Republic of the Philippines Province of Pangasinan

PROVINCIAL HEALTH OFFICE BAYAMBANG DISTRICT HOSPITAL

Bayambang, Pangasinan

Tel/Fax No.: Main:(075)592-2958 / Admin: (075)632-7986 Email Add.: bayambang_districthospital80@yahoo.com

VISION

The Bayambang District Hospital envisioned being the “Center of

Wellness” within its catchment municipalities by embracing promotive, preventive, rehabilitative and accurate modalities of health care including psychological and spiritual aspect.

MISSION

The Bayambang District Hospital serves as the “Center of Referrals” from

the different catchment municipalities coming from their Rural Health Units and Barangay Health Centers.

It also serves as the referring center for tertiary hospital and medical center for patients needing higher level of medical care.

It will cater health services to the general population but with specific focus on the marginalized sector of society.

“Pro–Family and Eco–Friendly Hospital”

Para sa inyong mga katanungan, komento o

reklamo, pumunta sa nakatalagang empleyado sa

Public Assistance and Complaint Desk. Ma-aari din

pong tumawag sa numero (075) 592-2958 at (075) 632-

7986 o punan ang Client Feedback o Client

Satisfaction Survey Form para malaman ang inyong opinion tungkol sa aming serbisyo.

This Brochure is designed for the clients of the Provincial Government of Pangasinan and implemented effective October 02, 2017.

Physical/Occupational Therapy 200.00/Student Affiliation Fee for Dialysis Nurse Training 13,000.00/Nurse

MISCELLANEOUS

NAME OF SERVICES Issuance of Medical Certificate For Local Employment 50.00 For Overseas Employment 100.00 Immigration Student 30.00 Senior Citizen 30.00 Medical Legal 200.00 Issuance of Training Certificate Volunteer Free Student 50.00 Issuance of Birth Certificate 50.00 Issuance of Death Certificate Free Issuance of Social Hygiene Card 10.00 Issuance of Sanitary Permits Commercial Non-Commercial Replacement of Lost Card Hospital Card 10.00 Social Hygiene Card 20.00 Ambulance Service Within City/Municipal Limits 300.00 Outside City/Municipal Limits (to & from: Excluding Toll Fees

25.00/Km

PROGRAM SERVICES FEES

NAME OF SERVICES ALL PROVINCIAL HOSPITALS Family Planning BTL 1,000.00 Injectable IUD Current Price + 10% increase Oral Contraceptives Vasectomy 1,000.00 Immunization Current Price + 10% increase Anti-Rabies BCG DPT Hepa B Measles OPV TT

PROGRAM SERVICES FEES

NAME OF SERVICES Dentistry 500.00/Student/Semester Hospital Dietetics 250.00/Student/192 Hrs Public Health Nutrition 250.00/Student/240 Hrs Medical Technology 100.00/Student/Month Medicine 3rd Year 20.00/Student/Hr 4th Year 1,000.00/Student/Month Midwifery 80.00/Student/30-40 Hrs Nursing 50-80 Hrs 200.00/Student 30-49 Hrs 100.00/Student 10-29 Hrs 50.00/Student 1-9 Hrs 30.00/Student Pharmacy 480 Hrs 600.00 160 Hrs 200.00 Psychology Baccalaureate 4.00/Student/Hr Masteral 5.00/Student/Hr Doctoral 6.00/Student/Hr Radiologic Technology 70.00/Student/Month Social Network 100.00/Student/Month Nurse/Health Aide 30.00/Student/Month Caregiver 100.00/Student/2 Weeks

Pneumonia II (High Risk) 9,600.00 22,400.00 32,000.00 Typhoid Fever 4,200.00 9,800.00 14,000.00 SURGICAL CASE RATES

CASES PROFESSIONAL FEE

OTHERS (Room, Boards,

Laboratories, Medicines,

Miscellaneous)

TOTAL CASE RATE

PAYMENT

Appendectomy 9,600.00 14,400.00 24,000.00 Cataract Surgery 6,400.00 9,600.00 16,000.00 Cesarian Section 7,600.00 11,400.00 19,000.00 Cholecystectomy 12,400.00 18,600.00 31,000.00 Dilation and Curretage 4,400.00 6,600.00 11,000.00 Hemodialysis 500.00 3,500.00 4,000.00 Herniorapphy 8,400.00 12,600.00 21,000.00 Hysterectomy 12,000.00 18,000.00 30,000.00 Mastectomy 8,800.00 13,200.00 22,000.00 Maternity Care Package (MCP)

3,200.00 4,800.00 8,000.00

NSD Package in Level 2 to 4 Hospitals

2,600.00 3,900.00 6,500.00

NSD Package in Level I Hospitals

3,200.00 4,800.00 8,000.00

Radiotherapy 1,200.00 1,800.00 3,000.00 Thyroidectomy 12,400.00 18,600.00 31,000.00

DENTAL FEE

NAME OF SERVICES ALL PROVINCIAL HOSPITALS Oral Examination Free Oral Prophylaxis Children 150.00 Adult 200.00 (Moderate Calcular Deposit) 300.00 (Severe Calcular Deposit) Filing 150.00/Tooth Cavity Temporary 200.00/Tooth Cavity (Incipient) Permanent 250.00/Tooth Cavity (Extensive Caries) (Amalgam) 100.00/Tooth

Thoracentesis/ Biopsy (Liver & Chest) Mammography Both Breasts 1,000.00 One Breast 400.00 Reading Fee for Special X-Ray Procedure: Barium Enema 720.00 Esophagram 550.00 Intra-Operative Cholangiogram 550.00 KUB-IVP 720.00 T-Tube Cholangiogram 720.00 Upper GI 720.00

OTHER PROFESSIONAL FEES

NAME OF SERVICES ALL PROVINCIAL HOSPITALS Catching Baby NSD 2,000.00 CS 2,500.00 Admission 200.00 Exchange Trasfusion 1,800.00 IV Insertion 60.00 Lumbar Tap 2,000.00 Marsupialization 8,000.00 Medico Legal 500.00 NGT/OGT Insertion 1,000.00 Umbilical Catherization 900.00

CASE PAYMENT RATES

MEDICAL CASE RATES

CASES PROFESSIONAL FEE

OTHERS (Room, Boards,

Laboratories, Medicines,

Miscellaneous)

TOTAL CASE RATE

PAYMENT

Acute Gastroenteritis (AGE) 1,800.00 4,200.00 6,000.00 Asthma 2,700.00 6,300.00 9,000.00 Cerebral Hemorrhage (CVA II)

11,400.00 26,600.00 38,000.00

Cerebral Infraction (CVA I) 8,400.00 19,600.00 28,000.00 Dengue I (Dengue Fever and DHF I & II)

2,400.00 5,600.00 8,000.00

Dengue II (DHF Grades III & IV)

4,800.00 11,200.00 16,000.00

Essential Hypertension 2,700.00 6,300.00 9,000.00 Newborn Care Package 525.00 1,225.00 1,750.00 Pneumonia I (Moderate Risk) 4,500.00 10,500.00 15,000.00

SEROLOGY

NAME OF SERVICES ALL PROVINCIAL HOSPITALS AFP 800.00 Anti HBE 500.00 Anti HBS 500.00 Anti HCV Titer 400.00 ASO 300.00 B-HCG 500.00 Blood Screening 1,000.00 CA 125 1,000.00 CA 15-3 1,100.00 CEA 900.00 Dengue 800.00 HAV IgG 500.00 HCV 300.00 HCV IgG 500.00 Hepatitis A Virus 400.00 Hepatitis B Antigen 250.00 HIV 300.00 PSA 800.00 RPR 300.00 Tubex 600.00 Widal Test 200.00

BACTERIOLOGY

NAME OF SERVICES SCREENING CONFIRMATORY AFB Stain - 100.00

ULTRASOUND/SPECIAL X-RAY PROCEDURE READING FEE

NAME OF SERVICES ALL PROVINCIAL HOSPITALS BPS 400.00 Cranial 400.00 Endovaginal 400.00 HBT 300.00 KUB with Prostate 300.00 Lower Abdomen 300.00 Pelvis 300.00 Thoracic 400.00 Thyroid 300.00 Ultrasound Guided Aspiration 900.00 Upper Abdomen 300.00 Whole Abdomen 400.00

Differential Count 60.00 Comb/s Test (Direct) 90.00 Comb/s Test (Indirect) 90.00 ESR 120.00 Leptospira 600.00 Malarial Smear 200.00 Peripheral Blood Smear 200.00 Platelet 100.00

IMMUNOLOGY

NAME OF SERVICES ALL PROVINCIAL HOSPITALS Typhoid Fever Test Typhi Dot (IgG/IgM) 700.00 Widal 200.00

MICROSCOPY

NAME OF SERVICES ALL PROVINCIAL HOSPITAL

Bile Test 45.00 CSF Analysis (Quantitative/ Qualitative) 500.00 Culture and Sensitivity (Blood) 1,000.00 Culture and Sensitivity (Urine) 1,000.00 Fecalysis 60.00 Occult Blood 100.00 Pregnancy Test (Test Pack) 200.00 Sperm Cell Count 300.00 Sugar/ Urine Sugar 60.00 Urinalysis 60.00 Urobilinogen 60.00

HISTOPATHOLOGY

NAMEOF SERVICES ALL PROVINCIAL HOSPITALS Histopathology Depends upon size of specimen 900.00 Biopsy (H&E) 1 Slide 600.00 Biopsy (H&E) 3 Slides 600.00 Biopsy (H&E) 6 Slides 600.00 Block 650.00 Cell Block 650.00

BLOOD CHEMISTRY

NAME OF SERVICES ALL PROVINCIAL HOSPITALS Acid Phosphate 140.00 Alkaline Phosphate 140.00 ALT (Serum Glutamate Phosphate) 140.00 Amylase 140.00 APTT 600.00 AST (Serum Glutamate Phosphate) 140.00 Blood Urea Nitrogen (BUN) 140.00 BUA 140.00 Calcium 140.00 Calcium 150.00 Chloride 140.00 Cholesterol 200.00 Creatinine 140.00 FT3, FT4 300.00 each Glucose/Fasting Blood Sugar 140.00 High Density Lipoprotein Cholesterol (HDL) 200.00 Lactate Dehydrogenase (LDH) 200.00 Lipid Profile 750.00 Liver Profile 950.00 Low Density Lipoprotein (LDL) 200.00 Phosphorous 200.00 Potassium 140.00 Random Blood Sugar 140.00 Sodium 140.00 T3, T4 (Hypothyroidism) 300.00 each T3T4TSH (Hyperthyroidism) Total Bilirubin 140.00 Total Bilirubin/ Direct Bilirubin/ Indirect Bilirubin (TBDBDIB)

200.00 each

Total Protein Acid Globulin (TPAG) 200.00 Total Protein/Albumin/Globulin 140.00 each Triglyceride 200.00 Troponin 600.00 TSH 400.00 Uric Acid 250.00

HEMATOLOGY

NAME OF SERVICES ALL PROVINCIAL HOSPITALS Bleeding Time/ Clotting Time 60.00 Blood Typing 150.00 Cross matching 300.00 CBC 200.00 Hemoglobin 75.00 Hematocrit 75.00

Lower Abdomen 650.00 Pelvis 650.00 Thoracic 650.00 Thyroid 650.00 Ultrasound guided Aspiration/ Thoracentesis/ Biopsy (Liver & Chest)

1,200.00

Upper Abdomen 650.00 Whole Abdomen 900.00 MAMMOGRAPHY Complete with UTZ Both Breasts 2,000.00 One Breasts 1,500.00 2D ECHO OUT-PATIENT/PAY (in-patient) Total Cost 3,000.00 Reader’s Fee 1,200.00 CHARITY/INDIGENT Total Cost 2,500.00 Reader’s Fee 700.00

LABORATORY FEES

SOCIAL HYGENE

NAME OF SERVICES ALL PROVINCIAL HOSPITALS Culture for N. Gonorrhea 600.00 Gram Stain 100.00 HBSAg Screening 250.00 HBSAg Titer 500.00 HEPA-B Profile 1,500.00 HIV (Test Kit) 400.00 Pap’s Smear (Excluding Pathologist’s Fee) 100.00 Rapid Plasma Raegan (RPR)/Venereal Disease (VD) – Qualitative Test

250.00

WATER ANALYSIS

NAME OF SERVICES PRICE PER SPECIMEN Culture and Sensitivity 220.00 Water Bacteriological Analysis 300.00

Pulse Oximeter 50.00/Hour X-Ray Services (inclusive of reading fee) Abdomen (Upright and Supine) 300.00 Ankle Joint 500.00 Cervical Spine 600.00 Chest PA-Lateral 600.00 Elbow Joint 500.00 Extremities 300.00 Femur/Thigh 300.00 Foot 500.00 Hand 500.00 Hip Joint 300.00 Humerus 600.00 Knee Joint 500.00 Lumbo-Sacral AP-Lateral 500.00 Mandible 600.00 Mastoid 600.00 Maxilla 300.00 Nasal Bone AP-Lateral 600.00 Paranasal Sinuses 600.00 Pelvic Sacral AP-Lateral 600.00 Radio – Ulna/Forearm 500.00 Shoulder Joint 300.00 Skull X-Ray 200.00 Skull X-Ray APL 600.00 Thoracic Cage 300.00 Thorac-Lumbar AP-Lateral 800.00 Tibia-Fibula/Leg 500.00 Wrist Joint 500.00 Special X-Ray Procedures: Barium Enema 2,100.00 Esophagram 1,600.00 Intra-Operative Cholangiogram 1,600.00 KUB-IVP 2,100.00 Plain KUB 300.00 T-Tube Cholagiogram 1,600.00 Upper GI Series 2,100.00 Digital Imaging System Tie-up with private provider

As indicated in the MOA, patients will be charge Php 300.00 on the first view and additional Php 100.00 per succeeding views of this, Php 200.00 will go to the Provincial Government and Php 100.00 to the private partner.

ULTRASOUND BPS 900.00 Cranial 900.00 Endovaginal 900.00 HBT 600.00 KUB (Prostate) 600.00

HOSPITAL FEES

ROOMS AND BOARDS

NAME OF SERVICE ALL PROVINCIAL HOSPITAL WARD Regular Ward 200.00/Day PAYWARD (2-4 PERSONS) W/O Aircon 300.00/Day W/ Aircon 600.00/Day PRIVATE ROOM (SINGLE) W/O Aircon 600.00/Day W/ Aircon 800.00/Day Suite (w/ TV, Ref & Sala Set) 1,500.00/Day OPERATING ROOM Major Procedure 2,500.00/Day Minor Procedure 1,000.00/Day DELIVERY ROOM 1,000.00 NURSERY W/ Bili Light 500.00/Day W/ Incubator 1,000.00/Day Nursery 100.00/Day

For Hospitals with designated Philhealth Wards Applicable for Disease not covered with PHIC Case Rates

Case Type A Case Type B Case Type C Case Typre D Tertiary Hospital 500/Day 500/Day 800/Day 1,100/Day Secondary Hospital

400/Day 400/Day 600/Day N/A

Primary Hospital 300/Day 300/Day N/A N/A

USE OF EQUIPMENT

NAME OF SERVICE ALL PROVINCIAL HOSPITALS OXYGEN TANK 1st min – 1 hr @ 25 psi/40 hrs 25.00/Hour 1st min – 1 hr @ 25 psi/20 hrs 50.00/Hour 1st min – 1 hr @ 25 psi/14 hrs 75.00/Hour 1st min – 1 hr @ 25 psi/10 hrs 100.00/Hour CARDIAC MONITOR (ICU/OR) 35.00/Hour ECG (w/ physician reading) 300.00 Doppler 50.00/Use Cautery: OPD 500.00/Use Electrocautery (OR) 1,000.00/Use Nebulizer 50.00/Use