Republic of the Philippines

Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Organ Transplant Services Unit

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 BLOOD EXTRACTION FEE 160.00 - -
2 Kidney Transplantation (Z package) 200,000.00 - -
3 Kidney Transplantation (Z package) 400,000.00 - -
4 Kidney Transplantation (Z package) variable co-pay 600,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Out-Patient Services
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 DRESSING FEE (MEDIUM, INCL REM SUT) 50.00 - -
2 Injection Fee 30.00 - -
3 NEBULIZATION FEE 50.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Parasitology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 C-Arm Machine 1,800.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Pharmacy
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 PARACETAMOL 500MG IV 50ML VIAL 253.00 - -
2 10% Dextrose in Water (D10W) 500ml Bottle 55.00 - -
3 10% DEXTROSE IN WATER 500 ML BOTTLE 55.00 - -
4 5% Dextrose in 0.3% Sodium Chloride Solution 500mL Bottle 55.00 - -
5 5% Dextrose in 0.9% Sodium Chloride Solution (D5 NSS) 1L Bottle 32.00 - -
6 5% Dextrose in Water (D5W) 500mL Bottle 30.00 - -
7 6-MERCAPTOPURINE (CAPMERIN) TABLET 47.25 - -
8 Acetazolamide 250mg Tablet 28.00 - -
9 ACETYLCYSTEINE (FLUIMUCIL) 100MG/ML SOLUTION FOR 144.00 - -
INHALATION AMPULE
10 ACETYLCYSTEINE 100MG/ML 3ML IV/IM AMPULE 180.00 - -
11 ACETYLCYSTEINE 200MG, GRANULES FOR ORAL SOLUTION, SACHET 9.00 - -

12 ACETYLCYSTEINE 200MG/ML IV VIAL 1,985.00 - -

13 ACETYLCYSTEINE 600MG EFFERVESCENT TABLET 25.00 - -
14 ACICLOVIR (ZYCLOR) 25MG/ML 10ML VIAL 489.00 - -
15 ACICLOVIR 250MG/10ML VIAL 243.00 - -
16 ACICLOVIR 400MG TABLET 13.00 - -
17 ACICLOVIR 800MG TABLET 69.50 - -
18 ACID CONCENTRATE (FS) 355.00 - -
19 ACYCLOVIR SODIUM 250ML VIAL 1,325.00 - -
20 ADENOSINE (CARDIOSINE) 3MG/ML 2ML AMPULE 326.00 - -
21 ADENOSINE 3MG/ML VIAL 280.00 - -
22 ADRENALINE/EPINEPHRINE 1MG/ML IM/SC/IV 1ML AMPULE 30.00 - -
23 Alendronic Acid (Reventa) 70mg Tablet 57.50 - -
24 Alendronic acid 70mg Tablet 169.00 - -
25 ALFUZOCIN HYDROCHLORIDE 10MG TABLET 42.00 - -
26 ALL-IN-ONE ADMIXTURES (KABIVEN) 3-IN-1 1000KCAL BAG 2,095.00 - -
27 ALL-IN-ONE ADMIXTURES 1400KCAL 2,313.00 - -
28 ALLOPURINOL (ALLUPREX) 300MG TABLET 3.00 - -
29 Allopurinol (Urisol) 100mg tablet 2.00 - -
30 ALLOPURINOL 100MG TABLET 8.00 - -
31 ALLOPURINOL 300MG TABLET 14.00 - -
32 Alprazolam 500mcg Tablet 21.00 - -
33 AMIKACIN 500MG VIAL 29.50 - -
34 AMIKACIN SULFATE 100mg vial 32.00 - -
35 AMIKACIN SULFATE 250MG VIAL 32.00 - -
36 AMINO ACID + ELECTROLYTES + GLUCOSE + VITAMIN B1 1000ML 1,028.00 - -
SOLUTION FOR INJECTION
37 AMINO ACID + ELECTROLYTES + GLUCOSE + VITAMIN B1 500ML 692.00 - -
SOLUTION FOR INJECTION
38 AMINO ACID + SORBITOL (NUTRILON-SN5) 500ML BOTTLE 723.00 - -
39 AMINO ACID + SORBITOL 500ML VIAL 675.00 - -
40 AMINO ACID 6% 100ML BOTTLE 523.00 - -
41 AMINO ACID SOLUTIONS FOR INFANTS 6% (AMINOSTERIL INFANT) 555.00 - -
100 ML
42 AMINO ACIDS 70MG/ML (7%W/V) IV 500ML SOL'N BOTTLE 489.00 - -
43 AMINO ACIDS 8%, 500ML BOTTLE 795.00 - -
44 AMINO ACIDS, CRYSTALLINE STANDARD 10% 500ML BOTTLE 645.00 - -
45 AMINOPHYLLINE 25MG/ML (AMINOSOL) 10ML AMPULE 42.00 - -
 46 AMINOPHYLLINE 25mg/ml 10ML AMPULE 26.00 - -
47 Amiodarone 200mg Tablet 13.00 - -
48 AMIODARONE HCL150MG/ML AMPULE 165.00 - -
49 AMLODIPINE (AMLOTHIX) 10MG TABLET 1.00 - -
50 AMLODIPINE (AS BESILATE) 10MG TABLET 2.00 - -
51 AMLODIPINE (AS BESILATE) 5MG TABLET 1.00 - -
52 AMLODIPINE (BLOCAPAST) 10MG TABLET 3.00 - -
53 Amoxicillin (as Trihydrate) 500 mg Capsule 2.00 - -
54 AMOXICILLIN (AXMEL) 250MG/5ML 60ML SUSPENSION 32.00 - -
55 AMOXICILLIN 100MG/ML 15ML DROPS 24.00 - -
56 AMOXICILLIN 100MG/ML DROPS 24.00 - -
57 AMOXICILLIN 500MG CAPSULE 2.00 - -
58 AMPHOTERICIN B 50MG WITH LIPIDS 11,573.00 - -
59 AMPICILLIN + SULBACTAM 1.5G VIAL 85.00 - -
60 AMPICILLIN + SULBACTAM 750MG VIAL 28.00 - -
61 AMPICILLIN 1g vial 15.00 - -
62 AMPICILLIN SODIUM 1G VIAL 15.00 - -
63 ANTI-RABIES (SPEEDA) 2.5IU/0.5ML 0.5ML PFS VACCINE 1,545.00 - -
64 ANTI-RABIES SERUM (EQUINE RABIES IMMUNOLOBULIN) 1,191.00 - -
1000IU/5ML
65 ANTI-RABIES VACCINE 0.5ML AMPULE 842.00 - -
66 ASCORBIC ACID (APCEE) 100MG/5ML 60ML SYRUP 31.00 - -
67 ASCORBIC ACID (ASCORGEN) 500MG TABLET 1.00 - -
68 ASCORBIC ACID (NOVACEE) 100MG/ML 30ML ORAL DROPS 32.00 - -
69 ASCORBIC ACID (VITAMIN C) 500MG/2ML AMPULE 56.00 - -
70 ASCORBIC ACID 500MG TABLET 2.00 - -
71 ASPIRIN (ASTHROMED) 100MG TABLET 2.00 - -
72 ASPIRIN (PHILPRIN) 80MG TABLET 2.00 - -
73 ASPIRIN 80MG TABLET 1.00 - -
74 Atenolol 100mg Tablet 6.50 - -
75 ATENOLOL 50MG TABLET 3.00 - -
76 ATORVASTATIN (ATORSAPH) 10MG TABLET 3.50 - -
77 ATORVASTATIN (ATORSAPH) 20MG TABLET 6.00 - -
78 ATORVASTATIN (VAZI2R) 40MG TABLET 6.00 - -
79 ATORVASTATIN CALCIUM 20MG TABLET 4.00 - -
80 ATORVASTATIN CALCIUM 40MG TABLET 9.00 - -
81 ATORVASTATIN CALCIUM 80MG TABLET 26.00 - -
82 Atracurium besylate 25mg/2.5ml ampule 95.00 - -
83 ATROPINE SULFATE (BADE'S) 1MG/ML AMPULE 294.00 - -
84 ATROPINE SULFATE 1MG/ML AMPULE 294.00 - -
85 AZITHROMYCIN (AS DIHYDRATE) 200MG/5ML POWDER FOR 195.00 - -
SUSPENSION 15ML BOTTLE (THROMAXIN)
86 AZITHROMYCIN (AZTROZIN) 500MG VIAL 402.00 - -
87 AZITHROMYCIN (PROXITRO-DS) 200MG/5ML 15ML SUSPENSION 243.00 - -
88 AZITHROMYCIN (PROZITHRO) 200MG/5ML 15ML SUSPENSION 243.00 - -
89 AZITHROMYCIN 500MG IV VIAL 483.00 - -
90 AZITHROMYCIN 500MG TABLET 12.50 - -
91 AZTREONAM 1G POWDER FOR INJECTION VIAL 1,006.00 - -
92 AZTREONAM 1G VIAL (ENDURE) 1,330.50 - -
93 Baclofen 10mg Tablet 22.00 - -
94 Baricitinib 4mg film-coated tablet 1,203.00 - -
95 BASILIXIMAB 20MG VIAL 46,286.00 - -
96 BENZATHINE BENZYLPENICILLIN (PHILPHARMA) 1,200,000 IU 99.00 - -
POWDER FOR INJECTION VIAL
97 BENZATHINE PENICILLIN 1.2M IU VIAL 70.00 - -
98 BENZYLPENICILLIN (BENZYLPENICILLIN) 1M UNITS VIAL 21.00 - -
99 BENZYLPENICILLIN (BENZYLPENICILLIN) 5M UNITS VIAL 20.00 - -
100 BENZYLPENICILLIN Na (HARBIPEN) 5MILLION UNITS VIAL 35.00 - -
101 Benzylpenicillin sodium 1.2MIU Vial 21.00 - -
102 BETAHISTINE (AS HYDROCHLORIDE) 16MG TABLET 15.50 - -
103 BETAHISTINE (AS HYDROCHLORIDE) 24MG TABLET 28.00 - -
104 BETAHISTINE (AS HYDROCHLORIDE) 8MG TABLET 13.00 - -
105 BETAHISTINE (Betzine) 16MG TABLET 12.00 - -
106 BETAMETHASONE (BETNOCHEM/METSOBET) 0.1% CREAM 5G TUBE 58.00 - -

107 BETAMETHASONE 0.1%, 5G OINTMENT TUBE 58.50 - -

108 BICALUTAMIDE 50MG TABLET 56.00 - -
109 Biperiden (Aketon) 2mg tablet 13.00 - -
110 BIPERIDEN 2MG TABLET 8.00 - -
111 BIPHASIC ISOPHANE HUMAN 70/30 (INSUGET 70/30) 100IU/ML VIAL 122.00 - -

112 BIPHASIC ISOPHANE HUMAN INSULIN (rDNA) 70/30 100IU/ML 10ML 121.00 - -

113 BISACODYL (DULXATIVE) 10MG ADULT SUPPOSITORY 33.00 - -

114 BISACODYL (DYLAX) 10MG TABLET 2.00 - -
115 BISACODYL 10MG SUPPOSITORY 27.00 - -
116 BISACODYL 5MG TABLET 17.00 - -
117 BLEOMYCIN SULFATE (TUMOCIN) 15UNITS VIAL 2,665.00 - -
118 BLEOMYCIN SULFATE 15MG VIAL 2,295.00 - -
119 Budesonide (Budeson) 250mcg/ml 2ml Nebule 67.00 - -
120 BUDESONIDE + FORMOTEROL 160 MCG + 4.5 MCG, 120 DOSES 1,021.00 - -
METERED DOSE INHALER
121 BUDESONIDE 250 MCG/ML 2ML RESPIRATORY SOLUTION NEBULE 42.00 - -

122 BUPIVACAINE (HEAVY) + DEXTROSE 0.5%, 8% 4ML AMPULE 114.00 - -

123 Bupivacaine (isobaric) 0.5% 10ml Ampule 122.00 - -
124 BUPIVACAINE ISOBARIC (BUPICAN) 0.5% 10ML AMPULE 138.00 - -
125 Butamirate Citrate 50mg MR Tablet 21.00 - -
126 CALCIPOTRIOL + BETAMETHASONE 50MCG+500MCG/G 30G TUBE 2,168.00 - -

127 CALCIUM + CHOLECALCIFEROL (VITAMIN D3) EQUIV. TO 600MG 5.00 - -

ELEMENTAL CALCIUM + 400IU FILM COATED TABLET
128 CALCIUM CARBONATE (CALCISAPH) 500MG TABLET 2.00 - -
129 CALCIUM FOLINATE (LEUCOWEL) 50MG/5ML VIAL 177.00 - -
130 CALCIUM FOLINATE 50MG/5ML VIAL 153.00 - -
131 CALCIUM GLUCONATE (CALCILYTE) 10%-10ML AMPULE 63.00 - -
132 Calcium Gluconate 10% 10mL ampule 21.50 - -
133 CANDESARTAN CILEXETIL 16MG TABLET 17.00 - -
134 CAPECITABINE (CAXETA) 500MG TABLET 64.00 - -
135 CAPECITABINE 500MG TABLET 63.00 - -
136 CAPTOPRIL (HYPERSTOP) 25MG TABLET 4.00 - -
137 CAPTOPRIL 25MG TABLET 4.25 - -
138 CARBAMAZEPINE 200MG TABLET 3.00 - -
139 CARBETOCIN (DURATOCIN RTS) 100MCG/ML VIAL 1,885.00 - -
140 CARBOPLATIN (CARBOL) 10MG/ML 45ML VIAL 1,710.00 - -
141 CARBOPLATIN (CARBOTIN) 10MG/ML 15ML VIAL 1,011.00 - -
142 CARBOPLATIN 10MG/ML 15ML VIAL 1,258.00 - -
143 CARBOPLATIN 10MG/ML 45ML VIAL 2,103.00 - -
144 CARVEDILOL (CARVIDOL) 6.25MG TABLET 4.00 - -
145 CARVEDILOL (GLOVEDOL) 6.25MG TABLET 4.50 - -
146 CARVEDILOL (KARVIDOL/CARDOZ) 25MG TABLET 6.50 - -
147 Carvedilol 25mg Tablet 8.40 - -
148 CARVEDILOL 6.25MG TABLET 2.00 - -
149 CEFADROXYL 500MG TABLET 32.50 - -
150 CEFALEXIN (SAPHLEXIN/ZEFALEX) 500MG CAPSULE 5.50 - -
151 Cefalexin 250mg/5ml 60ml Oral Suspension 37.00 - -
152 CEFALEXIN 500MG CAPSULE 4.00 - -
153 CEFAZOLIN SODIUM (FAZLIN) 1GM VIAL 45.00 - -
154 CEFAZOLIN SODIUM 1GM VIAL 24.00 - -
155 CEFEPIME (AS HYDROCHLORIDE) 1G SOLUTION VIAL 89.00 - -
156 CEFEPIME (AS HYDROCHLORIDE) 2G SOLUTION VIAL 530.00 - -
157 CEFEPIME (NEUPIME) 1G VIAL 161.00 - -
158 CEFEPIME (PIMEMAX) 1G VIAL 723.00 - -
159 CEFEPIME (SEPIME) 1G VIAL 489.00 - -
160 CEFIXIME (ZEFIX) 200MG CAPSULE 15.00 - -
161 CEFIXIME 100MG/5ML 60ML ORAL SUSPENSION 195.00 - -
162 CEFIXIME 200MG TABLET 10.00 - -
163 CEFIXIME 400MG TABLET 57.50 - -
164 CEFOTAXIME 1G POWDER FOR IM/IV INJECTION 47.00 - -
165 CEFOTAXIME SODIUM 500MG VIAL 73.00 - -
166 Cefoxitin Sodium 1g vial 92.50 - -
167 CEFTAZIDIME (AERUM) 1MG VIAL 435.00 - -
168 CEFTAZIDIME (CEFTIBAC) 1G VIAL 86.00 - -
169 Ceftazidime (Zeftacare) 1g vial 82.00 - -
170 CEFTAZIDIME 1MG VIAL 47.00 - -
171 CEFTRIAXONE (AGLOPHIN) 1G VIAL 159.00 - -
172 Ceftriaxone Sodium 1g Vial 21.50 - -
173 CEFUROXIME (AERUGINOX) 500MG TABLET 40.00 - -
174 CEFUROXIME (CEFUGET) 500MG TABLET 11.20 - -
175 CEFUROXIME (ZENOXIME) 500MG TABLET 21.00 - -
176 CEFUROXIME 250MG/5ML 120ML SUSPENSION 231.00 - -
177 CEFUROXIME 500MG TABLET 13.00 - -
178 CEFUROXIME SODIUM 750MG VIAL 20.00 - -
179 Celecoxib (Celcoxx) 400mg Capsule 10.50 - -
180 CELECOXIB 200MG CAPSULE 7.00 - -
181 CELECOXIB 400MG CAPSULE 16.00 - -
182 CETIRIZINE (ALLECUR P) 10MG/ML 10ML DROPS 63.00 - -
183 CETIRIZINE (CETI-MED) 1MG/ML 30ML ORAL DROPS 110.00 - -
184 CETIRIZINE (CETIREX/MEDRIZINE) 5MG/5ML 30ML SYRUP 49.00 - -
185 CETIRIZINE 10MG TABLET 1.00 - -
186 CETIRIZINE 10MG/ML 10ML DROPS 101.00 - -
187 Cetirizine 5mg/5ml 30ml Syrup 88.00 - -
188 CHLORPROMAZINE 200MG TABLET 3.00 - -
189 CILOSTAZOL (ZATSOL) 50MG TABLET 12.00 - -
190 Cilostazol 100mg Tablet 16.00 - -
191 CILOSTAZOL 50MG TABLET 3.00 - -
192 Ciprofloxacin (Provex) 500mg tablet 4.50 - -
193 CIPROFLOXACIN 2MG/ML 100ML VIAL 26.50 - -
194 CIPROFLOXACIN 500MG TABLET 2.00 - -
195 CISPLATIN (PLATICIN) 1MG/ML 50ML VIAL 435.00 - -
196 CISPLATIN 1MG/ML 50ML VIAL 736.00 - -
197 Clarithromycin (Clariget) 125mg/5ml 50ml suspension 195.00 - -
198 Clarithromycin (Clariget) 500mg Tablet 14.00 - -
199 CLARITHROMYCIN 125MG/5ML 50ML ORAL SUSPENSION 141.00 - -
200 CLARITHROMYCIN 500MG TABLET 21.00 - -
201 CLINDAMYCIN (CLINDAGOLD) 300MG CAPSULE 7.00 - -
202 CLINDAMYCIN 150MG/ML 4ML AMPULE 73.00 - -
203 CLINDAMYCIN 300MG CAPSULE 8.00 - -
204 CLOBETASOL (AS PROPIONATE) 15G OINTMENT 128.00 - -
205 CLOBETASOL (AS PROPIONATE) 5G OINTMENT 68.00 - -
206 CLONAZEPAM 2MG TABLET 11.00 - -
207 CLONIDINE (CATAPIN) 75MCG TABLET 10.50 - -
208 CLONIDINE (CLODIN) 150MCG TABLET 9.00 - -
209 CLONIDINE 150MCG TABLET 17.00 - -
210 CLONIDINE 150MCG/ML 1ML AMPULE 109.00 - -
211 CLONIDINE 75MCG TABLET 7.00 - -
212 Clopidogrel (Artheogrel) 75mg tablet 3.50 - -
213 CLOPIDOGREL 75MG TABLET 2.00 - -
214 CLOTRIMAZOLE (DERMOTRIM) 1% 10G CREAM TUBE 93.00 - -
215 CLOXACILLIN (PHILCLOX) 500MG CAPSULE 5.00 - -
216 CLOXACILLIN 500MG CAPSULE 7.00 - -
217 CLOZAPINE 100MG TABLET 10.00 - -
218 Co-Amoxiclav (Auget) 625mg Tablet 10.00 - -
219 CO-AMOXICLAV (IZZOBREX) 625MG TABLET 37.00 - -
220 CO-AMOXICLAV (RAPICLAV) 1G TABLET 68.00 - -
221 CO-AMOXICLAV 1G TABLET 15.50 - -
222 CO-AMOXICLAV 228.5MG/5ML 70ML SUSPENSION 152.00 - -
223 CO-AMOXICLAV 312.5MG/5ML 60ML SUSPENSION 146.00 - -
224 CO-AMOXICLAV 457MG/5ML 70ML SUSPENSION 193.20 - -
225 CO-AMOXICLAV 625MG TABLET 10.00 - -
226 Colchicine (Goutsaph) 500mcg tablet 3.00 - -
227 COLCHICINE 500MCG TABLET 3.00 - -
228 COLISTIMETHATE SODIUM (COLISAN) 2,000,000 IU VIAL 2,656.00 - -
229 COLISTIMETHATE SODIUM 2,000,000 IU VIAL 2,426.00 - -
230 COMBINED GLUCOSE AMINO ACID SOLUTIONS 5%, 500ML BOTTLE 987.00 - -

231 COTRIMOXAZOLE (ZOLBACH) 800MG/160MG TABLET 3.00 - -

232 COTRIMOXAZOLE 400MG/80MG 5ML 1,765.00 - -
233 COTRIMOXAZOLE 800MG/160MG TABLET 4.20 - -
234 Cyclophosphamide (Cytoace) 500mg Vial 183.00 - -
235 Cyclophosphamide (Glotoxan) 500mg Vial 502.00 - -
236 CYCLOPHOSPHAMIDE 1G VIAL 589.00 - -
237 CYCLOPHOSPHAMIDE 500MG VIAL 484.00 - -
238 CYTARABINE (MPL) 100MG VIAL 525.00 - -
239 Cytarabine 100mg/ml 1ml vial 465.00 - -
240 CYTARABINE 1G VIAL 1,405.00 - -
241 D5 0.45% SODIUM CHLORIDE 1L BOTTLE 178.00 - -
242 D5 0.45% SODIUM CHLORIDE 500ML BOTTLE 55.00 - -
243 D5 LRS 1L 62.00 - -
244 D5 WATER (PHILPHARMA) 500ML BOTTLE 59.00 - -
245 D50 WATER 50ML VIAL 73.00 - -
246 DACARBAZINE (DUTICIN) 200MG VIAL 1,237.00 - -
247 DBL DOCETAXEL INJECTION 20MG/2ML (HOSPIRA) VIAL 1,177.00 - -
248 DBL DOCETAXEL INJECTION 80MG/80ML (HOSPIRA) VIAL 2,879.00 - -
249 DEFERASIROX 125MG DISPERSIBLE TABLET 420.00 - -
250 DEFERASIROX 250MG DISPERSIBLE TABLET 825.00 - -
251 DEFERIPRONE 500MG TABLET 112.00 - -
252 DESFERRIOXAMINEMESILATE 500MG 428.00 - -
253 Dexamethasone (as sodium phosphate) 4mg/mL solution 2mL 15.00 - -
ampule
254 DEXAMETHASONE (DEXANEED) 4MG/ML (8MG/2ML) AMPULE 17.00 - -
255 Dexamethasone 4mg Tablet 21.00 - -
256 DEXAMETHASONE PHOSPHATE (DEXAMAX) 4MG/ML 2ML AMPULE 83.00 - -

257 DEXMEDETOMIDINE 100MCG/ML 2ML 2,012.00 - -

258 DEXTROSE 5% WATER (D5W) 250ML BOTTLE 105.00 - -
259 DIAZEPAM 10MG/ML AMPULE 94.00 - -
260 DICLOFENAC SODIUM 75MG/3ML AMPULE 24.25 - -
261 DICLOFENAC SODIUM (PHILFLAM) 50MG TABLET 2.00 - -
262 DICLOFENAC SODIUM 50MG TABLET 2.00 - -
263 DICYCLOVERINE (DIACIEL) 10MG TABLET 1.00 - -
264 DIGOXIN 250MCG TABLET 6.50 - -
265 Digoxin 500mcg/2ml Ampule 146.50 - -
266 DIGOXIN ELIXIR 50MCG/ML 60ML BOTTLE 825.00 - -
267 DILTIAZEM 30mg TABLET 19.00 - -
268 DILTIAZEM 60mg TABLET 31.50 - -
269 DIPHENHYDRAMINE HCL (BEXIL) 50MG/ML AMPULE 29.00 - -
270 DIPHENHYDRAMINE HCL (RABAPHEN/ALLERIGHT) 50MG/ML 29.00 - -
AMPULE
271 DIPHENHYDRAMINE HCL 50MG/ML AMPULE 26.00 - -
272 DOBUTAMINE (DOBUCORE) 12.5MG/ML 250MG/20ML VIAL 327.00 - -
273 DOBUTAMINE HCL 250MG/ML 20ML VIAL 327.00 - -
274 DOCETAXEL 20MG/0.5ML VIAL 1,273.00 - -
275 DOCETAXEL 40MG/ML 2ML VIAL 3,273.00 - -
276 DOMPERIDONE (ACCEDOME) 1MG/ML 60ML SUSPENSION 116.00 - -
277 DOMPERIDONE (SAPHRIDONE) 10MG TABLET 2.00 - -
278 DOMPERIDONE 1MG/ML 60ML SUSPENSION 145.00 - -
279 DONEPEZIL 10MG ODT TABLET 49.00 - -
280 DONEPEZIL 5MG ODT TABLET 21.00 - -
281 DOPAMINE (DOPAMAX) 40MG/ML 5ML AMPULE 100.00 - -
282 DOPAMINE 200MG/250ML 387.00 - -
283 DOXORUBICIN 2MG/ML 25ML VIAL 832.00 - -
284 DOXYCYCLINE (DOXYSAPH/MYDOXY) 100MG CAPSULE 3.50 - -
285 Doxycycline 100mg Capsule 2.00 - -
286 DYDROGESTERONE 10MG TABLET 72.00 - -
287 ELTROMBOPAG OLAMINE 50MG TABLET 1,572.00 - -
288 ENOXAPARIN (CLAXO 60) 100MG/ML 0.6ML PRE-FILLED SYRINGE 675.00 - -
289 ENOXAPARIN NA 100MG/ML 0.4ML PRE-FILLED SYRINGE 236.00 - -
290 ENOXAPARIN NA 100MG/ML 0.6ML PRE-FILLED SYRINGE 369.00 - -
291 EPERISONE 50MG TABLET 17.00 - -
292 EPHEDRINE SULFATE 50MG/ML 1ML AMPULE 125.00 - -
293 EPOETIN BETA (RECORMON) 5000 IU / 0.3 ML PRE- FILLED SYRINGE 1,151.00 - -

294 ERTAPENEM (AS SODIUM) 1G SOLUTION VIAL 2,934.00 - -

295 ERYTHROMYCIN (ERYSAPH T500) 500MG TABLET 6.00 - -
296 ERYTHROMYCIN (ERYZIN) 5MG/G (0.5%) OPTHALMIC OINTMENT 163.00 - -
297 ERYTHROMYCIN 0.5% OPTHALMIC OINMENT 122.00 - -
298 ERYTHROMYCIN 500MG TABLET 6.00 - -
299 Escitalopram oxalate 10mg Tablet 5.00 - -
300 ESMOLOL HCL 10MG/ML (100MG/ML) SOLUTION VIAL 611.00 - -
301 ETOPOSIDE (ETOPA) 100MG 5ML AMPULE 673.50 - -
302 Etoposide 100mg vial 649.00 - -
303 FAMOTIDINE 20MG/2ML VIAL 170.00 - -
304 FAVIPIRAVIR 200MCG TABLET 82.00 - -
305 FELODIPINE 5mg TABLET 11.00 - -
306 FENOFIBRATE 200MG TABLET 16.00 - -
307 FENTANYL CITRATE 50MCG/ML 2ML AMPULE 70.00 - -
308 FERROUS SULFATE + FOLIC ACID (PHIL PHARMA) 60MG ELEMENTAL 3.00 - -
IRON + 400MCG FILM COATED TABLET
309 FERROUS SULFATE + FOLIC ACID TABLET 4.00 - -
310 FILGRASTIN 300MCG/ML VIAL 1,247.00 - -
311 FINASTERIDE (VEXFIN) 5MG TABLET 7.00 - -
312 Finasteride 5mg Tablet 10.00 - -
313 FLUCONAZOLE (DIFLU-150) 150MG CAPSULE 35.00 - -
314 FLUCONAZOLE (DIFLUCAN) 2MG/ML 100 ML VIAL 675.00 - -
315 FLUCONAZOLE (FUNGICAN) 200MG/100ML VIAL 470.00 - -
316 FLUCONAZOLE 150MG CAPSULE 82.00 - -
317 Fluconazole 200mg Capsule 255.00 - -
318 Fluconazole 200mg/100ml Vial 288.00 - -
319 FLUOROURACIL (RACIFLUORO) 50MG/ML 10ML VIAL 90.00 - -
320 FLUOXETINE 20MG TABLET 10.50 - -
321 FLUPENTIXOL 20MG/ML 10ML AMPULE 422.00 - -
322 FLUPHENAZINE DECANOATE (FLENAZINE) 250MG/ML VIAL10ML 176.00 - -
323 FOLIC ACID (FOLTZ) 5MG TABLET 4.20 - -
324 FOLIC ACID 5MG TABLET 3.00 - -
325 FONDAPARINUX SODIUM 2.5/0.5ML PRE-FILLED SYRINGE 1,380.00 - -
326 FOSFOMYCIN (MONUROL) 3G GRANULES FOR SOLUTION 437.00 - -
327 FUROSEMIDE 20MG / ml AMPULE 8.00 - -
328 FUROSEMIDE 20MG TABLET 2.00 - -
329 FUROSEMIDE 40MG TABLET 2.50 - -
330 FUSIDATE SODIUM 2% 5G OINTMENT 255.00 - -
331 FUSIDIC ACID 2% 15G OINTMENT 291.00 - -
332 GABAPENTIN (GABIX) 100MG TABLET 7.00 - -
333 GABAPENTIN (GABIX) 300MG TABLET 8.00 - -
334 Gabapentin 100mg tablet 8.00 - -
335 Gabapentin 300mg tablet 7.00 - -
336 GADOBUTROL 1.0MMOL/ML SOLUTION FOR INJECTION 5ML PRE- 2,535.00 - -
FILLED SYRINGE
337 GADOTERIC ACID 0.5 MMOL/ML, 10ML SOLUTION FOR INJECTION 3,195.00 - -

338 GADOTERIC ACID 0.5 MMOL/ML, 20ML SOLUTION FOR INJECTION 3,745.00 - -

339 GANCICLOVIR 500MG VIAL 2,968.00 - -

340 GEMCITABINE 1G VIAL 2,163.00 - -
341 GENTAMICIN 40MG/ML 2ML AMPULE 4.50 - -
342 GLICLAZIDE (MELANOV MR 30) 30MG TABLET 3.50 - -
343 GLICLAZIDE 30MG TABLET 5.00 - -
344 GLICLAZIDE 60MG TABLET 10.00 - -
345 GLICLAZIDE 80MG TABLET 5.25 - -
346 GOSERELIN ACETATE 3.6MG DEPOT SOLUTION 4,646.00 - -
347 HALOPERIDOL (SEREDOL) 5MG/ML 1ML AMPULE 537.00 - -
348 HALOPERIDOL (ZUREDEL) 20MG TABLET 49.00 - -
349 HALOPERIDOL (ZUREDEL) 5MG TABLET 25.00 - -
350 HALOPERIDOL 20MG TABLET 34.00 - -
351 HALOPERIDOL 5MG TABLET 5.00 - -
352 Haloperidol 5mg/mL ampule 590.00 - -
353 HEPARIN SODIUM (APRINOL) 1000IU/ML VIAL 109.00 - -
354 HEPARIN SODIUM (APRINOL) 5000IU/ML VIAL 231.00 - -
355 HEPARIN SODIUM 1000IU/ML VIAL 83.00 - -
356 HEPARIN SODIUM 5000IU/ML VIAL 272.00 - -
357 HEPATITIS B VACCINE (HEPLIV) 20MCG/ML VIAL 405.00 - -
358 HEPATITIS B VACCINE ADULT 20MCG/1ML VIAL 176.00 - -
359 HEPATITIS B VACCINE PEDIA 10MCG/0.5ML VIAL 231.00 - -
360 HUMAN ALBUMIN (ALBUKED) 20% 50ML VIAL 1,906.00 - -
361 HUMAN ALBUMIN (PLASBUTEIN) 20% 50ML VIAL 2,425.00 - -
362 Human Albumin 20% 50mL vial 1,869.00 - -
363 HUMAN INSULIN REGULAR 100IU/ML 10ML VIAL 140.00 - -
364 HUMAN RECOMBINANT ERYTHROPOEITIN (DYPOTIN) 4000IU ALPHA 550.00 - -
PFS
365 HUMAN RECOMBINANT ERYTHROPOEITIN (EFOTIN/EPOGEN) 550.00 - -
4000IU ALPHA PFS
366 HUMAN RECOMBINANT ERYTHROPOEITIN 10,000IU BETA PFS 3,636.00 - -
367 HUMAN RECOMBINANT ERYTHROPOEITIN 2000IU BETA PFS 505.00 - -
368 HUMAN RECOMBINANT ERYTHROPOEITIN 4000IU ALPHA PFS 600.00 - -
369 HUMAN RECOMBINANT ERYTHROPOEITIN 5000IU BETA PFS 1,151.00 - -
370 HUMAN RECOMBINANT ERYTHROPOEITIN ALPHA 2000IU/0.5ML, 471.00 - -
PRE-FILLED SYRINGE (IV,SC)
371 HUMAN RECOMBINANT ERYTHROPOIETIN ALFA (EPOSINO) 1,095.00 - -
10,000IU/1ML PRE-FILLED SYRINGE
372 HUMAN RECOMBINANT ERYTHROPOIETIN ALFA 10,000IU/1ML PRE- 1,545.00 - -
FILLED SYRINGE
373 HUMAN RECOMBINANT TISSUE TYPE PLASMINOGEN ACTIVATOR 32,678.00 - -
VIAL
374 HUMAN TETANUS IMMUNOGLOBULIN (SERO-TET) 250IU PFS 1ML 1,347.00 - -
VIAL
375 Human Tetanus Immunoglobulin 250 IU/ml 1ml PFS 749.00 - -
376 HYDRALAZINE (APREZAL) 20MG/ML SOLUTION 1ML AMPULE 60.00 - -
377 HYDRALAZINE (AS HYDROCHLORIDE) 20MG/ML SOLUTION 1ML 37.00 - -
AMPULE
378 HYDROCHLORTHIAZIDE 2MG TABLET 3.50 - -
379 HYDROCORTISONE (STERICORT) 500MG VIAL 132.00 - -
380 HYDROCORTISONE 1% 15G CREAM 399.00 - -
381 HYDROCORTISONE 1% 5G CREAM 153.00 - -
382 HYDROCORTISONE 250MG VIAL 62.00 - -
383 HYDROCORTISONE 500MG VIAL 113.50 - -
384 Hydroxychloroquine 200mg tablet 103.00 - -
385 HYDROXYETHYL STARCH 6% 500ML BOTTLE 399.00 - -
386 HYDROXYUREA (HYDOC-500) 500MG CAPSULE 19.00 - -
387 Hydroxyurea 500mg Capsule 22.00 - -
388 HYOSCINE N- BUTYL BROMIDE (BELLOID) 10MG TABLET 5.50 - -
389 HYOSCINE N-BUTYL BROMIDE (HYOPHIL) 20MG/ML AMPULE 27.00 - -
390 HYOSCINE N-BUTYL BROMIDE 10MG TABLET 5.75 - -
391 HYOSCINE N-BUTYL BROMIDE 20MG/ML AMPULE 20.00 - -
392 HYPERTONIC LACTATE SOLUTION (TOTILAC) 250 MLSOLUTION FOR 873.00 - -
INFUSION
393 HYPERTONIC LACTATE SOLUTION 250ML 877.00 - -
394 HYPROMELLOSE 0.3% 10ML OPHTHALMIC SOLUTION 194.00 - -
395 I.V. FLUIDS, BALANCED MULTIPLE MAINTENANCE SOLUTION WITH 51.00 - -
5% DEXTROSE FOR PEDIA (D5 IMB) 500 ML BOTTLE
396 IBUPROFEN (FEVRAL) 200MG TABLET 2.00 - -
397 IBUPROFEN (SQFEN) 200MG/5ML 60ML SUSPENSION 104.00 - -
398 IBUPROFEN 200MG/5ML 60ML SUSPENSION 88.00 - -
399 IFOSFAMIDE 1G VIAL 1,525.00 - -
400 IMATINIB (AS MESILATE) 100MG TABLET 118.00 - -
401 IMATINIB (IMATINATE) 100MG TABLET 89.50 - -
402 IMMUNOGLOBULIN NORMAL HUMAN (IMMUNOREL) (IV IG) 11,115.00 - -
50MG/ML,100ML VIAL
403 IMMUNOGLOBULIN NORMAL HUMAN (IV IG) 50MG/ML,100ML VIAL 12,765.00 - -

404 IMMUNOGLOBULIN NORMAL, HUMAN (IMMUNOREL) (IG/IV) 5,260.00 - -

50MG/ML 50ML
405 IMMUNOGLOBULIN, NORMAL, (HUMAN) (IGIV), 50 MG/ML, 50ML 5,010.00 - -
2.5G VIAL
406 INDACATEROL MALEATE + GLYCOPYRRONIUM BROMIDE (ULTIBRO 87.00 - -
HNCI) 110MCG + 50MCG INHALATION POWDER HARD CAPSULE

407 INFLIXIMAB 100MG 10ML VIAL 22,267.05 - -

408 IODIXANOL (VISIPAQUE) 320MG/100ML CONTRAST MEDIUM VIAL 5,008.00 - -

409 IODIXANOL (VISIPAQUE) 320MG/50ML CONTRAST MEDIUM VIAL 2,769.00 - -

410 IODIXANOL 320MG/100ML CONTRAST MEDIUM VIAL 2,701.00 - -
411 IOHEXOL 300MG/ML 100ML VIAL 2,258.00 - -
412 IOHEXOL 300MG/ML 50ML VIAL 1,237.00 - -
413 IOHEXOL 350MG/ML 100ML VIAL 2,809.00 - -
414 IOHEXOL 350MG/ML 50ML VIAL 1,489.00 - -
415 IOPAMIDOL 300MG 100ML VIAL 1,552.00 - -
416 IOPAMIDOL 300MG 50ML VIAL 799.00 - -
417 IOPAMIDOL 370MG 100ML VIAL 2,272.00 - -
418 IOPAMIDOL 370MG 50ML VIAL 1,326.00 - -
419 IOPROMIDE (ULTRAVIST 370/100) 370MG/ML EQUIV. TO 729MG 4,016.00 - -
IODINE 100ML VIAL
420 IOPROMIDE (ULTRAVIST 370/50) 370MG/ML EQUIV. TO 729MG 2,712.00 - -
IODINE 50ML VIAL
421 IOVERSOL 300MG/100ML VIAL 2,315.00 - -
422 IOVERSOL 300MG/50ML VIAL 1,435.00 - -
423 IOVERSOL 350MG/50ML VIAL 1,545.00 - -
424 IRBERSARTAN (IRBEVEX) 300MG TABLET 17.50 - -
425 IRBESARTAN (IRBEZIL) 150MG TABLET 6.00 - -
426 Irbesartan 150mg Tablet 5.00 - -
427 Irbesartan 300mg Tablet 10.50 - -
428 IRINOTECAN HYDROCHLORIDE 100MG/5ML VIAL 4,385.00 - -
429 IRON SUCROSE (FERUVIN) 20MG/ML AMPULE 231.00 - -
430 IRON SUCROSE 20MG/ML 5ML AMPULE 153.00 - -
431 IROS SUCROSE (IROFER) 100MG/5ML SOLUTION FOR INJECTION 135.00 - -
AMPULE
432 ISONIAZID 300MG TABLET 3.00 - -
433 ISOSORBIDE 5-MONONITRATE 30MG TABLET 10.00 - -
434 ISOSORBIDE 5-MONONITRATE 60MG TABLET 10.00 - -
435 ISOSORBIDE DINITRATE 10MG TABLET 15.00 - -
436 ISOSORBIDE DINITRATE 1MG/ML 10ML AMPULE 174.00 - -
437 ISOSORBIDE DINITRATE 5MG TABLET 14.00 - -
438 ISOTONIC ELECTROLYTE SOLUTION (STEROFUNDIN) 1L BOTTLE 243.00 - -
439 Isotonic Electrolyte Solution 1 liter Bottle 159.00 - -
440 ISOXSUPRINE 10MG TABLET 9.00 - -
441 ITRACONAZOLE 100MG CAPSULE 35.00 - -
442 KETAMINE 50MG/ML 10ML VIAL 433.00 - -
443 KETOCONAZOLE 2% (20 MG/G) 15G CREAM 96.50 - -
444 KETOROLAC 300MG/ML 1ML AMPULE 21.00 - -
445 LACTULOSE (ACCELLAC) 3.3G/5ML 120ML SYRUP 56.00 - -
446 lactulose 3.3g/5ml 120ml syrup 91.00 - -
447 LAGUNDI (CAFGARD) 300MG/5ML 60ML SYRUP 68.00 - -
448 LAGUNDI 300MG TABLET 2.50 - -
449 LAGUNDI 300MG/5ML 120ML SYRUP 80.00 - -
450 L-ASPARAGINASE 10,000/IU VIAL 1,974.00 - -
451 LETROZOLE (LEZOLE) 2.5MG TABLET 27.00 - -
452 Letrozole 2.5mg tablet 30.00 - -
453 LEUPROLIN ACETATE 3.75MG/2ML POWDER FOR INJECTION VIAL 4,460.00 - -

454 LEVETIRACETAM (VEXLEV) 500MG TABLET 14.50 - -

455 Levetiracetam 100mg/ml 300ml Oral Solution 1,825.00 - -
456 LEVETIRACETAM 100MG/ML 5ML VIAL 2,115.00 - -
457 LEVETIRACETAM 1G TABLET 104.00 - -
458 Levetiracetam 250mg Tablet 25.20 - -
459 Levetiracetam 500mg Tablet 13.00 - -
460 LEVOBUPIVACAINE (AS HYDROCHLORIDE) 5MG/ML SOLUTION FOR 267.00 - -
INJECTION 10ML AMPULE
461 LEVOFLOXACIN (DIAFLOXCIN) 5MG/ML 100ML VIAL 240.00 - -
462 LEVOFLOXACIN 500MG TABLET 7.00 - -
463 LEVOFLOXACIN 5MG/100ML VIAL 88.00 - -
464 LEVOFLOXACIN 750MG TABLET 18.00 - -
465 LEVOTHYROXINE 100MCG TABLET 10.00 - -
466 LEVOTHYROXINE 50MCG TABLET 5.00 - -
467 LIDOCAINE (SENZITENE) 2% AMPULE 23.00 - -
468 LIDOCAINE 10% 50ML SPRAY 2,755.00 - -
469 LIDOCAINE 2% 5ML AMPULE 11.00 - -
470 LIDOCAINE 2% WITH ADRENALINE CARPULE 26.00 - -
471 LINEZOLID (AXAZOLID) 2 MG/ML 300 ML SOLUTION FOR INJECTION 2,549.00 - -

472 LINEZOLID 2MG/ML (600/300ML) SOLUTION FOR INFUSION 4,295.00 - -

473 LINEZOLID 600MG TABLET 1,435.00 - -
474 LIPIDS 20% SOLUTION 100ML VIAL 602.00 - -
475 LIPIDS 20%, 250ML BOTTLE 1,035.00 - -
476 LITHIUM CARBONATE 450MG TABLET 7.00 - -
477 LOPERAMIDE (VEXIL) 2MG CAPSULE 1.00 - -
478 LOPERAMIDE 2MG CAPSULE 1.00 - -
479 LORATADINE 10MG TABLET 2.00 - -
480 LOSARTAN (ANGISARTAN) 50MG TABLET 2.50 - -
481 LOSARTAN (GETZAR) 50MG TABLET 1.50 - -
482 LOSARTAN (SAPHLOR 100) 100MG TABLET 4.00 - -
483 LOSARTAN + HYDROCHLORTHIAZIDE (ARTAZIDE) 50MG + 12.5MG 3.00 - -
TABLET
484 LOSARTAN POTASSIUM 100 MG TABLET 4.00 - -
485 LOSARTAN POTASSIUM 50 MG TABLET 1.00 - -
486 MAGNESSIUM SULFATE (PHIL PHARMAWEALTH) 250MG/ML 119.00 - -
POLYAMPULE
487 MAGNESSIUM SULFATE 250MG/ML POLYAMPULE 31.00 - -
488 MANNITOL 20% 500ML BOTTLE 122.00 - -
489 MEBENDAZOLE (DRUGMAKER'S) 500MG TABLET 5.50 - -
490 MECOBALAMIN 500 MCG TABLET 16.00 - -
491 MECOBALAMIN 500MCG/ML 1ML AMPULE 267.00 - -
492 MEFENAMIC ACID 500MG CAPSULE 2.00 - -
493 MEMANTINE 10MG TABLET 20.00 - -
494 Meropenem (Mepenem) 1G Vial 259.00 - -
495 MEROPENEM (MERROBE/SITIPENAM) 1G VIAL 711.00 - -
496 Meropenem trihydrate 1g Vial 187.00 - -
497 MESNA (ONCOMES) 100MG/ML 4ML AMPULE 165.00 - -
498 MESNA 100MG/ML 4ML AMPULE 183.00 - -
499 METFORMIN (SAPHORMIN T500) 500MG TABLET 1.00 - -
500 METFORMIN 500MG TABLET 2.00 - -
501 METHIMAZOLE 5MG TABLET 3.00 - -
502 Methotrexate 2.5mg Tablet 10.00 - -
503 METHOTREXATE 50MG/2ML VIAL 468.00 - -
504 METHYLDOPA 50MG TABLET 15.50 - -
505 METHYLERGOMETRINE 200MCG/ML, 1ML AMPULE 18.00 - -
506 Methylprednisolone (Solu-Medrol) 1g Vial 2,975.00 - -
507 METHYLPREDNISOLONE 16MG TABLET 11.50 - -
508 Methylprednisolone 40mg/mL vial 387.00 - -
509 METHYLPREDNISOLONE 4MG TABLET 8.00 - -
510 METHYLPREDNISOLONE LYOPHILIZED POWDER 1G VIAL 1,617.00 - -
511 METHYLPREDNISOLONE LYOPHILIZED POWDER 500MG VIAL 2,520.00 - -
512 METOCLOPRAMIDE (MYCLOSIL) 10MG TABLET 2.50 - -
513 METOCLOPROMIDE 5MG/ML 2ML AMPULE 5.00 - -
514 METOPROLOL (PROLOL) 50MG TABLET 1.50 - -
515 METOPROLOL 100MG TABLET 2.00 - -
516 METOPROLOL 50MG TABLET 1.50 - -
517 METRONIDAZOLE (AMBIDAZOL) 125MG/5ML 60ML SUSPENSION 33.00 - -
518 METRONIDAZOLE (DYNAZOLE) 5MG/ML 500MG/100ML SOLUTION 49.00 - -
FOR IV INFUSION
519 METRONIDAZOLE (ERZOL) 5MG/ML 100ML VIAL 35.00 - -
520 METRONIDAZOLE (FLAMIBAZID) 500MG TABLET 2.00 - -
521 METRONIDAZOLE (METROZOLE) 125MG/5ML 60ML SUSPENSION 31.00 - -
522 METRONIDAZOLE 500MG IV VIAL 18.00 - -
523 METRONIDAZOLE 500MG TABLET 3.00 - -
524 MICAFUNGIN 50MG LYOPHILIZED POWDER FOR INJECTION 3,965.00 - -
525 MIDAZOLAM (MIDAZOLEX) 1MG/ML, 5ML SOLUTION FOR 128.50 - -
INJECTION
526 MIDAZOLAM 15MG/ML 3ML AMPULE 124.00 - -
527 MOLNUPIRAVIR 200MG CAPSULE 189.00 - -
528 MOLNUPIRAVIR 400MG CAPSULE 331.00 - -
529 MONOBASIC SODIUM PHOSPHATE 19g/7g 133ml BOTTLE 210.00 - -
530 MONTELUKAST (AUROHEX) 4MG TABLET 6.00 - -
531 Montelukast (Bronast) 5mg tablet 8.00 - -
532 Montelukast (Montiget) 10mg Tablet 7.00 - -
533 MONTELUKAST 10MG TABLET 9.00 - -
534 MONTELUKAST 4MG TABLET 6.00 - -
535 MONTELUKAST SODIUM 4MG GRANULES 6.00 - -
536 MORPHINE 10MG MST TABLET 16.00 - -
537 MORPHINE SULFATE 10MG/ML 1ML AMPULE 77.00 - -
538 MORPHINE SULFATE 30MG TABLET 41.58 - -
539 MOXIFLOXACIN 400 MG TABLET 241.00 - -
540 MULTIVITAMINS (FULVIT) 60ML PER 5ML SYRUP 31.00 - -
541 MULTIVITAMINS + FE (HANIZYN) TABLET 3.00 - -
542 Multivitamins for Adult capsule 3.00 - -
543 MULTIVITAMINS PER 5ML 60ML SYRUP 32.20 - -
544 MUPIROCIN (BACTRIDERM) 2% 15G OINTMENT 195.00 - -
545 MUPIROCIN (MICROSCOT) 2% OINTMENT 5G TUBE 159.00 - -
546 MUPIROCIN 2% 15G OINTMENT 165.00 - -
547 Mupirocin 2% 5g Ointment 60.00 - -
548 MYCOPHENOLATE MOFETIL (MYOTEC) 500MG TABLET 68.00 - -
549 MYCOPHENOLATE MOFETIL 500MG TABLET 68.00 - -
550 MYCOPHENOLIC ACID (MYFORTIC) 360MG TABLET 81.50 - -
551 MYCOPHENOLIC ACID 360MG TABLET 89.00 - -
552 NALBUPHINE (NUKAINE) 10MG/ML AMPULE 115.50 - -
553 NALOXONE HCL 400 MCG/1 ML AMPULE 315.00 - -
554 NAPROXEN SODIUM 550MG TABLET 8.50 - -
555 NEOSTIGMINE (NEOTALIS) 500MCG/ML 1ML AMPULE 122.00 - -
556 NEOSTIGMINE METHYLSULFATE 0.5MG/ML 1 ML AMPULE 159.00 - -
557 NICARDIPINE (CARDIONID) 1 MG/ML SOLUTION 10 ML AMPULE 214.00 - -
558 NICARDIPINE (NICARVIN) 1MG/ML 10ML AMPULE 387.00 - -
559 NICARDIPINE 10MG/ML 10ML AMPULE 186.00 - -
560 Nifedipine 10mg Capsule 5.00 - -
561 NIFEDIPINE 5MG SOFTGEL CAPSULE 7.50 - -
562 NITROGLYCERIN/GLYCERYL TRINITRATE (NITROSAN) 1MG/1ML 543.00 - -
10ML AMPULE
563 NITROGLYCERINE 10MG/ML 10ML AMPULE 617.00 - -
564 NORADRENALINE/NOREPINEPHRINE 1MG/ML CONCENTRATE 1,269.00 - -
SOLUTION FOR INFUSION 10ML AMPULE
565 NORADRENALINE/NOREPINEPHRINE 1MG/ML CONCENTRATE 109.00 - -
SOLUTION FOR INFUSION 2ML AMPULE
566 NORADRENALINE/NOREPINEPHRINE 1MG/ML CONCENTRATE 203.00 - -
SOLUTION FOR INFUSION 4ML AMPULE
567 NOREPINEPHRINE (BIEMEFRIN) 1MG/ML 4ML AMPULE 183.00 - -
568 NOREPINEPHRINE (NORBIT) 1MG/ML 10ML AMPULE 695.00 - -
569 NYSTATIN (NYSTRIN) 100,000IU/ML 30ML DROPS 109.00 - -
570 OCTREOTIDE (OCTRIDE) 100MCG/ML X 1ML SOLUTION FOR 793.00 - -
INJECTION
571 OCTREOTIDE 100MCG/ML 1ML SOLUTION FOR INJECTION VIAL 480.00 - -
572 OFLOXACIN 0.3% 5ML EYE DROPS 124.00 - -
573 OLANZAPINE (ODT) 10MG TABLET 21.00 - -
574 OLANZAPINE (OLAVEX) 10MG TABLET 6.00 - -
575 OLANZAPINE (OLEANZ ODT) 10MG TABLET 76.00 - -
576 OLANZAPINE (PLAIN) 10MG TABLET 5.00 - -
577 Omeprazole (Ranzole) 40mg capsule 8.00 - -
578 OMEPRAZOLE 20MG CAPSULE 2.00 - -
579 OMEPRAZOLE 40MG CAPSULE 5.00 - -
580 OMEPRAZOLE 40MG/ML IV VIAL 33.00 - -
581 ONDANSETRON (EMITRON) 2MG/ML 4ML AMPULE 99.00 - -
582 ONDANSETRON 2MG/ML 2ML AMPULE 169.00 - -
583 ONDANSETRON 8MG/ML 4ML AMPULE 93.00 - -
584 ORAL REHYDRATION SALTS (DEHYDROSOL) 5.125G SACHET 5.00 - -
585 OXACILLIN (OXAVIN) 500MG VIAL 28.00 - -
586 OXALIPLATIN (VEXPLATIN) 50MG VIAL 1,189.00 - -
587 OXALIPLATIN 100MG VIAL 2,734.00 - -
588 OXALIPLATIN 50MG VIAL 1,759.00 - -
589 OXYCODONE 10MG TABLET 175.39 - -
590 OXYCODONE 10MG/ML 1ML AMPULE 775.23 - -
591 OXYCODONE 10MG/ML 2ML AMPULE 1,284.96 - -
592 PACLITAXEL (ANZATAX) 30MG/5ML VIAL 3,902.00 - -
593 PACLITAXEL 6MG/ML 5ML VIAL 900.00 - -
594 PACLITAXEL 6MG/ML16.67ML VIAL 2,013.00 - -
595 PARACETAMOL (AMCETAM) 150MG/2ML AMPULE 9.00 - -
596 PARACETAMOL (AMGESIC/AMADOL) 150MG/2ML AMPULE 9.00 - -
597 PARACETAMOL (NOVAMOL DROPS) 100MG/ML 15ML DROPS 23.00 - -
598 PARACETAMOL (PARAGESIC) 125MG SUPPOSITORY 28.00 - -
599 PARACETAMOL (PARAGESIC) 250MG SUPPOSITORY 35.00 - -
600 PARACETAMOL (PARAVIN) 1G/ML VIAL 339.00 - -
601 PARACETAMOL (PYRESAPH) 250MG/5ML 60ML BOTTLE 27.00 - -
602 PARACETAMOL (TAMIN) 10MG/ML 50ML SOLUTION FOR INJECTION 277.00 - -

603 Paracetamol 100mg/ml 15ml Oral drops 27.00 - -

604 PARACETAMOL 120MG/5ML 60ML SYRUP 23.00 - -
605 PARACETAMOL 125MG SUPPOSITORY 28.00 - -
606 PARACETAMOL 150MG/2ML AMPULE 7.00 - -
607 PARACETAMOL 1GM/100ML VIAL 122.00 - -
608 PARACETAMOL 250MG SUPPOSITORY 33.00 - -
609 Paracetamol 250mg/5ml 60ml Syrup 63.00 - -
610 PARACETAMOL 500MG TABLET 1.00 - -
611 PENICILLIN G CRYSTALLINE (BENYZYLPENICILLIN) 1,000,000 UNITS 21.00 - -
POWDER FOR INJECTION VIAL
612 PENICILLIN G CRYSTALLINE (BENYZYLPENICILLIN) 5,000,000 UNITS 20.00 - -
POWDER FOR INJECTION VIAL
613 Permethrin lotion 5% 60ml bottle 267.00 - -
614 PHENYTOIN 100MG CAPSULE 19.00 - -
615 PHENYTOIN NA (LANTIDIN) 50MG/ML 2ML AMPULE 165.00 - -
616 PHENYTOIN NA 50MG/ML 2ML AMPULE 134.00 - -
617 PHYTOMENADIONE (AMBIVIT K/MENARIGHT) 10MG/ML 1ML 26.00 - -
AMPULE
618 PHYTOMENADIONE 10MG/ML AMPULE 21.50 - -
619 PILOCARPINE 2% 15ML EYE DROPS 340.00 - -
620 Piperacillin + Tazobactam (as sodium) 2g+250mg solution vial 95.50 - -
621 PIPERACILLIN + TAZOBACTAM (PIZOBA-4.5) 4G + 500MG VIAL 393.00 - -
622 PIPERACILLIN + TAZOBACTAM (TAZOBET) 2G + 250MG VIAL 277.00 - -
623 Piperacillin + Tazobactam (Vigocid) 4g/500mg Vial 289.00 - -
624 PIPERACILLIN + TAZOBACTAM 2.25MG VIAL 95.50 - -
625 PIPERACILLIN + TAZOBACTAM 4.5MG VIAL 137.50 - -
626 PLAIN NSS 1L 30.00 - -
627 PLAIN NSS 50ML VIAL 30.00 - -
628 PLAINLR 1L 65.00 - -
629 POLYMYCIN B. SULFATE 500000IU 5ML VIAL 2,890.00 - -
630 Potassium Chloride (Kaligen) 750mg Tablet 30.00 - -
631 POTASSIUM CHLORIDE 2MEQ/ML 20ML VIAL 31.00 - -
632 POTASSIUM CHLORIDE 600MG TABLET 15.00 - -
633 POTASSIUM CHLORIDE 750MG TABLET 18.00 - -
634 POTASSIUM CITRATE 10MEQ TABLET 10.00 - -
635 PREDNISONE (CORT) 10MG/5ML 60ML SUSPENSION 129.00 - -
636 PREDNISONE (PREND/CORT) 20MG TABLET 6.00 - -
637 PREDNISONE (VONWELT) 10MG TABLET 2.00 - -
638 PREDNISONE (VONWELT/DERPSON) 5MG TABLET 1.50 - -
639 PREDNISONE 10MG TABLET 3.50 - -
640 PREDNISONE 20MG TABLET 5.00 - -
641 PREDNISONE 5MG TABLET 3.00 - -
642 PREDNISONE ACETATE 1% 10MG/ML 5ML DROPS 195.00 - -
643 PROPOFOL 10MG/ML 20ML VIAL 64.50 - -
644 PROPRANOLOL (ORANOL) 10MG TABLET 2.00 - -
645 PROPRANOLOL (ORANOL) 40MG TABLET 2.00 - -
646 PROPRANOLOL 10MG TABLET 17.00 - -
647 Propranolol 40mg Tablet 10.00 - -
648 PROTAMINE SULFATE 50MG/ML 5ML VIAL 794.00 - -
649 PURIFIED COBRA ANTIVENIN AMP 800IU/ML, 5ML (IV INFUSION) 1,545.00 - -
AMPULE
650 QUETIAPINE 100MG TABLET 36.00 - -
651 QUETIAPINE 200MG TABLET 45.00 - -
652 QUETIAPINE 25MG TABLET 17.00 - -
653 QUETIAPINE 300MG TABLET 42.00 - -
654 QUETIAPINE AS FUMARATE (Q-WIN) 100MG TABLET 31.00 - -
655 QUETIAPINE AS FUMARATE (Q-WIN) 25MG TABLET 16.00 - -
656 QUETIAPINE AS FUMARATE (SEROTIA) 100MG TABLET 31.00 - -
657 QUETIAPINE AS FUMARATE (SEROTIA) 300MG TABLET 63.00 - -
658 RANITIDINE (AS HYDROCHLORIDE) 25 MG/ML SOLUTION 2ML 5.00 - -
AMPULE
659 REMDESIVIR (PANDOVIR) 100MG LYOPHILIZED POWDER FOR IV 1,035.00 - -
INFUSION VIAL
660 REMIFENTANIL (SUBLIFEN) 1MG VIAL 1,765.00 - -
661 REMIFENTANIL 1MG VIAL 1,765.00 - -
662 Rifaximin 200mg Tablet 86.00 - -
663 RISPERIDONE (RISPEDIN-2) 2MG TABLET 11.00 - -
664 RISPERIDONE 2MG QUICKLET ODT TABLET 40.00 - -
665 RISPERIDONE 2MG TABLET 21.00 - -
666 RITUXIMAB 10MG/ML 10ML VIAL 11,511.00 - -
667 RITUXIMAB 10MG/ML 50ML VIAL 46,978.00 - -
668 ROCURONIUM (AS BROMIDE) 10MG/ML SOLUTION 5ML VIAL 198.00 - -
669 ROSUVASTATIN (ROSUCARE) 10MG TABLET 4.00 - -
670 ROSUVASTATIN (ROVISTA) 20MG TABLET 5.50 - -
671 ROSUVASTATIN 10MG TABLET 11.50 - -
672 ROSUVASTATIN 20MG TABLET 9.00 - -
673 SACUBITRIL + VALSARTAN (VYMADA) 100MG TABLET 78.50 - -
674 SACUBITRIL + VALSARTAN (VYMADA) 50MG TABLET 78.50 - -
675 SACUBITRIL + VALSARTAN 100MG TABLET 77.50 - -
676 SACUBITRIL + VALSARTAN 50MG TABLET 77.50 - -
677 SALBUTAMOL (VENTOLAX INHALER) 100MCG/DOSE X 200 DOSES 147.00 - -
678 SALBUTAMOL + IPRATROPIUM (AETROPSAL) 2.5MG/500MCG/2.5ML 34.00 - -
NEBULE
679 SALBUTAMOL + IPRATROPIUM (COMBIPUL) 2.5MG/500MCG/2.5ML 21.00 - -
NEBULE
680 SALBUTAMOL + IPRATROPIUM 2.5MG/500MCG/2.5ML NEBULE 14.00 - -
681 Salbutamol 100mcg/dose metered dose inhaler 177.00 - -
682 SALBUTAMOL 1MG/ML, 2.5ML NEBULE 7.00 - -
683 SALBUTAMOL 2.5MG/ML, 2.5ML NEBULE 7.00 - -
684 Salbutamol 2mg/5ml 60ml Syrup 21.00 - -
685 SALMETEROL+FLUTICASONE PROPIONATE 25/125MCG INHALER 230.00 - -
686 SALMETEROL+FLUTICASONE PROPIONATE 25/250MCG INHALER 280.00 - -
687 SAMBONG (KIDNEYGEN FORTE) 500MG TABLET 9.00 - -
688 SAMBONG 500MG TABLET 7.50 - -
689 SENNA CONCENTRATE 187mg TABLET 11.50 - -
690 SENNA CONCENTRATE 374MG TABLET 15.75 - -
691 SERTRALINE (ZOSERT) 50MG TABLET 21.00 - -
692 SERTRALINE 50MG TABLET 10.00 - -
693 Sevelamer carbonate 800mg Tablet 48.00 - -
694 SEVOFLURANE LIQUID FOR INHALATION, 250ML BOTTLE 4,724.00 - -
695 SILVER SULFADIAZINE 1% CREAM 25G TUBE 88.00 - -
696 SILVER SULFADIAZINE 1% CREAM 500G JAR 1,035.00 - -
697 SILVER SULFADIAZINE CREAM (FLAMIZIN) 1% 25G TUBE 309.00 - -
698 SIMVASTATIN (ZIMVAST) 40MG TABLET 6.00 - -
699 SIMVASTATIN 20MG TABLET 2.00 - -
700 SIMVASTATIN 40MG TABLET 4.20 - -
701 SODIUM ASCORBATE 500MG + ZINC 10MG TABLET 8.50 - -
702 SODIUM BICARBONATE (SOLUNATE) 1MEQ/ML 20ML AMPULE 249.00 - -
703 SODIUM BICARBONATE 2.5MEQ/ML 20ML VIAL 237.00 - -
704 SODIUM VALPROATE/VALPROIC ACID 500MG TABLET 16.00 - -
705 SOMATOSTATIN 250MCGÂ AMPULE 4,805.00 - -
706 SPIRONOLACTONE (HAIROS) 25MG TABLET 14.50 - -
707 Spironolactone 100mg Tablet 34.00 - -
708 STERILE WATER FOR INJECTION (DISTILLED WATER VIAL) 50ML 22.00 - -
709 STERILE WATER FOR INJECTION 50ML VIAL (ENFRACARE) 45.00 - -
710 SUGAMMADEX (BRIDION) 100MG/ML 2ML VIAL 5,898.00 - -
711 SUGAMMADEX SODIUM 100MG/ML 2 ML VIAL 5,898.00 - -
712 SUXAMETHONIUM (SUCCINYLCHOLINE) (ANEKTIL) 20MG/ML 10ML 525.00 - -

713 SUXAMETHONIUM HCL 20MG/ML 10ML AMPULE 188.50 - -

714 TACROLIMOS (CIDIMUS) 1MG CAPSULE 110.00 - -
715 TACROLIMOS 1MG TABLET 110.00 - -
716 TAMOXIFEN (GENZIFEN) 20MG TABLET 10.50 - -
717 TAMOXIFEN 20MG TABLET 7.50 - -
718 Tamsulosin (as Hydrochloride) 200 mcg Tablet 15.00 - -
719 Tamsulosin (as Hydrochloride) 400 mcg Tablet 14.00 - -
720 TAMSULOSIN (URITAM) 400MCG MR FC TABLET 17.00 - -
721 TELMISARTAN (TELMISAPH) 40MG TABLET 14.00 - -
722 TELMISARTAN (Telsitan) 80MG TABLET 14.00 - -
723 TELMISARTAN 40MG TABLET 7.00 - -
724 TEMOZOLOMIDE 100MG TABLET 3,415.00 - -
725 TERAZOSIN 2mg TABLET 47.50 - -
726 TERBUTALINE SULFATE 500MCG / 1ML AMPULE 96.00 - -
727 TETANUS TOXOID 40IU/0.5ML AMPULE 48.00 - -
728 TETANUS TOXOID ADSORBED (PHIL PHARMA) 40IU/0.5ML AMPULE 102.00 - -

729 TINZAPARIN 10,000 IU VIAL 1,576.50 - -

730 TINZAPARIN SODIUM (INNOHEP) 10,000 ANTI-XA IU/ML 2ML VIAL 869.00 - -

731 TOBRAMYCIN 0.3% + DEXAMETHASONE 0.1% EYE DROPS 5ML 290.00 - -

732 Tocilizumab 400mg/20mL vial 22,182.00 - -
733 TOCILIZUMAB 80MG/4ML VIAL 5,524.00 - -
734 Tolvaptan 15mg Tablet 769.00 - -
735 TRAMADOL (AMBIDOL) 50 MG/ML 2 ML AMPULE 27.00 - -
736 TRAMADOL HCL 100MG/ML AMPULE 10.00 - -
737 TRAMADOL HCL 50MG CAPSULE 2.00 - -
738 TRANEXAMIC ACID (TRANCE) 500MG/5ML AMPULE 40.00 - -
739 TRANEXAMIC ACID (TRANEXAGEN) 500MG CAPSULE 6.50 - -
740 TRANEXAMIC ACID 100 MG/ML 5 ML AMPULE 21.00 - -
741 TRANEXAMIC ACID 500MG CAPSULE 7.00 - -
742 TRASTUZUMAB (HERCEPTIN) 150MG/ML VIAL 28,252.00 - -
743 TRASTUZUMAB (HERCEPTIN) 600MG/ML VIAL 55,438.00 - -
744 TRASTUZUMAB 150MG VIAL 14,060.00 - -
745 TRASTUZUMAB 600MG/5ML SC VIAL 55,438.00 - -
746 TRIMETAZIDINE (DINEMIC MR) 35MG TABLET 7.00 - -
747 Trimetazidine (Trimebet) 35mg tablet 7.00 - -
748 TRIMETAZIDINE (VASEREL) 35MG TABLET 5.25 - -
749 TRIMETAZIDINE 35MG TABLET 5.00 - -
750 URSODEOXYCHOLIC ACID (ORDECHA) 250MG TABLET 42.00 - -
751 UrsodeoxYcholic Acid (Ursofalk) 500mg TABLET 120.00 - -
752 URSODEOXYCHOLIC ACID 250MG TABLET 42.00 - -
753 Ursodeoxycholic acid 500mg Tablet 99.00 - -
754 Valaciclovir (as Hydrochloride) 500 mg Tablet 108.00 - -
755 VALPROATE DISODIUM + VALPROIC ACID (ENCORATE CHRONO) 16.00 - -
500MG TABLET
756 VALPROIC ACID (ENCORATE) 250MG/5ML 120ML SYRUP 374.00 - -
757 VALSARTAN (VALVEX) 80MG TABLET 12.00 - -
758 Valsartan 160mg Tablet 15.00 - -
759 VANCOMYCIN (AVANCOMYCIN) 500MG VIAL 170.00 - -
760 VANCOMYCIN (VANCOWELL/AFOCIN) 1G VIAL 426.00 - -
761 VANCOMYCIN HCl 500MG VIAL 179.00 - -
762 Verapamil HCl 5mg/2ml Ampule 233.00 - -
763 VINBLASTINE 10MG VIAL 1,345.00 - -
764 VINCRISTINE 1MG/ML 1ML VIAL 613.00 - -
765 VINCRISTINE 1MG/ML 2ML VIAL 800.00 - -
766 VITAMIN B COMPLEX (B1 B6 B12) TABLET 2.00 - -
767 VITAMIN B COMPLEX (NERVITA) 100mg + 100mg + 1mg TABLET 3.00 - -
768 VITAMIN B COMPLEX AMPULE 59.00 - -
769 VITAMIN D TABLET 5.00 - -
770 Warfarin Na 1mg Tablet 19.00 - -
771 Warfarin Na 2.5mg Tablet 14.00 - -
772 Zinc sulfate 27.5mg/ml 15ml Oral Drops 49.00 - -
773 Zinc sulfate 55mg/5ml 60ml Syrup 63.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Polymerase Chain Reaction Laboratory

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 AH1N1 4,000.00 - -
2 COVID-19 RT-PCR TEST 1,200.00 - -
3 FILM ARRAY BLOOD CULTURE IDENTIFICATION PANEL 17,000.00 - -
4 FILM ARRAY GASTROINTESTINAL PANEL 17,000.00 - -
5 FILM ARRAY MENINGITIS/ENCEPHALITIS PANEL 17,000.00 - -
6 FILM ARRAY PNEUMONIA PANEL 17,000.00 - -
7 HEPATITIS B (HBV DNA) 4,000.00 - -
8 HEPATITIS C (HCV RNA) 4,000.00 - -
9 MRSA 3,700.00 - -
10 RESPIRATORY 2.1 (RP2.1) PANEL WITH SARS-COV-2 9,500.00 - -
11 RESPIRATORY PANEL 2+ (RP2+) FREE - - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Radiation Oncology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Conventional Radiotherapy (2D/3D) Session 5,160.00 800.00 2,200.00
2 CT Simulation- IMRT 57,730.00 11,546.00 27,430.00
3 IMRT Treatment Session 16,245.00 1,680.00 4,000.00
4 LINAC Daily fee 5,160.00 800.00 2,200.00
5 Treatment Planning Dosimetry (Xray) 24,225.00 2,380.00 7,225.00
6 TREATMENT PLANNING SYSTEM (IMRT) 25,265.00 8,400.00 12,265.00
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Radiology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 ABDOMEN CROSS-TABLE LATERAL VIEW 150.00 - -
2 Cervical Plain 4,000.00 562.50 750.00
3 Cervical Plain Stat 4,400.00 618.75 825.00
4 Cervical STAT 5,500.00 618.75 825.00
5 Cervical STAT PW 6,500.00 731.25 975.00
6 CRANIAL PLAIN 4,000.00 562.50 750.00
7 Cranial Plain Stat 4,400.00 618.75 825.00
8 Cranial Plain Stat PW 5,200.00 731.25 975.00
9 Cranial w/ Contrast 5,000.00 562.50 750.00
10 Cranial w/ Contrast Stat 5,500.00 618.75 825.00
11 Cranial w/ Contrast Stat PW 6,500.00 731.25 975.00
12 CT Stonogram 9,000.00 562.50 750.00
13 CT Stonogram Stat 9,900.00 618.75 825.00
14 CT Stonogram Stat PW 11,700.00 731.25 975.00
15 CT-Angiogram 10,000.00 3,787.50 5,050.00
16 CT-Angiogram STAT 11,000.00 4,166.25 5,555.00
17 CT-Angiogram STAT PW 13,000.00 4,923.75 6,565.00
18 CT-BIOPSY 2,500.00 3,412.50 4,550.00
19 CT-BIOPSY STAT 2,750.00 3,753.75 5,005.00
20 CT-BIOPSY STAT PW 3,250.00 4,436.25 5,915.00
21 CT-Chest 5,000.00 562.50 750.00
22 CT-Chest STAT 5,500.00 618.75 825.00
23 CT-Chest STAT PW 6,500.00 731.25 975.00
24 CT-Chest with contrast 6,000.00 562.50 750.00
25 CT-Chest with contrast Stat 6,600.00 618.75 825.00
26 CT-Chest with contrast Stat PW 7,800.00 731.25 975.00
27 Distal Extremity (Foot/Hand) 4,000.00 562.50 750.00
28 Distal Extremity (Foot/Hand) STAT 4,400.00 618.75 825.00
29 Distal Extremity (Foot/Hand) STATPW 5,200.00 731.25 975.00
30 Distal Extremity (Leg/Arm) 4,000.00 562.50 750.00
31 Distal Extremity (Leg/Arm) STAT 4,400.00 618.75 825.00
32 Distal Extremity (Leg/Arm) STATPW 5,200.00 731.25 975.00
33 High Resolution Chest CT 8,000.00 562.50 750.00
34 High Resolution Chest CT Stat 8,800.00 618.75 825.00
35 High Resolution Chest CT Stat PW 10,400.00 731.25 975.00
36 Kidney and Adrenal with Contrast 7,000.00 562.50 750.00
37 Kidney and Adrenals 6,000.00 562.50 750.00
38 Kidney and Adrenals STAT 6,600.00 618.75 825.00
39 Kidney and Adrenals STAT PW 7,800.00 731.25 975.00
40 LOWER ABDOMEN 6,000.00 562.50 750.00
41 Lower Abdomen STAT 6,600.00 618.75 825.00
42 Lower Abdomen STAT PW 7,800.00 731.25 975.00
43 Lower Abdomen w/ Contrast 7,000.00 562.50 750.00
44 Lower Abdomen w/ Contrast STAT 7,700.00 618.75 825.00
45 Lower Abdomen w/ Contrast STAT PW 9,100.00 731.25 975.00
46 Lower Thoracic 6,000.00 562.50 750.00
47 Lower Thoracic STAT 6,600.00 618.75 825.00
48 Lower Thoracic STAT PW 7,800.00 731.25 975.00
49 Lumbar 6,000.00 562.50 750.00
50 LUMBAR PLAIN 5,000.00 562.50 750.00
 51 LUMBAR PLAIN STAT 5,500.00 618.75 825.00
52 LUMBAR PLAIN STAT PW 6,500.00 731.25 975.00
53 Lumbar STAT 6,600.00 618.75 825.00
54 Lumbar STAT PW 7,800.00 731.25 975.00
55 MRA OF THE LOWER EXTREMETIES 8,300.00 975.00 1,300.00
56 MRA OF THE UPPER EXTREMETIES 8,300.00 975.00 1,300.00
57 Nasopharynx Plain 6,000.00 562.50 750.00
58 Nasopharynx Plain STAT 6,600.00 618.75 825.00
59 Nasopharynx Plain STAT PW 7,800.00 731.25 975.00
60 Nasopharynx w/ Contrast STAT 7,700.00 618.75 825.00
61 Nasopharynx w/ Contrast STAT PW 9,100.00 731.25 975.00
62 Neck Plain 6,000.00 562.50 750.00
63 Neck Plain Stat 6,600.00 618.75 825.00
64 Neck Plain Stat PW 7,800.00 731.25 975.00
65 Neck w/ Contrast 7,000.00 562.50 750.00
66 Neck w/ Contrast Stat 7,700.00 618.75 825.00
67 Neck w/ Contrast Stat PW 9,100.00 731.25 975.00
68 Orbit STAT 7,700.00 618.75 825.00
69 Orbit STAT PW 9,100.00 731.25 975.00
70 Oropharynx 6,000.00 562.50 750.00
71 Oropharynx Stat 6,600.00 618.75 825.00
72 Oropharynx Stat PW 7,800.00 731.25 975.00
73 Oropharynx w/ Contrast 7,000.00 562.50 750.00
74 Oropharynx w/ Contrast Stat 7,700.00 618.75 825.00
75 Oropharynx w/ Contrast Stat PW 9,100.00 731.25 975.00
76 Pelvis 6,000.00 562.50 750.00
77 Pelvis STAT 6,600.00 618.75 825.00
78 Pelvis STAT PW 7,800.00 731.25 975.00
79 Pelvis w/ Contrast 7,000.00 562.50 750.00
80 Pelvis w/ Contrast STAT 7,700.00 618.75 825.00
81 Pelvis w/ Contrast STAT PW 9,100.00 731.25 975.00
82 PNS Plain 5,000.00 562.50 750.00
83 PNS Plain STAT 5,500.00 618.75 825.00
84 PNS Plain STAT PW 6,500.00 731.25 975.00
85 PNS w/ Contrast 6,000.00 562.50 750.00
86 PNS w/ Contrast STAT 6,600.00 618.75 825.00
87 PNS w/ Contrast STAT PW 7,800.00 731.25 975.00
88 Temporal Bone or Ear Plain 6,000.00 562.50 750.00
89 Temporal Bone or Ear Plain STAT 6,600.00 618.75 825.00
90 Temporal bone or Ear Plain STAT PW 9,100.00 731.25 975.00
91 TEMPORAL BONE OR EAR W/ CONT STAT 7,700.00 618.75 825.00
92 TEMPORAL BONE OR EAR W/ CONTRAST 7,000.00 562.50 750.00
93 THORACIC PLAIN 5,000.00 562.50 750.00
94 Upper Thoracic 6,000.00 562.50 750.00
95 Upper Thoracic STAT 6,600.00 618.75 825.00
96 Upper Thoracic STAT PW 7,800.00 731.25 975.00
97 WHOLE ABDOMEN 8,000.00 562.50 750.00
98 Whole Abdomen STAT 8,800.00 618.75 825.00
99 Whole Abdomen STAT PW 10,400.00 731.25 975.00
100 Whole Abdomen w/ Contrast 9,000.00 562.50 750.00
101 Whole Abdomen w/ Contrast Stat 9,900.00 618.75 825.00
102 Whole Abdomen w/ Contrast Stat PW 11,700.00 731.25 975.00
103 Whole Extremity 4,000.00 562.50 750.00
104 Whole Extremity STAT 4,400.00 618.75 825.00
105 Whole Extremity STAT PW 5,200.00 731.25 975.00
106 `THORACOLUMBAR SPINE 420.00 - -
107 ABDOMEN (PLAIN) PAY-W 200.00 - -
108 ABDOMEN (UPRIGHT SUPINE) PAY-W 340.00 - -
109 ABDOMEN UPRIGHT/ SUPINE 255.00 - -
110 ABDOMEN UPRIGHT/ SUPINE (XRAY) 255.00 - -
111 ADULT CHEST LATERAL DECUBITUS 150.00 - -
112 ANKLE APL 135.00 - -
113 ankle APL (left) 135.00 - -
114 Ankle APL (right) 135.00 - -
115 Ankle Mortisse View (left) 100.00 - -
116 Ankle Mortisse View (right) 100.00 - -
117 Ankle, Both APL 295.00 - -
118 AXIAL VIEW, SHOULDER 130.00 - -
119 AXILLARY VIEW 130.00 - -
120 BABYGRAM 210.00 - -
121 CALCANEUS, LEFT 135.00 - -
122 CALDWELL PA 105.00 - -
123 CALDWELL'S VIEW 105.00 - -
124 CEPHALOMETRY 295.00 - -
125 CERVICAL 5,000.00 562.50 750.00
126 CERVICAL APL 205.00 - -
127 CERVICAL APL + Obliques 310.00 - -
128 CERVICAL APL + Obliques PAY-W 460.00 - -
129 CERVICAL APL PAY-W 280.00 - -
130 CERVICAL Oblique, Left 370.00 - -
131 CERVICAL OPEN-MOUTH 102.00 - -
132 CERVICAL R/L OBLIQUE 170.00 - -
133 CERVICAL R/L OBLIQUE PAY-W 230.00 - -
134 CERVICAL SPINE AP/LAT/OBLIQUE VIEWS 310.00 - -
135 CERVICAL SPINE APL IN PT 205.00 - -
136 Chest - Apicolordotic View 75.00 - -
137 CHEST (CONE DOWN VIEW) PAY-W 105.00 - -
138 CHEST (LATERAL Only) PAY-W 120.00 - -
139 CHEST (SPOT VIEW ) PAY-W 105.00 - -
140 CHEST (THORA BONE CAGE) PAY-W 185.00 - -
141 CHEST APICOLORDOTIC VIEW 75.00 - -
142 Chest Apicolordotic View Only 75.00 - -
143 CHEST APL 150.00 - -
144 CHEST CONE DOWN VIEW 75.00 - -
145 CHEST LATERAL DECUBITUS 150.00 - -
146 CHEST LATERAL DECUBITUS PAY-W 180.00 - -
147 CHEST LATERAL VIEW 90.00 - -
148 CHEST LATERAL VIEW ONLY 90.00 - -
149 CHEST PA 105.00 - -
150 CHEST PA (Adult) 105.00 - -
151 CHEST PA (ADULT) PAY-W 135.00 - -
152 Chest PA + Apicolordotic view 165.00 - -
153 CHEST PA VIEW 105.00 - -
154 CHEST PAL ADULT 195.00 - -
155 Chest PAL (Adult) 195.00 - -
156 Chest PAL (ADULT) PAY-W 250.00 - -
157 CHEST PAL (PEDIA) PAY-W 180.00 - -
158 CHEST PAL / PEDIA 150.00 - -
159 Chest PA-Lateral (Adult) 195.00 - -
160 CHEST SPOT View 75.00 - -
161 CHEST SPOT VIEW LEFT UPPER LF 75.00 - -
162 CHEST SPOT VIEW RIGHT, MLF 75.00 - -
163 CHEST X-RAY AP/LAT PEDIA 150.00 - -
164 CLAVICLE 115.00 - -
165 CLAVICLE AP 135.00 - -
166 CLAVICLE AP PAY-W 185.00 - -
167 CLAVICLE AP, Both 220.00 - -
168 CLAVICLE AP, Left 260.00 - -
169 CLAVICLE AP, Right 260.00 - -
170 CLAVICLE BOTH PAY-W 245.00 - -
171 CLAVICLE R AND L 195.00 - -
172 CLOSE REDUCTION 500.00 - -
173 COCCYX APL 160.00 - -
174 COCCYX AP 120.00 - -
175 COCCYX AP (XRAY) 120.00 - -
176 COCCYX AP PAY-W 170.00 - -
177 COCCYX APL 120.00 - -
178 COCCYX APL PAY-W 215.00 - -
179 CT SCAN OF UROGRAM - PLAIN 8,000.00 562.50 750.00
180 CT SCAN OF UROGRAM - PLAIN & CONTRAST 9,000.00 562.50 750.00
181 ELBOW APL 130.00 - -
182 Elbow APL (left) 130.00 - -
183 Elbow, Both APL 270.00 - -
184 Feet, Both APL 270.00 - -
185 FEMUR APL 215.00 - -
186 Femur APL (Right) 215.00 - -
187 FOOT APO 130.00 - -
188 Foot APO (Left) 130.00 - -
189 Foot APO (right) 130.00 - -
190 Foot Harris View 130.00 - -
191 Foot Lateral View (left) 100.00 - -
192 Foot Lateral View (right) 100.00 - -
193 FOREARM APL 130.00 - -
194 FOREARM APL (LEFT) 130.00 - -
195 Forearm APL (right) 130.00 - -
196 Forearm, Both APL 265.00 - -
197 HAND APO 135.00 - -
198 HAND APO (LEFT) 135.00 - -
199 Hand APO (right) 135.00 - -
200 Hand Lateral View (left) 75.00 - -
201 Hand Lateral View (right) 75.00 - -
202 Hand Left (Bone Aging) 135.00 - -
203 Hands, Both APO/APL 275.00 - -
204 HIP AP 170.00 - -
205 HIP AP / CT APL 170.00 - -
206 Humerus APL (left) 140.00 - -
207 Humerus APL (right) 140.00 - -
208 Humerus, Both APL 285.00 - -
209 INTERNAL AUDITORY MEATUS 265.00 - -
210 INTERNAL AUDITORY MEATUS AP/LATERAL/TOWNES 265.00 - -
211 Intra-Op Procedure 300.00 - -
212 JUDET VIEW 130.00 - -
213 JUDET VIEW-LEFT,HIP JOINT 130.00 - -
214 JUDET VIEW-RIGHT,HIP JOINT 130.00 - -
215 JUDET VIEWS, HIP JOINT 130.00 - -
216 KNEE APL 130.00 - -
217 Knee APL (left) 130.00 - -
218 Knee APL (right) 130.00 - -
219 Knee Sunrise View(Left) 130.00 - -
220 Knee Sunrise View(right) 130.00 - -
221 Knee Tunnel View(right) 130.00 - -
222 Knee, Tunnel View(Left) 130.00 - -
223 Knees, Both APL 265.00 - -
224 KNEES, BOTH TO INCL. ROSENBERG VIEW 265.00 - -
225 KUB (Bowel Prep. Needed) 145.00 - -
226 KUB (Bowel Prep. Needed) PAY-W 200.00 - -
227 KUB AP 145.00 - -
228 LEG APL 160.00 - -
229 Leg APL (left) 160.00 - -
230 Leg APL (right) 160.00 - -
231 Leg, Both APL 330.00 - -
232 LS AP (LUMBOSACRAL AP) IN PT 190.00 - -
233 LUMBOSACRAL (L/S) OBLIQUE 190.00 - -
234 LUMBOSACRAL AP/LATERAL/OBLIQUE 395.00 - -
235 LUMBOSACRAL APL 190.00 - -
236 LUMBOSACRAL FLEXION AND EXTENSION 190.00 - -
237 Lumbosacral Spine APL 190.00 - -
238 LUMBOSACRAL SPINE APL PAY-W 295.00 - -
239 LUMBOSACRAL SPINE APLO PAY-W 540.00 - -
240 Lumbosacral Spine Oblique Views 550.00 - -
241 MANDIBLE AP 195.00 - -
242 MANDIBLE APO 185.00 - -
243 MANDIBLE Panoramic Viewandib 300.00 - -
244 MANDIBLE PAO 185.00 - -
245 MASTOID APL 230.00 - -
246 MASTOID SERIES (XRAY) 230.00 - -
247 MASTOIDS 230.00 - -
248 MRA/MRV WITH CONTRAST 8,300.00 975.00 1,300.00
249 MRI CHEST WITH CONTRAST 6,600.00 975.00 1,300.00
250 MRI CONTRAST- CERVICAL SPINE 6,900.00 975.00 1,300.00
251 MRI CONTRAST- HEAD 6,400.00 975.00 1,300.00
252 MRI CONTRAST- THORACIC SPINE 6,800.00 975.00 1,300.00
253 MRI ELBOW WITH CONTRAST 6,400.00 975.00 1,300.00
254 MRI KNEE WITH CONTRAST 6,400.00 975.00 1,300.00
255 MRI LUMBOSACRAL SPINE WITH CONTRAST 6,300.00 975.00 1,300.00
256 MRI MRCP WITH CONTRAST 8,300.00 975.00 1,300.00
257 MRI NECK WITH CONTRAST 7,300.00 975.00 1,300.00
258 MRI PELVIS/HIP WITH CONTRAST 7,300.00 975.00 1,300.00
259 MRI PLAIN - MRA/MRV 8,300.00 975.00 1,300.00
260 MRI PLAIN - PELVIS/HIP 7,300.00 975.00 1,300.00
261 MRI PLAIN- CERVICAL SPINE 6,900.00 975.00 1,300.00
262 MRI PLAIN- CHEST 6,600.00 975.00 1,300.00
263 MRI PLAIN- ELBOW 6,400.00 975.00 1,300.00
264 MRI PLAIN- HEAD 6,400.00 975.00 1,300.00
265 MRI PLAIN- KNEE 6,400.00 975.00 1,300.00
266 MRI PLAIN- LUMBAR SPINE 6,300.00 975.00 1,300.00
267 MRI PLAIN- NECK 7,300.00 975.00 1,300.00
268 MRI PLAIN- PELVIC 7,300.00 975.00 1,300.00
269 MRI PLAIN- SHOULDER 6,400.00 975.00 1,300.00
270 MRI PLAIN- THORACIC SPINE 6,800.00 975.00 1,300.00
271 MRI PLAIN- WHOLE ABD 13,300.00 975.00 1,300.00
272 MRI PLAN EXTREMITIES 6,400.00 975.00 1,300.00
273 MRI PLAN MRCP 8,300.00 975.00 1,300.00
274 MRI SHOULDER WITH CONTRAST 6,400.00 975.00 1,300.00
275 MRI W/ CONTRAST - EXTREMITIES 6,400.00 975.00 1,300.00
276 NASAL BONE 115.00 - -
277 NASAL BONE 115.00 - -
278 NASAL BONE IN PT 115.00 - -
279 ORBIT 7,000.00 562.50 750.00
280 ORBIT IN PT 195.00 - -
281 ORTHO INTRA-OP 300.00 - -
282 Paranasal Sinuses 200.00 - -
283 Paranasal Sinuses Series 200.00 - -
284 PELVIS AP 130.00 - -
285 PELVIS AP PAY-W 180.00 - -
286 PELVIS APL 200.00 - -
287 PELVIS APL PAY-W 270.00 - -
288 PELVIS INLET OR OUTLET VIEWS 220.00 - -
289 PELVIS INLET OR OUTLET VIEWS PAY-W 290.00 - -
290 PELVIS OBLIQUE PAY-W 270.00 - -
291 PELVIS OR BOTH HIPS APO OR LATERAL 200.00 - -
292 Plain Abdomen 150.00 - -
293 PLAIN ABDOMEN (XRAY) 150.00 - -
294 Plain PNX 150.00 - -
295 PNS (PARANASAL SINUSES) IN PT 200.00 - -
296 PORTABLE USE FEE 300.00 - -
297 PORTABLE X-RAY (CHEST) IN PT 405.00 - -
298 RADIOLOGY MEDIA PUBLISHER 100.00 - -
299 Scapula AP 130.00 - -
300 SCAPULA AP PAY-W 175.00 - -
301 SCAPULA APL 130.00 - -
302 SCAPULA LATERAL PAY-W 120.00 - -
303 Scapula Lateral view 90.00 - -
304 SCAPULA Y VIEW 90.00 - -
305 SCAPULA Y-VIEW(PAY-W) 120.00 - -
306 Scoliosis AP 145.00 - -
307 SCOLIOSIS AP PAY-W 200.00 - -
308 SCOLIOSIS SERIES 425.00 - -
309 SCOLIOSIS SERIES PAY-W 580.00 - -
310 SH L 75.00 - -
311 Shoulder AP 130.00 - -
312 SHOULDER AP PAY-W 180.00 - -
313 Shoulder Apl 200.00 - -
314 SHOULDER APL - IPD 200.00 - -
315 SHOULDER APL PAY-W 275.00 - -
316 SKELETAL SURVEY (ADULT) 955.00 - -
317 SKELETAL SURVEY (PEDIA) 675.00 - -
318 SKULL (AP Only) PAY-W 120.00 - -
319 SKULL (CEPHALOMETRY) PAY-W 400.00 - -
320 SKULL ([Link]. MEATUS) PAY-W 350.00 - -
321 SKULL (LATERAL Only) PAY-W 120.00 - -
322 SKULL (MANDIBLE) PAY-W 250.00 - -
323 SKULL (MASTOIDS) PAY-W 315.00 - -
324 SKULL (NASAL BONE) PAY-W 270.00 - -
325 SKULL (ORBIT Only) PAY-W 250.00 - -
326 SKULL (PANORAMIC) PAY-W 395.00 - -
327 SKULL (PARANASAL SINUSES) PAY-W 270.00 - -
328 SKULL (Submento-vertex) PAY-W 125.00 - -
329 SKULL (TEMP MAND. JOINT) PAY-W 330.00 - -
330 SKULL (TOWNE'S Only) PAY-W 105.00 - -
331 SKULL (WATER'S Only) PAY-W 105.00 - -
332 Skull AP 90.00 - -
333 SKULL AP/LATERAL/TOWNE'S VIEW 75.00 - -
334 SKULL APL 170.00 - -
335 Skull APL (2 views) only 170.00 - -
336 SKULL APL OPD 170.00 - -
337 Skull Lateral View 90.00 - -
338 SKULL SERIES 220.00 - -
339 SKULL SERIES (APL + Townes views) 220.00 - -
340 SKULL SERIES (APL + TWN) PAY-W 295.00 - -
341 SKULL SERIES (APL Only) PAY-W 235.00 - -
342 SMV (Submentovertex view) 95.00 - -
343 Submento Vertex 95.00 - -
344 TBC APL 235.00 - -
345 TBC R AND L OBLIQUE 275.00 - -
346 TBC with obliques 190.00 - -
347 TEMPORO MANDIBULAR JOINT 245.00 - -
348 TEMPOROMANDIBULAR JOINTS OPEN/CLOSED 245.00 - -
349 Thigh, Both APL 360.00 - -
350 THORACIC APL 295.00 - -
351 THORACIC APL PAY-W 390.00 - -
352 THORACIC BONY CAGE (APL) PAY-W 310.00 - -
353 THORACIC BONY CAGE (OBL) PAY-W 365.00 - -
354 Thoracic Bony Cage AP 135.00 - -
355 THORACIC SPINE + OBLIQUE 190.00 - -
356 THORACO-LUMBAR SPINE APL 420.00 - -
357 THORACOLUMBAR SPINE PAY-W 555.00 - -
358 TOWNE'S VIEW 75.00 - -
359 TOWNE'S VIEW only 75.00 - -
360 WATER VIEW (X-RAY) - OPD 95.00 - -
361 WATER`S VIEW 75.00 - -
362 WATER'S VIEW 75.00 - -
363 WHOLE ABDOMEN (CONTRAST) (MRI) 13,300.00 975.00 1,300.00
364 Wrist APL (left) 145.00 - -
365 Wrist APL (right) 145.00 - -
366 WRIST PAL 145.00 - -
367 Wrist, Both APL 280.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Radiotherapy
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 VAGINAL CYLINDER BRACHYTHERAPY WITH SEDATION 62,112.50 12,422.50 34,412.50
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Rehabilitation Medicine
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Above elbow (AE) (PHIC Expanded Z MORPH) 70,000.00 - -
2 Above elbow (PHIC Z Benefit) 67,300.00 - -
3 Above knee or with knee disarticulation (AKKD) (PHIC Expanded Z 75,000.00 - -
MORPH)
4 Above knee or with knee disarticulation (AKKD) (PHIC Z Benefit) 61,940.00 - -
5 Ankle foot (PHIC Expanded Z MORPH) 17,500.00 - -
6 Ankle foot orthosis (AFO) (PHIC Z Benefit) 13,110.00 - -
7 Below elbow (BE) (PHIC Expanded Z MORPH) 50,000.00 - -
8 Below elbow (PHIC Z Benefit) 47,300.00 - -
9 Below knee or ankle disarticulation (PHIC Z Benefit) 31,540.00 - -
10 Below knee or Transtibial 15,000.00 - -
11 Cervicothoracic (PHIC Expanded Z MORPH) 45,000.00 - -
12 Finger glove (for 1 finger) (PHIC Z Benefit) 17,300.00 - -
13 Foot or Symes or Ankle (PHIC Z-MORPH PACKAGE) 15,000.00 - -
14 Hand glove (for more than 1 finger) (PHIC Z Benefit) 22,300.00 - -
15 Hip disarticulation (HD) (PHIC Expanded Z MORPH) 135,000.00 - -
16 Hip disarticulation (HD) (PHIC Z Benefit) 163,540.00 - -
17 Hip knee ankle foot (PHIC Expanded Z MORPH) 80,000.00 - -
18 Hip knee ankle foot orthosis (HKAFO) (PHIC Z Benefit) 50,810.00 - -
19 Knee ankle foot (PHIC Expanded Z MORPH) 35,000.00 - -
20 Knee ankle foot orthosis (KAFO) (PHIC Z Benefit) 29,210.00 - -
21 Lumbosacral (PHIC Expanded Z MORPH) 30,000.00 - -
22 OCCUPATIONAL THERAPY 150.00 50.00 50.00
23 OCCUPATIONAL THERAPY BASIC RATE EXERCISES WITH MODALITIES - 200.00 - -
IPD
24 Partial foot (PHIC Z Benefit) 26,540.00 - -
25 PHIC Z Benefit Developmental and functional assessment by a 3,626.00 - -
medical specialist (Physiatrist/Neurodevelopmental Pedia)
26 PHIC Z Benefit Developmental and functional assessment by a 4,176.00 - -
medical specialist (Physiatrist/Neurodevelopmental Pedia) and one
allied health professional or rehabilitation therapist (PT/OT/Speech
Therapist)
27 PHIC Z Benefit Developmental and functional assessment by a 5,276.00 - -
medical specialist (Physiatrist/Neurodevelopmental Pedia) and
three allied health professionals or rehabilitation therapist (PT, OT,
Speech Therapist)
28 PHIC Z Benefit Developmental and functional assessment by a 4,726.00 - -
medical specialist (Physiatrist/Neurodevelopmental Pedia) and two
allied health professionals or rehabilitation therapist (PT/OT/Speech
Therapist)
29 PHIC Z Benefit Developmental and functional discharge assessment 3,626.00 - -
by a medical specialist (Physiatrist/Neurodevelopmental Pedia)

30 PHIC Z Benefit Developmental and functional discharge assessment 4,176.00 - -

by a medical specialist (Physiatrist/Neurodevelopmental Pedia) and
one allied health professional or rehabilitation therapist
(PT/OT/Speech Therapist)
31 PHIC Z Benefit Developmental and functional discharge assessment 5,276.00 - -
by a medical specialist (Physiatrist/Neurodevelopmental Pedia) and
three allied health professionals or rehabilitation therapist (PT,OT,
Speech Therapist)
32 PHIC Z Benefit Developmental and functional discharge assessment 4,176.00 - -
by a medical specialist (Physiatrist/Neurodevelopmental Pedia) and
two allied health professionals or rehabilitation therapist
(PT/OT/Speech Therapist)
33 PHIC Z Benefit Rehabilitation Therapy - 10 sessions (CWD) 5,000.00 - -
34 PHYSICAL THERAPY BASIC RATE (EXERCISE WITH MODALITIES) 150.00 - -
35 PHYSICAL THERAPY BASIC RATE EXERCISES WITH MODALITIES - IPD 200.00 - -

36 Rehabilitation Consultation 50.00 - -

37 Shoulder disarticulation (PHIC Z Benefit) 132,300.00 - -
38 Spinal Bracing or Orthosis (PHIC Z Benefit) 32,180.00 - -
39 Talipes Equinovarus or clubfoot (PHIC Z Benefit) 17,860.00 - -
40 Thoracolumbosacral (PHIC Expanded Z MORPH) 40,000.00 - -
41 Van Ness Rotation Plasty (PHIC Expanded Z MORPH) 85,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Respiratory Unit Services

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 ARTERIAL BLOOD GAS(ABG) 525.00 - -
2 CPAP CANNULA(LARGE,MEDIUM,SMALL) 575.00 - -
3 CPAP CANNULA(XS,XXS) 655.00 - -
4 CPAP MASK(SMALL,[Link])-VENTED/NON VENTED 6,110.00 - -
5 ELECTROCARDIOGRAM-PAY PATIENT 450.00 - -
6 ELECTROCARDIOGRAM-SERVICE PATIENT 320.00 - -
7 FiO 70% (24HOURS) 1,422.00 - -
8 FiO2 100%(24HOURS) 2,275.20 - -
9 FiO2 25%(24HOURS) 142.20 - -
10 FiO2 30%(24HOURS) 284.40 - -
11 FiO2 35%(24HOURS) 426.60 - -
12 FiO2 40%(24HOURS) 568.80 - -
13 FiO2 45%(24HOURS) 711.00 - -
14 FiO2 50%(24HOURS) 853.20 - -
15 FiO2 55%(24HOURS) 995.40 - -
16 FiO2 60%(24HOURS) 1,137.60 - -
17 FiO2 65% (24HOURS) 1,279.80 - -
18 FiO2 75% (24HOURS) 1,564.20 - -
19 FiO2 80%(24HOURS) 1,706.40 - -
20 FiO2 85% (24HOURS) 1,848.60 - -
21 FiO2 90%(24HOURS) 1,990.80 - -
22 FiO2 95% (24HOURS) 2,133.00 - -
23 FLEX TUBE CONNECTOR 350.00 - -
24 HEAT AND MOISTURE EXCHANGER(HME) 400.00 - -
25 HIGH FLOW CANNULA(SMALL,[Link])-AIRVO 2,592.00 - -
26 HIGH FLOW CANNULA-HIFENT 1,795.00 - -
27 HIGH FLOW TUBING-HIFENT 5,980.00 - -
28 HIGH FLOW TUBINGS-AIRVO 7,930.00 - -
29 IN-LINE T-PIECE SET 270.00 - -
30 IN-LINE/JET NEBULIZER SET 1,000.00 - -
31 METERED DOSE INHALER(MDI) ADAPTOR 215.00 - -
32 OXYGEN NIPPLE 156.00 - -
33 PULMONARY FUNCTION TEST(SIMPLE SPIROMETRY) 900.00 - -
34 STERILE WATER(1L)-FOR VENTILATOR USE 179.00 - -
35 VENTILATOR BACTERIAL/VIRAL FILTER 253.00 - -
36 VENTILATOR CIRCUIT-ADULT 1,100.00 - -
37 VENTILATOR CIRCUIT-NEONATAL 1,100.00 - -
38 VENTILATOR CIRCUIT-PEDIATRIC 1,100.00 - -
39 VENTILATOR HUMIDIFIER CHAMBER-AUTOFEED 1,788.00 - -
40 VENTILATOR USAGE(1DAY)-SPECIAL UNITS/PAY PATIENT 1,500.00 - -
41 VENTILATOR USAGE(1DAY)-WARD/SERVICE PATIENTS 1,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Room and Board Rates

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Adult Onco Unit 1,000.00 - -
2 CCI Ward 1,000.00 - -
3 Childrens Blood Diseases Unit 1,000.00 - -
4 Covid ICU 5,000.00 - -
5 COVID PICU 5,000.00 - -
6 CP Ward 700.00 - -
7 CP2 COVID Holding Area 700.00 - -
8 CP-ICU 3,000.00 - -
9 EMERGENCY ROOM 500.00 - -
10 General Pediatric Surgery Ward 1,000.00 - -
11 HI East Wing Ward (8 beds) 1,000.00 - -
12 HI ICU 5,000.00 - -
13 HI Private Room 1 3,000.00 - -
14 HI Private Room 2 2,000.00 - -
15 HI Recovery Room (per hour) 210.00 - -
16 HI Suite Room 4,500.00 - -
17 ICU 4 5,000.00 - -
18 IM ICU 5 5,000.00 - -
19 Isolation Pedia Tent 1,000.00 - -
20 ISOLATION WARD 1 2,000.00 - -
21 ISOLATION WARD 3 1,000.00 - -
22 ISOLATION WARD 5 1,000.00 - -
23 ISOLATION WARD 6 2,000.00 - -
24 IWNH Gyne Ward 1,000.00 - -
25 IWNH Isolation 2,000.00 - -
26 IWNH Onco Tropho 2,000.00 - -
27 IWNH Ward ICU 3,000.00 - -
28 Kangaroo Room 1,500.00 - -
29 Medical Ward 1,000.00 - -
30 NEONATAL ISOLATION WARD 1,200.00 - -
31 Neuro ICU 3,000.00 - -
32 Neuro Ward 1,000.00 - -
33 NICU-IWNH 5,000.00 - -
34 OB ISOLATION WARD 700.00 - -
35 OB WARD 1,000.00 - -
36 ORTHO HOLDING AREA 2,000.00 - -
37 ORTHO WARD 1,000.00 - -
38 PAYWARD (LARGE ROOM) 2,500.00 - -
39 PAYWARD (PRIVATE ROOM) 2,000.00 - -
40 PAYWARD (SEMI-PRIVATE 2) 1,600.00 - -
41 PAYWARD (SEMI-PRIVATE 3) 1,400.00 - -
42 PAYWARD (SUITE ROOM) 3,000.00 - -
43 PEDIA COVID WARD 1,000.00 - -
44 PEDIA WARD 700.00 - -
45 Pedia-Annex 1,000.00 - -
46 Pediatric Specialty Wing 1,000.00 - -
47 Surgery East Ward 1,000.00 - -
48 Surgery ICU 5,000.00 - -
49 Surgery West Ward 1,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

ECG Unit
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 ABG 300.00 - -
2 ABG PACKAGE 1,400.00 - -
3 12-Lead Electrocardiogram OPD 224.00 96.00 -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Surgery
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Avulsion of nail plate, partial or complete 3,640.00 - -
2 Excision tumor, soft tissue of neck or thorax; subcutaneous 5,860.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Ultrasound
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Abdominal Aorta 440.00 - -
2 Biophysical Scoring PAY-W 800.00 - -
3 BREAST ULTRASOUND (IC) 1,000.00 - -
4 KNEE ULTRASOUND (SINGLE) PAY-W 600.00 - -
5 KUB, Prostate / Pelvis PAY-W 850.00 - -
6 WHOLE ABDOMEN PAY-W 1,200.00 - -
7 Abd, upper (liver, GB, HBT, Spl)PAY 800.00 - -
8 Abdomen Whole (upper abd + pelv)PAY 1,200.00 - -
9 ABDOMINAL AORTA (B-MODE) 385.00 - -
10 ABDOMINAL AORTA (B-MODE) PAY-W 510.00 - -
11 ADRENAL GLANDS PAY-W 700.00 - -
12 BIOPHYSICAL SCORING (MULTIFETAL) 800.00 - -
13 BIOPHYSICAL SCORING (SINGLE) 600.00 - -
14 BIOPHYSICAL SCORING (SINGLE) PAY-W 700.00 - -
15 Biophysical Scoring PAY-W 800.00 - -
16 BIOPHYSICAL SCORING(MULTIFET) PAY-W 900.00 - -
17 BPS (Biophysical Scoring) Single 700.00 - -
18 BPS (Biophysical Scoring) Twin / IV 900.00 - -
19 BREAST PAY-W 600.00 - -
20 BREAST ULTRASOUND (SINGLE) 600.00 - -
21 BREAST ULTRASOUND (SINGLE) PAY-W 1,000.00 - -
22 Breast Ultrasound (Single/Bil) 1,000.00 - -
23 BREAST USD (B) PAY-W 1,000.00 - -
24 Carotid Artery (Bilateral) 1,190.00 - -
25 Carotid Artery (Single) 590.00 - -
26 CAROTID DOPPLER (BOTH) 1,690.00 - -
27 CAROTID DOPPLER (BOTH) PAY-W 3,000.00 - -
28 CAROTID DOPPLER (ONE SIDE) 790.00 - -
29 CAROTID DOPPLER (ONE SIDE) PAY-W 1,500.00 - -
30 Chest/Thorax 355.00 - -
31 CHEST/THORAX PAY-W 480.00 - -
32 CHEST/THORAX WIC 480.00 - -
33 Cranial PAY-W 790.00 - -
34 Cranial Ultrasound 595.00 - -
35 CRANIAL ULTRASOUND PAY-W 790.00 - -
36 DOPPLER OF ABDOMINAL AORTA 440.00 - -
37 DOPPLER OF ABDOMINAL AORTA PAY-W 1,000.00 - -
38 DOPPLER OF LOWER EXTREMITY (BOTH) 1,690.00 - -
39 DOPPLER OF LOWER EXTREMITY (SINGLE) 790.00 - -
40 DOPPLER OF LOWER EXTREMITY(B) PAY-W 3,000.00 - -
41 DOPPLER OF LOWER EXTREMITY(S) PAY-W 1,500.00 - -
42 DOPPLER OF SCROTUM/TESTES 440.00 - -
43 DOPPLER OF SCROTUM/TESTES PAY-W 1,000.00 - -
44 DOPPLER OF UPPER EXTREMITY (BOTH) 1,690.00 - -
45 DOPPLER OF UPPER EXTREMITY (SINGLE) 790.00 - -
46 DOPPLER OF UPPER EXTREMITY(B) PAY-W 3,000.00 - -
47 DOPPLER OF UPPER EXTREMITY(S) PAY-W 1,500.00 - -
48 Doppler Ultrasound PAY-W 1,500.00 - -
49 FAST 500.00 - -
50 Fine Needle Aspiration Biopsy PAY-W 1,650.00 - -
 51 FOLICLE MONITORING 445.00 - -
52 FOLICLE MONITORING PAY-W 600.00 - -
53 GALL BLADDER PAY-W 650.00 - -
54 GALLBLADDER 550.00 - -
55 GUIDED ASPIRATION 690.00 - -
56 GUIDED ASPIRATION WIC 2,200.00 - -
57 Guided Biopsy 690.00 - -
58 GUIDED BIOPSY WIC 2,200.00 - -
59 HBT and pancreas 550.00 - -
60 HBT AND PANCREAS(PAY-W) 650.00 - -
61 HIP ULTRASOUND (BOTH) 705.00 - -
62 HIP ULTRASOUND (BOTH) PAY-W 950.00 - -
63 HIP ULTRASOUND (SINGLE) 445.00 - -
64 HIP ULTRASOUND (SINGLE) PAY-W 600.00 - -
65 Inguinal/Scrotal Ultrasound 330.00 - -
66 INGUINOSCROTAL PAY-W 450.00 - -
67 Kidneys only PAY-W 650.00 - -
68 KIDNEYS(CH) 550.00 - -
69 KIDNEYS, URINARY BLADDER 650.00 - -
70 Kidneys, Urinary Bladder PAY-W 750.00 - -
71 KNEE ULTRASOUND (SINGLE) 445.00 - -
72 KUB AND PROSTATE/PELVIS 850.00 - -
73 LIVER ABSCESS DRAINAGE 490.00 - -
74 LIVER ABSCESS DRAINAGE WIC 2,500.00 - -
75 LIVER AND SPLEEN 600.00 - -
76 LIVER AND SPLEEN PAY-W 700.00 - -
77 LIVER DOPPLER 590.00 - -
78 LIVER DOPPLER PAY-W 1,500.00 - -
79 Liver Only PAY-W 650.00 - -
80 LIVER USD 650.00 - -
81 LIVER, GB, HBT 600.00 - -
82 Liver, GB, HBT PAY-W 700.00 - -
83 LIVER, GB, HBT, PANCREAS 650.00 - -
84 Liver, GB, HBT, Pancreas PAY-W 750.00 - -
85 Liver, PAN, Spleen PAY-W 650.00 - -
86 LIVER,GB,HBT, PANCREAS PAY 750.00 - -
87 lower abdomen PAY-W 340.00 - -
88 neck ultrasound PAY-W 850.00 - -
89 NECK USD 750.00 - -
90 ORBIT USD 320.00 - -
91 ORBIT/USD(P-W) 435.00 - -
92 Pancreas 550.00 - -
93 PANCREAS PAY-W 650.00 - -
94 PAROTID GLAND USD (BOTH) 495.00 - -
95 PAROTID GLAND USD (BOTH) PAY-W 600.00 - -
96 PAROTID GLAND USD (SINGLE) 195.00 - -
97 PAROTID GLAND USD (SINGLE) PAY-W 300.00 - -
98 PELVIS 600.00 - -
99 PREG. EVALUATION (MULTIFETAL) 1,600.00 - -
100 PREG. EVALUATION (MULTIFETAL) PAY-W 1,800.00 - -
101 PREG. EVALUATION TVS (SINGLE) 700.00 - -
102 PREG. EVALUATION TVS (SINGLE) PAY-W 800.00 - -
103 PREG. EVALUATION(MULTIFET) PAY-W 1,800.00 - -
104 PREGNANCY EVALUATION (MULTIFET) 1,600.00 - -
105 PREGNANCY EVALUATION (S) 700.00 - -
106 PREGNANCY EVALUATION (S) PAY-W 800.00 - -
107 PROSTATE (TRANSABDOMINAL) 600.00 - -
108 PROSTATE (TRANSRECTAL) 600.00 - -
109 PROSTATE (TRANSRECTAL) PAY-W 750.00 - -
110 PROSTATE(transabdominal)/PAY-W 700.00 - -
111 Radio - Adrenal Glands 600.00 - -
112 Radio - Breast Ultrasound (BOTH) 900.00 - -
113 Renal (Native Kidney) Both 1,790.00 - -
114 RENAL DOPPLER (GRAFT/TRANSPLANT) 1,390.00 - -
115 RENAL DOPPLER (NATIVE KIDNEY) BOTH 1,690.00 - -
116 RENAL DOPPLER (NATIVE KIDNEY) SINGL 1,500.00 - -
117 SCROTUM/ TESTES 800.00 - -
118 SHOULDER ULTRASOUND (BOTH) 595.00 - -
119 SHOULDER ULTRASOUND (BOTH) PAY-W 800.00 - -
120 SHOULDER ULTRASOUND (SINGLE) 370.00 - -
121 SHOULDER ULTRASOUND (SINGLE) PAY-W 500.00 - -
122 Soft tissue (usd) PAY-W 340.00 - -
123 SPLEEN 550.00 - -
124 SPLEEN PAY-W 650.00 - -
125 SUBMANDIBULAR GLAND USD (B) PAY-W 600.00 - -
126 SUBMANDIBULAR GLAND USD (BOTH) 445.00 - -
127 SUBMANDIBULAR GLAND USD (S) PAY-W 300.00 - -
128 SUBMANDIBULAR GLAND USD (SINGLE) 195.00 - -
129 Submental USD PAY-W 340.00 - -
130 SUBXIPHOID 500.00 - -
131 SUPERFICIAL SOFT TISSUE 335.00 - -
132 SUPERFICIAL SOFT TISSUE PAY-W 450.00 - -
133 Testes PAY-W 580.00 - -
134 Thyroid gland PAY-W 500.00 - -
135 THYROID USD 370.00 - -
136 TRANSRECTAL USD (GYNE) 650.00 - -
137 TRANSRECTAL USD (GYNE) PAY-W 750.00 - -
138 TRANSVAGINAL USD (GYNE) 600.00 - -
139 TRANSVAGINAL USD (GYNE) PAY-W 750.00 - -
140 Transvaginal(TVS /Transrectal PAY-W 350.00 - -
141 ULTRASOUND GUIDED BIOPSY 10,540.00 - -
142 Ultrasound Guided Internal Jugular 10,540.00 - -
143 Ultrasound Guided Procedures PAY-W 1,650.00 - -
144 Ultrasound Guided Thoracenthesis 10,540.00 - -
145 Ultrasound Portable Fee 500.00 - -
146 UPPER ABDOMEN 800.00 - -
147 UPPER ABDOMEN OPD 800.00 - -
148 UPPER ABDOMEN PAY-W 900.00 - -
149 URINARY BLADDER 600.00 - -
150 URINARY BLADDER PAY-W 700.00 - -
151 USD BIOPSY FEE 2,520.00 - -
152 USD Guided Fem Vein Shunt Insertion 10,540.00 - -
153 USD Percutaneous PTC Insertion 10,540.00 - -
154 USDG-Thora Prof. Fee 2,520.00 - -
155 WHOLE ABD 1,100.00 - -
156 WHOLE ABDOMEN (PELVIS) 1,100.00 - -
157 WHOLE ABDOMEN (PROSTATE) 1,100.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Urology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Prostate Biopsy (SERVICE PATIENT) 13,609.00 2,625.00 -
2 Prostate Biopsy with Guided Transrectal Ultrasound (PAY
13,609.00
PATIENT)) 7,500.00 10,000.00
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Water Laboratory
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 WATER BACTERIOLOGICAL ANALYSIS 450.00 - -
2 WATER BACTERIOLOGICAL ANALYSIS FOR PSEUDOMONAS 200.00 - -
3 WATER BACTERIOLOGICAL ANALYSIS WITH PSEUDOMONAS 650.00 - -
4 WATER MANDATORY ANALYSIS WITH METALS 3,250.00 - -
5 WATER MANDATORY ANALYSIS WITHOUT METALS 1,650.00 - -
6 WATER PHYSICO-CHEMICAL ANALYSIS 1,200.00 - -
7 WATER PHYSICO-CHEMICAL ANALYSIS FOR RESIDUAL (CHLORINE) 200.00 - -
8 WATER PHYSICO-CHEMICAL ANALYSIS WITH METALS 2,800.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Wellness Package
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Excision of varicocele or ligation of spermatic veins for varicocele 12,900.00 6,300.00 6,300.00
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

X-Ray
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 ABDOMEN X-RAY AP (SUPINE AND UPRIGHT) ADULT (6 YEARS 255.00 - -
BEYOND)
2 Ankle AP and Lateral Bilateral 295.00 - -
3 Ankle APL Left 135.00 - -
4 ANKLE JOINT (RIGHT AND LEFT) X-RAY APL-OPD 135.00 - -
5 ANKLE JOINT X-RAY AP (MORTISE) AND LATERAL-OPD/HMO 100.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

2D Echo Services
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 2D ECHO (OPD) 1,250.00 750.00 850.00
2 2D ECHO (WARD) 1,250.00 750.00 1,250.00
3 2D ECHO (PAY IN-PATIENTS - MACHINE FEE) 1,250.00 1,250.00 1,250.00
4 2D ECHO ( PAY IN PATIENTS - PROFESSIONAL FEE) 1,250.00 1,250.00 1,250.00
5 2DECHO (PAY OPD - MACHINE PAY W/ PF) 2,100.00 - 850.00
6 2D ECHO (PAY OPD - MACHINE FEE) 1,250.00 - -
7 2D ECHO (PAY OPD - PROFESSIONAL FEE) 850.00 850.00 850.00
8 2D ECHO (SERVICE/OPD/IN-PATIENTS 2,000.00 750.00 1,250.00
9 2D ECHO (SERVICE/OPD/IN-PATIENTS - MACHINE FEE) 1,250.00 1,250.00 1,250.00
10 2D ECHO (SERVICE/OPD/IN-PATIENTS - PROFESSIONAL FEE) 750.00 750.00 850.00
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Ambulatory Surgery Unit

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Excision, other benign lesions diameter 0.5 cm or less 4,108.00 1,008.00 1,008.00
2 PTERYGIUM EXCISION 9,700.00 4,200.00 4,200.00
3 REMOVAL OF LENS MATERIAL; EXTRACAPSULAR 16,000.00 6,400.00 6,400.00
4 Extracapsular cataract removal with insertion of intraocular lens 16,000.00 6,400.00 6,400.00
prosthesis (one stage procedure)
5 Extracapsular cataract removal with insertion of intraocular lens 16,000.00 6,400.00 6,400.00
prosthesis
6 TRABECULECTOMY 23,300.00 12,600.00 12,600.00
7 ENUCLEATION 12,120.00 6,720.00 6,720.00
8 Evisceration of ocular contents; without implant 12,120.00 6,720.00 6,720.00
9 Evisceration of ocular contents; with implant 12,120.00 6,720.00 6,720.00
10 Ligation or transection of fallopian tube(s), abdominal or vaginal 7,000.00 1,000.00 1,000.00
approach, unilateral or bilateral
11 Dilation and Curettage 7,000.00 4,400.00 4,400.00
12 CAUTERIZATION OF CERVIX; ANY METHOD 4,000.00 1,680.00 1,680.00
13 REMOVAL OF IMPLANT; SUPERFICIAL (E.G., BURIED WIRE, PIN OR 10,540.00 5,040.00 5,040.00
ROD)
14 Removal of implant; deep (e.g., buried wire, pin, screw, metal band, 11,980.00 5,880.00 5,880.00
nail, rod or plate)
15 Excision, benign lesion, except skin tag (unless listed elsewhere), 3,640.00 840.00 840.00
scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less
16 Debridement; skin, and subcutaneous tissue 5,680.00 1,680.00 1,680.00
17 Debridement including removal of foreign material associated w/ 10,540.00 5,040.00 5,040.00
open fracture(s) and/or dislocation(s); skin and subcutaneous
tissues
18 APPLICATION OF BODY CAST, SHOULDER TO HIPS; SHOULDER TO 5,680.00 1,680.00 1,680.00
HAND (LONG ARM)
19 APPLICATION OF BODY CAST, SHOULDER TO HIPS; ELBOW TO 5,560.00 1,260.00 1,260.00
FINGER (SHORT ARM)
20 Application of body cast, shoulder to hips; hand and lower forearm 5,560.00 1,260.00 1,260.00
(gauntlet)
21 APPLICATION OF LONG LEG CAST (THIGH TO TOES) 8,020.00 2,520.00 2,520.00
22 APPLICATION OF LONG LEG CAST (THIGH TO TOES); 8,020.00 2,520.00 2,520.00
23 Application of short leg cast (below knee to toes); walking or 8,020.00 2,520.00 2,520.00
ambulatory type
24 Simple repair of superficial wounds of scalp, neck, axillae, external 3,640.00 840.00 840.00
genitalia, trunk and/or extremities (including hands and feet); 2.5
cm or less
25 Simple repair of superficial wounds of scalp, neck, axillae, external 5,560.00 1,260.00 1,260.00
genitalia, trunk and/or extremities (including hands and feet); 2.6
cm to 7.5 cm
26 Simple repair of superficial wounds of scalp, neck, axillae, external 5,680.00 1,680.00 1,680.00
genitalia, trunk and/or extremities (including hands and feet); 7.6
cm to 12.5 cm
27 Excision, other benign lesion (unless listed elsewhere), face, ears, 4,108.00 1,008.00 1,008.00
eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or
less
28 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), 4,108.00 1,008.00 1,008.00
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION
DIAMETER 0.6 TO 1.0 CM
29 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), 4,108.00 1,008.00 1,008.00
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION
DIAMETER 1.1 TO 2.0 CM
30 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), 4,108.00 1,008.00 1,008.00
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION
DIAMETER 2.1 TO 3.0 CM
31 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), 4,108.00 1,008.00 1,008.00
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION
DIAMETER 3.1 TO 4.0 CM
32 EXCISION, OTHER BENIGN LESION (UNLESS LISTED ELSEWHERE), 4,108.00 1,008.00 1,008.00
FACE, EARS, EYELIDS, NOSE, LIPS, MUCOUS MEMBRANE; LESION
DIAMETER OVER 4.0 CM
33 Simple repair of superficial wounds of face, ears, eyelids, nose, lips 5,680.00 1,680.00 1,680.00
and/or mucous membranes; 2.5 cm or less
34 EXCISION, NASAL POLYP(S), SIMPLE 8,020.00 2,520.00 2,520.00
35 INTERDENTAL WIRING, FOR CONDITION OTHER THAN FRACTURE 12,120.00 6,720.00 6,720.00
36 NASAL ENDOSCOPY, DIAGNOSTIC, UNILATERAL OR BILATERAL 10,540.00 5,040.00 5,040.00
37 NASAL/SINUS ENDOSCOPY, SURGICAL; W/ BIOPSY, POLYPECTOMY 12,120.00 6,720.00 6,720.00
OR DEBRIDEMENT
38 Repair initial inguinal hernia, age 6 months to under 5 years, w/ or 21,000.00 8,400.00 8,400.00
w/o hydrocelectomy; reducible
39 REPAIR INITIAL INGUINAL HERNIA, AGE 5 YEARS OR OVER; 21,000.00 8,400.00 8,400.00
REDUCIBLE
40 Hemorrhoidectomy, internal and external, simple 12,120.00 6,720.00 6,720.00
41 SURGICAL TREATMENT OF ANAL FISTULA 12,120.00 6,720.00 6,720.00
(FISTULECTOMY/FISTULOTOMY); SUBCUTANEOUS
42 THYROIDECTOMY, TOTAL OR COMPLETE 31,000.00 12,400.00 12,400.00
43 Creation of arteriovenous fistula by other than direct arteriovenous 12,900.00 6,300.00 6,300.00
anastomosis ; autogenous graft
44 CIRCUMCISION, USING CLAMP OR OTHER DEVICE; EXCEPT 3,000.00 840.00 840.00
NEWBORN
45 Cystourethroscopy, w/ removal of foreign body, calculus, or ureteral 10,540.00 5,040.00 5,040.00
stent from urethra or bladder
46 PLACEMENT OF CENTRAL VENOUS CATHETER (SUBCLAVIAN, 9,700.00 4,200.00 4,200.00
JUGULAR, OR OTHER VEIN) (E.G., FOR CENTRAL VENOUS PRESSURE,
HYPERALIMENTATION, HEMODIALYSIS, OR CHEMOTHERAPY);
PERCUTANEOUS OR CUTDOWN
47 MARSUPIALIZATION OF BARTHOLINS GLAND CYST 7,000.00 4,200.00 4,200.00
48 ALVEOLOPLASTY 18,000.00 8,400.00 8,400.00
49 OPERCULECTOMY, EXCISION PERICORONAL TISSUES 8,020.00 2,520.00 2,520.00
50 CLOSED TREATMENT OF MANDIBULAR OR MAXILLARY ALVEOLAR 12,120.00 6,720.00 6,720.00
RIDGE FRACTURE
51 CLOSED TREATMENT OF MANDIBULAR FRACTURE; W/ 14,960.00 7,560.00 7,560.00
INTERDENTAL FIXATION
52 DRAINAGE OF ABSCESS, CYST, HEMATOMA FROM DENTOALVEOLAR 5,680.00 1,680.00 1,680.00
STRUCTURES
53 DESTRUCTION OF LESION (EXCEPT EXCISION), DENTOALVEOLAR 8,260.00 3,360.00 3,360.00
STRUCTURES
54 Excision Of Baker'S Cyst 20,980.00 10,080.00 10,080.00
55 HERNIORRHAPHY ADULT / PEDIA 21,000.00 8,400.00 8,400.00
56 EXCISION OF HYDROCELE; UNILATERAL 9,700.00 4,200.00 4,200.00
57 RECTAL DILATATION 8,260.00 3,360.00 3,360.00
58 CHANGE OF TRACHEOSTOMY 12,120.00 6,720.00 6,720.00
59 Excision of Sublingual Cyst 9,300.00 2,100.00 2,100.00
60 POLYPECTOMY (NASAL) 8,020.00 2,520.00 2,520.00
61 REMOVAL OF INTERDENTAL WIRING 10,540.00 5,040.00 5,040.00
62 INTRAVITREAL INJECTION 12,120.00 6,720.00 6,720.00
63 Strabismus Surgery, any procedure; superior oblique muscle 18,000.00 8,400.00 8,400.00
64 Iridectomy, With corneoscleral or corneal suction; sector for 12,120.00 6,720.00 6,720.00
glaucoma
65 Vitrectomy, Mechanical, Pars Plana Approach with Internal 46,500.00 25,200.00 25,200.00
Tamponade with Air, Gas, Silicone Oil, Perfluorocarbon Liquid
66 Bilateral Tubal Ligation 4,000.00 1,000.00 1,000.00
67 Cauterization of Genital Warts, Vulva (Local Anesthesia) 9,300.00 2,100.00 2,100.00
68 Fractional Curettage 11,000.00 4,400.00 4,400.00
69 BIOPSY, SINGLE OR MULTIPLE, OR LOCAL EXCISION OF LESION, W/ 5,680.00 1,680.00 1,680.00
OR W/O FULGURATION
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Bloodbank and Transfusion Services

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 CROSSMATCHING (PER BAG) 850.00 - -
2 AUTOCONTROL AS PER REQUEST (PER TEST) 395.00 - -
3 COOMB'S TEST (DIRECT) 395.00 - -
4 COOMB'S TEST (INDIRECT) 395.00 - -
5 PLATELET CROSSMATCHING (PER BAG) 200.00 - -
6 Du VARIANT 180.00 - -
7 PLATELET CONCENTRATE (SINGLE RANDOM) 1,000.00 - -
8 PLATELET CONCENTRATE (APHERESIS, AS PER DEMAND) 14,000.00 - -
9 CONVALESCENT PLASMA (APHERESIS) 21,800.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Blood Transfusion Service

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 AUTOCONTROL (per test) 395.00 - -
2 BPF CRYOPRECIPITATE 1,000.00 - -
3 BPF CRYOSUPERNATE 1,000.00 - -
4 BPF FRESH FROZEN PLASMA 1,000.00 - -
5 BPF PRBC 1,500.00 - -
6 BPF RED CELL - PRBC 1,500.00 - -
7 BPF WHOLE BLOOD 1,800.00 - -
8 CONVALESCENT PLASMA (APHERESIS) Pay Patients 23,000.00 - -
9 CONVALESCENT PLASMA (APHERESIS) Service Patients 18,400.00 - -
10 COOMB'S (indirect) 395.00 - -
11 COOMB'S TEST (direct) 395.00 - -
12 CROSSMATCHING 850.00 - -
13 CRYOPRECIPITATE (Active Blood Donor & Direct Dependent) 500.00 - -
14 CRYOSUPERNATE (Active Blood Donor & Direct Dependent) 500.00 - -
15 FRESH FROZEN PLASMA (Active Blood Donor & Direct Dependent) 500.00 - -
16 PACKED RED BLOOD CELL 1,500.00 - -
17 PLATELET CONCENTRATE (Active Blood Donor & Direct Dependent) 500.00 - -

18 PLT CON 1,000.00 - -

19 PLT CON (APHERESIS) 14,000.00 - -
20 PLT CON, FFP, CRYOPPT RE-TYPING (per bag) 200.00 - -
21 RED CELL - PRBC (Active Blood Donor & Direct Dependent) 750.00 - -
22 RED CELL - WHOLE BLOOD (Active Blood Donor & Direct Dependent) 900.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Cardiac Rehab
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Adult Phase 1: Cardiac Rehab Package A (Service) 3,000.00 - -
2 Adult Phase 1: Cardiac Rehab Package C (Semi-private) 6,000.00 5,200.00 5,200.00
3 Adult Phase 1: Cardiac Rehab Package E (private ward) 6,800.00 5,200.00 5,200.00
4 Pedia Phase 1 Cardiac Rehab Package B (Service ) 3,000.00 - -
5 Pedia Phase 1 Cardiac Rehab Package D ( Semi Private ) 6,700.00 3,800.00 3,800.00
6 Pedia Phase 1 Cardiac Rehab Package F ( Private ) 7,700.00 3,800.00 3,800.00
7 Pedia Phase 1 Cardiac Rehab Package H ( Suite ) 8,200.00 3,800.00 3,800.00
8 Pedia Phase 2: Out patient Package A 3,000.00 3,000.00 3,000.00
9 Adult Pahse 2: Outpatient Package B 4,500.00 4,500.00 4,500.00
10 Adult Phase 2: Outpatient Package C 6,000.00 6,000.00 6,000.00
11 Adult Phase 2: Outpatient Package D 8,000.00 8,000.00 8,000.00
12 Adult Phase 3: Outpatient Maintenance Package A 3,000.00 2,000.00 2,000.00
13 Adult Phase 3: Outpatient Maintenance Package B 3,500.00 3,500.00 3,500.00
14 Adult Phase 3: Outpatient Maintenance Package C 4,000.00 3,500.00 3,500.00
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

CATHLAB
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 CL- Boston Scie PROMUS PREMIERE Angioplasty Package C (Stent, 193,050.00 - -
Balloon,Guidewire,Guidecath) (FS)
2 CCL- Firehawk Coronary stent (FS) 97,500.00 - -
3 PCI Package 1 stent 91,000.00 - -
4 2 Way Manifold 675.00 - -
5 3 Way Manifold 750.00 - -
6 CCL-Amplatz Guidewire 0.035x260cm(Regas) 4,301.50 - -
7 CL- Boston Scie PROMUS PREMIERE Angioplasty Package D (Stent, 243,100.00 - -
Balloon,Guidewire,Guidecath) (FS)
8 CCL- Terumo Ultimaster Stent Package 2 (2 stents,1 104,000.00 - -
guidecath,1PTCA wire,1PTCA balloon) (FS)
9 CCL-terumo Ultimaster stent Package 3 ( 3 stents,1 guidecath,1 162,500.00 - -
PTCA wire, 2 Balloons) (FS)
10 CCL-Terumo Ultimaster Stent Package 4 ( 4 stents,1Guidecath,1PTCA 201,500.00 - -
wire,2 Balloons) (FS)
11 Transradial kit (all sizes) FS 1,950.00 - -
12 USE OF ULTRASOUND MACHINE 2,500.00 - -
13 Use of Ivus machine 5,000.00 - -
14 Use of O2 sat machine (Oxicom) 450.00 - -
15 Use of IABP machine 5,520.00 - -
16 Use of power injector machine 750.00 - -
17 CCL-Ultravist 300,50 ml 1,400.00 - -
18 CCL-Ultravist 300,100 ml 4,428.00 - -
19 CCL-Optiray 300,100 ml 3,055.00 - -
20 CCL-OPTIRAY 300,50 ML 1,400.00 - -
21 CCL- Extension line 48" 280.00 - -
22 CCL- Braided Pressure Line 1,170.00 - -
23 Monitoring kit, Double 2,236.00 - -
24 CCL-Percutaneous Puncture Needle 585.00 - -
25 CCL-Transradial Band (FS) 1,430.00 - -
26 CCL- Transradial Band (FS) Regas 900.00 - -
27 CCL - ACT tube 154.75 - -
28 CCL- ABG (I-stat G3) 750.00 - -
29 CCL- Hemostatic Dressing 3,946.00 - -
30 CCL -Hydrophilic GW .035 x 150(Terumo) 1,820.00 - -
31 CCL- Hydrophilic GW .035 x 260 (Terumo) 2,931.00 - -
32 CCL-guidewire 0.035X150 cm ( Merit Inqwire ) 1,430.00 - -
33 CCL- Guidewire0.035 X 260 cm 2,080.00 - -
34 CCL-Amplatz Left Diag. Catheter 1,650.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Center for Diving, Hyperbaric Medicine & Difficult Wounds

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Hyperbaric Oxygen Therapy (Clinically Not Indicated) 10,000.00 4,000.00 4,000.00
2 Hyperbaric Oxygen Therapy (Clinically Indicated - Private) 6,000.00 2,400.00 2,400.00
3 Hyperbaric Oxygen Therapy (Clinically Indicated - Charity) 3,500.00 1,400.00 1,400.00
4 Hyperbaric Oxygen Therapy (Commercial Diving per hour) 50,000.00 20,000.00 20,000.00
5 Hyperbaric Oxygen Therapy (Recreational Diving per hour) 8,675.00 3,470.00 3,470.00
6 Transcutaneous Oximetry (TCOM or TCPO2) 8,000.00 3,000.00 3,000.00
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Center for Maternal Fetal Medicine

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 None Stress Test( NST) 500.00 50.00 50.00
2 Transvaginal Ultrasound (Gyne) 500.00 150.00 150.00
3 Pregnancy Evaluation (single) Biometry 450.00 150.00 150.00
4 Pregnancy Evaluation (Twins) Biometry Twins 750.00 300.00 300.00
5 Biophysical Scoring (Single) BPS 600.00 150.00 150.00
6 Biophysical Scoring (Twins) BPS 750.00 300.00 300.00
7 Doppler Velocimetery 1,800.00 700.00 2,100.00
8 Congenital Anomaly Scan (CAS) 1,800.00 700.00 2,100.00
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Colorectal Unit
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Endorectal Ultrasound 7,300.00 2,500.00 -
2 Endoanal Ultrasound 5,800.00 2,500.00 -
3 HEMORROIDECTOMY RUBBER BAND LIGATION PAY PATIENT 14,620.00 2,500.00 -
4 HEMORROIDECTOMY RUBBER BAND LIGATION SERVICE PATIENT 12,120.00 - -
5 PROCTOSIGMOIDOSCOPY PAY PATIENT 10,520.00 2,500.00 -
6 PROCTOSIGMOIDOSCOPY SERVICE PATIENT 8,020.00 - -
7 ANAL MANOMETRY PAY PATIENT 11,500.00 2,500.00 -
8 ANAL MANOMETRY SERVICE PATIENT 10,500.00 1,500.00 -
9 BIOFEEDBACK THERAPY PAY PATIENT 14,300.00 2,500.00 -
10 BIOFEEDBACK THERAPY SERVICE PATIENT 13,300.00 1,500.00 -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Dermatology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 DERMATOLOGY MINOR 0R- SKIN PUNCH BIOPSY - N0 SUTURING 3,640.00 - -
BASIC PACKAGE
2 Electrodessication for EMP, Face, With the Use of Emla 2,000.00 - -
3 Electrodessication for EMP, Face, With the Use of Lidocaine 700.00 - -
4 Electrodessication for EMP, Lower Abdomen, With the Use of Emla 2,000.00 - -

5 SKIN PUNCH BIOPSY 3,640.00 - -

6 shaving of single lesion .less than 0.6to 1cm 3,700.00 - -
7 excision biopsy small 3,640.00 - -
8 excision biopsy medium 4,108.00 - -
9 AVULSION OF NAIL PLATE 3,640.00 - -
10 ACNE SURGERY/MILIA MILD 500.00 - -
11 ACNE SURGERY/MILIA MODERATE 750.00 - -
12 ACNE SURGERY/MILIA SEVERE 1,000.00 - -
13 PHOTOTHERPY 350.00 - -
14 CHEMICAL PEEL 500.00 - -
15 TZANCK SMEAR 200.00 - -
16 Allergy Patch Test Package 3,500.00 - -
17 MOLLUSCUM EXTRACTION MILD 700.00 - -
18 MOLLUSCUM EXTRACTION MODERATE 1,200.00 - -
19 MOLLUSCUM EXTRACTION SEVERE 1,500.00 - -
20 ELECTROCAUTERY MILD 1,000.00 - -
21 ELECTROCAUTERY MODERATE 1,500.00 - -
22 ELECTROCAUTERY VERRUCA PLANA SEVERE 2,000.00 - -
23 ELECTROCAUTERY SYRINGOMA SEVERE 2,000.00 - -
24 ELECTROCAUTERY SYRINGOMA MILD 750.00 - -
25 ELECTROCAUTERY SYRINGOMA MODERATE1500 1,500.00 - -
26 ELECTROCAUTERY VERRUCA VULGARIS SINGLE 700.00 - -
27 INTRALESIONAL INJECTION 300.00 - -
28 INTRALESIONAL INJECTION MODERATE 500.00 - -
29 INTRALESIONAL INJECTION SEVERE 800.00 - -
30 DERMATOLOGY CONSULTATION WITHOUT CARD 100.00 - -
31 shaving 1.1 to 2 cm 8,020.00 - -
32 shaving of single lesion .less than 0.5 5,560.00 - -
33 Twin Beam Laser Toning (1064 and PDL) 9,540.98 - -
34 Facial or nasal Telangiectasia (2 to 3 stacks of 7mm) Per additional 2,927.57 - -
succeeding 2cm
35 Epidermal Pigmented Lesions (7mm PL, DCD off) 3,255.00 - -
36 Epidermal Melasma (7mm PL, DCD off) 3,255.00 - -
37 Soborrheic Dermatitis / Rosacea 50cm2 3,255.00 - -
38 PWS 50cm2 2,860.62 - -
39 Active Acne (lesiin only) Inflammatory Acne Vulgaris (lesion only) 3,147.88 - -
40 Post Acne Redness (lesion only) 3,147.88 - -
41 Hypertrophic Scar (est. 3 inches) Scar Prevention (est 3 inches) 3,147.88 - -
42 Stretchmarks (est. 3 inches) 3,147.88 - -
43 WART (lesion only) 3,147.88 - -
44 Hemangioma (25cm2) 2,766.89 - -
45 Laser Toning for Tightening (6mm or 8mm spot size: painting mode) 7,532.48 - -
Full Face (Cryogen off)
46 Facial Veins (1.5mm spot size) 3,396.22 - -
47 Leg Veins (3mm spot size) 3,797.92 - -
48 Cherry Angiomas 2,793.67 - -
49 Facial or Nasal Telangiectasia (2 to 3 stacks of 7mm) First 10 lesion 3,128.42 - -
or 1cm
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Endoscopy Unit
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Upper GI Endoscopy Charity 8,667.50 4,312.50 -
2 Upper GI Endoscopy PAY 15,646.00 11,291.40 -
3 COLONOSCOPY CHARITY 9,972.50 5,437.50 -
4 Colonoscopy PAY 23,930.00 19,575.00 -
5 ERCP Charity 19,867.50 13,687.50 -
6 ERCP PAY 55,455.00 49,275.00 -
7 UGIE+ Rubber band ligation Charity 11,480.00 7,125.00 -
8 UGIE+ Rubber band ligation Pay 30,005.00 25,650.00 -
9 UGIE+ Injection Hemostasis Pay 34,805.00 25,650.00 -
10 UGIE+ Injection Hemostasis Charity 16,280.00 7,125.00 -
11 UGIE+ Dilatation Pay 33,055.00 24,975.00 -
12 UGIE+ Percutaneous Endoscopic Gastrostomy Pay 41,075.00 36,720.00 -
13 UGIE+ Percutaneous Endoscopic Gastrostomy Charity 14,480.00 10,125.00 -
14 UGIE+ Snare Polypectomy /Endoloop Pay 25,925.00 19,845.00 -
15 UGIE+ Snare Polypectomy / Endoloop Charity 11,592.50 5,512.00 -
16 UGIE+ Foreign Body Removal 30,180.00 25,650.00 -
17 UGIE+ PEG Replacement 9,305.00 4,950.00 -
18 UGIE + Histoacryl Injection Pay 37,505.00 28,350.00 -
19 UGIE+Histoacryl Injection Charity 17,030.00 7,875.00 -
20 COLONOSCOPY + Snare Polypectomy /Endoloop Pay 30,380.00 25,650.00 -
21 COLONOSCOPY + Snare Polypectomy/Endoloop Charity 11,855.00 7,125.00 -
22 COLONOSCOPY + Injection Hemostasis Pay 34,847.00 25,650.00 -
23 COLONOSCOPY + Injection Hemostasis Charity 16,322.00 7,125.00 -
24 BRONCHOSCOPY CHARITY 8,855.00 4,500.00 5,500.00
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

ENT (Ear, Nose, Throat)

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 0.6CM TO 1.0CM IN DIAMETER 4,108.00 - -
2 1.1CM TO 2.0CM IN DIAMETER 4,108.00 - -
3 2.1CM TO 3.0CM IN DIAMETER 4,108.00 - -
4 2.6CM TO 5.0CM 9,300.00 - -
5 3.1CM TO 4.0CM IN DIAMETER 4,108.00 - -
6 5.1CM TO 7.5CM 9,552.00 - -
7 7.6CM TO 12.5CM 8,020.00 - -
8 ABSCESS 3,640.00 - -
9 APPLICATION OF INTERDENTAL WIRING WITH INTERMAXILLARY FIXATION
12,120.00 - -
10 AURAL POLYPECTOMY 8,020.00 - -
11 AURAL SUCTIONING 200.00 - -
12 CLOSE REDUCTION OF NASAL BONE FRACTURE 10,540.00 - -
13 CLOSE REDUCTION OF TMJ DISLOCATION 9,700.00 - -
14 FLOOR OF MOUTH 5,560.00 - -
15 INCISION AND REMOVAL OF FOREIGN BODY (SUBCUTANEOUS TISSUES) 3,640.00 - -
16 indirect laryngoscopy 8,020.00 - -
17 LESS THAN 0.5CM IN DIAMETER 4,108.00 - -
18 LESS THAN 2,5CM 5,680.00 - -
19 Minor Dressing 50.00 - -
20 MYRINGOTOMY WITH/WITHOUT VENTILATION TUBE INSERTION 5,640.00 - -
21 nasal endoscopy 10,540.00 - -
22 NASAL ENDOSCOPY WITH BIOPSY 12,120.00 - -
23 Nasal Polypectomy 8,020.00 - -
24 NASAL SEPTUM ABSCESS/HEMATOMA 5,560.00 - -
25 OVER 4.0CM IN DIAMETER 4,108.00 - -
26 PALATE/UVULA 5,560.00 - -
27 PLAY AUDIOMETRY 300.00 - -
28 POST-OP DRESSING 50.00 - -
29 PURE TONE AUDIOMETRY 300.00 - -
30 PURE TONE AUDIOMETRY WITH SPEECH RECEPTION THRESHOLD 400.00 - -
31 REAPPLICATION OF INTERDENTAL ORTHOBAND 200.00 - -
32 REMOVAL OF FOREIGN BODY (NASAL CAVITY) 200.00 - -
33 REMOVAL OF FOREIGN BODY (PHARYNX) 8,020.00 - -
34 REMOVAL OF IMPACTED CERUMEN 200.00 - -
35 REMOVAL OF IMPACTED FOREIGN BODY (EAR CANAL) 200.00 - -
36 REMOVAL OF INTERDENTAL WIRE 500.00 - -
37 REMOVAL OF SUTURES 100.00 - -
38 SALIVARY GLAND 5,560.00 - -
39 SEROMA/HEMATOMA 3,640.00 - -
40 SKIN 3,640.00 - -
41 THYROID 8,260.00 - -
42 TONGUE 5,560.00 - -
43 TYMPANOMETRY 200.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Heart Station
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 24 HOURS HOLTER AMBULATORY (PAY OPD - MACHINE FEE) 2,500.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Health Services and Specialty Clinic

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 COVID-19 RT PCR TESTING 2,800.00 - -
2 Dental Consultation 150.00 - -
3 Dental Extraction (Anterior) 300.00 - -
4 Dental Extraction (Posterior) 350.00 - -
5 Dental Restoration 500.00 - -
6 DIAGNOSTIC MAMMOGRAM 3,500.00 - -
7 ECG 320.00 - -
8 Neuro-Psychological Test (Abroad) 1,000.00 - -
9 Neuro-Psychological Test (Local) 600.00 - -
10 Odontectomy 8,000.00 - -
11 Oral Prophylaxis 500.00 - -
12 ORAL PROPHYLAXIS WITH FLOURIDE 750.00 - -
13 PHYSICAL EXAMINATION 150.00 - -
14 PPD Reading 200.00 - -
15 SCREENING MAMMOGRAM 2,500.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Institute of Psychiatry and Behavioral Medicine

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 In-Patient Occupational Therapy - Initial Evaluation 200.00 - -
2 In-Patient Occupational Therapy - OT Fee/session 100.00 - -
3 In-Patient Occupational Therapy - Re-evaluation 150.00 - -
4 Neuro-Psychiatric Evaluation 1st Level 1,000.00 - -
5 Neuro-Psychiatric Evaluation 2nd Level 1,500.00 - -
6 NPT - Psychological Assessment/Diagnostic Test 600.00 - -
7 NPT - Adoption, Custody, Child Support (per applicant) 1,500.00 - -
8 NPT - Counseling Fee/session/hour 100.00 - -
9 NPT - Declaration of Nullity of Marriage, Annulment of Marriage - 10,000.00 - -
Psychiatric Services (each petitioner, respondent)
10 NPT - Declaration of Nullity of Marriage, Annulment of Marriage - 7,000.00 - -
Psychological Services (each petitioner, respondent)
11 NPT - Employment Abroad 1,000.00 - -
12 NPT - Employment Local 600.00 - -
13 NPT - Hospital Training/Affiliation Requirement 300.00 - -
14 NPT - Mental Aging, IQ Test 300.00 - -
15 NPT - Naturalization 3,500.00 - -
16 NPT - Promotion, Renewal of Appointment 600.00 - -
17 NPT - Scholarship / School Requirement Abroad 1,000.00 - -
18 NPT - Scholarship / School Requirement Local 400.00 - -
19 NPT - VISA Purposes 1,000.00 - -
20 Out-Patient Occupational Therapy - Initial Evaluation 250.00 - -
21 Out-Patient Occupational Therapy - OT Fee/session 150.00 - -
22 Out-Patient Occupational Therapy - Re-evaluation 200.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Institute for Women and Newborn Health - Operating Room

As of August 31, 2022

# Service Name Rate/Fee

1 Bilateral Tubal Ligation BTL under SAB (Sub Arachnoid Block) 5,165.70
2 Cesarean Section under CEB (Continuous Epidural Block) 5,225.70
3 Cesarean Section under GETA (General Endotracheal Anesthesia) 5,485.70
4 Cesarean Section under SAB (Sub Arachnoid Block) 5,165.70
5 Cesarean Section with BTL under CEB (Continuous Epidural Block) 5,238.20
6 Cesarean Section with BTL under GETA (General Endotracheal Anesthesia)5,498.20
7 Cesarean Section with BTL under SAB (Sub Arachnoid Block) 5,178.20
8 Curettage (Complete/Fractional/Suction and Sharp) 1,064.00
9 Exlap (Salpingectomy/Salpingo-oophorectomy/Oophorocystectomy) 3,912.00
10 Exlap (Total Abdominal Hysterectomy with Bilateral Salpingo-oophorectomy/Total
4,299.50 Abdominal Hysterectomy/E
avao Region
CAL CENTER

- Operating Room

Professional Fee
Minimum Maximum
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Institute for Women and Newborn Health - CMIGS

As of August 31, 2022

# Service Name Rate/Fee

1 [Link], Surgical, with Sampling (Biopsy) of Endometrium and/or12,782.10
Polypectomy w/or w/o D and C
2 Cystoscopy (Bilateral Ureteral Catheter Insertion) 6,400.00
3 Cystoscopy (Open-End Ureteral Catheter Insertion, Bilateral) 6,400.00
4 HYSTEROSCOPY, DIAGNOSTIC 12,282.10
5 HYSTEROSCOPY, SURGICAL, WITH LYSIS OF INTRAUTERINE ADHESION (ANY 12,782.10
METHOD)
6 HYSTEROSCOPY, SURGICAL, WITH REMOVAL OF IMPACTED FOREIGN BODY 12,282.10
(IUD)
7 LAPAROSCOPIC TREATMENT OF ECTOPIC PREGNANCY; W/O SALPINGECTOMY 21,998.50
AND/OR OOPHORECTOMY
8 Laparoscopic treatment of ectopic pregnancy; w/salpingectomy and/or21,998.50
oophorectomy
9 Laparoscopy surgical, with vaginal hysterectomy, with removal of tube (s)
36,153.10
and or ovary (s)
10 Laparoscopy surgical; with vaginal hysterectomy 36,153.10
11 Laparoscopy, surgical myomectomy, excision, intramural myomas and/or 21,998.50
removal of surface myomas
12 LAPAROSCOPY, SURGICAL; WITH LYSIS OF ADHESIONS (SALPHINGOLYSIS, 21,998.50
OVARIOLYSIS)
13 LAPAROSCOPY, SURGICAL; WITH REMOVAL OF ADNEXAL STRUCTURES (PARTIAL 21,998.50OR TOTAL OOPHORECTOMY A
14 LAPAROSCOPY, SURGICAL; WITH SALPHINGOSTOMY (SALPINGONEOSTOMY) 21,998.50
15 Vaginoscopy 6,400.00
avao Region
CAL CENTER

alth - CMIGS

Professional Fee
Minimum Maximum
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Institute for Women and Newborn Health - Ultrasound

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 BIOPHYSICAL SCORING SINGLETON 600.00 - -
2 BIOPHYSICAL SCORING TRIPLETS 1,800.00 - -
3 BIOPHYSICAL SCORING TWINS 1,200.00 - -
4 CERVICAL LENGTH ASSESSMENT 500.00 - -
5 CONGENITAL ANOMALY SCAN SINGLETON 1,800.00 - -
6 CONGENITAL ANOMALY SCAN TRIPLETS 5,400.00 - -
7 CONGENITAL ANOMALY SCAN TWINS 3,600.00 - -
8 FETAL 3D/4D FACE SCAN 5,000.00 - -
9 GYNE 3D/4D SCAN 5,000.00 - -
10 GYNE DOPPLER SCAN 1,800.00 - -
11 GYNE ULTRASOUND GUIDED SCAN 5,000.00 - -
12 GYNE ULTRASOUND PARENTESIS 5,000.00 - -
13 HSSG ULTRASOUND 20,520.00 - -
14 OB DOPPLER VELOCIMETRY SINGLETON 1,800.00 - -
15 OB DOPPLER VELOCIMETRY TRIPLETS 5,400.00 - -
16 OB DOPPLER VELOCIMETRY TWINS 3,600.00 - -
17 ONCO ULTRASOUND 2,000.00 - -
18 Pelvic Floor Ultrasound 2,400.00 - -
19 PLACENTAL LOCATION ULTRASOUND 500.00 - -
20 PREGNANCY EVALUATION SINGLETON 450.00 - -
21 PREGNANCY EVALUATION TRIPLETS 1,350.00 - -
22 PREGNANCY EVALUATION TWINS 900.00 - -
23 SISH ULTRASOUND 10,540.00 - -
24 TRANSABDOMINAL ULTRASOUND 500.00 - -
25 Transrectal Ultrasound 500.00 - -
26 TRANSVAGINAL ULTRASOUND 500.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Femur APL (Left) 215.00 - -
2 PORTABLE FEE 785.00 - -
3 24HR URINE CHLORIDE 200.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Bloodbank
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 FFP,CRYOPPT RE-TYPING (PER BAG) 200.00 - -
2 RED CELL - PRBC 1,500.00 - -
3 CRYOPRECIPITATE 1,000.00 - -
4 CRYOSUPERNATE 1,000.00 - -
5 FRESH FROZEN PLASMA 1,000.00 - -
6 RED CELL - WHOLE BLOOD 1,800.00 - -
7 PLATELET CONCENTRATE 1,000.00 - -
8 PLATELET CONCENTRATE (APHERESIS) 14,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Clinical Chemistry

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 CC: GLUCOSE (24-HR URINE) 120.00 - -
2 URINE ALBUMIN-24 HRS. 200.00 - -
3 CC: CALCIUM (24-HR URINE) 200.00 - -
4 CC: CREATININE (24-HR URINE) 200.00 - -
5 CC: POTASSIUM (24-HR URINE) 180.00 - -
6 CC: SODIUM (24-HR URINE) 150.00 - -
7 CC: PROTEIN (24-HR URINE) 350.00 - -
8 CC: UREA NITROGEN (24-HR URINE) 220.00 - -
9 CC: URIC ACID (24-HR URINE) 160.00 - -
10 A/G RATIO 210.00 - -
11 CC: ALKALINE PHOSPHATASE 200.00 - -
12 SERUM AMMONIA 450.00 - -
13 CC: AMYLASE 400.00 - -
14 ASCITIC FLUID SUGAR AND PROTEIN 400.00 - -
15 CC: BUN 220.00 - -
16 CC: CHLORIDE 250.00 - -
17 CC: CHOLESTEROL, TOTAL 210.00 - -
18 CC: CREATININE 200.00 - -
19 CREATININE WITH EGFR 200.00 - -
20 CRP QUANTITATIVE 450.00 - -
21 CSF Sugar and Protein 400.00 - -
22 Direct Bilirubin 166.00 - -
23 Bilirubin Studies (Total, Indirect(B1),Direct(B2)) 500.00 - -
24 BILIRUBIN (INDIRECT) 167.00 - -
25 Total Bilirubin (B1B2) 167.00 - -
26 OGTT (ORAL GLUCOSE TOLERANCE) 3H 480.00 - -
27 GLUCOSE 2-HR PPBS 240.00 - -
28 GLUCOSE (RBS, FBS) 120.00 - -
29 Hemoglobin A1c (HbA1C) 440.00 - -
30 CC: POTASSIUM (RANDOM URINE) 150.00 - -
31 CC: LDH 318.00 - -
32 LIPID PROFILE (Chole, Trigly, HDL,LDL,VLDL) 600.00 - -
33 Lithium 400.00 - -
34 OGCT (ORAL GLUCOSE CHALLENGE) 240.00 - -
35 OGTT (ORAL GLUCOSE TOLERANCE) 5H 720.00 - -
36 PERICARDIAL FLUID SUGAR AND PROTEIN 400.00 - -
37 PERITONEAL FLUID SUGAR AND PROTEIN 400.00 - -
38 CC: PHOSPHORUS 335.00 - -
39 PLEURAL FLUID SUGAR AND PROTEIN 400.00 - -
40 CC: POTASSIUM 250.00 - -
41 URINE ALBUMIN-RANDOM (QUANTI) 175.00 - -
42 CC: CREATININE (RANDOM URINE) 200.00 - -
43 CC: GLUCOSE (RANDOM URINE) 120.00 - -
44 CC: PROTEIN (RANDOM URINE) 350.00 - -
45 SEROUS FLUID SUGAR AND PROTEIN 400.00 - -
46 CC: MAGNESIUM 282.00 - -
47 CC: URIC ACID 160.00 - -
48 CC: SGOT (AST) 180.00 - -
49 CC: SGPT (ALT) 185.00 - -
50 CC: SODIUM 250.00 - -
51 CC: SODIUM (RANDOM URINE) 150.00 - -
52 SYNOVIAL FLUID SUGAR AND PROTEIN 400.00 - -
53 TOTAL CALCIUM 220.00 - -
54 Total Protein 180.00 - -
55 TOTAL PROTEIN W/ A/G RATIO (TPAG) 300.00 - -
56 TRIGLYCERIDE 240.00 - -
57 CALCIUM (RANDOM URINE) 185.00 - -
58 CC: CHLORIDE (RANDOM URINE) 200.00 - -
59 CEREBROSPINAL FLUID CELL AND DIFF COUNT 100.00 - -
60 RAMDOM URINE ALBUMIN CREATININE RATIO 375.00 - -
61 RANDOM URINE ALBUMIN PROTEIN CREATININE RATIO 725.00 - -
62 Random Urine Total Protein Creatinine Ratio 550.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Clinical Microscopy

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 APTS TEST 80.00 - -
2 ASCITIC FLUID CELL AND DIFF COUNT 100.00 - -
3 CM: BENCE JONES PROTEIN 200.00 - -
4 BSMP- SMEAR FOR MALARIA 100.00 - -
5 STOOL EXAM/ FECALYSIS (KATO-KATZ) 60.00 - -
6 STOOL EXAM/ FECALYSIS (KATO-THICK/KAT) 60.00 - -
7 FILARIA SMEAR 240.00 - -
8 OCCULT BLOOD TEST 90.00 - -
9 PERICARDIAL FLUID CELL AND DIFF COUNT 100.00 - -
10 PERITONEAL FLUID CELL AND DIFF COUNT 100.00 - -
11 PLEURAL FLUID CELL AND DIFF COUNT 100.00 - -
12 PREGNANCY TEST: URINE 155.00 - -
13 SEMINAL FLUID ANALYSIS 200.00 - -
14 BSMP- SMEAR FOR MALARIA SERIAL X3 300.00 - -
15 SEROUS FLUID CELL AND DIFF COUNT 100.00 - -
16 SPUTUM FOR PARAGONIMUS 50.00 - -
17 STONE ANALYSIS 1,000.00 - -
18 STONE ANALYSIS PROCESSING FEE 300.00 - -
19 SYNOVIAL FLUID CELL AND DIFF COUNT 100.00 - -
20 URINE ANALYSIS - ROUTINE 110.00 - -
21 URINE ALBUMIN (QUALITATIVE) 75.00 - -
22 Urine Bilirubin(QUALITATIVE) 75.00 - -
23 URINE BLOOD (Urine Hemoglobin) 75.00 - -
24 URINE GLUCOSE (QUALITATIVE) 30.00 - -
25 URINE KETONE/ACETONE 75.00 - -
26 URINE PH 20.00 - -
27 CM: SPECIFIC GRAVITY (RANDOM URINE) 25.00 - -
28 CM: UROBILINOGEN (RANDOM URINE) 20.00 - -
29 Urine WBC/RBC Morphology 75.00 - -
30 BSMP- SMEAR FOR MALARIA SERIAL X2 200.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Drug Testing

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 DRUG TEST 225.00 - -
2 METHAMPHETAMINE DT 1,000.00 - -
3 TETRAHYDROCANNABINOL DT 1,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Hematology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 HEMA: APTT (PLASMA) 400.00 - -
2 APTT WITH MIXING 800.00 - -
3 BETA THALASSEMIA 4,000.00 - -
4 BLEEDING TIME 36.00 - -
5 BLOOD TYPING 80.00 - -
6 HEMA: BLOOD TYPING: (ABO+Rh) 80.00 - -
7 CBC WITH PLATELET CT 130.00 - -
8 CLOTTING TIME 36.00 - -
9 COMPREHENSIVE LEUKEMIA PANEL 19,500.00 - -
10 CT (SLIDE METHOD) 36.00 - -
11 Clotting And Bleeding Time (CT/BT) 50.00 - -
12 D-DIMER TEST 1,090.00 - -
13 DIFFERENTIAL COUNT 60.00 - -
14 HEMA: ESR 100.00 - -
15 EXTRACTION FEE 20.00 - -
16 FIBRINOGEN TEST 225.00 - -
17 HEMATOCRIT 25.00 - -
18 Hemoglobin & Hematocrit 130.00 - -
19 HEMATOCRIT + PLATELET 130.00 - -
20 HEMA: HEMOGLOBIN ONLY 25.00 - -
21 HEMOGLOBIN+HEMATOCRIT+PLATELET 130.00 - -
22 LEE WHITE CLOTTING TIME 60.00 - -
23 ALL ( T & B ONLY ) 12,500.00 - -
24 AML ONLY 12,000.00 - -
25 AML-M3 15,500.00 - -
26 LINEAGE PANEL (CYTOPLASMIC ALL+AML) 15,000.00 - -
27 Platelet Count 90.00 - -
28 Prothrombin Time(Protime/PT) 240.00 - -
29 RBC COUNT 90.00 - -
30 RETICULOCYTE COUNT 100.00 - -
31 SERIAL CBC+PLT X2 260.00 - -
32 SERIAL CBC+PLT X3 390.00 - -
33 SERIAL CBC+PLT X4 520.00 - -
34 SERIAL HCT+PLT X2 260.00 - -
35 SERIAL HCT+PLT X3 390.00 - -
36 SERIAL HCT+PLT X4 520.00 - -
37 SERIAL HGB+HCT X2 260.00 - -
38 SERIAL HGB+HCT X3 390.00 - -
39 SERIAL HGB+HCT+PLT X2 260.00 - -
40 SERIAL HGB+HCT+PLT X3 390.00 - -
41 TOXIC GRANULES 180.00 - -
42 WBC AND DIFF CT. 90.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Histopathology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Bone Marrow Smear/Aspirate 400.00 - -
2 PERIPHERAL BLOOD SMEAR 250.00 - -
3 ACID PHOSPHATASE 1,000.00 - -
4 ALKALINE PHOSPHATASE HISTO 1,000.00 - -
5 AUTOPSY PROCESSING 2,000.00 3,500.00 4,000.00
6 BIOPSY - LARGE 1,200.00 - -
7 BIOPSY - MEDIUM 900.00 - -
8 BIOPSY - SMALL 800.00 - -
9 BIOPSY- EXTRA LARGE 1,500.00 - -
10 CD 117, C-KIT 2,000.00 - -
11 CD 117 2,000.00 - -
12 IHC - CD 20 2,000.00 - -
13 IHC - CD15 2,000.00 - -
14 IHC - CD19 2,000.00 - -
15 SP: IHC - CD 3 2,000.00 - -
16 IHC - CD 30 2,000.00 - -
17 IHC - CD31, ENDOTHELIAL CELL 2,000.00 - -
18 SP: IHC - CD 45/LEUKO COMMON ANTIGEN 2,000.00 - -
19 IHC - CD99 2,000.00 - -
20 Cytology / Cell Block 800.00 - -
21 Cervical punch biopsy 800.00 - -
22 IHC - CHROMOGRANIN A 2,000.00 - -
23 IHC - CYTOKERATIN 20 2,000.00 - -
24 IHC - CYTOKERATIN 7 2,000.00 - -
25 DECALCIFICATION OF BONE TISSUE 600.00 - -
26 DEPOSIT BLOCK/SLIDE 200.00 - -
27 DEPOSIT SLIDE 100.00 - -
28 IHC - DESMIN 2,000.00 - -
29 DP-SKIN BIOPSY 500.00 - -
30 IHC - ER PR 3,500.00 - -
31 IMMUNOHISTOCHEMISTRY STAIN (IHC) (ER / PR / HER2) 5,500.00 - -
32 IHC - ESTERASE 1,000.00 - -
33 FITE FARACO 500.00 - -
34 FINE NEEDLE ASPIRATION BIOPSY (FNAB) 500.00 - -
35 BIOPSY - FROZEN SECTION 1,500.00 5,400.00 5,900.00
36 IHC - HER 2 2,000.00 - -
37 SP: IHC - CD 4 2,000.00 - -
38 IHC - STAIN AFP (ALPHA-1FETOPROTEIN) 2,000.00 - -
39 IHC - S-100 2,000.00 - -
40 SP: IHC - Ki 67 2,000.00 - -
41 IHC - CD 45/LCA 2,000.00 - -
42 LIQUID BASED PAP SMEAR 800.00 - -
43 LIQUID BASED PAP SMEAR PW 900.00 - -
44 IHC - MELAN-A 2,000.00 - -
45 IHC - MYOGENIN 2,000.00 - -
46 IHC - PANCYTOKERATIN 2,000.00 - -
47 PAP SMEAR 150.00 - -
48 PAS(PERIODIC ACID SCHIEFF) 1,000.00 - -
49 Peroxidase 1,000.00 - -
50 PLACENTAL PHOSPHATASE (PLAP) 2,000.00 - -
51 RECTAL BIOPSY 300.00 - -
52 REVIEW OF SLIDE 1,000.00 - -
53 SECOND OPINION 1,000.00 - -
54 IHC - SMOOTH MUSCLE ACTIN (SMA) 2,000.00 - -
55 SPECIAL STAINING OF TISSUE 500.00 - -
56 IHC - VIMENTIN 1,800.00 - -
57 SKIN BIOPSY WITH SPECIAL STAIN 750.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - HIV Laboratory

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 CD4 Count 2,200.00 - -
2 HIV RAPID 500.00 - -
3 HIV VIRAL LOAD TEST 7,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Immunology and Serology

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 Alpha Feto Protein (AFP) 775.00 - -
2 ANA 400.00 - -
3 Anti-HBc IgM 760.00 - -
4 ANTI-HBC TOTAL 760.00 - -
5 ASO (Anti - Streptolysin O ) 350.00 - -
6 BETA HCG 700.00 - -
7 C3 (RID METHOD) 480.00 - -
8 CA 125 800.00 - -
9 CEA 750.00 - -
10 CK-MB 780.00 - -
11 COVID-19 ANTIGEN RAPID TESTING (NPS) 960.00 - -
12 CRP - QUALITATIVE 250.00 - -
13 DENGUE RAPID TEST(NS1 IgM AND IgG) 680.00 - -
14 DILUTED BETA HCG 1:200 700.00 - -
15 DS-DNA 1,000.00 - -
16 DILUTED FERRITIN 1:10 680.00 - -
17 FERRITIN 680.00 - -
18 H PYLORI (SERUM) 720.00 - -
19 HBsAg (Qualitative) 220.00 - -
20 Hepatitis A/Anti-HAV IgG 600.00 - -
21 Hepatitis A/Anti-HAV IgM 600.00 - -
22 Hepatitis C/Anti-HCV (QUANTI) 1,000.00 - -
23 Hepatitis C/Anti-HCV (QUALI) 1,000.00 - -
24 HEPATITIS - HBsAG (QUANTI) 300.00 - -
25 HS TROPONIN -I 1,200.00 - -
26 PROCALCITONIN TEST 1,250.00 - -
27 PSA 900.00 - -
28 RHEUMATOID FACTOR 360.00 - -
29 SARSCOV-2 IgG ANTIBODY 750.00 - -
30 SARSCOV-2 IgM ANTIBODY 750.00 - -
31 SYPHILIS TEST 180.00 - -
32 THYROID - FT3 560.00 - -
33 THYROID - FT4 560.00 - -
34 THYROID - T3 280.00 - -
35 THYROID - T3+T4 520.00 - -
36 TSH3 - THYROID STIMULATING HORMONE 505.00 - -
37 HEPATITIS - ANTI HBS 500.00 - -
38 Typhidot 750.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Microbiology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 BLOOD CULTURE AND SENSITIVITY X2 2,400.00 - -
2 AFB - - -
3 BACTEC VIAL ONLY (ADULT) 600.00 - -
4 BACTEC VIAL ONLY (ADULT) X2 1,200.00 - -
5 BACTEC VIAL ONLY (PEDIA) 761.00 - -
6 BACTEC VIAL ONLY (PEDIA) X2 1,522.00 - -
7 BLOOD CULTURE AND SENSITIVITY 1,200.00 - -
8 BODY FLUIDS GRAM STAIN/CULTURE &SENSITIVITY 1,200.00 - -
9 BODY FLUIDS KOH 165.00 - -
10 CORNEAL SCRAPINGS GIEMSA 90.00 - -
11 CULTURE AND SENSITIVITY 1,200.00 - -
12 CVD/URETHRAL GRAM STAIN/CULTURE AND SENSITIVITY 1,200.00 - -
13 CVD/URETHRAL KOH 165.00 - -
14 ETA AFB - - -
15 ETA GRAM STAIN 165.00 - -
16 MB: CULTURE & SENSI (ETA, SPUTUM, THROAT SWAB) 1,200.00 - -
17 ETA KOH 165.00 - -
18 EYE DISCHARGE GRAM STAIN/CULTURE AND SENSITIVITY 1,200.00 - -
19 EYE DISCHARGE KOH 165.00 - -
20 GIEMSA 90.00 - -
21 CVD GRAM STAIN 165.00 - -
22 GRAMS STAIN OF TISSUE 165.00 - -
23 INDIA INK 150.00 - -
24 KOH 165.00 - -
25 SMEAR FOR TRICHOMONAS 165.00 - -
26 SPUTUM AFB - - -
27 SPUTUM GRAM STAIN 165.00 - -
28 STOOL GRAM STAIN 165.00 - -
29 STOOL GRAM STAIN/CULTURE & SENSITIVITY 1,200.00 - -
30 URETHRAL DISCHARGE GRAM STAIN 165.00 - -
31 URINE GRAM STAIN 165.00 - -
32 URINE GRAM STAIN/CULTURE AND SENSITIVITY 1,200.00 - -
33 WET MOUNT 150.00 - -
34 WOUND DISCHARGE GRAM STAIN/CULTURE AND SENSITIVY 1,200.00 - -
35 WOUND/ASPIRATE GRAM STAIN 165.00 - -
36 Oral Airway Yellow 50.00 - -
37 CHEST ELECTRODES ADULT 45.00 - -
38 ELECTRODES PEDIA 45.00 - -
39 ENDOTRACHEAL TUBE 2.5 45.00 - -
40 ENDOTRACHEAL TUBE 4.0 39.00 - -
41 ENDOTRACHEAL TUBE 7.0 50.00 - -
42 OPSITE POST-OP 6.5X5CM 60.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Laboratory - Mycobateriology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 TB CULTURE WITH SENSITIVITY 2,500.00 - -
2 TB CULTURE WITH SENSITIVITY X3 7,500.00 - -
3 TB POLYMERASE CHAIN REACTION 4,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Miscellaneous
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 CCL-Coronary Angiogram Procedure coronary 12,000.00 - -
2 ARTERIAL DUPLEX SCAN (PAY SUITE ROOM / CCU / ICU - MACHINE 1,000.00 - -
FEE)
3 ARTERIAL DUPLEX SCAN (PAY SUITE ROOM / CCU / ICU - 1,500.00 - -
PROFESSIONAL FEE)
4 ARTERIAL DUPLEX SCAN (SERVICE/OPD/IN-PATIENTS - MACHINE 1,800.00 - -
FEE W/ P.F.)
5 ARTERIAL DUPLEX SCAN (SERVICE/OPD/IN-PATIENTS - 900.00 - -
PROFESSIONAL FEE)
6 AUTOCLAVE STERRAD 912.00 - -
7 Baby Bonnet 13.00 - -
8 BETADINE CLEANSER PER cc 1.00 - -
9 Biophysical Scoring (BPS) Twin 750.00 - -
10 CAROTID DUPLEX SCAN (PAY SUITE ROOM / CCU / ICU - MACHINE 2,000.00 - -
FEE W/ P.F.
11 CCL- EMERGE BALLOON (discounted + package ) (FS) 16,628.30 - -
12 CCL- INTERLOCKING DETACHABLE COILS ( Boston Scien fic ) (FS) 37,500.00 - -

13 CCL- Terumo Ul master Stent Package 5 ( 5 stents, 2 guidecath, 1 227,500.00 - -

PTCA wire, 2 balloons) FS
14 CCL-ASAHI RG3 Guidewire (FS) 26,000.00 - -
15 CCL-Coronary Angiogram Procedure 12,000.00 - -
16 02 [Link] 200.00 - -
17 24 HOURS HOLTER AMBULATORY (PAY IN-PATIENTS - MACHINE FEE 3,000.00 - -
W/ P.F.)
18 24 HOURS HOLTER AMBULATORY (PAY IN-PATIENTS - MACHINE FEE) 2,500.00 - -

19 24 HOURS HOLTER AMBULATORY (PAY IN-PATIENTS - 500.00 - -

PROFESSIONAL FEE)
20 24 HOURS HOLTER AMBULATORY (PAY OPD - MACHINE FEE W/ P.F.) 3,000.00 - -

21 24 HOURS HOLTER AMBULATORY (PAY OPD - PROFESSIONAL FEE) 500.00 - -

22 24 HOURS HOLTER AMBULATORY (PAY SUITE ROOM / CCU / ICU - 3,000.00 - -
MACHINE FEE W/ P.F.)
23 24 HOURS HOLTER AMBULATORY (PAY SUITE ROOM / CCU / ICU - 2,500.00 - -
MACHINE FEE)
24 24 HOURS HOLTER AMBULATORY (PAY SUITE ROOM / CCU / ICU - 500.00 - -
PROFESSIONAL FEE)
25 24 HOURS HOLTER AMBULATORY (SERVICE/OPD/IN-PATIENTS - 2,800.00 - -
MACHINE FEE W/ P.F.)
26 24 HOURS HOLTER AMBULATORY (SERVICE/OPD/IN-PATIENTS - 2,400.00 - -
MACHINE FEE)
27 24 HOURS HOLTER AMBULATORY (SERVICE/OPD/IN-PATIENTS - 400.00 - -
PROFESSIONAL FEE)
28 3 WAY STOP COCK W/ TUBING 75.00 - -
29 3 WAY STOPCOCK W/ TUBING 75.00 - -
30 3needle 333.00 - -
31 ABDOMINAL PACK W/ XD (ADULT) (2pcs per pack) 182.00 - -
32 ABDOMINAL PACK W/ XD (ADULT) (5pcs. per pack) 368.00 - -
33 ABDOMINAL PACK W/ XD (ADULT) (per piece) 92.00 - -
34 ACT ANALYSIS 900.00 - -
35 ADHESIVE PLASTER 1 inch per yard 5.00 - -
36 ADHESIVE PLASTER 1/2 inch per yard 3.00 - -
37 ADHESIVE PLASTER 2 inches per yard 10.00 - -
38 ADHESIVE PLASTER 4 inches per yard 20.00 - -
39 ADHESSIVE HYDROCELLULAR FOAM DRESSING (ALLEVYN) 12.5cm 1,040.00 - -
40 ADHESSIVE HYDROCELLULAR FOAM DRESSING (ALLEVYN) 7.5cm 650.00 - -
41 Adjuster Squaring Metal 1 inch per piece 12.50 - -
42 AIRWAY, GUEDEL (ALL SIZES) 50.00 - -
43 ALCOHOL (per cc) 0.20 - -
44 alcohol 500cc bottle 80.00 - -
45 ALCOHOL PREP PADS 0.50 - -
46 ALCOHOL PREPBOX (per piece) 1.00 - -
47 Aluminum Flat Bar #1/8 x 1\ per foot" 200.00 - -
48 Aluminum Rivets # 3/16 x 1\\\ per piece" 3.25 - -
49 AMBU MASK SIZE 2 & 3 364.00 - -
50 AMBU MASK SIZES 1, 2, 3, 4 & 5 474.00 - -
51 ANATOMICALLY PREFORMED TUBE (RAE) 414.00 - -
52 ANESTHESIA CIRCUIT (ADULT / PEDIA) 900.00 - -
53 ANESTHESIA MACHINE (ASU) 500.00 - -
54 ANGIO-SYRINGE 10ML 1,100.00 - -
55 ANKLE TAG 3.00 - -
56 APPLE-HUNT TROCAR 5mm W/ SIDE PORT (REGAS) 1,100.00 - -
57 ARIA Treatment Planning 3D CRT 1,042.00 - -
58 ARIA Treatment Planning IMRT 2,084.00 - -
59 Arm Sling 100.00 - -
60 Arm Sling (Large) 90.00 - -
61 Arm Sling (Medium) 90.00 - -
62 Arm sling (small) 90.00 - -
63 ARM SUPPORT 50.00 - -
64 ARMOURED TUBE (ALL SIZES) 1,300.00 - -
65 ARTERIAL DUPLEX SCAN 1,300.00 - -
66 ARTERIAL DUPLEX SCAN (PAY IN-PATIENT - MACHINE FEE W/ P.F.) 2,500.00 - -

67 ARTERIAL DUPLEX SCAN (PAY IN-PATIENT - MACHINE FEE) 1,000.00 - -

68 ARTERIAL DUPLEX SCAN (PAY IN-PATIENT - PROFESSIONAL) 1,500.00 - -
69 ARTERIAL DUPLEX SCAN (PAY OPD - MACHINE FEE W/ P.F.) 2,500.00 - -
70 ARTERIAL DUPLEX SCAN (PAY OPD - MACHINE FEE) 1,000.00 - -
71 ARTERIAL DUPLEX SCAN (PAY OPD - PROFESSIONAL FEE) 1,500.00 - -
72 ARTERIAL DUPLEX SCAN (PAY SUITE ROOM / CCU / ICU - MACHINE 2,500.00 - -
FEE W/ P.F.)
73 ARTERIAL DUPLEX SCAN (SERVICE/OPD/IN-PATIENTS - MACHINE FEE) 900.00 - -

74 ASEPTO SYRINGE 35.00 - -

75 Atrioseptostomy catheter 43,750.00 - -
76 AUTOCLAVE TAPE 1inch 845.00 - -
77 AV BLOODLINE 155.20 - -
78 AV BLOODLINES WITH TRANSDUCER PROTECTOR (FS) 600.00 - -
79 AV FISTULA NEEDLE 100.00 - -
80 AV FISTULA NEEDLE (g-16 or g-17) (FS) 150.00 - -
81 B.S. OMEGA MONORAIL 2.5 X 20 (FS) 39,000.00 - -
82 B.S. OMEGA MONORAIL 2.75 X 32 (FS) 39,000.00 - -
83 BACTERIAL FILTER 273.00 - -
84 BAG, URINE 35.00 - -
85 Balance Salt Solution 600.00 - -
86 BANDAGE, ELASTIC 4 inches 25.00 - -
87 BANDAGE, ELASTIC 6 inches 36.00 - -
88 BAR SOAP 15.00 - -
89 BARD MAX Core disposable g1820cm 3,300.00 - -
90 BARDIA FOLEYCATH FR. 18 40.00 - -
91 BARDIA FOLEYCATH FR. 22 FOLEYCATH 26.00 - -
92 BARDIA FOLEYCATH FR. 24 240.00 - -
93 BARIUM ENEMA 250.00 - -
94 BATH TOWEL 120.00 - -
95 BATTERY AAA 32.00 - -
 96 BD posiflush prefilled syringe 5ml 52.00 - -
97 BEAVER BLADE 1,500.00 - -
98 BED SHEET 250.00 - -
99 Bed Sore Sponge 120.00 - -
100 Bed Sore Sponge (Regular Square Pack) 120.00 - -
101 bedpan, disposable 83.00 - -
102 BEDSIDE CARDIAC MONITOR 1,500.00 - -
103 Belly Board 6,500.00 - -
104 BETADINE ANTISEPTIC per cc 0.20 - -
105 BETADINE CLEANSER per cc 0.20 - -
106 BICARBONATE CONCENTRATE 739.00 - -
107 BICARBONATE CONCENTRATE (FS) 740.00 - -
108 BIG TOWEL PACK 50.00 - -
109 Binder 130.00 - -
110 Biophysical Scoring ( BPS) USD Single 600.00 - -
111 Biopsy Gun Needle Cannula G.14x100mm 988.00 - -
112 BISPECTRAL INDEX SENSOR (BIS) ADULT 2,080.00 - -
113 BISPECTRAL INDEX SENSOR (BIS) PEDIA 2,400.00 - -
114 Blocks ( COMPLEX ) 2,080.00 - -
115 Blocks (SIMPLE) 1,040.00 - -
116 BLOOD 1,300.00 - -
117 BLOOD TRANSFUSION /bag 200.00 - -
118 Blood Transfusion Set 65.00 - -
119 BLOOD TRANSFUSION SET MHC 40.00 - -
120 Blood typing (ABO and Rh) 50.00 - -
121 Blood typing (ABO only) 30.00 - -
122 Blood typing (Rh only) 30.00 - -
123 BLOOD VOLUMETRIC SET (SOLUSET) 298.00 - -
124 BLOODPCSO 2,750.00 - -
125 BLUE LIGHT (per day) 100.00 - -
126 BONE MARROW ASPIRATION 300.00 - -
127 Bone Marrow Aspiration (BMA) Instrument Set 500.00 - -
128 BONEWAX 146.00 - -
129 BOTTLED WATER per BOTTLE (MHC) 10.00 - -
130 BOTTLES STERILE WATER 10.00 - -
131 BOVIE TIP LONG 2,665.00 - -
132 BOVIE TIP LONG ( Regas ) 1,350.00 - -
133 BP APPARATUS 20.00 - -
134 bpf 260.00 - -
135 BPS AFI DETERMINATION USD 425.00 - -
136 Breast Board 6,500.00 - -
137 BREATHING CIRCUIT (ADULT) 1,495.00 - -
138 BREATHING CIRCUIT (ADULT) (per use) 748.00 - -
139 BREATHING CIRCUIT (PEDIA) 975.00 - -
140 Bronchoscopy Machine Fee w/o PHIC-Pay 4,355.00 - -
141 Bronchoscopy Machine Fee w/o PHIC-Pay(Senior Citizen) 3,484.00 - -
142 BRUSH 30.00 - -
143 C- ARM MACHINE 1,800.00 - -
144 CARBON DIOXIDE 600.00 - -
145 CARL ZEISS/LEICA OPERATING MICROSCOPE 550.00 - -
146 C-ARM COVER 20.00 - -
147 CAROTID DUPLEX SCAN 1,300.00 - -
148 CAROTID DUPLEX SCAN (PAY IN-PATIENTS - MACHINE FEE W/ P.F.) 2,000.00 - -

149 CAROTID DUPLEX SCAN (PAY IN-PATIENTS - MACHINE FEE) 1,000.00 - -

150 CAROTID DUPLEX SCAN (PAY IN-PATIENTS - PROFESSIONAL FEE) - 1,000.00 -
151 CAROTID DUPLEX SCAN (PAY OPD - MACHINE FEE W/ P.F.) 2,000.00 - -
152 CAROTID DUPLEX SCAN (PAY OPD - PROFESSIONAL FEE) - 1,000.00 -
153 CAROTID DUPLEX SCAN (PAY SUITE ROOM / CCU / ICU - MACHINE 2,000.00 - -
FEE W/ P.F.)
154 CAROTID DUPLEX SCAN (PAY SUITE ROOM / CCU / ICU - MACHINE 1,000.00 - -
FEE)
155 CAROTID DUPLEX SCAN (PAY SUITE ROOM / CCU / ICU - 1,000.00 - -
PROFESSIONAL FEE)
156 CAROTID DUPLEX SCAN (SERVICE/OPD/IN-PATIENTS - MACHINE FEE 1,800.00 - -
W/ P.F.)
157 CAROTID DUPLEX SCAN (SERVICE/OPD/IN-PATIENTS - MACHINE FEE) 900.00 - -

158 CAROTID DUPLEX SCAN (SERVICE/OPD/IN-PATIENTS - PROFESSIONAL 900.00 - -

FEE)
159 CASTING LONG 850.00 - -
160 CASTING SHORT 450.00 - -
161 CATHE JELL 295.00 - -
162 CATHEJELL Lidocaine HCL 20mg/500mcg (2%/0.05% /gm jel) 295.00 - -
163 CATHETER INSERTION 50.00 - -
164 catheter insertion w/ items 127.00 - -
165 CATHETER, THORACIC FR. 28 260.00 - -
166 CATHETER, THORACIC FR.20, 24, 32, 36 232.00 - -
167 CATHETER, UMBILICAL PVC LUMEN X-RAY OPAQUE 3cm FR.5 377.00 - -
168 CAUTERY TIP MODIFIED WITH SHOD 507.00 - -
169 CAUTERY TIP, LONG 6 inches (per use) 208.00 - -
170 CAVAFIX 335 780.00 - -
171 CAVAFIX 375 780.00 - -
172 CBG TAKING 30.00 - -
173 CCL - Balloon wedge cath. ( REGAS ) 5,700.00 - -
174 CCL - BS Zipwire 0.035 x 260 (FS) 2,600.00 - -
175 CCL - CORSAIR Microcath 135 cm,150 cm (FS) 50,700.00 - -
176 CCL - CVC Set 2 Lumen 4FR 2,860.00 - -
177 CCL - CVC set 2 Lumen 7 Fr x 20 (REF. CS-14402) 3,640.00 - -
178 CCL - ev3 REBAR 18 Microcatheter (FS) 46,800.00 - -
179 CCL - Histoacryl 0.5 ML (FS) 2,867.00 - -
180 CCL- Introducer sheath 11cm ( Regas) 825.00 - -
181 CCL - Introducer Sheath 80 cm Super Arrow flex (FS) 25,350.00 - -
182 CCL - Medtronic Bundle C Resolute Integrity (FS) 174,200.00 - -
183 CCL - Medtronic EBU 3.5 Guide cath (FS) 9,750.00 - -
184 CCL - Medtronic Stents Bundle B Resolute Integrity (FS) 136,500.00 - -
185 CCL - Medtronic Stents Bundle D Resolute Integrity(FS) 221,000.00 - -
186 CCL - MIcrocath ( MARATHON) (FS) 54,600.00 - -
187 CCL- 10 cc syringe (Embo syringe) 325.00 - -
188 CCL- 4 holes Angio pack ( Merit ) FS 2,535.00 - -
189 CCL- Abbott Hi-Torque Floppy Guidewire 7,020.00 - -
190 CCL- ANGIOGRAPHY PACK (4 holes) (FS) MACKRICK 5,862.00 - -
191 CCL- Angiopack (complete customized) SANATEC 6,850.00 - -
192 CCL- Angioplasty Pack Hemostasis Valve Device ( Regas ) 1,900.00 - -
193 CCL- Angioplasty pack PhD Hemostasis Valve (Merit) FS 3,835.00 - -
194 CCL- ANGIOSEAL (FS) 14,950.00 - -
195 CCL- Antegrade Hemodialysis Catheterization set (FS) 24,700.00 - -
196 CCL- APOLLO Detachable Microcath (FS) 84,500.00 - -
197 CCL- ASAHI CARAVEL Microcath 135/150 cm (FS) 37,700.00 - -
198 CCL- ASAHI Gaia Guidewire (First,Second,Third) FS 22,100.00 - -
199 CCL- ASAHI SION ( Black ) 16,900.00 - -
200 CCL- ASAHI SION (Blue,Soft,Granslam,[Link]) 14,300.00 - -
201 CCL- Balloon wedge Catheter 11,310.00 - -
202 CCL- Berman Angio Balloon Cath ( REGAS ) 5,850.00 - -
203 CCL- Boston Scie AMPLATZ Super Stiff Wire J Tip 0.035 x 150/ 0.035 8,603.00 - -
x 260
204 CCL- Boston Scie FILTERWIRE EZ 190 CM MT 78,650.00 - -
205 CCL- Boston Scie Guider Softip 40 XF (FS) 13,620.00 - -
206 CCL- Boston Scie Guidezilla ( discounted + Package ) (FS) 19,734.00 - -
207 CCL- Boston Scie Guidezilla (FS) 26,000.00 - -
208 CCL- Boston Scie MUSTANG Peripheral Balloon Dilatation Catheter 13,000.00 - -
(FS)
209 CCL- Boston Scie PROMUS PREMIERE Angioplasty Package A (Stent, 64,350.00 - -
Balloon,Guidewire,Guidecath) FS
210 CCL- Boston Scie PROMUS PREMIERE Angioplasty Package B (Stent, 128,700.00 - -
Balloon,Guidewire,Guidecath) FS
211 CCL- Boston Scie PROMUS PREMIERE Angioplasty Package E (Stent, 286,000.00 - -
Balloon,Guidewire,Guidecath) FS
212 CCL- Boston Scie PROMUS PREMIERE Angioplasty Package F (Stent, 328,900.00 - -
Balloon,Guidewire,Guidecath) FS
213 CCL- Boston Scie STERLING Peripheral Dilatation Catheter FS 23,400.00 - -
214 CCL- Boston Scie Target 360 Soft 6 mm x 10 mm FS 59,280.00 - -
215 CCL- BS Emerge Balloon FS 33,256.00 - -
216 CCL- BS [Link] VL 3.5 6FR FS 11,830.00 - -
217 CCL- BS Mach 1 Q 3.5 6Fr (FS) 11,934.00 - -
218 CCL- BS Mach1 Guide Cath ( 50% off + Package ) (FS) 6,075.00 - -
219 CCL- BS NC Quantum Balloon (FS) 37,375.00 - -
220 CCL- CG+PICC set 3L w/ 130 cm SWG 14,950.00 - -
221 CCL- COBRA Fr 5 ,80 cm 1,495.00 - -
222 CCL- Coil Pusher - 16 177 cm 8,735.00 - -
223 CCL- Cordis Diag. Cath JL4.5 5Fr 1,560.00 - -
224 CCL- Cordis Headhunter 5Fr 1,560.00 - -
225 CCL- Cordis Vista Brite JL 4.0 6FR 10,530.00 - -
226 CCL- Cordis Vistabrite JR 4.0 6FR 11,500.00 - -
227 CCL- Coronary Stent Firebird2 126,945.00 - -
228 CCL -CVC set 2 Lumen 4Fr x 8 cm 4,160.00 - -
229 CCL- DC Bead Embolisation System 100 - 300 um (FS) 85,500.00 - -
230 CCL- DC Bead Embolisation System 100 - 300 um (FS) DCBead 85,500.00 - -
231 CCL- Detachable coil GDC-10 360 soft 3mm x 6 cm SR (FS) 54,600.00 - -
232 CCL- Detachable coil GDC-10 360 soft 3mm x 6 cm SR (FS) coil 54,600.00 - -
233 CCL- Detachable coil Target 360 ultra 3mm x 6 cm (FS) 59,280.00 - -
234 CCL- Detachable coil Target 360 ultra 3mm x 6 cm (FS) coil 59,280.00 - -
235 CCL- [Link] (all sizes) 1,650.00 - -
236 CCL- DRAINAGE Catheter Pigtail BIO-Tech FORWARD STOCKING(FS) 6,825.00 - -
Drainage
237 CCL- EV3 AVIGO WIRE 23,400.00 - -
238 CCL- Ev3 X-Pedion Hydrophilic guidewire ( FS) 23,400.00 - -
239 CCL- Excelsior 1018 (FS) 35,100.00 - -
240 CCL- Excelsior SL-10 2 Tip Straight (FS) 35,100.00 - -
241 CCL- Excelsior XT 27 (FS) 32,793.23 - -
242 CCL- Fielder XT -A , XT - R (FS) 22,100.00 - -
243 CCL- FineCross Terumo (FS) 28,600.00 - -
244 CCL- Firebird 2 Stent discounted (FS) 39,000.00 - -
245 CCL- Flowgate (FS) 95,500.00 - -
246 CCL- GDC SL10 Stryker neurovascular (FS) 54,600.00 - -
247 CCL- HEARTRAIL BL 3.5 6FR (FS) 11,515.00 - -
248 CCL- Hemochron ACT JR. 750.00 - -
249 CCL- Hepasphere (FS) 84,500.00 - -
250 CCL- Hydrophilic Guidewire ( Silver Speed) (FS) 23,400.00 - -
251 CCL- I STAT ACT (FS) 920.00 - -
252 CCL- Inzone 2.0 Detachment system (FS) 10,400.00 - -
253 CCL- IVC Inferior Vena Cava Filter (Retrievable & Non-retrievable) 65,000.00 - -
LifeTech Aegisy (FS)
254 CCL- IZDS connecting cable (FS) 7,150.00 - -
255 CCL- JL 4.0 Diag. Catheter 1,560.00 - -
256 CCL- Maestro Microcath (FS) 26,000.00 - -
257 CCL- Medex Logical MONITORING KIT (SINGLE) 1,105.00 - -
258 CCL- Medtronic Intuition PTCA Guidewire (FS) 10,400.00 - -
259 CCL- Medtronic Stent Bundle A Resolute Integrity (FS) 57,200.00 - -
260 CCL- Medtronic stents Bundle E Resolute Integrity (FS) 299,000.00 - -
261 CCL- Merit Aspiration Catheter & Kit (FS) 56,250.00 - -
262 CCL- Microwave therapeutic Ablation System FORWARD STOCKING 100,000.00 - -

263 CCL- Model 6F PV Mach 1 ROC ( FS ) 13,127.00 - -

264 CCL- Monitoring Kit ( UTAH ) (FS) 1,820.00 - -
265 CCL- Navien 058 Catheter 84,500.00 - -
266 CCL- Navien 072 Catheter (FS) 78,000.00 - -
267 CCL- Neuro Guide Cath (regas) 5,000.00 - -
268 CCL- Neuroform 3 EZ (FS) 243,100.00 - -
269 CCL- Neuroform Atlas (FS) 254,275.80 - -
270 CCL- NUMED Atrioseptostomy Balloon Cath (FS) 52,000.00 - -
271 CCL- O.S. 4 x 4 /pack 50.00 - -
272 CCL- Onyx Embolic System kit (FS) 92,950.00 - -
273 CCL- Optease Retrieval Catheter 13,000.00 - -
274 CCL- PEELAWAY FR 8 ( St. Jude Medical ) FS 3,900.00 - -
275 CCL- PICC Set 3 - lumen 6 Fr x 50 cm (FS) 9,750.00 - -
276 CCL- PICC set w/ blue Flex tip Cath, 80 cm Palladium Tipped,Marked 11,050.00 - -
wire ( FS )
277 CCL- Progreat Microcath ( Re-gas) 7,392.00 - -
278 CCL- PTFE Peelable Introducer Sheath (FS) 4,550.00 - -
279 CCL- Pushable coil BS Vortx Diamond 3 mm x 3.3 mm (FS) 17,160.00 - -
280 CCL -Pushable Coil BS Votx-18 4mm x 4mm (FS) 17,160.00 - -
281 CCL- Radifocus Yashiro Fr 5, 70 cm 3,523.00 - -
282 CCL Synchro -10 Neuro Guidewire with Hydrophilic (FS) 30,420.00 - -
283 CCL- TERUMO ANGIO-SEAL (FS) 14,950.00 - -
284 CCL- Terumo Eliminate Aspiration Catheter 6F (FS) 58,500.00 - -
285 CCL- Terumo Hiryu Dilatation Balloon (FS) 22,100.00 - -
286 CCL- Terumo JL 3.5 5F (FS) 1,820.00 - -
287 CCL- Terumo Runthrough NS Floppy (FS) 10,563.00 - -
288 CCL Terumo Tiger 5Fr (FS) 1,820.00 - -
289 CCL- Terumo Ultimaster Stent Package 1 ( 1 stent,1 Guidecath,1 58,500.00 - -
Balloon, 1 Guidewire)
290 CCL- Transend wire EX,[Link] (FS) 19,630.85 - -
291 CCL- Trapeaze IVC Filter Device 58,500.00 - -
292 CCL- Ultimate 1 Performa Catheter (FS) 1,800.00 - -
293 CCL- V18 Control wire 300 cm x8 cm polytip 7,150.00 - -
294 CCL- VISIPAQUE 100 ML (FS) 5,781.88 - -
295 CCL- VISIPAQUE 50 ML (FS) 3,136.75 - -
296 CCL- Volcano Eagle Eye Digital IVUS Catheter 26,000.00 - -
297 CCL- VTCB FLEXIMA REGULAR Billiary Catheter 5,000.00 - -
298 CCL-Amplatz Right Diag. Catheter 1,650.00 - -
299 CCL-ANGIO PACK (cloth) 1,000.00 - -
300 CCL-angiosyringe 715.00 - -
301 CCL-AXIUM Helical Detachable Coil (FS) 61,100.00 - -
302 CCL-AXS CATALYST 6.060 IN X 132 CM (FS) 84,500.00 - -
303 CCL-Bearing nsPVA (Embolization particles) 7,475.00 - -
304 CCL-Berman Angio Balloon Cath 11,700.00 - -
305 CCL-Boston Scie Angioplasty Package G ( 400,400.00 - -
stent,balloon,guidewire,guidecath) (FS)
306 CCL-Boston Scie Control wire 300cm x8 cm Polytip V-18 (FS) 7,150.00 - -
307 CCL-Boston Scie Mach1 Jl 4.0 6Fr 11,800.00 - -
308 CCL-Boston Scie Target 360 soft 3mm x 10mm (FS) 59,280.00 - -
309 CCL-BS Choice Floppy GW (FS) 10,608.00 - -
310 CCL-BS Choice PT GW (FS) 10,608.00 - -
311 CCL-BS GW Zipwire .018 x 150 2,600.00 - -
312 CCL-BS MACH1 Q4 6F (FS) 11,830.00 - -
313 CCL-BS Zipwire 0.035 x 150 (FS) 2,080.00 - -
314 CCL-CD DISC COPY 240.00 - -
315 CCL-CELLO BALLOON (FS) EV3BALLOON 106,600.00 - -
316 CCL-Cervical Angiogram cervical 15,000.00 - -
317 CCL-CORDIS . guidewire .035X150 (regas) 600.00 - -
318 CCL-CORDIS AR mod 6FR 1,650.00 - -
319 CCL-Cordis [Link]. JL5.0 5Fr Cordis JL 1,560.00 - -
320 CCL-CORDIS JR 3.5 6 FR 1,650.00 - -
321 CCL-CORDIS JR 3.5 6 FR JR cath 1,650.00 - -
322 CCL-CORDIS VISTABRITE GC X B 3.5 FR 7 (FS) 11,500.00 - -
323 CCL-CORDIS VISTABRITE GC X B 3.5 FR 7 (FS) guid 11,500.00 - -
324 CCL-Coronary Balloon Jive (FS) jive 32,500.00 - -
325 [Link]. JL5.0 5Fr 1,560.00 - -
326 [Link]. PIGTAIL (all sizes) 1,650.00 - -
327 CCL-Introducer Sheath (all sizes) 1,897.00 - -
328 CCL--SYRINGE DISPO.3cc 6.00 - -
329 CHERRY BALLS X 5 40.00 - -
330 CHEST ELECTRODES (ADULT/PEDIA) 45.00 - -
331 CHLORHIXIDINE DRESSING TULLE GRAS 46.00 - -
332 CLIPPER BLADE 260.00 - -
333 CLIPPER PER USE 260.00 - -
334 COLOSTOMY SET 45MM 470.00 - -
335 COLOSTOMY SET 57MM 470.00 - -
336 COLOSTOMY SET 70MM 470.00 - -
337 COTTON APPLICATOR 5.00 - -
338 COTTON BALLS X 5 7.00 - -
339 cutasept per cc 2.00 - -
340 DIAPER ADULT 32.00 - -
341 DISPOSABLE MASK 17.00 - -
342 DRAPES 240.00 - -
343 DRAW SHEET (disposable) 185.00 - -
344 ELECTROCAUTERY CORD 715.00 - -
345 ELECTROCAUTERY PAD 760.00 - -
346 ENDO STAPLER GUN 1,500.00 - -
347 ENDO TOWER 2,000.00 - -
348 ENDOTRACHEAL TUBE 3.0 45.00 - -
349 ENDOTRACHEAL TUBE 3.5 45.00 - -
350 ENDOTRACHEAL TUBE 4.5 WITH STYLET 110.00 - -
351 ENDOTRACHEAL TUBE 5.0 50.00 - -
352 ENDOTRACHEAL TUBE 5.5 50.00 - -
353 ENDOTRACHEAL TUBE 6.5 42.00 - -
354 ENDOTRACHEAL TUBE 7.5 50.00 - -
355 ENDOTRACHEAL TUBE 8.0 50.00 - -
356 EPIDURAL SET (MINIPACK) 825.00 - -
357 EXTENSION TUBING 75cm 140.00 - -
358 EXTRACTOR PRO XL 12-15MM 1,174.50 - -
359 EXTRACTOR PRO XL 15-18MM 1,174.50 - -
360 FIBER GLASS CASTING TAPE 494.00 - -
361 FOLEYCATH FR.10 96.00 - -
362 FOLEYCATH FR.12 96.00 - -
363 FOLEYCATH FR.14 38.00 - -
364 FOLEYCATH FR.16 38.00 - -
365 FOLEYCATH FR.8 96.00 - -
366 FORCE TRIAD 585.00 - -
367 FORMALIN per cc 1.00 - -
368 FRAZIER TIP 608.00 - -
369 GIA STAPLER GUN 2,180.00 - -
370 GOWN X5 870.00 - -
371 HARMONIC 8,000.00 - -
372 Hydrogen Peroxide per cc 0.20 - -
373 HYPO NEEDLE ALL SIZES 5.00 - -
374 IDENTI-LOOP (VESSEL LOOP) 470.00 - -
375 INFUSABLE PRESSURE BAG (VITAL SIGNS) 870.00 - -
376 Insulin Syringe 10.50 - -
377 ISOLATION GOWN 530.00 - -
378 JACKSON REES 2,080.00 - -
379 JAGWIRE 025 STRAIGHT 1,560.00 - -
380 JAGWIRE 035 STRAIGHT 1,560.00 - -
381 JP DRAIN (WOUND DRAINAGE PFM) 2,340.00 - -
382 KY JELLY 17.00 - -
383 LAP INSTRUMENTS 1,500.00 - -
384 LAP MACHINE 3,500.00 - -
385 LAPAROTOMY PACK 2,574.00 - -
386 LIGASURE 6,700.00 - -
387 MUCUS EXTRACTOR 60.00 - -
388 NASAL OXYGEN CANNULA (ADULT/PEDIA) 21.00 - -
389 NASAL OXYGEN CANNULA (NEONATE) 36.00 - -
390 NASAL OXYGEN CANNULA (NEONATE) 39.00 - -
391 NASOPHARYNGEAL 7.5 550.00 - -
392 NASOPHARYNGEAL AIRWAY 6.5 550.00 - -
393 NASOPHARYNGEAL AIRWAY 7.0 550.00 - -
394 Nebulizer per use 50.00 - -
395 NEBULIZING KIT 80.00 - -
396 needle, disposable G 24 2.00 - -
397 NERVE STIMULATING NEEDLE (ECHOPLEX) 1,560.00 - -
398 NEURAY PATTIES 3X3 108.00 - -
399 NGT FR.10 40.00 - -
400 NGT FR.12 35.00 - -
401 NGT FR.14 25.00 - -
402 NGT FR.16 25.00 - -
403 NGT FR.5 40.00 - -
404 NGT FR.8 40.00 - -
405 [Link] FR.16 1,040.00 - -
406 OPSITE INCISE DRAPE 40X42CM 1,105.00 - -
407 OPSITE INCISE DRAPE 30X28CM 500.00 - -
408 OPSITE INCISE DRAPE 45X55 1,145.00 - -
409 OPSITE POST-OP 15X8.5CM 151.00 - -
410 OPSITE POST-OP 20X10 213.00 - -
411 OPSITE POST-OP 25X10CM 234.00 - -
412 OPSITE POST-OP 9.5X8.5CM 121.00 - -
413 ORAL AIRWAY (ALL SIZES) 50.00 - -
414 Oral Airway Green 50.00 - -
415 oral airway white 50.00 - -
416 ORTHO GLOVES ALL SIZES 150.00 - -
417 OS REGULAR x5 56.00 - -
418 OS STRIPS 60.00 - -
419 OS XD x5 60.00 - -
420 OXYGEN 2L/MIN 0.30 - -
421 OXYGEN MASK ADULT 82.00 - -
422 OXYGEN MASK PEDIA 82.00 - -
423 PEANUT BALLS X 5 30.00 - -
424 PENROSE DRAIN 20.00 - -
425 PENROSE DRAIN 1/4 25.00 - -
426 PENROSE DRAIN 3/4 20.00 - -
427 PERCUFLEX BILIARY STENT 10F 10CM 1,950.00 - -
428 PERCUFLEX BILIARY STENT 7F 10CM 1,950.00 - -
429 PERCUFLEX BILIARY STENT 7F 15CM 1,950.00 - -
430 PERFUSOR TUBING 75CM 130.00 - -
431 PLASTER HYPOALLERGENIC INCH 15.00 - -
432 PLASTER OF PARIS/ORTHOFIX 230.00 - -
433 POVIDONE 10% PER CC 18.00 - -
434 POVIDONE 7% PER CC 15.00 - -
435 PREP SET 200.00 - -
436 PROSTA PACK x2 74.00 - -
437 PROSTA PACK X5 80.00 - -
438 RAE TUBE ORAL (ALL SIZES) 415.00 - -
439 Skin Stapler 585.00 - -
440 SKIN STAPLER (REGAS) 350.00 - -
441 Specimen Bag 10.00 - -
442 SPECIMEN CUP 36.00 - -
443 SPINAL SET 150.00 - -
444 STERILIUM per cc 1.50 - -
445 STERI-STRIP 1/4 100.00 - -
446 STOP COCK 75.00 - -
447 STRECHER COVER 145.00 - -
448 SUCTION CATH FR.10 10.00 - -
449 SUCTION CATH FR.12 10.00 - -
450 SUCTION CATH FR.14 10.00 - -
451 SUCTION CATH FR.16 10.00 - -
452 SUCTION CATH FR.8 10.00 - -
453 SUCTION TIP 105.00 - -
454 SUCTION TUBE 105.00 - -
455 SURGICAL BLADE 10 12.00 - -
456 SURGICAL BLADE 11 12.00 - -
457 SURGICAL BLADE 12 12.00 - -
458 SURGICAL BLADE 15 13.00 - -
459 SURGICAL BLADE 20 13.00 - -
460 SURGICAL CAP 2.00 - -
461 Surgical gloves 6.0 35.00 - -
462 Surgical Gloves 6.5 35.00 - -
463 Surgical Gloves 7.0 35.00 - -
464 Surgical Gloves 7.5 35.00 - -
465 SURGICAL GLOVES 8.0 35.00 - -
466 Surgicel 1x1 990.00 - -
467 Surgicel 3x4 3,250.00 - -
468 SYRINGE DISPOSABLE 1cc 6.00 - -
469 SYRINGE DISPOSABLE 1Occ 15.00 - -
470 syringe disposable 20cc 13.00 - -
471 syringe disposable 30cc 19.00 - -
472 SYRINGE DISPOSABLE 3cc 6.00 - -
473 syringe disposable 5 cc 5.00 - -
474 syringe disposable 50cc 20.00 - -
475 Tongue Depressor 5.00 - -
476 TRUETOME SPHINCTEROTOME 1,144.00 - -
477 TWIN SITE I.V. EXTENTION SET (FS) 260.00 - -
478 ULTRASOUND INTRA-OP (per use) 1,500.00 - -
479 VASELINIZED GAUZE 29.00 - -
480 Wadding Sheet 45.00 - -
481 WOUND PROTECTOR PER USE 800.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Obstetrics
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 3D/ 4D Scan ( OB-GYN ) 5,000.00 - -
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Oncology
As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
Brachytherapy HDR General Anesthesia Intravenous Succeeding 48,625.00 8,162.50 18,000.00
1 Session
Brachytherapy HDR General Anesthesia Package Intravenous 1st 62,112.50 12,422.50 27,700.00
2 Session
3 CT SIMULATION 3DCRT - CRANIAL 41,630.00 13,500.00 16,800.00
4 CT SIMULATION 3DCRT - CRANIOSPINAL 47,817.00 13,500.00 16,800.00
5 CT SIMULATION 3DCRT - HEAD & NECK 42,734.00 13,500.00 16,800.00
6 CT SIMULATION 3DCRT - SCC 1 SEGMENT 38,295.00 13,500.00 16,800.00
7 CT SIMULATION 3DCRT- SCC WHOLE SPINE 49,220.00 13,500.00 16,800.00
8 DAILY TREATMENT 3DCRT 5,160.00 800.00 2,660.00
9 DAILY TREATMENT COMPLEX IMRT 18,245.00 4,000.00 1,680.00
10 DAILY TREATMENT SIMPLE IMRT 10,255.00 1,680.00 4,000.00
Intensity Modulated Radiotherapy(IMRT)-ABDOMEN WITH BELLY 57,730.00 13,500.00 16,800.00
11 BELLY BOARD STEREOSCOPIC CT
 Republic of the Philippines
Department of Health
Center for Health Development Davao Region
SOUTHERN PHILIPPINES MEDICAL CENTER
J.P. Laurel Avenue, Davao City
Trunkline: 082-227-2731 | Faxline: 082-221-7029

Operating Room/ Delivery Room Procedures

As of August 31, 2022

Professional Fee
# Service Name Rate/Fee Minimum Maximum
1 ANGIOGRAM (AVERAGE HCI FEES) 58,002.27 8,500.00 128,626.00
2 ANGIOPLASTY (AVERAGE HCI FEES) 301,548.80 16,800.00 665,634.36
3 APPENDECTOMY (AVERAGE HCI FEES) 54,674.35 9,600.00 57,541.39
4 ARTHRODESIS, POSTERIOR (AVERAGE HCI FEES) 124,203.70 37,800.00 304,450.00
5 ARTHROPLASTY (AVERAGE HCI FEES) 110,016.83 44,037.50 144,375.00
6 BILATERAL SALPINGO-OOPHORECTOMY WITH RADICAL DISSECTION 70,472.09 37,800.00 254,050.00
(AVERAGE HCI FEES)
7 BILATERAL TUBAL LIGATION (AVERAGE HCI FEES) 7,431.00 1,700.00 1,700.00
8 BRACHYTHERAPY (AVERAGE HCI FEES) 22,500.00 26,125.00 26,125.00
9 CHEMOTHERAPY (AVERAGE HCI FEES) 8,871.94 1,680.00 33,350.00
10 CHOLECYSTECTOMY (AVERAGE HCI FEES) 24,842.47 18,045.15 24,875.00
11 CLOSURE OF ENTEROSTOMY (AVERAGE HCI FEES) 98,708.78 17,030.00 242,165.00
12 COLECTOMY W/ ILEOCOLOSTOMY (AVERAGE HCI FEES) 177,629.30 46,200.00 68,382.35
13 COLONOSCOPY (AVERAGE HCI FEES) 22,242.38 6,720.00 187,724.00
14 CORONARY ARTERY BYPASS (AVERAGE HCI FEES) 717,138.13 29,400.00 610,900.00
15 CRANIECTOMY / CRANIOTOMY (AVERAGE HCI FEES) 163,100.43 40,505.89 824,159.50
16 CS DELIVERY (AVERAGE HCI FEES) 42,682.58 7,600.00 103,277.00
17 CYSTOURETHROSCOPY (AVERAGE HCI FEES) 10,085.16 5,040.00 14,400.00
18 DILATION AND CURETTAGE (AVERAGE HCI FEES) 20,569.83 4,400.00 34,106.00
19 DISKECTOMY (AVERAGE HCI FEES) 136,487.07 33,600.00 149,039.90
20 ENDOSCOPY (AVERAGE HCI FEES) 16,681.57 5,040.00 45,218.00
21 EXCISION OF MALIGNANT TUMOR (AVERAGE HCI FEES) 13,954.63 2,520.00 10,020.00
22 EXPLORATORY LAPAROTOMY (AVERAGE HCI FEES) 118,980.66 13,635.40 79,374.00
23 FISTULECTOMY / FISTULOTOMY (AVERAGE HCI FEES) 10,021.75 6,720.00 14,220.00
24 HARTMANN TYPE PROCEDURE (AVERAGE HCI FEES) 157,861.46 37,800.00 396,140.00
25 HEMORRHOIDECTOMY (AVERAGE HCI FEES) 13,565.36 6,720.00 14,220.00
26 HERNIA SURGERY (AVERAGE HCI FEES) 22,125.74 8,400.00 90,700.00
27 HYSTERECTOMY, TAHBSO (AVERAGE HCI FEES) 56,242.63 12,000.00 146,380.00
28 HYSTEROSCOPY (AVERAGE HCI FEES) 28,436.60 7,000.00 37,578.00
29 LAPAROSCOPIC CHOLECYSTECTOMY (AVERAGE HCI FEES) 61,774.55 12,400.00 227,200.00
30 LAPAROSCOPY W/ REMOVAL OF ADNEXAL STRUCTURES (AVERAGE 69,357.00 29,400.00 143,041.18
HCI FEES)
31 LITHOTRIPSY (AVERAGE HCI FEES) 24,391.86 8,400.00 43,400.00
32 MASTECTOMY (AVERAGE HCI FEES) 50,214.86 9,836.00 99,037.50
33 NEWBORN CARE (AVERAGE HCI FEES) 3,029.15 500.00 5,097.70
34 NORMAL DELIVERY (AVERAGE HCI FEES) 21,705.86 2,000.00 48,907.70
35 OPEN TREATMENT OF FEMORAL SHAFT FRACTURE (AVERAGE HCI 187,091.34 13,640.00 387,550.00
FEES)
36 PACEMAKER INSERTION (AVERAGE HCI FEES) 101,073.95 13,625.00 294,781.25
37 PELVIC EXENTERATION FOR GYNECOLOGIC MALIGNANCY (AVERAGE 98,364.24 50,400.00 229,100.00
HCI FEES)
38 POSTERIOR SEGMENTAL INSTRUMENTATION (AVERAGE HCI FEES) 152,640.80 30,660.00 292,725.00

39 PROSTATE BIOPSY (AVERAGE HCI FEES) 11,461.73 3,575.00 12,700.00

40 RADICAL HYSTERECTOMY (AVERAGE HCI FEES) 55,712.98 33,600.00 208,166.60
41 RADIOTHERAPY 3D DAILY TREATMENT (AVERAGE HCI FEES) 17,904.57 800.00 18,500.00
42 RADIOTHERAPY IMRT DAILY TREATMENT (AVERAGE HCI FEES) 32,504.24 1,680.00 19,875.00
43 RADIOTHERAPY TREATMENT PLANNING (AVERAGE HCI FEES) 16,341.71 8,400.00 16,750.00
44 REMOVAL CATARACT, LENS (AVERAGE HCI FEES) 11,046.47 6,400.00 14,525.00
45 REMOVAL OF IMPLANT (AVERAGE HCI FEES) 25,411.73 5,880.00 48,984.00
46 SPINAL INSTRUMENTATION (AVERAGE HCI FEES) 149,229.08 32,623.00 316,603.85
47 STEREOSCOPIC CT SCAN (AVERAGE HCI FEES) 25,126.28 16,800.00 21,000.00
48 SURGERY OF INTRACRANIAL ANEURYSM (AVERAGE HCI FEES) 163,972.10 50,400.00 355,294.00
49 THYROIDECTOMY (AVERAGE HCI FEES) 59,786.59 12,400.00 94,900.00
50 TONSILLECTOMY (AVERAGE HCI FEES) 46,834.38 9,100.00 61,365.20
51 TOTAL ESOPHAGECTOMY W/ THORACOTOMY (AVERAGE HCI FEES) 336,550.75 38,640.00 452,049.00

52 TOTAL THYROID LOBECTOMY (AVERAGE HCI FEES) 52,922.88 12,700.00 62,262.00

53 TRANSCATHETER OCLUSSION OR EMBOLIZATION (AVERAGE HCI 215,582.45 50,400.00 336,600.00
FEES)
54 TRANSURETHRAL ELECTROSURGICAL RESECTION OF PROSTATE 93,323.70 26,950.00 211,200.00
(AVERAGE HCI FEES)
55 VITRECTOMY (AVERAGE HCI FEES) 25,015.64 25,400.00 35,500.00