DOTC DEPARTMENT ORDER NO. 2002-57, November 15, 2002
[ DOTC DEPARTMENT ORDER NO. 2002-57, November 15, 2002 ]
AN ORDER REVISING CERTAIN FEES AND CHARGES OF THE AIR TRANSPORTATION OFFICE (ATO) FOR MEDICAL, DENTAL AND LABORATORY SERVICE UNDER D.O. #94-762.
In compliance with Executive Order Nos. 197 and 218 as implemented by DOF-DBM Joint Circular No. 2000-4 dated April 4, 2000, the following schedule of revised fees and charges for Part VIII of D.O. #94-762 is hereby adopted for implementation:
MEDICAL, LABORATORY AND DENTAL FEES
A. MEDICAL
1. Consultation
P100.00
2. Treatments (dressing, injection, etc.)
100.00
3. Minor Surgery
a) Circumcision
400.00
b) Incision and Drainage, Suturing
200.00
c) Removal of Cyst
300.00
4. Physical Examination with Issuance of Medical Certificate
50.00
5. Ambulance conduction fee within Metro Manila
500.00
6. Nebulization with kit and medicine
180.00
7. Nebulization without kit and medicine
30.00
8. Optical examination (refraction and visual acuity)
50.00
9. Neuro -Psychiatric Examination
150.00
10. Annual fee for designation of Aviation Medical Examiners
200.00
11. Treadmill/Stress Test
700.00
B. LABORATORY
1. ECG
200.00
2. Chest X-ray
14 x 17
150.00
11 x 14
120.00
3. Complete Blood Count
95.00
4. Hemoglobin
50.00
5. Hematocrit
50.00
6. White cell count
50.00
7. Red cell count
50.00
8. Blood typing
100.00
9. Platelet count
65.00
10. ESR
80.00
11. Differential count
50.00
12. Occult blood
85.00
13. Pregnancy test
145.00
14. Routine urinalysis
70.00
15. Urine albumin and sugar
60.00
16. Stool exam
60.00
17. Blood chemistry
a) Glucose
120.00
b) BUN
120.00
c) Creatinine
120.00
d) Uric Acid
120.00
e) Cholesterol
120.00
f) Triglycerides
130.00
g) HDL
180.00
h) SGOT
140.00
i ) SGPT
140.00
C. DENTAL
1. Treatment
35.00
2. Filling per tooth
100.00
3. Extraction per tooth
50.00
4. Prophylaxis (light)
100.00
REPEALING CLAUSE
All previous administrative/department orders, rules and regulations, or part thereof inconsistent with or contrary to any prevision of this order are hereby repealed or modified accordingly.
EFFECTIVITY DATE
This Order shall be published once a week for two (2) consecutive weeks in two (2) newspapers of general circulation in the Philippines and the same shall be effective fifteen (15) days after the last publication.
RECOMMENDING APPROVAL:
M/Gen. ADELBERTO F. YAP (Ret.)
Assistant Secretary
APPROVED:
(SGD.) LEANDRO R. MENDOZA
Secretary
Attachment
Rates for Medical, Laboratory and Dental Services
Examination/Procedure
Pay Rates – Class A
Charity Rates
Outpatients/Ward/Semi-Private/Private/ Deluxe./Suite
Ward/Semi- Priv .
Private
Suite Deluxe
Class D
Class B
Class C
A. Medical
1. Consultation (ER Only)
200.00
200.00
200.00
-
-
-
2. Treatment (dressing, Injection, etc.)
-
-
-
3. Minor Surgery
390.00
500.00
855.00
435.00
695.00
a. Circumcision
b. Incision & drainage, Suturing
c. removal of cyst
4. Physical Examination w/ Issuance of Medical Certificate
NA
NA
NA
NA
NA
NA
5. Ambulance Conduction Fee
600.00-
600.00
600.00
600.00
w./in Metro Manila
800.00
800.00
800.00
800.00
800.00
800.00
6. Nebulization w/Kit & Medicine
NA
NA
NA
NA
NA
NA
7. Nebulization w/o Kit & Medicine
35.00/day
35.00/day
35.00/day
-
-
-
8. Optical Examination (Refraction & Visual Acuity)
NA
NA
NA
NA
NA
NA
9. Neuro -Psychiatry Examination
NA
NA
NA
NA
NA
NA
10. Annual fee for designation of Aviation Medical examiners NA
NA
NA
NA
NA
NA
NA
B. Laboratory
1. ECG- Regular
200.00
240.00
350.00
-
70.00
40.00
- Bedside/ Emer .
260.00
310.00
-
-
-
-
2. Chest X-ray
PA
285.00
285.00
345.00
-
100.00
100.00
PA and lateral
345.00
345.00
415.00
-
130.00
140.00
3. Complete Blood Count
95.00
115.00
115.00
-
40.00
60.00
4. Hemoglobin
50.00
50.00
60.00
-
15.00
30.00
5. Hematocrit
50.00
50.00
60.00
-
15.00
30.00
6. White Cell Count
50.00
50.00
60.00
-
15.00
30.00
7. Differential Count
70.00
70.00
75.00
-
20.00
40.00
8. Hemoglobin only
50.00
50.00
60.00
-
15.00
30.00
9. Red Blood Cell/Count/ WBC Morpitology
65.00
65.00
70.00
-
20.00
35.00
10. Blood Typing
125.00
160.00
160.00
-
35.00
70.00
11. Platelet Count
65.00
65.00
80.00
-
20.00
40.00
12. ESR
100.00
100.00
100.00
-
50.00
55.00
13. Occult Blood
90.00
100.00
100.00
-
40.00
45.00
14. Pregnancy Test
Qualitative: Slide Test
100.00
110.00
110.00
-
40.00
45.00
Card Test
145.00
160.00
160.00
-
105.00
115.00
Quantitative: 24 hrs.
HCG
15. Urinalysis (Routine)
70.00
75.00
75.00
-
35.00
40.00
16. Urine Albumin
70.00
90.00
90.00
-
30.00
35.00
17. Sugar
45.00
50.00
50.00
-
30.00
35.00
18. Stool Exam (Routine)
70.00
75.00
75.00
-
20.00
25.00
19. Blood Chemistry
Glucose
350.00
350.00
385.00
-
95.00
195.00
BUN
85.00
100.00
100.00
-
25.00
50.00
Creatinine
90.00
90.00
105.00
-
25.00
55.00
Uric Acid
85.00
95.00
95.00
-
25.00
50.00
Cholesterol
105.00
115.00
115.00
-
30.00
60.00
Triglycerides
185.00
215.00
215.00
-
55.00
110.00
HDL
195.00
210.00
210.00
-
115.00
135.00
SGOT
115.00
125.00
125.00
-
30.00
65.00
SGPT
115.00
125.00
125.00
-
30.00
65.00
C. Dental
1. Treatment (Preventive periodontal therapy)
50.00
50.00
50.00
-
30.00
30.00
2. Filing per tooth
NA
NA
NA
NA
NA
NA
3. Extraction per tooth
32.00
32.00
32.00
-
18.00
18.00
4. Prophylaxis
50.00
50.00
50.00
50.00
50.00
50.00
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