S 25,000 0 Y N Clinical notes Intra procedure still 2
repair–Uretero - vaginal fistula repair - and IVP/ CT- photograph,Detailed
Laparoscopic IVP + discharge summary,
Scopy
confirming the
diagnosis for
which the
surgery is done,
1370 SU (Urology) Uretero-vaginal / Uterine fistula SU029D S 25,000 0 Y N Clinical notes Intra procedure still 2
repair–Uretero - Uterine fistula repair - and IVP/ CT- photograph,Detailed
Laparoscopic IVP + discharge summary,
Scopy
confirming the
diagnosis for
which the
surgery is done,
1371 SU (Urology) Ureteric reimplantation–Open SU030A S 23,000 0 Y N Clinical notes Intra procedure 3
and and CT- clinical
IVP/MRI photograph,Detailed
Urogram + discharge summary,
MCU detailed Procedure /
confirming Operative Notes
reflux and need
of surgery.
1372 SU (Urology) Ureteric reimplantation–Lap. SU030B S 23,000 0 Y N Clinical notes Intra procedure still 2
and and CT- photograph,Detailed
IVP/MRI discharge summary,
Urogram + detailed Procedure /
MCU Operative Notes
confirming
reflux and need
of surgery.
1373 SU (Urology) Boari flap for ureteric stricture–Open SU031A S 30,000 0 Y N Clinical notes Intra procedure still 3
and IVP/CT- photograph,Detailed
IVP+/-MCU discharge summary,
stricture longer Operative Notes
than 5 cms for including details of
which the omental wrapping if
surgery is done done
1374 SU (Urology) Boari flap for ureteric stricture–Lap. SU031B S 30,000 0 Y N Clinical notes Intra procedure still 2
and IVP/CT- photograph,Detailed
IVP+/-MCU discharge summary,
1375 SU (Urology) Ileal replacement for ureteric SU032A S 46,000 0 Y N Clinical notes Intra procedure still 4
stricture–Ileal replacement for ureteric and IVP/CT- photograph,Detailed
stricture IVP+/-MCU discharge summary,
1376 SU (Urology) DJ stenting including cystoscopy, SU033A S 10,000 0 Y N Clinical notes Post Procedure x- Daycare
ureteric catheterization, retrograde and CT-IVP/ ray showing stent;
pyelogram–DJ stenting including IVP confirming detailed Procedure /
cystoscopy, ureteric catheterization, the diagnosis Operative Notes
retrograde pyelogram and the need of detailing findings of
this surgery is cystoscopy/
done Retrogradepyelogra
m and ureteric
catheterization;
detailed discharge
summary.
1377 SU (Urology) DJ Stent Removal–DJ Stent Removal SU034A S 5,000 0 Y N Clinical notes discharge summary Daycare
with planned
line of
treatment
including
planned line of
treatment, X-
ray films with
reports,
Discharge
Summary of DJ
Stenting
1378 SU (Urology) Ureterocele incision including SU035A S 15,000 0 Y N Clinical notes Evidence of Daycare
cystoscopy, ureteric catheterization, and IVP/CT-IVP cystoscopy, ureteric
retrograde pyelogram–Ureterocele confirming the catheterization,
incision including cystoscopy, ureteric diagnosis for retrograde
catheterization, retrograde pyelogram which the pyelogram; Detailed
surgery is done, discharge summary,
Operative Notes
1379 SU (Urology) Ureteric sampling including SU036A S 11,000 0 Y N Clinical notes Evidence of Daycare
cystoscopy, ureteric catheterization, and Reports of cystoscopy, ureteric
retrograde pyelogram–Ureteric all previous catheterization,
sampling including cystoscopy, work up done retrograde
ureteric catheterization, retrograde (Xray/USG/CT pyelogram and the
pyelogram Scan), clinical diagnosis arrived at;
diagnosis Detailed discharge
suspected for summary, detailed
this procedure. Procedure /
Operative Notes
1380 SU (Urology) Acute management of upper urinary SU037A S 2,000 0 Y N Clinical notes Reports of all 5
tract trauma – detailing the investigations done
conservative–Acute management of case history, and consultation
upper urinary tract trauma – circumstances paper of treating
conservative that led to doctor mentioning
trauma, the final diagnosis
presenting and line of
complaints, treatment, Detailed
local discharge summary;
examination
findings,
injuries
sustained as
result of
trauma,
USG/CT
Abdomen
1381 SU (Urology) Endopyelotomy–Retrograde with laser SU038A S 25,000 0 Y N Clinical notes Intra operative Daycare
/ bugbee and IVP/CT/ CT- photograph.
renal scan, is summary, detailed
the hospital Procedure /
equipped with Operative Notes. If
Laser? bugbee electrode is
billed, insist on
invoice/ barcode.
1382 SU (Urology) Endopyelotomy–Antegrade with laser SU038B S 25,000 0 Y N Clinical notes Intra operative 2
/ bugbee and IVP/CT/ CT- photograph.
renal scan, is summary, detailed
the hospital Procedure /
equipped with Operative Notes. If
Laser? bugbee electrode is
billed, insist on
invoice/ barcode.
1383 SU (Urology) Open Pyelolithotomy - Follow SU039A S 1,200 0 Y N Earlier USG / Urine NA
Up–Open Pyelolithotomy - Follow Up Discharge Routine, Drugs
Summary
1384 SU (Urology) Cystolithotomy - Open, including SU040A S 18,500 0 Y N Clinical notes Detailed discharge 2
cystoscopy–Open - including and X ray summary , detailed
cystoscopy KUB/USG/IVP/ Procedure /
NCCT Operative Notes
confirming the
diagnosis of
large bladder
stone
1385 SU (Urology) Cystolithotripsy / Urethral Stone SU041A S 18,500 0 Y N Clinical notes Detailed discharge Daycare
endoscopic, including and X ray summary, detailed
cystoscopy–Cystolithotripsy KUB/USG/IVP/ Procedure /
endoscopic, including cystoscopy NCCT Operative Notes
confirming the
diagnosis of
large bladder
stone
1386 SU (Urology) Cystolithotripsy / Urethral Stone SU041B S 18,500 0 Y N Clinical notes Detailed discharge Daycare
endoscopic, including cystoscopy– and X ray summary, detailed
Urethral Stone removal endoscopic, KUB/USG/IVP/ Procedure /
including cystoscopy NCCT Operative Notes
confirming the
diagnosis of
large bladder
stone
1387 SU (Urology) Diagnostic Cystoscopy–Diagnostic SU042A S 6,500 0 Y N Clinical notes Intra procedure still Daycare
Cystoscopy and Reports of photograph;
all work up Detailed discharge
done ( summary Detailed
Xray/USG/CT Procedure /
Scan/MRI), Operative Notes
suspected
differential
diagnosis
1388 SU (Urology) Partial Cystectomy–Open SU043A S 23,000 0 Y N Clinical notes Histopathology,Deta 3
and CT/MRI iled discharge
confirming the summary; detailed
need of this Operative Notes
surgery with
supporting
Evidence of the
same
(FNAC/Biopsy)
1389 SU (Urology) Partial Cystectomy–Lap. SU043B S 23,000 0 Y N Clinical notes Histopathology,Deta 2
and CT/MRI iled discharge
confirming the summary; detailed
need of this Operative Notes
surgery with
supporting
Evidence of the
same
(FNAC/Biopsy)
1390 SU (Urology) Partial Cystectomy - Follow Up–Partial SU044A S 1,000 0 Y N Earlier USG NA
Cystectomy - Follow Up Discharge
Summary
1391 SU (Urology) Augmentation cystoplasty–Open SU045A S 30,000 0 Y N Clinical notes Intraoperative still 4
and IVP/CT images, Post
IVP/MRI procedure Imaging,
+Cystogram+/- Detailed discharge
Cystoscopy/, summary, detailed
indication for Operative Notes
which the
surgery is done,
1392 SU (Urology) Augmentation cystoplasty–Lap. SU045B S 30,000 0 Y N Clinical notes Intraoperative still 4
and IVP/CT images, Post
IVP/MRI procedure Imaging,
+Cystogram+/- Detailed discharge
Cystoscopy/, summary, detailed
indication for Operative Notes
which the
surgery is done,
1393 SU (Urology) Deflux for VUR–Deflux for VUR SU046A S 1,200 0 Y N Clinical notes IVU NA
with planned
line of
treatment
1394 SU (Urology) Bladder Diverticulectomy–Bladder SU047A S 1,000 0 Y N Earlier USG NA
Diverticulectomy - Follow Up Discharge
Summary
1395 SU (Urology) Open bladder diverticulectomy with / SU048A S 25,000 0 Y N Clinical notes Intra procedure 3
without ureteric re-implantation–Open and clinical photograph,
bladder diverticulectomy with / without USG/CT/MRI+/- Detailed discharge
ureteric re-implantation Cystoscopy summary, detailed
bladder Operative Notes
diverticulum
and need for
surgery
1396 SU (Urology) Bladder injury repair SU049A S 23,000 0 N N Clinical notes Detailed discharge 3
(with or without urethral and summary; detailed
injury)–Bladder injury repair USG/CT/MRI+/- Procedure /
(with or without urethral injury) cystogram Operative Notes
confirming the
diagnosis of
bladder injury;
MLC/ FIR if
traumatic.
1397 SU (Urology) Bladder injury repair with colostomy SU050A S 27,500 0 N N Clinical notes Detailed discharge 4
(with or without urethral injury)– and summary of both
Bladder injury repair with USG/CT/MRI+/- surgeries; detailed
colostomy cystogram Procedure /
(with or without urethral injury) confirming the Operative Notes;
diagnosis of Post procedue pic
bladder injury; of Colostomy
MLC/ FIR if
traumatic.
1398 SU (Urology) Extrophy Bladder repair including SU051A S 65,000 0 Y N Clinical notes Post Procedure 4
osteotomy if needed + epispadias and Clinical Photograph
repair + ureteric reimplant–Extrophy USG/CT/MRI of affected part,
Bladder repair including osteotomy if confirming the detailed Procedure /
needed + epispadias repair + ureteric diagnosis of Operative Notes
reimplant extrophy of
bladder/
epispadias.
Clinical
Photograph of
affected part
1399 SU (Urology) Neurogenic bladder - Package for SU052A S 14,300 0 Y N Clinical notes Evidence of all Daycare
evaluation / investigation (catheter + detailing the investigations done
ultrasound + culture + RGU/ MCU) for case history and still images of
1 month (medicines - antibiotics)– with previous RGU/ MCU done
Neurogenic bladder - Package for work up / initial with patient name &
evaluation / investigation (catheter + diagnosis date
ultrasound + culture + RGU/ MCU)
for 1 month (medicines - antibiotics)
1400 SU (Urology) Y V Plasty of Bladder Neck / Bladder SU053A S 23,000 0 Y N Clinical notes Detailed Procedure 4
Neck Reconstruction–Y V Plasty of and urethro / Operative Notes,
Bladder Neck / Bladder Neck Cystoscopy detailed discharge
Reconstruction +USG summary.
confirming the
diagnosis
1401 SU (Urology) Bladder Neck incision - SU054A S 15,000 0 Y N USG-KUB/PVR, Endoscopic picture Daycare
Endoscopic–Bladder Neck incision - Uroflometry
Endoscopic
1402 SU (Urology) TURBT SU055A S 27,500 5 Y N Clinical notes Histopathology, 2
(Transurethral Resection of the and USG/CT/ Detailed discharge
Bladder Tumor)–TURBT MRI confirming summary, detailed
(Transurethral Resection of the the diagnosis Procedure /
Bladder Tumor) bladder tumour Operative Notes
1403 SU (Urology) TURBT - Restage–TURBT - Restage SU056A S 18,000 0 Y N Clinical notes Intra procedure still 2
and USG/CT/ photograph
MRI confirming Histopathology,
the diagnosis Detailed discharge
bladder tumour summary , detailed
Procedure /
Operative Notes
1404 SU (Urology) Post TURBT - Check Cystoscopy (Per SU057A S 10,000 0 Y N Clinical notes Intra procedure still Daycare
sitting) with cold-cup biopsy–Post and photograph;
TURBT - Check Cystoscopy (Per Histopathology/ detailed discharge
sitting) with cold-cup biopsy biopsy summary; detailed
diagnosis of Operative Notes
bladder cancer
1405 SU (Urology) Urachal Cyst excision–Urachal Cyst SU058A S 18,500 0 Y N Clinical notes Histopathology, 2
excision - Open and Detailed discharge
USG/CT/MRI summary , detailed
Urachus
1406 SU (Urology) Urachal Cyst excision–Urachal Cyst SU058B S 18,500 0 Y N Clinical notes Histopathology, 2
excision - Laparoscopic and Detailed discharge
USG/CT/MRI summary , detailed
Urachus
1407 SU (Urology) VVF Repair - Follow Up–VVF Repair - SU059A S 1,500 0 Y N Earlier USG / UFM / Urine NA
Follow Up Discharge Routine
Summary
1408 SU (Urology) Intravesical BCG / SU060A S 15,000 0 Y N Clinical notes Detailed discharge Daycare
Mitomycin–Induction cycles and summary, Detailed
Histopathology/ Procedure /
confirming the original bills of
diagnosis of medicines
bladder cancer administered
1409 SU (Urology) Intravesical BCG / SU060B S 30,000 0 Y N Clinical notes Detailed discharge Daycare
Mitomycin–Maintenance and summary, Detailed
Histopathology/ Procedure /
confirming the original bills of
diagnosis of medicines
bladder cancer administered
1410 SU (Urology) Suprapubic Drainage - Closed / SU061A S 5,000 0 Y N Clinical notes Detailed Procedure Daycare
Trocar–Suprapubic Drainage - Closed and USG/CT / Operative Notes
/ Trocar confirming the detailing how mcuh
diagnosis for urine was drained,
which the detailed discharge
surgery is done summary
1411 SU (Urology) Stress incontinence surgery–Stress SU062A S 28,000 0 Y N Clinical notes Detailed Procedure 3
incontinence surgery - Open and / Operative Notes;
Cystoscopy/ detailed discharge
USG/ Uro summary
Dynamic study
to
confirm the
dignosis.
1412 SU (Urology) Repair of stress incontinence - Follow SU063A S 1,000 0 Y N Earlier Clinical notes with NA
Up–Repair of stress incontinence - Discharge planned line of
Follow Up Summary treatment
1413 SU (Urology) Emergency management of Acute SU064A S 2,000 0 N N Clinical notes Evidence of simple 2
retention of Urine–Emergency detailing catheterization and
management of Acute retention of chroniciy and details of how much
Urine and USG urine drained.
proving Detailed discharge
retention of summary giving
urine aetiology of
retention
1414 SU (Urology) Meatotomy / Meatoplasty–Meatotomy SU065A S 3,500 0 Y N Clinical notes Detailed discharge Daycare
and confirmed summary, detailed
diagnosis of Procedure /
meatal stenosis Operative Notes
1415 SU (Urology) Meatotomy / SU065B S 3,500 0 Y N Clinical notes Detailed discharge Daycare
Meatoplasty–Meatoplasty and confirmed summary, detailed
diagnosis of Procedure /
meatal stenosis Operative Notes
1416 SU (Urology) Urethroplasty–Urethroplasty - End to SU066A S 28,000 0 Y N Clinical notes Intra procedure 2
end and ACU clinical photograph,
(Anterograde Detailed discharge
urethrography)/ summary, detailed
micturating Procedure /
cysto- Operative Notes
urethrogram
(MCU) +
Retrograde
urethrography
justifying the
surgery.
1417 SU (Urology) Urethroplasty–Urethroplasty - SU066B S 28,000 0 Y N Clinical notes Intra procedure 4
Substitution - single stage and ACU clinical photograph,
urethrogram
(MCU) +
Retrograde
urethrography
justifying the
surgery.
1418 SU (Urology) Urethroplasty–Urethroplasty - SU066C S 41,500 0 Y N Clinical notes Intra procedure 4
Substitution - two stage and ACU clinical photograph,
urethrogram
(MCU) +
Retrograde
urethrography
justifying the
surgery.
1419 SU (Urology) Urethroplasty–Urethroplasty - SU066D S 32,000 0 Y N Clinical notes Intra procedure 4
Transpubic and ACU clinical photograph,
urethrogram
(MCU) +
Retrograde
urethrography
justifying the
surgery.
1420 SU (Urology) Urethroplasty Follow SU067A S 1,000 0 Y N Earlier USG / UFM / Urine NA
Up–Urethroplasty Follow Up Discharge Routine
Summary
1421 SU (Urology) Urethral Dilatation–Non endocopic as SU068A S 2,000 0 Y N Clinical notes Detailed discharge Daycare
an independent procedure and summary, Detailed
Investigation Procedure /
reports Operative Notes
confirming detailing size of
urethral dilators used
stricture
(RGU+/- MCU)
1422 SU (Urology) Urethral Dilatation–Endocopic as an SU068B S 5,000 0 Y N Clinical notes Endoscopic Intra Daycare
independent procedure and procedure still
Investigation photograph,
reports detailed discharge
confirming summary, Detailed
stricture Operative Notes
(RGU+/- MCU)
1423 SU (Urology) Perineal Urethrostomy without SU069A S 20,000 0 Y N Clinical notes Intra procedure 2
closure–Perineal Urethrostomy detailing the clinical photograph,
without closure pathology for Detailed discharge
which summary, detailed
performed with Procedure /
supporting Operative Notes
Evidence of
RGU
(Retrograde
urethrography)
+ MCU
1424 SU (Urology) Post. Urethral Valve fulguration–Post. SU070A S 14,000 0 Y N Clinical notes Intra procedure Daycare
Urethral Valve fulguration and clinical photograph,
confirmation of Post procedure
stenosis of Imaging (USG),
posterir urethral Detailed discharge
valve by summary, detailed
Voiding Procedure /
cystourethrogra Operative Notes
m (preferred) +
USG +/-
uroflowmetry.
1425 SU (Urology) Hypospadias repair–Single stage SU071A S 28,000 0 Y N Clinical notes Post Procedure 3
and Clinical Clinical Photograph
Photograph of affected part,
Operative Notes;
Detailed Procedure
/ Operative Notes
1426 SU (Urology) Hypospadias repair–Two or more SU071B S 12,000 0 Y N Clinical notes Post Procedure 3
stage (First Stage) and Clinical Clinical Photograph
Photograph of affected part,
Operative Notes
1427 SU (Urology) Hypospadias repair–Two or more SU071C S 20000 0 Y N Clinical notes Post Procedure 3
stage (Intermediate Stage) and Clinical Clinical Photograph
Photograph; of affected part,
evidence of detailed Procedure /
stage 1 Operative Notes
(Discharge
Summary)
1428 SU (Urology) Hypospadias repair–Two or more SU071D S 30,000 0 Y N Clinical notes Post Procedure 3
stage (Final Stage) and Clinical Clinical Photograph
Photograph; of affected part,
evidence of detailed Procedure /
stage 1 / 2 Operative Notes
(Discharge
Summary)
1429 SU (Urology) Hypospadias Repair - Follow SU072A S 1,000 0 Y N Discharge USG / UFM / Urine NA
Up–Hypospadias Repair - Follow Up Summary Routine
1430 SU (Urology) Emergency management of SU073A S 2,000 0 Y N Clinical notes Evidence of 2

Hematuria–Emergency management detailing the investigations done
of Hematuria hematuria with treatment given;
urine report detailed discharge
showing frank summary
or microscopic?
1431 SU (Urology) Excision of Urethral SU074A S 5,000 0 Y N Clinical notes Histopathology, Daycare
Caruncle–Excision of Urethral and confirmed Detailed discharge
Caruncle diagnosis of summary, detailed
carunclule. Operative Notes
1432 SU (Urology) Urethrovaginal fistula SU075A S 30,000 0 Y N Clinical notes Detailed Procedure 2
repair–Urethrovaginal fistula repair and urethro / Operative Notes,
Cystoscopy detailed discharge
+vaginoscopy summary.
+USG
confirming the
diagnosis
1433 SU (Urology) Urethrorectal fistula SU076A S 40,000 0 Y N Clinical notes detailed Procedure 4
repair–Urethrorectal fistula repair and / Operative Notes,
confirmation of Detailed discharge
fistula and it's summary
tract by
Cystoscopy+Sig
moidoscopy+/-
RGU+MCU
1434 SU (Urology) Open simple prostatetctomy for SU077A S 27,500 0 Y N Clinical notes Histopathology, 3
BPH–Open simple prostatetctomy for and USG with Detailed discharge
BPH prostate size summary, detailed
and Post Void Procedure /
Volume +/- Operative Notes
PSA, +/-
uroflometry
1435 SU (Urology) Radical prostatectomy–Open SU078A S 50,000 0 Y N Clinical notes Histopathology of 4
and MRI /CT prostate, Detailed
prostrate + discharge summary,
PSA+Biopsy; detailed Procedure /
Operative Notes
with details of nodes
removed.
1436 SU (Urology) Radical prostatectomy–Lap. SU078B S 50,000 0 Y N Clinical notes Histopathology of 4
and MRI /CT prostate, Detailed
prostrate + discharge summary,
PSA+Biopsy; detailed Procedure /
Operative Notes
with details of nodes
removed.
1437 SU (Urology) Holmium Laser SU079A S 40,000 0 Y N Clinical notes Histopathology, 2

Prostatectomy–Holmium Laser and USG with Detailed discharge
Prostatectomy prostate size summary, detailed
PSA, +/-
uroflometry Is
the hospital
registered for
holmium laser?
1438 SU (Urology) TURP-Transurethral Resection of the SU080A S 27,500 0 Y N Clinical notes Histopathology, 2
Prostate, BPH–Monopolar and USG with Detailed discharge
prostate size summary, detailed
PSA, +/-
uroflometry
1439 SU (Urology) TURP-Transurethral Resection of the SU080B S 27,500 0 Y N Clinical notes Histopathology, 2
Prostate, BPH–Bipolar and USG with Detailed discharge
prostate size summary, detailed
PSA, +/-
uroflometry
1440 SU (Urology) Transrectal Ultrasound guided SU081A S 10,000 0 Y N Clinical notes Histopathology Daycare
prostate biopsy (minimum 12 core)– and USG with showing reporting of
Transrectal Ultrasound guided prostate size minimum 12 core
prostate biopsy (minimum 12 core) and Post Void samples of prostate,
Volume Detailed discharge
establishing summary, detailed
suspicion of Procedure /
malignancy, +/- Operative Notes.
PSA
1441 SU (Urology) Penectomy–Partial Penectomy SU082A S 15,000 0 Y N Clinical notes Histopathology, 2
and Biopsy Detailed discharge
findings summary, detailed
Procedure /
Operative Notes
1442 SU (Urology) Penectomy–Total Penectomy + SU082B S 25,000 0 Y N Clinical notes Histopathology, 2
Perineal Urethrostomy and Biopsy Detailed discharge
findings summary, detailed
Procedure /
Operative Notes
detailing
urethrostomy
1443 SU (Urology) Surgery for Priapism–Aspiration SU083A S 15,000 0 N N Color-flow Detailed discharge 2
penile Doppler summary; detailed
imaging/ USG Procedure /
(patients with Operative Notes
high-flow
priapism)
1444 SU (Urology) Surgery for Priapism–Shunt SU083B S 15,000 0 N N Color-flow Detailed discharge 2
penile Doppler summary; detailed
imaging/ USG Procedure /
(patients with Operative Notes
high-flow
priapism)
1445 SU (Urology) Surgery for Priaprism - Follow SU084A S 1,000 0 Y N Earlier Clinical notes with NA
Up–Surgery for Priaprism - Follow Up Discharge planned line of
Summary treatment
1446 SU (Urology) Penile prosthesis insertion–Penile SU085A S 35,000 0 Y N Clinical notes Detailed discharge 2
prosthesis insertion with Previous summary, detailed
medical reports Procedure /
showing the Operative Notes,
panectomy and Bar code of implant
its indication used
1447 SU (Urology) Orchiectomy–High inguinal SU086A S 13,800 0 Y N Clinical notes Histopathology, 2

and USG/CT / Detailed discharge
Biopsy summary, detailed
testicular Operative Notes
cancer
1448 SU (Urology) Orchiectomy–Simple SU086B S 10,000 0 Y N Clinical notes Histopathology, Daycare
and USG/CT / Detailed discharge
testicular Operative Notes
cancer
1449 SU (Urology) Bilateral Orchidectomy for hormone SU087A S 10,000 0 Y N Clinical notes Histopathology, Daycare
ablation–Bilateral Orchidectomy for and USG/CT / Detailed discharge
hormone ablation Biopsy summary, detailed
bilateral Operative Notes
testicular
cancer
1450 SU (Urology) Orchiopexy–Orchiopexy with SU088A S 30,000 0 Y N Clinical notes Post Procedure 2
laparoscopy and USG Clinical Photograph
confirming that of affected part,
laparoscopy is detailed Procedure /
needed for Operative Notes;
locating the Detailed discharge
testes. Clinical summary
Photograph of
affected part
1451 SU (Urology) Orchiopexy–Orchiopexy without SU088B S 15,000 0 Y N Clinical notes Post Procedure 2
laparoscopy - U/L and USG Clinical Photograph
confirming of affected part,
location of detailed Procedure /
undescended Operative Notes;
testis, Clinical Detailed discharge
affected part
1452 SU (Urology) Orchiopexy–Orchiopexy without SU088C S 15,000 0 Y N Clinical notes Post Procedure 2
laparoscopy - B/L and USG Clinical Photograph
confirming of affected part,
location of detailed Procedure /
undescended Operative Notes;
testis, Clinical Detailed discharge
affected part
1453 SU (Urology) Surgical Correction of Varicocele–Non SU089A S 10,000 0 Y N Clinical notes Detailed discharge Daycare
Microsurgical and USG summary; detailed
Scrotum Procedure /
Operative Notes
1454 SU (Urology) Surgical Correction of SU089B S 15,000 0 Y N Clinical notes Detailed discharge Daycare
Varicocele–Microsurgical and USG summary; detailed
Scrotum; is the Procedure /
EHCP registred Operative Notes
for
microsurgery?
1455 SU (Urology) Radical Retroperitoneal lymph node SU090A S 36,500 0 Y N Clinical notes Histopathology, 3
dissection–Open and USG/CT / Detailed discharge
testicular
cancer
1456 SU (Urology) Radical Retroperitoneal lymph node SU090B S 36,500 0 Y N Clinical notes Histopathology, 3
dissection–Lap. and USG/CT / Detailed discharge
testicular
cancer
1457 SU (Urology) Ilio-Inguinal lymphadenectomy–Ilio- SU091A S 18,500 0 Y N Clinical notes Histopathology, 2
Inguinal lymphadenectomy and Detailed discharge
USG/CT/MRI / summary, detailed
Biopsy Procedure /
confirming the Operative Notes
diagnosis for
which the
surgery is done.
1458 SU (Urology) Hysterectomy as part of VVF / SU092A S 5,000 0 Y N Clinical notes Histopathology, NA
uterovaginal fistula repair– and Detailed Procedure
Hysterectomy as part of VVF / Cystoscopy+va / Operative Notes,
uterovaginal fistula repair ginoscopy+CT - detailed discharge
IVP/IVP +/- summary.
cystogram
confirming the
diagnosis
1459 SU (Urology) PCNL - Follow Up–PCNL - Follow Up SU093A S 1,200 0 Y N Earlier USG / Urine NA
Discharge Routine, Drugs
Summary
1460 SU (Urology) Emergency management of Ureteric SU094A S 3,500 0 Y N Clinical notes Detailed reports of Daycare
stone - Package for evaluation / detailing the all investigations
investigation (ultrasound + culture) for case history done and
3 weeks (medicines).–Emergency with previous consultation paper
management of Ureteric stone - work up / initial of treating doctor;
Package for evaluation / investigation diagnosis with culture & ABS
(ultrasound + culture) for 3 weeks stills of ureteric report and Evidence
(medicines). stone and of 3 weeks
treatment done medicines
so far
1461 SV (Cardio-thoracic Surgical Correction of Category - I SV001A S 100,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease and ECHO and summary, Detailed
–Unifocalization of MAPCA / or doppler Operative notes,
reports barcode of Implant,
if used.
1462 SV (Cardio-thoracic Surgical Correction of Category - I SV001B S 100,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease –Isolated and ECHO and summary, Detailed
Secundum Atrial Septal Defect (ASD) / or doppler Operative notes,
Repair reports barcode of Implant,
if used.
1463 SV (Cardio-thoracic Surgical Correction of Category - I SV001C S 100,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease –Glenn and ECHO and summary, Detailed
procedure / or doppler Operative notes,
if used.
1464 SV (Cardio-thoracic Surgical Correction of Category - I SV001D S 100,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease –Pulmonary and ECHO and summary, Detailed
Artery Banding / or doppler Operative notes,
if used.
1465 SV (Cardio-thoracic Surgical Correction of Category - I SV001E S 130,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease –Systemic - and ECHO and summary, Detailed
Pulmonary shunt / or doppler Operative notes,
if used.
1466 SV (Cardio-thoracic Surgical Correction of Category - I SV001F S 100,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease –Vascular and ECHO and summary, Detailed
Ring division / or doppler Operative notes,
if used.
1467 SV (Cardio-thoracic Surgical Correction of Category - I SV001G S 130,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease and ECHO and summary, Detailed
–Coarctation repair / or doppler Operative notes,
if used.
1468 SV (Cardio-thoracic Surgical Correction of Category - II SV002A S 160,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–ASD and ECHO summary, Detailed
closure + Partial Anomalous Venous report Operative notes,
Drainage Repair barcode of Implant,
if used.
1469 SV (Cardio-thoracic Surgical Correction of Category - II SV002B S 160,000 0 Y N Clinical notes Detailed discharge 10
Closure + Mitral procedure report Operative notes,
barcode of Implant,
if used.
1470 SV (Cardio-thoracic Surgical Correction of Category - II SV002C S 160,000 0 Y N Clinical notes Detailed discharge 10
Closure + Tricuspid procedure report Operative notes,
barcode of Implant,
if used.
1471 SV (Cardio-thoracic Surgical Correction of Category - II SV002D S 160,000 0 Y N Clinical notes Detailed discharge 10
Closure + Pulmonary procedure report Operative notes,
barcode of Implant,
if used.
1472 SV (Cardio-thoracic Surgical Correction of Category - II SV002E S 160,000 0 Y N Clinical notes Detailed discharge 10
Closure + Infundibular procedure report Operative notes,
barcode of Implant,
if used.
1473 SV (Cardio-thoracic Surgical Correction of Category - II SV002F S 120,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–VSD and ECHO summary, Detailed
closure report Operative notes,
barcode of Implant,
if used.
1474 SV (Cardio-thoracic Surgical Correction of Category - II SV002G S 120,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart and ECHO summary, Detailed
Disease–Infundibular PS repair report Operative notes,
barcode of Implant,
if used.
1475 SV (Cardio-thoracic Surgical Correction of Category - II SV002H S 120,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–Valvular and ECHO summary, Detailed
PS repair report Operative notes,
barcode of Implant,
if used.
1476 SV (Cardio-thoracic Surgical Correction of Category - II SV002I S 120,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–Partial AV and ECHO summary, Detailed
canal repair report Operative notes,
barcode of Implant,
if used.
1477 SV (Cardio-thoracic Surgical Correction of Category - II SV002J S 120,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart and ECHO summary, Detailed
Disease–Intermediate AV canal repair report Operative notes,
barcode of Implant,
if used.
1478 SV (Cardio-thoracic Surgical Correction of Category - II SV002K S 160,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–Atrial and ECHO summary, Detailed
septectomy + Glenn report Operative notes,
barcode of Implant,
if used.
1479 SV (Cardio-thoracic Surgical Correction of Category - II SV002L S 160,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–Atrial and ECHO summary, Detailed
septectomy + PA Band report Operative notes,
barcode of Implant,
if used.
1480 SV (Cardio-thoracic Surgical Correction of Category - II SV002M S 160,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–Sinus of and ECHO summary, Detailed
Valsalva aneurysm repair with aortic report Operative notes,
valve procedure barcode of Implant,
if used.
1481 SV (Cardio-thoracic Surgical Correction of Category - II SV002N S 160,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–Sinus of and ECHO summary, Detailed
Valsalva aneurysm repair without report Operative notes,
aortic valve procedure barcode of Implant,
if used.
1482 SV (Cardio-thoracic Surgical Correction of Category - II SV002O S 160,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Congenital Heart Disease–Sub-aortic and ECHO summary, Detailed
membrane resection report Operative notes,
barcode of Implant,
if used.
1483 SV (Cardio-thoracic Surgical Correction of Category - III SV003A S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Ebstien Doppler Report summary, Detailed
repair Operative notes,
barcode of Implant,
if used.
1484 SV (Cardio-thoracic Surgical Correction of Category - III SV003B S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Double Doppler Report summary, Detailed
switch operation Operative notes,
barcode of Implant,
if used.
1485 SV (Cardio-thoracic Surgical Correction of Category - III SV003C S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Rastelli Doppler Report summary, Detailed
Procedure Operative notes,
barcode of Implant,
if used.
1486 SV (Cardio-thoracic Surgical Correction of Category - III SV003D S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Fontan Doppler Report summary, Detailed
procedure Operative notes,
barcode of Implant,
if used.
1487 SV (Cardio-thoracic Surgical Correction of Category - III SV003E S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –AP Doppler Report summary, Detailed
window repair Operative notes,
barcode of Implant,
if used.
1488 SV (Cardio-thoracic Surgical Correction of Category - III SV003F S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Arch Doppler Report summary, Detailed
interruption Repair without VSD Operative notes,
closure barcode of Implant,
if used.
1489 SV (Cardio-thoracic Surgical Correction of Category - III SV003G S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Arch Doppler Report summary, Detailed
interruption Repair with VSD closure Operative notes,
barcode of Implant,
if used.
1490 SV (Cardio-thoracic Surgical Correction of Category - III SV003H S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –DORV Doppler Report summary, Detailed
Repair Operative notes,
barcode of Implant,
if used.
1491 SV (Cardio-thoracic Surgical Correction of Category - III SV003I S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease Doppler Report summary, Detailed
–Supravalvular AS repair Operative notes,
barcode of Implant,
if used.
1492 SV (Cardio-thoracic Surgical Correction of Category - III SV003J S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Konno Doppler Report summary, Detailed
barcode of Implant,
if used.
1493 SV (Cardio-thoracic Surgical Correction of Category - III SV003K S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Norwood Doppler Report summary, Detailed
barcode of Implant,
if used.
1494 SV (Cardio-thoracic Surgical Correction of Category - III SV003L S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –VSD Doppler Report summary, Detailed
closure + RV - PA conduit Operative notes,
barcode of Implant,
if used.
1495 SV (Cardio-thoracic Surgical Correction of Category - III SV003M S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –VSD + Doppler Report summary, Detailed
Aortic procedure Operative notes,
barcode of Implant,
if used.
1496 SV (Cardio-thoracic Surgical Correction of Category - III SV003N S 190,000 0 Y N ECHO / Detailed discharge 12
Mitral procedure Operative notes,
barcode of Implant,
if used.
1497 SV (Cardio-thoracic Surgical Correction of Category - III SV003O S 190,000 0 Y N ECHO / Detailed discharge 12
Tricuspid procedure Operative notes,
barcode of Implant,
if used.
1498 SV (Cardio-thoracic Surgical Correction of Category - III SV003P S 190,000 0 Y N ECHO / Detailed discharge 12
Pulmonary procedure Operative notes,
barcode of Implant,
if used.
1499 SV (Cardio-thoracic Surgical Correction of Category - III SV003Q S 190,000 0 Y N ECHO / Detailed discharge 12
Infundibular procedure Operative notes,
barcode of Implant,
if used.
1500 SV (Cardio-thoracic Surgical Correction of Category - III SV003R S 190,000 0 Y N ECHO / Detailed discharge 12
Coarctation repair Operative notes,
barcode of Implant,
if used.
1501 SV (Cardio-thoracic Surgical Correction of Category - III SV003S S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –TAPVC Doppler Report summary, Detailed
Repair Operative notes,
barcode of Implant,
if used.
1502 SV (Cardio-thoracic Surgical Correction of Category - III SV003T S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Truncus Doppler Report summary, Detailed
arteriosus repair Operative notes,
barcode of Implant,
if used.
1503 SV (Cardio-thoracic Surgical Correction of Category - III SV003U S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Tetralogy Doppler Report summary, Detailed
of Fallot Repair Operative notes,
barcode of Implant,
if used.
1504 SV (Cardio-thoracic Surgical Correction of Category - III SV003V S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Complete Doppler Report summary, Detailed
AV canal repair Operative notes,
barcode of Implant,
if used.
1505 SV (Cardio-thoracic Surgical Correction of Category - III SV003W S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Arterial Doppler Report summary, Detailed
switch operation Operative notes,
barcode of Implant,
if used.
1506 SV (Cardio-thoracic Surgical Correction of Category - III SV003X S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Senning Doppler Report summary, Detailed
Operation Operative notes,
barcode of Implant,
if used.
1507 SV (Cardio-thoracic Surgical Correction of Category - III SV003Y S 190,000 0 Y N ECHO / Detailed discharge 12
& Vascular surgery) Congenital Heart Disease –Mustard Doppler Report summary, Detailed
Operation Operative notes,
barcode of Implant,
if used.
1508 SV (Cardio-thoracic Coronary artery bypass grafting SV004A S 118,100 0 Y N ECHO + CAG Detailed Operation 10
& Vascular surgery) (CABG), report stills notes, detailed
including intra operative balloon pump showing discharge summary
(if required)–Coronary artery bypass significant
grafting (CABG), multiple blocks
including intra operative balloon pump & LVEF
(if required)
1509 SV (Cardio-thoracic Single Valve Procedure–Aortic Valve SV005A S 159,000 0 Y N Clinical notes Post op ECHO , 7
& Vascular surgery) and ECHO / Detailed procedure
Doppler report notes, detailed
discharge summary,
Barcode of implant,
if used.
1510 SV (Cardio-thoracic Single Valve Procedure–Mitral Valve SV005B S 159,000 0 Y N Clinical notes Post op ECHO , 7
& Vascular surgery) and ECHO / Detailed procedure
discharge summary,
Barcode of implant,
if used.
1511 SV (Cardio-thoracic Single Valve Procedure–Tricuspid SV005C S 159,000 0 Y N Clinical notes Post op ECHO , 7
& Vascular surgery) Valve and ECHO / Detailed procedure
discharge summary,
Barcode of implant,
if used.
1512 SV (Cardio-thoracic Double Valve Procedure–Double SV006A S 182,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Valve Procedure and ECHO and summary, Detailed
doppler reports Operative notes,
showing two barcode of
cardiac valves valves/rings used
diseased
1513 SV (Cardio-thoracic Triple valve procedure –Triple valve SV007A S 210,000 0 Y N Clinical notes Detailed discharge 12
& Vascular surgery) procedure and ECHO and summary, Detailed
doppler reports Operative notes,
showing three barcode of
cardiac valves valves/rings used
diseased
1514 SV (Cardio-thoracic Closed Mitral Valvotomy including SV008A S 57,000 0 Y N Clinical notes Detailed discharge 7
& Vascular surgery) thoracotomy–Closed Mitral Valvotomy and ECHO and summary, Detailed
including thoracotomy / or doppler Operative notes.
reports
1515 SV (Cardio-thoracic Ross Procedure–Ross Procedure SV009A S 270,000 0 Y N Clinical notes Detailed procedure 10
& Vascular surgery) and ECHO notes, detailed
report discharge summary,
Barcode of RV-PA
conduit
1516 SV (Cardio-thoracic Surgery for Hypertrophic Obstructive SV010A S 111,000 0 Y N Clinical notes Detailed discharge 10
& Vascular surgery) Cardiomyopathy (HOCM)–Surgery for and ECHO summary, Detailed
Hypertrophic Obstructive report Operation notes,
Cardiomyopathy (HOCM)
1517 SV (Cardio-thoracic Pericardial window (via SV011A S 30,000 0 N N Clinical notes Detailed Operation 7
& Vascular surgery) thoracotomy)–Pericardial window (via and CT Chest notes, detailed
thoracotomy) establishing the discharge summary.
aetiology for
which surgery is
done
1518 SV (Cardio-thoracic Pericardiectomy–Pericardiectomy SV012A S 67,000 0 Y N Clinical notes Detailed Operation 10

& Vascular surgery) an ECHO notes, Discharge
report summary
1519 SV (Cardio-thoracic Patent Ductus Arteriosus (PDA) SV013A S 57,000 0 Y N Clinical notes Detailed Operation 7
& Vascular surgery) Closure via thoracotomy–Patent and ECHO notes, Discharge
Ductus Arteriosus (PDA) Closure via report summary
thoracotomy
1520 SV (Cardio-thoracic Aortic Root Replacement SV014A S 250,000 0 Y N Clinical notes Detailed discharge 12
& Vascular surgery) Surgery–Bental Procedure and ECHO summary, Detailed
report, CT Operation notes.
angio / Angio /
MRI report
1521 SV (Cardio-thoracic Aortic Root Replacement SV014B S 250,000 0 Y N Clinical notes Detailed discharge 12
& Vascular surgery) Surgery–Aortic Dissection and ECHO summary, Detailed
angio / Angio /
MRI report
1522 SV (Cardio-thoracic Aortic Root Replacement SV014C S 250,000 0 Y N Clinical notes Detailed discharge 12
& Vascular surgery) Surgery–Aortic Aneurysm and ECHO summary, Detailed
angio / Angio /
MRI report
1523 SV (Cardio-thoracic Aortic Root Replacement SV014D S 250,000 0 Y N Clinical notes Detailed discharge 12
& Vascular surgery) Surgery–Valve sparing root and ECHO summary, Detailed
replacement report, CT Operation notes.
angio / Angio /
MRI report
1524 SV (Cardio-thoracic Aortic Root Replacement SV014E S 250,000 0 Y N Clinical notes Detailed discharge 12
& Vascular surgery) Surgery–AVR + Root enlargement and ECHO summary, Detailed
angio / Angio /
MRI report
1525 SV (Cardio-thoracic Aortic Arch Replacement / SV015A S 235,000 0 Y N Clinical notes Detailed procedure 12
& Vascular surgery) Thoracoabdominal aneurysm Repair and angio / CT notes, detailed
using bypass–Aortic Arch angio / MRI discharge summary.
Replacement using bypass reports
1526 SV (Cardio-thoracic Aortic Arch Replacement / SV015B S 235,000 0 Y N Clinical notes Detailed procedure 12
& Vascular surgery) Thoracoabdominal aneurysm Repair and angio / CT notes, detailed
using bypass–Thoracoabdominal angio / MRI discharge summary.
aneurysm Repair using bypass reports
1527 SV (Cardio-thoracic Aortic Aneurysm Repair–Aortic SV016A S 150,000 0 Y N Clinical notes Detailed procedure 10
& Vascular surgery) Aneurysm Repair using and ECHO / notes, detailed
Cardiopulmonary bypass (CPB) Angio / CT discharge summary.
angio / MRI
reports showing
aneurysm
1528 SV (Cardio-thoracic Aortic Aneurysm Repair–Aortic SV016B S 150,000 0 Y N Clinical notes Detailed procedure 10
& Vascular surgery) Aneurysm Repair using Left Heart and ECHO / notes, detailed
Bypass Angio / CT discharge summary.
angio / MRI
reports showing
aneurysm
1529 SV (Cardio-thoracic Aortic Aneurysm Repair–Aortic SV016C S 95,500 0 Y N Clinical notes Detailed procedure 10
& Vascular surgery) Aneurysm Repair without using angio / CT notes, detailed
Cardiopulmonary bypass (CPB) angio / MRI discharge summary.
reports
1530 SV (Cardio-thoracic Aortic Aneurysm Repair–Aortic SV016D S 95,500 0 Y N Clinical notes Detailed procedure 10
& Vascular surgery) Aneurysm Repair without using Left angio / CT notes, detailed
Heart Bypass angio / MRI discharge summary.
reports
1531 SV (Cardio-thoracic Aorto Iliac / Aorto femoral bypass (Uni SV017A S 99,500 0 Y N Clinical notes Detailed discharge 7
& Vascular surgery) and Bi)–Aorto Iliac bypass - U/L and MRA / CT summary, Detailed
angio / Angio Operative notes,,
reports barcode of synthetic
graft
1532 SV (Cardio-thoracic Aorto Iliac / Aorto femoral bypass (Uni SV017B S 99,500 0 Y N Clinical notes Detailed discharge 7
& Vascular surgery) and Bi)–Aorto femoral bypass - U/L and MRA / CT summary, Detailed
graft
1533 SV (Cardio-thoracic Aorto Iliac / Aorto femoral bypass (Uni SV017C S 99,500 0 Y N Clinical notes Detailed discharge 7
& Vascular surgery) and Bi)–Aorto Iliac bypass - B/L and MRA / CT summary, Detailed
graft
1534 SV (Cardio-thoracic Aorto Iliac / Aorto femoral bypass (Uni SV017D S 99,500 Y N Clinical notes Detailed discharge 7
& Vascular surgery) and Bi)–Aorto femoral bypass - B/L and MRA / CT summary, Detailed
graft
1535 SV (Cardio-thoracic Pulmonary Embolectomy / SV018A S 141,000 N N Clinical notes Detailed Operation 10
& Vascular surgery) Thromboendarterectomy–Pulmonary and ECHO notes, Discharge
Embolectomy report + CT summary
Chest report
1536 SV (Cardio-thoracic Pulmonary Embolectomy / SV018B S 141,000 N N Clinical notes Detailed Operation 10
& Vascular surgery) Thromboendarterectomy–Thromboen and ECHO notes, Discharge
darterectomy report + CT summary
Chest report
1537 SV (Cardio-thoracic Peripheral Arterial Surgeries–Femoro - SV019A S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) Femoral Bypass and Angiogram notes, Discharge
/ CT Angiogram summary; barcode
/ MRI reports of graft used.
1538 SV (Cardio-thoracic Peripheral Arterial Surgeries–Carotid - SV019B S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) endearterectomy and Angiogram notes, Discharge
1539 SV (Cardio-thoracic Peripheral Arterial Surgeries–Carotid SV019C S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) Body Tumor Excision and Angiogram notes, Discharge
1540 SV (Cardio-thoracic Peripheral Arterial Surgeries–Thoracic SV019D S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) Outlet syndrome Repair and Angiogram notes, Discharge
1541 SV (Cardio-thoracic Peripheral Arterial Surgeries–Carotid SV019E S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) aneurysm repair and Angiogram notes, Discharge
1542 SV (Cardio-thoracic Peripheral Arterial SV019F S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) Surgeries–Subclavian aneurysm and Angiogram notes, Discharge
repair / CT Angiogram summary; barcode
1543 SV (Cardio-thoracic Peripheral Arterial Surgeries–Axillary SV019G S 80,000 Y N Clinical notes Detailed operative 7
1544 SV (Cardio-thoracic Peripheral Arterial Surgeries–Brachial SV019H S 80,000 Y N Clinical notes Detailed operative 7
1545 SV (Cardio-thoracic Peripheral Arterial Surgeries–Femoral SV019I S 80,000 Y N Clinical notes Detailed operative 7
1546 SV (Cardio-thoracic Peripheral Arterial Surgeries–Popliteal SV019J S 80,000 Y N Clinical notes Detailed operative 7
1547 SV (Cardio-thoracic Peripheral Arterial Surgeries–Femoral SV019K S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) - popliteal Bypass and Angiogram notes, Discharge
1548 SV (Cardio-thoracic Peripheral Arterial Surgeries–Axillo - SV019L S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) Brachial Bypass and Angiogram notes, Discharge
1549 SV (Cardio-thoracic Peripheral Arterial Surgeries–Carotio - SV019M S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) carotid Bypass and Angiogram notes, Discharge
1550 SV (Cardio-thoracic Peripheral Arterial Surgeries–Carotido SV019N S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) - subclavian bypass and Angiogram notes, Discharge
1551 SV (Cardio-thoracic Peripheral Arterial Surgeries–Carotido SV019O S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) - axillary bypass and Angiogram notes, Discharge
1552 SV (Cardio-thoracic Peripheral Arterial Surgeries–Axillo - SV019P S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) femoral bypass - U/L and Angiogram notes, Discharge
1553 SV (Cardio-thoracic Peripheral Arterial Surgeries–Axillo - SV019Q S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) femoral bypass - B/L and Angiogram notes, Discharge
1554 SV (Cardio-thoracic Peripheral Arterial Surgeries–Aorto - SV019R S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) carotid bypass and Angiogram notes, Discharge
1555 SV (Cardio-thoracic Peripheral Arterial Surgeries–Aorto - SV019S S 80,000 Y N Clinical notes Detailed operative 7
& Vascular surgery) subclavian bypass and Angiogram notes, Discharge
1556 SV (Cardio-thoracic Thromboembolectomy SV020A S 28,000 N N Soon as Detailed discharge 4
& Vascular surgery) –Thromboembolectomy documents are summary and
uploaded, operative notes
confirm
evidence of
embolus/
Thrombus in
duples USG/
Angio
1557 SV (Cardio-thoracic Peripheral arterial injury repair SV021A S 30,000 N N Clinical notes Detailed discharge 4
& Vascular surgery) (without bypass)–Peripheral arterial with planned summary and
injury repair (without bypass) line of operative notes
treatment,
Doppler
1558 SV (Cardio-thoracic Thoracotomy, Thoraco Abdominal SV022A S 30,000 Y N Clinical notes Detailed Operation 10
& Vascular surgery) Approach–Thoracotomy, Thoraco and CT Chest notes, detailed
Abdominal Approach establishing the discharge summary.
aetiology for
which surgery is
done
1559 SV (Cardio-thoracic Lung surgery including SV023A S 45,000 Y N Clinical notes Detailed Operation 10
& Vascular surgery) Thoracotomy–Lung cyst exision and CT Chest notes, Discharge
summary
1560 SV (Cardio-thoracic Lung surgery including SV023B S 45,000 Y N Clinical notes Detailed Operation 10
& Vascular surgery) Thoracotomy–Decortication and CT Chest notes, Discharge
summary
1561 SV (Cardio-thoracic Lung surgery including SV023C S 45,000 Y N Clinical notes Detailed Operation 10
& Vascular surgery) Thoracotomy–Hydatid cyst and CT Chest notes, Discharge
summary
1562 SV (Cardio-thoracic Lung surgery including SV023D S 45,000 Y N Clinical notes Detailed Operation 10
& Vascular surgery) Thoracotomy–Other simple lung and CT Chest notes, Discharge
procedure excluding lung resection summary
1563 SV (Cardio-thoracic Pulmonary Resection–Pulmonary SV024A S 70,000 Y N Clinical notes HPE of resected 10
& Vascular surgery) Resection and Pre-Op X- tissue detailed
ray / CT Scan operation notes,
discharge summary.
1564 SV (Cardio-thoracic Foreign Body Removal with SV025A S 20,000 Y N Clinical notes Detailed Operative 2
& Vascular surgery) scope–Foreign Body Removal with and notes, Detailed
scope Radiological discharge summary,
evidence of Photograph of
foreign body Removed Foreign
body
1565 SV (Cardio-thoracic Surgical Correction of Bronchopleural SV026A S 65,000 Y N Clinical notes Detailed operative 10
& Vascular surgery) Fistula–Surgical Correction of and CT Chest notes and discharge
Bronchopleural Fistula summary
1566 SV (Cardio-thoracic Space - Occupying Lesion (SOL) SV027A S 65,500 Y N Clinical notes Detailed discharge 10
& Vascular surgery) mediastinum–Space - Occupying and CT Chest summary, Detailed
Lesion (SOL) mediastinum Operation notes,
HPE of SOL
1567 SV (Cardio-thoracic Isolated Intercostal Drainage and SV028A S 10,000 Y N Cl notes Detailed procedure 4
& Vascular surgery) Management of ICD, Intercostal detailing need notes. Detailed
Block, Antibiotics & Physiotherapy– of ICD; X-ray discharge summary
Isolated Intercostal Drainage and chest
Management of ICD, Intercostal
Block, Antibiotics & Physiotherapy
1568 SV (Cardio-thoracic Diaphragmatic Repair–Diaphragmatic SV029A S 32,000 Y N Clinical notes Detailed procedure 10
& Vascular surgery) Repair and Chest notes, detailed
XRAY, CT discharge summary.
Chest
1569 SV (Cardio-thoracic Surgery for Cardiac Tumour–Surgery SV030A S 95,000 Y N Clinical notes Detailed Operation 10
& Vascular surgery) for Cardiac Tumour and ECHO notes, Discharge
report summary, HPE
report of tumor.
1570 SV (Cardio-thoracic Immediate reoperation (within 5 SV031A S 115,000 Y N ECHO / Detailed discharge 12
& Vascular surgery) days)–Tetralogy of Fallot Repair Doppler Report, summary, Detailed
Detailed Operative notes,
Operative notes barcode of Implant,
indicating need if used. Ascertain
for Reoperation the need for
reoperation.
1571 SV (Cardio-thoracic Immediate reoperation (within 5 SV031B S 99,500 Y N Clinical notes Post op ECHO , 7
& Vascular surgery) days)–Aortic Valve and ECHO / Detailed procedure
Doppler report, notes, detailed
Detailed discharge summary,
Operative notes Barcode of implant,
reoperation.
1572 SV (Cardio-thoracic Immediate reoperation (within 5 SV031C S 99,500 1 Y N Clinical notes Post op ECHO , 7
& Vascular surgery) days)–Mitral Valve and ECHO / Detailed procedure
reoperation.
1573 SV (Cardio-thoracic Immediate reoperation (within 5 SV031D S 99,500 1 Y N Clinical notes Post op ECHO , 7
& Vascular surgery) days)–Tricuspid Valve and ECHO / Detailed procedure
reoperation.
1574 SV (Cardio-thoracic Immediate reoperation (within 5 SV031E S 111,000 1 Y N Clinical notes Detailed discharge 10
& Vascular surgery) days)–Double Valve Procedure and ECHO and summary, Detailed
doppler reports, Operative notes,
Detailed barcode of
Operative notes valves/rings used.
indicating need Ascertain the need
for Reoperation for reoperation.
1575 SV (Cardio-thoracic Immediate reoperation (within 5 SV031F S 125,000 1 Y N Clinical notes Detailed discharge 12
& Vascular surgery) days)–Triple valve procedure and ECHO and summary, Detailed
doppler reports, Operative notes,
Detailed barcode of
Operative notes valves/rings used.
indicating need Ascertain the need
for Reoperation for reoperation.
1576 SV (Cardio-thoracic Low Cardiac Output syndrome SV032A S 50,000 1 Y N Clinical notes Procedure / 7
& Vascular surgery) requiring IABP insertion post - with planned Operative Notes,
operatively–Low Cardiac Output line of Detailed Discharge
syndrome requiring IABP insertion treatment Summary
post - operatively (including
indication for
need of
required
Procedure )
1577 SV (Cardio-thoracic Re-do sternotomy–Re-do sternotomy SV033A S 20,000 1 Y N Clinical notes Procedure / NA
& Vascular surgery) with planned Operative Notes,
line of Detailed Discharge
treatment Summary
(including
indication for
need of
required
Procedure )
1578 SV (Cardio-thoracic Excessive bleeding requiring re- SV034A S 10,000 1 Y N Clinical notes Procedure / NA
& Vascular surgery) exploration–Excessive bleeding with planned Operative Notes,
requiring re-exploration line of Detailed Discharge
treatment Summary
(including
indication for
need of
required
Procedure )
1579 US (Unspecified Unspecified Surgical US001A S to be 1 Y N Clinical notes Procedure / NA
Surgical Package) Package–Unspecified Surgical negotiated with planned Operative Notes,
Package line of Detailed Discharge
treatment Summary
(including
indication for
need of
required
Procedure )
1580 DP (Diagnostic MRI Head - Without Contrast DP001A M 2500 1 N Y Daycare
Procedures)
1581 DP (Diagnostic MRI Head - with Contrast DP002A M 3500 1 N Y Daycare
Procedures)
1582 DP (Diagnostic MRI Orbits - without Contrast DP003A M 1700 1 N Y Daycare
Procedures)
1583 DP (Diagnostic MRI Orbits - with Contrast DP004A M 5000 1 N Y Daycare
Procedures)
1584 DP (Diagnostic MRI Nasopharynx and PNS - Without DP005A M 2500 1 N Y Daycare
Procedures) Contrast
1585 DP (Diagnostic MRI Nasopharynx and PNS - with DP006A M 5000 1 N Y Daycare
Procedures) Constrast
1586 DP (Diagnostic MRI Neck - Without Contrast DP007A M 2500 1 N Y Daycare
Procedures)
1587 DP (Diagnostic MRI Neck - with Contrast DP008A M 5000 1 N Y Daycare
Procedures)
1588 DP (Diagnostic MRI Shoulder - Without Contrast DP009A M 2500 1 N Y Daycare
Procedures)
1589 DP (Diagnostic MRI Shoulder - with Contrast DP010A M 5000 1 N Y Daycare
Procedures)
1590 DP (Diagnostic MRI Shoulder both Joint - Without DP011A M 2500 1 N Y Daycare
1591 DP (Diagnostic MRI Shoulder both Joint - with DP012A M 5000 1 N Y Daycare
1592 DP (Diagnostic MRI Wrist Single Joint - Without DP013A M 2500 1 N Y Daycare
1593 DP (Diagnostic MRI Wrist Single Joint - with Contrast DP014A M 5000 1 N Y Daycare
Procedures)
1594 DP (Diagnostic MRI Wrist both Joint - Without DP015A M 1000 1 N Y Daycare
1595 DP (Diagnostic MRI Wrist both Joint - with Contrast DP016A M 5000 1 N Y Daycare
Procedures)
1596 DP (Diagnostic MRI Knee Single Joint - Without DP017A M 2500 1 N Y Daycare
1597 DP (Diagnostic MRI Knee Single Joint - with Contrast DP018A M 5000 1 N Y Daycare
Procedures)
1598 DP (Diagnostic MRI Knee both Joint - Without DP019A M 2500 1 N Y Daycare
1599 DP (Diagnostic MRI Knee both Joint - with Contrast DP020A M 5000 1 N Y Daycare
Procedures)
1600 DP (Diagnostic MRI Ankle Single - Without Contrast DP021A M 2500 1 N Y Daycare
Procedures)
1601 DP (Diagnostic MRI Ankle Single - with Contrast DP022A M 5000 1 N Y Daycare
Procedures)
1602 DP (Diagnostic MRI Ankle Both - Without Contrast DP023A M 2500 1 N Y Daycare
Procedures)
1603 DP (Diagnostic MRI Ankle Both - with Contrast DP024A M 5000 1 N Y Daycare
Procedures)
1604 DP (Diagnostic MRI Hip - Without Contrast DP025A M 2500 1 N Y Daycare
Procedures)
1605 DP (Diagnostic MRI Hip - with Contrast DP026A M 5000 1 N Y Daycare
Procedures)
1606 DP (Diagnostic MRI Pelvis - Without Contrast DP027A M 2500 1 N Y Daycare
Procedures)
1607 DP (Diagnostic MRI Pelvis - with Contrast DP028A M 5000 1 N Y Daycare
Procedures)
1608 DP (Diagnostic MRI Extremities - Without Contrast DP029A M 2500 1 N Y Daycare
Procedures)
1609 DP (Diagnostic MRI Extremities - with Contrast DP030A M 5000 1 N Y Daycare
Procedures)
1610 DP (Diagnostic MRI Temporomandibular Single Joint - DP031A M 2500 1 N Y Daycare
Procedures) Without Contrast
1611 DP (Diagnostic MRI Temporomandibular Single Joint - DP032A M 5000 1 N Y Daycare
Procedures) with Contrast
1612 DP (Diagnostic MRI Temporomandibular Double DP033A M 2500 1 N Y Daycare
Procedures) Joints - Without Contrast
1613 DP (Diagnostic MRI Temporomandibular Double DP034A M 5000 1 N Y Daycare
Procedures) Joints - with contrast
1614 DP (Diagnostic MRI Abdomen - Without Contrast DP035A M 2500 1 N Y Daycare
Procedures)
1615 DP (Diagnostic MRI Abdomen - with Contrast DP036A M 5000 1 N Y Daycare
Procedures)
1616 DP (Diagnostic MRI Breast - Without Contrast DP037A M 2500 1 N Y Daycare
Procedures)
1617 DP (Diagnostic MRI Breast - with Contrast DP038A M 5000 1 N Y Daycare
Procedures)
1618 DP (Diagnostic MRI Spine Screening - Without DP039A M 1000 1 N Y Daycare
1619 DP (Diagnostic MRI Spine Screening - with Contrast DP040A M 4000 1 N Y Daycare
Procedures)
1620 DP (Diagnostic MRI Chest - Without Contrast DP041A M 2500 1 N Y Daycare
Procedures)
1621 DP (Diagnostic MRI Chest - with Contrast DP042A M 5000 1 N Y Daycare
Procedures)
1622 DP (Diagnostic MRI Cervical Spine - Without Contrast DP043A M 1000 1 N Y Daycare
Procedures)
1623 DP (Diagnostic MRI Cervical Spine - with Contrast DP044A M 5000 1 N Y Daycare
Procedures)
1624 DP (Diagnostic MRI Lumber Spine - Without Contrast DP045A M 2500 1 N Y Daycare
Procedures)
1625 DP (Diagnostic MRI Lumber Spine - with Contrast DP046A M 5000 1 N Y Daycare
Procedures)
1626 DP (Diagnostic MRI Screening - Without Contrast DP047A M 1000 1 N Y Daycare
Procedures)
1627 DP (Diagnostic MRI Screening - with Contrast DP048A M 4000 1 N Y Daycare
Procedures)
1628 DP (Diagnostic MRI Angiography - Without Contrast DP049A M 1200 1 N Y Daycare
Procedures)
1629 DP (Diagnostic MRI Angiography - with Contrast DP050A M 5000 1 N Y Daycare
Procedures)
1630 DP (Diagnostic Mammography (Single side) DP051A M 450 1 N Y Daycare
Procedures)
1631 DP (Diagnostic Mammography (Both sides) DP052A M 540 1 N Y Daycare
Procedures)
1632 DP (Diagnostic Pulmonary function test DP053A M 430 1 N Y Daycare
Procedures)
1633 DP (Diagnostic Fibroptic Bronchoscopy with DP054A M 1830 1 N Y Daycare
Procedures) Washing/Biopsy
1634 DP (Diagnostic Uroflow Study (Micturometry) DP055A M 330 1 N Y Daycare
Procedures)
1635 DP (Diagnostic Urodynamic Study (Cystometry) DP056A M 400 1 N Y Daycare
Procedures)
1636 DP (Diagnostic Cystoscopy with Retrograde Catheter - DP057A M 2620 1 N Y Daycare
Procedures) Unilateral
1637 DP (Diagnostic Cystoscopy with Retrograde Catheter - DP058A M 3300 1 N Y Daycare
Procedures) Bilateral
1638 DP (Diagnostic Cystoscopy Diagnostic DP059A M 1570 1 N Y Daycare
Procedures)
1639 DP (Diagnostic Cystoscopy with Bladder Biopsy DP060A M 2000 1 N Y Daycare
Procedures)
1640 DP (Diagnostic Cat Scan (C.T.) Head/ Brain - Without DP061A M 900 1 N Y Daycare
1641 DP (Diagnostic Cat Scan (C.T.) Head / Brain - with DP062A M 1400 1 N Y Daycare
1642 DP (Diagnostic C.T. Head Scan Involv. Spl. DP063A M 1400 1 N Y Daycare
Procedures) Investigation - Without Contrast
1643 DP (Diagnostic C.T. Head Involv. Spl. Investigation - DP064A M 1900 1 N Y Daycare
1644 DP (Diagnostic C.T. Chest (HRCT) - Without Contrast DP065A M 1700 1 N Y Daycare
Procedures)
1645 DP (Diagnostic C.T. Chest (HRCT) - with Contrast DP066A M 2140 1 N Y Daycare
Procedures)
1646 DP (Diagnostic C.T. Spine DP067A M 1440 1 N Y Daycare
Procedures) (Cervical,Dorsal,Lumbar,Sacral) -
Without Contrast
1647 DP (Diagnostic C.T. Spine DP068A M 2300 1 N Y Daycare
Procedures) (Cervical,Dorsal,Lumbar,Sacral) - with
Contrast
1648 DP (Diagnostic C.T. Cervical C.T. 3D Reconstruction DP069A M 2945 1 N Y Daycare
Procedures) only
1649 DP (Diagnostic C.T. Guided Biopsy DP070A M 1000 1 N Y Daycare
Procedures)
1650 DP (Diagnostic C.T. Guided percutaneous cath DP071A M 1200 1 N Y Daycare
Procedures) drainage
1651 DP (Diagnostic C.T. Myelogram (Cervical Spine) - DP072A M 1800 1 N Y Daycare
1652 DP (Diagnostic C.T. Myelogram (Cervical Spine) - DP073A M 2558 1 N Y Daycare
1653 DP (Diagnostic C.T. Myelogram (Lumbar Spine or DP074A M 2000 1 N Y Daycare
Procedures) D/S) - Without Contrast
1654 DP (Diagnostic C.T. Myelogram (Lumbar Spine or DP075A M 2558 1 N Y Daycare
Procedures) D/S)- with Contrast
1655 DP (Diagnostic C.T. Scan Chest - Without Contrast DP076A M 1400 1 N Y Daycare
Procedures)
1656 DP (Diagnostic C.T. Scan Chest - with Contrast DP077A M 2325 1 N Y Daycare
Procedures)
1657 DP (Diagnostic C.T. Scan Upper Abdomen - Without DP078A M 1300 1 N Y Daycare
1658 DP (Diagnostic C.T. Scan Upper Abdomen - with DP079A M 2092 1 N Y Daycare
1659 DP (Diagnostic C.T. Scan Lower Abdomen - Without DP080A M 1680 1 N Y Daycare
1660 DP (Diagnostic C.T. Scan Lower Abdomen - with DP081A M 2092 1 N Y Daycare
1661 DP (Diagnostic C.T. Scan Whole Abdomen - Without DP082A M 2092 1 N Y Daycare
1662 DP (Diagnostic C.T. Scan Whole Abdomen - with DP083A M 3400 1 N Y Daycare
1663 DP (Diagnostic C.T. Scan Neck (Thyroid Soft Tissue) - DP084A M 1560 1 N Y Daycare
1664 DP (Diagnostic C.T. Scan Neck (Thyroid Soft Tissue) - DP085A M 1940 1 N Y Daycare
1665 DP (Diagnostic C.T. Scan Orbits - Without Contrast DP086A M 1200 1 N Y Daycare
Procedures)
1666 DP (Diagnostic C.T. Scan Orbits - with contract DP087A M 1750 1 N Y Daycare
Procedures)
1667 DP (Diagnostic C.T. Scan Limbs - Without Contrast DP088A M 1700 1 N Y Daycare
Procedures)
1668 DP (Diagnostic C.T. Scan Limbs - with Contrast DP089A M 2300 1 N Y Daycare
Procedures)
1669 DP (Diagnostic C.T. Scan Whole Body - Without DP090A M 6700 1 N Y Daycare
1670 DP (Diagnostic C.T. Scan Whole Body - with Contrast DP091A M 9000 1 N Y Daycare
Procedures)
1671 DP (Diagnostic C.T. Scan of Para Nasal Sinus - DP092A M 1520 1 N Y Daycare
1672 DP (Diagnostic C.T. Scan of Para Nasal Sinus - with DP093A M 1860 1 N Y Daycare
Procedures) Constrast

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Health Benefit Package 2.

0 under Ayushman Bharat and HIMCARE

13 BM (Burns Electrical contact burns–Electrical BM004A S 30,000 2 Y N Circumstances Post Treatment 19

14 BM (Burns Electrical contact burns–Electrical BM004B S 40,000 2 Y N Circumstances Post Treatment 19

16 BM (Burns Electrical contact burns–Electrical BM004D S 50,000 1 Y N Circumstances Post Treatment 19

17 BM (Burns Chemical burns–Chemical burns: BM005A S 40,000 4 Y N Circumstances Post Treatment 19

21 ER (Emergency Laceration - Suturing / ER001A M 2,000 1 N N Clinical notes Clinical notes / NA

23 ER (Emergency Cardiopulmonary ER002B M 10,000 2 N N Clinical notes Clinical notes / NA

40 MC (Cardiology) Right / Left Heart MC001A S 5,000 2 Y N Clinical notes Discharge 2

46 MC (Cardiology) Balloon Dilatation–Pulmonary Artrey MC003B S 71,600 2 Y N ECHO & CT Procedure / 2

48 MC (Cardiology) Balloon Pulmonary / Aortic MC004B S 56,400 2 Y N Clinical notes Procedure / 2

49 MC (Cardiology) Balloon Mitral Valvotomy–Balloon MC005A S 90,700 2 Y N Clinical notes Procedure / 2

50 MC (Cardiology) Balloon Atrial Septostomy–Balloon MC006A S 24,400 2 Y N Clinical notes Procedure / 2

55 MC (Cardiology) PTCA, inclusive of diagnostic MC011A S 72,200 3 Y N ECG, ECHO, Procedure / 2

64 MC (Cardiology) Pericardiocentesis–Pericardiocentesis MC019A S 12,100 2 Y N Clinical notes Intra procedure 1

70 MG (General Malaria–Complicated malaria MG003B M Package 2 N N Clinical notes Detailed ICPs, NA

74 MG (General Chikungunya fever–Chikungunya MG005A M Package 2 N N Clinical notes Detailed ICPs, NA

80 MG (General Diarrohea–Chronic diarrohea MG010A M Package 6 N N Clinical notes Detailed Discharge NA

82 MG (General Dysentery–Dysentery MG011A M Package 5 N N Clinical notes Detailed ICPs, NA

86 MG (General Visceral leishmaniasis–Visceral MG015A M Package 3 N N Clinical notes Detailed ICPs, NA

88 MG (General Severe pneumonia–Severe MG017A M Package 1 N N Clinical notes Detailed ICPs, NA

92 MG (General Pericardial / Pleural MG020B M Package 5 N N Clinical notes Detailed ICPs, NA

108 MG (General Ascites–Ascites MG034A M Package 2 Y N Clinial notes, Ascitic Fluid NA

124 MG (General Seizures–Seizures MG046A M Package 5 N N Clinical notes Detailed ICPs, NA

126 MG (General Cerebrovascular MG048A M Package 6 N N Clinical notes Detailed ICPs, NA

132 MG (General Hydrocephalus–Hydrocephalus MG051A M Package 3 N N Clinical notes Detailed ICPs, NA

136 MG (General Pneumothroax–Pneumothroax MG055A M Package 5 N N Clinical notes Detailed ICPs, NA

138 MG (General Hypoglycemia–Hypoglycemia MG057A M Package 0 N N Clincal notes, Post treatment NA

146 MG (General Accelerated MG062A M Package 0 N N Clinical notes Detailed ICPs, NA

164 MG (General Unspecified Medical MG077A M to be 0 Y N Clinical Notes Detailed treatment NA

591 SB (Orthopaedics) Arthrodesis–Shoulder SB026B S 20,000 3 Y N Clinical notes Post procedure X- 3

593 SB (Orthopaedics) Arthrodesis–Knee SB026D S 25,000 1 Y N Clinical notes Post procedure X- 4

594 SB (Orthopaedics) Arthrodesis–Hand SB026E S 27,000 1 Y N Clinical notes Post procedure X- 3

595 SB (Orthopaedics) Arthrodesis–Foot SB026F S 27,000 1 Y N Clinical notes Post procedure X- 3

650 SB (Orthopaedics) Fasciotomy–Fasciotomy SB050A S 10,500 10 Y N Clinical Detailed discharge 2

685 SC (Surgical Maxillectomy–Radical SC003B S 33,000 3 Y N Clinical notes detailed Procedure / 8

686 SC (Surgical Maxillectomy–Total SC003C S 30,000 3 Y N Clinical notes detailed Procedure / 8

690 SC (Surgical Transthoracic esophagectomy: 2F / SC006A S 60,000 3 Y N Clinical notes Procedure / 7

696 SC (Surgical Intersphincteric resection–Lap. SC009B S 40,200 3 Y N Clinical notes Procedure / 6

728 SC (Surgical Radical Urethrectomy –Radical SC026A S 30,000 7 Y N CT KUB, Procedure / 5

749 SC (Surgical Total Pharyngectomy–Total SC038A S 36,000 2 Y N Clinical notes Procedure / 8

759 SC (Surgical Mediastinoscopy–Diagnostic SC047A S 22,200 5 Y N Cinical notes, Procedure / 2

769 SC (Surgical Thoracostomy–Thoracostomy SC054A S 19,800 5 Y N Clinical notes Procedure / 2

869 SG (General Gastrojejunostomy–Gastrojejunostom SG010A S 18,500 10 N N Clinical notes intra operative 5

870 SG (General CystoJejunostomy / SG011A S 20,000 10 N N Clinical notes Detailed discharge 6

875 SG (General Ileostomy–Ileostomy SG013A S 14,000 0 N N Clinical notes Histopath, Post 6

881 SG (General Appendicectomy–Lap. SG017B S 11,000 0 N N Clinical notes Histopathology 3

882 SG (General Appendicular SG018A S 17,500 0 N N Clinical notes Histopath, Intra 5

885 SG (General Total Colectomy–Lap. SG020B S 23,000 0 N N Clinical notes Histopathology, 7

900 SG (General Resection Anastomosis–Open SG030A S 25,000 0 N N Clinical notes Histopath of 7

919 SG (General Splenectomy–Open SG042A S 25,000 5 N N Clinical notes Detailed Operative 7

948 SG (General Vasovasostomy–Vasovasostomy SG058A S 12,000 0 N N Clinical notes Detailed discharge 2

975 SG (General Thoracoplasty–Thoracoplasty SG079A S 20,000 0 N N Clinical notes Post procedure 6

978 SG (General Lobectomy–Open SG081B S 27,500 7 N N Clinical notes Intra procedure 5

1008 SL Stapedectomy / SL003A S 18,000 10 Y N Clinical notes Intra procedure 2

1028 SL Tonsillectomy–Tonsillectomy - B/L SL016B S 7,500 0 Y N Indication for Histopathology 2

1041 SL Parotidectomy–Superficial SL021B S 23,800 0 Y N CT Scan, Histopathology 3

1053 SL Neck dissection–Comprehensive SL027B S 18,800 0 Y N Indication for Histopathology 3

1055 SL Neck dissection–Comprehensive SL027D S 18,800 0 Y N Indication for Histopathology 3

1065 SL Lateral skull base SL031A S 33,700 7 Y N Clinical notes Procedure / 6

1093 SN (Neurosurgery) CranioPlasty–CranioPlasty with SN002A S 20,000 0 Y N CT/MRI Post procedure 7

1096 SN (Neurosurgery) Craniostenosis–Craniostenosis SN004A S 28,000 0 N N Clinical notes Post procedure 7

1099 SN (Neurosurgery) Meningocele–Occipital SN005C S 50,000 0 N N Clinical notes Post procedure 10

1145 SN (Neurosurgery) Neurectomy–Neurectomy SN035A S 16,000 0 N N Clinical notes Post procedure 5