Page 1

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 10 خدمات الكشف CONSULTATION Service

بيان المجموعة 1010 خدمات الكشف Specialist Service

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

133 DENTAL CONSULTATION DENTAL CONSULTATION 50 12 50 11

203 فحص العمالة مع التطعيم فحص العمالة مع التطعيم 120 120 0

1000 CONSULTATION CONSULTATION 50 50

1001 CONSULTANT FEE CONSULTANT FEE 100 100

1002 SPECIALIST FEE SPECIALIST FEE 50 50

1003 ER DOCTOR FEE ER DOCTOR FEE 50 50

1004 GP DOCTOR FEE GP DOCTOR FEE 50 50

1005 OUTSIDE EXPERT CONSULTANT FEE OUTSIDE EXPERT CONSULTANT FEE 1000 1000

1009 HOME VISIT, CONSULTANT HOME VISIT, CONSULTANT 1000 1000

1010 HOME VISIT, SPECIALIST HOME VISIT, SPECIALIST 500 500 30

1011 Deff Consultant Deff Consultant 0 0 0

1012 AMBULANCE INSIDE AMBULANCE INSIDE 500 500 30

1013 AMBULANCE OUT 50 KM AMBULANCE OUT 50 KM 700 700 30

1014 AMBULANCE TO AMBULANCE TO 3000 3000 30

1015 AMBULANCE TO JEDDAH AMBULANCE TO JEDDAH 5000 5000 30

3881 INR INR

4704 فحص العمالة الوافدة فحص العمالة الوافدة 150 150 30

4707 فحص خاص برخصة المرور فحص خاص برخصة المرور 100 100 30

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

100 pregnacy test pregnancy test(Pregnancy) 100 70

101 phosphorus (serum) phosphorus (serum) 200 60

102 STOOL CULTURE STOOL CULTURE 150 120

103 VAGINAL SWAB CULTURE VAGINAL SWAB CULTURE 150 180 19

104 نفخ شفايف SKIN SCRAPING ( KOH) 180 100 20

105 SPUTUM FOR ZN STAIN SPUTUM FOR ZN STAIN 100 60

106 HIV 1 - 2 (ELISA) HIV 1 - 2 (ELISA) 160 165

107 BLOOD GROUP (RH) BLOOD GROUP (RH) 30 40

108 WIDAL TEST WIDAL TEST 70 70

109 TROPONIN T TROPONIN T 200 190

110 HBS AG HBS AG 160 165

111 HCV HCV 160 150

112 RUBELLA IGG RUBELLA IGG 150 200

113 RUBELLA IGM RUBELLA IGM 150 220

114 ANTI - CCP TEST ANTI - CCP TEST 220 380

115 CRP (C- REACTIVE PROTEIN) CRP (C- REACTIVE PROTEIN) 100 125

116 RHEMATOID FACTOR (RF) RHEMATOID FACTOR (RF) 70 120

117 H.PYLORI IN BLOOD H.PYLORI IN BLOOD 150 200

119 TSH TSH 150 200

120 CORTISOL AM CORTISOL AM 185 185

121 CORTISOL PM CORTISOL PM 185 185

122 CA125 (OVARIAN CANCER) CA125 (OVARIAN CANCER) 270 0

123 CA15 (BREAST CANCER) CA15 (BREAST CANCER) 350 0

Page 2

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

124 CA19 - 9 (PANCREATIC CANCER) CA19 - 9 (PANCREATIC CANCER) 350 0

125 TESTOSTERONE (TOTAL) TESTOSTERONE (TOTAL) 150 165

126 TESTOSTERON (FREE) TESTOSTERON (FREE) 150 165

127 URETHRAL SWAB CULTURE URETHRAL SWAB CULTURE 150 180

128 (PPBS) POST PRANDIAL BLOOD SUGAR (PPBS) POST PRANDIAL BLOOD SUGAR 40 50

129 (LH) LEUTENIZIING HORMON (LH) LEUTENIZIING HORMON 150 185

130 PSA (TOTAL) PSA (TOTAL) 150 150

131 PSA (FREE) PSA (FREE) 180 200

132 FSH (FOLLICULR STIMULATING HORMON) FSH (FOLLICULR STIMULATING HORMON) 150 180

134 PTH (PARA THYROID HORMON) PTH (PARA THYROID HORMON) 315 315

135 PAP SMEAR PAP SMEAR 230 230

136 ANTI PHOSPHOLIPID ABS ANTI PHOSPHOLIPID ABS 300 300

137 ANTI LUPUS Abs ANTI LUPUS Abs 200 0

138 ANTI CARDIOLIPIN Abs IGG ANTI CARDIOLIPIN Abs IGG 310 310

139 ANTI CARDIOLIPIN IGM ANTI CARDIOLIPIN IGM 310 310

140 GROWTH HORMON GROWTH HORMON 200 250

141 INDIRECT AND DIRECT COMBS TEST INDIRECT AND DIRECT COMBS TEST 120 200

142 (G6PD) GLUCOSE 6 PHOSPHATE DEHYDROGENES (G6PD) GLUCOSE 6 PHOSPHATE DEHYDROGENES 150 180

143 FREE CALCIUM FREE CALCIUM 0

144 (HSV) HERPS SIMPLEX VIRUS IGG (HSV) HERPS SIMPLEX VIRUS IGG 235 235

145 (HSV) HERPS SIMPLEX VIRUS IGM (HSV) HERPS SIMPLEX VIRUS IGM 235 235

146 فحص الزهري shphylis 150 75

265 VIT B12 (OFFER ) VIT B12 (OFFER ) 150 150 0

270 CBC FREE CBC Free 120 0

274 thyroid hormones thyroid hormones 280 280 0

344 فحص شامل check 1 1020 510 50

473 check up 2 check up 2 480 480 0

485 1 Hours After Glucose dose 1 Hours After Glucose dose 0

651 semen analysis semen analysis 70 100

1304 تحليل المدارس العام تحليل المدارس العام 700

1481 NEWBORN SCREENING PROFILE NEWBORN SCREENING PROFILE 1500 1900

1482 WESTREN BLOT WESTREN BLOT 1350 1350

1483 HTLV I AND II HTLV I AND II 2000 2000

1484 LIPID PROFILE LIPID PROFILE 400 210

1485 OXALATE OXALATE 250 250

1486 PSA FREE PSA FREE 250 400

1487 MEASLES ABS IGG & IGM MEASLES ABS IGG & IGM 250 750

1488 HISTOPLASMOSIS HISTOPLASMOSIS 1100 1100

1489 LAMOTRIGIN LAMOTRIGIN 680 680

1490 ALCAT TEST ALCAT TEST 6000 6000

1491 CERULOPLASMIN CERULOPLASMIN 260 260

1492 ZINC (S) @ ZINC (S) @ 350 560

1493 COPPER (S) @ COPPER (S) @ 350 670

1494 GASTRIN (S) @ GASTRIN (S) @ 500 730

Page 3

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1495 NIESSERIA AGGLUTINO TEST (S) NIESSERIA AGGLUTINO TEST (S) 320 320

1496 H1N1 MEDIA TRANSFER H1N1 MEDIA TRANSFER 210 210

1497 CHRONIC PROSTATIC ASSESSMENT PROTOCOL CHRONIC PROSTATIC ASSESSMENT PROTOCOL 830 830

1498 LEGIONELA PNEUMOPHILA LEGIONELA PNEUMOPHILA 1200 1200

1499 90 FOODS ALLERGY TEST (S) 90 FOODS ALLERGY TEST (S) 1600 1600

1500 HBDH (S) HBDH (S) 210 210

1501 ADH ADH 1600 1600

1502 LACTIC DEHYDROGENASE (LLDH) LACTIC DEHYDROGENASE (LLDH) 250 250

1503 OSMITIC FRAGILITY OSMITIC FRAGILITY 350 350

1504 FRUCTOSE (SEMEN) FRUCTOSE (SEMEN) 500 620

1505 FACTOR V MUTATION GENE FACTOR V MUTATION GENE 2400 2400

1506 COXSACKIE ECHO - VIRUS (ENTRO VIRUS) COXSACKIE ECHO - VIRUS (ENTRO VIRUS) 600 600

1507 LEGIONELLA ABS LEGIONELLA ABS 1200 1200

1508 LEPTOSPIRA ABS LEPTOSPIRA ABS 1250 1250

1509 CAROTENE (S) @ CAROTENE (S) @ 1100 1100

1510 LIPOPROTEIN ELECTROPHORESIS (S) @ LIPOPROTEIN ELECTROPHORESIS (S) @ 450 450

1511 CANNABINOIDS AND AMPHETAMINE SCREEN CANNABINOIDS AND AMPHETAMINE SCREEN 400 400

1512 UREA CLEARANCE UREA CLEARANCE 250 250

1513 ANTI PLATELATE ANTI PLATELATE 1100 1100

1514 PERTUSSIS PERTUSSIS 580 580

1515 BARVOVIRUS PCR BARVOVIRUS PCR 900 900

1516 TANDEM ICON STREP A (S) TANDEM ICON STREP A (S) 125 125

1517 ENA/EXTRACTABLE NUCLEAR ABS ENA/EXTRACTABLE NUCLEAR ABS 870 870

1518 HER2 TEST HER2 TEST 1450 1450

1519 ANTI CCP ANTI CCP 350 830

1520 SMOOTH MUSCLE.AB SMOOTH MUSCLE.AB 415 415

1521 ANCA ANCA 620 620

1522 HEMATOCRIT (B) HEMATOCRIT (B) 50 90

1523 COLLAGEN ABS PROFILE COLLAGEN ABS PROFILE 950 950

1524 BETA 2-MICROGLOBULIN (S) BETA 2-MICROGLOBULIN (S) 570 570

1525 R.B.C. COUNT (B) R.B.C. COUNT (B) 90 90

1526 W.B.C. COUNT (B) W.B.C. COUNT (B) 90 90

1527 DIFFERENTIAL COUNT (B) DIFFERENTIAL COUNT (B) 90 90

1528 HIV P24 HIV P24 400 400

1529 GLIADINE ABS GLIADINE ABS 1100 1100

1530 IGF1 @ IGF1 @ 1350 1350

1531 PLATELET COUNT (B) PLATELET COUNT (B) 70 100

1532 IGFBP-3 @ IGFBP-3 @ 1100 1100

1533 ENDOMYSIUM IGA ABS @ ENDOMYSIUM IGA ABS @ 580 580

1534 RETICULIN IGA & IGG ABS @ RETICULIN IGA & IGG ABS @ 620 620

1535 ANGIOTENSIN-1-CONVERTING ENZYME(ACE)S ANGIOTENSIN-1-CONVERTING ENZYME(ACE)S 730 730

1536 THROMBIN TIME THROMBIN TIME 170 170

1537 BLOOD FILM FOR FILARIA (B) BLOOD FILM FOR FILARIA (B) 150 150

1538 ANCA-C & ANCA-P ANCA-C & ANCA-P 970 970

Page 4

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1539 HEMOGLOBIN ELECTROPHOR.QUANT. (B) HEMOGLOBIN ELECTROPHOR.QUANT. (B) 450 450

1540 G.6.P.D. QUALITATIVE ESTIMATIN (B) (new born) G.6.P.D. QUALITATIVE ESTIMATIN (B) (new born) 280 280

1541 PRE-OPERATIVE PROFILE # (S) PRE-OPERATIVE PROFILE # (S) 1000 1350

1542 GLUCOMETER GLUCOSE GLUCOMETER GLUCOSE 100 100

1544 NAP SCORE NAP SCORE 320 320

1545 NAP SCORE NAP SCORE 210 210

1546 BENCE JONES PROTEIN (U) BENCE JONES PROTEIN (U) 450 450

1547 BILE SALTS (U) BILE SALTS (U) 60 60

1548 URINE ROUTINE AND CULTURE URINE ROUTINE AND CULTURE 250 250

1549 UROBILINOGEN (U) UROBILINOGEN (U) 40 100

1550 CHOLINESTERASE (PSEUDOCHOLINESTERASE) CHOLINESTERASE (PSEUDOCHOLINESTERASE) 870 870

1551 UROBILIN (U) UROBILIN (U) 100 100

1552 CATECHOLOMINE (U) @ CATECHOLOMINE (U) @ 1370 1370

1553 RENAL BIOPSY ELECTRON MICROSCOPY RENAL BIOPSY ELECTRON MICROSCOPY 7040 7040

1554 BIOTIN LEVEL BIOTIN LEVEL 910 910

1555 GLUCOSE, QUANTITATIVE (U)/CSF GLUCOSE, QUANTITATIVE (U)/CSF 100 100

1556 TOTAL COMPLEMENT (CH100/CH50) TOTAL COMPLEMENT (CH100/CH50) 450 450

1557 PROTEIN RANDOM URINE QUANT PROTEIN RANDOM URINE QUANT 150 150

1558 C.S.F. EXAMINATION C.S.F. EXAMINATION 830 830

1559 EFFUSIONS AND OTHER FLUIDS EFFUSIONS AND OTHER FLUIDS 210 210

1560 DENGUE VIRAL CULTURE DENGUE VIRAL CULTURE 750 750

1561 INFLUENZA REAL TIME PCR SWINE- SEASONAL INFLUENZA REAL TIME PCR SWINE- SEASONAL 1250 1250

1562 CLOSTRIDIUM DIFFICILE TOXIN CLOSTRIDIUM DIFFICILE TOXIN 540 540

1563 C-REACTIVE PROTEIN (QUALT) C-REACTIVE PROTEIN (QUALT) 300 300

1564 PROTEIN S (TOTAL,FREE AND ACTIVITY) PROTEIN S (TOTAL,FREE AND ACTIVITY) 450 450

1565 PROTEIN C ACTIVITY PROTEIN C ACTIVITY 450 450

1566 L.E. LATEX L.E. LATEX 210 210

1567 BONE MARROW TREPHINE (BIOPSY) BONE MARROW TREPHINE (BIOPSY) 2700 2700

1568 SUDAN BLOCK STAIN FOR B.M.FILM SUDAN BLOCK STAIN FOR B.M.FILM 525 525

1569 PAS STAIN FOR B.M. FILMS PAS STAIN FOR B.M. FILMS 320 320

1570 CSF EXAM FOR BLAST CELLS CSF EXAM FOR BLAST CELLS 320 320

1571 LACTATE SERUM LACTATE SERUM 225 225

1572 IGG - (CSF) IGG - (CSF) 450 450

1573 LACTATE - (CSF) LACTATE - (CSF) 225 225

1574 SPECIFIC GRAVITY - (CSF) SPECIFIC GRAVITY - (CSF) 125 125

1575 C S F - C/S C S F - C/S 180 250

1576 CERVICAL C/S CERVICAL C/S 180 250

1577 EAR SWAB C/S EAR SWAB C/S 180 250

1578 EYE SWAB C/S EYE SWAB C/S 180 250

1579 GENITAL SWAB C/S GENITAL SWAB C/S 180 250

1580 HVS SWAB C/S HVS SWAB C/S 180 250

1581 NASAL SWAB C/S NASAL SWAB C/S 180 250

1582 PERITONEAL FLUID C/S PERITONEAL FLUID C/S 180 250

Page 5

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1583 PLEURAL FLUID C/S PLEURAL FLUID C/S 180 250

1584 PROSTATIC SECRECTION C/S PROSTATIC SECRECTION C/S 180 250

1585 PUS / WOUND SWAB C/S PUS / WOUND SWAB C/S 180 250

1586 COLD AUTO ABS/AGGLUTINING COLD AUTO ABS/AGGLUTINING 300 350

1587 SEMEN C/S SEMEN C/S 250 250

1588 SPUTUM C/S SPUTUM C/S 250 250

1589 STOOL / RECTAL SWAB C/S STOOL / RECTAL SWAB C/S 250 250

1590 SYNOVIAL FLUID C/S SYNOVIAL FLUID C/S 250 250

1591 THROAT SWAB C/S THROAT SWAB C/S 250 250

1592 URETHAL SWAB C/S URETHAL SWAB C/S 250 250

1593 URINE C/S URINE C/S 150 250

1594 HCV ABS (S) HCV ABS (S) 350 350

1595 HIV (PCR) - QUALITATIVE HIV (PCR) - QUALITATIVE 1700 1700

1596 HIV 1 & 2 (PCR) HIV 1 & 2 (PCR) 1700 1700

1597 HIV (DNA) - QUANTITATIVE HIV (DNA) - QUANTITATIVE 1700 1700

1598 HIV CONFIRM (WB) HIV CONFIRM (WB) 1700 1700

1599 HCV PCR HCV PCR 1700 1700

1600 TOXO IGG, IGM (CSF) TOXO IGG, IGM (CSF) 720 720

1601 TOXOPLASMA PCR TOXOPLASMA PCR 1800 2900

1602 BRUCELLA CSF ABS BRUCELLA CSF ABS 395 395

1603 TRIPONIN QUALITATIVE (S) TRIPONIN QUALITATIVE (S) 480 480

1604 TB PCR TB PCR 2900 2900

1605 HLA CLASS(1) & CLASS(2) HLA CLASS(1) & CLASS(2) 3110 3110

1606 UA/HBSAG/HCV/HIV/HAVAB UA/HBSAG/HCV/HIV/HAVAB 1200 1200

1607 CANDIDA IN HVS CANDIDA IN HVS 250 250

1608 P.C.T. (POST COITAL TEST) - LAB P.C.T. (POST COITAL TEST) - LAB 350 350

1609 ENTRO VIRUS (COXSACKIE) ENTRO VIRUS (COXSACKIE) 560 560

1610 BACTERIAL CULTURE W/O SENSITIVITY BACTERIAL CULTURE W/O SENSITIVITY 250 250

1611 BACTERIAL ANTIGEN CFF BACTERIAL ANTIGEN CFF 250 250

1612 TB CULTURE & SENSITIVITY TB CULTURE & SENSITIVITY 730 730

1613 B-HEMOLYTIC STREP A B-HEMOLYTIC STREP A 210 210

1614 BACTERIAL COUNT BACTERIAL COUNT 130 130

1615 SKIN ALLERGY TEST SKIN ALLERGY TEST 1000 1000

1616 MUCOPO LYSECCHARIDES, SCREEN @ MUCOPO LYSECCHARIDES, SCREEN @ 410 410

1617 AMINO ACID SCREEN IN URINE @ AMINO ACID SCREEN IN URINE @ 320 320

1618 CHLAMYDIA CHLAMYDIA 350 665

1619 LABORATORY OUT SIDE SERV LABORATORY OUT SIDE SERV 1650 1650

1620 TB-GOLD TB-GOLD 1650 1650

1621 CYTOMEGALO VIRUS IGG & IGM CYTOMEGALO VIRUS IGG & IGM 670 670

1622 HERPES SIMPLEX VIRUS TYPE I @ HERPES SIMPLEX VIRUS TYPE I @ 170 170

1623 HERPES SIMPLEX IG-G 1&2 HERPES SIMPLEX IG-G 1&2 750 750

1624 CYTO TOXIC ABS CYTO TOXIC ABS 1450 1450

1625 AMIKACIN AMIKACIN 520 520

1626 HIV AG/AB COMBO HIV AG/AB COMBO 750 750

1627 VIRAL SCREENING VIRAL SCREENING 1100 1100

1628 ANTO-TPO (ANTI-THYROID PEROXIDASE) ANTO-TPO (ANTI-THYROID 350 350

Page 6

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

PEROXIDASE)

1629 CBC WITH DIFFERNTIAL CBC WITH DIFFERNTIAL 100 100

1630 GALACTOSAEMIA SCREEN GALACTOSAEMIA SCREEN 250 250

1631 T3-UPTAKE @ T3-UPTAKE @ 300 300

1632 SERUM CROSSLAPS @ SERUM CROSSLAPS @ 1240 1240

1633 CLONAZEPAM (RIVOTRIL) CLONAZEPAM (RIVOTRIL) 730 730

1634 PROTHROMBIN MUTATION PROTHROMBIN MUTATION 990 990

1635 ALPHA-1-ANTITRYPSIN PHENOTYPINS ALPHA-1-ANTITRYPSIN PHENOTYPINS 620 620

1636 VIRAL ISOLATION (R.V.F) VIRAL ISOLATION (R.V.F) 830 830

1637 SEROLOGY IGG & IGM (R.V.F) SEROLOGY IGG & IGM (R.V.F) 415 415

1638 CORTISOL (24 H URINE) CORTISOL (24 H URINE) 300 300

1639 FOOD PANEL FOOD PANEL 1000 1000

1640 FREE TESTOSTERONE FREE TESTOSTERONE 250 300

1641 ESTRIOL (S,U) ESTRIOL (S,U) 250 300

1642 DIPHENYLHYDANTOIN (EAPNOT) LEVL @ DIPHENYLHYDANTOIN (EAPNOT) LEVL @ 500 500

1643 HPL (HUMAN PLACENTA LACTOGEN) (S)@ HPL (HUMAN PLACENTA LACTOGEN) (S)@ 430 430

1644 DENGUE FEVER VIRAL ISOLATION DENGUE FEVER VIRAL ISOLATION 750 750

1645 DENGUE FEVER IGG DENGUE FEVER IGG 750 750

1646 DENGUE FEVER IGM DENGUE FEVER IGM 750 750

1647 B-HCG (S) # B-HCG (S) # 180 300

1648 CORTISOL AM/PM CORTISOL AM/PM 200 300

1649 HGH (S) HGH (S) 300 300

1650 PRO INSULIN PRO INSULIN 300 300

1651 INSULIN ANTIBODIES (IGG) & (IGM) (S) @ INSULIN ANTIBODIES (IGG) & (IGM) (S) @ 850 850

1652 IVF HORMONAL ASSAY PROFILE IVF HORMONAL ASSAY PROFILE 1600 1600

1653 HEPATITIS DELTA ABS HEPATITIS DELTA ABS 450 450

1654 LEGIONELLA ABS LEGIONELLA ABS 1950 1950

1655 PROFILE 4 (OVARIAN INSUF. SEC) PROFILE 4 (OVARIAN INSUF. SEC) 1300 1300

1656 GONOCOCCAL ANTIBODIES (S) @ GONOCOCCAL ANTIBODIES (S) @ 430 430

1657 CML CML 4800 4800

1658 TREPONEMAL ABS (S) @ TREPONEMAL ABS (S) @ 460 460

1659 ALDOSTERONE (P,U) @ ALDOSTERONE (P,U) @ 890 890

1660 GLUTAMINE - (CSF) GLUTAMINE - (CSF) 320 320

1661 IMMUNOFIXATION (S,U,CSF) @ IMMUNOFIXATION (S,U,CSF) @ 890 890

1662 V.M.A. (U) @ V.M.A. (U) @ 450 450

1663 5-HIAA (U) 5-HIAA (U) 450 450

1664 17 KETOSTEROIDS (U) @ 17 KETOSTEROIDS (U) @ 980 980

1665 THYREOGLOBULIN ABS @ (S) THYREOGLOBULIN ABS @ (S) 290 290

1666 IG. -M QUANT (S.CSF) IG. -M QUANT (S.CSF) 250 250

1667 IG.-A QUANT (S.CSF) IG.-A QUANT (S.CSF) 250 250

1668 IG. -D QUANT (S. CSF) @ IG. -D QUANT (S. CSF) @ 225 225

1669 IG.-E QUALITATIVE (S) IG.-E QUALITATIVE (S) 415 415

1670 IG. -G QUANT (S.CSF) IG. -G QUANT (S.CSF) 415 415

1671 HERPES VIRUS IGM SPC. ABS HERPES VIRUS IGM SPC. ABS 750 750

Page 7

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1672 MAST TEST MAST TEST 2800 2800

1673 GALACTOSE (S) @ GALACTOSE (S) @ 745 745

1674 RENIN (S) @ RENIN (S) @ 730 730

1675 BARBITURATES (S) BARBITURATES (S) 500 500

1676 HEROIN (U) HEROIN (U) 400 400

1677 HEROIN (S) HEROIN (S) 400 400

1678 OPIATES (U) OPIATES (U) 400 400

1679 BENZODIAZIPINES (U) BENZODIAZIPINES (U) 400 400

1680 17-HYDROXY PROGESTERONE (S) @ 17-HYDROXY PROGESTERONE (S) @ 700 700

1681 PKU SCREENING (Microbiological) PKU SCREENING (Microbiological) 205 205

1682 PRE-OP I <18Y:CBC,FBS,HEP B/C,HIV PRE-OP I <18Y:CBC,FBS,HEP B/C,HIV 1080 1080

1683 PRE-OP<35Y:CBC,FBS,HEP B/C,HIV,S.CREA,SGPT PRE-OP<35Y:CBC,FBS,HEP B/C,HIV,S.CREA,SGPT 1080 1080

1684 PRE- OP:CBC,FBS,HEP,HIV,S.CREA,SGPT,ECG,CX PRE- OP:CBC,FBS,HEP,HIV,S.CREA,SGPT,EC G,CX 1080 1080

1685 CHROMOSOME ANALYSIS (A.F.) CHROMOSOME ANALYSIS (A.F.) 4800 4800

1686 DENGUE NSI AG DENGUE NSI AG 450 450

1687 CHICKUNGUNYA - IGM CHICKUNGUNYA - IGM 420 420

1688 ANTICARDIOLIPIN IGM ABS@ ANTICARDIOLIPIN IGM ABS@ 1000 1000

1689 CRYOGLOBULINS CRYOGLOBULINS 210 210

1690 HAPTOGLOBIN (S) @ HAPTOGLOBIN (S) @ 350 350

1691 TRANSFEERIN (S) TRANSFEERIN (S) 640 640

1692 ALDOLASE (S) ALDOLASE (S) 320 320

1693 MYOGLOBIN QUANT. (S) @ MYOGLOBIN QUANT. (S) @ 520 520

1694 MYOGLOBIN (U) MYOGLOBIN (U) 560 560

1695 CALCITONIN (S) CALCITONIN (S) 300 300

1696 CATECHOLAMINES (P/S) @ CATECHOLAMINES (P/S) @ 1650 1650

1697 11-DEOXYCORTISOL (S) @ 11-DEOXYCORTISOL (S) @ 750 750

1698 17-OH-PROGESTERONE (S) @ 17-OH-PROGESTERONE (S) @ 750 750

1699 17-HYDROXYCORTICOSTEROIDS (S) @ 17-HYDROXYCORTICOSTEROIDS (S) @ 480 480

1700 17-KETOSTERIODS FRACTIONATION @ 17-KETOSTERIODS FRACTIONATION @ 1450 1450

1701 17-KETOSTERIODS (U) @ 17-KETOSTERIODS (U) @ 475 475

1702 5-NUCLEOTIDASE (S) @ 5-NUCLEOTIDASE (S) @ 415 415

1703 ACETYLCHOLINE RECEPTOR ABS (S) @ ACETYLCHOLINE RECEPTOR ABS (S) @ 1650 1650

1704 ACETYLCHOL INSETERASE (S) @ ACETYLCHOL INSETERASE (S) @ 270 270

1705 ADENO VIRUS ABS (S, CSF) @ ADENO VIRUS ABS (S, CSF) @ 210 210

1706 ADENOSINE 3,5, MONOPHOSPHATE (S) @ ADENOSINE 3,5, MONOPHOSPHATE (S) @ 430 430

1707 ADRENAL CORTEX ABS @ ADRENAL CORTEX ABS @ 520 520

1708 ALKALINE (LENCOCYTE) PHOSPHATASE ALKALINE (LENCOCYTE) PHOSPHATASE 580 580

1709 ALKALINE PHOSPHATASE ISOENZYM (S) @ ALKALINE PHOSPHATASE ISOENZYM (S) @ 1550 1550

1710 ALPHA-1-ANTI-TRYPSIN (S) @ ALPHA-1-ANTI-TRYPSIN (S) @ 220 290

1711 ALPHA-1-GLYCOPROTEIN (S) @ ALPHA-1-GLYCOPROTEIN (S) @ 150 190

1712 ALPHA-2-MACROGLOBULIN (S) @ ALPHA-2-MACROGLOBULIN (S) @ 160 190

1713 ALUMINUM (S) @ ALUMINUM (S) @ 560 560

1714 AMINO ACID QUANT(P,U) @ AMINO ACID QUANT(P,U) @ 1650 1650

Page 8

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1715 AMINO ACID SCREEN QUAL (P,U) @ AMINO ACID SCREEN QUAL (P,U) @ 370 370

1716 AMITRYPTALINE @ AMITRYPTALINE @ 750 750

1717 AMOEBIC ABS IHA @ AMOEBIC ABS IHA @ 250 250

1718 ANCA-C AND ANCA-P @ ANCA-C AND ANCA-P @ 960 960

1719 ANDROSTENEDIONE (S) @ ANDROSTENEDIONE (S) @ 830 830

1720 ANGIOTENSION-1-CONVERTING (S) @ ANGIOTENSION-1-CONVERTING (S) @ 700 700

1721 ANTIBODY SCREEN ANTIBODY SCREEN 1045 200

1722 ANTISTREPTOKINASE @ ANTISTREPTOKINASE @ 270 270

1723 ANTITHROMBIN III @ ANTITHROMBIN III @ 520 520

1724 ANTI-ENA ABS (INCL. ANTI RNP) @ ANTI-ENA ABS (INCL. ANTI RNP) @ 845 845

1725 ANTI-HAV SCREEN @ ANTI-HAV SCREEN @ 350 350

1726 ANTI-HYALURONIDASE (STREPTOCO) @ ANTI-HYALURONIDASE (STREPTOCO) @ 185 185

1727 ANTI RNA ABS @ ANTI RNA ABS @ 280 280

1728 ANTI-STAPHYLOLYSIN ANTI-STAPHYLOLYSIN 190 190

1729 APOLIPOPROTEIN AI (S) @ APOLIPOPROTEIN AI (S) @ 350 350

1730 APOLIPOPROTEIN AII (S) @ APOLIPOPROTEIN AII (S) @ 650 650

1731 ARSENIC @ (S) ARSENIC @ (S) 830 830

1732 BASAL MEMBRANE ABS/BASEMENT @ BASAL MEMBRANE ABS/BASEMENT @ 620 620

1733 BETA 2-MICROGLOBULIN (S,U) @ BETA 2-MICROGLOBULIN (S,U) @ 560 560

1734 BILE DUCT ABS (CANAL) @ BILE DUCT ABS (CANAL) @ 410 410

1735 BILE DUCT ABS (EPITHELIA) @ BILE DUCT ABS (EPITHELIA) @ 410 410

1736 BILHARZIA (SCHISTOSOMA) ABS BILHARZIA (SCHISTOSOMA) ABS 410 410

1737 BISMUTH @ BISMUTH @ 1620 1620

1738 BORDATELLA PETUSSIS (WHOOPING @ BORDATELLA PETUSSIS (WHOOPING @ 810 810

1739 BRUCELLA (IGG + IGM) @ BRUCELLA (IGG + IGM) @ 600 600

1740 BRUCELLA ABS @ BRUCELLA ABS @ 600 600

1741 CI-ESTERASE DECAY @ CI-ESTERASE DECAY @ 660 660

1742 CI-ESTERASE INHIBITOR @ CI-ESTERASE INHIBITOR @ 660 660

1743 CA 12-5 (TUMOUR MARKER) (S) CA 12-5 (TUMOUR MARKER) (S) 350 700

1744 CARBOXY-HAEMOGLOBIN @ (B) CARBOXY-HAEMOGLOBIN @ (B) 210 210

1745 BRUCELLA IGM BRUCELLA IGM 600 600

1746 EPSTEIN BARR VIRUS (PCR)@ EPSTEIN BARR VIRUS (PCR)@ 1700 1700

1747 CERULOPLASMIN (S) @ CERULOPLASMIN (S) @ 225 225

1748 C 100 COMPLEMENT @ C 100 COMPLEMENT @ 450 450

1749 CHLAMYDIA PLT (PSITTACOSIS) @ CHLAMYDIA PLT (PSITTACOSIS) @ 235 235

1750 CHROMOSOME ANALYSIS (B) @ CHROMOSOME ANALYSIS (B) @ 3350 3350

1751 CHROMOSOME ANALYSIS (B.M.) @ CHROMOSOME ANALYSIS (B.M.) @ 4770 4770

1752 COMPLEMENT-C3 COMPONENT COMPLEMENT-C3 COMPONENT 450 450

1753 COMPLEMENT-C4 COMPONENT COMPLEMENT-C4 COMPONENT 450 450

1754 CYSTICERCOSIS ABS(TAENIA ABS) @ CYSTICERCOSIS ABS(TAENIA ABS) @ 750 750

1755 DELTA AMINOLAEVULINIC @ DELTA AMINOLAEVULINIC @ 370 370

1756 ECHINOCOCCUS ABS CF + IHA @ ECHINOCOCCUS ABS CF + IHA @ 700 700

1757 FACTOR II-IMUTATION (PROTROMBIN) FACTOR II-IMUTATION (PROTROMBIN) 1970 1970

1758 ENTEROVIRUS @ ENTEROVIRUS @ 335 335

1759 EPSTEIN BARR VIRUS ABS (IGM + @ EPSTEIN BARR VIRUS ABS (IGM + @ 700 700

Page 9

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1760 ESTROGEN/PROGESTERON RECEPTOR @ ESTROGEN/PROGESTERON RECEPTOR @ 1700 1700

1761 FACTOR 2 @ FACTOR 2 @ 450 450

1762 FACTOR 5 @ FACTOR 5 @ 450 450

1763 FACTOR 7 FACTOR 7 450 450

1764 FACTOR 8 ASSAY FACTOR 8 ASSAY 450 450

1765 FACTOR 8 ASSCIATED AG @ FACTOR 8 ASSCIATED AG @ 450 450

1766 FACTOR 8 INHIBITOR @ FACTOR 8 INHIBITOR @ 450 450

1767 FACTOR 8 RISTOCETIN COFACTOR @ FACTOR 8 RISTOCETIN COFACTOR @ 450 450

1768 FACTOR 9 ASSAY FACTOR 9 ASSAY 450 450

1769 FACTOR 10 FACTOR 10 450 450

1770 FACTOR 11 @ FACTOR 11 @ 450 450

1771 FACTOR 12 @ FACTOR 12 @ 450 450

1772 FACTOR 13 @ FACTOR 13 @ 450 450

1773 PROTINE - C PROTINE - C 450 450

1774 FILARIASIS ABS IFT @ FILARIASIS ABS IFT @ 150 150

1775 PROTINE - S PROTINE - S 450 450

1776 FUNGUS SEROLOGY @ FUNGUS SEROLOGY @ 350 350

1777 FRUCTOSAMINE @ FRUCTOSAMINE @ 810 810

1778 GASTRIC ABS @ GASTRIC ABS @ 560 560

1779 HBV DNA (PCR) @ HBV DNA (PCR) @ 1700 1700

1780 HEMOLYSIN @ HEMOLYSIN @ 415 415

1781 HEMOSIDERIN @ HEMOSIDERIN @ 290 290

1782 HEPATITIS A ANTIGEN ANTI-HAV @ HEPATITIS A ANTIGEN ANTI-HAV @ 350 350

1783 HERPES CULTURE @ HERPES CULTURE @ 450 450

1784 HERPES PROFILE (INC. I/II IGG) @ HERPES PROFILE (INC. I/II IGG) @ 720 720

1785 HLA ABS@ HLA ABS@ 1450 1450

1786 HLA B27 @ HLA B27 @ 1950 1950

1787 HLA FULL TYPING (A,B+C) @ HLA FULL TYPING (A,B+C) @ 5600 5600

1788 HLA FULL TYPING (A,B,C+DR) @ HLA FULL TYPING (A,B,C+DR) @ 8500 8500

1789 INFLUENZA A @ INFLUENZA A @ 190 190

1790 INFLUENZA B @ INFLUENZA B @ 190 190

1791 INTRINSIC ABS FACTOR @ INTRINSIC ABS FACTOR @ 640 640

1792 ISLET CELL ABS @ ISLET CELL ABS @ 500 500

1793 IGM (CSF) @ IGM (CSF) @ 250 250

1794 LEISHMANIA IF & IHA @ LEISHMANIA IF & IHA @ 1225 1225

1795 I.U.I LAB I.U.I LAB 415 415

1796 LEPTOSPIRA ABS @ LEPTOSPIRA ABS @ 1180 1180

1797 LEUCOCYTE / ABS @ LEUCOCYTE / ABS @ 1560 1560

1798 LIPOPROTEIN X @ LIPOPROTEIN X @ 320 320

1799 LISTERIA ABS @ LISTERIA ABS @ 640 640

1800 LIVER MEMBRANCE ABS @ LIVER MEMBRANCE ABS @ 670 670

1801 ATOBY PANEL 20 ATOBY PANEL 20 1600 1600

1802 LYSOZYME (S,U) @ LYSOZYME (S,U) @ 225 225

1803 MALARIA ABS @ MALARIA ABS @ 150 150

1804 MANGANESE @ MANGANESE @ 830 830

Page 10

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1805 MEASLES ABS TITRE @ MEASLES ABS TITRE @ 750 750

1806 MELANIN SCREEN @ MELANIN SCREEN @ 210 210

1807 METHAEMOGLOBIN @ METHAEMOGLOBIN @ 560 560

1808 MITOCHONDRIAL ABS+ANTI-SMOOTH @ MITOCHONDRIAL ABS+ANTI-SMOOTH @ 830 830

1809 MONONUCLEOSIS ABS(EPSTEIN BR) @ MONONUCLEOSIS ABS(EPSTEIN BR) @ 2700 2700

1810 MUMPS VIRUS ABS (IGG + IGM) @ MUMPS VIRUS ABS (IGG + IGM) @ 670 670

1811 MYCOPLASMA PNEUMONIAE ABS @ MYCOPLASMA PNEUMONIAE ABS @ 270 270

1812 NSE (NEURONE SPECIFIC ENOLASE) NSE (NEURONE SPECIFIC ENOLASE) 960 960

1813 PARAINFLUENZA 9 TYPE 1,2,3 @ PARAINFLUENZA 9 TYPE 1,2,3 @ 850 850

1814 PARIETAL CELL ABS @ PARIETAL CELL ABS @ 350 350

1815 PORPHYRINS IN ERTHROCYTES @ PORPHYRINS IN ERTHROCYTES @ 480 480

1816 PORPHYRINS IN URINE @ PORPHYRINS IN URINE @ 2070 2070

1817 LIVER KIDNEY MICROSOMAL ABS @ LIVER KIDNEY MICROSOMAL ABS @ 960 960

1818 PTH-C (44-68) PARATHORMONE (S) @ PTH-C (44-68) PARATHORMONE (S) @ 1350 1350

1819 SEROTONIN (S) @ SEROTONIN (S) @ 525 525

1820 SMOOTH MUSCLE ABS (INC. MITO) - @ SMOOTH MUSCLE ABS (INC. MITO) - @ 415 415

1821 SOMATOSTATIN-C (S) @ SOMATOSTATIN-C (S) @ 1640 1640

1822 STRIATED MUSCLE ABS @ STRIATED MUSCLE ABS @ 415 415

1823 THYROGLOBULIN (S) @ THYROGLOBULIN (S) @ 670 670

1824 TOTAL COMPLEMENT/C-50 TOTAL COMPLEMENT/C-50 450 450

1825 TOXOCARA ABS IGG TOXOCARA ABS IGG 475 475

1826 VARICELLA ZOSTER (CF + IGG+IGM) @ VARICELLA ZOSTER (CF + IGG+IGM) @ 750 750

1827 VITAMIN A (RETINOL) @ VITAMIN A (RETINOL) @ 700 700

1828 VITAMIN D VITAMIN D 300 700

1829 VITAMIN C (ASCORBIC ACID) @ VITAMIN C (ASCORBIC ACID) @ 300 700

1830 CALCITRIOL CALCITRIOL 300 700

1831 CALCIDIOL @ CALCIDIOL @ 700 700

1832 VITAMIN E (ALPHA TOCOPHEROL) @ VITAMIN E (ALPHA TOCOPHEROL) @ 300 700

1833 FREE PROSTATE SPECIFIC ANTIGEN (S) FREE PROSTATE SPECIFIC ANTIGEN (S) 350 350

1834 PROGESTERONE RECEPTORS (INC.) @ PROGESTERONE RECEPTORS (INC.) @ 1700 1700

1835 PRENATAL PROFILE PRENATAL PROFILE 1600 1600

1836 PROFILE TORCH PROFILE TORCH 1000 1100

1837 CHEMISTRY FOR DIABETES CHEMISTRY FOR DIABETES 255 255

1838 ADENOSIME DEAMINASE ADENOSIME DEAMINASE 1970 1970

1839 HVA HOMOVANILLIC HVA HOMOVANILLIC 355 355

1840 NEURON SPECIFIC ENOLASE NEURON SPECIFIC ENOLASE 975 975

1841 IMMUNOGLOBIN PROFILE IMMUNOGLOBIN PROFILE 1900 1900

1842 CYCLOSPORINE C.2. LEVEL CYCLOSPORINE C.2. LEVEL 2250 2250

1843 VAGINAL PANEL VAGINAL PANEL 350 350

1844 BONE PROFILE BONE PROFILE 1110 1110

1845 FOOD ALLERGY PROFILE FOOD ALLERGY PROFILE 1000 1000

1846 TOBRAMYCIN (S) TOBRAMYCIN (S) 750 750

1847 NEONATAL PROFILE NEONATAL PROFILE 620 620

1848 AMIKACIN (S) AMIKACIN (S) 520 520

1849 CA 549 CA 549 500 700

1850 CYFRA 21-1 CYFRA 21-1 700 700

Page 11

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1851 NSE NSE 450 450

1852 SCC SCC 890 890

1853 OSTEOCALCIN OSTEOCALCIN 1900 1900

1854 FUNGUL STAINING FUNGUL STAINING 250 250

1855 FINE NEEDLE ASPIRATION CYTOLGY FINE NEEDLE ASPIRATION CYTOLGY 900 1100

1856 TWO DIFFERENT SPECIMENS TWO DIFFERENT SPECIMENS 1700 1700

1857 PHILADELPHIA CHROMOSOME PHILADELPHIA CHROMOSOME 6210 6210

1858 TINY SPECIMEN TINY SPECIMEN 520 520

1859 CYTOLOGY NON GYNE CYTOLOGY NON GYNE 700 700

1860 CYTOLOGY GYNE CYTOLOGY GYNE 700 700

1861 HISTOPATHOLOGY BIOPSY (SMALL) HISTOPATHOLOGY BIOPSY (SMALL) 1200 1200

1862 HISTOPATHOLOGY BIOPSY (LARGE) HISTOPATHOLOGY BIOPSY (LARGE) 2000 2000

1863 SMALL SPECIMEN SMALL SPECIMEN 1200 1200

1864 HISTOPATHOLOGY BIOPSY FROZEN SECTION HISTOPATHOLOGY BIOPSY FROZEN SECTION 1200 1200

1865 IMMUNO-HISTOCHIMESTRY STUDY IMMUNO-HISTOCHIMESTRY STUDY 1100 1100

1866 BONE MARROW ASPIRATE BONE MARROW ASPIRATE 2070 2070

1867 IMUGARD III (LUCOCYTE REMOVAL FILTER) IMUGARD III (LUCOCYTE REMOVAL FILTER) 370 370

1868 UNIT DONOR SCREEN UNIT DONOR SCREEN 320 320

1869 فحص فصيلة الدم فحص فصيلة الدم 40 100

1870 TINY SPECIMEN TINY SPECIMEN 525 525

1871 PLATELET CONCENTRATE W/O DONOR PLATELET CONCENTRATE W/O DONOR 2500 2500

1872 BLOOD CROSS MATCHING BLOOD CROSS MATCHING 280 350

1873 PLATELET CONCENTRATE W/ DONOR PLATELET CONCENTRATE W/ DONOR 3500 3500

1874 PLATELET APHRESIS WITH DONOR PLATELET APHRESIS WITH DONOR 3500 3500

1875 PLASMA PER UNIT PLASMA PER UNIT 2000 2000

1876 BLOOD ALL POSITIVE GROUPS/UNIT BLOOD ALL POSITIVE GROUPS/UNIT 2000 2000

1877 THERAPEUTIC APHERESIS THERAPEUTIC APHERESIS 6500 6500

1878 BLOOD O-VE PER UNIT BLOOD O-VE PER UNIT 2000 2000

1879 BLOOD WITHOUT DONOR BLOOD WITHOUT DONOR 2000 2000

1880 BLOOD DONOR SCREENING BLOOD DONOR SCREENING 1600 1600

1881 CRYO PRECIPITATE UNIT CRYO PRECIPITATE UNIT 1600 1600

1882 THERAPUTIC PLASMA EXCHANGE THERAPUTIC PLASMA EXCHANGE 10350 10350

1883 AUTALOGOUS BLOOD TRANSFUSION AUTALOGOUS BLOOD TRANSFUSION 1100 1100

1884 THERAPUTIC PLASMA EXCHANGE (ICU) THERAPUTIC PLASMA EXCHANGE (ICU) 6500 6500

1885 FRESH FROZEN PLASMA W/DONOR FRESH FROZEN PLASMA W/DONOR 2000 2000

1886 PLATELET CONCENTRATE PLATELET CONCENTRATE 2000 2000

1887 FRESH FROZEN PLASMA W/O DONOR FRESH FROZEN PLASMA W/O DONOR 2000 2000

1888 GLUCOSE, FASTING (S) FBS GLUCOSE, FASTING (S) FBS 40 100

1889 BLOOD GLUCOSE, 2 H.P.P. BLOOD GLUCOSE, 2 H.P.P. 80 100

1890 GLUCOSE - RANDOM (S) RBS GLUCOSE - RANDOM (S) RBS 40 100

1891 GLUCOSE TOLERANCE TEST(GTT) GLUCOSE TOLERANCE TEST(GTT) 250 350

1892 H.D.L. CHOLESTEROL (S) H.D.L. CHOLESTEROL (S) 100 150

1893 L.D.L. CHOLESTEROL (S) L.D.L. CHOLESTEROL (S) 100 150

1894 CHOLESTEROL (TOTAL) (S) CHOLESTEROL (TOTAL) (S) 65 100

1895 GAMMA GT. (S) GAMMA GT. (S) 130 130

Page 12

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1896 TRIGLYCERIDES (S) TRIGLYCERIDES (S) 70 100

1897 LDH (S) LDH (S) 160 180

1898 CPK (S) CPK (S) 200 200

1899 UREA (S) UREA (S) 50 130

1900 GLOBULINS (S) GLOBULINS (S) 130 130

1901 URIC ACID (S) URIC ACID (S) 50 130

1902 CREATININE (S) CREATININE (S) 50 100

1903 SODIUM (S) SODIUM (S) 50 100

1904 POTASSIUM (S) POTASSIUM (S) 50 100

1905 CHLORIDE (S) CHLORIDE (S) 50 100

1906 CARBON DIOXIDE (S) CARBON DIOXIDE (S) 255 255

1907 ACID PHOSPHATASE (S) ACID PHOSPHATASE (S) 190 190

1908 IONIZED CALCIUM (S) IONIZED CALCIUM (S) 350 350

1909 CALCIUM SERUM CALCIUM SERUM 50 100

1910 INORGANIC PHOSPHATE (S) INORGANIC PHOSPHATE (S) 130 130

1911 IRON (S) IRON (S) 60 150

1912 IRON-BINDING CAPACITY (S) IRON-BINDING CAPACITY (S) 180 180

1913 MAGNESIUM (S) MAGNESIUM (S) 100 150

1914 BILIRUBIN DIRECT (B) BILIRUBIN DIRECT (B) 65 130

1915 BILIRUBIN TOTAL (B) BILIRUBIN TOTAL (B) 65 130

1916 TOTAL PROTEINS (S) TOTAL PROTEINS (S) 65 130

1917 ALBUMIN (S) ALBUMIN (S) 60 130

1918 ALKALINE PHOSPHATASE (S) ALKALINE PHOSPHATASE (S) 80 130

1919 ALKALINE PHOSPHATASE (S) ALKALINE PHOSPHATASE (S) 55 130

1920 S.G.O.T (AST) (S) S.G.O.T (AST) (S) 50 150

1921 S.G.P.T. (ALT) (S) S.G.P.T. (ALT) (S) 50 150

1922 AMYLASE (S) AMYLASE (S) 90 150

1923 LIPASE (S) LIPASE (S) 90 150

1924 OSMOLALITY (S) OSMOLALITY (S) 350 350

1925 PROTEIN ELECTROPHORESIS (S) PROTEIN ELECTROPHORESIS (S) 450 450

1926 AMMONIA (P) AMMONIA (P) 335 335

1927 HEMOGLOBIN ELECTROPHOR. QUALIT (B) HEMOGLOBIN ELECTROPHOR. QUALIT (B) 450 450

1928 HBA1C (B) HBA1C (B) 120 250

1929 RENAL STONE ANALYSIS RENAL STONE ANALYSIS 350 350

1930 BLOOD GASES (B) BLOOD GASES (B) 400 400

1931 C-REACTIVE PROTEIN (QUANT) C-REACTIVE PROTEIN (QUANT) 300 300

1932 LACTATE LACTATE 415 415

1933 MICROALBUMIN / CREATININE IN URINE MICROALBUMIN / CREATININE IN URINE 250 250

1934 MICRO-ALBUMINURIA (U) MICRO-ALBUMINURIA (U) 250 250

1935 50G-GLUCOSE CHALLENGETEST # # 50G-GLUCOSE CHALLENGETEST # # 100 100

1936 GLUCOSE POST PRANDIAL (50 mg) GLUCOSE POST PRANDIAL (50 mg) 100 100

1937 GLUCOSE POST PRANDIAL (+75 GRAMS) GLUCOSE POST PRANDIAL (+75 GRAMS) 100 100

1938 RENAL PROFILE RENAL PROFILE 960 960

1939 CKMB (S) CKMB (S) 150 200

1940 FERRITIN (S) FERRITIN (S) 160 525

Page 13

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1941 HOMOCYSTEINE (S) HOMOCYSTEINE (S) 750 750

1942 D-DIMER D-DIMER 300 700

1943 R.P.R. QUANTITATIVE (S) R.P.R. QUANTITATIVE (S) 100 120

1944 TROPONIN-I TROPONIN-I 220 420

1945 ANTI-TG (ANTI-THYROGLOBIN) ANTI-TG (ANTI-THYROGLOBIN) 420 420

1946 C A 125 (S) C A 125 (S) 350 700

1947 CA 19-9 (S) CA 19-9 (S) 350 700

1948 CEA (S) CEA (S) 350 700

1949 BLOOD SUGAR BY ONE TOUCH BLOOD SUGAR BY ONE TOUCH 100 100

1950 C-PEPTIDE (S) C-PEPTIDE (S) 300 450

1951 FOLIC ACID (FOLATE) (S/B) @ FOLIC ACID (FOLATE) (S/B) @ 200 250

1952 VITAMIN B12 (B/S) @ VITAMIN B12 (B/S) @ 300 700 0

1953 FREE - T4 FREE - T4 150 300

1954 T4-FREE (S) T4-FREE (S) 200 300

1955 T3 - TOTAL (S) T3 - TOTAL (S) 200 300

1956 T3 - FREE (S) (FT3) T3 - FREE (S) (FT3) 150 300

1957 FT4 FT4 200 300

1958 T.S.H. (S) T.S.H. (S) 180 300

1959 PROLACTIN (S) PROLACTIN (S) 170 300

1960 F.S.H. (S) F.S.H. (S) 200 300

1961 L.H. (S) L.H. (S) 200 300

1962 PROGESTERONE (S) PROGESTERONE (S) 150 300

1963 ESTRADIOL (E2) ESTRADIOL (E2) 150 300

1964 TESTOSTERONE (S) TESTOSTERONE (S) 200 300

1965 TOTAL AND FREE TESTOSTERONE TOTAL AND FREE TESTOSTERONE 200 300

1966 B-HCG QUANTITATIVE (S) # B-HCG QUANTITATIVE (S) # 220 300

1967 B-HCG QUALITATIVE (S) # B-HCG QUALITATIVE (S) # 220 300

1968 A.C.T.H., INTACT (S) A.C.T.H., INTACT (S) 200 300

1969 CORTISOL AM (S) CORTISOL AM (S) 200 300

1970 CORTISOL PM (S) CORTISOL PM (S) 200 300

1971 INSULIN (S) @ INSULIN (S) @ 450 450

1972 THYROID MICROSOMAL ABS THYROID MICROSOMAL ABS 225 225

1973 DHEA-S (S) @ DHEA-S (S) @ 2000 2000

1974 PTH INTACT (S) @ PTH INTACT (S) @ 1450 1450

1976 HEMOGLOBIN % (B) HEMOGLOBIN % (B) 90 90

1977 RETICULOCYTE COUNT (B) RETICULOCYTE COUNT (B) 100 100

1978 E.S.R. (B) (ESR) E.S.R. (B) (ESR) 50 70

1979 BLEEDING TIME (B) BLEEDING TIME (B) 50 70

1980 CLOTTING TIME (B) CLOTTING TIME (B) 50 70

1981 PROTHROMBIN TIME (B) PROTHROMBIN TIME (B) 120 170

1982 PARTIAL THROMBOPLAST.TIME(PTT) (B) PARTIAL THROMBOPLAST.TIME(PTT) (B) 120 170

1983 BLOOD FILM FOR MALARIA BLOOD FILM FOR MALARIA 150 150

1984 BLOOD FILM FOR MORPHOLOGY (B) BLOOD FILM FOR MORPHOLOGY (B) 145 145

1985 L.E. CELLS (B) L.E. CELLS (B) 150 150

1986 SICKLING SCREEN TEST SICKLING SCREEN TEST 100 150

1987 G.6.P.D. QUANTITATIVE ESTIMATN (B) G.6.P.D. QUANTITATIVE ESTIMATN (B) 280 280

Page 14

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1988 FIBRINOGEN (B) FIBRINOGEN (B) 250 350

1989 V.D.R.L. (S) V.D.R.L. (S) 100 130

1990 V.D.R.L. QUANTITATIVE (S) V.D.R.L. QUANTITATIVE (S) 70 130

1991 SALMOMELLA, ANTIB AGGLUTIN. TEST SALMOMELLA, ANTIB AGGLUTIN. TEST 500 500

1992 A.S.O. A.S.O. 250 250

1993 COOMB'S TEST (DIRECT) COOMB'S TEST (DIRECT) 140 140

1994 COOMB'S TEST (INDIRECT) COOMB'S TEST (INDIRECT) 100 140

1995 Rh Antibody Titer Rh Antibody Titer 100 100

1996 ABO RH GROUPING ABO RH GROUPING 60 100

1997 PARVOVIRUS B-19 ABS PARVOVIRUS B-19 ABS 450 450

1998 COAGULATION STUDY COAGULATION STUDY 1090 1090

1999 TOTAL AND FREE PSA TOTAL AND FREE PSA 350 350

2000 FOOD IgG ANTIBODY TEST FOOD IgG ANTIBODY TEST 1600 1601

2002 H. PYLORI IGG (S) H. PYLORI IGG (S) 300 450

2003 RSV-RESPIRATORY SYNCYTIAL VIRS (S) RSV-RESPIRATORY SYNCYTIAL VIRS (S) 320 320

2004 BILIRUBIN (U) BILIRUBIN (U) 90 90

2005 DENGUE ABS (IGG & IGM) DENGUE ABS (IGG & IGM) 750 750

2006 SYPHILIS CONFIRM TEST (VDRL) SYPHILIS CONFIRM TEST (VDRL) 170 170

2007 MONOTEST, LATEX (S) MONOTEST, LATEX (S) 140 140

2008 BRUCELLA, LATEX (S) BRUCELLA, LATEX (S) 150 260

2009 RHEUMATOID, LATEX RHEUMATOID, LATEX 200 200

2010 CMV IGG (S) CMV IGG (S) 400 400

2011 CMV IGM (S) CMV IGM (S) 400 400

2012 HEV ABS (S) HEV ABS (S) 450 450

2013 TOXOPLASMA-IGG (S) TOXOPLASMA-IGG (S) 130 260

2014 TOXOPLASMA - IGM (S) TOXOPLASMA - IGM (S) 130 460

2015 HIV Ag / Ab HIV Ag / Ab 280 350

2016 RUBELLA SCREEN IG-G RUBELLA SCREEN IG-G 180 260

2017 RUBELLA SCREEN IG-M RUBELLA SCREEN IG-M 180 300

2018 HEPATITIS BS ANTIGENS (S) # HEPATITIS BS ANTIGENS (S) # 180 260

2019 HEPATITIS BS ANTIBODY (S) # HEPATITIS BS ANTIBODY (S) # 180 260

2020 HEPATITIS BE ANTIGEN (S) HEPATITIS BE ANTIGEN (S) 180 260

2021 HEPATITIS BE ANTIBODY (S) HEPATITIS BE ANTIBODY (S) 180 260

2022 HEPATITIS BC IGM (S) HEPATITIS BC IGM (S) 450 450

2023 HEPATITIS BC ANTIBODY (S) # HEPATITIS BC ANTIBODY (S) # 260 260

2024 HEPATITIS A IGM ANTIBODY HEPATITIS A IGM ANTIBODY 450 450

2025 HEPATITIS C ANTIBODIES (S) HEPATITIS C ANTIBODIES (S) 450 450

2026 PROTEIN-C PROTEIN-C 450 450

2027 PROTEIN-S PROTEIN-S 450 450

2028 KARYOTYPING KARYOTYPING 2700 2700

2029 CELIAG Abs CELIAG Abs 2500 2500

2030 ENDOMYCIUM Abs ENDOMYCIUM Abs 2300 2300

2031 CLIADINE Ab CLIADINE Ab 1100 1100

2032 IMMUNOPHENOTYPING (CLL) IMMUNOPHENOTYPING (CLL) 10350 10350

2033 HERPES PCR HERPES PCR 1700 1700

2034 TB PCR TB PCR 6250 6250

Page 15

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2035 RENAL BIOPSY RENAL BIOPSY 7250 7250

2036 ANTICENTROMENE ANTICENTROMENE 620 620

2037 CRYTOCOCCUS Ag CRYTOCOCCUS Ag 730 730

2038 A N A (S) @ A N A (S) @ 480 480

2039 ANTICARDIOLIPIN ABS IGG@ ANTICARDIOLIPIN ABS IGG@ 1010 1010

2040 ANTI-DS-DNA ABS ANTI-DS-DNA ABS 620 620

2041 CHLAMYDIA ABS (IGG, IGM) (S) @ CHLAMYDIA ABS (IGG, IGM) (S) @ 2250 2250

2042 EBV - IGM EBV - IGM 700 700

2043 HEPATITIS B VIRUS DNA/PCR QT @ HEPATITIS B VIRUS DNA/PCR QT @ 1700 1700

2044 HEPATITIS C VIRUS (RNA) QUALIT @ HEPATITIS C VIRUS (RNA) QUALIT @ 1700 1700

2045 HERPES PROFILE HERPES PROFILE 1700 1700

2046 IGE, QUANT (S,CSF) IGE, QUANT (S,CSF) 420 420

2047 LUPUS TYPE ANTICOAGULANT @ LUPUS TYPE ANTICOAGULANT @ 1350 1350

2048 HEPATITIS B VIRUS DNA/PCR (QL) @ HEPATITIS B VIRUS DNA/PCR (QL) @ 1700 1700

2049 HEPATITIS C VIRUS RNA(QUANT)@ HEPATITIS C VIRUS RNA(QUANT)@ 1700 1700

2050 ANTI DNASE ANTI DNASE 620 620

2051 PHILADELPHIA CHROMOSOME QUALI PHILADELPHIA CHROMOSOME QUALI 6210 6210

2052 PHILADELPHIA CHROMOSOME QUANTI PHILADELPHIA CHROMOSOME QUANTI 10800 10800

2053 FACTOR II - MUTATION FACTOR II - MUTATION 2500 2500

2054 FACTOR V - LEIDEN FACTOR V - LEIDEN 3100 3100

2055 JAK 2 GENE JAK 2 GENE 10350 10350

2056 MTHFR - GENE MTHFR - GENE 5175 5175

2057 HEPATITIS C GENOTYPING HEPATITIS C GENOTYPING 4140 4140

2058 FACTOR VIII (VWF) FACTOR VIII (VWF) 700 700

2059 PROCALCITONIN PROCALCITONIN 1600 1600

2060 ANTIBODY IDENTIFICATION ANTIBODY IDENTIFICATION 950 950

2061 ALPHA - FETOPROTEIN (S) ALPHA - FETOPROTEIN (S) 350 700

2062 C A 19-9 (S) C A 19-9 (S) 350 700

2063 CA 15-3 (S) CA 15-3 (S) 350 700

2064 PROSTATE SPECIFIC ANTIGEN (S) PROSTATE SPECIFIC ANTIGEN (S) 350 350

2065 OSMOLALITY (U) OSMOLALITY (U) 350 350

2066 CREATININE CLEARANCE CREATININE CLEARANCE 250 250

2068 KETONE BODIES (U) KETONE BODIES (U) 70 70

2069 SODIUM (U) SODIUM (U) 100 150

2070 POTASSIUM (U) POTASSIUM (U) 100 150

2071 CHLORIDE (U)/CSF CHLORIDE (U)/CSF 100 150

2072 UREA (U) UREA (U) 70 150

2073 CALCIUM URINE/DAY CALCIUM URINE/DAY 100 130

2074 URINE PHOSPHATE (24H) URINE PHOSPHATE (24H) 100 150

2075 CREATININE (U) CREATININE (U) 80 130

2076 PROTEIN, 24 HOURS (U)/CSF PROTEIN, 24 HOURS (U)/CSF 150 150

2077 GLUGOSE, QUALITATIVE (U) GLUGOSE, QUALITATIVE (U) 100 100

2078 PREGNANCY TEST (U) PREGNANCY TEST (U) 100 300

2079 ALBUMIN QUALITATIVE (U) ALBUMIN QUALITATIVE (U) 130 130

2080 OSTEOPOROSIS SCREEN @ OSTEOPOROSIS SCREEN @ 2270 2270

2081 LFT PROFILE LFT PROFILE 1320 1320

Page 16

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2083 BLOOD BANK (RECIPIENT) PANEL BLOOD BANK (RECIPIENT) PANEL 1350 1350

2084 D.U.A. (4 ITEMS) D.U.A. (4 ITEMS) 400 400

2085 D.U.A. TEST D.U.A. TEST 400 400

2086 UREA BREATH TEST UREA BREATH TEST 250 550

2087 REDUCING SUBSTANCES (S) REDUCING SUBSTANCES (S) 210 210

2089 OCCULT BLOOD IN STOOL OCCULT BLOOD IN STOOL 80 140

2090 ROTA VIRUS (STOOL) ROTA VIRUS (STOOL) 350 350

2091 SEMEN ANALYSIS (SPERMOGRAM) SEMEN ANALYSIS (SPERMOGRAM) 150 150

2092 B HEMOLYTIC STREP A QUICK TEST B HEMOLYTIC STREP A QUICK TEST 210 210

2093 BLOOD C/S BLOOD C/S 300 300

2094 KOH FOR FUNGUS MICROSCOPY KOH FOR FUNGUS MICROSCOPY 250 250

2095 DIRECT SMEAR (GRAM STAIN) DIRECT SMEAR (GRAM STAIN) 350 350

2096 DIRECT SMEAR - ACIDFAST BACILLI DIRECT SMEAR - ACIDFAST BACILLI 350 350

2097 BACTERIAL C/S BACTERIAL C/S 300 300

2098 ENDOTOXIN ENDOTOXIN 620 620

2099 COCAINE COCAINE 400 400

2100 LITHIUM (S) LITHIUM (S) 400 400

2101 PHENYTOIN (S) PHENYTOIN (S) 400 400

2102 CARBAMAZEPINE (S) CARBAMAZEPINE (S) 400 400

2103 PARACETAMOL (S) PARACETAMOL (S) 400 400

2104 VALPORIC ACID (S) VALPORIC ACID (S) 400 400

2105 CANNABINOIDS (S) CANNABINOIDS (S) 400 400

2106 THEOPHILINE (AMINOPHYLINE) (S) THEOPHILINE (AMINOPHYLINE) (S) 400 400

2107 ALCOHOL (S) ALCOHOL (S) 400 400

2108 DIGOXIN (S) DIGOXIN (S) 400 400

2109 PHENOBARBITAL (S) PHENOBARBITAL (S) 400 400

2110 D.A.U OPIATE ASSAY (U) D.A.U OPIATE ASSAY (U) 400 400

2111 BARBITURATE (URINE) BARBITURATE (URINE) 400 400

2112 AMPHETAMINE (URINE) AMPHETAMINE (URINE) 400 400

2113 BENZODIAZAPINE, QUANT BENZODIAZAPINE, QUANT 400 400

2114 CHLORIDE CSF CHLORIDE CSF 150 150

2115 GLUCOSE CSF GLUCOSE CSF 125 125

2116 PROTEIN CSF PROTEIN CSF 125 125

2117 GRAM STAIN AND C/S - (CSF) GRAM STAIN AND C/S - (CSF) 350 350

2118 MICROSCOPY - (CSF) MICROSCOPY - (CSF) 220 220

2119 2 Hours After Glucose dose 2 Hours After Glucose dose 0

2476 BAND ADJUSTMENT SPECIAL BAND ADJUSTMENT SPECIAL 1100 1100

2477 GASTRIC BANDAGE ADJUSTMENT UNDER IMAGE GASTRIC BANDAGE ADJUSTMENT UNDER IMAGE 1100 1100

2478 U/S 4D U/S 4D 1450 1450

2479 MD CT CEREBRAL ANGIOGRAPHY MD CT CEREBRAL ANGIOGRAPHY 3150 3150

2480 X-RAY READING AND REPORT X-RAY READING AND REPORT 80 80

2481 X-RAY MOBILE UNIT X-RAY MOBILE UNIT 110 110

2482 MRI - FISTULOGRAM MRI - FISTULOGRAM 3150 3150

2483 BARIUM CUP OR BARIUM ENEMA BAG BARIUM CUP OR BARIUM ENEMA BAG 110 110

2484 UROGRAFIN 76% (100 ML) UROGRAFIN 76% (100 ML) 110 110

Page 17

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 1111 Laboratory Test Laboratory

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2485 ULTRAVIST 300 MG (50 ML) ULTRAVIST 300 MG (50 ML) 270 270

2487 CONTRAST MEDIA FOR CT/MRI CONTRAST MEDIA FOR CT/MRI 650 650

2488 CONTRAST MEDIA FOR CT/MRI CONTRAST MEDIA FOR CT/MRI 650 650

2489 IMAGING CD BURNER IMAGING CD BURNER 110 110

4411 vit d vit d 300 300

4412 H-PYLORI, BREATH TEST (OFFER 2) H-PYLORI, BREATH TEST (OFFER 2) 300 300 0

4413 VIRAL CHECK-UP, ANEMIA HEREDITARY DISEASE (OFFER 3) VIRAL CHECK-UP, ANEMIA HEREDITARY DISEASE (OFFER 3) 300 300 0

4576 LIVER TUMOR, ALPHA FETO PROTEIN (AFP) (OFFER 6) LIVER TUMOR, ALPHA FETO PROTEIN (AFP) (OFFER 6) 300 300 0

4577 COLON TUMOR, CEA (OFFER 6) COLON TUMOR, CEA (OFFER 6) 300 300 0

4578 PANCREAS TUMOR, CA19-9 (OFFER 6) PANCREAS TUMOR, CA19-9 (OFFER 6) 300 300 0

4579 BREAST TUMOR, CA15-3 (OFFER 6) BREAST TUMOR, CA15-3 (OFFER 6) 300 300 0

4581 Antenatal (Frist Vist) Antenatal (Frist Vist) 0 0

4582 Antenatal care (2nd Visit) Antenatal care (2nd Visit) 0 0

4612 تحليل التهاب اللوزتين ASO 120

4666 3 Hours After Glucose dose 3 Hours After Glucose dose 0

4667 hepatitis A IGg hepatitis A IGg 100 100

4668 hepatitis A IGM hepatitis A IGM 180 180

4669 virus check up virus check up 240 240 0

4697 fertility hormones fertility hormones 339 339 0

4702 immunoglobuline A(IGA) immunoglobuline A(IGA) 200 200

4711 VIT D+H.PYLORI VIT D+H.PYLORI 250 250 0

4712 antiliver kidney microsomal antibody(LKM) antiliver kidney microsomal antibody(LKM) 300 300

4713 igg igg 100 100

4714 antinuclearantibody(ana) antinuclearantibody 300 300

5000 blood film for leishmania blood film for leishmania 100

5001 food allergy food allergy 400 400

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 4648 hema hema

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

118 H.PYLORI STOOL ANTIGEN TEST H.PYLORI STOOL ANTIGEN TEST 80 150

1543 CBC WITHOUT DIFFERNTIAL CBC WITHOUT DIFFERNTIAL 70 100

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 4650 hormon hormon

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2088 STOOL ANALYSIS STOOL ANALYSIS 40 28

بيان نوع الخدمة 11 خدمات قسم المختبر Laboratory

بيان المجموعة 4651 micr micr

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2067 URINE ANALYSIS URINE ANALYSIS 30 40

Page 18

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 12 خدمات قسم الأشعة Radiology

بيان المجموعة 1212 خدمات قسم الأشعة Radiology

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

147 ABDOMINAL ULTRASOUND ABDOMINAL ULTRASOUND 250 250

2120 PERIAPICAL X-RAY (Post) Per Tooth PERIAPICAL X-RAY (Post) Per Tooth 60 60

2122 TMJ X2 TMJ X2 300 350

2123 TMJ X4 TMJ X4 400 450

2124 SINUS POSITION SINUS POSITION 350 350

2125 LUMBOSACRAL SPINE OBLIQUES LUMBOSACRAL SPINE OBLIQUES 350 350

2126 X-RAY SELLA TURCICA X-RAY SELLA TURCICA 250 250

2127 ABDOMEN SUPINE (1 FILM) ABDOMEN SUPINE (1 FILM) 250 250

2128 CHEST - 1 VIEW CHEST - 1 VIEW 100 100

2129 CHEST I VIEW PORTABLE CHEST I VIEW PORTABLE 250 250

2130 CLAVICLE - 1 VIEW CLAVICLE - 1 VIEW 120 350

2131 STERNOCLAVICULAR JOINTS STERNOCLAVICULAR JOINTS 350 350

2132 STERNUM - 2 VIEWS STERNUM - 2 VIEWS 150 350

2133 ABDOMEN/KUB - 1 VIEW ABDOMEN/KUB - 1 VIEW 200 250

2134 HUMERUS UPPER ARM - 2 VIEWS HUMERUS UPPER ARM - 2 VIEWS 180 180

2135 ULNA RADIUS (FOREARM) - 2 VIEWS ULNA RADIUS (FOREARM) - 2 VIEWS 250 350

2136 LEG - 2 VIEWS LEG - 2 VIEWS 250 350

2137 LEG - 2 VIEWS INFANT LEG - 2 VIEWS INFANT 250 350

2138 ANKLE - 2 VIEWS ANKLE - 2 VIEWS 250 350

2139 ANKLE - 3 VIEWS ANKLE - 3 VIEWS 300 430

2140 NASAL BONES 2 POSITIONS NASAL BONES 2 POSITIONS 300 350

2141 PELVIS - 1 VIEW PELVIS - 1 VIEW 200 350

2142 HIP - 1 VIEW HIP - 1 VIEW 200 350

2143 SINUSES 1 POSITION SINUSES 1 POSITION 200 350

2144 SINUSES 2 POSITION SINUSES 2 POSITION 250 350

2145 KNEE - 3 VIEWS KNEE - 3 VIEWS 300 450

2146 KNEE - 2 VIEWS KNEE - 2 VIEWS 200 350

2147 HIP - 2 VIEW HIP - 2 VIEW 200 350

2148 HAND - 3 VIEWS HAND - 3 VIEWS 250 450

2149 ELBOW - 2 VIEWS ELBOW - 2 VIEWS 200 350

2150 SHOULDER - 2 VIEWS SHOULDER - 2 VIEWS 200 350

2151 ACROMIO CLAVICULAR JOINT BILATERAL ACROMIO CLAVICULAR JOINT BILATERAL 250 350

2152 WRIST - 2 VIEWS WRIST - 2 VIEWS 200 350

2153 WRIST - 3 VIEWS WRIST - 3 VIEWS 300 430

2154 CLAVICLE - 3 VIEWS CLAVICLE - 3 VIEWS 300 350

2155 ELBOW - 3 VIEWS ELBOW - 3 VIEWS 300 350

2156 JOINT STRESS VIEWS JOINT STRESS VIEWS 250 350

2157 KNEE - 4 VIEWS KNEE - 4 VIEWS 350 520

2158 KNEES BILATERAL KNEES BILATERAL 350 630

2159 BONE AGE (WRIST& ELBOW AP) BONE AGE (WRIST& ELBOW AP) 350 350

2160 ORBITS 2 POSITIONS ORBITS 2 POSITIONS 300 350

2161 WRIST A.P. FOR RICKETS WRIST A.P. FOR RICKETS 300 350

2162 CERVICAL SPINE - 2 VIEWS CERVICAL SPINE - 2 VIEWS 200 350

2163 SCOLIOSIS STUDY SCOLIOSIS STUDY 900 1150

2164 CERVICAL SPINE-3 VIEWS(AP,LAT,OPEN MOUTH CERVICAL SPINE-3 VIEWS(AP,LAT,OPEN MOUTH 250 350

Page 19

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 12 خدمات قسم الأشعة Radiology

بيان المجموعة 1212 خدمات قسم الأشعة Radiology

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2165 FEMUR/THIGH - 2 VIEWS FEMUR/THIGH - 2 VIEWS 200 350

2166 SKELETAL SURVEY SKELETAL SURVEY 900 1070

2167 CHEST - 2 VIEWS AP/LAT CHEST - 2 VIEWS AP/LAT 200 220

2168 CHEST - 4 VIEWS CHEST - 4 VIEWS 300 600

2169 CHEST 4 VIEWS WITH FLUROSCOPY CHEST 4 VIEWS WITH FLUROSCOPY 450 700

2170 SKULL 2 POSITIONS SKULL 2 POSITIONS 300 350

2171 ABDOMEN ERECT AND SUPINE ABDOMEN ERECT AND SUPINE 400 450

2172 MASTOIDS - 2 VIEWS MASTOIDS - 2 VIEWS 200 350

2173 NASAL BONES/SINUSES - 2 VIEWS, ADENOIDS NASAL BONES/SINUSES - 2 VIEWS, ADENOIDS 200 350

2174 IAM (INTERNAL AUDITORY MEATUS) IAM (INTERNAL AUDITORY MEATUS) 300 350

2175 DORSAL SPINE - 2 VIEWS DORSAL SPINE - 2 VIEWS 200 350

2176 THORACIC SPINE COMPLETE - 4 VIEWS THORACIC SPINE COMPLETE - 4 VIEWS 300 450

2177 DORSOLUMBAR SPINE -2 VIEWS DORSOLUMBAR SPINE -2 VIEWS 200 350

2178 LUMBO SACRAL SPINE - 2 VIEWS LUMBO SACRAL SPINE - 2 VIEWS 200 350

2179 X-RAY LATERAL L.S.(flexion&extension) X-RAY LATERAL L.S.(flexion&extension) 200 350

2180 SACRUM & COCCYX - 2 VIEWS SACRUM & COCCYX - 2 VIEWS 200 350

2181 NECK - SOFT TISSUE NECK - SOFT TISSUE 250 350

2182 NASOPHARYNX (ADENOID) LATERAL NASOPHARYNX (ADENOID) LATERAL 250 350

2183 BARIUM SWALLOW BARIUM SWALLOW 550 800

2184 BAND NARROWING BAND NARROWING 600 720

2185 BARIUM MEAL/UPPER G.I. SERIES BARIUM MEAL/UPPER G.I. SERIES 900 1400

2186 BARIUM MEAL DOUBLE CONTRAST BARIUM MEAL DOUBLE CONTRAST 1800 2400

2187 MANDIBLE/JAW - 2 VIEW MANDIBLE/JAW - 2 VIEW 200 350

2188 MANDIBLE/JAW - 4 VIEWS MANDIBLE/JAW - 4 VIEWS 300 830

2189 SALIVARY GLANDS SALIVARY GLANDS 200 350

2190 SACRO ILIAC JOINT - 2 VIEWS SACRO ILIAC JOINT - 2 VIEWS 200 350

2191 MASTOIDS - 3 VIEWS MASTOIDS - 3 VIEWS 300 540

2192 FACIAL BONES(p.n.s) pns FACIAL BONES(p.n.s) pns 250 350

2193 ORBIT - 3 VIEWS OPTIC FORAMINA ORBIT - 3 VIEWS OPTIC FORAMINA 250 540

2194 SKULL - 3 VIEWS SKULL - 3 VIEWS 250 430

2195 TM JOINT - BILATERAL TM JOINT - BILATERAL 500 830

2196 PELVIS - 3 VIEWS PELVIS - 3 VIEWS 250 350

2197 TM JOINT - ONE SIDE TM JOINT - ONE SIDE 250 350

2198 SKULL - 4 VIEWS SKULL - 4 VIEWS 250 350

2199 ORBIT - 4 VIEWS ORBIT - 4 VIEWS 250 540

2200 P.T.C(PERCUTANEOUS TRANSHEPATIC CHOLANG) P.T.C(PERCUTANEOUS TRANSHEPATIC CHOLANG) 1800 2275

2201 ASCENDING URETHROGRAM ASCENDING URETHROGRAM 550 700

2202 VOIDING CYSTOURETHROGRAPHY (CYCLIC) VOIDING CYSTOURETHROGRAPHY (CYCLIC) 550 700

2203 PANORAMIC X-RAY FOR TEETH 260 300

2204 CYSTOGRAPHY CYSTOGRAPHY 550 700

2205 VOIDING URETHRO CYSTOGRAPHY VOIDING URETHRO CYSTOGRAPHY 550 700

2206 LYMPHANGIOGRAPHY LYMPHANGIOGRAPHY 4500 6000

2207 GASTRIC BANDAGE ADJUSTMENT U/FLUOROSCOPY GASTRIC BANDAGE ADJUSTMENT U/FLUOROSCOPY 650 830

2208 RETROGRADE PYELOGRAPHY UNILATERAL RETROGRADE PYELOGRAPHY UNILATERAL 550 900

Page 20

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 12 خدمات قسم الأشعة Radiology

بيان المجموعة 1212 خدمات قسم الأشعة Radiology

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2209 IVP (INTRAVENOUS PYELOGRAM)+PLAIN IVP (INTRAVENOUS PYELOGRAM)+PLAIN 550 900

2210 I.V. UROGRAM I.V. UROGRAM 1200 1600

2211 BARIUM ENEMA-SINGLE CONTRAST BARIUM ENEMA-SINGLE CONTRAST 900 900

2212 BARIUM ENEMA DOUBLE CONTRAST BARIUM ENEMA DOUBLE CONTRAST 1400 1400

2213 IVP W/TOMO IVP W/TOMO 1500 2000

2214 I.V.P. DRIP INFUSION OR H.D.U I.V.P. DRIP INFUSION OR H.D.U 650 900

2215 MYELOGRAPHY - CERVICAL MYELOGRAPHY - CERVICAL 4500 4500

2216 MYELOGRAPHY - ENTIRE SPINE MYELOGRAPHY - ENTIRE SPINE 4800 4800

2217 MYELOGRAPHY - THORACIC MYELOGRAPHY - THORACIC 2300 2300

2218 MYELOGRAPHY - LUMBAR MYELOGRAPHY - LUMBAR 2300 2300

2219 BARIUM MEAL SMALL BOWEL/FOLLOW THROUGH BARIUM MEAL SMALL BOWEL/FOLLOW THROUGH 1400 1400

2220 SHOULDER (4 VIEWS) SHOULDER (4 VIEWS) 350 560

2221 VENOGRAPHY - EXTREMITY UNILATERAL VENOGRAPHY - EXTREMITY UNILATERAL 2400 2400

2222 VENOGRAPHY - EXTREMITY BILATERAL VENOGRAPHY - EXTREMITY BILATERAL 2700 2700

2223 CHOLANGIOGRAM OPERATIVE CHOLANGIOGRAM OPERATIVE 1200 1200

2224 CHOLANGIOGRAM - T/TUBE CHOLANGIOGRAM - T/TUBE 1200 1200

2225 NASAL BONES - 3 VIEWS, ADENOIDS NASAL BONES - 3 VIEWS, ADENOIDS 250 560

2226 NASAL/SINUSES - 3 VIEWS NASAL/SINUSES - 3 VIEWS 250 350

2227 ELBOW ARTHROGRAPHY ELBOW ARTHROGRAPHY 2300 2300

2228 TM JOINT - ARTHROGRAPHY TM JOINT - ARTHROGRAPHY 1100 1100

2229 SHOULDER ARTHROGRAPHY SHOULDER ARTHROGRAPHY 2300 2300

2230 HIP ARTHROGRAPHY HIP ARTHROGRAPHY 2275 2275

2231 KNEE ARTHROGRAPHY KNEE ARTHROGRAPHY 2050 2050

2232 ANKLE ARTHROGRAPHY ANKLE ARTHROGRAPHY 1900 1900

2233 CERVICAL SPINE - 4 VIEWS CERVICAL SPINE - 4 VIEWS 300 750

2234 LUMBO SACRAL SPINE - 3 VIEWS LUMBO SACRAL SPINE - 3 VIEWS 250 200

2235 LUMBO SACRAL SPINE - 4 VIEWS LUMBO SACRAL SPINE - 4 VIEWS 300 620

2236 RIBS - (AP & OBLIQUES) RIBS - (AP & OBLIQUES) 300 350

2237 PELVIMETRY E.L.P. PELVIMETRY E.L.P. 350 350

2238 PELVIMETRY - 2 VIEWS PELVIMETRY - 2 VIEWS 200 350

2239 CT BONE DENSITY STUDY CT BONE DENSITY STUDY 350 350

2240 FINGER/THUMB - 2 VIEWS FINGER/THUMB - 2 VIEWS 200 200

2241 BOTH HANDS OR FEET (TWO VIEWS) BOTH HANDS OR FEET (TWO VIEWS) 200 350

2242 HAND - 4 VIEWS HAND - 4 VIEWS 300 540

2243 JOINT FOUR VIEWS JOINT FOUR VIEWS 350 540

2244 SCAPULA COMPLETE SCAPULA COMPLETE 250 350

2245 OSCALCIS 2 -VIEWS OSCALCIS 2 -VIEWS 200 350

2246 FOOT 3 VIEWS FOOT 3 VIEWS 250 450

2247 HEEL - 2 VIEWS HEEL - 2 VIEWS 200 350

2248 TOES - 2 VIEWS TOES - 2 VIEWS 200 350

2249 FOOT -2 VIEWS FOOT -2 VIEWS 200 350

2250 HANDS -2 VIEWS HANDS -2 VIEWS 200 350

2251 THALIUM EXERCISE TEST (HEART) THALIUM EXERCISE TEST (HEART) 5200 5200

2252 VENTILATION PERFUSION SCAN VENTILATION PERFUSION SCAN 4150 4150

Page 21

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 12 خدمات قسم الأشعة Radiology

بيان المجموعة 1212 خدمات قسم الأشعة Radiology

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2253 RENAL ISOTOP SCAN RENAL ISOTOP SCAN 2700 2700

2254 SPINE (OBLIQUE VIEWS) SPINE (OBLIQUE VIEWS) 250 350

2255 STERNOCLAVICULAR JOINT STERNOCLAVICULAR JOINT 250 350

2256 STROKE PROTOCOL (CT AND MRI) STROKE PROTOCOL (CT AND MRI) 5175 5175

2257 ANGIOGRAPHY - EXTREMITY UNILATERAL ANGIOGRAPHY - EXTREMITY UNILATERAL 4600 4600

2258 ANGIOGRAPHY - EXTREMITY BILATERAL ANGIOGRAPHY - EXTREMITY BILATERAL 7250 7250

2259 PULMONARY ANGIOGRAPHY PULMONARY ANGIOGRAPHY 5250 5250

2260 VISCERAL ANGIOGRAPHY (1 REGION) VISCERAL ANGIOGRAPHY (1 REGION) 4600 4600

2261 VISCERAL ANG. (MULTIPLE ORGANS) VISCERAL ANG. (MULTIPLE ORGANS) 5250 5250

2262 AORTOGRAM - THORACIC PERCUTANEOUS AORTOGRAM - THORACIC PERCUTANEOUS 3120 3120

2263 AORTOGRAM - ABDOMINAL & RUNOFF AORTOGRAM - ABDOMINAL & RUNOFF 4600 4600

2264 ANGIOGRAPHY - CAROTID CERVICAL ANGIOGRAPHY - CAROTID CERVICAL 4600 4600

2265 VERTEBRAL ANGIOGRAPHY VERTEBRAL ANGIOGRAPHY 4600 4600

2266 ANGIOGRAPHY - CAROTID VERTEBRAL/CEREBRAL ANGIOGRAPHY - CAROTID VERTEBRAL/CEREBRAL 6625 6625

2267 VENACAVOGRAM VENACAVOGRAM 4140 4140

2268 IVC FILTER INSERTION IVC FILTER INSERTION 35500 35500

2269 HEPATIC CHEMO-EMBOLIZATION HEPATIC CHEMO-EMBOLIZATION 6250 6250

2270 PERIPHERAL ANGIOGRAPHY PERIPHERAL ANGIOGRAPHY 6500 6500

2271 CAROTID ANGIOGRAPHY CAROTID ANGIOGRAPHY 7100 7100

2272 VISCERAL ANGIOGRAPHY VISCERAL ANGIOGRAPHY 6250 6250

2273 AORTOGRAPHY (THORACIC OR ABDOMINAL) AORTOGRAPHY (THORACIC OR ABDOMINAL) 6250 6250

2274 CHEMOTHERAPY+EMBOLISATION (2 SESSIONS) CHEMOTHERAPY+EMBOLISATION (2 SESSIONS) 16560 16560

2275 EMBOLISATION (AVM/BLEEDER/TUMOUR) EMBOLISATION (AVM/BLEEDER/TUMOUR) 13500 13500

2276 VENOGRAPHY (IVC OR SVC) VENOGRAPHY (IVC OR SVC) 5250 5250

2277 VENOGRAPHY (PERIPHERAL) VENOGRAPHY (PERIPHERAL) 3350 3350

2278 GONADAL VENOGRAPHY+EMBOLISATION GONADAL VENOGRAPHY+EMBOLISATION 12500 12500

2279 GONADAL VENOGRAPHY W/OUT EMBOLISATION GONADAL VENOGRAPHY W/OUT EMBOLISATION 6210 6210

2280 PORTOGRAPHY PORTOGRAPHY 7250 7250

2281 ANGIOPLASTY OF KIDNEY TRANSPLANT ANGIOPLASTY OF KIDNEY TRANSPLANT 15000 15000

2282 ANGIOPLASTY (OTHER VESSELS)+STENT ANGIOPLASTY (OTHER VESSELS)+STENT 15000 15000

2283 ANGIOPLASTY W/OUT STENT ANGIOPLASTY W/OUT STENT 12500 12500

2284 I.V. CAVA FILTER I.V. CAVA FILTER 20700 20700

2285 PERC. ABLATION OF LIVER CYST/SMALL TUMOR PERC. ABLATION OF LIVER CYST/SMALL TUMOR 4250 4250

2286 PERC. TRANSHEP CHOLANGIOGRAM(PTC) PERC. TRANSHEP CHOLANGIOGRAM(PTC) 6250 6250

2287 PERC. BILIARY DRAINAGE (EXTERNAL) PERC. BILIARY DRAINAGE (EXTERNAL) 8500 8500

2288 PERC. BILIARY DRAINAGE (INTERNAL) PERC. BILIARY DRAINAGE (INTERNAL) 10350 10350

2289 BILIARY STRICTURE DILATATION BILIARY STRICTURE DILATATION 13500 13500

2290 INTERNAL BILIARY STENTING INTERNAL BILIARY STENTING 15700 15700

2291 PERC. RENAL CYST ABLATION PERC. RENAL CYST ABLATION 6250 6250

2292 NEPHROSTOMY NEPHROSTOMY 6250 6250

2293 NEPHROSTOMY & STRICTURE DILATATION NEPHROSTOMY & STRICTURE 11500 11500

Page 22

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 12 خدمات قسم الأشعة Radiology

بيان المجموعة 1212 خدمات قسم الأشعة Radiology

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

DILATATION

2294 PERC. DRAINAGE OF ABSCESS OR COLLECTION PERC. DRAINAGE OF ABSCESS OR COLLECTION 6250 6250

2295 BIOPSIES(ANY AREA EXCEPT BRAIN) BIOPSIES(ANY AREA EXCEPT BRAIN) 4500 4500

2296 BREAST MASS LOCAIZATION(PRE-OP) BREAST MASS LOCAIZATION(PRE-OP) 3100 3100

2297 PLEURAL EFFUSION TAPING FOR CYTOLOGY PLEURAL EFFUSION TAPING FOR CYTOLOGY 1100 1100

2298 X-RAY IMAGE INTENSIFIER/30 MIN X-RAY IMAGE INTENSIFIER/30 MIN 250 250

2299 EXTERNAL BILIARY DRAINAGE EXTERNAL BILIARY DRAINAGE 4600 4600

2300 ABSCESS DRAINAGE ABSCESS DRAINAGE 3500 3500

2301 DRAINAGE TUBE REPOSITION DRAINAGE TUBE REPOSITION 1100 1100

2302 INJECTION OF ALCOHOL INJECTION OF ALCOHOL 2100 2100

2303 SCLEROTHERAPY OF VARICOCELE SCLEROTHERAPY OF VARICOCELE 4500 4500

2304 PERIPHERAL TRANS. ANGIOPLASTY PERIPHERAL TRANS. ANGIOPLASTY 9600 9600

2305 PERCUTANEOUS SYMPATHETIC BLOCK PERCUTANEOUS SYMPATHETIC BLOCK 2500 2500

2306 FILM DUPLICATES (MRI, CT, ANGIO) FILM DUPLICATES (MRI, CT, ANGIO) 75 75

2486 X-RAY DUPLICATE (EACH FILM) X-RAY DUPLICATE (EACH FILM) 70 70

4580 breast ultrasound breast ultrasound 600 600

بيان نوع الخدمة 12 خدمات قسم الأشعة Radiology

بيان المجموعة 1213 خدمات الموجات فوق صوتيه والدوبلر

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2307 ULTRASOUND EXAMINATION ULTRASOUND EXAMINATION 210 210

2308 BED SIDE ABD. OR PELVIS U.S. BED SIDE ABD. OR PELVIS U.S. 750 750

2309 BED SIDE PELVI - ABDOMINAL U.S. BED SIDE PELVI - ABDOMINAL U.S. 750 750

2310 EXTRA CHARGE FOR PORTABLE ULTRASOUND EXTRA CHARGE FOR PORTABLE ULTRASOUND 415 415

2311 U/S - KUB+KIDNEY AND URINARY BLADDER U/S - KUB+KIDNEY AND URINARY BLADDER 750 750

2312 TRANS-RECTAL U/S BIOPSY TRANS-RECTAL U/S BIOPSY 4600 4600

2313 U/S BRAIN (TRANSFONTANELLER) U/S BRAIN (TRANSFONTANELLER) 450 450

2314 BREAST LOCALIZATION BREAST LOCALIZATION 450 450

2315 ULTRASOUND GUIDED ASPIRATION ULTRASOUND GUIDED ASPIRATION 3500 3500

2316 ULTRASOUND - GUIDED NEEDLE BIOPSY ULTRASOUND - GUIDED NEEDLE BIOPSY 3500 3500

2317 ULTRASOUND - GUIDED ASPIRATION CYST ULTRASOUND - GUIDED ASPIRATION CYST 3500 3500

2318 US GUIDED BIOPSY BREAST-RENAL- OTHERS US GUIDED BIOPSY BREAST-RENAL- OTHERS 3500 3500

2319 US GUIDED ASPIRATION (PLEURAL/OTHERS) US GUIDED ASPIRATION (PLEURAL/OTHERS) 3500 3500

2320 ULTRA SOUND GUIDED BIOPSY (TRUE CUT) ULTRA SOUND GUIDED BIOPSY (TRUE CUT) 3500 3500

2321 EMERGENCY ULTRASONOGRAPHY- 1 REGION EMERGENCY ULTRASONOGRAPHY- 1 REGION 750 750

2322 ULTRASOUND, UPPER ABDOMEN ULTRASOUND, UPPER ABDOMEN 750 750

2323 ULTRASOUND - RETROPERITONEAL ULTRASOUND - RETROPERITONEAL 900 900

2324 ULTRASOUND - PELVIS ULTRASOUND - PELVIS 400 400

2325 ULTRASOUND - ANTENATAL ULTRASOUND - ANTENATAL 450 450

2326 SONOGRAM, UPPER & LOWER ABDOMEN SONOGRAM, UPPER & LOWER ABDOMEN 750 750

2327 ULTRASOUND - TRANSVAGINAL ULTRASOUND - TRANSVAGINAL 900 900

Page 23

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 12 خدمات قسم الأشعة Radiology

بيان المجموعة 1213 خدمات الموجات فوق صوتيه والدوبلر

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2328 ULTRASOUND - THYROID - NECK ULTRASOUND - THYROID - NECK 450 450

2329 ULTRASOUND - CHEST ULTRASOUND - CHEST 450 450

2330 SONOGRAM, KIDNEYS AND OTHERS SONOGRAM, KIDNEYS AND OTHERS 750 750

2331 ULTRASOUND - BREAST ULTRASOUND - BREAST 450 450

2332 ULTRASOUND - SCROTUM AND CONTENT ULTRASOUND - SCROTUM AND CONTENT 450 450

2333 ULTRASOUND - TRANSRECTAL ULTRASOUND - TRANSRECTAL 900 900

2334 ULTRASOUND REPEAT ULTRASOUND REPEAT 450 450

2335 ULTRASOUND REPEAT ULTRASOUND REPEAT 450 450

2336 ULTRASOUND JOINTS,MUSCULOSKELETAL ULTRASOUND JOINTS,MUSCULOSKELETAL 450 450

2337 U/S EMERGENCY UPPER AND LOWER ABDOMEN U/S EMERGENCY UPPER AND LOWER ABDOMEN 750 750

2338 U/S EMERGENCY UPPER ABDOMEN U/S EMERGENCY UPPER ABDOMEN 750 750

2339 U/S EMERGENCY LOWER ABDOMEN U/S EMERGENCY LOWER ABDOMEN 750 750

2340 U/S EMERGENCY ANTENATAL U/S EMERGENCY ANTENATAL 450 450

2341 U/S EMERGENCY PREGNANCY U/S EMERGENCY PREGNANCY 750 750

2342 FOLLICULOMETRY FOLLICULOMETRY 650 650

2343 U/S DOPLER KIDNEYS & RENAL VESSELS U/S DOPLER KIDNEYS & RENAL VESSELS 750 750

2344 U/S DOPPLER CAROTID BILATERAL U/S DOPPLER CAROTID BILATERAL 1200 1200

2345 U/S DOPPLER CAROTID UNILATERAL U/S DOPPLER CAROTID UNILATERAL 900 900

2346 FOLLICULOMETRY ENDOVAGINAL FOLLICULOMETRY ENDOVAGINAL 1100 1100

2347 U/S DOPPLER ART LWR EXTREMITY UNILATERAL U/S DOPPLER ART LWR EXTREMITY UNILATERAL 900 900

2348 U/S DOPPLER VEIN EXTREMITY UNILATERAL U/S DOPPLER VEIN EXTREMITY UNILATERAL 900 900

2349 U/S DOPPLER ART UP EXTREMITY UNILATERAL U/S DOPPLER ART UP EXTREMITY UNILATERAL 900 900

2350 U/S DOPPLER ART LWR EXTREMITY BILATERAL U/S DOPPLER ART LWR EXTREMITY BILATERAL 1200 1200

2351 U/S DOPPLER VEIN EXTREMITY BILATERAL U/S DOPPLER VEIN EXTREMITY BILATERAL 1200 1200

2352 U/S DOPPLER ART UP EXTREMITY BILATERAL U/S DOPPLER ART UP EXTREMITY BILATERAL 1200 1200

2353 U/S DOPPLER MAJOR VSLS COMPL U/S DOPPLER MAJOR VSLS COMPL 900 900

2354 U/S DOPPLER MAJOR VSLS LTD U/S DOPPLER MAJOR VSLS LTD 900 900

2355 U/S DOPPLER HEMODIALYSIS ACCESS U/S DOPPLER HEMODIALYSIS ACCESS 900 900

2356 DOPPLER UTERINE BIOPHYSICAL PROFILE DOPPLER UTERINE BIOPHYSICAL PROFILE 900 900

2357 DOPPLER SCROTUM DOPPLER SCROTUM 900 900

2358 U/S DOPPLER PENILE VSLS COMPL U/S DOPPLER PENILE VSLS COMPL 1200 1200

2359 U/S DOPPLER PENILE VSLS LTD U/S DOPPLER PENILE VSLS LTD 1200 1200

2360 DOPPLER RENAL GRAFT DOPPLER RENAL GRAFT 900 900

2361 TRANSRECTAL SEM. VESICULOGRAPHY TRANSRECTAL SEM. VESICULOGRAPHY 2100 2100

2362 3D ULTRASOUND (EARLY) 3D ULTRASOUND (EARLY) 750 750

2363 3D ULTRASOUND (LATE) 3D ULTRASOUND (LATE) 1100 1100

2364 CT READING CT READING 450 450

بيان نوع الخدمة 13 خدمات الجراحة SURGERY SERVICE

بيان المجموعة 1313 خدمات الجراحة SURGERY SERVICE

Page 24

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 13 خدمات الجراحة SURGERY SERVICE

بيان المجموعة 1313 خدمات الجراحة SURGERY SERVICE

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1168 DOPLAR EXAMINATION FOR VEINS DOPLAR EXAMINATION FOR VEINS 900 900 13

1169 HEMORRHOIDS INJECTION / 1 SESS HEMORRHOIDS INJECTION / 1 SESS 1100 1100

1170 HEMORRHOIDS INJECTION / 2 SESS HEMORRHOIDS INJECTION / 2 SESS 1860 1860

1171 HEMORRHOIDS INJECTION / 3 SESS HEMORRHOIDS INJECTION / 3 SESS 5000 5000

1172 DRAINAGE OF SMALL ABSCESS L/A DRAINAGE OF SMALL ABSCESS L/A 1200 1200

1173 POST HEMORRHIOD. DILATATION POST HEMORRHIOD. DILATATION 60 60

1174 VARICOSE VEIN INJECTION VARICOSE VEIN INJECTION 1320 1320

1175 PARACENTESIS ABDOMINAL PARACENTESIS ABDOMINAL 620 620

1176 I&D SUPERFICIAL ABCESS I&D SUPERFICIAL ABCESS 500 500

1177 NAIL REMOVAL FIXED NAIL REMOVAL FIXED 1200 1200

1178 TOE NAIL REMOVAL TOE NAIL REMOVAL 1200 1200

1179 NAIL PUNCTURE NAIL PUNCTURE 125 125

1180 SUTURING SUPERF WOUND W/ANEST/STITCH SUTURING SUPERF WOUND W/ANEST/STITCH 60 60

1181 SUTURE SUPERFICIAL LACERATION SUTURE SUPERFICIAL LACERATION 500 500

1182 FORIGN BODY REMOVAL, SUPERFIC FORIGN BODY REMOVAL, SUPERFIC 2000 2000

1183 NAIL REMOVAL, LOOSE + DRESSING NAIL REMOVAL, LOOSE + DRESSING 1200 1200

1184 HEMATOMA SUBLINGUAL DRAINAGE HEMATOMA SUBLINGUAL DRAINAGE 500 500

1185 HEAMATOMA EVACUATION SMALL HEAMATOMA EVACUATION SMALL 320 320

1186 DRESSING BURN SMALL DRESSING BURN SMALL 300 300

1187 DRESSING BURN MEDIUM DRESSING BURN MEDIUM 400 400

1188 DRESSING BURN LARGE/SITE DRESSING BURN LARGE/SITE 800 800

1189 SMALL DRESSING SMALL DRESSING 50 125

1190 DRESSING MEDIUM DRESSING MEDIUM 75 100

1191 DRESSING LARGE DRESSING LARGE 120 200

1192 STITCHES REMOVAL STITCHES REMOVAL 50 50

2643 ANAL/RECTAL POLYPS ANAL/RECTAL POLYPS 3000 3000

2644 MASS EXCISION MASS EXCISION 3100 3100

2645 REPOSITIONING OF RESERVOIR REPOSITIONING OF RESERVOIR 6250 6250

2646 VASCULAR ANEURISM SMALL EXCISION VASCULAR ANEURISM SMALL EXCISION 2100 2100

2647 THROMBECTOMY + VENOUS PATCH GRAFT THROMBECTOMY + VENOUS PATCH GRAFT 7250 7250

2648 BREAST BIOPSY BREAST BIOPSY 2500 2500

2649 REVISION OF CIRCUMCISION REVISION OF CIRCUMCISION 4500 4500

2650 DISTAL SPLENO - RENAL SHUNT DISTAL SPLENO - RENAL SHUNT 14500 14500

2651 DECORTICATION/PLE/BEL/LAPAROSCOPIC DECORTICATION/PLE/BEL/LAPAROSCO PIC 10350 10350

2652 DECORTICATION/PLEURECTOMY/BLTMY OPEN DECORTICATION/PLEURECTOMY/BLTM Y OPEN 8300 8300

2653 AXILLARY SINUS EXCISION AXILLARY SINUS EXCISION 3800 3800

2654 AXILLARY LUMP EXCISION AXILLARY LUMP EXCISION 3100 3100

2655 VARICOSE VEIN LIGATION VARICOSE VEIN LIGATION 5500 5500

2656 MICRODOCHECTOMY (BREAST CYST) MICRODOCHECTOMY (BREAST CYST) 7500 7500

2657 PANCREATICO DUODENECTOMY PANCREATICO DUODENECTOMY 20700 20700

2658 EXCISION OF OLECRANON / SYNOVIUM BURSA EXCISION OF OLECRANON / SYNOVIUM BURSA 8000 8000

2659 NAIL REMOVAL, LOOSE + DRESSING NAIL REMOVAL, LOOSE + DRESSING 1200 1200

2660 HEMATOMA SUBLINGUAL DRAINAGE HEMATOMA SUBLINGUAL DRAINAGE 420 420

2661 HEAMATOMA EVACUATION, SMALL HEAMATOMA EVACUATION, SMALL 250 250

Page 25

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 13 خدمات الجراحة SURGERY SERVICE

بيان المجموعة 1313 خدمات الجراحة SURGERY SERVICE

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2662 HEAMATOMA EVACUATION , LARGE HEAMATOMA EVACUATION , LARGE 1100 1100

2663 DEBRIDEMENT SMALL WOUND DEBRIDEMENT SMALL WOUND 1100 1100

2664 EXCISION OF CLITORIAL CYST EXCISION OF CLITORIAL CYST 1600 1600

2665 ABDOMINAL TAPPING ABDOMINAL TAPPING 420 420

2666 FORIEGN BODY REMOVAL, SUPERFICIAL FORIEGN BODY REMOVAL, SUPERFICIAL 1100 1100

2667 MEATAL DILATATION MEATAL DILATATION 1100 1100

2668 I&D SUPERFICIAL ABCESS I&D SUPERFICIAL ABCESS 900 900

2669 PERI ANAL HEMATOMA (EXCSN PER EVACUATN) PERI ANAL HEMATOMA (EXCSN PER EVACUATN) 4000 4000

2670 FOREIGN BODY REMOVAL, DEEP FOREIGN BODY REMOVAL, DEEP 2000 2000

2671 AXILLARY BREAST SECONDARY AXILLARY BREAST SECONDARY 1100 1100

2672 TONGUE TIE RELEASE TONGUE TIE RELEASE 1100 1100

2673 DRESSING CHANGE IN O.R./SITE (AREA) DRESSING CHANGE IN O.R./SITE (AREA) 830 830

2674 SUTURE SUPERFICIAL LACERATION SUTURE SUPERFICIAL LACERATION 1200 1200

2675 SUTURE SUPERFICIAL LACERATION G.A. SUTURE SUPERFICIAL LACERATION G.A. 2300 2300

2676 CHEST TAPPING CHEST TAPPING 620 620

2677 CIRCUMCISION LESS THAN 1 YEAR CIRCUMCISION LESS THAN 1 YEAR 800 800

2678 EXCISION HEMANGIOMA EXCISION HEMANGIOMA 2100 2100

2679 EXCISION OF HEMANGIOMA LARGE EXCISION OF HEMANGIOMA LARGE 4200 4200

2680 RELEASE OF UNDESCENDED TESTES RELEASE OF UNDESCENDED TESTES 3350 3350

2681 CENTRAL LINE PLACEMENT PER CUTANEOUS CENTRAL LINE PLACEMENT PER CUTANEOUS 1000 1000

2682 FORIGN BODY REMOVAL, INTERNAL ORGAN FORIGN BODY REMOVAL, INTERNAL ORGAN 4150 4150

2683 RECTAL MASS EXCISION THRU ANUS RECTAL MASS EXCISION THRU ANUS 4150 4150

2684 LYMPH NODE EXCISION LYMPH NODE EXCISION 2000 2000

2685 SUEGERY EXAMINATION (G.A) SUEGERY EXAMINATION (G.A) 1100 1100

2686 OESPHAGEAL STRUCTURE REPAIR OESPHAGEAL STRUCTURE REPAIR 12500 12500

2687 SINUS NOSE BRIDGE EXCISION SINUS NOSE BRIDGE EXCISION 2900 2900

2688 SEBACEOUS CYST SEBACEOUS CYST 1500 1500

2689 ANAL IMPERFORATE LOW ANAL IMPERFORATE LOW 7500 7500

2690 INTERCOSTAL TUBE INSERTION UNDER LA INTERCOSTAL TUBE INSERTION UNDER LA 2500 2500

2691 THROMBECTOMY THROMBECTOMY 10350 10350

2692 SPINCTEROTOMY SPINCTEROTOMY 2500 2500

2693 JEJUNOSTOMY FEEDING TUBE INSERTION JEJUNOSTOMY FEEDING TUBE INSERTION 2100 2100

2694 EXCISION OF ULCER EXCISION OF ULCER 2100 2100

2695 HERNIOTOMY HERNIOTOMY 6000 6000

2696 AXILLARY BREAST EXCISION UNILATERAL AXILLARY BREAST EXCISION UNILATERAL 4800 4800

2697 FECAL IMPACTED STOOL EVACUATION FECAL IMPACTED STOOL EVACUATION 2100 2100

2698 BIOPSY INTERAL ORGANS BIOPSY INTERAL ORGANS 2500 2500

2699 TUMOR EXISION SIMPLE TUMOR EXISION SIMPLE 2100 2100

2700 LIPOMA EXCISION LIPOMA EXCISION 2000 2000

2701 LIPOMA EXCISION SMALL LIPOMA EXCISION SMALL 2000 2000

2702 LIPOMA MORE THAN 3 LIPOMA MORE THAN 3 5000 5000

2703 MASTECTOMY PARTIAL MASTECTOMY PARTIAL 10000 10000

Page 26

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 13 خدمات الجراحة SURGERY SERVICE

بيان المجموعة 1313 خدمات الجراحة SURGERY SERVICE

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2704 MASTECTOMY (MALE) MASTECTOMY (MALE) 12000 12000

2705 ANAL FISTULA BRANCHING ANAL FISTULA BRANCHING 9000 9000

2706 SKIN GRAFT FINGER (SMALL AREA) SKIN GRAFT FINGER (SMALL AREA) 6000 6000

2707 A.V. FISTULA CREATION A.V. FISTULA CREATION 3100 3100

2708 DEBRIDEMENT LARGE WOUND DEBRIDEMENT LARGE WOUND 3100 3100

2709 SCAR CORRECTION, SMALL SCAR CORRECTION, SMALL 2700 2700

2710 SCAR CORRECTION, LARGE SCAR CORRECTION, LARGE 5200 5200

2711 CORRECTION OF HALLUX VALGUS (BUNION) CORRECTION OF HALLUX VALGUS (BUNION) 7100 7100

2712 COLOSTOMY CLOSURE COLOSTOMY CLOSURE 12000 12000

2713 PERCUTANEOUS WIRING PERCUTANEOUS WIRING 2100 2100

2714 TENDON SUPRASPINATUS CALCIFIED TENDON SUPRASPINATUS CALCIFIED 7000 7000

2715 FASIOTOMY FASIOTOMY 5000 5000

2716 PERTUCATENOUS GASTROSTOMY PERTUCATENOUS GASTROSTOMY 8000 8000

2717 SUTURE DEEP LACERATIONS SUTURE DEEP LACERATIONS 4800 4800

2718 REMOVAL OF PLASTIC SUTURES G/A REMOVAL OF PLASTIC SUTURES G/A 1100 1100

2719 EOSOPHAGEALJEJUNOFTOMY RECONSTRUCTION EOSOPHAGEALJEJUNOFTOMY RECONSTRUCTION 12500 12500

2720 TOTAL GASTRECTOMY TOTAL GASTRECTOMY 25000 25000

2721 COLONOSCOPY W/WO BIOPSY COLONOSCOPY W/WO BIOPSY 3500 3500

2722 TENDON RELEASE FINGER/WRIST /DEQUERVAN TENDON RELEASE FINGER/WRIST /DEQUERVAN 6000 6000

2723 GASTROSTOMY, COLOSTOMY GASTROSTOMY, COLOSTOMY 8000 8000

2724 AMPUTATION FINGER OR TOE AMPUTATION FINGER OR TOE 3000 3000

2725 FIBRO ADENOMA EXCISION FIBRO ADENOMA EXCISION 4800 4800

2726 VARICOSE VEINS (ONE SIDE) VARICOSE VEINS (ONE SIDE) 6500 6500

2727 SINUS PILONIDAL EXCISION-CLOSED/OPEN SINUS PILONIDAL EXCISION- CLOSED/OPEN 6000 6000

2728 LAPAROTOMY - MINI LAPAROTOMY - MINI 10000 10000

2729 EXPLORATION OF WOUND LARGE EXPLORATION OF WOUND LARGE 3100 3100

2730 EXPLORATION OF SMALL WOUND EXPLORATION OF SMALL WOUND 1100 1100

2731 RECTAL BIOPSY RECTAL BIOPSY 2500 2500

2732 COLNOSCOPY WITH POLYPECTOMY COLNOSCOPY WITH POLYPECTOMY 3500 3500

2733 PAROTID DRAINAGE PAROTID DRAINAGE 3100 3100

2734 SIMPLE EXCISION SIMPLE EXCISION 1100 1100

2735 I&D ABCESS WITH GA / LA I&D ABCESS WITH GA / LA 1900 1900

2736 PILONIDAL ABSCESS WITH GENERAL ANAESTH PILONIDAL ABSCESS WITH GENERAL ANAESTH 6000 6000

2737 TOE NAIL REMOVAL & SUTURING TOE NAIL REMOVAL & SUTURING 1200 1200

2738 GASTROSCOPY WITH PROCEDURE GASTROSCOPY WITH PROCEDURE 3100 3100

2739 REMOVAL OF EXCESS FINGER REMOVAL OF EXCESS FINGER 1100 1100

2740 RELEASE OF NECK MUSCLE RELEASE OF NECK MUSCLE 2100 2100

2741 TRIMMING OF FINGER TRIMMING OF FINGER 2100 2100

2742 REFASIONING OF AMPUTATED STUMP REFASIONING OF AMPUTATED STUMP 4200 4200

2743 BIOPSY SUPERFICIAL BIOPSY SUPERFICIAL 1200 1200

2744 INTERCOSTAL TUBE INSERTION L.A. INTERCOSTAL TUBE INSERTION L.A. 2500 2500

2745 INTERCOSTAL TUBE INSERTION G.A. INTERCOSTAL TUBE INSERTION G.A. 2500 2500

2746 SALIVARY STONE SUBMAND REMOVED SALIVARY STONE SUBMAND REMOVED 4500 4500

2747 THROMBOSED PILE REMOVED THROMBOSED PILE REMOVED 5000 5000

Page 27

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 13 خدمات الجراحة SURGERY SERVICE

بيان المجموعة 1313 خدمات الجراحة SURGERY SERVICE

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2748 PERIANAL ABSCESS PERIANAL ABSCESS 6000 6000

2749 PERIANAL SINUS PERIANAL SINUS 6000 6000

2750 CYST/TUMOUR EXCISION SUPER CYST/TUMOUR EXCISION SUPER 1100 1100

2751 PARTIAL RECTAL PROLAP PARTIAL RECTAL PROLAP 9000 9000

2752 CAUTERY OF THE SCROTUM CAUTERY OF THE SCROTUM 2500 2500

2753 ANAL DILATATION ANAL DILATATION 4000 4000

2754 STERNAL PUNCTURE STERNAL PUNCTURE 1100 1100

2755 EXCISION/REPAIR OF CIRCUMSION EXCISION/REPAIR OF CIRCUMSION 4500 4500

2756 HEMORRIHOIDECTOMY HEMORRIHOIDECTOMY 7500 7500

2757 HEMORRIHOIDECTOMY + SIGMOIDOSCOPY HEMORRIHOIDECTOMY + SIGMOIDOSCOPY 5200 5200

2758 ANAL FISSURECTOMY ANAL FISSURECTOMY 6000 6000

2759 ANAL FISTULA LOW SIMPLE ANAL FISTULA LOW SIMPLE 4500 4500

2760 HIGH ANAL FISTULA - ONE STAGE HIGH ANAL FISTULA - ONE STAGE 9000 9000

2761 VARICOCELES UNILATERAL VARICOCELES UNILATERAL 4500 4500

2762 SPERMATOCELE SPERMATOCELE 6000 6000

2763 HEMATOCELE HEMATOCELE 6000 6000

2764 INFRA RED COAGULATION OF PILES INFRA RED COAGULATION OF PILES 5000 5000

2765 CIRCUMCISION MORE THAN 1 YEAR CIRCUMCISION MORE THAN 1 YEAR 4500 4500

2766 SECONDARY SUTURES SECONDARY SUTURES 1100 1100

2767 CYSTOR TUMOUR LARGE & DEEP CYSTOR TUMOUR LARGE & DEEP 2100 2100

2768 LUMP EXCISION OF THE NECK/BREAST LUMP EXCISION OF THE NECK/BREAST 7500 7500

2769 LAPAROSCOPY DIAGNOSTIC LAPAROSCOPY DIAGNOSTIC 4500 4500

2770 TUMOR EXCISION COMPLEX TUMOR EXCISION COMPLEX 5200 5200

2771 MASTECTOMY (SIMPLE) MASTECTOMY (SIMPLE) 10000 10000

2772 SCAR MULTIPLE CORRECTION SCAR MULTIPLE CORRECTION 6250 6250

2773 GYNAECOMASTIA IN MALES/ONE SIDE GYNAECOMASTIA IN MALES/ONE SIDE 5600 5600

2774 HERNIA INGUINAL/UMBILICAL/FEMO HERNIA INGUINAL/UMBILICAL/FEMO 7500 7500

2775 HERNIA STRANGULATED W/O R.A. HERNIA STRANGULATED W/O R.A. 7500 7500

2776 HERNIA REPAIR+HERNIOPLASTY SMALL HERNIA REPAIR+HERNIOPLASTY SMALL 7500 7500

2777 HERNIA REPAIR+HERNIOPLASTY LARGE HERNIA REPAIR+HERNIOPLASTY LARGE 7500 7500

2778 HERNIA RECURRENT REPAIR HERNIA RECURRENT REPAIR 10000 10000

2779 TESTES UNDESCESCENDED INGUINAL TESTES UNDESCESCENDED INGUINAL 4200 4200

2780 EXPLARATION OF COMMON BILE DUCT EXPLARATION OF COMMON BILE DUCT 4200 4200

2781 APPENDECTOMY APPENDECTOMY 8500 8500

2782 MECKELS DIVERTICULECTOMY MECKELS DIVERTICULECTOMY 9500 9500

2783 AMPUTATION IN CASE OF GANGRENE AMPUTATION IN CASE OF GANGRENE 20000 20000

2784 BONE SWELLING EXCISION BONE SWELLING EXCISION 4600 4600

2785 HERNIA INCISE SMALL NO H/PLASTY REPAIR HERNIA INCISE SMALL NO H/PLASTY REPAIR 6000 6000

2786 VARICOSE VEINS BILATERAL VARICOSE VEINS BILATERAL 9000 9000

2787 RECONSTRUCTION OF ANUS RECONSTRUCTION OF ANUS 7500 7500

2788 REMOVAL & RE-INSERTION OF PERMCATH REMOVAL & RE-INSERTION OF PERMCATH 4200 4200

2789 THYROIDECTOMY PARTIAL THYROIDECTOMY PARTIAL 14000 14000

2790 THYROGLOSSAL CYST OR FISTULA THYROGLOSSAL CYST OR FISTULA 12000 12000

2791 SUBMANDIBULAR GLAND EXISION SUBMANDIBULAR GLAND EXISION 7000 7000

Page 28

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 13 خدمات الجراحة SURGERY SERVICE

بيان المجموعة 1313 خدمات الجراحة SURGERY SERVICE

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2792 TREPHINE TREPHINE 4200 4200

2793 SKIN GRAFT LARGE AREA SKIN GRAFT LARGE AREA 10000 10000

2794 CARPAL TUNNEL SYNDROME SURGERY CARPAL TUNNEL SYNDROME SURGERY 5000 5000

2795 DIVERCATION OF RECTI MUSCULAR REPAIR DIVERCATION OF RECTI MUSCULAR REPAIR 8250 8250

2796 HERNIA DIAPHRAGMATIC REPAIR HERNIA DIAPHRAGMATIC REPAIR 9000 9000

2797 BOWEL ANASTOMOSIS RESECTION BOWEL ANASTOMOSIS RESECTION 21000 21000

2798 GASTRIC/INTESTINAL PERFORATION REPAIR GASTRIC/INTESTINAL PERFORATION REPAIR 21000 21000

2799 BOWEL REPAIR BOWEL REPAIR 21000 21000

2800 FAECAL FISTULA REPAIR FAECAL FISTULA REPAIR 25000 25000

2801 PYLORIC STENOSIS CONGENITAL REPAIR PYLORIC STENOSIS CONGENITAL REPAIR 5200 5200

2802 SPHINCTEROPLASTY SPHINCTEROPLASTY 5200 5200

2803 LAPAROSCOPIC VARICOCELECTOMY LAPAROSCOPIC VARICOCELECTOMY 4500 4500

2804 EMBOLECTOMY EMBOLECTOMY 13250 13250

2805 VARICOCELES BILATERAL VARICOCELES BILATERAL 6000 6000

2806 ORCHIOPEXY ORCHIOPEXY 5200 5200

2807 APPENDECTOMY LAPAROSCOPIC APPENDECTOMY LAPAROSCOPIC 8500 8500

2808 APPENDICECTOMY & MECKELS DIVER APPENDICECTOMY & MECKELS DIVER 8500 8500

2809 NERVE REPAIR NERVE REPAIR 18000 18000

2810 ARTERY REPAIR ARTERY REPAIR 9600 9600

2811 PARA THYROID EXCISION PARA THYROID EXCISION 14000 14000

2812 VASCULAR GRAFT ARTERY / VEIN VASCULAR GRAFT ARTERY / VEIN 7500 7500

2813 PSEUDO ANIORISM RESECTION PSEUDO ANIORISM RESECTION 6250 6250

2814 HEMICOLECTOMY HEMICOLECTOMY 10700 10700

2815 THORACOSCOPY PROCEED TO THORACOTOMY THORACOSCOPY PROCEED TO THORACOTOMY 14500 14500

2816 PER. GASTROSTOMY GUIDED BY GASTROSCOPY PER. GASTROSTOMY GUIDED BY GASTROSCOPY 8000 8000

2817 HI LIG OF SAPHENOFEMORAL JN & PERFORATOR HI LIG OF SAPHENOFEMORAL JN & PERFORATOR 8300 8300

2818 OMETECTOMY OMETECTOMY 2100 2100

2819 INTERNAL SKIN TRANSPLANTATN INTERNAL SKIN TRANSPLANTATN 6700 6700

2820 SECONDARY SUTURING POST ABDOMINOPLASTY SECONDARY SUTURING POST ABDOMINOPLASTY 4200 4200

2821 SLING OPERATION SLING OPERATION 9000 9000

2822 SEPERATION OF EMBEDDED PENIS FRM SCROTUM SEPERATION OF EMBEDDED PENIS FRM SCROTUM 4200 4200

2823 EXCISION BIOPSY EXCISION BIOPSY 1100 1100

2824 LAPAROSCOPIC REMOVAL OF FOREIGN BODY LAPAROSCOPIC REMOVAL OF FOREIGN BODY 6250 6250

2825 PROCTOSCOPY PROCTOSCOPY 1100 1100

2826 DILATATION OF PAROTID DUCT DILATATION OF PAROTID DUCT 3100 3100

2827 HERNIA STRANG BOWEL ANASTOMOS HERNIA STRANG BOWEL ANASTOMOS 9000 9000

2828 TOE NAIL REMOVER TOE NAIL REMOVER 1200 1200

2829 PERIPHERIAL ANEURYSM REPAIR PERIPHERIAL ANEURYSM REPAIR 11800 11800

2830 PERIPHERIAL ANEURYSM PERIPHERIAL ANEURYSM 19000 19000

2831 HERNIA INCISIONAL W/HERNIOPLAS HERNIA INCISIONAL W/HERNIOPLAS 7500 7500

2832 HERNIA LAPAROSCOPIC HERNIA LAPAROSCOPIC 10000 10000

2833 OESOPH.STRICTURE RELEASE OESOPH.STRICTURE RELEASE 6250 6250

Page 29

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 13 خدمات الجراحة SURGERY SERVICE

بيان المجموعة 1313 خدمات الجراحة SURGERY SERVICE

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2834 LAPAROTOMY LAPAROTOMY 10000 10000

2835 LAPAROTOMY W/ PROCEDURE LAPAROTOMY W/ PROCEDURE 10000 10000

2836 LAPAROSCOPY W/PROCEDURE LAPAROSCOPY W/PROCEDURE 21000 21000

2837 VAGOTOMY W/ OR W/O GASTROENTRO VAGOTOMY W/ OR W/O GASTROENTRO 8300 8300

2838 SYMPATHECTOMY ONE SIDE SYMPATHECTOMY ONE SIDE 8400 8400

2839 PERITONITIS ACUTE PERITONITIS ACUTE 10000 10000

2840 INTESTINAL VOLVULOUS INTESTINAL VOLVULOUS 25000 25000

2841 GASTRECTORY PARTIAL GASTRECTORY PARTIAL 25000 25000

2842 INTESTINAL STRICTURES CONGENITAL INTESTINAL STRICTURES CONGENITAL 6250 6250

2843 CHOLECYSTECTOMY CHOLECYSTECTOMY 18000 18000

2844 LAPOROSCOPY EXPLORATION LAPOROSCOPY EXPLORATION 10000 10000

2845 CHOLECYSTO-ENTROSTOMY CHOLECYSTO-ENTROSTOMY 18000 18000

2846 TRANS DUODENAL SPHINT. PLASTY TRANS DUODENAL SPHINT. PLASTY 6250 6250

2847 HEPATIC CYST EXCISION HEPATIC CYST EXCISION 18000 18000

2848 LIVER ABSCESS LIVER ABSCESS 18000 18000

2849 SPLENECTOMY SPLENECTOMY 18000 18000

2850 LAPAROSCOPIC SPLENECTOMY LAPAROSCOPIC SPLENECTOMY 18000 18000

2851 RECTAL PROLAPSE COMPLETE REPAIR RECTAL PROLAPSE COMPLETE REPAIR 18000 18000

2852 REDUCTION OF RECTAL PROLAPSE REDUCTION OF RECTAL PROLAPSE 1100 1100

2853 MASTECTOMY RADICAL MASTECTOMY RADICAL 10000 10000

2854 THYROIDECTOMY RADICAL THYROIDECTOMY RADICAL 20000 20000

2855 THYROIDECTOMY TOTAL THYROIDECTOMY TOTAL 20000 20000

2856 REVISION OF GORTEX GRAFT REVISION OF GORTEX GRAFT 3100 3100

2857 EXCISION OF EXTRA FINGER OR TOE EXCISION OF EXTRA FINGER OR TOE 2100 2100

2858 SURVICAL LYMPH NODE BIOPSY SURVICAL LYMPH NODE BIOPSY 5000 5000

2859 INTESTINAL CANCER SURGERY INTESTINAL CANCER SURGERY 7500 7500

2860 PANCREATECTOMY PARTIAL /TOTAL PANCREATECTOMY PARTIAL /TOTAL 12500 12500

2861 PELVIC EXCENTRATION TOTAL PELVIC EXCENTRATION TOTAL 11500 11500

2862 PAROTIDECTOMY PAROTIDECTOMY 18000 18000

2863 LAPAROSCOPIC ADHESIOLYSIS LAPAROSCOPIC ADHESIOLYSIS 7500 7500

2864 LAPAROSCOPIC ORCHIOPEXY LAPAROSCOPIC ORCHIOPEXY 6250 6250

2865 STOMACH STAPLING STOMACH STAPLING 8500 8500

2866 INTESTINAL FISTULA REPAIR INTESTINAL FISTULA REPAIR 25000 25000

2867 INTESTINAL ATRESIA REPAIR INTESTINAL ATRESIA REPAIR 8500 8500

2868 FEMORO POPLETEAL BY-PASS FEMORO POPLETEAL BY-PASS 11500 11500

2869 ANTERIOR RESECTION+INTESTINAL ANASTOMOSI ANTERIOR RESECTION+INTESTINAL ANASTOMOSI 8500 8500

2870 FEMORO POSTERIOR TIBIAL FEMORO POSTERIOR TIBIAL 8500 8500

2871 FEMORO PERONEAL FEMORO PERONEAL 8500 8500

2872 AORTO BI-FEMORAL AORTO BI-FEMORAL 27000 27000

2873 AORTIC ANEURYSM AORTIC ANEURYSM 27000 27000

2874 TOTAL RADICAL GASTRECTOMY TOTAL RADICAL GASTRECTOMY 25000 25000

2875 BY-PASS ARTERIAL GRAFTING BY-PASS ARTERIAL GRAFTING 12000 12000

2876 CHOLECYSTECTOMY LAPAROSCOPIC CHOLECYSTECTOMY LAPAROSCOPIC 18000 18000

2877 ORAL CANCER SURGERY RADICAL ORAL CANCER SURGERY RADICAL 11500 11500

2878 SIGMOIDOSCOPY SIGMOIDOSCOPY 2100 2100

Page 30

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 13 خدمات الجراحة SURGERY SERVICE

بيان المجموعة 1313 خدمات الجراحة SURGERY SERVICE

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2879 VERTICAL BANDING GASTROPLASTY VERTICAL BANDING GASTROPLASTY 11500 11500

2880 PLEURODESIS PLEURODESIS 8500 8500

2881 AMPUTATION LONG BONES AMPUTATION LONG BONES 20000 20000

2882 LAPAROSCOPIC HIGH SEL. VAGOTOMY LAPAROSCOPIC HIGH SEL. VAGOTOMY 12500 12500

2883 LAP . BOWEL TUMOR EX. & ANASTOM LAP . BOWEL TUMOR EX. & ANASTOM 21000 21000

2884 SINUS SKIN EXCISION SINUS SKIN EXCISION 3000 3000

2885 LAPAROSCOPIC NISSEN'S FUNDOPL LAPAROSCOPIC NISSEN'S FUNDOPL 12500 12500

2886 LAPAROSCOPIC GASTRIC BANDING LAPAROSCOPIC GASTRIC BANDING 14500 14500

2887 OPEN GASTRIC BANDING OPEN GASTRIC BANDING 12500 12500

2888 LAPAR. GASTRIC BANDING REMOVAL LAPAR. GASTRIC BANDING REMOVAL 7500 7500

2889 THYROIDECTOMY RECURENT, COMPL. THYROIDECTOMY RECURENT, COMPL. 14000 14000

2890 CHEST TUBE INSERTION(L.A.) CHEST TUBE INSERTION(L.A.) 1200 1200

2891 DIVISION OF ARTERIOVENOUS FISTULA DIVISION OF ARTERIOVENOUS FISTULA 10350 10350

2892 CHEST TUBE INSERTION (G.A) CHEST TUBE INSERTION (G.A) 2500 2500

2893 SINUS EXCISION OF THE PERINEUM SINUS EXCISION OF THE PERINEUM 6000 6000

2894 DRAINAGE DEEP ABSCESS W/ANESTH DRAINAGE DEEP ABSCESS W/ANESTH 3500 3500

2895 HAEMORRHOIDECTOMY HAEMORRHOIDECTOMY 7500 7500

2896 HEMORRIHODES BANDING HEMORRIHODES BANDING 3000 3000

4439 Breast Vacum Suction Breast Vacum Suction 100 100

بيان نوع الخدمة 14 العلاج الطبيعى Physiotherapy

بيان المجموعة 1414 العلاج الطبيعى Physiotherapy

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

486 MASSAGE FOR RELAXATION FOR THE SKIN MASSAGE FOR RELAXATION FOR THE SKIN 50 50

487 MASSAGE WITH STONE INSTRUMENT MASSAGE WITH STONE INSTRUMENT 250 250

488 MASSAGE WITH OIL PERFUME MASSAGE WITH OIL PERFUME 200 200

489 MASSAGE FOR OILY SKIN MASSAGE FOR OILY SKIN 200 200

490 MASSAGE FOR SCALP MASSAGE FOR SCALP 50 50

491 MEDICAL MASSAGE FOR 3RD DEGREE BURN MEDICAL MASSAGE FOR 3RD DEGREE BURN

492 EFFLEURAGE MASSAGE EFFLEURAGE MASSAGE 200 200

493 MASSAGE TAPPING MASSAGE TAPPING 200 200

494 MASSAGE FOR VARICOSE VEIN MASSAGE FOR VARICOSE VEIN 80 80

495 SHIATSU MASSAGE SHIATSU MASSAGE 200 200

1397 NEURO-MUSCULAR REHABILITATION NEURO-MUSCULAR REHABILITATION 125 125

1398 EMG COMPUTERIZED EMG COMPUTERIZED 1250 1250

1399 PHYSIOTHERAPY PHYSIOTHERAPY 1250 1250

1400 POSTNATAL EXERCISES/DAY POSTNATAL EXERCISES/DAY 125 125

1401 HOME VISIT , PHYSICAL THERAPY HOME VISIT , PHYSICAL THERAPY 1000 1000

1402 SHORTWAVE DIATHERMY SHORTWAVE DIATHERMY 150 150

1403 P.T. SESSION FOR INPATIENT /DAY P.T. SESSION FOR INPATIENT /DAY 250 250

1404 LASER THERAPY LASER THERAPY 250 250

1405 INFRARED IRRADIATION INFRARED IRRADIATION 150 150

1406 FARADIC STIMULATION FARADIC STIMULATION 150 150

1407 MUD THERAPY MUD THERAPY 125 125

Page 31

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 14 العلاج الطبيعى Physiotherapy

بيان المجموعة 1414 العلاج الطبيعى Physiotherapy

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1408 GALVANIC ELECTRIC STIMULATION GALVANIC ELECTRIC STIMULATION 150 150

1409 PARAFIN WAX BATH PARAFIN WAX BATH 150 150

1410 MASSAGE MASSAGE 250 250

1411 AQUA MASSAGE AQUA MASSAGE 250 250

1412 MEDICAL MASSAGE, WHOLE BODDY MEDICAL MASSAGE, WHOLE BODDY 250 250

1413 U/S BMD U/S BMD 370 370

1414 ULTRAVIOLET RADIATION ULTRAVIOLET RADIATION 150 150

1415 ULTRASOUND PHYSICAL THERAPY ULTRASOUND PHYSICAL THERAPY 150 150

1416 TRACTION CERVICAL TRACTION CERVICAL 150 150

1417 WHIRLPOOL WHIRLPOOL 150 150

1418 HYDRO THERAPY HYDRO THERAPY 250 250

1419 HOT MOIST PACK HOT MOIST PACK 150 150

1420 ICE THERAPY ICE THERAPY 150 150

1421 EXERCISE ROUTINE - MINOR EXERCISE ROUTINE - MINOR 150 150

1422 EXERCISE ROUTINE - MAJOR EXERCISE ROUTINE - MAJOR 200 200

1423 C.P.M. C.P.M. 200 200

1424 GAIT TRAINING GAIT TRAINING 200 200

1425 BREATHING EXERCISES BREATHING EXERCISES 150 150

1426 CHEST THERAPY CHEST THERAPY 150 150

1427 ACUPUNCTURE SESSION ACUPUNCTURE SESSION 250 250

1428 ACUPUNCTURE ADD SESSION ACUPUNCTURE ADD SESSION 370 370

1429 MAGNET THERAPY MAGNET THERAPY 125 125

1430 DIDYNAMIC CURRENT DIDYNAMIC CURRENT 125 125

1431 TENS TENS 150 150

1432 INTERFERENTIAL CURRENT INTERFERENTIAL CURRENT 125 125

1433 CERVICAL ADJUSTMENT MANIPULATN CERVICAL ADJUSTMENT MANIPULATN 190 190

1434 THERACIC ADJUSTMENT/MANIPULATN THERACIC ADJUSTMENT/MANIPULATN 190 190

1435 LUMBOSACRAL ADJUST/MANIPULATN LUMBOSACRAL ADJUST/MANIPULATN 190 190

1436 UPPER EXAMITY ADJUST/MANIPUL UPPER EXAMITY ADJUST/MANIPUL 190 190

1437 LOWER EXTREMITY ADJUST/MANIPUL LOWER EXTREMITY ADJUST/MANIPUL 190 190

1438 ACTIVATOR ACTIVATOR 190 190

1439 TRIGGER POINT THERAPY/MANIPUL TRIGGER POINT THERAPY/MANIPUL 190 190

1440 FLEXION/DISTRUCTION (COX TEC) FLEXION/DISTRUCTION (COX TEC) 190 190

1441 NEURO- MUSCULAR EDUCATION NEURO- MUSCULAR EDUCATION 125 125

1442 INTERSEGMENTAL TRACTION CERVCL INTERSEGMENTAL TRACTION CERVCL 125 125

1443 INTERSEGMENTAL TRACTION LUMBAR INTERSEGMENTAL TRACTION LUMBAR 125 125

1444 FLEXIONTRACTION MANUAL FLEXIONTRACTION MANUAL 125 125

1445 ROM - CERVICAL SPINE ROM - CERVICAL SPINE 125 125

1446 ROM - LUMBAR SPINE ROM - LUMBAR SPINE 125 125

1447 ROM - EXTREMITIES ROM - EXTREMITIES 125 125

1448 ACTIVITY OF DAILY LIVING (ADL) ACTIVITY OF DAILY LIVING (ADL) 125 125

1449 KINETIC STRENGTH ACTIVITY KINETIC STRENGTH ACTIVITY 125 125

1450 EXTERNAL U/S ONE SESSION EXTERNAL U/S ONE SESSION 415 415

4595 EFLORAGE MASSAGE EFLORAGE MASSAGE 300 300 0

4596 THIRD DEGREE BURNS MASSAGE THIRD DEGREE BURNS MASSAGE

4597 SHIATSU MASSAGE SHIATSU MASSAGE 300 300 0

Page 32

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 14 العلاج الطبيعى Physiotherapy

بيان المجموعة 1414 العلاج الطبيعى Physiotherapy

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4598 مساج الحجر البركاني + حمام مغربي VOLCANIC STONE MASSAGE + MOROCCAN BATH 500 500 0

4599 TAPING MASSAGE TAPING MASSAGE 300 300 0

4600 VARICOSE VEINS MASSAGE VARICOSE VEINS MASSAGE 150 150 0

4601 مساج البودرة البشره الدهنية + حمام مغربي OILY SKIN POWDER MASSAGE + MOROCCAN BATH 500 500 0

4602 مساج الزيوت العطرية + حمام مغربي AROMATIC OILS MASSAGE + MOROCCAN BATH 500 500 0

بيان نوع الخدمة 15 الصيدلية والادوية Pharmacy

بيان المجموعة 1515 الصيدلية والادوية Pharmacy

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

343 اصناف الصيدليه اصناف الصيدليه

بيان نوع الخدمة 17 خدمات قسم الأسنان DENTAL

بيان المجموعة 1717 خدمات قسم الأسنان DENTAL

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

148 PFM PFM 550 550 0

151 PERIAPICAL X-RAY PERIAPICAL X-RAY 30 30 0

152 COMPOSITE 1 SURFACE) COMPOSITE 1 SURFACE) 180 180 0

153 COMPOSITE 2 SURFACE) COMPOSITE 2 SURFACE) 220 220 0

154 composite filling 3 surfaces and more composite filling 3surfaces and more 350 350 0

155 composite build up COMPOSITE BUILD UP 420 420 0

156 SCREW POST SCREW POST 250 250 0

157 FIBER POST FIBER POST 300 300 0

158 RCT For (ANT) By Rotarry With Filling RCT For (ANT) By Rotarry With Filling 350 350 0

159 RCT Rttt For (ANT) By Rotarry Or Manual Per Tooth With Filling RCT Rttt For (ANT) By Rotarry Or Manual Per Tooth With Filling 350 350 0

160 RCT For (Post) (Two Canal) By Rotarry Or Manual Per Tooth With Filling RCT For (Post) (Two Canal) By Rotarry Or Manual Per Tooth With Filling 400 400 0

161 RCT Manual Post W/O Filling Per Canal RCT Manual Post W/O Filling Per Canal 550 550 0

162 RCT REttt. Manual Post. W/O Filling Per Canal RCT REttt. Manual Post. W/O Filling Per Canal 550 550 0

163 بوب ليسيوم PULPUTOMY 190 190 0

164 SCALING And Polishing (GRADE1) SCALING And Polishing (GRADE1) 150 160 0

165 SCALING AND POLISHING (GRADE 2) SCALING AND POLISHING (GRADE 2) 180 180 0

166 SCALING AND POLISHING (GRADE 3) SCALING AND POLISHING (GRADE 3) 230 230 0

167 FISSURE SEALANT (PER TOOTH) FISSURE SEALANT (PER TOOTH) 250 250 0

168 BLEACHING of Theeth BLEACHING of Theeth 900 900 0

171 dental implant (discountable) dental implant (discountable) 4800 4800 0

172 GLASS INOMER FILLING GLASS INOMER FILLING 180 180 0

173 panoramic and cepj=halometric panoramic and cepj=halometric 150 150 0

174 AMALGAM FILLING SIMPLE AMALGAM FILLING SIMPLE 120 120

175 NORMAL EXTRACTION (PEDO) NORMAL EXTRACTION of (PEDO) tooth (ANT,POST) PER TOOTH 90 90 0

176 FLOURIDE TREATMENT FLOURIDE TREATMENT 220 220 0

177 STAINLESS STEEL CROWN STAINLESS STEEL CROWN 400 400 0

178 SPACE MAINTAINER SPACE MAINTAINER 650 650 0

179 THUMB SUCKING Appliance THUMB SUCKING Appliance 1800 1800 0

Page 33

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 17 خدمات قسم الأسنان DENTAL

بيان المجموعة 1717 خدمات قسم الأسنان DENTAL

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

180 NORMAL EXTRACTION ) NORMAL EXTRACTION 130 130 0

181 NORMAL EXTRACTION (Posterior Adult) NORMAL EXTRACTION (Posterior Adult) 200 200 0

182 IMPRESS INCERAM impress inceram 1200 1200 0

183 LUMINATE VENEER LUMINATE VENEER 1200 1200 0

184 ZIRCON Zircon CRWON per tooth ZIRCON Zircon CRWON per tooth 950 950 0

185 GUM SMILE (PER TOOTH) GUMSMILE (PER TOOTH) 2500 2500 0

186 ACRYLIC PARTIAL DENTURE (one arch) ACRYLIC PARTIAL DENTURE 850 850 0

187 COMPLETE DENTURE (ONE ARCH) COMPLETE DENTURE (ONE ARCH) 1500 1500 0

188 COMPLETE DENTURE chrome cobalt (two arch) COMPLETE DENTURE chrome cobalt (two arch) 4200 4200 0

189 PARTIAL CHROME COBALT Denture (ONE ARCH) PARTIAL CHROME COBALT Denture (ONE ARCH) 1800 1800 0

190 PARTIAL CHROME COBALT Denture (UPPER AND LOWER) arch PARTIAL CHROME COBALT Denture (UPPER AND LOWER) arch 3200 3200 0

191 TEMPORARY CROWN (ACRYLIC) TEMPORARY CROWN (ACRYLIC) 200 200 0

192 DENTURE REPAIR DENTURE REPAIR 180 180 0

193 DENTURE RELINING OR REBASING DENTURE RELINING OR REBASING 700 700 0

194 TOOTH ADDITION TO THE DENTURE (EACH TOOTH) TOOTH ADDITION TO THE DENTURE (EACH TOOTH) 180 180 0

195 LUMINEERS(PER TOOTH) LUMINEERS(PER TOOTH) 1200 1200 0

196 NIGHT GUARD NIGHT GUARD 280 280 0

197 CROWN LENGTHING Per Tooth CROWN LENGTHING Per Tooth 500 500 0

198 TREATMENT OF TEETH SENSITIVITY (Pedo,Adult) TREATMENT OF TEETH SENSITIVITY (Pedo,Adult) 150 150 0

199 METAL CROWN Per Tooth METAL CROWN Per Tooth 450 450 0

200 METAL CROWN WITH (ACRYLIC FACING) Per Tooth METAL CROWN WITH (ACRYLIC FACING) Per Tooth 480 480 0

201 METAL CROWN WITH (CERAMIC FACING) Per Tooth METAL CROWN WITH (CERAMIC FACING) Per Tooth 550 550 0

202 EXTRACTION REMAINING ROOT (ANT.OR POST.( EXTRACTION REMAINING ROOT (ANT.OR POST.( 150 150 0

204 RCT ant. with filling RCT ant. with filling

205 AMALGAM FILLING COMPLEX AMALGAM FILLING COMPLEX 250 260 0

206 RCT REMOVAL BROKEN Inst. U/S Per Tooth RCT REMOVAL BROKEN Inst. U/S Per Tooth 800 800 0

207 APEXIFICATION (ANT) Per Tooth APEXIFICATION (ANT) Per Tooth 1500 1500 0

208 APEXIFICATION (POST) Per Tooth APEXIFICATION (POST) Per Tooth 2500 2500 0

209 CRYSTAL CEMENTATION CRYSTAL CEMENTATION 180 180 0

210 CERAMIC INLAY Per Tooth CERAMIC INLAY Per Tooth 850 850 0

211 MTA REAPIR SIMPLE Per tooth MTA REAPIR SIMPLE Per tooth 750 750 0

212 MTA REAPIR COMPLEX PER TOOTH MTA REAPIR COMPLEX PER TOOTH 1200 1200 0

213 PULPECTOMY PULPECTOMY (palp ampotation) 300 300 0

214 EXTRACTION R>R SURGICAL EXTRACTION R>R SURGICAL 250 250 0

215 RCT PREMOLAR WITH FILLING RCT PREMOLAR WITH FILLING

216 ADULT EXTRACTION ANT. (SURGICAL) ADULT EXTRACTION ANT. (SURGICAL) 300 300 0

217 ADULT EXTRACTIONPOST. (SURGICAL) ADULT EXTRACTIONPOST. (SURGICAL) 400 400 0

218 APICEECTOMY ANTERIOR APICEECTOMY ANTERIOR 1600 1600 0

219 APICEECTOMY POSTERIOR APICEECTOMY POSTERIOR 1800 1800 0

220 EXTRACTION LOOSE TOOTH EXTRACTION LOOSE TOOTH 80 80 0

221 EXTRACTION IMPACTED WISDOME (SOFT TISSUE) EXTRACTION IMPACTED WISDOME (SOFT TISSUE) 1400 1400 0

222 EXTRACTION IMPACTED WISDOME (BONY) EXTRACTION IMPACTED WISDOME 1400 1500 0

Page 34

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 17 خدمات قسم الأسنان DENTAL

بيان المجموعة 1717 خدمات قسم الأسنان DENTAL

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

(BONY)

223 CROWN REMOVAL CROWN REMOVAL 50 50 0

224 CROWN CEMENTATION /TOOTH CROWN CEMENTATION /TOOTH 100 120 0

225 oral stich of wound ORAL STITCHS OF WOUND 120 150 0

226 INCISION AND DRAINAGE OF ABCESS INCISION AND DRAINAGE OF ABCESS 150 150 0

227 RCT EMERGENCY Per Tooth RCT EMERGENCY Per Tooth 200 200 0

228 REMOVAL GUM ON WISDOM REMOVAL GUM ON WISDOM 200 200 0

229 DRY SOCKET IRRIGATION Adult DRY SOCKET IRRIGATION Adult 180 180 0

230 AVULSED TOOTH REIMPLANTATION AVULSED TOOTH REIMPLANTATION 420 420 0

231 RECEMENTATION JACKET BRIDGE RECEMENTATION JACKET BRIDGE 200 200 0

232 RCT MOLAR WITH FILLING RCT MOLAR WITH FILLING

233 CYST REMOVAL CYST REMOVAL

234 DENTAL IMPLANT Per Tooth DENTAL IMPLANT Per Tooth 5500 5500 0

235 GINGIVAL DEPIGMENTATION Per Tooth GINGIVAL DEPIGMENTATION Per Tooth 900 900 0

236 GINGIVOPLASTY(Arch) GINGIVOPLASTY(Arch) 900 900 0

237 GINGIVECTOMY PER TOOTH GINGIVECTOMY PER TOOTH 300 300 0

238 FRENECTOMY Per frenum FRENECTOMY Per frenum 480 480 0

239 OPERCULECTOMY Per Tooth OPERCULECTOMY Per Tooth 480 480 0

240 SINUS LIFTING SINUS LIFTING 4200 4200 0

241 BONE GRAFT PER 0.5 cc BONE GRAFT PER 0.5cc 1800 1800 0

242 COLLAGEN MEMBRANE COLLAGEN MEMBRANE 580 580 0

243 OPEN FLAP DEBRIDENT PER QUADRANT OPEN FLAP DEBRIDENT PER QUADRANT 580 580 0

244 FULL MOUTH ROOT PLANNING FULL MOUTH ROOT PLANNING 580 580 0

245 CASTED POST CASTED POST 550 550 0

246 IMPLANT RETAINED OVER DENTURE IMPLANT RETAINED OVER DENTURE 2900 2900 0

247 SURGICAL EXPOSURE TEETH SURGICAL EXPOSURE TEETH 950 950 0

248 ROOT CANAL 1 ROOT INFECTED RCT ROOT CANAL 1 ROOT INFECTED RCT

249 ROOT CANAL 2 ROOTS RCT INFECTED ROOT CANAL 2 ROOTS RCT INFECTED

250 RE ROOT CANAL TTT RCT RE ROOT CANAL TTT RCT

251 EXTRACTION OF IMPACTED REMAINING ROOTS EXTRACTION OF IMPACTED REMAINING ROOTS

252 OCCUSAL INTRA ORAL FILM OCCUSAL INTRA ORAL FILM

253 ROOT CANAL 1 ROOT RCT ROOT CANAL 1 ROOT RCT

254 ROOT CANAL 2 ROOTS RCT ROOT CANAL 2 ROOTS RCT

255 ROOT CANAL 3 ROOTS RCT ROOT CANAL 3 ROOTS RCT

256 ROOT CANAL RETENTION SCREW RCT ROOT CANAL RETENTION SCREW RCT

257 PANORAMIC AND CEPHALOMETRIC PANORAMIC AND CEPHALOMETRIC

258 ACRYLIC Partial Denture (one arch ) MORE THAN 3 theeth ACRYLIC Partial Denture (one arch ) MORE THAN 3 theeth 650 650 0

259 ACRYLIC Partial Denture (one arch) LESS THAN 3 Teeth ACRYLIC Partial Denture (one arch) LESS THAN 3 Teeth 650 650 0

260 APICAL SURGERY (rct not included ) APICAL SURGERY (rct not included )

261 BITEWING 2 VIEWS BITEWING 2 VIEWS

262 HALF IMPACTED WOSDOM TOOTH HALF IMPACTED WOSDOM TOOTH 650 650 0

263 occlusal x-ray film occlusal x-ray film

264 denture( fast service) denture( fast service) 2500 2500 0

266 VENEER OR LOMENEIR VENEER OR LOMENEIR 950 950 0

Page 35

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 17 خدمات قسم الأسنان DENTAL

بيان المجموعة 1717 خدمات قسم الأسنان DENTAL

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

267 INCERAM ONE TOOTH INCERAM ONE TOOTH 950 950 0

268 IMPRESS ONE TOOTH IMPRESS ONE TOOTH 950 950 0

269 IMPRESSION IMPRESSION 150 150 0

271 PANORAMIC X-RAY PANORAMIC X- RAY 150 150 0

1313 INCISION OF INTRA ORAL ABSCESS INCISION OF INTRA ORAL ABSCESS 200 200 0

1314 IRRIGATE ABSCESS/SEPTIC SOCKET IRRIGATE ABSCESS/SEPTIC SOCKET 100 100 0

1315 TEETH SCALING AND POLISHING TEETH SCALING AND POLISHING 150 150 0

1317 CURETTAGE & GENGIVAL TREAT/JAW (NON SUR) CURETTAGE & GENGIVAL TREAT/JAW (NON SUR) 200 200 0

1320 FILLING 1 SURFACE FILLING 1 SURFACE 150 300 0

1321 FILLING 2 SURFACE FILLING 2 SURFACE 200 200 0

1322 FILLING BUILD UP FILLING BUILD UP 300 300 0

1325 FILLING COMPOSITE / POST TEETH FILLING COMPOSITE / POST TEETH 300 300 0

1326 SINUS IRRIGATION SINUS IRRIGATION 800 800 0

1327 TEMPORARY FILLING / Conservative TEMPORARY FILLING / Conservative 100 100 0

1328 PERIODONTAL ADD. SESSION PERIODONTAL ADD. SESSION 450 450 0

1335 BIOPSY SUPERFICIAL BIOPSY SUPERFICIAL 900 900 0

1336 GINGIVECTOMY GINGIVECTOMY 900 900 0

1337 GUM FLAP OPERATION 1/2 JAW GUM FLAP OPERATION 1/2 JAW 900 900 0

1338 SINUS MAXILIARY LIFTING SINUS MAXILIARY LIFTING 1800 1800 0

1339 SURGICAL SUTURE 1/2 JAW, G.A. SURGICAL SUTURE 1/2 JAW, G.A. 800 800 0

1340 SUTURING OF LARGE WOUND SUTURING OF LARGE WOUND 800 800 0

1341 SURG. CYST DENT. SMAL/FORGN BODY SURG. CYST DENT. SMAL/FORGN BODY 800 800 0

1342 CYST DENTAL LARGE TREATMENT CYST DENTAL LARGE TREATMENT 1100 1100 0

1343 STITCHES, EACH (DEEP WOUND) STITCHES, EACH (DEEP WOUND) 700 700 0

1344 STITCHES REMOVAL, EACH STITCHES REMOVAL, EACH 50 50 0

1345 CYST DENTAL LARGE TREATMENT / HOUR CYST DENTAL LARGE TREATMENT / HOUR 1200 1200 0

1346 EPISECTOMY ANTERIOR TEETH WO RCT EPISECTOMY ANTERIOR TEETH WO RCT 1800 1800 0

1347 SOFT ACRYLIC (DEFLEX) UPPER OR LOWER SOFT ACRYLIC (DEFLEX) UPPER OR LOWER 4800 4800 0

1348 CYSTOR TUMOUR LARGE & DEEP CYSTOR TUMOUR LARGE & DEEP 800 800 0

1349 MOUTH GAURD MOUTH GAURD 800 800 0

1350 CROWN REMOVAL OR CEMENTING CROWN REMOVAL OR CEMENTING 100 100 0

1352 PIT AND FISSURE SEALANT PER TOOTH PIT AND FISSURE SEALANT PER TOOTH 200 200 0

1353 FIXATION OF LOOSE TOOTH, EACH FIXATION OF LOOSE TOOTH, EACH 250 250 0

1354 Night Guard (Pedo,adult) Night Guard (Pedo,adult) 1200 1200 0

1355 OPTURATOR FOR HARD AND SOFT PALAT OPTURATOR FOR HARD AND SOFT PALAT 12500 12500 0

1356 ATTACHEMENT FOR VITALIUM EACH ATTACHEMENT FOR VITALIUM EACH 12500 12500 0

1357 INLAY CORE + ACRYLIC CROWN INLAY CORE + ACRYLIC CROWN 950 950 0

1358 POST WITH CORE POST WITH CORE 800 800 0

1365 OPTURATOR FOR HARD PALAT OPTURATOR FOR HARD PALAT 5500 5500 0

1382 DOWEL CROWN PORCELAIN DOWEL CROWN PORCELAIN 2200 2200 0

1383 BRIDGES VENER CROWN W/O GOLD EACH BRIDGES VENER CROWN W/O GOLD EACH 1200 1200 0

1394 O.R & I.F. OF MANDABLE SUBCOND O.R & I.F. OF MANDABLE SUBCOND 8500 8500 0

4585 AMALGAM 1 SURFACE AMALGAM 1 SURFACE 150 150 0

Page 36

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 17 خدمات قسم الأسنان DENTAL

بيان المجموعة 1717 خدمات قسم الأسنان DENTAL

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4586 AMALGAM 2 SURFACE AMALGAM 2 SURFACE 200 200 0

4587 AMALGAM 3 SURFACE AMALGAM 3 SURFACE 300 300 0

4588 COMPOSITE 3 SURFACE) COMPOSITE 3 SURFACE) 300 300 0

4591 panaoramic x ray with orthostudy cast panaoramic x ray with orthostudy cast 450 450 0

4593 EXTRACTION NORMAL teeth / Simple extraction for permanant EXTRACTION NORMAL teeth / Simple extraction for permanant 100 100 0

4594 SCALING $ POLISHING / CLEANING SCALING $ POLISHING / CLEANING 150 150 0

4613 GUM TRAETMENT FOR QUARDRANT GUM TRAETMENT FOR QUARDRANT 150 150 0

4614 FLOURIDE APPLICATION FLOURIDE APPLICATION 200 200 0

4619 Complicated deciduous teeth ext Complicated deciduous teeth ext 150 150 0

4620 deciduous Tooth Extraction(child) milky deciduous Tooth Extraction(child) milky 70 70 0

4622 PULPECTOMY +TEMPORARY FILLING PULPECTOMY +TEMPORARY FILLING 200 200 0

4623 TEMPORARY PLASTIC CROWN TEMPORARY PLASTIC CROWN 100 100 0

4624 GINGIVAL CURRETAGE /QUADRANT GINGIVAL CURRETAGE /QUADRANT 200 200 0

4625 BITEWING X-RAY FILM BITEWING X-RAY FILM 30 30 0

4627 AMALGAM 4 SURFACE AMALGAM 4 SURFACE 300 300 0

4628 AMALGAM BUILD-UP +RETENTION PIN AMALGAM BUILD-UP +RETENTION PIN 300 300 0

4629 COMPOSITE 4 SURFACE OR MORE COMPOSITE 4 SURFACE OR MORE 300 300 0

4630 PRIAPICAL CRYST REMOVAL PRIAPICAL CRYST REMOVAL 280 280 0

4634 ROOT CANAL (3 ROOT) INFECTED RCT ROOT CANAL (3 ROOT) INFECTED RCT 700 800 0

4635 ROOT CANAL (4 ROOT) INFECTED RCT ROOT CANAL (4 ROOT) INFECTED RCT 800 900 0

4636 TEMPORARY METAL CROWN TEMPORARY METAL CROWN 150 100 0

4637 FISSURE SEALANT (ONE TEETH) FISSURE SEALANT (ONE TEETH) 100 100 0

4640 CHILD ANTERIOR(RCT) CHILD ANTERIOR(RCT) 300 300 0

4641 CHILD POSTERIOR CHILD POSTERIOR(RCT) 300 300 0

4646 CBCT FOR IMPLKANTS PT. CBCT FOR IMPLKANTS PT. 400 400 0

4647 FIXED lingual splinting FIXED lingual splinting 700 700 0

4648 gingivectomy gingivectomy 1400 1400 0

4657 Surgical Extraction of (ANT) per tooth Adult Surgical Extraction of (ANT) per tooth Adult 400 400 0

4658 Surgical Extraction of (POST) per tooth Adult Surgical Extraction of (POST) per tooth Adult 800 800 0

4659 Surgical Extraction of Impacted tooth under (soft tissue) (adult) Surgical Extraction of Impacted tooth under (soft tissue) (adult) 1400 1400 0

4660 Surgical Extraction of Impacted tooth under (bony Tissue) (adult) Surgical Extraction of Impacted tooth under (bony Tissue) (adult) 1800 1800 0

4661 Sinus Lifting Surgical procedure (adult) Sinus Lifting Surgical procedure (adult) 3800 3800 0

4662 Surgical Exposure of canine (adult) Surgical Exposure of canine (adult) 1200 1200 0

4663 Insicion and Drainage of Abscess (Child,Adult) Insicion and Drainage of Abscess (Child,Adult) 150 150 0

4664 Avulsed Toth Reimplantation (child,adult) Avulsed Toth Reimplantation (child,adult) 700 700 0

4665 Ortho Panoramic Graph (OPG) Ortho Panoramic Graph (OPG) 250 250 0

4672 Fiber Post Fiber Post 400 400 0

4673 Porcelain Fused to Metal Crown Tooth Porcelain Fused to Metal Crown Tooth 550 550 0

4675 Veneer Per Tooth Veneer Per Tooth 1200 1200 0

4676 Remove Crown from tooth Remove Crown from tooth 80 80 0

4677 Recement of Crown to tooth per tooth Recement of Crown to tooth per tooth 80 80 0

4678 Recement of Bridge Recement of Bridge 200 200 0

4679 Recemnt of Veneer Per Tooth Recemnt of Veneer Per Tooth 180 180 0

4680 Partial Denture Repair Partial Denture Repair 200 200 0

Page 37

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 17 خدمات قسم الأسنان DENTAL

بيان المجموعة 1717 خدمات قسم الأسنان DENTAL

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4683 Complet Denture Repair Complet Denture Repair 300 300 0

4684 Impression of one tooth Impression of one tooth 200 200 0

4685 RCT Removal Complex Post Per Tooth RCT Removal Complex Post Per Tooth 700 800 0

4686 APICEOTOMY (ANT) PER TOOTH APICEOTOMY (ANT) PER TOOTH 2200 2200 0

4688 Pulpoctomy Pulpoctomy 400 400 0

4690 Open flap Currtage Per Quadrant Open flap Currtage Per Quadrant 550 550 0

4691 Fluoride Treatment Fluoride Treatment 220 220 0

4692 StanSteel Crown (Pedo) StanSteel Crown (Pedo) 400 400 0

4693 Lip & Cheek Sucking Appliance Lip & Cheek Sucking Appliance 1200 1200 0

4694 Tongue Thrusting Appliance Tongue Thrusting Appliance 1200 1200 0

4695 RCT For (Post) (Three Canal) By Rotarry Or Manual Per Tooth With Filling RCT For (Post) (Three Canal) By Rotarry Or Manual Per Tooth With Filling 0 0 0

4696 RCT Rttt For (Post) (Three Canal) By Rotarry Or Manual Per Tooth With Filling RCT Rttt For (Post) (Three Canal) By Rotarry Or Manual Per Tooth With Filling 0 0 0

4698 OROANTRAL FISTULA PLUG OROANTRAL FISTULA PLUG 0 0 0

بيان نوع الخدمة 18 خدمات قسم النساء والولادة OBG&OBSTET.

بيان المجموعة 1818 خدمات قسم النساء والولادة OBG

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

522 antenatalcare program antenatalcarprogram 1700 1700

1477 MANUAL EVACUATION MANUAL EVACUATION 125 125

1478 RING REMOVAL RING REMOVAL 80 80

1479 CTG MONITOR CTG MONITOR 450 450

1480 I.U.C.D. APPLICATION/REMOVAL I.U.C.D. APPLICATION/REMOVAL 450 450

2531 CERVICAL CAUTERY CERVICAL CAUTERY 600 600

2532 REMOVAL OF NOR IMPLANT REMOVAL OF NOR IMPLANT 400 400

2533 EVACUATION OF VULVAL PER VAGINA HEAMATO EVACUATION OF VULVAL PER VAGINA HEAMATO 3500 3500

2534 EXCISION OF CLITORIAL CYST EXCISION OF CLITORIAL CYST 3500 3500

2535 VULVAL CYST/ABCESS ASPIRATION VULVAL CYST/ABCESS ASPIRATION 3500 3500

2536 CAUTERIZATION OF VULVAL WARTS MULTIPLE CAUTERIZATION OF VULVAL WARTS MULTIPLE 2500 2500

2537 COLPOSCOPY COLPOSCOPY 3000 3000

2538 CIRCULAGE REMOVAL CIRCULAGE REMOVAL 525 525

2539 HYSTROSCOPY DIVISION OF UT. ADHESIONS HYSTROSCOPY DIVISION OF UT. ADHESIONS 4500 4500

2540 IUD REMOVAL UNDER G.A. IUD REMOVAL UNDER G.A. 4500 4500

2541 IUFD EXPULSION IN DR BEFORE 28 WKS IUFD EXPULSION IN DR BEFORE 28 WKS 4500 4500

2542 CRYO CAUTERY G.A CRYO CAUTERY G.A 3500 3500

2543 CERVICAL POLYPS AVULSION CERVICAL POLYPS AVULSION 2690 2690

2544 OBSTETRIC EXAM GENERAL ANESTH OBSTETRIC EXAM GENERAL ANESTH 2100 2100

2545 OPEN OOPHRECTOMY UNILATERAL OPEN OOPHRECTOMY UNILATERAL 6000 6000

2546 EXCISION OF CERVICAL POLYPS EXCISION OF CERVICAL POLYPS 3000 3000

2547 OBSTETRIC EVACUATION SURGICAL OBSTETRIC EVACUATION SURGICAL 4500 4500

2548 CAUTERIZATION OF VAGINAL SKIN /G.A. CAUTERIZATION OF VAGINAL SKIN /G.A. 2500 2500

2549 D & C D & C 4500 4500

2550 HYSTEROSCOPY + BIOPSY HYSTEROSCOPY + BIOPSY 3500 3500

2551 HYMEN IMPERFORATE INCISION HYMEN IMPERFORATE INCISION 1100 1100

Page 38

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 18 خدمات قسم النساء والولادة OBG&OBSTET.

بيان المجموعة 1818 خدمات قسم النساء والولادة OBG

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2552 ENDOMETRIAL BIOPSY ENDOMETRIAL BIOPSY 2100 2100

2553 POLYPECTOMY FRACT, CURREITAGE POLYPECTOMY FRACT, CURREITAGE 3500 3500

2554 HYSCROSCOPY DIVISION UT. SEPTUM HYSCROSCOPY DIVISION UT. SEPTUM 3500 3500

2555 CONE BIOPSY CONE BIOPSY 3100 3100

2556 HYSTEROSCOPY + POLYPECTOMY HYSTEROSCOPY + POLYPECTOMY 7000 7000

2557 DIAGNOSTIC HYSTOROSCOPY W/BIOPSY DIAGNOSTIC HYSTOROSCOPY W/BIOPSY 3500 3500

2558 UNILATERAL SALPHYNGO-OOPHRECTOMY UNILATERAL SALPHYNGO- OOPHRECTOMY 6000 6000

2559 HYSTEROSCOPY+REMOVAL OF IUCD HYSTEROSCOPY+REMOVAL OF IUCD 4500 4500

2560 HYSTEROSCOPY W/ENDOMETRIAL RESECTION HYSTEROSCOPY W/ENDOMETRIAL RESECTION 4500 4500

2561 DOUGLAS' POUCH ABSCESS DRAINAG DOUGLAS' POUCH ABSCESS DRAINAG 5000 5000

2562 D & INSUFLATION D & INSUFLATION 4500 4500

2563 VAGINAL POLYPECTOMY VAGINAL POLYPECTOMY 3000 3000

2564 BARTHOLIN'S CYST EXCISION BARTHOLIN'S CYST EXCISION 3500 3500

2565 HYMENECTOMY HYMENECTOMY 1100 1100

2566 COLPOPERINEORRHAPHY POSTERIOR COLPOPERINEORRHAPHY POSTERIOR 7000 7000

2567 COLPOPERINEORRHAPHY ANTERIOR COLPOPERINEORRHAPHY ANTERIOR 6000 6000

2568 CERVIX AMPUTATION CERVIX AMPUTATION 7000 7000

2569 CERVICAL CERCLAGE CERVICAL CERCLAGE 6000 6000

2570 DELIVERY NORMAL W/ EPISIOTOMY DELIVERY NORMAL W/ EPISIOTOMY 6000 6000

2571 DELIVERY NORMAL DELIVERY NORMAL 6000 6000

2572 DELIVERY FORCEPS/VENTOUS + EPISI DELIVERY FORCEPS/VENTOUS + EPISI 6000 6000

2573 DELIVERY BREECH W/ EPISIOTOMY DELIVERY BREECH W/ EPISIOTOMY 6000 6000

2574 LAPAROSCOPY DIAGNOSTIC LAPAROSCOPY DIAGNOSTIC 4500 4500

2575 TUBAL LIGATION TUBAL LIGATION 5200 5200

2576 CRAINIOTOMY W/ VAG DELIVERY CRAINIOTOMY W/ VAG DELIVERY 2070 2070

2577 REMOVAL / FALLOPIAN TUBE REMOVAL / FALLOPIAN TUBE 6000 6000

2578 HYSTROSCOPY - DIAGNOSTIC HYSTROSCOPY - DIAGNOSTIC 3500 3500

2579 CIRCULAGE (SHIRODKAR'S OP) CIRCULAGE (SHIRODKAR'S OP) 2500 2500

2580 VENTRO SUSPENSION VENTRO SUSPENSION 9000 9000

2581 INTERNAL PODALLIC VERSION INTERNAL PODALLIC VERSION 2500 2500

2582 ANTERIOR CERVICAL MEDIATINASCOPY ANTERIOR CERVICAL MEDIATINASCOPY 3100 3100

2583 CYST ASPIRATION CYST ASPIRATION 1600 1600

2584 AMNIOCENTESIS (DIAGNOSTIC) AMNIOCENTESIS (DIAGNOSTIC) 2300 2300

2585 CERVICAL BIOPSY CERVICAL BIOPSY 2100 2100

2586 LAPAROTOMY W/ PROCEDURE LAPAROTOMY W/ PROCEDURE 10000 10000

2587 LAPAROTOMY - MINI LAPAROTOMY - MINI 3500 3500

2588 REPAIR OF WOUND SECONDARY SUTURING REPAIR OF WOUND SECONDARY SUTURING 3500 3500

2589 EXCISION/REPAIR OF EPISIOTOMY EXCISION/REPAIR OF EPISIOTOMY 4000 4000

2590 EXCISION HEMANGIOMA EXCISION HEMANGIOMA 3100 3100

2591 MARSUPIALISATION MARSUPIALISATION 3100 3100

2592 METROPLASTY METROPLASTY 4600 4600

2593 VAGINAL/PERINEAL REPAIR VAGINAL/PERINEAL REPAIR 5000 5000

2594 CERVICAL REPAIR CERVICAL REPAIR 5000 5000

2595 DELIVERY TWINS DELIVERY TWINS 6000 6000

Page 39

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 18 خدمات قسم النساء والولادة OBG&OBSTET.

بيان المجموعة 1818 خدمات قسم النساء والولادة OBG

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2596 OPEN OOPHRECTOMY BILATERAL OPEN OOPHRECTOMY BILATERAL 10000 10000

2597 LAP. SALPINGO-OOPHORECTOMY LAP. SALPINGO-OOPHORECTOMY 10000 10000

2598 LAPAROSCOPY WITH D & C LAPAROSCOPY WITH D & C 4500 4500

2599 LAPAROSCOPIC TUBAL LIGATION LAPAROSCOPIC TUBAL LIGATION 10000 10000

2600 OVARIAN CYSTECTOMY OVARIAN CYSTECTOMY 8000 8000

2601 LAP. OVARIAN CYSTECTOMY LAP. OVARIAN CYSTECTOMY 8000 8000

2602 SALPINGO-OOPHORECTOMY SALPINGO-OOPHORECTOMY 10000 10000

2603 MYOMECTOMY MYOMECTOMY 10000 10000

2604 MYOMECTOMY VAGINAL MYOMECTOMY VAGINAL 10000 10000

2605 HYSTROSCOPY RESECTION OF MYOMA HYSTROSCOPY RESECTION OF MYOMA 10000 10000

2606 EXCISION OF VAGINA CYST EXCISION OF VAGINA CYST 3500 3500

2607 TUBAL ABCESS DRAINAGE TUBAL ABCESS DRAINAGE 10000 10000

2608 VULVECTOMY SIMPLE VULVECTOMY SIMPLE 6000 6000

2609 FOTHERGILL'S OPERATION FOTHERGILL'S OPERATION 9000 9000

2610 CLASSICAL REPAIR CLASSICAL REPAIR 10000 10000

2611 VAGINAL HYSTERECTOMY VAGINAL HYSTERECTOMY 12000 12000

2612 00PHRECTOMY 00PHRECTOMY 10000 10000

2613 TUBAL PREGNANCY EXCISION TUBAL PREGNANCY EXCISION 10000 10000

2614 HYSTERECTOMY PARTIAL HYSTERECTOMY PARTIAL 12000 12000

2615 CERVICAL DILATATION GA CERVICAL DILATATION GA 4500 4500

2616 INCISION OF VAILVAL ABSESS INCISION OF VAILVAL ABSESS 3500 3500

2617 REMOVAL OF PLACENTA REMOVAL OF PLACENTA 1100 1100

2618 SUTURING OF PERINEAL LACERATION SUTURING OF PERINEAL LACERATION 5000 5000

2619 REMOVL/PLACENTA & SUTRNG/PERINEAL LACERT REMOVL/PLACENTA & SUTRNG/PERINEAL LACERT 5000 5000

2620 LAPAROSCOPIC OVARIAN ELEC/CAUT LAPAROSCOPIC OVARIAN ELEC/CAUT 8000 8000

2621 CAESARIAN SECTION FOR TWIN CAESARIAN SECTION FOR TWIN 12000 12000

2622 LAPAROSCOPY ASSISTED VAGINAL HISTERECTMY LAPAROSCOPY ASSISTED VAGINAL HISTERECTMY 12000 12000

2623 LAPARATOMY W/PROCEDURE LAPARATOMY W/PROCEDURE 10000 10000

2624 LAPAROSCOPIC ECTOPIC PREGNANCY LAPAROSCOPIC ECTOPIC PREGNANCY 10000 10000

2625 LAPAROSCOPIC REMOVAL OF FOREIGN BODY LAPAROSCOPIC REMOVAL OF FOREIGN BODY 4500 4500

2626 LAPAROSCOPIC MYOMECTOMY LAPAROSCOPIC MYOMECTOMY 10000 10000

2627 MYOMECTOMY RECURRENT MYOMECTOMY RECURRENT 10000 10000

2628 CAESARIAN SECTION CAESARIAN SECTION 10000 10000

2629 CAESARIAN SECTION, REPEATED CAESARIAN SECTION, REPEATED 12000 12000

2630 RECURRENT OVARIAN TUMOUR RECURRENT OVARIAN TUMOUR 8000 8000

2631 CAESARIAN SECTION ABD HYSTCTMY CAESARIAN SECTION ABD HYSTCTMY 16000 16000

2632 LAPAROSCOPIC/TUBOPLASTY LAPAROSCOPIC/TUBOPLASTY 10000 10000

2633 HYSTERECTOMY HYSTERECTOMY 16000 16000

2634 RECTO-VAGINAL FISTULA REPAIR RECTO-VAGINAL FISTULA REPAIR 10000 10000

2635 VESICO-VAGINAL FISTULA REPAIR VESICO-VAGINAL FISTULA REPAIR 10000 10000

2636 LAPAROSCOPIC ADHESIOLYSIS LAPAROSCOPIC ADHESIOLYSIS 10000 10000

2637 LAPAROSCOPIC HYSTECTOMY LAPAROSCOPIC HYSTECTOMY 16000 16000

2638 VULVECTOMY RADICAL VULVECTOMY RADICAL 14000 14000

2639 ABDOMINAL PANHYSTERECTOMY ABDOMINAL PANHYSTERECTOMY 16000 16000

Page 40

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 18 خدمات قسم النساء والولادة OBG&OBSTET.

بيان المجموعة 1818 خدمات قسم النساء والولادة OBG

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2640 HYSTEROTOMY HYSTEROTOMY 12000 12000

2641 HYSTERECTOMY RADICAL HYSTERECTOMY RADICAL 16000 16000

2642 COLPOSCOPY + CERVICAL BIOPSY COLPOSCOPY + CERVICAL BIOPSY 6000 6000

4583 Antenatal care (3rd Visit) Antenatal care (3rd Visit) 0 0 0

4705 ANC 3 MONTHES ANC 3 MONTHES 1200 1200 0

4706 ANC 4 MONTHES ANC 4 MONTHES 1000 1000 0

بيان نوع الخدمة 19 تنويم ADMISSION

بيان المجموعة 1919 تنويم

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2490 INPATIENT CONSULTATION FEES / DAY INPATIENT CONSULTATION FEES / DAY 300 300

2491 SPECIAL NURSING CARE SPECIAL NURSING CARE 500 500

2492 ROOM FIRST CLASS PER DAY ROOM FIRST CLASS PER DAY 1200 1200

2493 ROOM SECOND CLASS PER DAY ROOM SECOND CLASS PER DAY 600 600

2494 ROOM ROYAL SUITE PER DAY ROOM ROYAL SUITE PER DAY 5000 5000

2495 ROOM ISOLATION SPECIAL CARE ROOM ISOLATION SPECIAL CARE 3000 3000

2496 ROOM INTENSIVE CARE PER DAY ROOM INTENSIVE CARE PER DAY 2000 2000

2497 POST ICU COVALESCENCE POST ICU COVALESCENCE 1250 1250

2498 PATIENT COMPANION ACCOMODATION PATIENT COMPANION ACCOMODATION 200 200

2499 ROOM DELUXE SUITE PER DAY ROOM DELUXE SUITE PER DAY 3000 3000

2500 NURSING SERVICE FEE NURSING SERVICE FEE 150 150

2501 OXYGEN PER HOUR OXYGEN PER HOUR 100 100

2502 OXYGEN PER DAY OXYGEN PER DAY 1000 1000

2503 OXYGEN HALF DAY OXYGEN HALF DAY 500 500

2504 INCUBATOR PER DAY INCUBATOR PER DAY 1200 1200

2505 INCUBATOR PORTABLE PER HOUR INCUBATOR PORTABLE PER HOUR 170 170

2506 PHOTOTHERAPY PER DAY PHOTOTHERAPY PER DAY 550 550

2507 VENTILATOR PER DAY VENTILATOR PER DAY 1000 1000

2508 RESPIRATOR PER DAY RESPIRATOR PER DAY 1000 1000

2509 LUMBAR PUNCTURE LUMBAR PUNCTURE 625 625

2510 PHOTOTHERAPY / DAY PHOTOTHERAPY / DAY 500 500

2511 PEDIATRIC EXAMINATION GA PEDIATRIC EXAMINATION GA 1100 1100

2512 PEDIATRIC MANIPULATION GA PEDIATRIC MANIPULATION GA 4000 4000

2513 CHEST PHYSIOTHERAPY 9NEONATE0 CHEST PHYSIOTHERAPY 9NEONATE0 60 60

2514 CATH. SUBCLAVIAN MAHUKAR INSERTION CATH. SUBCLAVIAN MAHUKAR INSERTION 550 550

2515 CODE BLUE CODE BLUE 2700 2700

2516 BLADDER WASHOUT BLADDER WASHOUT 750 750

2517 COLD COMPRESS COLD COMPRESS 10 10

2518 STEAM INHALATION STEAM INHALATION 65 65

2519 RESPIRATOR / HOUR RESPIRATOR / HOUR 65 65

2520 ENEMA FLEET ENEMA FLEET 150 150

2521 TRACHEOSTOMY COLLAR PHILADELPHIA XL TRACHEOSTOMY COLLAR PHILADELPHIA XL 260 260

2522 ATERIAL LINE INSERTION ATERIAL LINE INSERTION 370 370

2523 CATHETERIZATION FEMORAL CATHETERIZATION FEMORAL 370 370

Page 41

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 19 تنويم ADMISSION

بيان المجموعة 1919 تنويم

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2524 VENOUS CUTDOWN VENOUS CUTDOWN 620 620

2525 CVP INSERTION / CARE CVP INSERTION / CARE 1000 1000

2526 NGT INSERTION NGT INSERTION 320 320

2527 ARTERIAL LINE INSERTION ARTERIAL LINE INSERTION 370 370

2528 I.V. PUMP / DAY I.V. PUMP / DAY 150 150

2529 EPIDURAL INFILTARATION EPIDURAL INFILTARATION 1250 1250

2530 ANESTHESIA FOR CT OR MRI ANESTHESIA FOR CT OR MRI 750 750

بيان نوع الخدمة 20 خدمات المراجعة FOLLOW UP

بيان المجموعة 2020 خدمات المراجعة RE- Specialist

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

99 follow up Review 0

بيان نوع الخدمة 21 فحص العماله IQAMA CENTER

بيان المجموعة 2121 فحص العماله

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

276 company iqama test company iqama test 140 140

1006 فحص الاقامة IQAMA TEST 280 280

1007 تجديد الاقامة IQAMA RENEWAL 280 280

1008 فحص الموظفين PRE-EMPLOYMENT MEDICAL EXAM 1000 1000

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2201 الابر والمحاليل

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

345 INJ. ADERNALINE INJ. ADERNALINE 30

346 INJ. ATROPHINE INJ. ATROPHINE 20

347 INJ. ALLERFIN INJ. ALLERFIN 25

348 INJ. BUSCOPAN INJ. BUSCOPAN 30

349 INJ. CALCIUM GLUCONATE INJ. CALCIUM GLUCONATE 45

350 INJ . CORDARONE INJ . CORDARONE 60 10.5

351 INJ. DEXAMETHASONE INJ. DEXAMETHASONE 20

352 INJ. DICYNONE INJ. DICYNONE 25

353 INJ. DOPAMINE INJ. DOPAMINE 70

354 INJ. DOBUTAMINE INJ. DOBUTAMINE 110

355 INJ. DIGOXINE INJ. DIGOXINE 70

356 INJ. ISOPTIN INJ. ISOPTIN 130

357 INJ. EUPHYLLINE INJ. EUPHYLLINE 30

358 INJ. LASIX INJ. LASIX 25

359 INJ. SOLU-CORTEF INJ. SOLU-CORTEF 25

360 INJ. VOLTAREN INJ. VOLTAREN 25

361 INJ. ZANTAC INJ. ZANTAC 20

362 INJ. PRIMPERAN INJ. PRIMPERAN 25

363 TYENOL SUPPOSITORX TYENOL SUPPOSITORX 20

365 INJ. SODIUM BICARBONATE INJ. SODIUM BICARBONATE 25

Page 42

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2201 الابر والمحاليل

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

366 INJ. METROGYL INJ. METROGYL 55

367 INJ. SYNTOCINON INJ. SYNTOCINON 20

368 INJ. TOWAGYL INJ. TOWAGYL 20

369 INJ. DORMICUM INJ. DORMICUM 20

370 INJ. NOOTROPHIL INJ. NOOTROPHIL 25

371 INJ. PHENYTOIN INJ. PHENYTOIN 75

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2202 التطعيمات

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1118 PREVINAR VACCINE PREVINAR VACCINE 730 730

1119 VAXIGRIP VACCINE VAXIGRIP VACCINE 150 150

1120 VARICELLA VACCINE VARICELLA VACCINE 450 450

1121 VACCINATION, HEPATITIS VACCINATION, HEPATITIS 230 230

1122 VACCINATION, POLIO AND DPT VACCINATION, POLIO AND DPT 110 110

1123 VACCINATION, POLIO VACCINATION, POLIO 60 60

1124 VACCINATION, DPT VACCINATION, DPT 230 230

1125 HIBERIX VACCINE HIBERIX VACCINE 130 130

1126 VACCINATION, POLIO AND DT VACCINATION, POLIO AND DT 120 120

1127 VACCINATION, DT VACCINATION, DT 60 60

1128 VACCINATION, MEASLES VACCINATION, MEASLES 70 70

1129 TWINRIX ADULTS VACCINE TWINRIX ADULTS VACCINE 320 320

1130 VACCINATION, MMR VACCINATION, MMR 180 180

1131 VACCINATION, BCG VACCINATION, BCG 120 120

1132 SYNFLORIX VACCINE SYNFLORIX VACCINE 350 350

1133 PEDIACEL VACCINE PEDIACEL VACCINE 320 320

1134 ROTARIX VACCIN ROTARIX VACCIN 550 550

1135 INFANRIX HEXA AMP INFANRIX HEXA AMP 450 450

1136 HAVRIX 1ML (CHILD DOSE)VIAL HAVRIX 1ML (CHILD DOSE)VIAL 230 230

1137 AVAXIM (HEP.A VACCINE)PEDATRIC AVAXIM (HEP.A VACCINE)PEDATRIC 270 270

1138 HIBTITER IM 0.5ML VIAL HIBTITER IM 0.5ML VIAL 220 220

1139 TETAVAX SYRING 0.5ML TETAVAX SYRING 0.5ML 60 60

1140 ACTACEL VACCIN ACTACEL VACCIN 300 300

1141 BCG VACCINE VIAL/10 DOSES BCG VACCINE VIAL/10 DOSES 420 420

1142 INFANRIX IPV HIB INFANRIX IPV HIB 320 320

1143 TUBERCULIN TEST(PPD) SC 1ML=20 DOSES TUBERCULIN TEST(PPD) SC 1ML=20 DOSES 210 210

1144 ACT-HIB VACCINE 10 MICROGRAM / VIAL ACT-HIB VACCINE 10 MICROGRAM / VIAL 210 210

1145 RABIES VACCINE RABIES VACCINE 190 190

1146 PNEUMO 23 0.5ML SYRINGE PNEUMO 23 0.5ML SYRINGE 150 150

1147 MENINGOCOCCAL ACWY VACCINE MENINGOCOCCAL ACWY VACCINE 160 160

1148 MENACTRA VACCINE MENACTRA VACCINE 750 750

1149 MENINGOCOCCAL A/C/W/Y (STAFF/FAMILY) MENINGOCOCCAL A/C/W/Y (STAFF/FAMILY) 160 160

1150 TETRA ACT-HIB 0.5ML SC IM VIALS TETRA ACT-HIB 0.5ML SC IM VIALS 210 210

1151 PNEUMOCOCCAL VACCINE PNEUMOCOCCAL VACCINE 210 210

Page 43

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2202 التطعيمات

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1152 TRIPACELL 0.5ML IM SC AMPOULES TRIPACELL 0.5ML IM SC AMPOULES 160 160

1153 TYPHOID VACCINE 20 DOSES IN 10ML VIAL TYPHOID VACCINE 20 DOSES IN 10ML VIAL 130 130

1154 TYPHOID VACCINE 1 DOSE VIAL TYPHOID VACCINE 1 DOSE VIAL 130 130

1155 TRITANIREX HIB VACCINE TRITANIREX HIB VACCINE 225 225

1156 TETRAIMMUNE VACCIN TETRAIMMUNE VACCIN 165 165

1157 INFANRIX VACCINE INFANRIX VACCINE 165 165

1158 INFANRIX HIB VACCINE INFANRIX HIB VACCINE 270 270

1159 ENGERIX B10 HEPATITIS B VACCINE PED ENGERIX B10 HEPATITIS B VACCINE PED 250 250

1160 ENGERIX B 20 HEPATITIS B VACCIN ADULT ENGERIX B 20 HEPATITIS B VACCIN ADULT 250 250

1161 INFLUVAC 0.5ML IM SC SYRINGES INFLUVAC 0.5ML IM SC SYRINGES 250 250

1162 ARAMEN MENINGOCOCCAL CONJUGATE ARAMEN MENINGOCOCCAL CONJUGATE 450 450

1163 MENCEVAX (MENINGICOCL VACCINE) MENCEVAX (MENINGICOCL VACCINE) 450 450

1164 BOOSTRIX VACCINE BOOSTRIX VACCINE 100 100

1165 VACCINATION, MENINGITIS VACCINATION, MENINGITIS 450 450

1166 VACCINATION, CHOLERA VACCINATION, CHOLERA 60 60

1167 PRIORIX TETRA VACCINE PRIORIX TETRA VACCINE 440 440

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

364 multiparine injection2500 multiparine injection2500 22 22

372 NITRODERM PATCH 5MG NITRODERM PATCH 5MG 25

373 NITRODERM PATCH 10MG NITRODERM PATCH 10MG 25

374 ANTI-MENINGITIS ANTI-MENINGITIS 350

375 PANADOL TAB PANADOL TAB 2

376 INJ. TETANUS TOXOID INJ. TETANUS TOXOID 30

377 ANTI-TYPHOID VACCINE ANTI-TYPHOID VACCINE 70

378 INJ. PETHIDINE INJ. PETHIDINE 35

379 INJ. XEFO INJ. XEFO 50

380 INJ. MANNITOL INJ. MANNITOL 75

381 INJ. VALIUM INJ. VALIUM 50

382 INJ. TRAMAL INJ. TRAMAL 30

383 INJ. MORPHINE INJ. MORPHINE 30

384 INJ.INDERAL INJ.INDERAL 100

385 INJ. POTASSIUM CHLORIDE INJ. POTASSIUM CHLORIDE 25

386 INJ. MAGNESIUM SULPHATE INJ. MAGNESIUM SULPHATE 25

387 INJ. LIVOPHED INJ. LIVOPHED 20

388 INJ. METHERGIN INJ. METHERGIN 50

389 INJ. HEPARIN INJ. HEPARIN 250

390 INJ. HUMILIN R INJ. HUMILIN R 120

391 INJ. STREPTOKINASE INJ. STREPTOKINASE 1000

392 INJ. AMINOPHYLLIN INJ. AMINOPHYLLIN 30

393 INJ. AUGMENTIN 1.2MG INJ. AUGMENTIN 1.2MG 60

Page 44

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

394 INJ. SAMIXON 500MG INJ. SAMIXON 500MG 60

395 INJ.TRIAXONE 1MG INJ.TRIAXONE 1MG 100

396 INJ. ZITHROMAX 500MG INJ. ZITHROMAX 500MG 50

397 INJ. SAMIXONE 1000 MG INJ. SAMIXONE 1000 MG 100

398 INJ.ANTI-TETANUS INJ.ANTI-TETANUS 140

399 INJ. ROCEPHINE 1 GM INJ. ROCEPHINE 1 GM 120

400 INJ.KENACORT OR DIPROFOS INJ.KENACORT OR DIPROFOS 40

401 RISEK VIAL RISEK VIAL 65

402 INJ. NEGACEF 1G INJ. NEGACEF 1G 70

403 INJ. ENOXIRT 1G INJ. ENOXIRT 1G 95

404 INJ. ENOXIRT 500MG INJ. ENOXIRT 500MG 55

405 INJ. ATROVENT INJ. ATROVENT 20

406 INJ. PULMICORT INJ. PULMICORT 25

407 INJ. EPICOCILLIN 1G INJ. EPICOCILLIN 1G 25

408 INJ. EPICOCILLIN 500MG INJ. EPICOCILLIN 500MG 18

409 INJ. DEPOVIT B12 INJ. DEPOVIT B12 20

410 INJ. NEUROBINE INJ. NEUROBINE 25

411 INJ. MIACIN INJ. MIACIN 30

412 INJ. JULMENTINE INJ. JULMENTINE 60

413 INJ. FEROSAC AMP INJ. FEROSAC AMP 90

414 INJ.ZINACEF 1.5 GM INJ.ZINACEF 1.5 GM 70

415 INJ. VANCOLON 500 INJ. VANCOLON 500 80

416 INJ.KONAKION INJ.KONAKION 60

417 INJ. KAPRARTI AMP INJ. KAPRARTI AMP 70

418 INJECTION OUTSIDE INJECTION OUTSIDE 10

419 PERFALGAN INJ PERFALGAN INJ 60

420 NORMAL SALINE NORMAL SALINE 50

421 RINGE SOLUTION RINGE SOLUTION 60

422 RINGE LACTAT SOLUTION RINGE LACTAT SOLUTION 70

423 DEXTROSE 5% DEXTROSE 5% 60

424 DEXTROSE 10% DEXTROSE 10% 70

425 DEXTROSE 25% DEXTROSE 25% 80

426 DEXTROSE 5% NORMAL SALINE DEXTROSE 5% NORMAL SALINE 60

427 1/2 DEXTROSE NORMAL SALINE 1/2 DEXTROSE NORMAL SALINE 70

428 1/4 DEXTROSE NORMAL SALINE 1/4 DEXTROSE NORMAL SALINE 70

429 SUPP. FEVADOL 200mg SUPP. FEVADOL 200mg 15

430 SUPP. FEVADOL 100mg SUPP. FEVADOL 100mg 15

431 SUP. FEVADOL 125mg SUP. FEVADOL 125mg 15

432 SUPP. FEVADOL 250mg SUPP. FEVADOL 250mg 15

433 SUPP. DICLOFENAC 25mg SUPP. DICLOFENAC 25mg 15

434 SUPP. DICLOFENAC 12.5 SUPP. DICLOFENAC 12.5 15

435 FUSIBACT OINTMENT (cream) FUSIBACT OINTMENT (cream) 20

436 MEBO (CREAM) MEBO (CREAM) 20

437 LIDOCAIN (GEL) LIDOCAIN (GEL) 20

438 INJ. AMIKACIN INJ. AMIKACIN 50

439 INJ. CA-GLUCONATE INJ. CA-GLUCONATE 50

Page 45

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

440 INJ. AMPICILLIN INJ. AMPICILLIN 40

441 INJ. OPRAZOLE INJ. OPRAZOLE 70

442 INJ. CEFTRIAXONE INJ. CEFTRIAXONE 100

443 INJ 2% LIDOCAIN INJ 2% LIDOCAIN 20

444 INJ. LEVOFLOXACIN INJ. LEVOFLOXACIN 100

445 LIDOCAIN SPRAY LIDOCAIN SPRAY 20

446 INJ. 3 NaHCo INJ. 3 NaHCo 40

447 INJ. 4 Mgso INJ. 4 Mgso 40

448 INJ. Dexa INJ. Dexa 30

449 INJ. TETAVAX INJ. TETAVAX 70

450 INJ. SNAKE ANTIVENO INJ. SNAKE ANTIVENO 50

451 INJ. SCORPION ANTIVENOM INJ. SCORPION ANTIVENOM 50

452 INJ. ATROPIN INJ. ATROPIN 30

453 INJ. CIOROFLOXACIN INJ. CIOROFLOXACIN 70

454 INJ. METRONIDAZOLE INJ. METRONIDAZOLE 70

455 INJ. HYDROCORTISONE 250mg INJ. HYDROCORTISONE 250mg 50

456 INJ. HYDROCORTISONE 100mg INJ. HYDROCORTISONE 100mg 40

457 INJ. PANTOPRAZOLE INJ. PANTOPRAZOLE 80

458 INJ. CEFUROXIME INJ. CEFUROXIME 90

459 INJ. CEFTRIAXONE IV 500mg INJ. CEFTRIAXONE IV 500mg 75

460 INJ. DICLOFENAC INJ. DICLOFENAC 30

461 INJ. NEURORUBINE INJ. NEURORUBINE 30

462 INJ. SCOPINAL INJ. SCOPINAL 30

463 INJ. CHLOROHISTOL INJ. CHLOROHISTOL 40

464 INJ. PREMOSAN INJ. PREMOSAN 25

465 INJ. RANITIDINE INJ. RANITIDINE 70

466 SALBUTAMOL SALBUTAMOL 50

467 ATROVENT ATROVENT 50

468 PULMICORT PULMICORT 50

469 TAB. AMLODIPINE TAB. AMLODIPINE 20

470 TAB. CONCORE 5mg TAB. CONCORE 5mg 20

471 TAB. CONCORE 10mg TAB. CONCORE 10mg 20

472 TAB. ASPIRIN TAB. ASPIRIN 20

498 Large Abscess Drainage ( or deep / big ) any area LA Large Abscess Drainage ( or deep / big ) any area LA 300 300

499 Anterior Nasal Pack Anterior Nasal Pack 120 120

500 Tympanometry / AUDIOGRAM&TYMPANOGRAM / PTA ( PURE TONE AUDIOMETRY ) for each one Tympanometry / AUDIOGRAM&TYMPANOGRAM / PTA ( PURE TONE AUDIOMETRY ) for each one 100 100

501 OXYGEN ( O2 ) INHALATION / HOUR OXYGEN ( O2 ) INHALATION / HOUR 20 20

502 CAST REMOVAL CAST REMOVAL 50 50

503 SUTURE (Stitch) REMOVAL SUTURE (Stitch) REMOVAL 10 10

504 EAR PIERCING & Ring ( Earing / Earring ) EAR PIERCING & Ring ( Earing / Earring ) 70 70

505 Dressing, small ( minor ) Dressing, small ( minor ) 20 20

506 MEDIUM DRESSING MEDIUM DRESSING 30 30

507 BIG DRESSING ( MAJOR , Large ) BIG DRESSING ( MAJOR , Large ) 50 50

508 Drainage of a small abscess / superficial any area LA Drainage of a small abscess / superficial any area LA 100 100

Page 46

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

509 Excision Sebaceous cyst Excision Sebaceous cyst 200 200

510 Excision of Small Lipoma Under Local Anesthesia LA Excision of Small Lipoma Under Local Anesthesia LA 200 200

511 Major Dressing burn ( big , Large ) Major Dressing burn ( big , Large ) 100 100

512 Medium Dress Burn Medium Dress Burn 70 70

513 Minor DressBurn ( small ) Minor DressBurn ( small ) 50 50

514 Fleet Enema Fleet Enema 60 60

515 IV CANNULA + Insertion IV CANNULA + Insertion 30 30

516 Skin sensitivity testing Skin sensitivity testing 10 10

517 ( Electro - Cryo - Chemical ) Cautery for every 1 Wart ( Electro - Cryo - Chemical ) Cautery for every 1 Wart 50 50

518 Circumcision (6 - 12 yrs) with Local Anaethesia Circumcision (6 - 12 yrs) with Local Anaethesia 500 500

519 Unilateral Ear Wash Unilateral Ear Wash 50 50

520 Bilateral Ear Wash Bilateral Ear Wash 80 80

521 Nasogastric ( NG ) Tube Fixation & Gastric Lavage / stomach wash NGT Nasogastric ( NG ) Tube Fixation & Gastric Lavage / stomach wash NGT 100 100

523 IV Fluid Infusion ( IVF ) IV Fluid Infusion ( IVF ) 100 100

524 JOINT TAPING / ASPIRATION SMALL JOINT JOINT TAPING / ASPIRATION SMALL JOINT 50 50

525 Foreign Body Extraction from nose or ear or throat Foreign Body Extraction from nose or ear or throat 100 100

526 IV injection ( intra venous ) IV injection ( intra venous ) 14 14

527 INJECTION/SC W/O MEDICINE INJECTION/SC W/O MEDICINE 10 10

528 Removal ( excision ) OF BARTHolin CYST Removal ( excision ) OF BARTHolin CYST 200 200

529 CALLUS EXCISION / callous CALLUS EXCISION / callous 200 200

530 LOCAL INJECTION TO (JOINT OR TENDON / INTRA LESIONAL / Subconjunctival / Intra-C LOCAL INJECTION TO (JOINT OR TENDON / INTRA LESIONAL / Subconjunctival / Intra-C 100 100

531 Ant + Post Nasal Packs one side Ant + Post Nasal Packs one side 200 200

532 Cautery cervical errosion ( chelical or electrical or thermal ) Cautery cervical errosion ( chelical or electrical or thermal ) 600 600

533 Removal of Subcutaneous Foreign Body LA Removal of Subcutaneous Foreign Body LA 200 200

534 Removal of Cervical polyp & cautery Removal of Cervical polyp & cautery 300 300

535 Steam + drug by NEBULIZER or with Oxygen / nebulization set Steam + drug by NEBULIZER or with Oxygen / nebulization set 40 40

536 Dressing For Diabetic Foot ( 1 foot ) Dressing For Diabetic Foot ( 1 foot ) 200 200

537 LACRIMAL PASSAGE SYRINGING & WASH LACRIMAL PASSAGE SYRINGING & WASH 150 150

538 HOLTER MONITORING / DAY HOLTER MONITORING / DAY 300 300

539 Posterior nasal pack Posterior nasal pack 120 120

540 POP CAST BELOW ELBOW / KNEE FOR CHILD (GYPSONA) / short leg or arm POP CAST BELOW ELBOW / KNEE FOR CHILD (GYPSONA) / short leg or arm 250 250

541 POP CAST BELOW ELBOW / KNEE FOR CHILD (SCOTCH) / short leg or arm POP CAST BELOW ELBOW / KNEE FOR CHILD (SCOTCH) / short leg or arm 300 300

542 POP CAST ABOVE ELBOW / KNEE FOR CHILD (GYPSONA) / long leg or arm POP CAST ABOVE ELBOW / KNEE FOR CHILD (GYPSONA) / long leg or arm 300 300

543 POP CAST ABOVE ELBOW / KNEE FOR CHILD (SCOTCH) / long leg or arm POP CAST ABOVE ELBOW / KNEE FOR CHILD (SCOTCH) / long leg or arm 350 350

544 POP CAST BELOW ELBOW / KNEE FOR ADULT (GYPSONA) / short leg or arm POP CAST BELOW ELBOW / KNEE FOR ADULT (GYPSONA) / short leg or arm 300 300

545 POP CAST BELOW ELBOW / KNEE FOR ADULT (SCOTCH) /short leg or arm POP CAST BELOW ELBOW / KNEE FOR ADULT (SCOTCH) /short leg or arm 350 350

546 POP CAST ABOVE ELBOW / KNEE FOR ADULT (GYPSONA) / long leg or arm POP CAST ABOVE ELBOW / KNEE FOR ADULT (GYPSONA) / long leg or arm 350 350

547 POP CAST ABOVE ELBOW / KNEE FOR ADULT (SCOTCH) / long leg or arm POP CAST ABOVE ELBOW / KNEE FOR ADULT (SCOTCH) / long leg or arm 400 400

Page 47

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

548 ECG WITH REPORT ECG WITH REPORT 100 100

549 UNILATERAL EAR SUCTION ( one ear ) UNILATERAL EAR SUCTION ( one ear ) 40 40

550 REMOVAL OF URETHERAL / URINE CATHETER REMOVAL OF URETHERAL / URINE CATHETER 25 25

551 CTG (CARDIO TOPGRAPHY) (FETAL HEART) CTG (CARDIO TOPGRAPHY) (FETAL HEART) 120 120

552 FB REMOVAL eye FB REMOVAL eye 100 100

553 CHALAZION EXCISION LA CHALAZION EXCISION LA 200 200

554 1% W-V LIDOCAINE HCL INJECTION USP 1% W-V LIDOCAINE HCL INJECTION USP 22 22

555 15% W-V POTASSIUM CHLORIDE FOR INJ. USP 15% W-V POTASSIUM CHLORIDE FOR INJ. USP 15 15

556 2% W-V LIDOCAINE HCL INJECTION USP 2% W-V LIDOCAINE HCL INJECTION USP 18 18

557 ACLASTA 5MG-100ML SOLUTION FOR Infusion ACLASTA 5MG-100ML SOLUTION FOR Infusion 4077 4077

558 ACTACEL VACCINE ACTACEL VACCINE 299 299

559 ACTILYSE SET(2VLS+2SOLV&INFSET) ACTILYSE SET(2VLS+2SOLV&INFSET) 6471 6471

560 ACTRAPID ACTRAPID 140 140

561 ADENOCOR 6MG-2ML VIAL ADENOCOR 6MG-2ML VIAL 67 67

562 ADENOHARDT 30MG/10ML SOLUTION FOR INFUSION ADENOHARDT 30MG/10ML SOLUTION FOR INFUSION 140 140

563 ADENOHARDT 6MG/2ML SOLUTION FOR INFUSION ADENOHARDT 6MG/2ML SOLUTION FOR INFUSION 62 62

564 ADRIBLASTINA 10MG VIAL & SOLV ADRIBLASTINA 10MG VIAL & SOLV 67 67

565 ADRIBLASTINA 50MG VIAL & SOLV ADRIBLASTINA 50MG VIAL & SOLV 244 244

566 AGGRASTAT 0.25MG/ML I.V. VIAL AGGRASTAT 0.25MG/ML I.V. VIAL 2460 2460

567 AIMAFIX 500I.U. POW. FOR SOLU. FOR INFU AIMAFIX 500I.U. POW. FOR SOLU. FOR INFU 1119 1119

568 ALBUMINATIVE 20% I.V. ALBUMINATIVE 20% I.V. 441 441

569 ALBUTEIN 20% SOLN. FOR INJ ALBUTEIN 20% SOLN. FOR INJ 352 352

570 ALEXAN 20MG-1ML VIAL ALEXAN 20MG-1ML VIAL 42 42

571 ALEXAN 50MG-ML VIAL ALEXAN 50MG-ML VIAL 159 159

572 ALIMTA 500MG POWDER FOR SOLUTION FOR INFUSION ALIMTA 500MG POWDER FOR SOLUTION FOR INFUSION 11654 11654

573 ALPHANATE 250 IU VIAL+5ML DILUENT ALPHANATE 250 IU VIAL+5ML DILUENT 852 852

574 AMBISOME 50 MG VIAL AMBISOME 50 MG VIAL 899 899

575 AMOCLAN 1.2 GM VIAL AMOCLAN 1.2 GM VIAL 39 39

576 AMOCLAN 600MG VIAL AMOCLAN 600MG VIAL 27 27

577 AMOXIL VIALS 500 MG AMOXIL VIALS 500 MG 24 24

578 AMOXIPLUS 1.2GM POWDER FOR INJECTION AMOXIPLUS 1.2GM POWDER FOR INJECTION 22 22

579 AMPICILLIN 1GM POWDER FOR IV AND IM INJECTION AMPICILLIN 1GM POWDER FOR IV AND IM INJECTION 18 18

580 AMPICILLIN 500MG POWDER FOR IV AND IM INJECTION AMPICILLIN 500MG POWDER FOR IV AND IM INJECTION 16 16

581 AMPIPLUS 1.5GM POWDER FOR INJECTION AMPIPLUS 1.5GM POWDER FOR INJECTION 40 40

582 ANZATAX 6MG-ML VIAL ANZATAX 6MG-ML VIAL 1165 1165

583 APIDRA 100 U- ML Injection APIDRA 100 U- ML Injection 69 69

584 ARAMEN POWDER SOLUTION FOR INJECTION (VIAL+VIAL) ARAMEN POWDER SOLUTION FOR INJECTION (VIAL+VIAL) 503 503

585 ARAPENTA Injection ARAPENTA Injection 172 172

586 ATROVENT 250MCG-2ML UDV (SOLUTION FOR INHALATION) ATROVENT 250MCG-2ML UDV (SOLUTION FOR INHALATION) 13 13

587 ATROVENT 500MCG-2ML UDV (SOLUTION ATROVENT 500MCG-2ML UDV 15 15

Page 48

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

FOR INHALATION) (SOLUTION FOR INHALATION)

588 AUGMENTIN 1.2GM VIAL AUGMENTIN 1.2GM VIAL 51 51 0

589 AUGMENTIN 600MG VIAL AUGMENTIN 600MG VIAL 30 30

590 AVONEX 30MCG LYOPHILIZED POWDER FOR INJ AVONEX 30MCG LYOPHILIZED POWDER FOR INJ 2369 2369

591 BCG VACCINE SSI 0.75MG-VIAL BCG VACCINE SSI 0.75MG-VIAL 137 137

592 BENEFIX 1000 I.U. POWDER FOR SOLUTION FOR INJECTION BENEFIX 1000 I.U. POWDER FOR SOLUTION FOR INJECTION 7618 7618

593 BENEFIX 2000 I.U. POWDER FOR SOLUTION FOR INJECTION BENEFIX 2000 I.U. POWDER FOR SOLUTION FOR INJECTION 15227 15227

594 BENEFIX 250 I.U. POWDER FOR SOLUTION FOR INJECTION BENEFIX 250 I.U. POWDER FOR SOLUTION FOR INJECTION 1912 1912

595 BENEFIX 500 I.U. POWDER FOR SOLUTION FOR INJECTION BENEFIX 500 I.U. POWDER FOR SOLUTION FOR INJECTION 3814 3814

596 BENLYSTA 120MG POWDER FOR SOLUTION FOR INFUSION BENLYSTA 120MG POWDER FOR SOLUTION FOR INFUSION 915 915

597 BENLYSTA 400MG POWDER FOR SOLUTION FOR INFUSION BENLYSTA 400MG POWDER FOR SOLUTION FOR INFUSION 3028 3028

598 BETAFERON 8MIU\ML VIAL BETAFERON 8MIU\ML VIAL 688 688

599 BLEOCIN 15MG VIAL BLEOCIN 15MG VIAL 204 204

600 BOOSTRIX 0.5 ML SUSPENSION FOR INJECTION VACCINE BOOSTRIX 0.5 ML SUSPENSION FOR INJECTION VACCINE 136 136

601 BOTOX 100UNITS BOTOX 100UNITS 1886 1886

602 BRAVELLE 75IU POWDER FOR SOLU. FOR INJ BRAVELLE 75IU POWDER FOR SOLU. FOR INJ 116 116

603 BRIETAL SODIUM 500MG - 50ML VIAL BRIETAL SODIUM 500MG - 50ML VIAL 41 41

604 BUCAINE 0.25% VIAL BUCAINE 0.25% VIAL 43 43

605 BUCAINE 0.5% VIAL BUCAINE 0.5% VIAL 44 44

606 BUMINATE 25% BOTTLE FOR I.V ADMINISTERAT BUMINATE 25% BOTTLE FOR I.V ADMINISTERAT 152 152

607 CALCIUM FOLINATE (EBEWE) 10MG-ML VIAL CALCIUM FOLINATE (EBEWE) 10MG-ML VIAL 377 377

608 CALCIUM FOLINATE 50MG-5ML VIAL CALCIUM FOLINATE 50MG-5ML VIAL 174 174

609 CAMPTO 100MG-5ML VIAL FOR I.V INFUSION CAMPTO 100MG-5ML VIAL FOR I.V INFUSION 1762 1762

610 CANCIDAS 50 MG VIAL CANCIDAS 50 MG VIAL 5107 5107

611 CANCIDAS 70 MG VIAL CANCIDAS 70 MG VIAL 6493 6493

612 CARBOPLATIN "EBEWE" 50MG-5ML CARBOPLATIN "EBEWE" 50MG-5ML 356 356

613 CARBOPLATIN 10MG-ML VIAL CARBOPLATIN 10MG-ML VIAL 903 903

614 CAVERJECT 20MCG VIAL CAVERJECT 20MCG VIAL 156 156

615 CEFAXON 1GM I.M+5 ML LIDOCAINE VIAL CEFAXON 1GM I.M+5 ML LIDOCAINE VIAL 106 106

616 CEFAXON 1GM I.V VIAL CEFAXON 1GM I.V VIAL 106 106

617 CEFAXON 500 MG I.M+5 ML LIDOCAINE VIAL CEFAXON 500 MG I.M+5 ML LIDOCAINE VIAL 69 69

618 CEFAXON 500 MG I.V VIAL CEFAXON 500 MG I.V VIAL 69 69

619 CEFAZOLIN 0.5GM VIAL CEFAZOLIN 0.5GM VIAL 23 23

620 CEFAZOLIN 1GM VIAL CEFAZOLIN 1GM VIAL 32 32

621 CEFIZOX 1000 VIAL I-V CEFIZOX 1000 VIAL I-V 71 71

622 CEFIZOX 1000MG I-M VIAL+SOLV 0.5%LIDOCAI CEFIZOX 1000MG I-M VIAL+SOLV 0.5%LIDOCAI 71 71

623 CEFIZOX 2000 VIAL CEFIZOX 2000 VIAL 122 122

624 CEFIZOX 500 VIAL I-V CEFIZOX 500 VIAL I-V 48 48

625 CEFIZOX 500MG I-M VIAL+SOLV 0.5%LIDOCAIN CEFIZOX 500MG I-M VIAL+SOLV 0.5%LIDOCAIN 48 48

626 CEFOBID 1GM VIAL I-M & I-V CEFOBID 1GM VIAL I-M & I-V 51 51

Page 49

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

627 CEFOBID 2GM VIAL I-M & I-V CEFOBID 2GM VIAL I-M & I-V 81 81

628 CEFOFIX 1.5 GM VIAL CEFOFIX 1.5 GM VIAL 50 50

629 CEFOFIX 750 MG VIALS CEFOFIX 750 MG VIALS 32 32

630 CEFROM 1GM VIAL+10ML WATER FOR INFUSION CEFROM 1GM VIAL+10ML WATER FOR INFUSION 171 171

631 CEFROM 2GM VIAL+20ML WATER FOR INFUSION CEFROM 2GM VIAL+20ML WATER FOR INFUSION 297 297

632 CEFROM 500MG VIAL+5ML WATER FOR INFUSION CEFROM 500MG VIAL+5ML WATER FOR INFUSION 109 109

633 CEFTAX 1000MG VIAL+SOLVENT CEFTAX 1000MG VIAL+SOLVENT 85 85

634 CEFTAX 500MG VIAL+SOLVENT CEFTAX 500MG VIAL+SOLVENT 57 57

635 CEFUZIME 750 MG INJECTION,I.M - I.V VIAL CEFUZIME 750 MG INJECTION,I.M - I.V VIAL 30 30

636 CEPHRADINE -TABUK 1GM VIAL(I.V-I.M) CEPHRADINE -TABUK 1GM VIAL(I.V-I.M) 22 22

637 CEPHRADINE -TABUK 500MG VIAL (I.V-I.M) CEPHRADINE -TABUK 500MG VIAL (I.V- I.M) 17 17

638 CEPROTIN 1000 IU POWDER FOR SOLUTION FOR INJECTION OR INFUSION CEPROTIN 1000 IU POWDER FOR SOLUTION FOR INJECTION OR INFUSION 19203 19203

639 CEPROTIN 500 IU POWDER FOR SOLUTION FOR INJECTION OR INFUSION CEPROTIN 500 IU POWDER FOR SOLUTION FOR INJECTION OR INFUSION 9607 9607

640 CERNEVIT INJECTION CERNEVIT INJECTION 60 60

641 CERVARIX VACCINE CERVARIX VACCINE 543 543

642 CETROTIDE 0.25MG POW. FOR SOLU. FOR INJ. CETROTIDE 0.25MG POW. FOR SOLU. FOR INJ. 323 323

643 CETROTIDE 3MG POW. FOR SOLU. FOR INJ. CETROTIDE 3MG POW. FOR SOLU. FOR INJ. 1887 1887

644 CHORIOMON 1000 I.U VIAL+AMP OF SOLVENT CHORIOMON 1000 I.U VIAL+AMP OF SOLVENT 20 20

645 CHORIOMON 5000 I.U VIAL+AMP OF SOLVENT CHORIOMON 5000 I.U VIAL+AMP OF SOLVENT 105 105

646 CIFLOX 200MG-100ML I.V. INFUSION CIFLOX 200MG-100ML I.V. INFUSION 137 137

647 CIPROBAY 200 VIAL CIPROBAY 200 VIAL 237 237

648 CISPLATIN 0.5MG-ML INJ. CISPLATIN 0.5MG-ML INJ. 59 59

649 CISPLATIN 1MG-1ML VIAL CISPLATIN 1MG-1ML VIAL 119 119

650 CISPLATYL 10MG VIAL CISPLATYL 10MG VIAL 67 67

652 CISPLATYL 25MG VIAL CISPLATYL 25MG VIAL 125 125

653 CISPLATYL 50MG VIAL CISPLATYL 50MG VIAL 143 143

654 CLAFO 0.5GM POWDER FOR INJ. I.M I.V VIAL CLAFO 0.5GM POWDER FOR INJ. I.M I.V VIAL 19 19

655 CLAFO 1GM POWDER FOR INJ. I.M I.V VIAL CLAFO 1GM POWDER FOR INJ. I.M I.V VIAL 26 26

656 CLAFORAN 1 GM I.V. VIAL CLAFORAN 1 GM I.V. VIAL 100 100

657 CLAFORAN 1 GM (LIDOCAINE) IM VIAL CLAFORAN 1 GM (LIDOCAINE) IM VIAL 100 100

658 CLAFORAN 500 MG I.M.-I.V.VIALS CLAFORAN 500 MG I.M.-I.V.VIALS 66 66

659 CLAFOTAX 1GM I.M VIAL CLAFOTAX 1GM I.M VIAL 69 69

660 CLAFOTAX 1GM I.V VIAL CLAFOTAX 1GM I.V VIAL 69 69

661 CLAFOTAX 500MG I.V VIAL CLAFOTAX 500MG I.V VIAL 47 47

662 CLINDAMYCIN PHOSPHATE 150MG-ML INJ CLINDAMYCIN PHOSPHATE 150MG-ML INJ 52 52

663 CLOXA 1000MG VIAL CLOXA 1000MG VIAL 15 15

664 CLOXA 500MG VIAL CLOXA 500MG VIAL 14 14

665 CONFORTID INJ I.V 50MG CONFORTID INJ I.V 50MG 77 77

666 CURAM 1.2GM POW. FOR SOLN. FOR INJECTION- INFUSION CURAM 1.2GM POW. FOR SOLN. FOR INJECTION- INFUSION 23 23

Page 50

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

667 CURAM 2.2GM POW. FOR SOLN. FOR INJECTION- INFUSION CURAM 2.2GM POW. FOR SOLN. FOR INJECTION- INFUSION 32 32

668 CURAM 600MG POW. FOR SOLN. FOR INJECTION- INFUSION CURAM 600MG POW. FOR SOLN. FOR INJECTION- INFUSION 18 18

669 CYCLOPHOSPHAMIDE 1000MG VIAL CYCLOPHOSPHAMIDE 1000MG VIAL 47 47

670 CYCLOPHOSPHAMIDE 100MG VIAL CYCLOPHOSPHAMIDE 100MG VIAL 17 17

671 CYCLOPHOSPHAMIDE 200MG VIAL CYCLOPHOSPHAMIDE 200MG VIAL 19 19

672 CYTARABINE 100MG-1ML VIAL CYTARABINE 100MG-1ML VIAL 131 131

673 CYTOSAR 1GM VIAL I.V CYTOSAR 1GM VIAL I.V 309 309

674 CYTOSAR VIAL 100 MG CYTOSAR VIAL 100 MG 52 52

675 CYTOSAR VIAL 500MG CYTOSAR VIAL 500MG 175 175

676 D.T.Coq VACCINE D.T.Coq VACCINE 32 32

677 DAUNOBLASTINA 20MG VIAL+SOLV DAUNOBLASTINA 20MG VIAL+SOLV 46 46

678 DBL ACYCLOVIR 250MG-10ML VIAL DBL ACYCLOVIR 250MG-10ML VIAL 95 95

679 DBL ACYCLOVIR I,V 500MG-20ML VIAL DBL ACYCLOVIR I,V 500MG-20ML VIAL 177 177

680 DECAPEPTYL DEPOT NOVUM 3.75MG VIAL+SOLVT DECAPEPTYL DEPOT NOVUM 3.75MG VIAL+SOLVT 1409 1409

681 DEPAKINE 400MG-4ML POWDER FOR INJECTION DEPAKINE 400MG-4ML POWDER FOR INJECTION 132 132

682 DEPO MEDROL VIAL 40MG-ML SAS DEPO MEDROL VIAL 40MG-ML SAS 72 72

683 DEPO-PROVERA VIAL I-M 150MG-ML DEPO-PROVERA VIAL I-M 150MG-ML 130 130

684 DESFERAL VIAL 500MG DESFERAL VIAL 500MG 59 59

685 DETICENE 100MG I.V VIAL+SOLV 10ML AMP DETICENE 100MG I.V VIAL+SOLV 10ML AMP 37 37

686 DETICENE 200MG I.V VIAL DETICENE 200MG I.V VIAL 66 66

687 D-GAM 250IU VIAL D-GAM 250IU VIAL 324 324

688 D-GAM 500IU VIAL D-GAM 500IU VIAL 513 513

689 D-GAM 1500 IU VAIL D-GAM 1500 IU VAIL 827 827

690 D-GAM 2500IU VIAL D-GAM 2500IU VIAL 1692 1692

691 DIAMOX VIALS 500 MG DIAMOX VIALS 500 MG 43 43

692 DIBEKACIN MEIJI DIBEKACIN MEIJI 61 61

693 DIPRIVAN VIAL 10MG-ML DIPRIVAN VIAL 10MG-ML 147 147

694 DOBUTAMINE HCL 250MG-20ML VIAL DOBUTAMINE HCL 250MG-20ML VIAL 73 73

695 DOBUTREX 250 MG VIAL DOBUTREX 250 MG VIAL 74 74

696 DOCETAXEL HOSPIRA DOCETAXEL HOSPIRA 1173 1173

697 DOPAMIN HCL 40MG-ML INJ VIAL DOPAMIN HCL 40MG-ML INJ VIAL 77 77

698 DORAL S.F 1000MG VIAL DORAL S.F 1000MG VIAL 24 24

699 DORAL S.F 500MG VIAL DORAL S.F 500MG VIAL 18 18

700 DORIBAX 500MG/VIAL POWDER FOR INFUSION DORIBAX 500MG/VIAL POWDER FOR INFUSION 204 204

701 DOTAREM 0.5MOL-L GLASS BOTTLE W- STOPPER DOTAREM 0.5MOL-L GLASS BOTTLE W- STOPPER 505 505

702 DOXORUBICIN 2MG-MLVIAL DOXORUBICIN 2MG-MLVIAL 61 61

703 DRIED FACTOR VIII TYPE 8Y 25IU-ML VIAL DRIED FACTOR VIII TYPE 8Y 25IU-ML VIAL 2860 2860

704 DUMOCYCLIN 1.M.VIAL DUMOCYCLIN 1.M.VIAL 21 21

705 DUMOCYCLINE 500MG INJ DUMOCYCLINE 500MG INJ 23 23

706 EBETAXEL 6MG-ML SOLU. FOR I.V. INFUSION EBETAXEL 6MG-ML SOLU. FOR I.V. INFUSION 581 581

707 ECALTA 100MG POWDER FOR CONCENTRATE FOR SOLUTION FOR INFUSION ECALTA 100MG POWDER FOR CONCENTRATE FOR SOLUTION FOR INFUSION 1644 1644

Page 51

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

708 ELDISINE 5MG VIAL+SOLVENT 5ML ELDISINE 5MG VIAL+SOLVENT 5ML 641 641

709 ELOXATIN 100MG VIAL ELOXATIN 100MG VIAL 4815 4815

710 ELOXATIN 50MG VIAL ELOXATIN 50MG VIAL 2804 2804

711 ENDOXAN. VIAL 500 MG ENDOXAN. VIAL 500 MG 69 69

712 ENDOXAN. VIAL 1 GM. ENDOXAN. VIAL 1 GM. 86 86

713 ENDOXAN. VIAL 200 MG ENDOXAN. VIAL 200 MG 32 32

714 ENGERIX B 20MCG ENGERIX B 20MCG 99 99

715 ENGERIX-B 10MCG ENGERIX-B 10MCG 82 82

716 ENOXIRT 0.25GM I.M. VIAL + SOLVENT ENOXIRT 0.25GM I.M. VIAL + SOLVENT 47 47

717 ENOXIRT 0.25GM I.M. VIAL + SOLVENT + SYRINGE ENOXIRT 0.25GM I.M. VIAL + SOLVENT + SYRINGE 47 47

718 ENOXIRT 0.25GM I.V. VIAL + SOLVENT ENOXIRT 0.25GM I.V. VIAL + SOLVENT 47 47

719 ENOXIRT 0.25GM I.V. VIAL + SOLVENT + SYRINGE ENOXIRT 0.25GM I.V. VIAL + SOLVENT + SYRINGE 47 47

720 ENOXIRT 1GM I.M. VIAL + SOLVENT ENOXIRT 1GM I.M. VIAL + SOLVENT 117 117

721 ENOXIRT 1GM I.M. VIAL + SOLVENT + SYRINGE ENOXIRT 1GM I.M. VIAL + SOLVENT + SYRINGE 117 117

722 ENOXIRT 1GM I.V. VIAL + SOLVENT ENOXIRT 1GM I.V. VIAL + SOLVENT 117 117

723 ENOXIRT 1GM I.V. VIAL + SOLVENT + SYRINGE ENOXIRT 1GM I.V. VIAL + SOLVENT + SYRINGE 117 117

724 ENOXIRT 500MG I.M. VIAL + SOLVENT ENOXIRT 500MG I.M. VIAL + SOLVENT 75 75

725 ENOXIRT 500MG I.M. VIAL + SOLVENT + SYRINGE ENOXIRT 500MG I.M. VIAL + SOLVENT + SYRINGE 75 75

726 ENOXIRT 500MG I.V. VIAL + SOLVENT ENOXIRT 500MG I.V. VIAL + SOLVENT 75 75

727 ENOXIRT 500MG I.V. VIAL + SOLVENT + SYRINGE ENOXIRT 500MG I.V. VIAL + SOLVENT + SYRINGE 75 75

728 EPENTAL 0.5G VIAL EPENTAL 0.5G VIAL 18 18

729 EPENTAL 1G VIAL EPENTAL 1G VIAL 20 20

730 EPICOCILLIN VIAL 1G EPICOCILLIN VIAL 1G 19 19

731 EPICOCILLIN VIAL 500MG EPICOCILLIN VIAL 500MG 17 17

732 EPIRUBICIN HCL2MG-MLI.V&INTRAVESICAL INF EPIRUBICIN HCL2MG- MLI.V&INTRAVESICAL INF 100 100

733 EPISTIGMIN 2.5MG/ML VIAL EPISTIGMIN 2.5MG/ML VIAL 26 26

734 EPIZOLONE DEPOT 40MG/ML VIAL EPIZOLONE DEPOT 40MG/ML VIAL 26 26

735 EPREX 40000IU\ML EPREX 40000IU\ML 2974 2974

736 EPREX NEW STABILIZER 4000IU-ML VIAL EPREX NEW STABILIZER 4000IU-ML VIAL 404 404

737 ERYTHROCIN I.V. 1G VIAL ERYTHROCIN I.V. 1G VIAL 93 93

738 ERYTHROCIN I.V. 500MG VIAL ERYTHROCIN I.V. 500MG VIAL 56 56

739 ERYTHROMYCIN LACTOBIONATE 1G IV VIAL ERYTHROMYCIN LACTOBIONATE 1G IV VIAL 82 82

740 ESMERON 10MG\ML VIAL ESMERON 10MG\ML VIAL 62 62

741 ETOPOSID "EBEWE" 200MG VIAL ETOPOSID "EBEWE" 200MG VIAL 167 167

742 ETOPOSID "EBEWE" 20MG-ML VIAL ETOPOSID "EBEWE" 20MG-ML VIAL 116 116

743 ETOPOSID "EBEWE" 50 MG VIAL ETOPOSID "EBEWE" 50 MG VIAL 67 67

744 FARMARUBICIN 10MG VIAL FARMARUBICIN 10MG VIAL 114 114

745 FARMORUBICIN 50MG VIAL FARMORUBICIN 50MG VIAL 455 455

746 FEROMAX 20MG/ML Injection FEROMAX 20MG/ML Injection 40 40

747 FIRMAGON 120 MG POWDER FOR SOLUTION FOR INJECTION FIRMAGON 120 MG POWDER FOR SOLUTION FOR INJECTION 1591 1591

748 FIRMAGON 80MG POWDER FOR SOLUTION FOR INJECTION FIRMAGON 80MG POWDER FOR SOLUTION FOR INJECTION 1637 1637

Page 52

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

749 FLEBOGAMMA 5% SOLU. FOR I.V. INJECTION FLEBOGAMMA 5% SOLU. FOR I.V. INJECTION 318 318

750 FLOXAPEN VIAL 250MG FLOXAPEN VIAL 250MG 21 21

751 FLUCAND 200MG-100ML INFUSION VIAL FLUCAND 200MG-100ML INFUSION VIAL 164 164

752 FLUCO-SOL 2MG/ML SOLUTION FOR I.V. INFUSION FLUCO-SOL 2MG/ML SOLUTION FOR I.V. INFUSION 126 126

753 FLUDARABINE EBEWE 25 MG/ML CONCENTRATE FOR SOLUTION FOR INFUSION FLUDARABINE EBEWE 25 MG/ML CONCENTRATE FOR SOLUTION FOR INFUSION 1012 1012

754 FLUKAS 100 VIAL FLUKAS 100 VIAL 52 52

755 FLUKAS 200 VIAL FLUKAS 200 VIAL 69 69

756 FLUOROURACIL 250MG-10ML VIAL FLUOROURACIL 250MG-10ML VIAL 26 26

757 FLUOROURACIL 500MG-10ML VIAL FLUOROURACIL 500MG-10ML VIAL 35 35

758 FLUOROURACIL EBEWE VIAL 50MG-ML FLUOROURACIL EBEWE VIAL 50MG-ML 207 207

759 FORTUM FORTUM 106 106

760 FOSTIMON HP 150 IU VIAL IM(WOMEN URIN) FOSTIMON HP 150 IU VIAL IM(WOMEN URIN) 287 287

761 FOSTIMON HP 75 IU VIAL (IM) USE FOSTIMON HP 75 IU VIAL (IM) USE 158 158

762 FOXIME 1GM VIAL+5ML SOLVENT LIDOCAINE IM FOXIME 1GM VIAL+5ML SOLVENT LIDOCAINE IM 83 83

763 FOXIME 1GM VIAL+5ML WATER FOR INJ IV USE FOXIME 1GM VIAL+5ML WATER FOR INJ IV USE 83 83

764 FOXIME 500MG VIAL+AMP OF WATER IM-IV USE FOXIME 500MG VIAL+AMP OF WATER IM-IV USE 55 55

765 FOXITIN 1GM VIAL I.V OR I.M ADMINISTRATI FOXITIN 1GM VIAL I.V OR I.M ADMINISTRATI 70 70

766 GAMMAGARD S-D 0.5GM\10ML VIAL GAMMAGARD S-D 0.5GM\10ML VIAL 1945 1945

767 GARDASIL RECOMBINANT VACCINE GARDASIL RECOMBINANT VACCINE 1202 1202

768 GEMCITABIN EBEWE 1000MG-100ML VAIL GEMCITABIN EBEWE 1000MG-100ML VAIL 1210 1210

769 GEMCITABIN EBEWE 200MG-20ML VAIL GEMCITABIN EBEWE 200MG-20ML VAIL 261 261

770 GEMCITABIN EBEWE 500MG-50ML VAIL GEMCITABIN EBEWE 500MG-50ML VAIL 610 610

771 GEMZAR 200MG LYPH.VIAL 5ML GEMZAR 200MG LYPH.VIAL 5ML 390 390

772 GENOTROPIN 4IU INJECTION GENOTROPIN 4IU INJECTION 200 200

773 GLUCAGEN 1MG HYPOKIT FILLED WITH WATER GLUCAGEN 1MG HYPOKIT FILLED WITH WATER 137 137

774 GLUCAGEN 1MG VIAL+WATER FOR INJ. GLUCAGEN 1MG VIAL+WATER FOR INJ. 125 125

775 GLUCAGON 10MG VIAL+SOLVENT GLUCAGON 10MG VIAL+SOLVENT 632 632

776 GLYPRESSIN 1MG POWDER FOR I.V. Injection GLYPRESSIN 1MG POWDER FOR I.V. Injection 346 346

777 HAVRIX ADULT MONO DOSE VIAL HAVRIX ADULT MONO DOSE VIAL 317 317

778 HEMOFIL M 1000 IU VIAL+10ML STERIL WATER HEMOFIL M 1000 IU VIAL+10ML STERIL WATER 3434 3434

779 HEMOFIL M 250 IU VIAL+10ML STERIL WATER HEMOFIL M 250 IU VIAL+10ML STERIL WATER 866 866

780 HEMOFIL M 500 IU VIAL HEMOFIL M 500 IU VIAL 1722 1722

781 HERCEPTIN 150MG VIAL HERCEPTIN 150MG VIAL 7521 7521

782 HIBERIX 10MCG-DOSE VACCINE HIBERIX 10MCG-DOSE VACCINE 145 145

783 HOLOXAN 1GM I.V. VIAL HOLOXAN 1GM I.V. VIAL 293 293

784 HOLOXAN 2GM IV. VIAL HOLOXAN 2GM IV. VIAL 502 502

785 HOLOXAN 500MG VIAL IV HOLOXAN 500MG VIAL IV 168 168

786 HUMALOG 100 I.U VIALS HUMALOG 100 I.U VIALS 198 198

787 HUMAN ALBUMIN 20% HUMAN ALBUMIN 20% 453 453

788 HUMAN ALBUMIN 20% +INFUSION SET HUMAN ALBUMIN 20% +INFUSION SET 478 478

Page 53

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

789 HUMAN ALBUMIN 200G-I BAXTER 50ML HUMAN ALBUMIN 200G-I BAXTER 50ML 494 494

790 HUMAN ALBUMIN 5% HUMAN ALBUMIN 5% 137 137

791 HUMAN ALBUMIN GRIFOLS 20% I.V. INJECTION HUMAN ALBUMIN GRIFOLS 20% I.V. INJECTION 695 695

792 HUMATROPE 4 IU VIAL I-M OR S-C HUMATROPE 4 IU VIAL I-M OR S-C 270 270

793 HUMULIN 70-30 100U-ML HUMULIN 70-30 100U-ML 117 117

794 HUMULIN U ULTRALENTE VIAL HUMULIN U ULTRALENTE VIAL 117 117

795 HUMULIN-L LENTE 100 U-ML HUMULIN-L LENTE 100 U-ML 117 117

796 HUMULIN-N-NPH 100 U-ML HUMULIN-N-NPH 100 U-ML 117 117

797 HUMULIN-R-REGULAR 100 U-ML HUMULIN-R-REGULAR 100 U-ML 117 117

798 HYCAMTIN 4MG I.V. VI HYCAMTIN 4MG I.V. VI 1811 1811

799 HYDROCORTISONE 100M VIAL+SOLVENT 2ML AMP HYDROCORTISONE 100M VIAL+SOLVENT 2ML AMP 26 26

800 IMMUNATE S-D 1000 I.U. POWDER FOR INJ IMMUNATE S-D 1000 I.U. POWDER FOR INJ 4226 4226

801 IMMUNATE S-D 250 I.U. POWDER FOR INJ IMMUNATE S-D 250 I.U. POWDER FOR INJ 1239 1239

802 IMMUNATE S-D 500 I.U. POWDER FOR INJ IMMUNATE S-D 500 I.U. POWDER FOR INJ 2468 2468

803 IMMUNINE 1200I.U. LOY. POW. FOR I.V. INJ IMMUNINE 1200I.U. LOY. POW. FOR I.V. INJ 2968 2968

804 IMMUNINE 200I.U. LOY. POW. FOR I.V. INJ IMMUNINE 200I.U. LOY. POW. FOR I.V. INJ 627 627

805 IMMUNINE 600I.U. LOY. POW. FOR I.V. INJ IMMUNINE 600I.U. LOY. POW. FOR I.V. INJ 1489 1489

806 IMOVAX POLIO SUSPENSION FOR IM OR SC Injection IMOVAX POLIO SUSPENSION FOR IM OR SC Injection 94 94

807 IMUKIN 100MCG-0.5ML VIAL IMUKIN 100MCG-0.5ML VIAL 948 948

808 IMURAN 50MG VIAL IMURAN 50MG VIAL 120 120

809 INNOHEP 10000 ANTI-XA IU-ML VIAL INNOHEP 10000 ANTI-XA IU-ML VIAL 143 143

810 INNOHEP 20000 ANTI-XA IU-ML VIAL INNOHEP 20000 ANTI-XA IU-ML VIAL 238 238

811 INSULATARD INSULATARD 140 140

812 INTRAGLOBIN 2.5G +50ML DILUENT INTRAGLOBIN 2.5G +50ML DILUENT 1394 1394

813 INTRAGLOBIN 250MG INTRAGLOBIN 250MG 169 169

814 INTRAGLOBIN 500MG+DILUENT INTRAGLOBIN 500MG+DILUENT 328 328

815 INTRATECT 50MG-ML SOLUTION FOR INJECTION INTRATECT 50MG-ML SOLUTION FOR INJECTION 423 423

816 INTRON-A 10MN IU.VIAL INTRON-A 10MN IU.VIAL 756 756

817 IOPAMIRO 150 INJ IOPAMIRO 150 INJ 77 77

818 IOPAMIRO 300 INJ. IOPAMIRO 300 INJ. 131 131

820 IOPAMIRO 370 INJ IOPAMIRO 370 INJ 139 139

821 IPPROTON 4OMG POWDER FOR I.V. INJECTION IPPROTON 4OMG POWDER FOR I.V. INJECTION 64 64

822 JULMENTIN 1.2GM INJ. JULMENTIN 1.2GM INJ. 44 44

823 JULMENTIN 600MG INJ. JULMENTIN 600MG INJ. 24 24

824 JULPHACEF 1GM I.M.-I.V. INJECTION JULPHACEF 1GM I.M.-I.V. INJECTION 21 21

825 KABIKINASE 600000 IU VIAL KABIKINASE 600000 IU VIAL 202 202

826 KABIKINASE VIAL 100000 IU KABIKINASE VIAL 100000 IU 129 129

827 KEFADIM INJ 1G VIAL KEFADIM INJ 1G VIAL 96 96

828 KEFADIM INJ 2G VIAL KEFADIM INJ 2G VIAL 182 182

829 KEFLIN N 2 GM VIAL KEFLIN N 2 GM VIAL 60 60

830 KEFZOL 1 GM.-10 ML. VIAL KEFZOL 1 GM.-10 ML. VIAL 53 53

Page 54

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

831 KEFZOL 250MG.-10ML. VIAL KEFZOL 250MG.-10ML. VIAL 25 25

832 KEFZOL 500MG.-10 ML. VIAL KEFZOL 500MG.-10 ML. VIAL 38 38

833 KENACORT-A 40MG\ML INJ KENACORT-A 40MG\ML INJ 44 44

834 KIDROLASE 10000 U-2.5ML VIAL KIDROLASE 10000 U-2.5ML VIAL 241 241

835 KIOVIG 100MG/ML SOLUTION FOR INFUSION KIOVIG 100MG/ML SOLUTION FOR INFUSION 558 558

836 KOATE DVI 1000 IU VIAL KOATE DVI 1000 IU VIAL 2460 2460

837 KOATE DVI 250 IU VIAL KOATE DVI 250 IU VIAL 623 623

838 KOATE DVI 500 IU VIAL KOATE DVI 500 IU VIAL 1235 1235

839 KOGENATE FS KOGENATE FS 1389 1389

840 LANTUS 100 I.U - ML VIAL LANTUS 100 I.U - ML VIAL 450 450

841 LEUCOVORIN CALCIUM 15MG-2ML VIAL LEUCOVORIN CALCIUM 15MG-2ML VIAL 52 52

842 LEVONIC 500MG-100ML SOLUTION FOR I.V. INFUSION LEVONIC 500MG-100ML SOLUTION FOR I.V. INFUSION 186 186

843 LOSEC 40MG-10ML I-V VIAL LOSEC 40MG-10ML I-V VIAL 99 99

844 LOVRAK 250MG POWDER FOR I.V. INFUSION LOVRAK 250MG POWDER FOR I.V. INFUSION 75 75

845 LUCENTIS 10MG-ML INTRAVITREAL Injection LUCENTIS 10MG-ML INTRAVITREAL Injection 14107 14107

846 LUPRON DEPOT 3.75MG-VIAL LUPRON DEPOT 3.75MG-VIAL 858 858

847 LUPRON DEPOT 7.5MG -VIAL LUPRON DEPOT 7.5MG -VIAL 1447 1447

848 LUVERIS 75 I.U. POWDER FOR SOLU. FOR INJ LUVERIS 75 I.U. POWDER FOR SOLU. FOR INJ 302 302

849 M.M.R II 0.5ML VACCINE+ 0.7ML DILUENT M.M.R II 0.5ML VACCINE+ 0.7ML DILUENT 114 114

850 MABTHERA 10MG-1ML CONC. FOR I.V INFUSION MABTHERA 10MG-1ML CONC. FOR I.V INFUSION 14224 14224

851 MAGNESIUM SULFATE 50% I.V. Injection MAGNESIUM SULFATE 50% I.V. Injection 24 24

852 MAGNESIUM SULPHATE 10% Injection MAGNESIUM SULPHATE 10% Injection 11 11

853 MAXIL 1500 VIAL MAXIL 1500 VIAL 54 54

854 MAXIL 750 VIAL MAXIL 750 VIAL 34 34

855 MEGION 0.25GM I.V - I.M INJECTION MEGION 0.25GM I.V - I.M INJECTION 39 39

856 MEGION 0.5GM I.V INJECTION MEGION 0.5GM I.V INJECTION 58 58

857 MEGION 1GM I.V - I.M INJECTION MEGION 1GM I.V - I.M INJECTION 92 92

858 MEGION 2GM POW. FOR SOLU. FOR INJ OR INF MEGION 2GM POW. FOR SOLU. FOR INJ OR INF 140 140

859 MENACTRA 4 MCG SOLUTION FOR INJECTION MENACTRA 4 MCG SOLUTION FOR INJECTION 503 503

860 MENCEVAX ACWY 50MCG\0.5ML VIAL MENCEVAX ACWY 50MCG\0.5ML VIAL 139 139

861 MENINGOCOCCAL VACCINE A&C VIAL MENINGOCOCCAL VACCINE A&C VIAL 82 82

862 MENVEO POWDER SOLUTION FOR INJECTION MENVEO POWDER SOLUTION FOR INJECTION 503 503

863 MERIONAL-HP 150 IU VIAL MERIONAL-HP 150 IU VIAL 215 215

864 MERIONAL-HP 75 IU VIAL MERIONAL-HP 75 IU VIAL 112 112

865 MERONEM 1GM VIAL I-V MERONEM 1GM VIAL I-V 313 313

866 MERONEM 500MG VIAL I-V MERONEM 500MG VIAL I-V 171 171

867 MESPORIN 1000 I.M. MESPORIN 1000 I.M. 104 104

868 MESPORIN 1000 I.V. MESPORIN 1000 I.V. 104 104

869 MESPORIN 2000 I.V. MESPORIN 2000 I.V. 155 155

870 MESPORIN 250 I.M. MESPORIN 250 I.M. 42 42

871 MESPORIN 250 I.V. MESPORIN 250 I.V. 42 42

872 MESPORIN 500 I.M. MESPORIN 500 I.M. 64 64

Page 55

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

873 MESPORIN 500 I.V. MESPORIN 500 I.V. 64 64

874 METALYSE 10000 U I.V VIAL METALYSE 10000 U I.V VIAL 10091 10091

875 METHOTREXATE "EBEWE" 100MG-ML VIAL METHOTREXATE "EBEWE" 100MG-ML VIAL 1158 1158

876 METHOTREXATE "EBEWE" 10MG-ML VIAL METHOTREXATE "EBEWE" 10MG-ML VIAL 53 53

877 METHOTREXATE 1G-10ML INJ.FOR I.V OR I.M METHOTREXATE 1G-10ML INJ.FOR I.V OR I.M 256 256

878 METHOTREXATE 25MG-1ML VIAL METHOTREXATE 25MG-1ML VIAL 46 46

879 METHOTREXATE ROGER BELLON 500MG VIAL METHOTREXATE ROGER BELLON 500MG VIAL 164 164

880 METHOTREXATE ROGER BELLON 50MG V. METHOTREXATE ROGER BELLON 50MG V. 51 51

881 METHOTREXATE ROGER BELLON 5MG V. METHOTREXATE ROGER BELLON 5MG V. 26 26

882 MIRCERA 100MCG-0.3ML SOLN. FOR INJ MIRCERA 100MCG-0.3ML SOLN. FOR INJ 1790 1790

883 MIRCERA 150MCG-0.3ML SOLN. FOR INJ MIRCERA 150MCG-0.3ML SOLN. FOR INJ 2680 2680

884 MIRCERA 200MCG-0.3ML SOLN. FOR INJ MIRCERA 200MCG-0.3ML SOLN. FOR INJ 3570 3570

885 MIRCERA 50MCG-0.3ML SOLN. FOR INJ MIRCERA 50MCG-0.3ML SOLN. FOR INJ 900 900

886 MIRCERA 75MCG-0.3ML SOLN. FOR INJ MIRCERA 75MCG-0.3ML SOLN. FOR INJ 1345 1345

887 MITOXANTRON EBEWE 2MG-1ML SOL. FOR INFU MITOXANTRON EBEWE 2MG-1ML SOL. FOR INFU 1065 1065

888 MIXTARD 30 MIXTARD 30 140 140

889 MULTIPARIN 1000 UNITS-ML INJ MULTIPARIN 1000 UNITS-ML INJ 18 18

890 MULTIPARIN 25000 UNITS-ML INJ MULTIPARIN 25000 UNITS-ML INJ 106 106

891 MULTIPARIN 5000 UNITS-ML INJ MULTIPARIN 5000 UNITS-ML INJ 34 34

892 MYCAMINE 50-10ML VIAL MYCAMINE 50-10ML VIAL 1030 1030

893 NAVELBINE 10MG-ML I-V VIAL NAVELBINE 10MG-ML I-V VIAL 248 248

894 NEBCIN 20MG-2ML VIAL NEBCIN 20MG-2ML VIAL 29 29

895 NEBCIN 80MG-2ML VIAL NEBCIN 80MG-2ML VIAL 48 48

896 NEGACEF 0.5MG INJ. NEGACEF 0.5MG INJ. 59 59

897 NEGACEF 1GM VIAL NEGACEF 1GM VIAL 97 97

898 NEGACEF 2GM Injection NEGACEF 2GM Injection 150 150

899 NEUPOGEN 30 MU NEUPOGEN 30 MU 999 999

900 NEUPOGEN 48 MU NEUPOGEN 48 MU 1592 1592

901 NEXIUM 40MG VIAL POWDER FOR IV. INFUSION NEXIUM 40MG VIAL POWDER FOR IV. INFUSION 76 76

902 NIMBEX 5MG\ML INJ NIMBEX 5MG\ML INJ 497 497

903 NITROGLYCERINE INJ F.T.V.5 ML 25 MG NITROGLYCERINE INJ F.T.V.5 ML 25 MG 84 84

904 NITROGLYCERINE INJ F.T.V.50MG-10 ML NITROGLYCERINE INJ F.T.V.50MG-10 ML 111 111

905 NOOTROPIL 12GM-60ML INFUSION SOLU NOOTROPIL 12GM-60ML INFUSION SOLU 67 67

906 NORCURON 10MG VIAL NORCURON 10MG VIAL 50 50

907 NOVO SEVEN 1.2MG-VIAL NOVO SEVEN 1.2MG-VIAL 8034 8034

908 NOVO SEVEN 2.4MG-VIAL NOVO SEVEN 2.4MG-VIAL 16052 16052

909 NOVO SEVEN 4.8MG-VIAL NOVO SEVEN 4.8MG-VIAL 32101 32101

910 NOVOSEVEN 1MG POWDER FOR SOLUTION FOR INJECTION NOVOSEVEN 1MG POWDER FOR SOLUTION FOR INJECTION 7388 7388

911 NOVOSEVEN 2MG POWDER FOR SOLUTION FOR INJECTION NOVOSEVEN 2MG POWDER FOR SOLUTION FOR INJECTION 14766 14766

912 NOVOSEVEN 5MG POWDER FOR SOLUTION FOR INJECTION NOVOSEVEN 5MG POWDER FOR SOLUTION FOR INJECTION 36899 36899

913 OCTAGAM 1GM-20ML I.V OCTAGAM 1GM-20ML I.V 2073 2073

Page 56

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

914 OCTANATE 250IU VIAL OCTANATE 250IU VIAL 1328 1328

915 OCTANATE 1000 I.U - ML OCTANATE 1000 I.U - ML 4226 4226

916 OCTANATE 500IU VIAL OCTANATE 500IU VIAL 2645 2645

917 OCTANINE F 250IU VIAL OCTANINE F 250IU VIAL 867 867

918 OCTANINE F 1000 I.U\10ML VIAL OCTANINE F 1000 I.U\10ML VIAL 3439 3439

919 OCTANINE F 500 IU OCTANINE F 500 IU 1725 1725

920 OGMANT 1200 MG POWDER FOR INJECTION VIAL OGMANT 1200 MG POWDER FOR INJECTION VIAL 25 25

921 OGMANT 600 MG POWDER FOR INJECTION VIAL OGMANT 600 MG POWDER FOR INJECTION VIAL 19 19

922 OMNIPAQUE OMNIPAQUE 49 49

923 OMNISCAN OMNISCAN 290 290

924 ONCOVIN 1MG VIAL+SOLVENT 10ML ONCOVIN 1MG VIAL+SOLVENT 10ML 105 105

925 OPRAZOLE 40MG- VIAL I.VI INFUSION OPRAZOLE 40MG- VIAL I.VI INFUSION 59 59

926 OPTIMARK 0.5MMOL-ML SOLUTION For I.V. Injection OPTIMARK 0.5MMOL-ML SOLUTION For I.V. Injection 1213 1213

927 OPTIRAY 160MG-ML SOLUTION FOR IV. Injection OPTIRAY 160MG-ML SOLUTION FOR IV. Injection 95 95

928 OPTIRAY 240MG-ML SOLUTION FOR IV. Injection OPTIRAY 240MG-ML SOLUTION FOR IV. Injection 328 328

929 OPTIRAY 300MG-ML SOLUTION FOR IV. Injection OPTIRAY 300MG-ML SOLUTION FOR IV. Injection 408 408

930 OPTIRAY 320MG-ML SOLUTION FOR IV. Injection OPTIRAY 320MG-ML SOLUTION FOR IV. Injection 180 180

931 OPTIRAY 350MG-ML SOLUTION FOR IV. Injection OPTIRAY 350MG-ML SOLUTION FOR IV. Injection 381 381

932 OPVERO OPVERO 35 35

933 ORBENIN 500MG VIAL ORBENIN 500MG VIAL 45 45

934 ORENCIA 250MG POWDER FOR SOLUTION FOR INFUSION ORENCIA 250MG POWDER FOR SOLUTION FOR INFUSION 3431 3431

935 OVITRELLE 250MCG POWDER & SOLVENT FOR INJ OVITRELLE 250MCG POWDER & SOLVENT FOR INJ 295 295

936 OXALIPLATIN 5 MG-ML VIAL OXALIPLATIN 5 MG-ML VIAL 1965 1965

937 OXALIPLATIN HOSPIRA 5MG/ML CONCENTRATE FOR SOLUTION FOR INFUSION OXALIPLATIN HOSPIRA 5MG/ML CONCENTRATE FOR SOLUTION FOR INFUSION 504 504

938 OXALIPLATIN HOSPIRA 5MG/ML POWDER FOR SOLUTION FOR INFUSION OXALIPLATIN HOSPIRA 5MG/ML POWDER FOR SOLUTION FOR INFUSION 879 879

939 OXALIPLATIN MEDAC 100MG POWDER OXALIPLATIN MEDAC 100MG POWDER 2819 2819

940 OXALIPLATIN MEDAC 150MG POWDER OXALIPLATIN MEDAC 150MG POWDER 3895 3895

941 OXALIPLATIN MEDAC 50MG POWDER OXALIPLATIN MEDAC 50MG POWDER 1415 1415

942 PANTOZOL 40MG I.V POWDER FOR Injection PANTOZOL 40MG I.V POWDER FOR Injection 93 93

943 PARACETAMOL 1% INJECTION PARACETAMOL 1% INJECTION 37 37

944 PARZIDIME 1 GM POWDER FOR SOLUTION FOR Injection PARZIDIME 1 GM POWDER FOR SOLUTION FOR Injection 46 46

945 PEDIACEL VACCINE PEDIACEL VACCINE 285 285

946 PEG-INTRON 100MCG\0.5ML VIAL PEG-INTRON 100MCG\0.5ML VIAL 2020 2020

947 PEG-INTRON 120MCG\0.5ML VIAL PEG-INTRON 120MCG\0.5ML VIAL 2422 2422

948 PEG-INTRON 150MCG\0.5ML VIAL PEG-INTRON 150MCG\0.5ML VIAL 3025 3025

949 PEG-INTRON 50MCG\0.5MLVIAL PEG-INTRON 50MCG\0.5MLVIAL 1015 1015

950 PEG-INTRON 80MCG\0.5ML VIAL PEG-INTRON 80MCG\0.5ML VIAL 1618 1618

951 PENBRITIN VIAL 250 MG PENBRITIN VIAL 250 MG 17 17

952 PENICILLIN G INJ 1 MILLION IU PENICILLIN G INJ 1 MILLION IU 14 14

Page 57

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

953 PENICILLIN-G SOD 500000 IU VIAL PENICILLIN-G SOD 500000 IU VIAL 14 14

954 PENTOSTAM PENTOSTAM 31 31

955 PERFALGAN 10 MG - ML INJECTION VIAL PERFALGAN 10 MG - ML INJECTION VIAL 41 41

956 PIPERACILLIN - TAZOPACTAM SANDOZ 2.25GM VIAL PIPERACILLIN - TAZOPACTAM SANDOZ 2.25GM VIAL 74 74

957 PIPERACILLIN - TAZOPACTAM SANDOZ 4.5GM VIAL PIPERACILLIN - TAZOPACTAM SANDOZ 4.5GM VIAL 138 138

958 PLASBUMIN 20% SOLUTION FOR I.V. INJECTION PLASBUMIN 20% SOLUTION FOR I.V. INJECTION 504 504

959 PLASMA PROTEIN FRACTION 5% VIAL PLASMA PROTEIN FRACTION 5% VIAL 506 506

960 POLIOSABIN ORAL VACCINE POLIOSABIN ORAL VACCINE 40 40

961 POTASSIUM ACETATE INJ F.T.V. 40MEQ POTASSIUM ACETATE INJ F.T.V. 40MEQ 22 22

962 POTASSIUM CHLORIDE 10mEqFTV ADDITIVE INJ POTASSIUM CHLORIDE 10mEqFTV ADDITIVE INJ 28 28

963 POTASSIUM CHLORIDE 20mEq FTV. ADDITIVE POTASSIUM CHLORIDE 20mEq FTV. ADDITIVE 19 19

964 PRECEDEX 100 MCG -ML IV. VIAL PRECEDEX 100 MCG -ML IV. VIAL 266 266

965 PRIMOCEF 0.5 GM I.M- I.V VIALc PRIMOCEF 0.5 GM I.M- I.V VIAL 51 51

966 PRIMOCEF 1 GM I.M VIAL PRIMOCEF 1 GM I.M VIAL 76 76

967 PRIMOCEF 1 GM I.V VIAL PRIMOCEF 1 GM I.V VIAL 76 76

968 PRIORIX 0.5ML VIAL PRIORIX 0.5ML VIAL 100 100

969 PRIORIX-TETRA VACCINE PRIORIX-TETRA VACCINE 434 434

970 PRIZMA 2GM/0.25GM POWDER FOR I.V. INFUSION PRIZMA 2GM/0.25GM POWDER FOR I.V. INFUSION 81 81

971 PRIZMA 4GM-0.5GM POWDER FOR I.V INFUSION PRIZMA 4GM-0.5GM POWDER FOR I.V INFUSION 153 153

972 PROFENID 100MG I.M VIAL+SOLV. PROFENID 100MG I.M VIAL+SOLV. 21 21

973 PROTEC 1 GM Injection PROTEC 1 GM Injection 91 91

974 PROTEC 2 GM Injection PROTEC 2 GM Injection 138 138

975 PUREGON 100 I.U AMP + SOLV PUREGON 100 I.U AMP + SOLV 421 421

976 PUREGON 100IU VIAL PUREGON 100IU VIAL 439 439

977 PUREGON 50 I.U AMP +SOLVENT PUREGON 50 I.U AMP +SOLVENT 215 215

978 PUREGON 50IU VIAL PUREGON 50IU VIAL 225 225

979 QUINVAXEM Injection QUINVAXEM Injection 172 172

980 RECOFOL 10MG-ML INJECTION RECOFOL 10MG-ML INJECTION 132 132

981 RECOFOL 20MG-ML I.V. EMULSION FOR INFU RECOFOL 20MG-ML I.V. EMULSION FOR INFU 170 170

982 RECOMBINATE 1000IU VIAL RECOMBINATE 1000IU VIAL 5019 5019

983 RECOMBINATE 250IU VIAL RECOMBINATE 250IU VIAL 1553 1553

984 RECOMBINATE 500IU VIAL RECOMBINATE 500IU VIAL 3096 3096

985 RECOMBIVAX HB RECOMBIVAX HB 103 103

986 RECORMON 1000 I.U -ML VIAL RECORMON 1000 I.U -ML VIAL 126 126

987 RECORMON 2000 I.U+1ML WATER FOR INJ VIAL RECORMON 2000 I.U+1ML WATER FOR INJ VIAL 303 303

988 RECORMON 5000 I.U -ML VIAL RECORMON 5000 I.U -ML VIAL 577 577

989 RECORMON 5000 I.U+1ML WATER FOR INJ VIAL RECORMON 5000 I.U+1ML WATER FOR INJ VIAL 726 726

990 REMEFLIN 8 MG-VIAL 3ML. REMEFLIN 8 MG-VIAL 3ML. 12 12

991 REMICADE 100MG VIAL FOR INJ REMICADE 100MG VIAL FOR INJ 5593 5593

992 REPARIL AMP 5MG REPARIL AMP 5MG 29 29

993 REPLENINE-VF 500IU+10ML STERILISED WATER REPLENINE-VF 500IU+10ML STERILISED WATER 1379 1379

Page 58

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

994 RETARPEN 1.2MEGA U.WITH SOLVENT RETARPEN 1.2MEGA U.WITH SOLVENT 23 23

995 RETARPEN 2.4MEGA U. VIAL+SOLVENT RETARPEN 2.4MEGA U. VIAL+SOLVENT 33 33

996 RETARPEN 600000U+ SOLVENT VIAL RETARPEN 600000U+ SOLVENT VIAL 17 17

997 RISEK 40MG INJ RISEK 40MG INJ 70 70

998 ROCEPHIN 1GM i.m. + 3.5 ML SOLVENT ROCEPHIN 1GM i.m. + 3.5 ML SOLVENT 129 129

999 ROCEPHIN 1GM i.v. + 10 ML SOLVENT ROCEPHIN 1GM i.v. + 10 ML SOLVENT 129 129

1461 I.M. INJECTION I.M. INJECTION 25 25

1462 I.V. INJECTION I.V. INJECTION 50 50

1463 I.V.INFUSION I.V.INFUSION 150 150

1464 I.V. INSERTION I.V. INSERTION 150 150

1465 SUBCUTANEOUS INJECTION SUBCUTANEOUS INJECTION 25 25

1466 NEBULIZATION INHALATION NEBULIZATION INHALATION 150 150

1467 SKIN SENSITIVITY TEST SKIN SENSITIVITY TEST 20 20

1468 STOMACH WASH, ADULT STOMACH WASH, ADULT 400 400

1469 STOMACH WASH, BABY STOMACH WASH, BABY 400 400

1470 SUCTION SUCTION 150 150

1471 INTUBATION ENDOTRACHEAL INTUBATION ENDOTRACHEAL 250 250

1472 LOCAL INJECTION LOCAL INJECTION 300 300

1975 ROCEPHIN 250MG i.m. + 2 ML SOLVENT ROCEPHIN 250MG i.m. + 2 ML SOLVENT 59 59

2001 ROCEPHIN 250MG i.v. + 5 ML SOLVENT ROCEPHIN 250MG i.v. + 5 ML SOLVENT 59 59

3882 ROCEPHIN 250MG VIAL + 2ML SOLVENT ROCEPHIN 250MG VIAL + 2ML SOLVENT 55 55

3883 ROCEPHIN 250MG VIAL + 5 ML SOLVENT ROCEPHIN 250MG VIAL + 5 ML SOLVENT 55 55

3884 ROCEPHIN 500MG i.m. + 2 ML SOLVENT ROCEPHIN 500MG i.m. + 2 ML SOLVENT 99 99

3885 ROCEPHIN 500MG i.v. + 5 ML SOLVENT ROCEPHIN 500MG i.v. + 5 ML SOLVENT 99 99

3886 ROCEPHIN 500MG VIAL + 2 ML SOLVENT ROCEPHIN 500MG VIAL + 2 ML SOLVENT 91 91

3887 ROCEPHIN 500MG VIAL + 5 ML SOLVENT ROCEPHIN 500MG VIAL + 5 ML SOLVENT 91 91

3888 ROFERON-A 18MN.IU VIAL ROFERON-A 18MN.IU VIAL 1388 1388

3889 ROFERON-A 3MIU-0.5 ML ROFERON-A 3MIU-0.5 ML 213 213

3890 ROFERON-A 4.5MIU-0.5ML ROFERON-A 4.5MIU-0.5ML 269 269

3891 ROFERON-A 9MIU-0.5ML ROFERON-A 9MIU-0.5ML 810 810

3892 ROTARIX ORAL SUSPENSION VACCINE ROTARIX ORAL SUSPENSION VACCINE 375 375

3893 ROTARIX ORAL VACCINE ROTARIX ORAL VACCINE 375 375

3894 ROTATEQ ORAL VACCINE ROTATEQ ORAL VACCINE 432 432

3895 ROUVAX LYOPHOLIZED 10 DOSE VIAL + DILUENT SYRINGE ROUVAX LYOPHOLIZED 10 DOSE VIAL + DILUENT SYRINGE 37 37

3896 ROUVAX LYOPHOLIZED SINGLE DOSE VIAL + DILUENT SYRINGE ROUVAX LYOPHOLIZED SINGLE DOSE VIAL + DILUENT SYRINGE 56 56

3897 ROXCEF 1GM I.M INJECTION ROXCEF 1GM I.M INJECTION 103 103

3898 ROXCEF 1GM I.V INJECTION ROXCEF 1GM I.V INJECTION 102 102

3899 ROXCEF 250MG I.M INJECTION ROXCEF 250MG I.M INJECTION 45 45

3900 ROXCEF 250MG I.V INJECTION ROXCEF 250MG I.V INJECTION 45 45

3901 ROXCEF 500MG I.M INJECTION ROXCEF 500MG I.M INJECTION 71 71

3902 ROXCEF 500MG I.V INJECTION ROXCEF 500MG I.V INJECTION 71 71

3903 SAIZEN 1.33MG VIAL SAIZEN 1.33MG VIAL 213 213

3904 SAIZEN 8MG CLICK EASY SAIZEN 8MG CLICK EASY 1676 1676

3905 SAMIXON 1GM VIAL SAMIXON 1GM VIAL 114 114

3906 SAMIXON 1GM VIAL + SOLVENT SAMIXON 1GM VIAL + SOLVENT 114 114

Page 59

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3907 SAMIXON 500MG VIAL SAMIXON 500MG VIAL 77 77

3908 SAMIXON 500MG VIAL + SOLVENT SAMIXON 500MG VIAL + SOLVENT 77 77

3909 SANDIMMUN CONC.FOR INFUSIN 250MG- 5ML SANDIMMUN CONC.FOR INFUSIN 250MG-5ML 128 128

3910 SANDOSTATIN LAR 20MG VIAL SANDOSTATIN LAR 20MG VIAL 10663 10663

3911 SANDOSTATIN LAR 30MG VIAL SANDOSTATIN LAR 30MG VIAL 13951 13951

3912 SIMULECT 20 MG I.V VIAL SIMULECT 20 MG I.V VIAL 12820 12820

3913 SOD. CHLORIDE 14.61% SOLU. FOR INJECTION SOD. CHLORIDE 14.61% SOLU. FOR INJECTION 31 31

3914 SOD. CHLORIDE 20% SOLUTION SOD. CHLORIDE 20% SOLUTION 31 31

3915 SOD. CHLORIDE 23.4% SOLUTION SOD. CHLORIDE 23.4% SOLUTION 31 31

3916 SOD. CHLORIDE 30% SOLUTION SOD. CHLORIDE 30% SOLUTION 31 31

3917 SODIUM ACETATE F.T.V.40mEq SODIUM ACETATE F.T.V.40mEq 26 26

3918 SODIUM BICARBONATE 7.5% EMG.SYRINGE SODIUM BICARBONATE 7.5% EMG.SYRINGE 79 79

3919 SODIUM BICARBONATE 8.4% INJ. VIAL SODIUM BICARBONATE 8.4% INJ. VIAL 26 26

3920 SODIUM PHOSPHATE 45mM VIAL SODIUM PHOSPHATE 45mM VIAL 27 27

3921 SOLU CORTEF MOV 100 MG SOLU CORTEF MOV 100 MG 34 34

3922 SOLU CORTEF MOV 250 MG VIAL SOLU CORTEF MOV 250 MG VIAL 51 51

3923 SOLU-MEDROL INJ. 500 MG. SOLU-MEDROL INJ. 500 MG. 215 215

3924 SOLU-MEDROL MOV 40 MG INJ. SOLU-MEDROL MOV 40 MG INJ. 55 55

3925 SOLU-MEDROL. INJ. 1000 MG. SOLU-MEDROL. INJ. 1000 MG. 476 476

3926 SOLU-MEDROL-INJ. 125 MG SOLU-MEDROL-INJ. 125 MG 123 123

3927 SOMATOSTATINE-UCB 3MG LYOP.VIAL+SOLVENT SOMATOSTATINE-UCB 3MG LYOP.VIAL+SOLVENT 1007 1007

3928 SOMATOSTATIN-UCB250MCG LYOP.VIAL+SOLVENT SOMATOSTATIN-UCB250MCG LYOP.VIAL+SOLVENT 137 137

3929 SOPALAMIN 3B VIAL SOPALAMIN 3B VIAL 22 22

3930 STALORAL ANIMAL ORIGIN INITIAL STALORAL ANIMAL ORIGIN INITIAL 459 459

3931 STALORAL ANIMAL ORIGIN MAINTENANCE STALORAL ANIMAL ORIGIN MAINTENANCE 750 750

3932 STALORAL MITES INITIAL STALORAL MITES INITIAL 504 504

3933 STALORAL MITES MAINTENANCE STALORAL MITES MAINTENANCE 684 684

3934 STALORAL MOULDS INITIAL STALORAL MOULDS INITIAL 504 504

3935 STALORAL MOULDS MAINTENANCE STALORAL MOULDS MAINTENANCE 684 684

3936 STALORAL POLLENS INITIAL STALORAL POLLENS INITIAL 504 504

3937 STALORAL POLLENS MAINTENANCE STALORAL POLLENS MAINTENANCE 684 684

3938 STANDACILLIN 1G VIAL WITH SOLVENT STANDACILLIN 1G VIAL WITH SOLVENT 39 39

3939 STANDACILLIN 500MG INJ WITH SOLVENT STANDACILLIN 500MG INJ WITH SOLVENT 26 26

3940 STREPTAS 250000I.U VIAL STREPTAS 250000I.U VIAL 337 337

3941 STREPTAS 750000I.U VIAL STREPTAS 750000I.U VIAL 509 509

3942 SUCCINYL SICCUM 500MG VIAL SUCCINYL SICCUM 500MG VIAL 26 26

3943 SURVANTA INTRATRACHEAL SUSP.VIAL 8ML SURVANTA INTRATRACHEAL SUSP.VIAL 8ML 3685 3685

3944 SYNAGIS 100MG\ML I.M VIAL SYNAGIS 100MG\ML I.M VIAL 7370 7370

3945 SYNFLORIX VACCINE SYNFLORIX VACCINE 341 341

3946 TARGOCID 200MG VIAL+DILUENT TARGOCID 200MG VIAL+DILUENT 221 221

3947 TARIVID I.V2MG-MLSOLUTION FOR INFUSION TARIVID I.V2MG-MLSOLUTION FOR INFUSION 18 18

3948 TAVANIC 5 MG -1 ML SOLUTION I.V INFUSION TAVANIC 5 MG -1 ML SOLUTION I.V INFUSION 13 13

Page 60

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3949 TAXOTERE 20MG VIAL +SOLVENT TAXOTERE 20MG VIAL +SOLVENT 1442 1442

3950 TAXOTERE 80MG VIAL +SOLVENT TAXOTERE 80MG VIAL +SOLVENT 4305 4305

3951 TAZOCIN 2.25G VIAL TAZOCIN 2.25G VIAL 125 125

3952 TAZOCIN 4.5GM VIAL + EDTA TAZOCIN 4.5GM VIAL + EDTA 214 214

3953 TAZOLINE 0.5GM VIAL IV+10MLWATER FOR INJ TAZOLINE 0.5GM VIAL IV+10MLWATER FOR INJ 29 29

3954 TAZOLINE 1GM VIAL I.M+5MLSOLV.LIDOCAINE TAZOLINE 1GM VIAL I.M+5MLSOLV.LIDOCAINE 49 49

3955 TAZOLINE 1GM VIAL IV+10ML WATER FOR INJ. TAZOLINE 1GM VIAL IV+10ML WATER FOR INJ. 49 49

3956 TAZOLINE0.5GM VIAL I.M+5MLSOLV.LIDOCAINE TAZOLINE0.5GM VIAL I.M+5MLSOLV.LIDOCAINE 29 29

3957 TAZORAX 2.25 GM POWDER FOR INJECTION TAZORAX 2.25 GM POWDER FOR INJECTION 74 74

3958 TAZORAX 4.5 GM POWDER FOR INJECTION TAZORAX 4.5 GM POWDER FOR INJECTION 138 138

3959 TEKAM 10MG-ML 10ML VIAL TEKAM 10MG-ML 10ML VIAL 23 23

3960 TEKAM 50MG-ML 10ML VIAL TEKAM 50MG-ML 10ML VIAL 63 63

3961 TELEBRIX 12 SODIUM 120MG-ML INFUSION TELEBRIX 12 SODIUM 120MG-ML INFUSION 104 104

3962 TESLASCAN 0.01 MMOL-ML I.V Infusion TESLASCAN 0.01 MMOL-ML I.V Infusion 1265 1265

3963 TETAVAX 40 I.U INJ. TETAVAX 40 I.U INJ. 41 41

3964 THIOPENTAL 0.5G INJ THIOPENTAL 0.5G INJ 21 21

3965 THIOPENTAL 1G VIAL THIOPENTAL 1G VIAL 24 24

3966 THIOPHENICOL INJ 750MG VIAL+5ML SOLVENT THIOPHENICOL INJ 750MG VIAL+5ML SOLVENT 24 24

3967 TIENAM 500 MG VIAL I.V. TIENAM 500 MG VIAL I.V. 151 151

3968 TORISEL 25MG/ML CONC. FOR IV INFUSION TORISEL 25MG/ML CONC. FOR IV INFUSION 8986 8986

3969 TOTAM 1GM IV\IM INJECTION TOTAM 1GM IV\IM INJECTION 69 69

3970 TOTAM 500MG IV\IM INJECTION TOTAM 500MG IV\IM INJECTION 47 47

3971 TPN ELECTROLYTES VIAL TPN ELECTROLYTES VIAL 40 40

3972 TRACTOCIL 7.5MG-ML VIAL TRACTOCIL 7.5MG-ML VIAL 244 244

3973 TRIAXONE 0.5G I.M VIAL+5ML SOLV.LIDOCAIN TRIAXONE 0.5G I.M VIAL+5ML SOLV.LIDOCAIN 83 83

3974 TRIAXONE 1GM VIAL I.M+5ML SOLV.LIDOCAINE TRIAXONE 1GM VIAL I.M+5ML SOLV.LIDOCAINE 129 129

3975 TRIAXONE 500MG VIAL I.V+5MLWATER FOR INJ TRIAXONE 500MG VIAL I.V+5MLWATER FOR INJ 83 83

3976 TRIAXONE1GM VIAL I.V +10ML WATER FOR INJ TRIAXONE1GM VIAL I.V +10ML WATER FOR INJ 129 129

3977 TRIPACEL VACCINE TRIPACEL VACCINE 149 149

3978 TRITANRIX HB+ HIBRIX 1 DOSE VIAL TRITANRIX HB+ HIBRIX 1 DOSE VIAL 172 172

3979 TRITANRIX-HB 10ug-ML 0.5ML VIAL TRITANRIX-HB 10ug-ML 0.5ML VIAL 95 95

3980 TYGACIL 50MG LYOP. POW. FOR I.V.INFUSION TYGACIL 50MG LYOP. POW. FOR I.V.INFUSION 440 440

3981 ULTIVA 1MG VIAL(LYOPHILIZED) ULTIVA 1MG VIAL(LYOPHILIZED) 57 57

3982 ULTIVA 2MG VIAL(LYOPHILIZED) ULTIVA 2MG VIAL(LYOPHILIZED) 102 102

3983 ULTIVA 5MG VIAL(LYOPHILIZED) ULTIVA 5MG VIAL(LYOPHILIZED) 199 199

3984 ULTRAVIST300 ULTRAVIST300 235 235

3985 UMAN ALBUMIN 20% SOLUTION FOR INFUSION UMAN ALBUMIN 20% SOLUTION FOR INFUSION 340 340

3986 UNASYN 1000:500MG VIAL UNASYN 1000:500MG VIAL 36 36

3987 UNASYN 2000:1000MG VIAL UNASYN 2000:1000MG VIAL 37 37

3988 UNASYN 500:250MG VIAL UNASYN 500:250MG VIAL 28 28

Page 61

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3989 VANCOCIN-CP 500MG-10 ML. VIAL VANCOCIN-CP 500MG-10 ML. VIAL 114 114

3990 VANCOLON 0.5GM-VIAL I.V. VANCOLON 0.5GM-VIAL I.V. 103 103

3991 VANCOLON 1GM POWDER FOR I.V. INFUSION VANCOLON 1GM POWDER FOR I.V. INFUSION 139 139

3992 VANCOMYCIN ALPHARMA 1GM VIAL VANCOMYCIN ALPHARMA 1GM VIAL 164 164

3993 VANCOMYCIN ALPHARMA 500MG VIAL VANCOMYCIN ALPHARMA 500MG VIAL 100 100

3994 VANCOMYCIN HCL 1 G VIAL FOR INFUSION VANCOMYCIN HCL 1 G VIAL FOR INFUSION 184 184

3995 VANCOMYCIN HCL 500MG VIAL FOR INFUSION VANCOMYCIN HCL 500MG VIAL FOR INFUSION 111 111

3996 VAQTA VACCINE 50 U VIAL VAQTA VACCINE 50 U VIAL 238 238

3997 VARILRIX 2000 PFU -0.5ML VIAL VARILRIX 2000 PFU -0.5ML VIAL 343 343

3998 VELBE 10MG VIAL+SOLVENT 10ML VELBE 10MG VIAL+SOLVENT 10ML 108 108

3999 VELCADE 3.5MG POWDER FOR I.V. INJECTION VELCADE 3.5MG POWDER FOR I.V. INJECTION 12509 12509

4000 VELOSEF 1GM VIAL VELOSEF 1GM VIAL 11 11

4001 VFEND 200MG POWDER FOR SOLU.FOR INFUSION VFEND 200MG POWDER FOR SOLU.FOR INFUSION 1186 1186

4002 VINBLASTINE SULPHATE 10MG-10ML VIAL VINBLASTINE SULPHATE 10MG-10ML VIAL 100 100

4003 VINCRISTIN SULPH. 1MG-ML VIAL VINCRISTIN SULPH. 1MG-ML VIAL 74 74

4004 VINCRISTINE ROGER BELLON 1MG-VIAL VINCRISTINE ROGER BELLON 1MG-VIAL 89 89

4005 VINORELBINE ACTAVIS 50MG/5ML CONCENTRATION SOLUTION FOR INFUSION VINORELBINE ACTAVIS 50MG/5ML CONCENTRATION SOLUTION FOR INFUSION 936 936

4006 VIRAZOLE 20MG-MLUPON RECONSTITUTON INHAL VIRAZOLE 20MG-MLUPON RECONSTITUTON INHAL 1238 1238

4007 VISIPAQUE VISIPAQUE 95 95

4008 VISUDYNE 15MG POWDER FOR INFUSION VISUDYNE 15MG POWDER FOR INFUSION 13321 13321

4009 XEFO 8MG POWDER FOR Injection XEFO 8MG POWDER FOR Injection 42 42

4010 XENETIX 300MG IODINE-ML SOLN FOR INJ. XENETIX 300MG IODINE-ML SOLN FOR INJ. 368 368

4011 XENETIX 350MG IODINE-ML SOLN.FOR INJ XENETIX 350MG IODINE-ML SOLN.FOR INJ 254 254

4012 XOLAIR 150MG POWDER FOR INJECTION XOLAIR 150MG POWDER FOR INJECTION 4239 4239

4013 XORIM 1500MG POW. FOR SOLU. FOR I.V. INJ XORIM 1500MG POW. FOR SOLU. FOR I.V. INJ 44 44

4014 XORIM 250MG POW. FOR SOLU. FOR I.V. INJ XORIM 250MG POW. FOR SOLU. FOR I.V. INJ 16 16

4015 XORIM 750MG POW. FOR SOLU. FOR I.V. INJ XORIM 750MG POW. FOR SOLU. FOR I.V. INJ 27 27

4016 XYLOCAINE 0.5% INJ XYLOCAINE 0.5% INJ 25 25

4017 XYLOCAINE 0.5% W-ADREN. 5MCG-ML INJ XYLOCAINE 0.5% W-ADREN. 5MCG-ML INJ 27 27

4018 XYLOCAINE 5% HEAVY INJ XYLOCAINE 5% HEAVY INJ 21 21

4019 XYNTHA 1000 I.U. POWDER FOR SOLUTION FOR INJECTION XYNTHA 1000 I.U. POWDER FOR SOLUTION FOR INJECTION 5019 5019

4020 XYNTHA 2000 I.U. POWDER FOR SOLUTION FOR INJECTION XYNTHA 2000 I.U. POWDER FOR SOLUTION FOR INJECTION 10029 10029

4021 XYNTHA 250 I.U. POWDER FOR SOLUTION FOR INJECTION XYNTHA 250 I.U. POWDER FOR SOLUTION FOR INJECTION 1553 1553

4022 XYNTHA 500 I.U. POWDER FOR SOLUTION FOR INJECTION XYNTHA 500 I.U. POWDER FOR SOLUTION FOR INJECTION 3096 3096

4023 ZAVEDOS 10MG VIAL ZAVEDOS 10MG VIAL 1127 1127

4024 ZAVEDOS 5MG VIAL ZAVEDOS 5MG VIAL 667 667

4025 ZIDACEF 1000 MG VIAL I.M - I.V Injection ZIDACEF 1000 MG VIAL I.M - I.V Injection 50 50

Page 62

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4026 ZIDACEF 500 MG VIAL I.M - I.V Injection ZIDACEF 500 MG VIAL I.M - I.V Injection 31 31

4027 ZIDIME 1GM GLASS VIAL IV-IM ZIDIME 1GM GLASS VIAL IV-IM 113 113

4028 ZIDIME 2GM I.V INJ ZIDIME 2GM I.V INJ 201 201

4029 ZINACEF ZINACEF 59 59

4030 ZINOXIME 1.5GM VIAL FOR I.V ZINOXIME 1.5GM VIAL FOR I.V 54 54

4031 ZINOXIME 750MG VIAL FOR I.V- I.M ZINOXIME 750MG VIAL FOR I.V- I.M 35 35

4032 ZITHROMAX 500 MG POWDER FOR IV INFUSION ZITHROMAX 500 MG POWDER FOR IV INFUSION 131 131

4033 ZOLECIN 1GM VIAL I.V ZOLECIN 1GM VIAL I.V 27 27

4034 ZOLECIN 250MG INJ IM-IV ZOLECIN 250MG INJ IM-IV 17 17

4035 ZOLECIN 500MG INJ IM-IV ZOLECIN 500MG INJ IM-IV 20 20

4036 ZOMETA 4MG VIAL\5ML ZOMETA 4MG VIAL\5ML 2988 2988

4037 ZOVIRAX 250MG IV INFUSION ZOVIRAX 250MG IV INFUSION 103 103

4038 ZYPADHERA 210MG POWDER FOR SOLUTION FOR I.M. INJECTION ZYPADHERA 210MG POWDER FOR SOLUTION FOR I.M. INJECTION 1794 1794

4039 ZYPADHERA 300MG POWDER FOR SOLUTION FOR I.M. INJECTION ZYPADHERA 300MG POWDER FOR SOLUTION FOR I.M. INJECTION 2558 2558

4040 ZYPADHERA 405MG POWDER FOR SOLUTION FOR I.M. INJECTION ZYPADHERA 405MG POWDER FOR SOLUTION FOR I.M. INJECTION 3450 3450

4041 ZYPREXA 10MG POWDER FOR INJECTION ZYPREXA 10MG POWDER FOR INJECTION 54 54

4042 ZYVOX 2 MG/ML SOLUTION FOR INFUSION ZYVOX 2 MG/ML SOLUTION FOR INFUSION 613 613

4043 3V AMPOULES 3V AMPOULES 16 16

4044 ADDAMEL AMP. ADDAMEL AMP. 22 22

4045 ADRENALINE 1:1000 INJ ADRENALINE 1:1000 INJ 12 12

4046 ADRENALINE HCL 1MG-ML AMP ADRENALINE HCL 1MG-ML AMP 10 10

4047 AGLUMIN AMPULES 250 MG AGLUMIN AMPULES 250 MG 18 18

4048 ALLERFIN AMP 10MG-ML ALLERFIN AMP 10MG-ML 12 12

4049 ALPAX AMP. 2MG-ML ALPAX AMP. 2MG-ML 14 14

4050 AMIKIN AMP 100MG-2ML AMIKIN AMP 100MG-2ML 50 50

4051 AMIKIN AMP 500MG-2ML AMIKIN AMP 500MG-2ML 77 77

4052 AMINOPHYLLINE 250 Mg Injection AMINOPHYLLINE 250 Mg Injection 13 13

4053 AMINOPHYLLINE INJ 250MG AMINOPHYLLINE INJ 250MG 18 18

4054 ANEXATE 0.5MG AMP 5ML ANEXATE 0.5MG AMP 5ML 145 145

4055 APRESOLINE 20MG-ML INJ APRESOLINE 20MG-ML INJ 27 27

4056 ATACURE 10MG-ML INJ. ATACURE 10MG-ML INJ. 29 29

4057 ATRACURIUM BESYLATE 10MG-ML AMP ATRACURIUM BESYLATE 10MG-ML AMP 28 28

4058 ATRACURIUM- HAMELN 10MG-ML SOLU. FOR INJ ATRACURIUM- HAMELN 10MG-ML SOLU. FOR INJ 44 44

4059 ATROPINE ATROPINE 12 12

4060 ATROPINE SULF. E.S 50MCG-ML ATROPINE SULF. E.S 50MCG-ML 36 36

4061 ATROPINE SULF.E.S 100MCG-ML ATROPINE SULF.E.S 100MCG-ML 40 40

4062 ATROPINE SULPHATE 0.5MG\ML AMPOULE ATROPINE SULPHATE 0.5MG\ML AMPOULE 12 12

4063 ATROPINE SULPHATE 0.6MG\ML AMPOULE ATROPINE SULPHATE 0.6MG\ML AMPOULE 12 12

4064 ATROPINE SULPHATE INJ 1MG-1 ML ATROPINE SULPHATE INJ 1MG-1 ML 11 11

4065 ATROPULM 500MCG-2ML SOLUTION FOR INHALATION ATROPULM 500MCG-2ML SOLUTION FOR INHALATION 14 14

4066 BACTRIM AMP 5ML I.V BACTRIM AMP 5ML I.V 25 25

4067 BALANCED SALT SOLUTION AMPOULE BALANCED SALT SOLUTION AMPOULE 16 16

Page 63

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4068 BETACORT 4MG-ML AMP BETACORT 4MG-ML AMP 20 20

4069 BETOLVEX INJ 1MG BETOLVEX INJ 1MG 43 43

4070 BIOVIT 12 DEPOT AMPOULES BIOVIT 12 DEPOT AMPOULES 14 14

4071 BONDRONAT 2MG-2ML AMPOULE BONDRONAT 2MG-2ML AMPOULE 964 964

4072 BONEFOS 60MG-ML CONC.FOR PARE.INFUSION BONEFOS 60MG-ML CONC.FOR PARE.INFUSION 167 167

4073 BRICANYL AMP. BRICANYL AMP. 14 14

4074 BRICANYL 2.5MG-ML SOLN.FOR NEBULISATION BRICANYL 2.5MG-ML SOLN.FOR NEBULISATION 12 12

4075 BUPIVACAINE 0.25% STERILE PACK AMP. BUPIVACAINE 0.25% STERILE PACK AMP. 47 47

4076 BUPIVACAINE 0.5% STERILE PACK AMP. BUPIVACAINE 0.5% STERILE PACK AMP. 48 48

4077 CALCIJEX 1MCG-ML I.V. AMP CALCIJEX 1MCG-ML I.V. AMP 55 55

4078 CALCIJEX 2MCG-ML AMP CALCIJEX 2MCG-ML AMP 83 83

4079 CALCIUM CHLORIDE 10% EMERGENCY SYRINGE CALCIUM CHLORIDE 10% EMERGENCY SYRINGE 50 50

4080 CALCIUM CHLORIDE 10% INJECTION CALCIUM CHLORIDE 10% INJECTION 11 11

4081 CALCIUM CHLORIDE 7.35% INJECTION CALCIUM CHLORIDE 7.35% INJECTION 11 11

4082 CALCIUM FOLINATE(EBEWE) 10MG-ML AMP. CALCIUM FOLINATE(EBEWE) 10MG-ML AMP. 92 92

4083 CALCIUM FOLINATE(EBEWE)3MG-ML AMP. CALCIUM FOLINATE(EBEWE)3MG-ML AMP. 20 20

4084 CALCIUM GLUCONATE 10% AMP CALCIUM GLUCONATE 10% AMP 12 12

4085 CALCIUM GLUCONATE 10% W-V INJECTION CALCIUM GLUCONATE 10% W-V INJECTION 18 18

4086 CHLOROHISTOL 10MG-ML Injection CHLOROHISTOL 10MG-ML Injection 13 13

4087 CINOKORT 40 MG - 2 ML AMPOULE CINOKORT 40 MG - 2 ML AMPOULE 14 14

4088 CLOFEN 75MG INJECTION CLOFEN 75MG INJECTION 20 20

4089 CLOPIXOL DEPOT INJ 200MG-ML CLOPIXOL DEPOT INJ 200MG-ML 54 54

4090 CLOPIXOL DEPOT INJ 500MG-ML OILY AMP CLOPIXOL DEPOT INJ 500MG-ML OILY AMP 106 106

4091 CLOPIXOL INJ 10MG-ML CLOPIXOL INJ 10MG-ML 17 17

4092 CLOPIXOL-ACUPHASE 50MG-ML OILY AMP CLOPIXOL-ACUPHASE 50MG-ML OILY AMP 57 57

4093 COBRA ANTIVENOM (EQUINE) AMP COBRA ANTIVENOM (EQUINE) AMP 300 300

4094 CORDARONE 150MG-3ML AMP. CORDARONE 150MG-3ML AMP. 19 19

4095 COSMOFER 625MG-2ML AMPOULES COSMOFER 625MG-2ML AMPOULES 46 46

4096 CYKLOKAPRON INJ 100MG-ML INJECTION CYKLOKAPRON INJ 100MG-ML INJECTION 25 25

4097 CYNOVIT 1MG-1ML I.M. Injection CYNOVIT 1MG-1ML I.M. Injection 13 13

4098 DALACIN-C VIAL 150 MG - ML DALACIN-C VIAL 150 MG - ML 45 45

4099 DANSETRON 2MG\ML AMP. FOR I.V INJECTION DANSETRON 2MG\ML AMP. FOR I.V INJECTION 81 81

4100 DECADURABOLIN ORGAJECT 25MG-ML DECADURABOLIN ORGAJECT 25MG-ML 48 48

4101 DECADURABOLIN ORGAJECT 50MG-ML DECADURABOLIN ORGAJECT 50MG-ML 83 83

4102 DEPOVIT B12 1000 AMP 1ML DEPOVIT B12 1000 AMP 1ML 17 17

4103 DEXAMETHASONE SOD.PHOSPHATE 8MG- 2ML AMP DEXAMETHASONE SOD.PHOSPHATE 8MG-2ML AMP 14 14

4104 DICLOGESIC 75MG-3ML AMP DICLOGESIC 75MG-3ML AMP 17 17

4105 DICLORISM 75MG-3ML AMP DICLORISM 75MG-3ML AMP 12 12

4106 DICYNONE 2ML-AMP 250MG DICYNONE 2ML-AMP 250MG 19 19

4107 DIPROFOS INJ. 2ML DIPROFOS INJ. 2ML 44 44

4108 DISPERCAM 20MG-ML AMP.FOR I-M USE DISPERCAM 20MG-ML AMP.FOR I-M USE 12 12

Page 64

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4109 DIUSEMIDE 20MG-2ML AMP DIUSEMIDE 20MG-2ML AMP 12 12

4110 DOBUJECT 50MG-ML(250MG-5ML) AMPOULE DOBUJECT 50MG-ML(250MG-5ML) AMPOULE 61 61

4111 DOGMATIL AMP 100MG DOGMATIL AMP 100MG 14 14

4112 DORMICUM 15MG-3ML AMP. DORMICUM 15MG-3ML AMP. 32 32

4113 DORMICUM 5MG-1ML AMP. DORMICUM 5MG-1ML AMP. 19 19

4114 DORMICUM 5MG-5ML AMP. DORMICUM 5MG-5ML AMP. 19 19

4115 EPIFASI 5000 IU LYOPHILIZED POWDER FOR I.M. Injection EPIFASI 5000 IU LYOPHILIZED POWDER FOR I.M. Injection 42 42

4116 EPIFENAC 75MG/3ML SOLUTION FOR INJECTION EPIFENAC 75MG/3ML SOLUTION FOR INJECTION 12 12

4117 EPIGONAL 75 I.U. LYOPHILIZED POWDER FOR I.M. Injection EPIGONAL 75 I.U. LYOPHILIZED POWDER FOR I.M. Injection 61 61

4118 EPINEPHRINE INJ 1:10000 ABBOJECT GLASS SYRINGE (18 G x 3 1/2") EPINEPHRINE INJ 1:10000 ABBOJECT GLASS SYRINGE (18 G x 3 1/2") 66 66

4119 EPINEPHRINE INJ 1:10000 ABBOJECT GLASS SYRINGE (20 G x 1 1/2") EPINEPHRINE INJ 1:10000 ABBOJECT GLASS SYRINGE (20 G x 1 1/2") 65 65

4120 EPSIKAPRON AMP 4G+WATER FOR INJ 10ML EPSIKAPRON AMP 4G+WATER FOR INJ 10ML 24 24

4121 FELDENE 20MG-ML AMP. FELDENE 20MG-ML AMP. 22 22

4122 FENTANYL CITRATE 50MCG-ML VIAL FENTANYL CITRATE 50MCG-ML VIAL 23 23

4123 FENTANYL-JANSSEN 0.05MG-ML AMPOULES FENTANYL-JANSSEN 0.05MG-ML AMPOULES 14 14

4124 FEROSAC INJ 20MG-ML AMP FEROSAC INJ 20MG-ML AMP 48 48

4125 FEROTON 20MG-ML SOLU. FOR I.V. INJECTION FEROTON 20MG-ML SOLU. FOR I.V. INJECTION 44 44

4126 FLIXOTIDE 0.5MG-2ML NEBULE FLIXOTIDE 0.5MG-2ML NEBULE 23 23

4127 FLIXOTIDE 2MG-2ML NEBULE FLIXOTIDE 2MG-2ML NEBULE 39 39

4128 FLUANXOL DEPOT 100MG-ML I.M AMP FLUANXOL DEPOT 100MG-ML I.M AMP 113 113

4129 FLUANXOL DEPOT INJ 20MG-ML FLUANXOL DEPOT INJ 20MG-ML 48 48

4130 FLUOROURACIL EBEWE AMP 50MG-ML FLUOROURACIL EBEWE AMP 50MG-ML 26 26

4131 FLUPHENAZINE DECANOATE 25MG-ML Injection FLUPHENAZINE DECANOATE 25MG-ML Injection 36 36

4132 FORTEO 20MCG-80MCL SOLU. FOR Injection FORTEO 20MCG-80MCL SOLU. FOR Injection 170 170

4133 GAMMA GLOBULIN 16% INJ GAMMA GLOBULIN 16% INJ 25 25

4134 GENTA 20MG-2ML AMPOULE GENTA 20MG-2ML AMPOULE 12 12

4135 GENTA 40MG-2ML AMPOULE GENTA 40MG-2ML AMPOULE 12 12

4136 GENTA 80MG-2ML AMPOULE GENTA 80MG-2ML AMPOULE 13 13

4137 GENTAM 20MG-2ML AMP GENTAM 20MG-2ML AMP 20 20

4138 GENTAM 80MG-2ML AMP GENTAM 80MG-2ML AMP 37 37

4139 GLYCERYL TRINITRATE 50MG-10ML I-V AMP GLYCERYL TRINITRATE 50MG-10ML I-V AMP 62 62

4140 GONAL-F 150 IU AMPOULE GONAL-F 150 IU AMPOULE 497 497

4141 GONAL-F 75 IU AMPOULE GONAL-F 75 IU AMPOULE 321 321

4142 GRANITRON 1MG-ML SOLUTION FOR Injection GRANITRON 1MG-ML SOLUTION FOR Injection 72 72

4143 GRANITRON 3MG-3ML SOLUTION FOR Injection GRANITRON 3MG-3ML SOLUTION FOR Injection 141 141

4144 GUTRON Injection GUTRON Injection 15 15

4145 HALDOL 5MG-ML AMP HALDOL 5MG-ML AMP 19 19

4146 HALDOL DECANOAS INJ 100MG-ML HALDOL DECANOAS INJ 100MG-ML 93 93

4147 HALDOL DECANOAS INJ 50MG HALDOL DECANOAS INJ 50MG 54 54

4148 HEPA - MERZ INFUSION HEPA - MERZ INFUSION 43 43

Page 65

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4149 HEPATECT AMP HEPATECT AMP 774 774

4150 HEPATECT AMP HEPATECT AMP 15 15

4151 HIKMA MIDAZOLAM 5MG-1ML AMPOULES HIKMA MIDAZOLAM 5MG-1ML AMPOULES 15 15

4152 HISTARHINE SYRUP HISTARHINE SYRUP 17 17

4153 HONVAN AMPOULE 300MG-5 ML HONVAN AMPOULE 300MG-5 ML 28 28

4154 IMPUGAN 10MG-ML INJ 2ML AMP IMPUGAN 10MG-ML INJ 2ML AMP 12 12

4155 INDERAL AMPULES 1MG-ML INDERAL AMPULES 1MG-ML 13 13

4156 INFLA-BAN 75MG-3ML AMP INFLA-BAN 75MG-3ML AMP 13 13

4157 INSTENON AMP INSTENON AMP 15 15

4158 INTAL NEBULISER SOLN 1% 2ML AMP INTAL NEBULISER SOLN 1% 2ML AMP 13 13

4159 IOPAMIRO 200 INJ IOPAMIRO 200 INJ 48 48

4160 IPRADOL AMPULES 5MCG-2 ML IPRADOL AMPULES 5MCG-2 ML 13 13

4161 ISOKET 0.1% AMPOULE ISOKET 0.1% AMPOULE 24 24

4162 ISOPTIN AMP 2.5MG-ML ISOPTIN AMP 2.5MG-ML 17 17

4163 JECTOFER AMP. 100 MG JECTOFER AMP. 100 MG 18 18

4164 KEMADRIN INJ 10MG-2ML KEMADRIN INJ 10MG-2ML 25 25

4165 KONAKION AMP 10MG-ML KONAKION AMP 10MG-ML 15 15

4166 KONAKION AMP 1MG-0.5ML KONAKION AMP 1MG-0.5ML 14 14

4167 KONAKION MM 10MG-ML AMP I.V. KONAKION MM 10MG-ML AMP I.V. 18 18

4168 KONAKION MM PAED 2MG-0.2ML AMP KONAKION MM PAED 2MG-0.2ML AMP 17 17

4169 KYTRIL 1MG-ML AMP KYTRIL 1MG-ML AMP 98 98

4170 KYTRIL 3MG-3ML AMP KYTRIL 3MG-3ML AMP 197 197

4171 LANIBOS 0.25MG-2ML INJ. LANIBOS 0.25MG-2ML INJ. 13 13

4172 LANITOP AMP 0.1MG-ML LANITOP AMP 0.1MG-ML 13 13

4173 LANOXIN 0.25MG/ML INJ LANOXIN 0.25MG/ML INJ 15 15

4174 LASIX AMP 20MG-2ML LASIX AMP 20MG-2ML 16 16

4175 LASIX INFUSION SOLN 250 MG. LASIX INFUSION SOLN 250 MG. 61 61

4176 LASTET 100MG AMP FOR INFUSION LASTET 100MG AMP FOR INFUSION 69 69

4177 LEUCOMAX 300 MICROGRAM VIAL+SOLVENT AMP LEUCOMAX 300 MICROGRAM VIAL+SOLVENT AMP 762 762

4178 LEUCOMAX 400 MICROGRAM VIAL+SOLVENT AMP LEUCOMAX 400 MICROGRAM VIAL+SOLVENT AMP 1013 1013

4179 LEVOPHED 4MG-4ML AMP(I.V) LEVOPHED 4MG-4ML AMP(I.V) 203 203

4180 LIDOCAINE HCL 1% AMPOULE LIDOCAINE HCL 1% AMPOULE 16 16

4181 LIDOCAINE HCL 2% INJ 20ML LIDOCAINE HCL 2% INJ 20ML 13 13

4182 LIGNOCAINE 1%W-V AMP LIGNOCAINE 1%W-V AMP 12 12

4183 LIGNOCAINE 2%W-V AMP LIGNOCAINE 2%W-V AMP 13 13

4184 LYSTHENON SICCUM VIAL LYSTHENON SICCUM VIAL 35 35

4185 MADECASSOL Injection MADECASSOL Injection 12 12

4186 MAGNESIUM SULFATE 50% AMPOULE MAGNESIUM SULFATE 50% AMPOULE 13 13

4187 MAGNEVIST INJ. MAGNEVIST INJ. 866 866

4188 MARCAINE INJ 0.5% MARCAINE INJ 0.5% 41 41

4189 MARCAINE INJ. 0.25% MARCAINE INJ. 0.25% 40 40

4190 MENOGON 75 I.U FSH & 75 I.U LH AMPOULES MENOGON 75 I.U FSH & 75 I.U LH AMPOULES 83 83

4191 METHERGINE 0.2MG-ML AMPULES METHERGINE 0.2MG-ML AMPULES 30 30

4192 METHOTREXATE "EBEWE 10MG-ML AMP. METHOTREXATE "EBEWE 10MG-ML AMP. 41 41

Page 66

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4193 METHYCOBAL 500 MCG AMPOULES METHYCOBAL 500 MCG AMPOULES 22 22

4194 MIACALCIC 100 IU-ML AMP MIACALCIC 100 IU-ML AMP 69 69

4195 MIACALCIC AMP 50 IU-ML MIACALCIC AMP 50 IU-ML 49 49

4196 MIACIN 100MG-2ML AMP MIACIN 100MG-2ML AMP 24 24

4197 MIACIN 500MG-2ML AMP MIACIN 500MG-2ML AMP 60 60

4198 MIDARINE 100 MG - 2 ML AMP MIDARINE 100 MG - 2 ML AMP 16 16

4199 MIDAZOLAM- HAMELN 1MG-ML SOLU. FOR INJ MIDAZOLAM- HAMELN 1MG-ML SOLU. FOR INJ 15 15

4200 MIDAZOLAM- HAMELN 5MG-ML SOLU. FOR INJ MIDAZOLAM- HAMELN 5MG-ML SOLU. FOR INJ 15 15

4201 MIKACIN 100MG-2ML INJ. MIKACIN 100MG-2ML INJ. 37 37

4202 MIKACIN 500MG-2 ML AMP MIKACIN 500MG-2 ML AMP 54 54

4203 MIVACRON 2MG\ML INJ MIVACRON 2MG\ML INJ 46 46

4204 MONOPARIN 1000 U-ML INJ MONOPARIN 1000 U-ML INJ 13 13

4205 MONOPARIN 25000 U-ML INJ MONOPARIN 25000 U-ML INJ 33 33

4206 MONOPARIN 5000 U-MLINJ MONOPARIN 5000 U-MLINJ 16 16

4207 NALOXONE HCL 400MCG-ML AMP NALOXONE HCL 400MCG-ML AMP 40 40

4208 NAROPIN 10MG-ML AMP NAROPIN 10MG-ML AMP 48 48

4209 NAROPIN 2MG-ML PLASTIC AMP NAROPIN 2MG-ML PLASTIC AMP 27 27

4210 NAROPIN 7.5MG-ML AMP NAROPIN 7.5MG-ML AMP 59 59

4211 NAVOBAN 5MG-5ML AMP NAVOBAN 5MG-5ML AMP 193 193

4212 NAXONE 0.02MG-ML INJ 2ML NAXONE 0.02MG-ML INJ 2ML 37 37

4213 NAXONE 0.4MG-ML INJ NAXONE 0.4MG-ML INJ 41 41

4214 NEBIDO 1000 MG- 4 ML SOLUTION FOR INJ NEBIDO 1000 MG- 4 ML SOLUTION FOR INJ 1130 1130

4215 NEOSTIGMINE 2.5MG-ML AMP NEOSTIGMINE 2.5MG-ML AMP 13 13

4216 NEOSTIGMINE METHYLSULFATE 0.5 MG/ML AMPOULE NEOSTIGMINE METHYLSULFATE 0.5 MG/ML AMPOULE 14 14

4217 NEUROBION NEUROBION 19 19

4218 NEUROCOMB I.M INJECTION NEUROCOMB I.M INJECTION 17 17

4219 NEURORUBINE SOLUTION NEURORUBINE SOLUTION 15 15

4220 NEUROVIT AMPOULES NEUROVIT AMPOULES 15 15

4221 NIMBEX 2MG\ML SOLUTION FOR INJ NIMBEX 2MG\ML SOLUTION FOR INJ 29 29

4222 NIPRIDE DOUBLE 50 MG AMP. NIPRIDE DOUBLE 50 MG AMP. 62 62

4223 NON PYROGENIC ACETATE F6(3-006-010) I.V NON PYROGENIC ACETATE F6(3-006- 010) I.V 92 92

4224 NON PYROGENIC ACID CONC (12-110- 005)I.V NON PYROGENIC ACID CONC (12-110- 005)I.V 74 74

4225 NON PYROGENIC ACID CONC (12-123- 005)I.V NON PYROGENIC ACID CONC (12-123- 005)I.V 74 74

4226 NON PYROGENIC ACID CONC (3-017-005)I.V NON PYROGENIC ACID CONC (3-017- 005)I.V 74 74

4227 NON PYROGENIC ACID CONC (3-023-005)I.V NON PYROGENIC ACID CONC (3-023- 005)I.V 74 74

4228 NON PYROGENIC ACID CONC(12-111-005)I.V NON PYROGENIC ACID CONC(12-111- 005)I.V 74 74

4229 NON PYROGNIC ACETATE F1(3-001-010)I.V NON PYROGNIC ACETATE F1(3-001- 010)I.V 92 92

4230 NOOTROPIL AMP 1GM-5ML NOOTROPIL AMP 1GM-5ML 15 15

4231 OLFEN-75 OLFEN-75 19 19

4232 ONE-ALPHA 2MCG-ML AMP. ONE-ALPHA 2MCG-ML AMP. 32 32

4233 ORADEXON AMPULES 5 MG.-ML. ORADEXON AMPULES 5 MG.-ML. 38 38

Page 67

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4234 PAINSTOP 20MG-ML AMPOULE PAINSTOP 20MG-ML AMPOULE 13 13

4235 PAVULON 2MG-ML INJ 2ML PAVULON 2MG-ML INJ 2ML 22 22

4236 PED-EL 20ML VIAL PED-EL 20ML VIAL 35 35

4237 PENTAGLOBIN AMP I.V PENTAGLOBIN AMP I.V 3866 3866

4238 PHENTOLEP 50MG-ML AMPOULE PHENTOLEP 50MG-ML AMPOULE 39 39

4239 PHENYTOIN 250MG-5ML AMP PHENYTOIN 250MG-5ML AMP 42 42

4240 PLASMA PROTEIN FRACTION 5% SOLUTION PLASMA PROTEIN FRACTION 5% SOLUTION 248 248

4241 PLASMANATE 5% SOLUTION FOR I.V. INJECTION PLASMANATE 5% SOLUTION FOR I.V. INJECTION 328 328

4242 POLYVALENT SNAKE ANTIVENUM(EQUINE) AMP POLYVALENT SNAKE ANTIVENUM(EQUINE) AMP 590 590

4243 POTASSIUM CHLORIDE 7.5% AMP POTASSIUM CHLORIDE 7.5% AMP 13 13

4244 PREGNYL +SOLVENT PREGNYL +SOLVENT 38 38

4245 PREGNYL 5000 IU AMP+SOLVENT PREGNYL 5000 IU AMP+SOLVENT 105 105

4246 PREMOSAN 10MG Injection PREMOSAN 10MG Injection 11 11

4247 PRIMPERAN 5MG-ML 2ML-AMP. PRIMPERAN 5MG-ML 2ML-AMP. 12 12

4248 PROLUTON DEPOT AMP 250MG-ML(500mg- 2ML) PROLUTON DEPOT AMP 250MG- ML(500mg-2ML) 51 51

4249 PROPOFOL 1% I.V INJ OR INFUSION PROPOFOL 1% I.V INJ OR INFUSION 51 51

4250 PROPOFOL-LIPURO1% INJ OR INF AMPOULE PROPOFOL-LIPURO1% INJ OR INF AMPOULE 38 38

4251 PROSTIN E2 0.5ML I.V.AMP PROSTIN E2 0.5ML I.V.AMP 235 235

4252 PROSTIN E2 0.75ML AMP PROSTIN E2 0.75ML AMP 112 112

4253 PROSTIN VR AMP PROSTIN VR AMP 699 699

4254 PROSULF 10MG/ML SOLUTION FOR INJECTION PROSULF 10MG/ML SOLUTION FOR INJECTION 16 16

4255 PROTAMINE SULPHATE INJ 1% PROTAMINE SULPHATE INJ 1% 11 11

4256 PROVISC 10MG-ML SYRINGE FOR I-O USE PROVISC 10MG-ML SYRINGE FOR I-O USE 419 419

4257 PULMICORT 0.5MG-ML (S.DOSE FOR NUB) SUSP PULMICORT 0.5MG-ML (S.DOSE FOR NUB) SUSP 341 341

4258 PULMICORT0.25MG-ML SINGLE DOSE PLASTIC U PULMICORT0.25MG-ML SINGLE DOSE PLASTIC U 19 19

4259 RANTAG 50MG AMP. RANTAG 50MG AMP. 18 18

4260 RAPIFEN 500MCG-ML AMP RAPIFEN 500MCG-ML AMP 18 18

4261 REGITINE AMP REGITINE AMP 42 42

4262 RHEUMARENE 75MG-3ML SOLU. FOR INJECTION RHEUMARENE 75MG-3ML SOLU. FOR INJECTION 12 12

4263 RIVOTRIL AMP 1MG+SOLV 1ML RIVOTRIL AMP 1MG+SOLV 1ML 17 17

4264 ROFENAC 75MG AMP ROFENAC 75MG AMP 23 23

4265 ROLAN 50MG\2ML AMP ROLAN 50MG\2ML AMP 17 17

4266 SALURIN 20MG-2ML AMPOULES SALURIN 20MG-2ML AMPOULES 14 14

4267 SANDIMMUN 50MG-ML AMPULE SANDIMMUN 50MG-ML AMPULE 334 334

4268 SANDOSTATIN 0.05MG-ML AMP SANDOSTATIN 0.05MG-ML AMP 53 53

4269 SANDOSTATIN 0.1MG-ML AMP SANDOSTATIN 0.1MG-ML AMP 91 91

4270 SANDOSTATIN 0.2MG-ML 5ML AMP SANDOSTATIN 0.2MG-ML 5ML AMP 300 300

4271 SCOPINAL 20MG AMPOULE SCOPINAL 20MG AMPOULE 13 13

4272 SCORPION ANTIVENOM (EQUINE) AMP SCORPION ANTIVENOM (EQUINE) AMP 113 113

4273 SEDACORON 150 MG- 3ML AMPOULES SEDACORON 150 MG- 3ML AMPOULES 17 17

4274 SEPTRIN I.M INJ 3ML SEPTRIN I.M INJ 3ML 32 32

4275 SEPTRIN INJECTION SEPTRIN INJECTION 32 32

Page 68

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4276 SHIFA PIROXICAM 20 MG-ML I.M AMP SHIFA PIROXICAM 20 MG-ML I.M AMP 12 12

4277 SHIFA RANITIDINE50MG\2ML AMPOULE SHIFA RANITIDINE50MG\2ML AMPOULE 12 12

4278 SOD. CHLORIDE 3% I.V INJECTION AMP SOD. CHLORIDE 3% I.V INJECTION AMP 11 11

4279 SOD.CHLORIDE 0.9% SOD.CHLORIDE 0.9% 11 11

4280 SODIUM CHLORIDE 5.85% AMP SODIUM CHLORIDE 5.85% AMP 12 12

4281 SOLUPARAXIN 1G VIAL+SOLVENT SOLUPARAXIN 1G VIAL+SOLVENT 26 26

4282 SPASMOPAN 20MG AMP. SPASMOPAN 20MG AMP. 12 12

4283 STESOLID INJ 10 MG-2 ML STESOLID INJ 10 MG-2 ML 14 14

4284 SUFENTA AMP 5MCG-ML SUFENTA AMP 5MCG-ML 18 18

4285 SUFENTA FORTE AMP 50MCG-ML SUFENTA FORTE AMP 50MCG-ML 87 87

4286 SUFUNTANIL- HAMELN 5MCG-ML SOLU. FOR INJ SUFUNTANIL- HAMELN 5MCG-ML SOLU. FOR INJ 31 31

4287 SULPHADIAZINE INJ 27.2%W-V 4ML AMP SULPHADIAZINE INJ 27.2%W-V 4ML AMP 18 18

4288 SUSTANON 100 AMP SUSTANON 100 AMP 38 38

4289 SUSTANON 250 AMP SUSTANON 250 AMP 57 57

4290 SYLADOR INJ 5MG-ML SYLADOR INJ 5MG-ML 16 16

4291 SYNACTHEN DEPOT SYNACTHEN DEPOT 56 56

4292 SYNTOCINON AMP 5 IU-ML SYNTOCINON AMP 5 IU-ML 15 15

4293 TENORMIN INJ 500MCG-ML TENORMIN INJ 500MCG-ML 25 25

4294 TESTOVIRON DEPOT 250MG-1ML AMP TESTOVIRON DEPOT 250MG-1ML AMP 63 63

4295 TIAPRIDAL AMP TIAPRIDAL AMP 13 13

4296 TILCOTIL 20MG VIAL TILCOTIL 20MG VIAL 23 23

4297 TOBRAMYCIN 20MG-2ML VIAL TOBRAMYCIN 20MG-2ML VIAL 26 26

4298 TRABILIN 100MG AMPOULES TRABILIN 100MG AMPOULES 17 17 0

4299 TRACRIUM 10MG\ML TRACRIUM 10MG\ML 33 33 0

4300 TRACUTIL SOLUSION FOR INFUSION AMPOULE TRACUTIL SOLUSION FOR INFUSION AMPOULE 19 19 0

4301 TRAMADOL AWD 100MG-2ML AMPOULE TRAMADOL AWD 100MG-2ML AMPOULE 18 18 0

4302 TRAMADONE 50MG-ML(100MG-2ML) AMPOULE TRAMADONE 50MG-ML(100MG-2ML) AMPOULE 18 18 0

4303 TRAMAL 50 MG-1 ML AMPOULE TRAMAL 50 MG-1 ML AMPOULE 17 17 0

4304 TRANDATE INJ. 100 MG.-AMP.20ML TRANDATE INJ. 100 MG.-AMP.20ML 45 45 0

4305 UBRETID 0.5MG AMP UBRETID 0.5MG AMP 12 12 0

4306 UROMITEXAN 400MG-4ML AMP UROMITEXAN 400MG-4ML AMP 21 21 0

4307 VALIUM AMP 10MG-2ML VALIUM AMP 10MG-2ML 15 15 0

4308 VENTOLIN 0.5MG\ML INJ VENTOLIN 0.5MG\ML INJ 17 17 0

4309 VOLTAREN 75 MG AMP VOLTAREN 75 MG AMP 28 28 0

4310 VOLTIC 75 MG-3ML AMPOULES VOLTIC 75 MG-3ML AMPOULES 19 19

4311 VOTREX 75MG-3ML AMP VOTREX 75MG-3ML AMP 17 17

4312 WATER FOR INJ AMP WATER FOR INJ AMP 11 11

4313 WATER FOR INJ. AMP WATER FOR INJ. AMP 11 11

4314 XYLOCAINE 1% WITH ADRENALINE INJ XYLOCAINE 1% WITH ADRENALINE INJ 38 38

4315 XYLOCAINE 2% WITH ADRENALINE INJ SOLN XYLOCAINE 2% WITH ADRENALINE INJ SOLN 39 39

4316 XYLOCAINE, INJ, SOLN 2% XYLOCAINE, INJ, SOLN 2% 22 22

4317 XYLOCAINE,INJ SOLN 1% XYLOCAINE,INJ SOLN 1% 21 21

4318 ZANTAC ZANTAC 20 20

4319 ZENOS AMP 4MG-ML ZENOS AMP 4MG-ML 21 21

Page 69

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4320 ZOFRAN 2MG\ML INJECTION ZOFRAN 2MG\ML INJECTION 106 106

4321 ZYDAC 50MG-2 ML SOLUTION FOR IV . IM ZYDAC 50MG-2 ML SOLUTION FOR IV . IM 17 17

4322 LUMBAR-PUNCTURE LUMBAR-PUNCTURE 500 500

4323 CPR WITH OR W/O DIFIBRILATION CPR WITH OR W/O DIFIBRILATION 500 500

4324 OXYGEN INHALATION / DAY OXYGEN INHALATION / DAY 400 400

4325 REDUCTION OF PULLED ELBOW REDUCTION OF PULLED ELBOW 100 100

4326 Prostatic massage (ONE SESSION) Prostatic massage (ONE SESSION) 60 60

4327 Tongue tie release Tongue tie release 200 200

4328 Excision benign tumor LA Excision benign tumor LA 200 200

4329 ECHOCARDIOGRAPHY / ECHOCARDIOGRAM ECHOCARDIOGRAPHY / ECHOCARDIOGRAM 500 500

4330 Thumb Spica Cast pop Thumb Spica Cast pop 150 150

4331 Above Elbow Pack-Slab Above Elbow Pack-Slab 276 276

4332 Knee Brace Knee Brace 40 40

4333 Ankle Brace ( banadage ) Ankle Brace ( banadage ) 40 40

4334 Above Knee Pack-Slab Above Knee Pack-Slab 300 300

4335 HOT AND Cold fomentation HOT AND Cold fomentation 10 10

4336 Inhalation Therapy (Atrovent & Flixotide) Inhalation Therapy (Atrovent & Flixotide) 40 40

4337 Excision of Large Lipoma Under Local Anesthesia LA Excision of Large Lipoma Under Local Anesthesia LA 300 300

4338 Epidermoid Cyst Excision Epidermoid Cyst Excision 200 200

4339 Multiple Papilloma Excision Under Local Anesthesia Multiple Papilloma Excision Under Local Anesthesia 200 200

4340 Nasal Turbinate Cauterization Nasal Turbinate Cauterization 100 100

4341 Posterior Wrist Slab / FIXATION SPRAIN WRIST Posterior Wrist Slab / FIXATION SPRAIN WRIST 200 200

4342 Closed Reduction & Splintage of Finger Joint Dislocation Closed Reduction & Splintage of Finger Joint Dislocation 300 300

4343 Urinary Nelaton Catheterization Urinary Nelaton Catheterization 50 50

4344 Endotracheal Intubation Endotracheal Intubation 150 150

4345 Nasogastric ( NG ) Tube Fixation NGT Nasogastric ( NG ) Tube Fixation NGT 50 50

4346 ABDOMINAL TAPPING ABDOMINAL TAPPING 100 100

4347 HAEMATOMA INCISION HAEMATOMA INCISION 150 150

4348 SPIRAL PHOTOTHERAPY SPIRAL PHOTOTHERAPY 300 300

4349 INVASIVE PRESSURE MONITORING INVASIVE PRESSURE MONITORING 400 400

4350 BP Blood pressure MONITORING 1 DAY BP Blood pressure MONITORING 1 DAY 50 50

4351 CARDIAC MONITORING / Day CARDIAC MONITORING / Day 250 250

4352 CVP - MONITORING / DAY CVP - MONITORING / DAY 150 150

4353 PULSE Oximeter / DAY PULSE Oximeter / DAY 100 100

4354 ASCETIC FLUID PUNCTURE ASCETIC FLUID PUNCTURE 500 500

4355 REMOVAL OF CERCVICAL Stitch ( suture ) / REMOVAL OF SHIRODKAR SUTURE REMOVAL OF CERCVICAL Stitch ( suture ) / REMOVAL OF SHIRODKAR SUTURE 100 100

4356 UMBILical VENous or ARTErial CANNULATION UMBILical VENous or ARTErial CANNULATION 200 200

4357 ( Electro - Cryo - Chemical ) Cautery for 10 or MORE WARTS ( Electro - Cryo - Chemical ) Cautery for 10 or MORE WARTS 500 500

4358 Retrobulbar - Injection FOR ONE EYE Retrobulbar - Injection FOR ONE EYE 100 100

4359 EVERTED PUNCTUM CAUTERY EVERTED PUNCTUM CAUTERY 200 200

4360 JOINT TAPING / ASPIRATION MEDIUM JOINT JOINT TAPING / ASPIRATION MEDIUM JOINT 100 100

4361 JOINT TAPING / ASPIRATION LARGE JOINT JOINT TAPING / ASPIRATION LARGE 150 150

Page 70

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

JOINT

4362 POP SLAB BELOW ELBOW / KNEE POP SLAB BELOW ELBOW / KNEE 200 200

4363 CAST MENERVA CAST MENERVA 500 500

4364 ANTERIOR OR POSTERIOR NASAL PACKAGE (BOTH SIDES) ANTERIOR OR POSTERIOR NASAL PACKAGE (BOTH SIDES) 200 200

4365 EPIDURAL LOCAL INJECTION EPIDURAL LOCAL INJECTION 250 250

4366 CLAVICLE BRACE CLAVICLE BRACE 100 100

4367 EVACUATION OF NAIL HEMATOMA EVACUATION OF NAIL HEMATOMA 70 70

4368 Hearing Test (Screening) Hearing Test (Screening) 250 250

4369 ( AURAL ) EAR PACK (FOR EACH EAR) Unilateral ( AURAL ) EAR PACK (FOR EACH EAR) Unilateral 30 30

4370 Nasal / NOSE suction / sputum suction / suction per mouth Nasal / NOSE suction / sputum suction / suction per mouth 30 30

4371 PEAK FLOW METER (PFM) PEAK FLOW METER (PFM) 50 50

4372 IOP MEASUREMENT (intra occular pressure) IOP MEASUREMENT (intra occular pressure) 30 30

4373 INCISION OF LACRIMAL CYST INCISION OF LACRIMAL CYST 200 200

4374 VENTOLIN NEBULISER + o2 OXYGEN / Inhalation Therapy (Oxygen & Adrenaline) VENTOLIN NEBULISER + o2 OXYGEN / Inhalation Therapy (Oxygen & Adrenaline) 30 30

4375 foreign body removal from both eyes foreign body removal from both eyes 140 140

4376 unilateral wash for lacrimal gland unilateral wash for lacrimal gland 60 60

4377 bilateral wash for lacrimal gland bilateral wash for lacrimal gland 100 100

4378 casts for fingers pop casts for fingers pop 100 100

4379 Stitch ( suture ) per each / TENDON SUTURE- EACH SUTURE Stitch ( suture ) per each / TENDON SUTURE-EACH SUTURE 20 20

4380 MUSCuLAR Stitch ( suture ) MUSCuLAR Stitch ( suture ) 20 20

4381 EXCISION OF GANGLION EXCISION OF GANGLION 200 200

4382 eye lid suture per one eye lid suture per one 40 40

4383 oxytocin inj. oxytocin inj. 50

4384 conjuntival suture per one conjuntival suture per one 50 50

4385 Cold Compressed Cold Compressed 14 14

4386 UVA (SESSION) UVA (SESSION) 30 30

4387 Skin Traction - Pediatric / day Skin Traction - Pediatric / day 150 150

4388 Skin Traction -Adult / day Skin Traction -Adult / day 200 200

4389 Scaphoid Cast POP Scaphoid Cast POP 150 150

4390 Scaphoid Cast Dynacost Scaphoid Cast Dynacost 250 250

4391 Leishmanic Cautery Leishmanic Cautery 50 50

4392 Leishmanic Cautery Multiple Leishmanic Cautery Multiple 150 150

4393 Cautery Of Lashes Cautery Of Lashes 100 100

4394 Epistaxis> Laser Cauterisation Epistaxis> Laser Cauterisation 250 250

4395 Cold sponging / TEPID SPONGE BATH Cold sponging / TEPID SPONGE BATH 30 30

4396 Puva therapy for 1 setting Puva therapy for 1 setting 50 50

4397 Removal of milia by sterile needle ( EACH) Removal of milia by sterile needle ( EACH) 40 40

4398 Epilation of eye lash ( ABERRANT / rubbing ) Removal Epilation of eye lash ( ABERRANT / rubbing ) Removal 50 50

4399 SYRINGE PUMP PER DAY SYRINGE PUMP PER DAY 100 100

4400 Eye tension mesuring / APPLANATION TONOMETRY FOR BOTH EYES Eye tension mesuring / APPLANATION TONOMETRY FOR BOTH EYES 50 50

4401 USE OF INTERMIT SUC PUMP/DAY USE OF INTERMIT SUC PUMP/DAY 120 120

4402 FEMORAL CAST BRACE HINGES FEMORAL CAST BRACE HINGES 1200 1200

4403 Repair of old perineal tear Repair of old perineal tear 1000 1000

Page 71

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4404 Eye wash & eye drops / EYE IRRIGATION Eye wash & eye drops / EYE IRRIGATION 50 50

4405 TIBIAL CAST BRACE TIBIAL CAST BRACE 600 600

4406 Removal of loose nail Removal of loose nail 50 50

4407 Short wave sitting for prostate Short wave sitting for prostate 50 50

4408 Fetal Monitoring / DAY Fetal Monitoring / DAY 200 200

4409 Field of Vision – Peripheral Field of Vision – Peripheral 60 60

4410 Field of Vision – Central Field of Vision – Central 100 100

4418 Cautery procedure for ulcer cornea Cautery procedure for ulcer cornea 100 100

4419 Dressing For Diabetic 1 Toe Dressing For Diabetic 1 Toe 80 80

4420 Dressing For Diabetic (each Toe more) Dressing For Diabetic (each Toe more) 40 40

4421 Sternal puncture Sternal puncture 400 400

4422 Probing of the lacrimal canal / duct LA Probing of the lacrimal canal / duct LA 100 100

4423 REMOVAL OF SLAB REMOVAL OF SLAB 50 50

4424 AUDIOMETRY WITH MASKING AUDIOMETRY WITH MASKING 250 250

4425 METAL SLAB OF FINGER METAL SLAB OF FINGER 80 80

4426 CUT DOWN INFUSION LINE CUT DOWN INFUSION LINE 200 200

4427 WATER STEAM INHALATION WATER STEAM INHALATION 24 24

4428 LARYNGOSCOPY/DIAGNOSTIC + BIOSPY / FILM LARYNGOSCOPY/DIAGNOSTIC + BIOSPY / FILM 700 700

4429 LACRIMAL PASSAGE SYRINGING & WASH / bilateral LACRIMAL PASSAGE SYRINGING & WASH / bilateral 250 250

4430 PEAK FLOW METER (PFM) PRE & POST PEAK FLOW METER (PFM) PRE & POST 100 100

4431 REMOVAL OF PTDS (ONE EYE) REMOVAL OF PTDS (ONE EYE) 100 100

4432 Electrolysis of rubbing eyelash simple ( one eye ) Electrolysis of rubbing eyelash simple ( one eye ) 100 100

4433 FOREIGN BODY REMOVAL FROM LARYNX / BRONCHI FOREIGN BODY REMOVAL FROM LARYNX / BRONCHI 300 300

4434 ELASTIC BANDAGE WRIST ELASTIC BANDAGE WRIST 50 50

4435 COLOUR VISION TEST EXAM COLOUR VISION TEST EXAM 50 50

4436 EXCISION OF KELOID BY CAUTERY EXCISION OF KELOID BY CAUTERY 200 200

4437 AUDIOGRAM WITH READING AUDIOGRAM WITH READING 100 100

4438 INTERCOSTAL CHEST TUBE INTERCOSTAL CHEST TUBE 700 700

4440 BONE MARROW ASPIRATION-PROCEDURE + BIOPSY BONE MARROW ASPIRATION- PROCEDURE + BIOPSY 500 500

4441 INCISION OF ANT URETHRA INCISION OF ANT URETHRA 500 500

4442 Secondary closure of contamenated / INFECTED wound ( suture ) Secondary closure of contamenated / INFECTED wound ( suture ) 250 250

4443 BOUGIENAGE OF URETHRA BOUGIENAGE OF URETHRA 500 500

4444 single PHOTOTHERAPY PER DAY (PE) single PHOTOTHERAPY PER DAY (PE) 150 150

4445 TRIPLE PHOTO THERAPY W/O BLOOD PER DAY(PE) TRIPLE PHOTO THERAPY W/O BLOOD PER DAY(PE) 300 300

4446 Double Phototherapy per day Double Phototherapy per day 200 200

4447 Liver Biopsy w/o Histopath Liver Biopsy w/o Histopath 300 300

4448 PERIPHERAL ARTERIAL CANNULATION PERIPHERAL ARTERIAL CANNULATION 150 150

4449 ECHO 2 DIMENSION + M MODE ECHO 2 DIMENSION + M MODE 350 350

4450 COPY ECHO-VID CASS W/REPT COPY ECHO-VID CASS W/REPT 40 40

4451 DOBUTAMINE STRESS ECHO / EXERCISE ECHOCARDIOGRAM DOBUTAMINE STRESS ECHO / EXERCISE ECHOCARDIOGRAM 1000 1000

4452 ECHO-PAEDIA-2D+DOPLR+COL DPLR ECHO-PAEDIA-2D+DOPLR+COL DPLR 700 700

4453 ECHO-MMODE+2D ECHO +DOPLR ECHO-MMODE+2D ECHO +DOPLR 700 700

4454 EEG PTVIDEO MONITORING/DAY EEG PTVIDEO MONITORING/DAY 600 600

Page 72

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4455 EVOKED RESPONSE AUDIOMETRY EVOKED RESPONSE AUDIOMETRY 600 600

4456 TRANSESOPHAGEAL ECHOCARDIO TRANSESOPHAGEAL ECHOCARDIO 1000 1000

4457 INFUSION /SYRINGE PUMP/DAY INFUSION /SYRINGE PUMP/DAY 70 70

4458 EXTRACTION OF SUBMANDIBULAR STONE EXTRACTION OF SUBMANDIBULAR STONE 750 750

4459 TOTAL EXC Ingrowing TOE NAIL W/BED LA TOTAL EXC Ingrowing TOE NAIL W/BED LA 300 300

4460 all CAUTERY EPISTAXIS bilateral all CAUTERY EPISTAXIS bilateral 150 150

4461 all CAUTERY EPISTAXIS unilateral all CAUTERY EPISTAXIS unilateral 100 100

4462 BILATERAL EAR SUCTION BILATERAL EAR SUCTION 70 70

4463 PTD's PICKING (2 EYES) PTD's PICKING (2 EYES) 150 150

4464 Large TUMOR ON EYE-LID / CONJUNCTIVA LA / Excision of Conjunctival nevus / BIOPS Large TUMOR ON EYE-LID / CONJUNCTIVA LA / Excision of Conjunctival nevus / BIOPS 400 400

4465 PENILE INJECT FOR ERECTION PENILE INJECT FOR ERECTION 250 250

4466 o2 OXYGEN + No2 / 30 MINS o2 OXYGEN + No2 / 30 MINS 40 40

4467 URETHERAL DILATATION / UROFLOWMETRY URETHERAL DILATATION / UROFLOWMETRY 300 300

4468 LATERAL CERVICAL PUNCTURE LATERAL CERVICAL PUNCTURE 800 800

4469 CISTERNAL PUNCTURE CISTERNAL PUNCTURE 800 800

4470 VENTRICULAR PUNCTURE VENTRICULAR PUNCTURE 800 800

4471 SLIPPER CAST SYNTHETIC / foot cast SLIPPER CAST SYNTHETIC / foot cast 250 250

4472 PED-SLIPPER CAST PLASTER / foot cast pop PED-SLIPPER CAST PLASTER / foot cast pop 180 180

4473 PED-SLIPPER CAST (SYNTHETIC) / foot cast PED-SLIPPER CAST (SYNTHETIC) / foot cast 200 200

4474 Urethral stone extraction ULA Urethral stone extraction ULA 500 500

4475 URETHRAL DILATATION UNDER LOCAL A URETHRAL DILATATION UNDER LOCAL A 600 600

4476 PROSTATIC U/S GUIDED BIOPSY PROSTATIC U/S GUIDED BIOPSY 900 900

4477 Small TUMOR 1LID CONJUNCTIVA LA Small TUMOR 1LID CONJUNCTIVA LA 200 200

4478 CATHERIZATION URETHRAL AND URINE BAG CATHERIZATION URETHRAL AND URINE BAG 100 100

4479 GROMMET TUBE REMOVAL (OPD) GROMMET TUBE REMOVAL (OPD) 100 100

4481 URETHRAL IRRIGATION URETHRAL IRRIGATION 150 150

4482 APNEA MONITOR APNEA MONITOR 100 100

4483 HEMODYNAMIC MONITOR PER DAY HEMODYNAMIC MONITOR PER DAY 100 100

4484 ( OXYGEN & VENTOLIN & PULMECORT & ATROVET) INHELATION ( OXYGEN & VENTOLIN & PULMECORT & ATROVET) INHELATION 70 70

4485 CIRCUMCISION OF NEW BORN (1M UP TO 6 MONTHS) CIRCUMCISION OF NEW BORN (1M UP TO 6 MONTHS) 250 250

4486 CIRCUMCISION (ABOVE 12 YEARS) CIRCUMCISION (ABOVE 12 YEARS) 600 600

4487 Intra-Articular Injection W/ US Intra-Articular Injection W/ US 300 300

4488 PROSTATIC NEEDLE ASPIRATION PROSTATIC NEEDLE ASPIRATION 400 400

4489 EYE / CONJUNTIVAL / Lacrimal CYST EXCISION LA EYE / CONJUNTIVAL / Lacrimal CYST EXCISION LA 400 400

4490 EAR GRANULATION TISSUE CHEMICAL CAUTERY EAR GRANULATION TISSUE CHEMICAL CAUTERY 200 200

4491 REMOVAL OF INTUBATION FROM DCR REMOVAL OF INTUBATION FROM DCR 100 100

4492 SLIPPER CAST plaster / foot cast pop SLIPPER CAST plaster / foot cast pop 200 200

4493 Thumb Spica Cast synthetic Thumb Spica Cast synthetic 250 250

4494 EXCISION PILONIDAL SINUS ULA EXCISION PILONIDAL SINUS ULA 500 500

4495 SLIT LAMP EXAMINATION / SLIT LAMP WITH FLORESCENT LAMP SLIT LAMP EXAMINATION / SLIT LAMP WITH FLORESCENT LAMP 50 50

Page 73

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4496 EXOPHTHALMOMETRY EXOPHTHALMOMETRY 50 50

4497 CORNEAL SCRAPING (STAINING / CULTURE) CORNEAL SCRAPING (STAINING / CULTURE) 100 100

4498 FB REMOVAL CORNEA / CONJUNCTIVA / eye FB REMOVAL CORNEA / CONJUNCTIVA / eye 100 100

4499 CHALAZION EXCISION LA ( Small / Infected / LARGE ) CHALAZION EXCISION LA ( Small / Infected / LARGE ) 200 200

4500 Picking of trachomatous pleps Picking of trachomatous pleps 150 150

4501 GONIOSCOPY GONIOSCOPY 50 50

4502 KERATOSCOPY KERATOSCOPY 50 50

4503 RETINOMETRY RETINOMETRY 50 50

4504 Splint / Plaster Removal Splint / Plaster Removal 50 50

4505 Removal / CURTTAGE / Excision of Molluscum Removal / CURTTAGE / Excision of Molluscum 200 200

4506 WOOD'S LIGHT EXAM WOOD'S LIGHT EXAM 50 50

4507 DEFIBRILLATOR DEFIBRILLATOR 100 100

4508 NERVE BLOCKADE NERVE BLOCKADE 150 150

4509 CVP set + insertion CVP set + insertion 350 350

4510 NERVE CONDUCTION VELOCITY - 1 NERVE NERVE CONDUCTION VELOCITY - 1 NERVE 150 150

4511 NERVE CONDUCTION VELOCITY - 2 NERVES NERVE CONDUCTION VELOCITY - 2 NERVES 250 250

4512 NERVE CONDUCTION VELOCITY - 3 NERVES OR MORE NERVE CONDUCTION VELOCITY - 3 NERVES OR MORE 400 400

4513 Nasal Polypectomy (LA) (UNILATERAL) Nasal Polypectomy (LA) (UNILATERAL) 350 350

4514 NASAL POLYPECTOMY LA (BILATERAL) NASAL POLYPECTOMY LA (BILATERAL) 500 500

4515 REPAIR OF EAR LOBULE / Pinna REPAIR OF EAR LOBULE / Pinna 150 150

4516 Repair Post Partum Tear ( new ) Repair Post Partum Tear ( new ) 500 500

4517 SUTURING OF CERV / VAG TEAR SUTURING OF CERV / VAG TEAR 300 300

4518 Figure of 8 Bandage For Fracture Clavicle Figure of 8 Bandage For Fracture Clavicle 150 150

4519 INSERT FEEDING TUBE(TUBE INCL) INSERT FEEDING TUBE(TUBE INCL) 50 50

4520 NASAL CRUST REMOVAL(UNILATERAL) NASAL CRUST REMOVAL(UNILATERAL) 50 50

4521 NASAL CRUST REMOVAL(BILATERAL) NASAL CRUST REMOVAL(BILATERAL) 100 100

4522 Fundoscopy with Direct / Indirect / 3 Mirror fundus Lenses Fundoscopy with Direct / Indirect / 3 Mirror fundus Lenses 50 50

4523 SYNOPTOPHORE EXAM SYNOPTOPHORE EXAM 50 50

4524 C-ARM MACHINE / HR C-ARM MACHINE / HR 300 300

4525 TRICHIASIS ELECTROLYSIS / Electrolysis of rubbing eyelash complicated ( one eye TRICHIASIS ELECTROLYSIS / Electrolysis of rubbing eyelash complicated ( one eye 500 500

4526 ANAL DILATION FOR ANAL STENOSIS / ( LA ) ANAL DILATION FOR ANAL STENOSIS / ( LA ) 120 120

4527 CLO TEST CLO TEST 100 100

4528 Incision of Imperforate Hymen / Hymenectomy ( LA ) Incision of Imperforate Hymen / Hymenectomy ( LA ) 500 500

4529 APNOEA ALARM / DAY APNOEA ALARM / DAY 80 80

4530 NEW BORN BAY WARMER NEW BORN BAY WARMER 100 100

4531 KERATOMETRY KERATOMETRY 100 100

4532 Meatotomy / urethral dilatation Meatotomy / urethral dilatation 350 350

4533 SUPRAPUBIC TAP / URINE ASPIRATION / PUNCTURE SUPRAPUBIC TAP / URINE ASPIRATION / PUNCTURE 150 150

4534 Suprapubic Catheter Suprapubic Catheter 300 300

4535 UPPER GIT ENDOSCOPY WITHOUT BIOPSY UPPER GIT ENDOSCOPY WITHOUT BIOPSY 500 500

4536 UPPER GIT ENDOSCOPY WITH BIOPSY UPPER GIT ENDOSCOPY WITH BIOPSY 800 800

Page 74

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 22 الضماد والطوارئ Emergency

بيان المجموعة 2222 الضماد والطوارئ Emergency

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4537 RACEMIC PULMICORT & ADRENALINE inhalation RACEMIC PULMICORT & ADRENALINE inhalation 50 50

4538 CYCLOPLEGIC TEST CYCLOPLEGIC TEST 50 50

4539 RING BLOCK ANAESTHESIA RING BLOCK ANAESTHESIA 40 40

4540 LOCAL ANAESTHESIA SMALL AREA LOCAL ANAESTHESIA SMALL AREA 40 40

4541 LOCAL ANAESTHESIA LARGE AREA LOCAL ANAESTHESIA LARGE AREA 100 100

4542 REMOVAL OF K-WIRE - SUPERFICIAL W/O Anesthesia REMOVAL OF K-WIRE - SUPERFICIAL W/O Anesthesia 200 200

4543 Vaginal Exam Under Anesthesia Vaginal Exam Under Anesthesia 100 100

4544 BUCCAL SMEAR BUCCAL SMEAR 50 50

4545 Refraction Refraction 50 50

4546 POP REMOVAL POP REMOVAL 50 50

4547 CHILD POP FULL L.L. OR U.L. CHILD POP FULL L.L. OR U.L. 400 400

4548 REDUCTION OF PILES REDUCTION OF PILES 100 100

4549 MIDDLE EAR FLUID ASPIRATION UNDER LA MIDDLE EAR FLUID ASPIRATION UNDER LA 250 250

4550 EAR MOPPING EAR MOPPING 20 20

4551 INCISION OF EAR FURUNCLE INCISION OF EAR FURUNCLE 50 50

4552 Cranioscopy Cranioscopy 50 50

4553 TOE SUPPORT (METALLIC) TOE SUPPORT (METALLIC) 50 50

4554 METALLIC CAST FOREARM METALLIC CAST FOREARM 80 80

4555 Aspiration of bursa Aspiration of bursa 80 80

4556 ALUMINIUM SPLINT LARGE ALUMINIUM SPLINT LARGE 80 80

4557 Ultraviolet Radiation session ( UVR ) Ultraviolet Radiation session ( UVR ) 50 50

4558 Sensitivity Test In Eye Sensitivity Test In Eye 20 20

4559 MAN-REPOSTION OF INVER UTERUS (LA) MAN-REPOSTION OF INVER UTERUS (LA) 400 400

4560 Ventilation Tube (Gromet S) LA Ventilation Tube (Gromet S) LA 500 500

4561 Insulflation of fallopian tubes & uterus Insulflation of fallopian tubes & uterus 500 500

4562 ORCHIDOMETER ORCHIDOMETER 50 50

4563 Aspiration of Cyst Aspiration of Cyst 250 250

4564 Excision more than one sebaceous Cyst Excision more than one sebaceous Cyst 500 500

4565 Excision more than one lipoma or cysts LA Excision more than one lipoma or cysts LA 500 500

4566 LASER CAPSULOTOMY (YAG) LASER CAPSULOTOMY (YAG) 1000 1000

4567 LASER PHOTOCOAGULATION /ONE EYE/ 1ST SETTING LASER PHOTOCOAGULATION /ONE EYE/ 1ST SETTING 1200 1200

4568 LASER PHOTOCOAGULATION /ONE EYE/ 2ND SETTING LASER PHOTOCOAGULATION /ONE EYE/ 2ND SETTING 600 600

4569 E C G with Excersise ( Stress )TREADMILL E C G with Excersise ( Stress )TREADMILL 300 300

4570 LA DEBRIDEMENT OF SMALL WOUND LA DEBRIDEMENT OF SMALL WOUND 200 200

4571 Debridement Of Diabetic Foot Under (LA) Debridement Of Diabetic Foot Under (LA) 800 800

4572 EXCISION SUBCUTANEOUS SWELLING LA EXCISION SUBCUTANEOUS SWELLING LA 200 200

4573 PED-HIP/SHOULDER SPICA(PLASTER) PED-HIP/SHOULDER SPICA(PLASTER) 400 400

4574 ADU-HIP/SHOULDER SPICA (PLASTER) ADU-HIP/SHOULDER SPICA (PLASTER) 500 500

4575 PED-HIP/SHOULDER SPICA(SYNTHETIC) PED-HIP/SHOULDER SPICA(SYNTHETIC) 500 500

بيان نوع الخدمة 24 الباكظيجات ---------

بيان المجموعة 2424 الباكيجات --------------

Page 75

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 24 الباكظيجات ---------

بيان المجموعة 2424 الباكيجات --------------

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1303 تحليل المدارس dddddddddddddddddddd 600

بيان نوع الخدمة 27 الامراض النفسبة والعصبية NEUROLOGY

بيان المجموعة 2727 الامراض النفسبة والعصبية Other Services

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1101 E.E.G. (AWAKE) E.E.G. (AWAKE) 1500 1500

1102 E.E.G. (ASLEEP) E.E.G. (ASLEEP) 1500 1500

1103 ECHOENCEPHALOGRAPHY ECHOENCEPHALOGRAPHY 370 370

1104 EEG UNDER SEDATION + MEDICINES EEG UNDER SEDATION + MEDICINES 2000 2000

1105 PERSONALITY TESTING PERSONALITY TESTING 370 370

1106 CEREBRAL STIMULATION CEREBRAL STIMULATION 500 500

1107 PSYCHOTHERAPY - I/P. O/P PSYCHOTHERAPY - I/P. O/P 370 370

1108 SOMATO-SENSORY EVOKED RESPONSE SOMATO-SENSORY EVOKED RESPONSE 2000 2000

1109 NERVE CONDUCTION STUDIES NERVE CONDUCTION STUDIES 750 750

1110 BEHAVIOR THERAPY BEHAVIOR THERAPY 370 370

1111 RELAXATION THERAPY RELAXATION THERAPY 370 370

1112 A.T. BECK DEPRESSION A.T. BECK DEPRESSION 370 370

1113 SELF CONFIDENCE SELF CONFIDENCE 370 370

1114 I.Q. TEST I.Q. TEST 620 620

1115 ELECTRO CONVULSIVE THERAPY SINGLE SEIZUR (E.C.T) ELECTRO CONVULSIVE THERAPY SINGLE SEIZUR (E.C.T) 1500 1500

1116 ELECTRO CONVULSIVE THERAPY MULTIPLE SZUR (E.C.T) ELECTRO CONVULSIVE THERAPY MULTIPLE SZUR (E.C.T) 1500 1500

بيان نوع الخدمة 28 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

بيان المجموعة 2828 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

149 FULL BODY LASER FULL BODY LASER 1000 1000

272 جلسة تجميل (1) جلسة تجميل (1)

273 جلسة تجميل (2( جلسة تجميل (2(

275 جلسة تجميل (3( جلسة تجميل (3(

277 Face Hair Removal Face Hair Removal 200 200

278 Moustach Hair Removal Moustach Hair Removal 100 100

279 Chin Beard Hair Removal Chin Beard Hair Removal 200 200

280 Beard Determination For Men Beard Determination For Men 300 300

281 Axilla Hair Removal Axilla Hair Removal 300 300

282 Bikini Hair Removal Bikini Hair Removal 300 250

283 Axilla & Bikini Hair Removal Axilla & Bikini Hair Removal 850 850

284 Arms Hair Removal Arms Hair Removal 200 200

285 Lower Leg Hair Removal Lower Leg Hair Removal 300 300

286 Thigh Hair Removal Thigh Hair Removal 300 300

287 Lower Leg & Thigh Hair Removal Lower Leg & Thigh Hair Removal 1000 1000

288 Carbon Peel For Rejuvenation Carbon Peel For Rejuvenation 600 600

289 Carbon Peel For ACNE Carbon Peel For ACNE 200 200

290 Carbon Peel For Wide Pores Carbon Peel For Wide Pores 200 200

Page 76

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 28 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

بيان المجموعة 2828 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

291 Carbon Peel For melasma Carbon Peel For Helasma 200 200

292 Lip Tint By Spectra Lip Tint By Spectra 300 300

293 Lip Tint By Fractional Lip Tint By Fractional 300 300

294 Removal Of Freckles Small No. Removal Of Freckles Small No. 300 300

295 Removal Of Freckles Large No. Removal Of Freckles Large No. 600 600

296 Removal Of Hyper Pigmented Spot (Small Lesion) Removal Of Hyper Pigmented Spot (Small Lesion) 300 300

297 Removal Of Hyper Pigmented Spot (Large Lesion) Removal Of Hyper Pigmented Spot (Large Lesion) 600 600

298 Removal Of Tatto (Small) Removal Of Tatto (Small) 300 300

299 Removal Of Tatto (Large) Removal Of Tatto (Large) 600 600

300 Hair Bleaching (Small Are) Hair Bleaching (Small Are) 300 300

301 Hair Bleaching (Large Area) Hair Bleaching (Large Area) 600 600

302 Fine Hair Removal (Small Area) Fine Hair Removal (Small Area) 300 300

303 Fine Hair Removal (Large Area) Fine Hair Removal (Large Area) 600 600

304 Eye Brow Bleaching Eye Brow Bleaching 300 300

305 Treatment Of Nail One Session Treatment Of Nail One Session 500 500

306 Ultra Former Number Of Shot 50 Ultra Former Number Of Shot 50 250 250

307 Ultra Former Number Of Shot 100 Ultra Former Number Of Shot 100 500 500

308 Ultra Former Number Of Shot 200 Ultra Former Number Of Shot 200 1000 1000

309 Ultra Former Number Of Shot 400 Ultra Former Number Of Shot 400 2000 2000

310 Vaginal Tighting (One Session) Vaginal Tighting (One Session) 1500 1500

311 III Of Urinary Incontinence (One Session) III Of Urinary Incontinence (One Session) 1500 1500

312 Fractional For Face Fractional For Face 1200 1200

313 Ultra Former Number Of Shot 300 Ultra Former Number Of Shot 300 1500 1500

314 BOTOX UPPER FACE BOTOX UPPER FACE 1500 1500

315 BOTOX ONE SITE BOTOX ONE SITE 500 500

316 BOTOX AXILLARY HYPER hydrosis BOTOX AXILLARY HYPER HYDENSIS 2000 2000

317 BOTOX PALMER BOTOX PALMER 2000 2000

318 BOTOX PLANTER BOTOX PLANTER 2500 2500

319 FILLER 1ML FILLER 1ML 1500 1500

320 FILLER 2 ML FILLER 2 ML 2800 2800

321 FILLER 3ML FILLER 3ML 4000 4000

322 PLASMA NORMAL TUBES PLASMA NORMAL TUBES 800 800

323 PLASMA (PRP) KITS PLASMA (PRP) KITS 1600 1600

324 MESO THARAPY FOR REJUVENATION MESO THARAPY FOR REJUVENATION 300 300

325 MESO THARAPY FOR WHITING MESO THARAPY FOR WHITING 300 300

326 MESO THARAPY FOR HAIR (ONE SESSION) MESO THARAPY FOR HAIR (ONE SESSION) 300 300

327 REMOVAL OF WART SINGLE LESION REMOVAL OF WART SINGLE LESION 100 100

328 REMOVAL OF SKIN TAGS SINGLE LESION REMOVAL OF SKIN TAGS SINGLE LESION 100 100

329 MESO LIBOLYSIS ONE SITE MESO LIBOLYSIS ONE SITE 500 500

330 PEELING AND WHITING MASK PLUS Complte Tharapy PEELING AND WHITING MASK PLUS Complte Tharapy 2500 2500

331 PEELING AND WHITING MASK PEELING AND WHITING MASK 1800 1800

332 PEELING SENSITIVE AREA PEELING SENSITIVE AREA 1000 1000

333 CHEMICAL PEELING ( ONE SESSION ) CHEMICAL PEELING ( ONE SESSION ) 300 300

334 REJUVENATION MASK REJUVENATION MASK 400 400

Page 77

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 28 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

بيان المجموعة 2828 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

335 FULL BODY HAIR REMOVAL FULL BODY HAIR REMOVAL 1000 1000

336 HAIR REMOVAL FACE HAIR REMOVAL FACE 200 200

337 BEARD HAIR REMOVAL MAN BEARD HAIR REMOVAL MAN 150 150

338 AXILLA HAIR REMOVER AXILLA HAIR REMOVER 100 100

339 ARMS HAIR REMOVAL ARMS HAIR REMOVAL 150 150

340 LEGS HAIR REMOVAL LEGS HAIR REMOVAL 150 150

341 AXILLA BIKINI HAIR REMOVAL AXILLA BIKINI HAIR REMOVAL 300 300

342 TOTAL BODY TOTAL BODY 600 600

474 MASSAGE OILS PERFIUMS MASSAGE OILS PERFIUMS 200

475 SKINE CLEANING HYDRAVICHL SKINE CLEANING HYDRAVICHL 550 550 0

476 SUPPLY LIPS SUPPLY LIPS 200

477 CHALK LASER EXEBROES CHALK LASER EXEBROES 200

478 BATHROOM MOROCCAN BATHROOM MOROCCAN 300 300

479 MASK COLLAGON MASK COLLAGON 200

480 PACKAGE ASMAA ALNEKHAFY PACKAGE ASMAA ALNEKHAFY 500

481 SKINE CLEANING HYDRAVICHL+CHALK LASER SKINE CLEANING HYDRAVICHL+CHALK LASER 800 800 30

482 PEEL WHOLE BODY 2 SEASONS+LASER EXEBROWS PEEL WHOLE BODY 2 SEASONS+LASER EXEBROWS 1200

483 MESOTHERPY + LASER EXEBROWS MESOTHERPY + LASER EXEBROWS 1200

484 FEILER LIPS AND FRESHNES+LASER EXEB FEILER LIPS AND FRESHNES+LASER EXEB 1500

496 جلسة تجميل (4( جلسة تجميل (4(

497 جلسة تجميل (5( جلسة تجميل (5(

819 mesolipolysis mesolipolysis 550 550

1055 DERMABRASION DERMABRASION 3750 3750

1056 DERMABRASION MINOR PROCEDURE DERMABRASION MINOR PROCEDURE 2500 2500

1057 DERMABRASION MODERATE PROCEDUR DERMABRASION MODERATE PROCEDUR 5000 5000

1058 DERMABRASION MAJOR PROCEDURE DERMABRASION MAJOR PROCEDURE 7450 7450

1059 MESOTHERAPY-MESOHAIR SINGLE MESOTHERAPY-MESOHAIR SINGLE 990 990

1060 MESOTHERAPY-MESOHAIR 3 SESSIONS MESOTHERAPY-MESOHAIR 3 SESSIONS 2750 2750

1061 MESOTHERAPY-MESOHAIR 5 SESSIONS MESOTHERAPY-MESOHAIR 5 SESSIONS 4500 4500

1062 MESOTHERAPY-MESOGLOW SINGLE MESOTHERAPY-MESOGLOW SINGLE 1860 1860

1063 MESOTHERAPY-MESOGLOW 6 SESSIONS I MESOTHERAPY-MESOGLOW 6 SESSIONS I 9680 9680

1064 MESOTHERAPY-MESOGLOW 6 SESSIONS II MESOTHERAPY-MESOGLOW 6 SESSIONS II 11200 11200

1065 MESOTHERAPY-MESOGLOW MESOHYAL I MESOTHERAPY-MESOGLOW MESOHYAL I 1900 1900

1066 MESOTHERAPY-MESOGLOW MESOHYAL II MESOTHERAPY-MESOGLOW MESOHYAL II 2120 2120

1067 FILLERS-FINE WRINKLES FILLERS-FINE WRINKLES 2440 2440

1068 FILLERS-DEEP LINES FILLERS-DEEP LINES 2980 2980

1069 FILLERS-LIP AUGMENTATION(FILLER) FILLERS-LIP AUGMENTATION(FILLER) 4470 4470

1070 FILLERS-FINE/DEEP FILLER FILLERS-FINE/DEEP FILLER 4470 4470

1071 BOTOX-UPPER FACE BOTOX INJECTION BOTOX-UPPER FACE BOTOX INJECTION 4470 4470

1072 LASER-HAIR REMOVAL I LASER-HAIR REMOVAL I 630 630

1073 LASER-HAIR REMOVAL II LASER-HAIR REMOVAL II 1250 1250

1074 LASER-HAIR REMOVAL III LASER-HAIR REMOVAL III 1900 1900

Page 78

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 28 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

بيان المجموعة 2828 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1075 LASER-HAIR REMOVAL IV LASER-HAIR REMOVAL IV 2500 2500

1076 LASER-HAIR REMOVAL V LASER-HAIR REMOVAL V 3150 3150

1077 MICRO DERMA ABRASION-SINGLE SESSION I MICRO DERMA ABRASION-SINGLE SESSION I 1250 1250

1078 MICRO DERMA ABRASION-SINGLE SESSION II MICRO DERMA ABRASION-SINGLE SESSION II 1400 1400

1079 MICRO DERMA ABRASION-SINGLE SESSION III MICRO DERMA ABRASION-SINGLE SESSION III 1650 1650

1080 MICRO DERMA ABRASION-SINGLE FACE/BACK MICRO DERMA ABRASION-SINGLE FACE/BACK 2230 2230

1081 MICRO DERMA ABRASION-5 SESSIONS I MICRO DERMA ABRASION-5 SESSIONS I 5000 5000

1082 MICRO DERMA ABRASION-5 SESSIONS II MICRO DERMA ABRASION-5 SESSIONS II 6250 6250

1083 MICRO DERMA ABRASION-5 SESSIONS III MICRO DERMA ABRASION-5 SESSIONS III 7450 7450

1084 MICRO DERMA ABRASION-5 SESSION FACE/BACK MICRO DERMA ABRASION-5 SESSION FACE/BACK 11200 11200

1085 MESO LIPO ONE SESSION MESO LIPO ONE SESSION 2100 2100

1086 MESO HAIR & FACE-6 SESSIONS MESO HAIR & FACE-6 SESSIONS 10350 10350

1087 MESO HAIR,FACE & LIPO- 6 SESSIONS MESO HAIR,FACE & LIPO- 6 SESSIONS 15530 15530

1088 FOLLOWUP MESO HAIR- 6 SESSIONS FOLLOWUP MESO HAIR- 6 SESSIONS 4000 4000

1089 FOLLOWUP MESO FACE - 6 SESSIONS FOLLOWUP MESO FACE - 6 SESSIONS 6500 6500

1090 FOLLOWUP MESOLIPO - 4 SESSIONS FOLLOWUP MESOLIPO - 4 SESSIONS 5800 5800

1091 LASER HAIR REMOVAL FACE LASER HAIR REMOVAL FACE 850 850

1092 LASER FOR PIGMENTATION LASER FOR PIGMENTATION 1100 1100

1093 MESOTHERAPY FOR PIGMENTATION MESOTHERAPY FOR PIGMENTATION 850 850

1094 UV CABIN - 3 SESSIONS UV CABIN - 3 SESSIONS 650 650

1095 UV. CABIN - 6 SESSIONS UV. CABIN - 6 SESSIONS 1250 1250

1096 UV. CABIN - 12 SESSIONS UV. CABIN - 12 SESSIONS 2500 2500

1097 COSMETIC-PEEL /SESSION COSMETIC-PEEL /SESSION 750 750

1098 COSMETIC - PEEL / 5 SESSIONS COSMETIC - PEEL / 5 SESSIONS 3200 3200

1099 COMEDO EXTRACTION COMEDO EXTRACTION 80 80

1100 PUVA THERAPY PUVA THERAPY 130 130

2082 العودة للمدارس (1) العودة للمدارس (1) 500 500 0

4603 TWO SESSIONS SKIN PLASMA TWO SESSIONS SKIN PLASMA 1000 1000 0

4604 TWO SESSIONS BODY PEELING TWO SESSIONS BODY PEELING 1200 1200 0

4605 العودة للمدارس(2) العودة للمدارس (2) 1000 1000 0

4606 LIP FILLER + SKIN SESSION LIP FILLER + SKIN SESSION 1500 1500 0

4607 3 SESSIONS MESOTHERAPHY 3 SESSIONS MESOTHERAPHY 1200 1200 0

4608 FRACTIONAL LASER PEELING FACE FRACTIONAL LASER PEELING FACE 400 400 0

4609 ACIDS PEELING FACE ACIDS PEELING FACE 300 300 0

4610 ULTRAFORMER FACE TIGHTEN ULTRAFORMER FACE TIGHTEN 2000 2000 0

4611 FOUR SESSIONS LASER SKIN FOUR SESSIONS LASER SKIN 1200 1200 0

4643 Full Body Cleaning Full Body Cleaning 500 700

4644 Bride Bridegroom VIP Bride Bridegroom VIP 1500 1500

4645 خدمات قسم الجلدية DERMATOLOGY SERVICES

4699 تشقير الحواب بالليزر، تنظيف البشرہ يخار الاءوزون ومواد عظويہ Lactation of the human is the cleaning of human beings and the aromatic substanc 300 300

4700 حمام مغربي ملکي تنطيف بشررہ ببخار اللءوزون والمواد العضويہ تشقير حواجب بالليزر Morocan bath for the body of a full body 500 500

4701 حمام مغربي تنظيف جسم کامل فل بدي بالمواد العضويہ تشقير حواجب بالليزر Morocan Bath 500 500

Page 79

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 28 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

بيان المجموعة 2828 خدمات مركز التجميل والعناية بالبشرة DERMATOLOGY AND BEAUTY CENTER

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4703 تنظيف البشرة بالبخار تنظيف البشرة بالبخار 250 250

4708 full body hair removal (offer) full body hair removal (offer) 650 650 0

4709 ultraformer(offer) ultraformer(offer) 1000 1000 0

4710 narrow band narrow band 70 70 0

بيان نوع الخدمة 29 خدمات عيادة الانف والاذن والحنجرة E.N.T

بيان المجموعة 2929 خدمات عيادة الانف والاذن والحنجرة E.N.T

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1260 EXTERNAL NASAL SPLINT SMALL EXTERNAL NASAL SPLINT SMALL 620 620

1261 NASAL SPLINT INSERTION NASAL SPLINT INSERTION 1100 1100

1262 OTOENDOSCOPY OTOENDOSCOPY 415 415

1263 EAR WASH EAR WASH 150 150

1264 NASAL ENDOSCOPY (OPD) NASAL ENDOSCOPY (OPD) 4200 4200

1265 RHINOMANOMETRY RHINOMANOMETRY 4200 4200

1266 FLEXIBLE NASOPHARYNGEAL LARYNGOSCOPE FLEXIBLE NASOPHARYNGEAL LARYNGOSCOPE 4200 4200

1267 FOREIGN BODY EAR & THROAT (OPD) FOREIGN BODY EAR & THROAT (OPD) 350 350

1268 NASAL PACK ANTERIOR NASAL PACK ANTERIOR 400 400

1269 ACOUSTIC RHINOMETRY ACOUSTIC RHINOMETRY 320 320

1270 NASAL CAUTERY (OPD) NASAL CAUTERY (OPD) 350 350

1271 NASAL PACK ANTERIOR REMOVED NASAL PACK ANTERIOR REMOVED 210 210

1272 DRAINAGE OF FURUCLE DRAINAGE OF FURUCLE 900 900

1273 SECONDARY SUTURES SECONDARY SUTURES 900 900

1274 DEBRIDEMENT SMALL WOUND DEBRIDEMENT SMALL WOUND 900 900

1275 DRAINAGE OF ABSCESS IN NECK DRAINAGE OF ABSCESS IN NECK 3500 3500

1276 GROMMET TUBE REMOVAL (OPD) GROMMET TUBE REMOVAL (OPD) 110 110

1277 EAR SUCTION EAR SUCTION 150 150

1278 NOSE SUCTION NOSE SUCTION 150 150

1279 SINUS WASHOUT L.A.(ONE SIDE) SINUS WASHOUT L.A.(ONE SIDE) 320 320

1280 WICK DRESSING WICK DRESSING 110 110

1281 OPD ENDOSCOPIC GUIDED REMOVAL/POLYPOSIS OPD ENDOSCOPIC GUIDED REMOVAL/POLYPOSIS 520 520

1282 ELECTRICAL CAUTERY (ONE SIDE) ELECTRICAL CAUTERY (ONE SIDE) 350 350

1283 ELECTRICAL CAUTERY (BOTH SIDES) ELECTRICAL CAUTERY (BOTH SIDES) 700 700

1284 ELECTRO CAUTERIZATION OF SEPTUM ELECTRO CAUTERIZATION OF SEPTUM 1100 1100

1285 CHEMICAL CAUTERY (ONE SIDE) CHEMICAL CAUTERY (ONE SIDE) 350 350

1286 CHEMICAL CAUTERY (BOTH SIDES) CHEMICAL CAUTERY (BOTH SIDES) 700 700

1287 EXTERNAL NASAL SPLINT MED EXTERNAL NASAL SPLINT MED 850 850

1288 BASIC AUDIOLOGICAL EVALUATION BASIC AUDIOLOGICAL EVALUATION 1250 1250

1289 TYMPANOMETRY TYMPANOMETRY 350 350

1290 MULTIPLE FREQUENCY TEST MULTIPLE FREQUENCY TEST 500 500

1291 DIZZINESS ASSESMENT DIZZINESS ASSESMENT 3730 3730

1292 TINNITIUS ASSESMENT TINNITIUS ASSESMENT 2500 2500

1293 ACOUSTIC REFLEXES THRESHOLD ACOUSTIC REFLEXES THRESHOLD 500 500

1294 PURE TONE AUDIOGRAM (PTA) PURE TONE AUDIOGRAM (PTA) 700 700

1295 TONE DECAY TEST (TD) TONE DECAY TEST (TD) 500 500

Page 80

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 29 خدمات عيادة الانف والاذن والحنجرة E.N.T

بيان المجموعة 2929 خدمات عيادة الانف والاذن والحنجرة E.N.T

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1296 FREE FIELD TESTING (PTA) FREE FIELD TESTING (PTA) 500 500

1297 PLAY AUDIOMETRY PLAY AUDIOMETRY 450 450

1298 ACOUSTIC REFLEX TEST BATTERY ACOUSTIC REFLEX TEST BATTERY 1250 1250

1299 POSITIONAL TESTING POSITIONAL TESTING 500 500

1300 SPEECH AUDIOMETRY SPEECH AUDIOMETRY 450 450

1301 NASAL PACK ANTERIOR REMOVED NASAL PACK ANTERIOR REMOVED 250 250

1302 FREE FIELD TESTING (SPEECH) FREE FIELD TESTING (SPEECH) 450 450

3664 EAR EXTERNAL ABSCESS DRAINAGE EAR EXTERNAL ABSCESS DRAINAGE 1000 1000

3665 NASO PHARYNGOSCOPY WITHOUT BIOPSY NASO PHARYNGOSCOPY WITHOUT BIOPSY 3500 3500

3666 DRAINAGE OF ABSCESS DRAINAGE OF ABSCESS 900 900

3667 DRAINAGE OF QUINCY DRAINAGE OF QUINCY 3500 3500

3668 NASAL POLYPAECTOMY NASAL POLYPAECTOMY 3500 3500

3669 TRAUMATIC DRUM INJURY REPAIR TRAUMATIC DRUM INJURY REPAIR 2070 2070

3670 ANTROSCOPY ANTROSCOPY 2070 2070

3671 SUTURE DEEP LACERATIONS SUTURE DEEP LACERATIONS 2500 2500

3672 NASAL EXTERNAL FIXATION ADJUSTMENT NASAL EXTERNAL FIXATION ADJUSTMENT 6000 6000

3673 NASAL ENDOSCOPY (OR) NASAL ENDOSCOPY (OR) 3500 3500

3674 CRICOTHYRIOD APPROXIMATION CRICOTHYRIOD APPROXIMATION 3105 3105

3675 OESOPHAGEAL DILATATION OESOPHAGEAL DILATATION 3105 3105

3676 FOREIGN BODY IN THE NOSE(G.A.) FOREIGN BODY IN THE NOSE(G.A.) 5500 5500

3677 FOREIGN BODY IN THE EAR (G.A.) FOREIGN BODY IN THE EAR (G.A.) 5500 5500

3678 TRACHEOSTOMY / DIRECT TRACHEOSTOMY / DIRECT 4760 4760

3679 EXPLORATORY TYMPANOTOMY EXPLORATORY TYMPANOTOMY 5175 5175

3680 LYMTH NODE EXE - SIMPLE BIOPSY LYMTH NODE EXE - SIMPLE BIOPSY 5000 5000

3681 ANTRECTOMY ENDOSCOPIC ANTRECTOMY ENDOSCOPIC 3500 3500

3682 PAROTID DRAINAGE PAROTID DRAINAGE 3105 3105

3683 PALATE SUTURE - SIMPLE PALATE SUTURE - SIMPLE 1100 1100

3684 PALATE SUTURE-MAJOR PALATE SUTURE-MAJOR 2070 2070

3685 ENDOSCOPIC CAUTERY ENDOSCOPIC CAUTERY 2500 2500

3686 GROMMET TUBE REMOVAL -(GA) GROMMET TUBE REMOVAL -(GA) 1100 1100

3687 ENDOSCOPIC - INFUNDULOTOMY ENDOSCOPIC - INFUNDULOTOMY 1100 1100

3688 ENDOSCOPIC - MIDDLE MEATOTOMY ENDOSCOPIC - MIDDLE MEATOTOMY 1100 1100

3689 NASAL MANIPULATION NASAL MANIPULATION 1100 1100

3690 NASOPHARYNGOSCOPY AND BIOPSY NASOPHARYNGOSCOPY AND BIOPSY 3725 3725

3691 HAEMATOMA AURICULAR, REPAIR HAEMATOMA AURICULAR, REPAIR 3105 3105

3692 CANALOPLASTY CANALOPLASTY 2070 2070

3693 CAUTERY LITTLE'S AREA (G.A.) CAUTERY LITTLE'S AREA (G.A.) 2500 2500

3694 LARYNGOSCOPY DIRECT W/WO BIOPSY LARYNGOSCOPY DIRECT W/WO BIOPSY 3500 3500

3695 LARYNGOSSCOPY DIRECT LOCAL ANES LARYNGOSSCOPY DIRECT LOCAL ANES 3500 3500

3696 MYRINGOTOMY MYRINGOTOMY 5000 5000

3697 ENT EXAMINATION,(G.A.) ENT EXAMINATION,(G.A.) 1100 1100

3698 NASAL PACK POSTERIOR NASAL PACK POSTERIOR 1200 1200

3699 ANTRAL WASHOUT, INPATIENT/OUTPATIENT ANTRAL WASHOUT, INPATIENT/OUTPATIENT 2500 2500

3700 ADENOIDECTOMY ADENOIDECTOMY 3000 3000

Page 81

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 29 خدمات عيادة الانف والاذن والحنجرة E.N.T

بيان المجموعة 2929 خدمات عيادة الانف والاذن والحنجرة E.N.T

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3701 ADENOIDECTOMY REC. / ADULT ADENOIDECTOMY REC. / ADULT 3000 3000

3702 UVULA EXCISION UVULA EXCISION 1100 1100

3703 S.M.D. SUBMUCUS DIATHERMY S.M.D. SUBMUCUS DIATHERMY 4000 4000

3704 EXCISION OF NASAL CYST EXCISION OF NASAL CYST 2070 2070

3705 EXCISION OF LUMP NECK/HEAD EXCISION OF LUMP NECK/HEAD 2070 2070

3706 PARTIAL MAXILLECTOMY SIMPLE PARTIAL MAXILLECTOMY SIMPLE 8485 8485

3707 EXCISION BIOPSY EXCISION BIOPSY 1200 1200

3708 TONSILLECTOMY - CHILD TONSILLECTOMY - CHILD 3500 3500

3709 TONSILLECTOMY - ADULT TONSILLECTOMY - ADULT 3500 3500

3710 TONSILLECTOMY + ADENOIDECTOMY TONSILLECTOMY + ADENOIDECTOMY 6000 6000

3711 EXCISION OF MANDIBULAR MASS EXCISION OF MANDIBULAR MASS 7000 7000

3712 EXCISION HEMANGIOMA EXCISION HEMANGIOMA 2070 2070

3713 DIATHERMY LINGUAL TONSILS DIATHERMY LINGUAL TONSILS 3725 3725

3714 HEAMATOMA EVACUATION , LARGE HEAMATOMA EVACUATION , LARGE 415 415

3715 I&D DEEP NECK MASS I&D DEEP NECK MASS 3500 3500

3716 JAW COMPLEX FRACTURE JAW COMPLEX FRACTURE 7245 7245

3717 REMOVAL OF EAR WAX REMOVAL OF EAR WAX 150 150

3718 NASAL BONE FRACTURE REDUCTION NASAL BONE FRACTURE REDUCTION 3500 3500

3719 REMOVAL OF NASAL SPLINT REMOVAL OF NASAL SPLINT 250 250

3720 PALATAL NODULE EXCISION PALATAL NODULE EXCISION 1100 1100

3721 THYROGLOSSAL CYST OR FISTULA THYROGLOSSAL CYST OR FISTULA 12000 12000

3722 TONSILLECTOMY W/AVULSION OF STYLOID PRCS TONSILLECTOMY W/AVULSION OF STYLOID PRCS 3500 3500

3723 PUNC. OF UNI. MEMBRANOUS CHOANAL ATRESIA PUNC. OF UNI. MEMBRANOUS CHOANAL ATRESIA 2070 2070

3724 EXCISION AURICULAR REGION EXCISION AURICULAR REGION 3105 3105

3725 UVCLECTOMY UVCLECTOMY 2070 2070

3726 TRACHEOSTOMY CLOSURE - SIMPLE TRACHEOSTOMY CLOSURE - SIMPLE 1100 1100

3727 S.M.R. S.M.R. 5000 5000

3728 PREAURICULAR FISTULA EXCISION PREAURICULAR FISTULA EXCISION 4140 4140

3729 S.M.R. MINI S.M.R. MINI 4000 4000

3730 PREAURICULAR SINUS EXCISION PREAURICULAR SINUS EXCISION 2070 2070

3731 PREAURICULAR SINUS EXCIS./REC PREAURICULAR SINUS EXCIS./REC 3105 3105

3732 FOREIGN BODY OESOPHAGUS FOREIGN BODY OESOPHAGUS 3105 3105

3733 CYST/TUMOUR EXCISION SUPER CYST/TUMOUR EXCISION SUPER 1100 1100

3734 OESOPHAGOSCOPY OESOPHAGOSCOPY 2070 2070

3735 I&D NASAL ABCESS UNDER G.A. I&D NASAL ABCESS UNDER G.A. 2500 2500

3736 MYRINGOTOMY + GROMET TUBE INSERT MYRINGOTOMY + GROMET TUBE INSERT 5000 5000

3737 SYNECTOMY SYNECTOMY 2070 2070

3738 AURAL POLYPECTOMY AURAL POLYPECTOMY 5000 5000

3739 SEPTAL PLICATION SEPTAL PLICATION 2070 2070

3740 OSSICULAR RECONSTRUCTION + TROP OSSICULAR RECONSTRUCTION + TROP 2070 2070

3741 FACIAL NERVE DISSECTION FACIAL NERVE DISSECTION 4140 4140

3742 LINGUAL TONSILLECTOMY LINGUAL TONSILLECTOMY 3500 3500

3743 ENDOSCOPIC - ETHMOIDECTOMY ENDOSCOPIC - ETHMOIDECTOMY 3500 3500

3744 SUBMANDIBULAR DUCT STONE REMOVAL SUBMANDIBULAR DUCT STONE REMOVAL 7000 7000

Page 82

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 29 خدمات عيادة الانف والاذن والحنجرة E.N.T

بيان المجموعة 2929 خدمات عيادة الانف والاذن والحنجرة E.N.T

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3745 I & D DEEP NECK ABCESS I & D DEEP NECK ABCESS 3500 3500

3746 TURBINECTOMY - SM TURBINECTOMY - SM 5500 5500

3747 TURBINECTOMY TURBINECTOMY 5500 5500

3748 NASAL VALVOPLASTY NASAL VALVOPLASTY 6000 6000

3749 NASAL OSTEOTOMIES NASAL OSTEOTOMIES 6000 6000

3750 MYRINGO PLASTY MYRINGO PLASTY 5000 5000

3751 SPHENOPALATINE CAUTERIZATION SPHENOPALATINE CAUTERIZATION 3500 3500

3752 TONSILLECTOMY, QUINZY TONSILLECTOMY, QUINZY 3500 3500

3753 ATTICOTOMY ATTICOTOMY 4140 4140

3754 VESTIBULAPLASTY VESTIBULAPLASTY 4140 4140

3755 CORDAL NODULE B-TUMOUR V-CORD CORDAL NODULE B-TUMOUR V-CORD 5175 5175

3756 FOREIGN BODY MAXILLARY SINUS FOREIGN BODY MAXILLARY SINUS 5175 5175

3757 MASTOIDECTOMY-SIMPLE MASTOIDECTOMY-SIMPLE 4000 4000

3758 TRIGEMINAL BLOCK TRIGEMINAL BLOCK 5175 5175

3759 INTRA NASAL ANTROSTOMY INTRA NASAL ANTROSTOMY 3500 3500

3760 ETHMOIDECTOMY INTRANASAL ETHMOIDECTOMY INTRANASAL 3500 3500

3761 SNELLENS OPERATIM SNELLENS OPERATIM 5175 5175

3762 SUBMANDIBULAR SIALADENECTOMY SUBMANDIBULAR SIALADENECTOMY 7000 7000

3763 SPERFICIAL PARATIDECTOMY SPERFICIAL PARATIDECTOMY 5175 5175

3764 THYROIDECTOMY PARTIAL THYROIDECTOMY PARTIAL 14000 14000

3765 MICRO-LARYNGO SURGERY MICRO-LARYNGO SURGERY 3500 3500

3766 ETHMOID OPERATION-EXTERNAL ETHMOID OPERATION-EXTERNAL 7245 7245

3767 ETHMOID ARTERY LIGATION ETHMOID ARTERY LIGATION 6210 6210

3768 VOCAL CORD OPERATION VOCAL CORD OPERATION 7245 7245

3769 ARYTENOIDECTOMY ARYTENOIDECTOMY 7245 7245

3770 STYLOHYOID LIGAMENT EXCISION STYLOHYOID LIGAMENT EXCISION 7245 7245

3771 PHONOSURGERY PHONOSURGERY 7245 7245

3772 STAPES MOBILIZATION STAPES MOBILIZATION 6210 6210

3773 LYMPH NODE EXCISION-BOCCA TYPE LYMPH NODE EXCISION-BOCCA TYPE 5000 5000

3774 TYMPANIC NEURECTOMY TYMPANIC NEURECTOMY 7245 7245

3775 TRACHEOSTOMY CLOSURE - FLAPS TRACHEOSTOMY CLOSURE - FLAPS 6210 6210

3776 EXTERNAL RHINOPLASTY APPROACH EXTERNAL RHINOPLASTY APPROACH 6000 6000

3777 TIP PLASTY TIP PLASTY 6000 6000

3778 JAW COMPLEX FRACTURE JAW COMPLEX FRACTURE 6000 6000

3779 FESS(FUNCTION.ENDOS.SINUS)SURG GRADE 3 FESS(FUNCTION.ENDOS.SINUS)SURG GRADE 3 3500 3500

3780 FESS(FUNCTION.ENDOS.SINUS) SURG GRADE 1 FESS(FUNCTION.ENDOS.SINUS) SURG GRADE 1 3500 3500

3781 FESS(FUNCTION.ENDOS.SINUS)SURG GRADE 2 FESS(FUNCTION.ENDOS.SINUS)SURG GRADE 2 3500 3500

3782 ATTICOANTROTOMY ATTICOANTROTOMY 6210 6210

3783 REVISION OSSICULAR RECONTRUCT. REVISION OSSICULAR RECONTRUCT. 7245 7245

3784 FOREIGN BODY TRACHEA & BRONCHI FOREIGN BODY TRACHEA & BRONCHI 6210 6210

3785 NASAL RECONSTRUCTION NASAL RECONSTRUCTION 6000 6000

3786 CORONAL OFTEOPLASTIC FLAP CORONAL OFTEOPLASTIC FLAP 6210 6210

3787 CRICOPHARYNGEAL MYOTOMY CRICOPHARYNGEAL MYOTOMY 7245 7245

3788 SEPTOPLASTY SEPTOPLASTY 6000 6000

Page 83

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 29 خدمات عيادة الانف والاذن والحنجرة E.N.T

بيان المجموعة 2929 خدمات عيادة الانف والاذن والحنجرة E.N.T

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3789 MASTOIDECTOMY RADICAL MASTOIDECTOMY RADICAL 7500 7500

3790 CORDOPEXY CORDOPEXY 7245 7245

3791 LARYNGECTOMY PARTIAL + TRACHEOST LARYNGECTOMY PARTIAL + TRACHEOST 7245 7245

3792 CULDWEL-LUC OPERATION CULDWEL-LUC OPERATION 8000 8000

3793 ORO-ANTRAL FISTULA REPAIR ORO-ANTRAL FISTULA REPAIR 6210 6210

3794 MASTOIDECTOMY MODIFIED RADICAL MASTOIDECTOMY MODIFIED RADICAL 7500 7500

3795 EXCISION OF MAXILLARY PALATAL CYST EXCISION OF MAXILLARY PALATAL CYST 6210 6210

3796 MEATOPLASTY MEATOPLASTY 9000 9000

3797 TYMPANOPLASTY TYMPANOPLASTY 9000 9000

3798 RHINOPLASTY RHINOPLASTY 6000 6000

3799 SIMPLE RHINOPLASTY W/LOCAL SIMPLE RHINOPLASTY W/LOCAL 3000 3000

3800 EXTERNAL FRONTAL OPERATION EXTERNAL FRONTAL OPERATION 8000 8000

3801 STAPEDECTOMY STAPEDECTOMY 12000 12000

3802 TRACHEO-PLASTY END/END ANASTOM TRACHEO-PLASTY END/END ANASTOM 9350 9350

3803 TRACHEO-PLASTY WITH GRAFT TRACHEO-PLASTY WITH GRAFT 9350 9350

3804 ZYGOMATIC FRACT. REPOS/INT.FIX ZYGOMATIC FRACT. REPOS/INT.FIX 8280 8280

3805 PAROTID DUCT TRANSLOCATION PAROTID DUCT TRANSLOCATION 8280 8280

3806 SPHENOIBECPOMY SPHENOIBECPOMY 8280 8280

3807 SUB PETROUS DRAINAGE SUB PETROUS DRAINAGE 8280 8280

3808 SEPTOPLASTY, REVISION SEPTOPLASTY, REVISION 6000 6000

3809 PANENDOSCOPY TRIPLE PANENDOSCOPY TRIPLE 8280 8280

3810 LYMTH NODE EXE - RADICAL NECK LYMTH NODE EXE - RADICAL NECK 8280 8280

3811 PALATE REPAIR - FLAPS PALATE REPAIR - FLAPS 8280 8280

3812 MEDICAL MAXILLOETHMOIDECTOMY MEDICAL MAXILLOETHMOIDECTOMY 8280 8280

3813 VIDIAN NEURECTOMY VIDIAN NEURECTOMY 8280 8280

3814 SEPTAL PERPORATION REPAIR SEPTAL PERPORATION REPAIR 6000 6000

3815 UVELO PALATO PHARYNGOPLASTY UVELO PALATO PHARYNGOPLASTY 6000 6000

3816 MASTOIDECTOMY I.C.W. (I.CANAL) MASTOIDECTOMY I.C.W. (I.CANAL) 4000 4000

3817 MASTOIDECTOMY REVISION MASTOIDECTOMY REVISION 7500 7500

3818 MASTOIDECTOMY RADICAL + TYMPANOP MASTOIDECTOMY RADICAL + TYMPANOP 7500 7500

3819 MAXILLARY ARTERY LIGATION MAXILLARY ARTERY LIGATION 8180 8180

3820 EAR/NOSE/THROAT CANCER SURGERY EAR/NOSE/THROAT CANCER SURGERY 8180 8180

3821 OTOPLASTY OTOPLASTY 9000 9000

3822 POST CHOANAL ATRESIA POST CHOANAL ATRESIA 8280 8280

3823 TRANSNASAL HYPOPHYSECTOMY TRANSNASAL HYPOPHYSECTOMY 12500 12500

3824 CONTROL OF BLEEDING POST TONSILLECTOMY CONTROL OF BLEEDING POST TONSILLECTOMY 2070 2070

3825 RECURRENT ADENOIDECTOMY CHILD RECURRENT ADENOIDECTOMY CHILD 3000 3000

3826 FUNCTIONAL RHINOPLASTY FUNCTIONAL RHINOPLASTY 6000 6000

3827 SEBACEOUS CYST SEBACEOUS CYST 1500 1500

3828 SUTURE SUPERFICIAL LACERATION SUTURE SUPERFICIAL LACERATION 900 900

3829 REMOVAL OF PLASTIC SUTURES G/A REMOVAL OF PLASTIC SUTURES G/A 2500 2500

3830 TRACHEOSTOMY TUBE REPLACEMENT TRACHEOSTOMY TUBE REPLACEMENT 1100 1100

3831 EAR RECONSTRUCTION EAR RECONSTRUCTION 10350 10350

3832 TOTAL LARYNGECTOMY+PARTIAL PHARYNGECTOMY TOTAL LARYNGECTOMY+PARTIAL PHARYNGECTOMY 14490 14490

Page 84

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 29 خدمات عيادة الانف والاذن والحنجرة E.N.T

بيان المجموعة 2929 خدمات عيادة الانف والاذن والحنجرة E.N.T

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4480 SPEECH AUDIOMETRY SPEECH AUDIOMETRY 250 250

بيان نوع الخدمة 30 خدمات عيادة الأطفال Pediatric

بيان المجموعة 3030 خدمات عيادة الأطفال Pediatric

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1117 EAR PIERCING EAR PIERCING 150 150

بيان نوع الخدمة 31 خدمات الجلدية والتناسلية Dermatology

بيان المجموعة 3131 خدمات الجلدية والتناسلية Dermatology

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1025 ANGIO KERATOMA ELECTROCAUTERY ANGIO KERATOMA ELECTROCAUTERY 3750 3750

1026 SKIN POLYP SKIN POLYP 1250 1250

1027 INCISION & CURETTAGE INCISION & CURETTAGE 1250 1250

1028 EXCISION ACCESSORY AURICLE EXCISION ACCESSORY AURICLE 1250 1250

1029 BOWN'S DISEASE EXCISION BOWN'S DISEASE EXCISION 3750 3750

1030 CALLOSITIES CALLOSITIES 1250 1250

1031 BASAL CELL CARCINOMA BASAL CELL CARCINOMA 5000 5000

1032 ELECTROCAUTERY/PLANTER WARTS G.A GRADE2 ELECTROCAUTERY/PLANTER WARTS G.A GRADE2 1500 1500

1033 ELECTROCAUTERY/PLANTER WARTS G.A GRADE3 ELECTROCAUTERY/PLANTER WARTS G.A GRADE3 2500 2500

1034 CAUTERY-ELECTRIC,(EACH) CAUTERY-ELECTRIC,(EACH) 350 350

1035 ELECTROCAUTERY/PLANTER WARTS G.A GRADE1 ELECTROCAUTERY/PLANTER WARTS G.A GRADE1 1500 1500

1036 ELECROCAUTERY OF SKIN TAGS ELECROCAUTERY OF SKIN TAGS 1500 1500

1037 CAUTERIZATION OF VENEREAL WART / LESION CAUTERIZATION OF VENEREAL WART / LESION 1500 1500

1038 CAUTERIZATION OF VENEREAL WART(MULTIPLE) CAUTERIZATION OF VENEREAL WART(MULTIPLE) 2500 2500

1039 CAUTERIZATION OF WART L.A. CAUTERIZATION OF WART L.A. 1200 1200

1040 CAUTERIZATION OF MULTIPLE WARTS G.A. CAUTERIZATION OF MULTIPLE WARTS G.A. 3500 3500

1041 CRYOTHERAPY CRYOTHERAPY 320 320

1042 CRYO SURGERY-CRYO THERAPY CRYO SURGERY-CRYO THERAPY 500 500

1043 CRYO SURGERY-CRYO (PLANTER WART) I CRYO SURGERY-CRYO (PLANTER WART) I 1500 1500

1044 CRYO SURGERY-CRYO (PLANTER WART) II CRYO SURGERY-CRYO (PLANTER WART) II 1500 1500

1045 CRYO SURGERY-CRYO (PLANTER WART) III CRYO SURGERY-CRYO (PLANTER WART) III 1500 1500

1046 CRYO SURGERY-CRYO (PLANTER WART) IV CRYO SURGERY-CRYO (PLANTER WART) IV 1500 1500

1047 CAUTERY CHEMICAL CAUTERY CHEMICAL 350 350

1048 SIMPLE EXCISION SIMPLE EXCISION 1250 1250

1049 PLANTAR WART PLANTAR WART 1200 1200

1050 SKIN BIOPSY SKIN BIOPSY 1200 1200

1051 SKIN TAG EXCISION,(EACH) SKIN TAG EXCISION,(EACH) 300 300

1052 MILIA EXTRACTION,(EACH) MILIA EXTRACTION,(EACH) 250 250

1053 DIPROFOS INJECTION DIPROFOS INJECTION 110 110

1054 DIATHERMY CURTAGE DIATHERMY CURTAGE 370 370

Page 85

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 32 خدمات عيادة العظام Ortho

بيان المجموعة 3232 خدمات عيادة العظام Ortho

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1193 PLASTER PANTALOON PLASTER PANTALOON 1500 1500

1194 SPLINT FOR FACTURE SPLINT FOR FACTURE 550 550

1195 SKULL CALIPER TRACTION FRACTRE SKULL CALIPER TRACTION FRACTRE 3725 3725

1196 SPINE PLASTER BED TB/SCOLIOSIS SPINE PLASTER BED TB/SCOLIOSIS 4550 4550

1197 SKELETAL TRACTION SKELETAL TRACTION 2000 2000

1198 OSSATRON SOFT TISSUE THERAPY/PT OSSATRON SOFT TISSUE THERAPY/PT 2700 2700

1199 INTRA ARTICULAR INJECTION INTRA ARTICULAR INJECTION 350 350

1200 JOIN ASPIRATION, COMPLETE JOIN ASPIRATION, COMPLETE 800 800

1201 FOREIGN BODY REMOVAL, SUPERFICIAL FOREIGN BODY REMOVAL, SUPERFICIAL 1250 1250

1202 SLAB ABOVE KNEE SLAB ABOVE KNEE 350 350

1203 SLAB BELOW KNEE SLAB BELOW KNEE 1250 1250

1204 SLAB ABOVE ELBOW SLAB ABOVE ELBOW 500 500

1205 SLAB BELOW ELBOW SLAB BELOW ELBOW 500 500

1206 P.O.P. ABOVE THE ELBOW P.O.P. ABOVE THE ELBOW 750 750

1207 P.O.P. BELOW THE ELBOW P.O.P. BELOW THE ELBOW 500 500

1208 P.O.P. ABOVE KNEE P.O.P. ABOVE KNEE 750 750

1209 P.O.P. BELOW KNEE P.O.P. BELOW KNEE 500 500

1210 PLASTER GYPS LARGE PLASTER GYPS LARGE 1500 1500

1211 PLASTER DELTALITE LARGE PLASTER DELTALITE LARGE 1500 1500

1212 PLASTER GYPS SMALL PLASTER GYPS SMALL 500 500

1213 PLASTER DELTALITE SMALL PLASTER DELTALITE SMALL 1500 1500

1214 PLASTER CAST ARM PLASTER CAST ARM 500 500

1215 PLASTER STRAPPING (TOE/FINGER) PLASTER STRAPPING (TOE/FINGER) 110 110

1216 PLASTER CAST BELOW THE ELBOW PLASTER CAST BELOW THE ELBOW 500 500

1217 CYST EXCISION CYST EXCISION 1200 1200

1218 PLASTER REMOVAL ADULT PLASTER REMOVAL ADULT 300 300

1219 PLASTER REMOVAL, CHILD PLASTER REMOVAL, CHILD 300 300

1220 TRACTION SKIN W/THOMAS SPLINT TRACTION SKIN W/THOMAS SPLINT 850 850

1221 SKIN TRACTION SKIN TRACTION 750 750

1222 CERVICAL TRACTION, CONTINEOUS CERVICAL TRACTION, CONTINEOUS 500 500

1223 PELVIC TRACTION IN BED PELVIC TRACTION IN BED 1500 1500

1224 FINGER SLAB FINGER SLAB 30 30

1225 TENSOPLAST STRAPPING TENSOPLAST STRAPPING 350 350

1226 CREPE BANDAGE CREPE BANDAGE 10 10

1227 THUMB WRIST SPLINT THUMB WRIST SPLINT 90 90

بيان نوع الخدمة 33 خدمات عيادة المسالك البولية UROLOGY

بيان المجموعة 3333 خدمات عيادة المسالك البولية UROLOGY

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1228 CATHETERIZATION - INTRAVESICAL THERAPY CATHETERIZATION - INTRAVESICAL THERAPY 1080 1080

1229 CATHETARIZATION URETHRAL CATHETARIZATION URETHRAL 350 350

1230 URETHERAL CALIBRATION URETHERAL CALIBRATION 1860 1860

1231 UROFLOMETRY UROFLOMETRY 415 415

1232 CATHETERIZATION SUPRAPUPIC CATHETERIZATION SUPRAPUPIC 1100 1100

Page 86

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 33 خدمات عيادة المسالك البولية UROLOGY

بيان المجموعة 3333 خدمات عيادة المسالك البولية UROLOGY

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1233 CYSTOMETRY CYSTOMETRY 1100 1100

1234 PROSTATIC MASSAGE PROSTATIC MASSAGE 200 200

1235 URETHRAL IRRIGATION URETHRAL IRRIGATION 210 210

1236 URETHERAL DILATATION EXTERNAL URETHERAL DILATATION EXTERNAL 1240 1240

3421 OPEN CYSTOSTOMY OPEN CYSTOSTOMY 2070 2070

3422 URETHRAL STENT INSERTION URETHRAL STENT INSERTION 3725 3725

3423 TRANS URETHRAL VAPORIZATION /PROSTHESIS TRANS URETHRAL VAPORIZATION /PROSTHESIS 5175 5175

3424 ESWL PLUS STENT ESWL PLUS STENT 9935 9935

3425 DOUBLE J INSERTION DOUBLE J INSERTION 3725 3725

3426 URODYNAMIC STUDY URODYNAMIC STUDY 3725 3725

3427 CYSTOSCOPY + BIOPSY CYSTOSCOPY + BIOPSY 3725 3725

3428 LITHOLAPAXY LITHOLAPAXY 7500 7500

3429 PROSTATIC BIOPSY PROSTATIC BIOPSY 4500 4500

3430 CYSTOSCOPY PLUS STENT CYSTOSCOPY PLUS STENT 3725 3725

3431 VASECTOMY LOCAL ANESTHESIA VASECTOMY LOCAL ANESTHESIA 1100 1100

3432 VASECTOMY VASECTOMY 4970 4970

3433 CYSTOSCOPY PLUS REMOVAL OF STONE CYSTOSCOPY PLUS REMOVAL OF STONE 4760 4760

3434 TRANSURETHERAL INCISION OF PROSTATE TRANSURETHERAL INCISION OF PROSTATE 14000 14000

3435 URETEROSCOPY + STENT INSERTION URETEROSCOPY + STENT INSERTION 5175 5175

3436 PELVI URETEROLYSIS PELVI URETEROLYSIS 5175 5175

3437 URETHRAL CORRECTION URETHRAL CORRECTION 14000 14000

3438 REVISION OF SUPRAPUBIC CYSTOSTOMY REVISION OF SUPRAPUBIC CYSTOSTOMY 11000 11000

3439 REMOVAL OF IMPLANTS REMOVAL OF IMPLANTS 3000 3000

3440 VARICOCELES UNILATERAL VARICOCELES UNILATERAL 4500 4500

3441 VARICOCELES BILATERAL VARICOCELES BILATERAL 6000 6000

3442 URS+REMOV STONE+JJ/URE.CATH.INSERT URS+REMOV STONE+JJ/URE.CATH.INSERT 7245 7245

3443 URS+REMOV STONE+JJ/URE.CATH.INSERT+RETRO URS+REMOV STONE+JJ/URE.CATH.INSERT+RETRO 8280 8280

3444 MEATOTOMY TRANS-URETHRAL (INTERNAL) MEATOTOMY TRANS-URETHRAL (INTERNAL) 3725 3725

3445 URETHRO-LITHOTOMY ANTERIOR URETHRO-LITHOTOMY ANTERIOR 6500 6500

3446 VIU/OPTICAL URETHROTOMY VIU/OPTICAL URETHROTOMY 6500 6500

3447 SINGLE CYST DEROOFING OF THE KIDNEY SINGLE CYST DEROOFING OF THE KIDNEY 3105 3105

3448 REMOVAL OF STENT REMOVAL OF STENT 2070 2070

3449 CYSTOSCOPY + URETERAL CATHETER CYSTOSCOPY + URETERAL CATHETER 3726 3726

3450 CYSTOSCOPY, EXAMINATION CYSTOSCOPY, EXAMINATION 2070 2070

3451 CYSTOSCOPY BIOPSY CYSTOSCOPY BIOPSY 3725 3725

3452 PROSTATIC ABSCESS DRAINAGE PROSTATIC ABSCESS DRAINAGE 5500 5500

3453 OPTICAL LITHOTHREPSY OPTICAL LITHOTHREPSY 3725 3725

3454 BLADDER EVACUATION BLADDER EVACUATION 1100 1100

3455 CYSTOSCOPY THERAPEUTIC CYSTOSCOPY THERAPEUTIC 4140 4140

3456 URETERAL DILATATION URETERAL DILATATION 6500 6500

3457 ORCHIDECTOMY ORCHIDECTOMY 6000 6000

3458 EXCISION OF CYST EPIDID/SPERAMA EXCISION OF CYST EPIDID/SPERAMA 3725 3725

3459 EPIDIDYMECTOMY EPIDIDYMECTOMY 3725 3725

Page 87

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 33 خدمات عيادة المسالك البولية UROLOGY

بيان المجموعة 3333 خدمات عيادة المسالك البولية UROLOGY

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3460 MEATOPLASTY MEATOPLASTY 2275 2275

3461 VESICOLITHOTOMY (OPEN) VESICOLITHOTOMY (OPEN) 10000 10000

3462 CYSTOLITHOTOMY CYSTOLITHOTOMY 10000 10000

3463 NEPHROSTOMY NEPHROSTOMY 6620 6620

3464 RESECTION OF BLADDER NECK OBSTRACTION RESECTION OF BLADDER NECK OBSTRACTION 17000 17000

3465 RENAL CYST PUNCTURE (OPEN) RENAL CYST PUNCTURE (OPEN) 3105 3105

3466 CYSTOURETHROSCPY + TURP CYSTOURETHROSCPY + TURP 6500 6500

3467 URETHROLITHOTOMY POSTERIOR URETHROLITHOTOMY POSTERIOR 6500 6500

3468 C.A.V.H. (PARTIAL) C.A.V.H. (PARTIAL) 2070 2070

3469 A.V. SHUNT A.V. SHUNT 2070 2070

3470 AV FISTULA / SHUNT CLOSURE AV FISTULA / SHUNT CLOSURE 2485 2485

3471 LITHO-TRIPSY, ADDED SESSION LITHO-TRIPSY, ADDED SESSION 1240 1240

3472 TESTICULAR BIOPSY TESTICULAR BIOPSY 3500 3500

3473 HYDROCELE HYDROCELE 3725 3725

3474 STENT ADJUSTMENT FOR URETER STENT ADJUSTMENT FOR URETER 1100 1100

3475 MEATOTOMY EXTERNAL, GEN. ANES MEATOTOMY EXTERNAL, GEN. ANES 2070 2070

3476 URETEROSCOPY URETEROSCOPY 6500 6500

3477 DILATATION OF BLADDER NECK DILATATION OF BLADDER NECK 6500 6500

3478 URETHROSCOPY URETHROSCOPY 6500 6500

3479 URETHRA DILATE STRIC FILI DIL URETHRA DILATE STRIC FILI DIL 3725 3725

3480 URETHRA DILATE STRIC METAL DIL URETHRA DILATE STRIC METAL DIL 3725 3725

3481 MULTIPLE CYST DEROOFING OF THE KIDNEY MULTIPLE CYST DEROOFING OF THE KIDNEY 5175 5175

3482 ORCHIOPEXY ORCHIOPEXY 5175 5175

3483 PERI-NEPHRIC ABSCESS PERI-NEPHRIC ABSCESS 14000 14000

3484 RENAL BIOPSY RENAL BIOPSY 5795 5795

3485 PARTIAL AMPUTATION OF PENIS PARTIAL AMPUTATION OF PENIS 2070 2070

3486 C.A.V.H. (COMPLETE) C.A.V.H. (COMPLETE) 4140 4140

3487 FRACTURE PENIS REPAIR FRACTURE PENIS REPAIR 4140 4140

3488 PERCUTANOUS NEPHROLITHOTOMY PERCUTANOUS NEPHROLITHOTOMY 8280 8280

3489 NEPHROLITHOTOMY NEPHROLITHOTOMY 7450 7450

3490 TOTAL AMPUTATION OF PENIS TOTAL AMPUTATION OF PENIS 6210 6210

3491 PERCUTANEOUS CYST ASPIRATION PERCUTANEOUS CYST ASPIRATION 2070 2070

3492 URETEROSCOPY + STONE FRAGMENTATION URETEROSCOPY + STONE FRAGMENTATION 6000 6000

3493 STENT INSERTION STENT INSERTION 2070 2070

3494 URETHRAL RUPTURE REPAIR URETHRAL RUPTURE REPAIR 14000 14000

3495 BLADDER TUR (TUMORS) BLADDER TUR (TUMORS) 8690 8690

3496 BLADDER DIVERTICULUM EXCISION BLADDER DIVERTICULUM EXCISION 11000 11000

3497 BLADDER EXCISION PARTIAL BLADDER EXCISION PARTIAL 6210 6210

3498 PROSTATECTOMY SUPRAPUBIC PROSTATECTOMY SUPRAPUBIC 14000 14000

3499 NEPHRECTOMY PARTIAL NEPHRECTOMY PARTIAL 16000 16000

3500 NEPHROPAXY NEPHROPAXY 16000 16000

3501 URETERO-LITHOTOMY URETERO-LITHOTOMY 12000 12000

3502 PYELOLITHOTOMY PYELOLITHOTOMY 12000 12000

3503 PYELOPLASTY (G.U.) PYELOPLASTY (G.U.) 10350 10350

Page 88

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 33 خدمات عيادة المسالك البولية UROLOGY

بيان المجموعة 3333 خدمات عيادة المسالك البولية UROLOGY

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3504 URETERAL STRICTURE RECURRENT URETERAL STRICTURE RECURRENT 6210 6210

3505 URETER RESECT & ANASTOM/REIMPLNT URETER RESECT & ANASTOM/REIMPLNT 17000 17000

3506 URETEROCOLIC ANASTOMOSIS URETEROCOLIC ANASTOMOSIS 17000 17000

3507 URETHRAL FISTULA 2 STAGES URETHRAL FISTULA 2 STAGES 7245 7245

3508 CYSTECTOMY TOTAL CYSTECTOMY TOTAL 16000 16000

3509 URETERS REIMPLANTATION URETERS REIMPLANTATION 17000 17000

3510 EPISPADIUS EPISPADIUS 8280 8280

3511 HYPOSPADIUS HYPOSPADIUS 7000 7000

3512 REPAIR OF HYPOSPADIAS - 2 STAGES REPAIR OF HYPOSPADIAS - 2 STAGES 10000 10000

3513 URETHRA/PENIS PLASTIC OPERATN URETHRA/PENIS PLASTIC OPERATN 14000 14000

3514 CYSTOSCOPY WITH RETROGRADE STUDY CYSTOSCOPY WITH RETROGRADE STUDY 3725 3725

3515 NEPHROSCOPY NEPHROSCOPY 5175 5175

3516 RETROGRADE STUDY RETROGRADE STUDY 2070 2070

3517 PERITONEAL CATHETER FIXATION PERITONEAL CATHETER FIXATION 2070 2070

3518 CYSTOSCOPY + BLADDER INFLATION CYSTOSCOPY + BLADDER INFLATION 5175 5175

3519 URS +STONE FRAGMENTATION + JJ INSERTION URS +STONE FRAGMENTATION + JJ INSERTION 5175 5175

3520 URS + STENT + DILATATION + JJ INSERTION URS + STENT + DILATATION + JJ INSERTION 6500 6500

3521 REMOVAL OF STONE REMOVAL OF STONE 2070 2070

3522 NEPHRECTOMY RADICAL NEPHRECTOMY RADICAL 24000 24000

3523 NEPHRECTOMY SIMPLE NEPHRECTOMY SIMPLE 16000 16000

3524 EPIDIDYMO-VASOSTOMY EPIDIDYMO-VASOSTOMY 7245 7245

3525 URETEROSCOPY + REMOVAL OF STONE URETEROSCOPY + REMOVAL OF STONE 6500 6500

3526 URETERO RNEO CYSTOSTOMY URETERO RNEO CYSTOSTOMY 17000 17000

3527 HEMOPERFUSION HEMOPERFUSION 8280 8280

3528 KIDNEY CANCER SURGERY KIDNEY CANCER SURGERY 11385 11385

3529 CYSTECTOMY RADICAL CYSTECTOMY RADICAL 22000 22000

3530 PENILE PROSTHESIS IMPLANTATION PENILE PROSTHESIS IMPLANTATION 8280 8280

3531 SCROTAL EXPLORATION SCROTAL EXPLORATION 8280 8280

3532 PERCUTANEOUS NEPHRO LITHOTREPSY PERCUTANEOUS NEPHRO LITHOTREPSY 20700 20700

3533 KIDNEY TRANSPLANT (RECIPIENT) KIDNEY TRANSPLANT (RECIPIENT) 47610 47610

3534 LITHO-TRIPSY, FIRST SESSION LITHO-TRIPSY, FIRST SESSION 8280 8280

3535 A.V. FISTULA CREATION A.V. FISTULA CREATION 3105 3105

3536 CYSTOSCOPY & URET. CATH. BILAT. CYSTOSCOPY & URET. CATH. BILAT. 5500 5500

3537 BLADDER CONDITION RECURRENT BLADDER CONDITION RECURRENT 4140 4140

3538 DEBRIBMENT OF CARTILAGE DEBRIBMENT OF CARTILAGE 2070 2070

بيان نوع الخدمة 34 خدمات القلب CARDIOLOGY CENTER

بيان المجموعة 3434 خدمات العيون

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1016 TREADMILL STRESS TEST TREADMILL STRESS TEST 1000 1000

1017 ECHOCARDIOGRAPHY ECHOCARDIOGRAPHY 700 700

1018 ECHO DOPPLER ECHO DOPPLER 1200 1200

1019 PEDIATRIC ECHOCARDIOGRAM PEDIATRIC ECHOCARDIOGRAM 1700 1700

Page 89

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 34 خدمات القلب CARDIOLOGY CENTER

بيان المجموعة 3434 خدمات العيون

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1020 E.C.G. E.C.G. 100 100

1021 CARDIAC MONITORING CARDIAC MONITORING 350 350

1022 E.C.G. MONITOR PER DAY E.C.G. MONITOR PER DAY 350 350

1023 DEFIBRILLATOR DEFIBRILLATOR 370 370

1024 HOLTER MONITOR(PER DAY) HOLTER MONITOR(PER DAY) 2000 2000

1237 O.C.T SCAN IMAGING O.C.T SCAN IMAGING 450 450

1238 FUNDUS EXAMINATION FUNDUS EXAMINATION 150 150

1239 KERATOMERTY KERATOMERTY 600 600

1240 TENSION TENSION 150 150

1241 LENS POWER-ULTRASONIC BIOMETRY LENS POWER-ULTRASONIC BIOMETRY 600 600

1242 SLIT LAMP SLIT LAMP 150 150

1243 DRESSING (EYE) DRESSING (EYE) 100 100

1244 DRESSING + STITCH REMOVAL(EYE) DRESSING + STITCH REMOVAL(EYE) 900 900

1245 STITCH REMOVAL (EYE) STITCH REMOVAL (EYE) 900 900

1246 EYE FLOURESENT ANGIOGRAPHY EYE FLOURESENT ANGIOGRAPHY 1660 1660

1247 EYE GLASSES TRIAL DIOPTROM EYE GLASSES TRIAL DIOPTROM 150 150

1248 ORTHOSTATIC TRANING EXERC-EYE ORTHOSTATIC TRANING EXERC-EYE 210 210

1249 SUBCONJUNCTIVAL INJECTION SUBCONJUNCTIVAL INJECTION 900 900

1250 PUNCTAL OCCLUSION (TEMPORARY) PUNCTAL OCCLUSION (TEMPORARY) 415 415

1251 PUNCTAL OCCLUSION (PERMANENT) PUNCTAL OCCLUSION (PERMANENT) 830 830

1252 FUNDUS PHOTOGRAPHY FUNDUS PHOTOGRAPHY 830 830

1253 GONIOSCOPY GONIOSCOPY 800 800

1254 EYE ULTRASONOGRAPH PRELIMINARY EYE ULTRASONOGRAPH PRELIMINARY 1500 1500

1255 DIAGNOSTIC ULTRASONOGRAPHY DIAGNOSTIC ULTRASONOGRAPHY 1500 1500

1256 FUNDUS BIOMICROSCOPY FUNDUS BIOMICROSCOPY 620 620

1257 USE OF O.R. MICROSCOPE (CLINIC USE OF O.R. MICROSCOPE (CLINIC 210 210

1258 PERIMETERY COMPUTERISED PERIMETERY COMPUTERISED 1100 1100

1259 INTRAOCCULAR LENS CALCULATION INTRAOCCULAR LENS CALCULATION 350 350

3556 I&D ABCESS WITH GA / LA I&D ABCESS WITH GA / LA 1100 1100

3557 XANTHELASMA EXCISION XANTHELASMA EXCISION 2070 2070

3558 CYST / TUMOR EXCISION SUPER CYST / TUMOR EXCISION SUPER 1100 1100

3559 STYE EXCISION, ONE EYE STYE EXCISION, ONE EYE 500 500

3560 SCLERAL SUTURING SCLERAL SUTURING 2000 2000

3561 CORNEAL ULCER CAUTERY/SCRAPING CORNEAL ULCER CAUTERY/SCRAPING 520 520

3562 LACRIMAL PLUG IMPLANTATION LACRIMAL PLUG IMPLANTATION 1100 1100

3563 CONJUCTIVA FOREIGN BODY CONJUCTIVA FOREIGN BODY 500 500

3564 CAT. SURG. W/ PHAECOEMOULFICATION W/IOL CAT. SURG. W/ PHAECOEMOULFICATION W/IOL 12000 12000

3565 OPHTALMOLOGY EXAMINATION (G.A) OPHTALMOLOGY EXAMINATION (G.A) 1100 1100

3566 POSTERIOR CAPSULOTOMY POSTERIOR CAPSULOTOMY 7000 7000

3567 IRIS REPOSITION IRIS REPOSITION 1100 1100

3568 RETROBULBAR INJ. OF ALCOHOL RETROBULBAR INJ. OF ALCOHOL 1200 1200

3569 CHALAZION INFECTED INCISION CHALAZION INFECTED INCISION 700 700

3570 EYELID ELECTROLYSIS SINGLE EYELID ELECTROLYSIS SINGLE 1000 1000

3571 CORNEAL FOREIGN BODY SUPERFICL CORNEAL FOREIGN BODY SUPERFICL 500 500

3572 LACMIRAL PROBE LOCAL ANESTHES LACMIRAL PROBE LOCAL ANESTHES 2000 2000

Page 90

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 34 خدمات القلب CARDIOLOGY CENTER

بيان المجموعة 3434 خدمات العيون

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3573 EYELID ELECTROLYSIS BOTH EYELID ELECTROLYSIS BOTH 1000 1000

3574 CHALAZION SMALL ONE EYE EXCISION CHALAZION SMALL ONE EYE EXCISION 700 700

3575 CHALAZION SMALL ONE EYE EXCISION CHALAZION SMALL ONE EYE EXCISION 700 700

3576 PICKING PTD'S & SCRAPING/ONE EYE PICKING PTD'S & SCRAPING/ONE EYE 500 500

3577 CONJUCTIVA SMALL SWELLING CONJUCTIVA SMALL SWELLING 2500 2500

3578 EYELID SMALL SWELLING EYELID SMALL SWELLING 2500 2500

3579 CONJUCTIVA PAPILAE S.C. REMOVE CONJUCTIVA PAPILAE S.C. REMOVE 620 620

3580 LASER TREATMENT RETINA/SESSION LASER TREATMENT RETINA/SESSION 9000 9000

3581 LASER IRIDECTOMY / EYE LASER IRIDECTOMY / EYE 8000 8000

3582 LASER TRABECULOPLASTY / EYE LASER TRABECULOPLASTY / EYE 6000 6000

3583 RETINAL CRYOPEXY RETINAL CRYOPEXY 3350 3350

3584 INTRAVITRIAL DRUG INJECTION INTRAVITRIAL DRUG INJECTION 4500 4500

3585 REVISION OF STITCHES REVISION OF STITCHES 320 320

3586 STITCHES REMOVAL EYE G.A. STITCHES REMOVAL EYE G.A. 1100 1100

3587 EYELID LACERATION REPAIR (MINOR) EYELID LACERATION REPAIR (MINOR) 2000 2000

3588 EYE 3 SNIB OPERATION EYE 3 SNIB OPERATION 1100 1100

3589 PICKING POST-TRACHOMETOUS CONR PICKING POST-TRACHOMETOUS CONR 500 500

3590 CONJUCTIVA LACERATION MILD REPAIR CONJUCTIVA LACERATION MILD REPAIR 1500 1500

3591 CORNEAL SUB FOREIGN BODY MULTI CORNEAL SUB FOREIGN BODY MULTI 4000 4000

3592 CORNEAL SUB F. B. NEGLECTED CORNEAL SUB F. B. NEGLECTED 500 500

3593 CHALAZION LARGE ONE EYE EXCISION CHALAZION LARGE ONE EYE EXCISION 3000 3000

3594 CONJUCTIVA BIG SWELLING CONJUCTIVA BIG SWELLING 2500 2500

3595 CHALAZION MULTIPLE ONE EYE/SMALL CHALAZION MULTIPLE ONE EYE/SMALL 3000 3000

3596 CHALAZION MULTIPLE ONE EYE/LARGE CHALAZION MULTIPLE ONE EYE/LARGE 3000 3000

3597 BILATERAL MULTIPLE CHALAZION BILATERAL MULTIPLE CHALAZION 4500 4500

3598 ECTROPION ECTROPION 3000 3000

3599 LARGE PINGNECULA EXCISION LARGE PINGNECULA EXCISION 2484 2484

3600 ENTROPION ENTROPION 3000 3000

3601 EYELID TUMOR BIOPSY EYELID TUMOR BIOPSY 2070 2070

3602 CORNEAL GRAFT SUTURE REMOVAL CORNEAL GRAFT SUTURE REMOVAL 2300 2300

3603 CYCLO CRYO THERAPY CYCLO CRYO THERAPY 3725 3725

3604 TARSORRAPHY TARSORRAPHY 2500 2500

3605 EYELID LACERATION REPAIR MAJOR EYELID LACERATION REPAIR MAJOR 2000 2000

3606 LACRIMAL GLAND BIOPSY LACRIMAL GLAND BIOPSY 2485 2485

3607 DACRO CYSTECTOMY DACRO CYSTECTOMY 6000 6000

3608 CILLARY BOBY CAUTERIZATION CILLARY BOBY CAUTERIZATION 3725 3725

3609 LACRIMAL PROBE GENERAL ANESTH LACRIMAL PROBE GENERAL ANESTH 3500 3500

3610 EVISCERATION EVISCERATION 3320 3320

3611 ENUCLEATION ENUCLEATION 3320 3320

3612 PTERYGIUM EXCISION PTERYGIUM EXCISION 2400 2400

3613 CAPUSLOTOMY CAPUSLOTOMY 6000 6000

3614 HYPHEMA EVACUATION HYPHEMA EVACUATION 3725 3725

3615 GLAUCOMA OPERATION GLAUCOMA OPERATION 10000 10000

3616 I.O.L. IMPLANT, SECONDARY I.O.L. IMPLANT, SECONDARY 6000 6000

3617 REMOVAL OF DISLOCATED LENS REMOVAL OF DISLOCATED LENS 10000 10000

3618 CORNEAL TELESCOPE CORNEAL TELESCOPE 4140 4140

Page 91

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 34 خدمات القلب CARDIOLOGY CENTER

بيان المجموعة 3434 خدمات العيون

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3619 PTERYGIUM+MITOMYCIN TREATMENT PTERYGIUM+MITOMYCIN TREATMENT 3500 3500

3620 PTERYGIUM W/GRAFTING RECURRENT PTERYGIUM W/GRAFTING RECURRENT 4600 4600

3621 CYCLODIALYSIS CYCLODIALYSIS 7500 7500

3622 IRIDECTOMY IRIDECTOMY 8000 8000

3623 ORBITAL TUMOR BIOPSY ORBITAL TUMOR BIOPSY 5175 5175

3624 MUCUS MEM. GRAFTING/TRICHIASI MUCUS MEM. GRAFTING/TRICHIASI 4765 4765

3625 COREAL DERMOID EXCISION COREAL DERMOID EXCISION 4140 4140

3626 CORNEAL & SCLERA LACERATION CORNEAL & SCLERA LACERATION 7000 7000

3627 CORNEAL FOREIGN BODY DEEP CORNEAL FOREIGN BODY DEEP 2000 2000

3628 ENUCLEATION WITH IMPLANTS ENUCLEATION WITH IMPLANTS 8180 8180

3629 SQUINT REPAIR UNILATERAL SQUINT REPAIR UNILATERAL 5000 5000

3630 SQUINT REPAIR BILATERAL SQUINT REPAIR BILATERAL 7000 7000

3631 GONITOMY GONITOMY 5175 5175

3632 CATARACT EXTRACTION CATARACT EXTRACTION 10000 10000

3633 EYELID RECONSTRUCTION EYELID RECONSTRUCTION 5175 5175

3634 DACRYO CYSTORHINOSTOMY DACRYO CYSTORHINOSTOMY 7500 7500

3635 LACRIMAL CANALLICULUM RECONST LACRIMAL CANALLICULUM RECONST 6000 6000

3636 VITRECTOMY ANTERIOR VITRECTOMY ANTERIOR 6000 6000

3637 INTRAOCULAR FOREIGN BODY REMOV INTRAOCULAR FOREIGN BODY REMOV 10000 10000

3638 RETINAL PRIMARY DETACHMENT RETINAL PRIMARY DETACHMENT 9000 9000

3639 SCLERAL BUCKLE RE-OPERATION SCLERAL BUCKLE RE-OPERATION 7245 7245

3640 ORBIT EXPLO. & RECONSTRUCTION ORBIT EXPLO. & RECONSTRUCTION 6210 6210

3641 EXCISION BIOPSY EXCISION BIOPSY 1200 1200

3642 KERATOTOMY RADIAL KERATOTOMY RADIAL 6000 6000

3643 RUPTURE GLOBE RUPTURE GLOBE 7040 7040

3644 PTOSIS REPAIR PTOSIS REPAIR 4500 4500

3645 TRABECULECTOMY TRABECULECTOMY 6000 6000

3646 ORBITAL TUMOR EXPLO/EXCISION ORBITAL TUMOR EXPLO/EXCISION 8900 8900

3647 ORBITAL FLOOR FRACTURE\DECOMPRESSION ORBITAL FLOOR FRACTURE\DECOMPRESSION 8900 8900

3648 PTOSIS RECURRENT PTOSIS RECURRENT 10000 10000

3649 CATARACT EXTRACT. W/TRABECULEC CATARACT EXTRACT. W/TRABECULEC 10000 10000

3650 CATARACT COMPL OR DISLOCATED CATARACT COMPL OR DISLOCATED 10000 10000

3651 PHACO CATARACT SURGERY AND I.O.L. PHACO CATARACT SURGERY AND I.O.L. 12000 12000

3652 CORNEAL GRAFT (P. KERATOPLASTY CORNEAL GRAFT (P. KERATOPLASTY 15000 15000

3653 KERATOPLASTY LAMELLAR KERATOPLASTY LAMELLAR 15000 15000

3654 DACRO CYSTORHINOSTOMY W/TUBE DACRO CYSTORHINOSTOMY W/TUBE 7500 7500

3655 CORNEAL GRAFT W/ CATARACT EXTR CORNEAL GRAFT W/ CATARACT EXTR 15000 15000

3656 KERATOPROSTHESIS KERATOPROSTHESIS 15000 15000

3657 SCLERAL BUCKLE WITH VITRECTOMY SCLERAL BUCKLE WITH VITRECTOMY 6000 6000

3658 VITRECTOMY POSTERIOR VITRECTOMY POSTERIOR 6000 6000

3659 EXT. I.O.F.B. W/VITRECTOMY EXT. I.O.F.B. W/VITRECTOMY 6000 6000

3660 CATARACT EXTRA. I.O.L. IMPLANT CATARACT EXTRA. I.O.L. IMPLANT 12000 12000

3661 LASER TREATMENT 1 SESSION LASER TREATMENT 1 SESSION 1500 1500

3662 LASER 1 EYE COMPLETE TREATMENT LASER 1 EYE COMPLETE TREATMENT 7000 7000

3663 Y.A.G. LASER CAPSULATOMY - ONE EYE Y.A.G. LASER CAPSULATOMY - ONE EYE 7000 7000

Page 92

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 35 المناظير ENDOSCOPY UNIT

بيان المجموعة 3535 المناظير

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1451 ENDOSCOPY WITH BAND LIGATION ENDOSCOPY WITH BAND LIGATION 3750 3750

1452 LIMITTED COLONOSCOPY LIMITTED COLONOSCOPY 3500 3500

1453 E.R.C.P. E.R.C.P. 8000 8000

1454 ERCP+SPHENCTROTOMY+STENT ERCP+SPHENCTROTOMY+STENT 13700 13700

1455 UGIT ENDOSCOPY WITH BIOPSY UGIT ENDOSCOPY WITH BIOPSY 2300 2300

1456 UGIT ENDOSCOPY W/WO BIOPSY UGIT ENDOSCOPY W/WO BIOPSY 2300 2300

1457 BAND LIGATION BAND LIGATION 1000 1000

1458 UGIT ENDOSCOPY W/ FEEDING TUBE INSERTION UGIT ENDOSCOPY W/ FEEDING TUBE INSERTION 3725 3725

1459 SIGMOIDOSCOPY, RIGID (OUTPAT.) SIGMOIDOSCOPY, RIGID (OUTPAT.) 3100 3100

1460 SIGMOIDOFIBERSCOPY W/WT BIOPSY SIGMOIDOFIBERSCOPY W/WT BIOPSY 2300 2300

بيان نوع الخدمة 36 الامراض الصدرية CHEST

بيان المجموعة 3636 الامراض الصدرية

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

1473 RESPIRATORY THERAPIST RESPIRATORY THERAPIST 500 500

1474 INTRA-BRONCHIAL LAVAGE INTRA-BRONCHIAL LAVAGE 1100 1100

1475 BRONCHOSCOPY BRONCHOSCOPY 2700 2700

1476 PULMONARY FUNCTION TEST PULMONARY FUNCTION TEST 450 450

بيان نوع الخدمة 38 الاشعه المقطعية C T SCAN

بيان المجموعة 3838 الاشعه المقطعية

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2365 UPPER JAW COMPLETE 3D UPPER JAW COMPLETE 3D 1500 1500

2366 UPPER JAW COMPLETE 3D UPPER JAW COMPLETE 3D 1500 1500

2367 LOWER JAW COMPLETE 3D LOWER JAW COMPLETE 3D 1500 1500

2368 UPPER JAW (POST) - 3D UPPER JAW (POST) - 3D 1500 1500

2369 UPPER JAW (ANT) - 3D UPPER JAW (ANT) - 3D 1500 1500

2370 LOWER JAW (POST) - 3D LOWER JAW (POST) - 3D 1500 1500

2371 LOWER JAW (ANT) - 3D LOWER JAW (ANT) - 3D 1500 1500

2372 C.T. EXAMINATION C.T. EXAMINATION 750 750

2373 CT SERVICES CT SERVICES 90 90

2374 VIRTUAL CT COLONOSCOPY VIRTUAL CT COLONOSCOPY 3350 3350

2375 CT HELICAL NON-CONTRAST (RENAL) CT HELICAL NON-CONTRAST (RENAL) 1500 1500

2376 CT SCAN KNEE LOWER EXT WITH CONTRAST CT SCAN KNEE LOWER EXT WITH CONTRAST 1500 1500

2377 CT MEASURING EXTREMITIES CT MEASURING EXTREMITIES 1500 1500

2378 EMERGENCY CT SCAN - 1 REGION EMERGENCY CT SCAN - 1 REGION 1500 1500

2379 CT HEAD/BRAIN CT HEAD/BRAIN 1500 1500

2380 CT 3D (EXTRA CHARGE) CT 3D (EXTRA CHARGE) 1500 1500

2381 CT SCAN ONE REGION CT SCAN ONE REGION 1500 1500

2382 CT EMERGENCY- BRAIN W/O CONTRAST CT EMERGENCY- BRAIN W/O CONTRAST 1500 1500

2383 CT HEAD WITH CONTRAST CT HEAD WITH CONTRAST 2500 2500

2384 CT TEMPORAL BONES OR SELLA CT TEMPORAL BONES OR SELLA 1500 1500

2385 CT LIMITED CT LIMITED 1500 1500

Page 93

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 38 الاشعه المقطعية C T SCAN

بيان المجموعة 3838 الاشعه المقطعية

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2386 CT SPINES WITHOUT CONTRAST CT SPINES WITHOUT CONTRAST 1500 1500

2387 CT SPINES WITH CONTRAST CT SPINES WITH CONTRAST 2500 2500

2388 CT SPINE W/CONTRAST & MYELOGRAM CT SPINE W/CONTRAST & MYELOGRAM 2500 2500

2389 CT GUIDED ASPIRATION )PLEURAL/OTHERS) CT GUIDED ASPIRATION )PLEURAL/OTHERS) 4555 4555

2390 CT THORAX WITHOUT CONTRAST CT THORAX WITHOUT CONTRAST 2500 2500

2391 CT THORAX WITH CONTRAST CT THORAX WITH CONTRAST 2500 2500

2392 CT ABDOMEN & PELVIS W/ CONTRAST CT ABDOMEN & PELVIS W/ CONTRAST 3000 3000

2393 CT SCAN ABDOMEN CT SCAN ABDOMEN 2000 2000

2394 CT PELVIS CT PELVIS 2500 2500

2395 CT GUIDED BIOPSY (TRUE CUT) CT GUIDED BIOPSY (TRUE CUT) 3300 3300

2396 CT L-SPINE CT L-SPINE 1500 1500

2397 CT C-SPINE CT C-SPINE 1500 1500

2398 CT PELVIMETRY (AP & LATERAL) CT PELVIMETRY (AP & LATERAL) 2500 2500

2399 CT NECK/PH/LX CT NECK/PH/LX 1500 1500

2400 CT ORBIT CT ORBIT 1500 1500

2401 CT T-SPINE CT T-SPINE 1500 1500

2402 CT SINUSES ONE AXIS CT SINUSES ONE AXIS 1500 1500

2403 CT FACE/SINUS CT FACE/SINUS 1500 1500

2404 MD CT CEREBRAL & CAROTID ANGIOGRAPHY MD CT CEREBRAL & CAROTID ANGIOGRAPHY 4500 4500

2405 MD CT PULMONARY ANGIOGRAPHY MD CT PULMONARY ANGIOGRAPHY 3150 3150

2406 MD CT AORTOGRAPHY MD CT AORTOGRAPHY 4150 4150

2407 MD CT CARDIA & CORONARY ANGIOGRAPHY MD CT CARDIA & CORONARY ANGIOGRAPHY 7250 7250

2408 MD CT CARDIAC IMAGING MD CT CARDIAC IMAGING 5250 5250

2409 MD CT CORONARY ANGIOGRAPHY MD CT CORONARY ANGIOGRAPHY 4250 4250

2410 MD CT RENAL ANGIOGRAPHY MD CT RENAL ANGIOGRAPHY 3150 3150

2411 MD CT MESENTRIC ANGIOGRAPHY MD CT MESENTRIC ANGIOGRAPHY 3150 3150

2412 MD CT PERIPHERAL ANGIOGRAPHY(UL) MD CT PERIPHERAL ANGIOGRAPHY(UL) 4250 4250

2413 MD CT PERIPHERAL ANGIOGRAPHY(LL) MD CT PERIPHERAL ANGIOGRAPHY(LL) 5175 5175

2414 MD CT UROGRAPHY MD CT UROGRAPHY 2300 2300

2415 CT ANGIOHRAPHY CT ANGIOHRAPHY 5000 5000

2416 CT BONE DENSITY STUDY CT BONE DENSITY STUDY 1180 1180

2417 CT DENTAL CT DENTAL 1000 1000

2418 CT GUIDED CHEST TUBE INSERTION CT GUIDED CHEST TUBE INSERTION 2500 2500

2419 C.T. GUIDED BIOPSY LIVER,LUNG,OTHERS C.T. GUIDED BIOPSY LIVER,LUNG,OTHERS 3500 3500

2420 CT NEEDLE BIOPSY / DRAINAGE CT NEEDLE BIOPSY / DRAINAGE 3500 3500

2421 CT GUIDED ASPIRATION CT GUIDED ASPIRATION 3000 3000

2422 CT UP EXT CT UP EXT 1500 1500

2423 CT LO EXT WITHOUT CONTRAST CT LO EXT WITHOUT CONTRAST 1500 1500

2424 CT GUIDED INJECTION CT GUIDED INJECTION 1800 1800

2425 CT GUIDED BONE BIOPSY CT GUIDED BONE BIOPSY 4600 4600

بيان نوع الخدمة 39 الرنين المغناطيسي MRI

بيان المجموعة 3939 الرنين المغناطيسي

Page 94

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 39 الرنين المغناطيسي MRI

بيان المجموعة 3939 الرنين المغناطيسي

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2426 MRI - BRAIN WITHOUT CONTRAST MRI - BRAIN WITHOUT CONTRAST 2700 2700

2427 MRI - FACE/NECK/ORBIT MRI - FACE/NECK/ORBIT 2700 2700

2428 MRI - BRAIN WITH CONTRAST MRI - BRAIN WITH CONTRAST 3060 3060

2429 MRI-FACE/NECK/ORBIT WITH CONTRAST MRI-FACE/NECK/ORBIT WITH CONTRAST 3060 3060

2430 MRI-FACE/NECK/ORBIT WITH CONTRAST MRI-FACE/NECK/ORBIT WITH CONTRAST 3060 3060

2431 MRI ONE REGION MRI ONE REGION 2700 2700

2432 MRI EXAMINATION MRI EXAMINATION 2700 2700

2433 MRI - C-SPINE WITHOUT CONTRAST MRI - C-SPINE WITHOUT CONTRAST 2700 2700

2434 MRI - C-SPINE WITH CONTRAST MRI - C-SPINE WITH CONTRAST 3060 3060

2435 MRI - T-SPINE WITHOUT CONTRAST MRI - T-SPINE WITHOUT CONTRAST 3060 3060

2436 MRI - T-SPINE WITH CONTRAST MRI - T-SPINE WITH CONTRAST 3060 3060

2437 MRI - L-SPINE WITHOUT CONTRAST MRI - L-SPINE WITHOUT CONTRAST 2700 2700

2438 MRI - L-SPINE WITH CONTRAST MRI - L-SPINE WITH CONTRAST 3060 3060

2439 MRI - CHEST MRI - CHEST 2700 2700

2440 MRI - PELVIS MRI - PELVIS 2700 2700

2441 MRI - ADBDOMEN MRI - ADBDOMEN 2700 2700

2442 MRI - TM JOINT MRI - TM JOINT 2700 2700

2443 MRI -SHOULDER/ELBOW/WRIST MRI -SHOULDER/ELBOW/WRIST 2700 2700

2444 MRI - KNEE/ANKLE/HIP MRI - KNEE/ANKLE/HIP 2700 2700

2445 MRI SELLA TURCICA WITH CONTRAST MRI SELLA TURCICA WITH CONTRAST 3060 3060

2446 MRI OTHERS,SOFT TISSUE,THYROID W/CONTRST MRI OTHERS,SOFT TISSUE,THYROID W/CONTRST 3060 3060

2447 MRI - ANGIOGRAPHY PELVIS MRI - ANGIOGRAPHY PELVIS 4600 4600

2448 MRI -ANGIOGRAPHY SPINAL CERVICAL MRI -ANGIOGRAPHY SPINAL CERVICAL 4600 4600

2449 MRI - ANGIOGRAPHY UPPER EXTREMITY MRI - ANGIOGRAPHY UPPER EXTREMITY 5800 5800

2450 MRI - ANGIOGRAPHY CHEST MRI - ANGIOGRAPHY CHEST 4600 4600

2451 MRI-ANGIOGRAPHY LOWER EXTREMITY MRI-ANGIOGRAPHY LOWER EXTREMITY 5800 5800

2452 MR - ANGIOGRAPHY ABDOMEN MR - ANGIOGRAPHY ABDOMEN 4600 4600

2453 MRI - SPECTROSCOPY (ANY ORGAN) MRI - SPECTROSCOPY (ANY ORGAN) 5175 5175

2454 MRI - DIFFUSION (ANY ORGAN) MRI - DIFFUSION (ANY ORGAN) 3100 3100

2455 MRI - PERFUSION (ANY ORGAN) MRI - PERFUSION (ANY ORGAN) 5175 5175

2456 MRI - MAMMOGRAPHY MRI - MAMMOGRAPHY 3100 3100

2457 MRI - MRCP MRI - MRCP 3100 3100

2458 MRI - UROGRAPHY MRI - UROGRAPHY 3100 3100

2459 MRI - CARDIAC IMAGING MRI - CARDIAC IMAGING 6250 6250

2460 MRI LIMITED MRI LIMITED 2700 2700

2461 MRI - ANGIO NECK & HEAD MRI - ANGIO NECK & HEAD 5800 5800

2462 MR - ANGIOGRAPHY BRAIN MR - ANGIOGRAPHY BRAIN 4600 4600

2463 EMERGENCY MRI - 1 REGION EMERGENCY MRI - 1 REGION 2700 2700

2464 MRI TMJ (1 SIDE) MRI TMJ (1 SIDE) 2700 2700

2465 MRI READING MRI READING 415 415

بيان نوع الخدمة 40 جراحة اطفال PEDIATRIC SURGERY

بيان المجموعة 4040 جراحة اطفال

Page 95

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 40 جراحة اطفال PEDIATRIC SURGERY

بيان المجموعة 4040 جراحة اطفال

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2897 PED.BURN DEBRIDEMENT-SMALL AREA- ONE SITE PED.BURN DEBRIDEMENT-SMALL AREA-ONE SITE 300 300

2898 PED.BURN DEBRIDEMENT-SMAL AREA- MULTIPLE PED.BURN DEBRIDEMENT-SMAL AREA- MULTIPLE 800 800

2899 PED. DISTAL SPLENO RENAL SHUNT PED. DISTAL SPLENO RENAL SHUNT 16700 16700

2900 PED.BURN DEBRIDEMENT-MEDIUM AREA- ONE SIT PED.BURN DEBRIDEMENT-MEDIUM AREA-ONE SIT 800 800

2901 PED.BURN DEBRIDEMENT-MEDIUM AREA- MULTIPL PED.BURN DEBRIDEMENT-MEDIUM AREA-MULTIPL 1500 1500

2902 PED.BURN DEBRIDEMENT-MAJOR AREA- ONE SIT PED.BURN DEBRIDEMENT-MAJOR AREA-ONE SIT 1500 1500

2903 PED.BURN DEBRIDEMENT-MAJOR AREA- MULTIPLE PED.BURN DEBRIDEMENT-MAJOR AREA-MULTIPLE 1500 1500

2904 PED.SKIN GRAFTING FOR BURN-SMALL ONE SIT PED.SKIN GRAFTING FOR BURN-SMALL ONE SIT 9000 9000

2905 PED.SKING GRAFTING FOR BURN-SMALL MULTIP PED.SKING GRAFTING FOR BURN- SMALL MULTIP 12000 12000

2906 PED.SKIN GRAFTING FOR BUR-MEDIUM ONE SIT PED.SKIN GRAFTING FOR BUR-MEDIUM ONE SIT 14000 14000

2907 PED.SKING GRAFTING FOR BURN-MEDIUM MULTI PED.SKING GRAFTING FOR BURN- MEDIUM MULTI 14000 14000

2908 PED.SKIN GRAFTING FOR BURN-MAJOR ONE SIT PED.SKIN GRAFTING FOR BURN-MAJOR ONE SIT 15000 15000

2909 PED.SKING GRAFTING FOR BURN-MAJOR MULTIP PED.SKING GRAFTING FOR BURN- MAJOR MULTIP 15000 15000

2910 PED.COMPLEX WOUND CLOSURE PED.COMPLEX WOUND CLOSURE 1500 1500

2911 PED.SUBCUTANEOUS MASTECTOMY PED.SUBCUTANEOUS MASTECTOMY 10000 10000

2912 PED.MAJOR EXCISION OF SOFT TISSUE TUMOR PED.MAJOR EXCISION OF SOFT TISSUE TUMOR 8500 8500

2913 PED.MAJOR SOFT TISSUE REPAIR FOR TRAUMA PED.MAJOR SOFT TISSUE REPAIR FOR TRAUMA 6500 6500

2914 PED.CLEFT LIP/PALATE REPAIR PED.CLEFT LIP/PALATE REPAIR 5400 5400

2915 PED.THYROIDECTOMY PED.THYROIDECTOMY 14000 14000

2916 PED.PARATHYROIDECTOMY PED.PARATHYROIDECTOMY 14000 14000

2917 PED.BRANCHIAL CYST/SINUS PED.BRANCHIAL CYST/SINUS 5250 5250

2918 PED.THYROGLOSSAL DUCT CYST/SINUS PED.THYROGLOSSAL DUCT CYST/SINUS 12000 12000

2919 PED.DERMOID/OTHER CYST EXCISION PED.DERMOID/OTHER CYST EXCISION 1600 1600

2920 PED.TRACHEOSTOMY LESS THAN ONE YEAR PED.TRACHEOSTOMY LESS THAN ONE YEAR 4500 4500

2921 PED.TRACHEOSTOMY MORE THAN ONE YEAR PED.TRACHEOSTOMY MORE THAN ONE YEAR 3100 3100

2922 PED.REPAIR OF CHEST WALL DEFORMITY PED.REPAIR OF CHEST WALL DEFORMITY 12500 12500

2923 PED.RESECTION OF CHEST WALL TUMOR- SIMPLE PED.RESECTION OF CHEST WALL TUMOR-SIMPLE 8250 8250

2924 PED.RESECTION OF CHEST WALL TUMOR - COMPL PED.RESECTION OF CHEST WALL TUMOR -COMPL 14500 14500

2925 PED.EXCISION OF MEDIASTINAL TUMOR OPEN PED.EXCISION OF MEDIASTINAL TUMOR OPEN 14500 14500

2926 PED.EXCISION OF MEDIASTINAL TUMOR LAPARO PED.EXCISION OF MEDIASTINAL TUMOR LAPARO 16600 16600

2927 PED.EXCISION OF MEDIASTINAL CYST OPEN PED.EXCISION OF MEDIASTINAL CYST OPEN 10350 10350

2928 PED.EXCISION OF MEDIASTINAL CYST LAPAROS PED.EXCISION OF MEDIASTINAL CYST LAPAROS 12500 12500

2929 PED.PULMONARY RESECTION TUMOR.CONG MALFO PED.PULMONARY RESECTION TUMOR.CONG MALFO 16700 16700

2930 PED.THORACOTOMY FOR TRAUMA PED.THORACOTOMY FOR TRAUMA 12500 12500

2931 PED.LUNG BIOPSY OPEN PED.LUNG BIOPSY OPEN 6250 6250

2932 PED.LUNG BIOPSY LAPAROSCOPIC PED.LUNG BIOPSY LAPAROSCOPIC 8500 8500

Page 96

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 40 جراحة اطفال PEDIATRIC SURGERY

بيان المجموعة 4040 جراحة اطفال

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2933 PED.DECORTICATION/PLEURECTOMY/BLTM Y OPEN PED.DECORTICATION/PLEURECTOMY/B LTMY OPEN 10350 10350

2934 PED.DECORTICATION/PLE/BEL/LAPAROSC OPIC PED.DECORTICATION/PLE/BEL/LAPARO SCOPIC 12500 12500

2935 PED.OESPHAGEAL RESECTION MINOR PED.OESPHAGEAL RESECTION MINOR 12500 12500

2936 PED.OESPHAGEAL RESECTION MAJOR OR RPLMNT PED.OESPHAGEAL RESECTION MAJOR OR RPLMNT 16700 16700

2937 PED.OESPHAGOGOTOMY OPEN PED.OESPHAGOGOTOMY OPEN 10350 10350

2938 PED.OESPHAGOGOTOMY LAPAROSCOPIC PED.OESPHAGOGOTOMY LAPAROSCOPIC 12500 12500

2939 PED.REPAIR OF OESOPHAGEAL ATRASIA OR TRA PED.REPAIR OF OESOPHAGEAL ATRASIA OR TRA 14500 14500

2940 PED.REPAIR OF DIAPHRAGMATIC HERNIA OPEN PED.REPAIR OF DIAPHRAGMATIC HERNIA OPEN 20000 20000

2941 PED.PLICATION OF DIAPHRAGM OPEN PED.PLICATION OF DIAPHRAGM OPEN 12500 12500

2942 PED.PLICATION OF DIAPHRAGM LAPAROSCOPIC PED.PLICATION OF DIAPHRAGM LAPAROSCOPIC 14500 14500

2943 PED.THORACIC&/OR RETROPERITONEAL EXPOSUR PED.THORACIC&/OR RETROPERITONEAL EXPOSUR 14500 14500

2944 PED.PATENT DUCTUS ARTERIOSIS PED.PATENT DUCTUS ARTERIOSIS 12500 12500

2945 PED.VASCULAR RING PED.VASCULAR RING 12500 12500

2946 PED.AORTOPEXY PED.AORTOPEXY 12500 12500

2947 PED.RENAL ARTERY RECONSTRUCTION PED.RENAL ARTERY RECONSTRUCTION 12500 12500

2948 PED.PERIPHERAL ARTERY RECONSTRUCTION PED.PERIPHERAL ARTERY RECONSTRUCTION 10350 10350

2949 PED.CONSTRUCTION OR TAKE DOWN AV FISTULA PED.CONSTRUCTION OR TAKE DOWN AV FISTULA 6250 6250

2950 RELEASE OF PENILE ADHESION RELEASE OF PENILE ADHESION 1100 1100

2951 PED.DIALYSIS ACCESS INSERTION PED.DIALYSIS ACCESS INSERTION 6250 6250

2952 PED.DIALYSIS ACCESS REMOVAL PED.DIALYSIS ACCESS REMOVAL 2250 2250

2953 PED.MAJOR VESSEL RECONSTRUCTION PED.MAJOR VESSEL RECONSTRUCTION 12500 12500

2954 PED.ANTIREFLUX PROCEDURE OPEN PED.ANTIREFLUX PROCEDURE OPEN 12500 12500

2955 PED.ANTIREFLUX PROCEDURE LAPAROSCOPIC PED.ANTIREFLUX PROCEDURE LAPAROSCOPIC 14500 14500

2956 PED.PYLOROPLASTY/GASTRIC RESECTION W/O V PED.PYLOROPLASTY/GASTRIC RESECTION W/O V 25000 25000

2957 PED. GASTROSTOMY/JEJUNOSTOMY OPEN PED. GASTROSTOMY/JEJUNOSTOMY OPEN 8000 8000

2958 PED.GASTROSTOMY/JEJUNOSTOMY LAPAROSCOPIC PED.GASTROSTOMY/JEJUNOSTOMY LAPAROSCOPIC 8000 8000

2959 PED.PYLOROMYOTOMY PED.PYLOROMYOTOMY 8000 8000

2960 PED.OPERATION FOR MALROTATION PED.OPERATION FOR MALROTATION 14500 14500

2961 PED.REPAIR OF INTESTINAL ATRASIA STENOSI PED.REPAIR OF INTESTINAL ATRASIA STENOSI 16700 16700

2962 PED.INTESTINAL RESECTION PED.INTESTINAL RESECTION 12500 12500

2963 PED.OSTOMY FOR ANORECTAL MALFORMATIONP PED.OSTOMY FOR ANORECTAL MALFORMATIONP 6500 6500

2964 PEDIATRIC CLOSURE/REVESION ANY OSTOMY PEDIATRIC CLOSURE/REVESION ANY OSTOMY 6500 6500

2965 PED.APPENDECTOMY OPEN PED.APPENDECTOMY OPEN 8500 8500

2966 PED.APPENDECTOMY LAPAROSCOPIC PED.APPENDECTOMY LAPAROSCOPIC 8500 8500

2967 PED.PERINEALPROCEDURE FOR IMPERFRTE.ANUS PED.PERINEALPROCEDURE FOR IMPERFRTE.ANUS 7500 7500

2968 PED.PULL THROUGH FOR IMPERFORATE /HURCHB PED.PULL THROUGH FOR IMPERFORATE /HURCHB 7500 7500

2969 PED.PULL THROUGH FOR HURSCHBRUG'S LAPARO PED.PULL THROUGH FOR HURSCHBRUG'S LAPARO 14500 14500

Page 97

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 40 جراحة اطفال PEDIATRIC SURGERY

بيان المجموعة 4040 جراحة اطفال

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

2970 PED.EXPLORATORY LAPAROTOMY W/O BIOSPY PED.EXPLORATORY LAPAROTOMY W/O BIOSPY 10000 10000

2971 PED.EXCISION OF OMENTAL/MESENTRIC CYST PED.EXCISION OF OMENTAL/MESENTRIC CYST 8500 8500

2972 PED.OMPHALOCELE(ANY SURGICAL REPAIR) PED.OMPHALOCELE(ANY SURGICAL REPAIR) 12500 12500

2973 PED.GASTROSCHISIS(ANY SURGICAL REPAIR) PED.GASTROSCHISIS(ANY SURGICAL REPAIR) 12500 12500

2974 PED.RESECTION URACHAL REMENANT PED.RESECTION URACHAL REMENANT 17000 17000

2975 PED.OMPHALOMESENTRIC DUCT.CYST PED.OMPHALOMESENTRIC DUCT.CYST 8500 8500

2976 PED.EXCISION NEURO.ADRE.RETR.PERIO.TUMOR PED.EXCISION NEURO.ADRE.RETR.PERIO.TUMOR 16700 16700

2977 PED.EXCISION SACROCOCCYGEAL TERATOMA PED.EXCISION SACROCOCCYGEAL TERATOMA 14500 14500

2978 PED.REPAIR OF INGL.HERNIA.UNI.LESS 1YEAR PED.REPAIR OF INGL.HERNIA.UNI.LESS 1YEAR 6000 6000

2979 PED.REPAIR OF INGL.HERNIA.BIL.LESS.1YEAR PED.REPAIR OF INGL.HERNIA.BIL.LESS.1YEAR 9000 9000

2980 PED.REPAIR OF INGL.HERNIA.UNI.MORE 1YEAR PED.REPAIR OF INGL.HERNIA.UNI.MORE 1YEAR 7500 7500

2981 PED.REPAIR OF INGU.HERNIA.BILT.MORE1YEAR PED.REPAIR OF INGU.HERNIA.BILT.MORE1YEAR 7500 7500

2982 PED.REPAIR OF UMBLICAL/PARA UMBLICAL HER PED.REPAIR OF UMBLICAL/PARA UMBLICAL HER 7500 7500

2983 PED.REPAIR OF VENTRAL HERNIA PED.REPAIR OF VENTRAL HERNIA 7500 7500

2984 PED.MAJOR HEPATIC RESECTIN/REPAIR TUMOR PED.MAJOR HEPATIC RESECTIN/REPAIR TUMOR 14500 14500

2985 PED.LIVER BIOSPY OPEN PED.LIVER BIOSPY OPEN 6250 6250

2986 PED.LIVER BIOSPY LAPAROSCOPIC PED.LIVER BIOSPY LAPAROSCOPIC 7500 7500

2987 PED.CHLTMY.W/O COMMON BILE DUCT EXP.OPEN PED.CHLTMY.W/O COMMON BILE DUCT EXP.OPEN 15000 15000

2988 PED. CHOLECYSTECTOMY W/O C.B.D. EXP.LAP PED. CHOLECYSTECTOMY W/O C.B.D. EXP.LAP 18000 18000

2989 PED.PANCREATIC RESECTION FOR TRAUMA/HYP PED.PANCREATIC RESECTION FOR TRAUMA/HYP 14500 14500

2990 PED.OPERATION FOR PSEUDOCYST OPEN PED.OPERATION FOR PSEUDOCYST OPEN 7500 7500

2991 PED.OPERATION FOR PSEUDOCYST LAPAROSCOP PED.OPERATION FOR PSEUDOCYST LAPAROSCOP 9350 9350

2992 PED.SPLENECTOMY OPEN PED.SPLENECTOMY OPEN 18000 18000

2993 PED.SPLENECTOMY LAPAROSCOPIC PED.SPLENECTOMY LAPAROSCOPIC 18000 18000

2994 PED.PARTIAL NEPHRECTOMY PED.PARTIAL NEPHRECTOMY 8500 8500

2995 PED.TOTAL NEPHRECTOMY SIMPLE PED.TOTAL NEPHRECTOMY SIMPLE 16000 16000

2996 PED.TOTAL NEPHRECTOMY-RADICAL PED.TOTAL NEPHRECTOMY-RADICAL 24000 24000

2997 PED.RENAL TRANSPLANT PED.RENAL TRANSPLANT 16700 16700

2998 PED.RENAL BIOSPY OPEN PED.RENAL BIOSPY OPEN 6250 6250

2999 PED.PARTIAL CYSTECTOMY PED.PARTIAL CYSTECTOMY 16000 16000

3000 PED.TOTAL CYSTECTOMY PED.TOTAL CYSTECTOMY 22000 22000

3001 PED.NEPHROSTOMY PERCUTANOUS PED.NEPHROSTOMY PERCUTANOUS 2250 2250

3002 PED.NEPHROSTOMY OPEN PED.NEPHROSTOMY OPEN 6250 6250

3003 PED.OPERATION FOR NEPHRO- URETEROLITHIAS PED.OPERATION FOR NEPHRO- URETEROLITHIAS 8500 8500

3004 PED.BLADDER.REPAIR PED.BLADDER.REPAIR 8500 8500

3005 PED.BLADDER AUGMENTATION PED.BLADDER AUGMENTATION 14500 14500

3006 PED.URINARY DIVERSION PED.URINARY DIVERSION 12500 12500

3007 PED.PYELOPLASTY/UPJ RECOSTRUCTION PED.PYELOPLASTY/UPJ RECOSTRUCTION 10350 10350

3008 PED.URETERAL PED.URETERAL 17000 17000

Page 98

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 40 جراحة اطفال PEDIATRIC SURGERY

بيان المجموعة 4040 جراحة اطفال

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

RECONSTRUCTION/REIMPLANTATI RECONSTRUCTION/REIMPLANTATI

3009 PED.HYPOSPADIUS/EPISPADIUS MINOR PED.HYPOSPADIUS/EPISPADIUS MINOR 7000 7000

3010 PED.HYPOSPADIUS/EPISPADIUS MAJOR PED.HYPOSPADIUS/EPISPADIUS MAJOR 10000 10000

3011 PED.CIRCUMCISION LESS THAN TWO MONTH PED.CIRCUMCISION LESS THAN TWO MONTH 800 800

3012 PED.CIRCUMCISION MORE THAN TWO MONTH PED.CIRCUMCISION MORE THAN TWO MONTH 800 800

3013 PED.REVISION OF CIRCUMCISION PED.REVISION OF CIRCUMCISION 800 800

3014 PED.ORCHIDOPEXY OPEN UNILATERAL PED.ORCHIDOPEXY OPEN UNILATERAL 6000 6000

3015 REVISION OF CIRCUMCISION OF SCAR REVISION OF CIRCUMCISION OF SCAR 4500 4500

3016 PED.ORCHIDOPEXY OPEN BILATERAL PED.ORCHIDOPEXY OPEN BILATERAL 9000 9000

3017 PED.ORCHIDOPEXY LAPAROSCOPIC PED.ORCHIDOPEXY LAPAROSCOPIC 6000 6000

3018 PED.ORCHIDECTOMY PED.ORCHIDECTOMY 6000 6000

3019 PED.OPTN.FOR TORSION TESTIS OR APPENDAGE PED.OPTN.FOR TORSION TESTIS OR APPENDAGE 6000 6000

3020 PED.UNDESCENDED TESTIS PED.UNDESCENDED TESTIS 6000 6000

3021 PED.HYDROCELECTOMY/HEMATOCELETO MY PED.HYDROCELECTOMY/HEMATOCELE TOMY 6000 6000

3022 PED.VARICOCELECTOMY OPEN(UNILATERAL) PED.VARICOCELECTOMY OPEN(UNILATERAL) 4500 4500

3023 PED.VARICOCELECTOMY OPEN(BILATERAL) PED.VARICOCELECTOMY OPEN(BILATERAL) 6000 6000

3024 PED.VARICOCELECTOMY LAPAROSCOPIC (UNILAT PED.VARICOCELECTOMY LAPAROSCOPIC (UNILAT 4500 4500

3025 PED.VARICOCELECTOMY LAPAROSCOPIC BILATER PED.VARICOCELECTOMY LAPAROSCOPIC BILATER 6000 6000

3026 PED.URETHERAL RUPTURE REPAIR PED.URETHERAL RUPTURE REPAIR 7500 7500

3027 PED.VAGINAL RECONSTRUCTION PED.VAGINAL RECONSTRUCTION 12500 12500

3028 PED.CLITROPLASTY PED.CLITROPLASTY 5250 5250

3029 PED.PARTIAL OOPHERECTOMY OPEN PED.PARTIAL OOPHERECTOMY OPEN 6250 6250

3030 PED.PARTIAL OOPHERECTOMY LAPAROSCOPIC PED.PARTIAL OOPHERECTOMY LAPAROSCOPIC 7500 7500

3031 PED.TOTAL OOPHERECTOMY OPEN PED.TOTAL OOPHERECTOMY OPEN 8500 8500

3032 PED.TOTAL OOPHERECTOMY LAPAROSCOPIC PED.TOTAL OOPHERECTOMY LAPAROSCOPIC 9350 9350

3033 PED.HYSTERECTOMY OPEN PED.HYSTERECTOMY OPEN 12000 12000

3034 PED.SALPINGECTOMY OPEN PED.SALPINGECTOMY OPEN 7500 7500

3035 PED.HYSTERECTOMY LAPAROSCOPIC PED.HYSTERECTOMY LAPAROSCOPIC 12000 12000

3036 PED.SALPINGECTOMY LAPAROSCOPIC PED.SALPINGECTOMY LAPAROSCOPIC 9500 9500

3037 PED.REPAIR COMPLEX LACERATION VAGINAL/PE PED.REPAIR COMPLEX LACERATION VAGINAL/PE 8500 8500

3038 PED.DIAGNOSTIC THORACOSCOPY PED.DIAGNOSTIC THORACOSCOPY 7500 7500

3039 PED.DIAGNOSTIC LAPAROSCOPY PED.DIAGNOSTIC LAPAROSCOPY 4500 4500

3040 PED.CYSTOSCOPY PED.CYSTOSCOPY 5500 5500

3041 PED.BRONCHOSCOPY PED.BRONCHOSCOPY 3100 3100

3042 PED.OESOPHAGOSCOPY PED.OESOPHAGOSCOPY 4250 4250

3043 PED.REMOVAL OF F.B.OESOPHAGUS OR TRACHEA PED.REMOVAL OF F.B.OESOPHAGUS OR TRACHEA 5250 5250

3044 PED.OESOPHAGEAL DILATATION PED.OESOPHAGEAL DILATATION 7500 7500

3045 PED.COLONOSCOPY PED.COLONOSCOPY 3500 3500

3046 PED.SIGMOIDOSCOPY PED.SIGMOIDOSCOPY 2500 2500

3047 PED.LARYNGOSCOPY PED.LARYNGOSCOPY 3500 3500

3048 PED.TOTAL ABDOMINAL HYSTRECTOMY PED.TOTAL ABDOMINAL HYSTRECTOMY 10350 10350

Page 99

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 40 جراحة اطفال PEDIATRIC SURGERY

بيان المجموعة 4040 جراحة اطفال

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3049 PED.BILATERAL SALPINGO OOPHRECTOMY PED.BILATERAL SALPINGO OOPHRECTOMY 12500 12500

3050 PED.FLEXIBLE OESPHAGO GASTRO DUODOSCOPY PED.FLEXIBLE OESPHAGO GASTRO DUODOSCOPY 6250 6250

3051 EXCISION LARGE NECK CYSTIC HYGROMA EXCISION LARGE NECK CYSTIC HYGROMA 8500 8500

3052 PED. VESICOSTOMY PED. VESICOSTOMY 10000 10000

3053 PED I&D ABSCESS UNDER G.A. PED I&D ABSCESS UNDER G.A. 3500 3500

3054 PED I&D ABSCESS MINOR L.A. PED I&D ABSCESS MINOR L.A. 1200 1200

3055 PED CLOSURE MAJOR WOUND/LACERATION PED CLOSURE MAJOR WOUND/LACERATION 12500 12500

3056 PED CLOSURE MINOR WOUND/LACERATION PED CLOSURE MINOR WOUND/LACERATION 830 830

3057 PED. CYSTOSCOPY THERAPEUTIC PED. CYSTOSCOPY THERAPEUTIC 4000 4000

3058 PED. FULL THICKNESS RECTAL BIOPSY PED. FULL THICKNESS RECTAL BIOPSY 2500 2500

3059 NEC,MECONIUM,ILEUS,ATRESA NEONATAL(EXPL) NEC,MECONIUM,ILEUS,ATRESA NEONATAL(EXPL) 12500 12500

3060 PED GASTROSTOMY OPEN PED GASTROSTOMY OPEN 8000 8000

3061 PED GEN SURGERY EXAMINATION MINOR PED GEN SURGERY EXAMINATION MINOR 1100 1100

3062 PED GEN SURGERY EXAMINATION INTERMEDIATE PED GEN SURGERY EXAMINATION INTERMEDIATE 1600 1600

3063 PED GEN SURGERY EXAMINATION MAJOR PED GEN SURGERY EXAMINATION MAJOR 2250 2250

3064 PED EXPLOR LAPAR W/REDUCT INTUSSUCEPTION PED EXPLOR LAPAR W/REDUCT INTUSSUCEPTION 10350 10350

3065 EXPLOR LAPAR+MECKELS DIVERT+APPENDECTOMY EXPLOR LAPAR+MECKELS DIVERT+APPENDECTOMY 8500 8500

3066 PED.EXPLORATORY LAPAROTOMY W/O BIOSPY PED.EXPLORATORY LAPAROTOMY W/O BIOSPY 10000 10000

3067 BIOPSY SUBCU.NOD.FINE NEEDLE W/THRU CUT BIOPSY SUBCU.NOD.FINE NEEDLE W/THRU CUT 1600 1600

3068 OPEN BIOPSY SMALL SUBCUTANEOUS LESSION OPEN BIOPSY SMALL SUBCUTANEOUS LESSION 3100 3100

3069 RECTAL BIOPSY FOR NEW BORN RECTAL BIOPSY FOR NEW BORN 1100 1100

3070 RELEASE OF PENILE ADHESSION RELEASE OF PENILE ADHESSION 110 110

3071 PED.DERMOID/OTHER CYST EXCISION (2) PED.DERMOID/OTHER CYST EXCISION (2) 2250 2250

3072 EXCHANGE TRANSFUSION FEE/UNIT EXCHANGE TRANSFUSION FEE/UNIT 2250 2250

3073 COLONIC WASH COLONIC WASH 1100 1100

3074 EXTERNAL JUGULAR CANNULATION EXTERNAL JUGULAR CANNULATION 1100 1100

3075 CATHETERIZATION UMBILICAL CATHETERIZATION UMBILICAL 1100 1100

3076 PED. MEATOTOMY PED. MEATOTOMY 2250 2250

3077 PEDIA STOMA REVISION PEDIA STOMA REVISION 3100 3100

3078 RIGID ESOPHAGOSCOPE RIGID ESOPHAGOSCOPE 3100 3100

3079 PED. PYELOLITHOTOMY PED. PYELOLITHOTOMY 12000 12000

3080 REPAIR OF DUODENAL ATRESIA / STENOSIS REPAIR OF DUODENAL ATRESIA / STENOSIS 12500 12500

3081 POLYDACTYLY EXCISION POLYDACTYLY EXCISION 2100 2100

3082 PYELOPLASTY &RETROGRADE STUDY+CYSTOSCOPY PYELOPLASTY &RETROGRADE STUDY+CYSTOSCOPY 12500 12500

3083 PED. CYSTOSCOPY DIAGNOSTIC PED. CYSTOSCOPY DIAGNOSTIC 3100 3100

3084 COLOST/ILEOSTOMY CLSR W/BOWEL REANAST >1 COLOST/ILEOSTOMY CLSR W/BOWEL REANAST >1 21000 21000

3085 COLOST/ILEOSTOMY CLSR W/BOWEL REANAST <1 COLOST/ILEOSTOMY CLSR W/BOWEL REANAST <1 21000 21000

3086 FISTULA, TRACHEO-ESOPHAGEAL, CONGENITAL FISTULA, TRACHEO-ESOPHAGEAL, CONGENITAL 41000 41000

Page 100

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 41 جراحة تجميل PLASTIC SURGERY

بيان المجموعة 4141 جراحة تجميل

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3087 FAT TRANSPLANT LIPS FAT TRANSPLANT LIPS 1250 1250

3088 FAT TRANSPLANT CHEEKS/ CHIN/LABIA MAJORA FAT TRANSPLANT CHEEKS/ CHIN/LABIA MAJORA 1250 1250

3089 FAT TRANSPLANT ARM FAT TRANSPLANT ARM 1250 1250

3090 FAT TRANSPLANT THIGH FAT TRANSPLANT THIGH 2500 2500

3091 FAT TRANSPLANT BUTTLOCKS FAT TRANSPLANT BUTTLOCKS 2500 2500

3092 FAT TRANSPLANT ARMS FAT TRANSPLANT ARMS 1250 1250

3093 CHIN REDUCTION CHIN REDUCTION 6250 6250

3094 FULL SICKNESS GRAFT LARGE FULL SICKNESS GRAFT LARGE 5000 5000

3095 ALAR CARTRIDGE WEDGING ALAR CARTRIDGE WEDGING 2500 2500

3096 LAPOSUCTION BACK LAPOSUCTION BACK 6500 6500

3097 ARM LIFTING ARM LIFTING 3750 3750

3098 BURN CONTRACTURES, MINOR P.REP. BURN CONTRACTURES, MINOR P.REP. 3750 3750

3099 SCALP REDUCTION SCALP REDUCTION 5000 5000

3100 SCARS REVISION, SMALL SCARS REVISION, SMALL 2500 2500

3101 MOLE EXCISION MOLE EXCISION 2500 2500

3102 SEQUESTRATION OF DERMOID CYST SEQUESTRATION OF DERMOID CYST 7000 7000

3103 SKIN LESION REMOV. SMALL + CLOSUR SKIN LESION REMOV. SMALL + CLOSUR 3800 3800

3104 CORRECTION OF DEFORMED TOO CORRECTION OF DEFORMED TOO 2500 2500

3105 SPLIT EAR LOBULE CLOSURE 1 SID SPLIT EAR LOBULE CLOSURE 1 SID 5000 5000

3106 TATTOOS EXCISION, SMALL + CLOSURE TATTOOS EXCISION, SMALL + CLOSURE 3800 3800

3107 SEPARATION OF PALMAR FLAP SEPARATION OF PALMAR FLAP 2480 2480

3108 PREAURICULAR SINUS EXCISION PREAURICULAR SINUS EXCISION 2500 2500

3109 PROMINENT EARS CORRECTION PROMINENT EARS CORRECTION 5000 5000

3110 PROMINENT EAR CORRECTION PROMINENT EAR CORRECTION 2500 2500

3111 CORONAL & GLANDULR HYPOSPADIUM CORONAL & GLANDULR HYPOSPADIUM 7000 7000

3112 SYNDACTYLY BETWEEN FINGERS SYNDACTYLY BETWEEN FINGERS 6250 6250

3113 EAR RECONSTRUCTION 1ST STAGE EAR RECONSTRUCTION 1ST STAGE 4250 4250

3114 BLEPHAROPLASTY, UPPER EYE LIDS BLEPHAROPLASTY, UPPER EYE LIDS 5000 5000

3115 BLEPHAROPLASTY, LOWER EYE LIDS BLEPHAROPLASTY, LOWER EYE LIDS 3000 3000

3116 REMOVAL OF TISSUE EXPANDER REMOVAL OF TISSUE EXPANDER 3000 3000

3117 SCARS, MAJOR REVISION SCARS, MAJOR REVISION 5000 5000

3118 BUTTOCKS LIFTING BUTTOCKS LIFTING 5000 5000

3119 UMBILICOPLASTY UMBILICOPLASTY 3100 3100

3120 TATOOS EXCISION & SKIN GRAFT TATOOS EXCISION & SKIN GRAFT 9000 9000

3121 HEMECORNAL FLAP EXTENDED PREAUCULAR HEMECORNAL FLAP EXTENDED PREAUCULAR 5000 5000

3122 TIP RHINOPLASTY TIP RHINOPLASTY 6250 6250

3123 LIPOSUCTION BOTH FLANKS LIPOSUCTION BOTH FLANKS 6250 6250

3124 LIPOSUCTION ABDOMEN LIPOSUCTION ABDOMEN 6250 6250

3125 REMOVAL OF SCAR & UMBILICAL HERNIA REPR REMOVAL OF SCAR & UMBILICAL HERNIA REPR 7450 7450

3126 LIPOSUCTION BOTH ARMS LIPOSUCTION BOTH ARMS 6250 6250

3127 LIPOSUCTION BOTH LOWER LEG LIPOSUCTION BOTH LOWER LEG 6250 6250

3128 LIPOSUCTION BOTH THIGHS LIPOSUCTION BOTH THIGHS 6250 6250

3129 LIPOSUCTION OF ADIPOST TISSUE MAJOR LIPOSUCTION OF ADIPOST TISSUE MAJOR 3800 3800

3130 LIPOSUCTION BOTH BUTTOCKS LIPOSUCTION BOTH BUTTOCKS 6250 6250

Page 101

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 41 جراحة تجميل PLASTIC SURGERY

بيان المجموعة 4141 جراحة تجميل

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3131 LIPOSUCTION OF ADIPOST MINOR LIPOSUCTION OF ADIPOST MINOR 1300 1300

3132 LIPOSUCTION CHIN LIPOSUCTION CHIN 2500 2500

3133 REMOVAL OF PERMICATH REMOVAL OF PERMICATH 3100 3100

3134 TISSUE EXPANDER INSERTION TISSUE EXPANDER INSERTION 6250 6250

3135 EXCISION OF PREMAXILLA EXCISION OF PREMAXILLA 5000 5000

3136 FACE LIFT FACE LIFT 9000 9000

3137 BREAST AUGMENTATION / ONE SIDE BREAST AUGMENTATION / ONE SIDE 5000 5000

3138 BREAST AUGMENTATION /TWO SIDES BREAST AUGMENTATION /TWO SIDES 9000 9000

3139 PENILE HYPOSPADIUM PENILE HYPOSPADIUM 7000 7000

3140 CA. HEAD/NECK W/O DISSECTION CA. HEAD/NECK W/O DISSECTION 9000 9000

3141 PHARYNGOPLASTY PHARYNGOPLASTY 9000 9000

3142 VOLKMAN'S ISCHAEMIC CONTRACTUR VOLKMAN'S ISCHAEMIC CONTRACTUR 9000 9000

3143 CLEFT LIP INCOMPLETE (MAJOR) CLEFT LIP INCOMPLETE (MAJOR) 7500 7500

3144 CLEFT LIP INCOMPLETE (MINOR) CLEFT LIP INCOMPLETE (MINOR) 38000 38000

3145 CLEFT PALATE INCOMPLETE CLEFT PALATE INCOMPLETE 7450 7450

3146 CLEFT LIP/PALATE REVISION CLEFT LIP/PALATE REVISION 7450 7450

3147 TRAUMATIC OR ISCHEMIC EAR DISFIG CORRECT TRAUMATIC OR ISCHEMIC EAR DISFIG CORRECT 5000 5000

3148 RECONSTRUCTION OF TERMINAL PHALANGES RECONSTRUCTION OF TERMINAL PHALANGES 2485 2485

3149 MICRO VASCULAR REPAIR OF DIGITAL NERVE MICRO VASCULAR REPAIR OF DIGITAL NERVE 5175 5175

3150 TORTICOLLIS CORRECTION TORTICOLLIS CORRECTION 7455 7455

3151 LOCAL ROTATIONAL FLAP LOCAL ROTATIONAL FLAP 3725 3725

3152 DUPUYTREN'S CONTRACTURE DUPUYTREN'S CONTRACTURE 7455 7455

3153 EXCISION OF NEUROMA EXCISION OF NEUROMA 3726 3726

3154 Z-PLASTY ONE SIDE Z-PLASTY ONE SIDE 1240 1240

3155 BILATERAL BREAST LIFTING BILATERAL BREAST LIFTING 8690 8690

3156 DIMPLE ON CHIN DIMPLE ON CHIN 1240 1240

3157 CORRECTION OF NASAL DEFORMITY CORRECTION OF NASAL DEFORMITY 3725 3725

3158 REMOVE IMPLANTS/SMALL BONES REMOVE IMPLANTS/SMALL BONES 3725 3725

3159 SKIN REDUCTION / NECK LIFTING SKIN REDUCTION / NECK LIFTING 3725 3725

3160 SKIN REDUCTION LARGE SKIN REDUCTION LARGE 6210 6210

3161 LIPOSUCTION BOTH CALF LIPOSUCTION BOTH CALF 2485 2485

3162 HEAMATOMA EVACUATION , LARGE HEAMATOMA EVACUATION , LARGE 2485 2485

3163 EXCISION OF FIBROUS TISSUE EXCISION OF FIBROUS TISSUE 4970 4970

3164 LIP REDUCTION LIP REDUCTION 1240 1240

3165 HAEMATOMA EVACUATION, SMALL HAEMATOMA EVACUATION, SMALL 1240 1240

3166 LIMITED ABDOMINOPLASTY LIMITED ABDOMINOPLASTY 7450 7450

3167 EYEBROW LIFTING BILATERAL EYEBROW LIFTING BILATERAL 2485 2485

3168 CORRECTION OF PENILE SKIN CORRECTION OF PENILE SKIN 3730 3730

3169 BACK LIFTING BACK LIFTING 7450 7450

3170 LAPOSUCTION BOTH LEGS LAPOSUCTION BOTH LEGS 6210 6210

3171 BRACHIO PLASTY - BILATERAL BRACHIO PLASTY - BILATERAL 7450 7450

3172 THIGH PLASTY - BILATERAL THIGH PLASTY - BILATERAL 7450 7450

3173 DRAINAGE APPENDICULAR ABSCESS DRAINAGE APPENDICULAR ABSCESS 8500 8500

3174 MANIPULATION OF BREAST PROSTHESIS MANIPULATION OF BREAST PROSTHESIS 1240 1240

Page 102

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 41 جراحة تجميل PLASTIC SURGERY

بيان المجموعة 4141 جراحة تجميل

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3175 LIMITED ABDOMINOPLASTY LIMITED ABDOMINOPLASTY 7450 7450

3176 CLEFT LIP & PALATE COMPLETE CLEFT LIP & PALATE COMPLETE 11180 11180

3177 HAIR TRANSPLANTATION HAIR TRANSPLANTATION 9935 9935

3178 FACIAL MOVEMENTS RECONSTRUCTN. FACIAL MOVEMENTS RECONSTRUCTN. 11175 11175

3179 CLEFT LIP + PALATE BILAT. INCOMPL CLEFT LIP + PALATE BILAT. INCOMPL 9935 9935

3180 CLEFT WIDE SECONDARY PALATE CLEFT WIDE SECONDARY PALATE 9935 9935

3181 ABDOMINOPLASTY ABDOMINOPLASTY 9935 9935

3182 EAR LOBE CORRECTION ONE SIDE EAR LOBE CORRECTION ONE SIDE 1245 1245

3183 BREASTS PTOSIS CORRECTION BREASTS PTOSIS CORRECTION 9930 9930

3184 CA. TUMORS, HEAD/NECK+DISSECTION CA. TUMORS, HEAD/NECK+DISSECTION 12500 12500

3185 BREAST REDUCTION, BOTH SIDES BREAST REDUCTION, BOTH SIDES 12500 12500

3186 BREAST REDUCTION ONE SIDE BREAST REDUCTION ONE SIDE 6210 6210

3187 BREAST RECONSTR + MASTECTOMY BREAST RECONSTR + MASTECTOMY 12500 12500

3188 T.M.J. ANKYLOSIS REL + RIB GRAFT T.M.J. ANKYLOSIS REL + RIB GRAFT 12500 12500

3189 FAT FILLING HAND FAT FILLING HAND 1250 1250

بيان نوع الخدمة 42 جراحة عظام ORTHOPEDICS

بيان المجموعة 4242 جراحة عظام

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3190 RECONSTRUCTION&REPAIR OF TENDOR ACHILLES RECONSTRUCTION&REPAIR OF TENDOR ACHILLES 7000 7000

3191 RECONST. & REPAIR OF QUADRICIP MUSCLE RECONST. & REPAIR OF QUADRICIP MUSCLE 7000 7000

3192 IM NAILING HUMERUS IM NAILING HUMERUS 9350 9350

3193 DRESSING UNDER GA DRESSING UNDER GA 1100 1100

3194 CLOSED REDUCTION FINGER W/K-WIRE FIXATN CLOSED REDUCTION FINGER W/K- WIRE FIXATN 7500 7500

3195 DRAINAGE SMALL ABCESS LOC. ANST. DRAINAGE SMALL ABCESS LOC. ANST. 1100 1100

3196 REMOVAL OF K-WIRE REMOVAL OF K-WIRE 750 750

3197 READJUSTMENT OF K-WIRE READJUSTMENT OF K-WIRE 750 750

3198 BONE BIOPSY THRU THE NEEDLE BONE BIOPSY THRU THE NEEDLE 3000 3000

3199 I&D ABCESS WITH GA / LA I&D ABCESS WITH GA / LA 1240 1240

3200 RECNSTRCT AMMPUT FINGER NOGRAFT RECNSTRCT AMMPUT FINGER NOGRAFT 2480 2480

3201 MANIPULATE SMALL JOINT G.A. MANIPULATE SMALL JOINT G.A. 4000 4000

3202 REMOVE IMPLANTS/SMALL BONES REMOVE IMPLANTS/SMALL BONES 3720 3720

3203 REMOVAL OF EXTERNAL FIXATOR REMOVAL OF EXTERNAL FIXATOR 3720 3720

3204 PERICHONRITIS INCISION/DRAIN PERICHONRITIS INCISION/DRAIN 1240 1240

3205 REMOVAL OF FOREIGN BODY, DEEP REMOVAL OF FOREIGN BODY, DEEP 2485 2485

3206 DEBRIDEMENT LARGE WOUND DEBRIDEMENT LARGE WOUND 3725 3725

3207 DEBRIDEMENT SMALL WOUND DEBRIDEMENT SMALL WOUND 1240 1240

3208 ARTHROSCOPY (DIAGNOSTIC) SHOULDER ARTHROSCOPY (DIAGNOSTIC) SHOULDER 10000 10000

3209 C-REDUCT SIMPLE FRACTURE C-REDUCT SIMPLE FRACTURE 3000 3000

3210 PERCUTANEOUS WIRING PERCUTANEOUS WIRING 3000 3000

3211 REMOVAL OF K-WIRE REMOVAL OF K-WIRE 1800 1800

3212 PERCUTANEOUS WIRING + P.O.P PERCUTANEOUS WIRING + P.O.P 3000 3000

3213 C-REDUCT OF SHOULDER C-REDUCT OF SHOULDER 3500 3500

Page 103

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 42 جراحة عظام ORTHOPEDICS

بيان المجموعة 4242 جراحة عظام

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3214 C-REDUCT DISLOCATED PHALANGES C-REDUCT DISLOCATED PHALANGES 1240 1240

3215 EXTERNAL FIXATION OF SHORT BONES EXTERNAL FIXATION OF SHORT BONES 2485 2485

3216 RE-ADJUSTMENT OF SPINAL ROD RE-ADJUSTMENT OF SPINAL ROD 2485 2485

3217 HALLUX VLAUS CORRECTION HALLUX VLAUS CORRECTION 2485 2485

3218 ARTHRODESIS TOE ARTHRODESIS TOE 5000 5000

3219 GANGLION EXCISION GANGLION EXCISION 5000 5000

3220 REDUCT DISLOCATION & PLASTER REDUCT DISLOCATION & PLASTER 2485 2485

3221 SKIN GRAFT LOC. FLAP. FINGER TIP SKIN GRAFT LOC. FLAP. FINGER TIP 6000 6000

3222 TRIGGER FINGER TRIGGER FINGER 6000 6000

3223 TENDON RELEASE FINGERS/WRIST/DEQUERVAN TENDON RELEASE FINGERS/WRIST/DEQUERVAN 7000 7000

3224 TENDON RELEASE SHOULDER TENDON RELEASE SHOULDER 7000 7000

3225 ADDUCTORTENOTOMY ADDUCTORTENOTOMY 3725 3725

3226 EXCISION OF OLECRANON BURSA EXCISION OF OLECRANON BURSA 8000 8000

3227 REMOVAL OF IMPLANTS/BIG BONES REMOVAL OF IMPLANTS/BIG BONES 3000 3000

3228 REMOVAL OF SCREW REMOVAL OF SCREW 1240 1240

3229 GRACILLES TENDOM LENGTHENING GRACILLES TENDOM LENGTHENING 3725 3725

3230 EXTERNAL FIXATION ADJUSTMENT EXTERNAL FIXATION ADJUSTMENT 3725 3725

3231 ARTHROSCOPY FOR THE ANKLE ARTHROSCOPY FOR THE ANKLE 10000 10000

3232 EXCISION OF LOOSE BODY (ELBOW) EXCISION OF LOOSE BODY (ELBOW) 3725 3725

3233 AMPUTATION FINGER OR TOE AMPUTATION FINGER OR TOE 3000 3000

3234 EXCISION OF LOOSE BODY (TIBIA) EXCISION OF LOOSE BODY (TIBIA) 3726 3726

3235 PRE-TIBIAL BURSA EXCISION PRE-TIBIAL BURSA EXCISION 8000 8000

3236 EXCISION OF LOOSE BODY (SMALL BONE) EXCISION OF LOOSE BODY (SMALL BONE) 3725 3725

3237 SKIN GRAFTING SMALL AREA SKIN GRAFTING SMALL AREA 6000 6000

3238 O-REDUCT/INTERFIX FINGR/TOE O-REDUCT/INTERFIX FINGR/TOE 5000 5000

3239 O-REDUCT/INTERFIX RADIUS O-REDUCT/INTERFIX RADIUS 5000 5000

3240 C-REDUCT FRACTURE/DISLOCATION C-REDUCT FRACTURE/DISLOCATION 3000 3000

3241 O/R - I/F SMALL BONES HAND/FOOT O/R - I/F SMALL BONES HAND/FOOT 7000 7000

3242 C-REDUCT PLASTER CALC/TAL/META C-REDUCT PLASTER CALC/TAL/META 3000 3000

3243 ARTHROTOMY INFECTIVE ARTHRITIES ARTHROTOMY INFECTIVE ARTHRITIES 4555 4555

3244 ADJUSTMENT OF ILLIZAROVE ADJUSTMENT OF ILLIZAROVE 3725 3725

3245 PLANTAR FASCIA RELEASE PLANTAR FASCIA RELEASE 6000 6000

3246 CORRECT DEFORMED TENDON CORRECT DEFORMED TENDON 7000 7000

3247 EXPLORATION OF WOUND LARGE EXPLORATION OF WOUND LARGE 3726 3726

3248 EXPLORATION OF SMALL WOUND EXPLORATION OF SMALL WOUND 1245 1245

3249 SUTURING OF SMALL WOUND SUTURING OF SMALL WOUND 1245 1245

3250 SUTURING OF LARGE WOUND SUTURING OF LARGE WOUND 2485 2485

3251 DRAINAGE DEEP ABCESS W/ANESTH DRAINAGE DEEP ABCESS W/ANESTH 3720 3720

3252 DRAINAGE COLD ABSCESS/TB JOINT DRAINAGE COLD ABSCESS/TB JOINT 3500 3500

3253 SINUS SKIN EXCISION SINUS SKIN EXCISION 6000 6000

3254 DRAINAGE OF HAND INFECTIONS DRAINAGE OF HAND INFECTIONS 3720 3720

3255 LIGAMENTS RUPTURED JOINT LIGAMENTS RUPTURED JOINT 7000 7000

3256 EXCISION OF BURSA IN THE KNEE EXCISION OF BURSA IN THE KNEE 8000 8000

3257 ILLIZAROV FIXATION ILLIZAROV FIXATION 9940 9940

3258 FEMUR HEAD CORE DECOMPRESSION FEMUR HEAD CORE DECOMPRESSION 6000 6000

Page 104

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 42 جراحة عظام ORTHOPEDICS

بيان المجموعة 4242 جراحة عظام

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3259 ARTHROSCOPY RT ANKLE WITH SYNOVECTOMY ARTHROSCOPY RT ANKLE WITH SYNOVECTOMY 10000 10000

3260 BONE GRAFTING BONE GRAFTING 8000 8000

3261 PERCUTANEOUS CANNULATED SCREW FIXATION PERCUTANEOUS CANNULATED SCREW FIXATION 3720 3720

3262 LATERAL COLLATERAL LIGAMENT REPAIR LATERAL COLLATERAL LIGAMENT REPAIR 7000 7000

3263 REMOVAL OF STAPLE REMOVAL OF STAPLE 1240 1240

3264 HEAMATOMA EVACUATION, LARGE HEAMATOMA EVACUATION, LARGE 2485 2485

3265 RESECTION OF OSTEOMYELITIS RESECTION OF OSTEOMYELITIS 3725 3725

3266 REFASIONING OF AMPUTATED STUMP REFASIONING OF AMPUTATED STUMP 4970 4970

3267 REMOVAL OF CERCLAGE WIRE REMOVAL OF CERCLAGE WIRE 3000 3000

3268 LNGTHNING OSTEOTOMY W/ILIZROF TIBIA/FOOT LNGTHNING OSTEOTOMY W/ILIZROF TIBIA/FOOT 74520 74520

3269 MUSCLE REPAIR MUSCLE REPAIR 7000 7000

3270 POSTERIOR CRUSIATE LIGAMENT REPAIR POSTERIOR CRUSIATE LIGAMENT REPAIR 7000 7000

3271 CYST/TUMOR EXCISION SUPER CYST/TUMOR EXCISION SUPER 1240 1240

3272 FIBULAR OSTEOTOMY FIBULAR OSTEOTOMY 2485 2485

3273 REMOVAL OF STITCHES UNDER G.A. REMOVAL OF STITCHES UNDER G.A. 1240 1240

3274 APPLICATION OF POP ABOVE KNEE/CHILD APPLICATION OF POP ABOVE KNEE/CHILD 1240 1240

3275 SPINAL FACET LOCAL INJECTION SPINAL FACET LOCAL INJECTION 1240 1240

3276 K-WIRE FIXATION K-WIRE FIXATION 3000 3000

3277 REDUCTION UNDER I.I+K-WIRE PER PENING REDUCTION UNDER I.I+K-WIRE PER PENING 7000 7000

3278 SECONDARY SUTURES SECONDARY SUTURES 1240 1240

3279 EXTENSOR TENDON REPAIR EXTENSOR TENDON REPAIR 7000 7000

3280 FASCIA RELEIF FASCIA RELEIF 6000 6000

3281 REMOVAL OF POP UNDER G.A. REMOVAL OF POP UNDER G.A. 850 850

3282 CYST OR TUMOR LARGE & DEEP CYST OR TUMOR LARGE & DEEP 2484 2484

3283 ARTHROSCOPY (DIAGNOSTIC) ARTHROSCOPY (DIAGNOSTIC) 10000 10000

3284 ARTHROSCOPY WRIST ARTHROSCOPY WRIST 10000 10000

3285 PATELLECTOMY PATELLECTOMY 4968 4968

3286 TENNIS ELBOW TENNIS ELBOW 6210 6210

3287 MANIPULATE FROZEN JOINT(G.A.) MANIPULATE FROZEN JOINT(G.A.) 2980 2980

3288 BONE SWELLING BIOPSY BONE SWELLING BIOPSY 5380 5380

3289 SKIN GRAFTING LARGE AREA SKIN GRAFTING LARGE AREA 15000 15000

3290 TUMOR EXCISION COMPLEX TUMOR EXCISION COMPLEX 6210 6210

3291 O-REDUCTION/INTERFIX CLAV O-REDUCTION/INTERFIX CLAV 12000 12000

3292 CARPAL TUNNEL SYNDROME SURGERY CARPAL TUNNEL SYNDROME SURGERY 5000 5000

3293 TARSAL TUNNEL SYNDROME SURGERY TARSAL TUNNEL SYNDROME SURGERY 5000 5000

3294 SYNOVECTOMY JOINTS WRST/ELB/KN SYNOVECTOMY JOINTS WRST/ELB/KN 8000 8000

3295 RADIUS HEAD EXCISION RADIUS HEAD EXCISION 6000 6000

3296 ULNA EXCISION LOWER END ULNA EXCISION LOWER END 6210 6210

3297 ARTHRODESIS WRIST ARTHRODESIS WRIST 12000 12000

3298 TENDON TO BONE REPAIR AVULSAD TEND TENDON TO BONE REPAIR AVULSAD TEND 7000 7000

3299 EXCISION SIMPLE TUMOR NO GRAFT (BONE) EXCISION SIMPLE TUMOR NO GRAFT (BONE) 6210 6210

3300 BONE TUMOR EXCISION BONE TUMOR EXCISION 3105 3105

Page 105

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 42 جراحة عظام ORTHOPEDICS

بيان المجموعة 4242 جراحة عظام

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3301 TENDON SUPRASPINATUS CALCIFIED TENDON SUPRASPINATUS CALCIFIED 7000 7000

3302 ACROMION EXCISION ACROMION EXCISION 6210 6210

3303 TENDON REPAIR TENDON REPAIR 7000 7000

3304 ULNAR COLLAT.LIGAMENT REPAIR ULNAR COLLAT.LIGAMENT REPAIR 7000 7000

3305 ULNAR NERVE TRANSFER ULNAR NERVE TRANSFER 18000 18000

3306 FLEXOR TENDON REPAIR FINGER WRIST FLEXOR TENDON REPAIR FINGER WRIST 7000 7000

3307 STERMNOMASTOID TUMOR EXCISION STERMNOMASTOID TUMOR EXCISION 7040 7040

3308 SYNOVECTOMY LOOSE BODIES KNEE SYNOVECTOMY LOOSE BODIES KNEE 8000 8000

3309 RELEASE OF T.E.V. DEFORMITY RELEASE OF T.E.V. DEFORMITY 6210 6210

3310 O-REDUCTION M/C - M/T BONE O-REDUCTION M/C - M/T BONE 7000 7000

3311 OPEN REDUCTION FIBULA OPEN REDUCTION FIBULA 12000 12000

3312 OPEN REDUCTION ELBOW OPEN REDUCTION ELBOW 12000 12000

3313 ASPIRATION/REINJECTION B/MAROW ASPIRATION/REINJECTION B/MAROW 4970 4970

3314 ARTHROSCOPIC TX/OSTEO CHONDRITIS DIFFCNS ARTHROSCOPIC TX/OSTEO CHONDRITIS DIFFCNS 10000 10000

3315 ARTHROSCOPY WITH MENISECTOMY ARTHROSCOPY WITH MENISECTOMY 15000 15000

3316 ARTHROSCOPY WITH MENISCAL REPAIR ARTHROSCOPY WITH MENISCAL REPAIR 15000 15000

3317 DRILLING DRILLING 1100 1100

3318 PATELLOPLASTY PATELLOPLASTY 8690 8690

3319 SURGICAL ARTHROSCOPY SURGICAL ARTHROSCOPY 10000 10000

3320 TENDON GRAFT TENDON GRAFT 7000 7000

3321 Z-PLASTY ONE SIDE Z-PLASTY ONE SIDE 1240 1240

3322 EXCISION OF BAKER'S CYST EXCISION OF BAKER'S CYST 3725 3725

3323 O-REDUCT/INTERFIX ULNA/OLECRAN O-REDUCT/INTERFIX ULNA/OLECRAN 7000 7000

3324 C-REDUCT & PLASTER BED SPINE C-REDUCT & PLASTER BED SPINE 7000 7000

3325 EXC.LOSE BODY(KNEE, HIP,ANKLE) EXC.LOSE BODY(KNEE, HIP,ANKLE) 4000 4000

3326 SOFT TISSUE RELEASE, JOINT SOFT TISSUE RELEASE, JOINT 7450 7450

3327 CORRECT FOOT DEFORMITIES CORRECT FOOT DEFORMITIES 9440 9440

3328 ARTHODESIS ELBOW OR ANKLE ARTHODESIS ELBOW OR ANKLE 7000 7000

3329 OSTEOTOMY FINGER OSTEOTOMY FINGER 4965 4965

3330 ACHILLES TENDON LENGTHENING ACHILLES TENDON LENGTHENING 7000 7000

3331 SEQUESTRECTOMY SHORT BONES SEQUESTRECTOMY SHORT BONES 7000 7000

3332 NERVE EXPLORATION & SUTURING NERVE EXPLORATION & SUTURING 18000 18000

3333 NERVE EXPLORATION NERVE EXPLORATION 18000 18000

3334 EXPLORATION TENDOM ACHILLES EXPLORATION TENDOM ACHILLES 6500 6500

3335 ARTHROSCOPY (SURGICAL) ARTHROSCOPY (SURGICAL) 10000 10000

3336 ARTHROSCOPIC SYNOVECTOMY ARTHROSCOPIC SYNOVECTOMY 10000 10000

3337 O-REDUCT/INTERFIX PATTELLA O-REDUCT/INTERFIX PATTELLA 7000 7000

3338 ARTHROPLASTY SMALL HAND JOINT ARTHROPLASTY SMALL HAND JOINT 7450 7450

3339 OSTEOTOMY TIBIA W/O INTERNAL OSTEOTOMY TIBIA W/O INTERNAL 4970 4970

3340 OSSATRON SOFT TISSUE THERAPY OSSATRON SOFT TISSUE THERAPY 4970 4970

3341 OSTATRON BONEY TISSUE THERAPY OSTATRON BONEY TISSUE THERAPY 6955 6955

3342 MEDIAL COLLATERAL LEGAMENT MEDIAL COLLATERAL LEGAMENT 4965 4965

3343 OSTEOTOMY FIBULA W/O INTERNAL FIXATION OSTEOTOMY FIBULA W/O INTERNAL FIXATION 4965 4965

3344 LAMINECTOMY LAMINECTOMY 9935 9935

Page 106

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 42 جراحة عظام ORTHOPEDICS

بيان المجموعة 4242 جراحة عظام

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3345 OSTEOTOMY SPINAL OSTEOTOMY SPINAL 9935 9935

3346 ARTHROSCOPIC A.C.L KNEE ARTHROSCOPIC A.C.L KNEE 10000 10000

3347 ARTHROSCOPIC ACL REPAIR WITH MENISECTOMY ARTHROSCOPIC ACL REPAIR WITH MENISECTOMY 15000 15000

3348 LAMINECTOMY LAMINECTOMY 9935 9935

3349 ARTHROSCOPIC BANKART REPAIR ARTHROSCOPIC BANKART REPAIR 9935 9935

3350 UNREANED FEMORAL NAILING UNREANED FEMORAL NAILING 12000 12000

3351 SUBTALAR IMPLANT SUBTALAR IMPLANT 31050 31050

3352 MENISCECTOMY OR CYST OF KNEE (OPEN) MENISCECTOMY OR CYST OF KNEE (OPEN) 9935 9935

3353 O.R. INTERNAL FIXATION OF HUMEROUS O.R. INTERNAL FIXATION OF HUMEROUS 7000 7000

3354 O-REDUCT/INTERFIX SHOULDER O-REDUCT/INTERFIX SHOULDER 16000 16000

3355 SEQUESTRECTOMY LONG BONES SEQUESTRECTOMY LONG BONES 12000 12000

3356 O-REDUCT/INTERFIX NEGLECTED FRAC O-REDUCT/INTERFIX NEGLECTED FRAC 12000 12000

3357 O-REDUCT/INTERFIX MALUNITED FRAC O-REDUCT/INTERFIX MALUNITED FRAC 12000 12000

3358 SPINE FUSION FRACTURE/DISLOCAT SPINE FUSION FRACTURE/DISLOCAT 12000 12000

3359 O-REDUCT/INTERFIX SPINE O-REDUCT/INTERFIX SPINE 11175 11175

3360 O-REDUCT/INTER,FIX. FEMUR O-REDUCT/INTER,FIX. FEMUR 12000 12000

3361 O-REDUCT/INTER.FIX. TIBIA O-REDUCT/INTER.FIX. TIBIA 12000 12000

3362 TIBIAL NAILING TIBIAL NAILING 12000 12000

3363 O-REDUCT/INTERFIX PELVIS O-REDUCT/INTERFIX PELVIS 12000 12000

3364 O - REDUCT/INTFIX FEMUR NECK O - REDUCT/INTFIX FEMUR NECK 12000 12000

3365 OSTEOTOMY/INTFIX FEMUR NECK OSTEOTOMY/INTFIX FEMUR NECK 20000 20000

3366 O-REDUCT/INTERFIX CAL/TALUS/ANKL O-REDUCT/INTERFIX CAL/TALUS/ANKL 12000 12000

3367 CORRECT DEFORMED LIMB CORRECT DEFORMED LIMB 9935 9935

3368 TRIPLE FUSION DEFORMITY TRIPLE FUSION DEFORMITY 12000 12000

3369 TENDON TRANSFER TENDON TRANSFER 7000 7000

3370 O-REDUCT INTERFIX MAJOR JOINTS O-REDUCT INTERFIX MAJOR JOINTS 12000 12000

3371 ARTHRODESIS (WS.KN.SHOUL. T.B.) ARTHRODESIS (WS.KN.SHOUL. T.B.) 15000 15000

3372 OSTEOTOMY SUPRACONDYLAR OSTEOTOMY SUPRACONDYLAR 9940 9940

3373 O-REDUCT/INTERFIX MULTP. FIX HAND O-REDUCT/INTERFIX MULTP. FIX HAND 7000 7000

3374 ROTATOR CUFF COMPLETE RUPTURE ROTATOR CUFF COMPLETE RUPTURE 9935 9935

3375 SOFT TISSUE RELEASE + TENDON LENGTHENING SOFT TISSUE RELEASE + TENDON LENGTHENING 7000 7000

3376 ACHILLIS TENDOM REPAIR W/TENDONERAPHY ACHILLIS TENDOM REPAIR W/TENDONERAPHY 7000 7000

3377 ARTHRODESIS HIP ARTHRODESIS HIP 20000 20000

3378 OSTEOTOMY HIP DEFORMITIES OSTEOTOMY HIP DEFORMITIES 10000 10000

3379 AMPUTATION LONG BONES AMPUTATION LONG BONES 20000 20000

3380 EXTERNAL FIXATION EXTERNAL FIXATION 12000 12000

3381 O-REDUCT/HIP DISLOCATION O-REDUCT/HIP DISLOCATION 12000 12000

3382 CORRECT KNEE DEFORMAITY CORRECT KNEE DEFORMAITY 10000 10000

3383 OSTEOTOMY SHORT BONES OSTEOTOMY SHORT BONES 7450 7450

3384 ARTHRODESIS SHOULDER/KNEE ARTHRODESIS SHOULDER/KNEE 20000 20000

3385 SURGERY-RECURRENT SHOULDER DISLOCATION SURGERY-RECURRENT SHOULDER DISLOCATION 16000 16000

3386 EXCISION LARGE TUMOR BONE EXCISION LARGE TUMOR BONE 10000 10000

3387 PUTTI PLAT SURGERY PUTTI PLAT SURGERY 10000 10000

Page 107

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 42 جراحة عظام ORTHOPEDICS

بيان المجموعة 4242 جراحة عظام

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3388 SHOULDER ARTHROSCOPY W/ ACROMIOPLASTY SHOULDER ARTHROSCOPY W/ ACROMIOPLASTY 10000 10000

3389 KNEE ATHROSCOPY W/ PLICA EXCISION KNEE ATHROSCOPY W/ PLICA EXCISION 10000 10000

3390 REPAIR OF TENDON SUPRA SPINATOS REPAIR OF TENDON SUPRA SPINATOS 7000 7000

3391 AUSTIN MOORE HIP PROSTHESIS INSERTION AUSTIN MOORE HIP PROSTHESIS INSERTION 7450 7450

3392 OSTEOTOMY OR EXCISION SCAPULA OSTEOTOMY OR EXCISION SCAPULA 9935 9935

3393 CALCANIUM/KNEE BURSA EXCISION CALCANIUM/KNEE BURSA EXCISION 8000 8000

3394 CERVICAL RIB EXCISION CERVICAL RIB EXCISION 9935 9935

3395 MAJOR JOINTS DISARTICULATION MAJOR JOINTS DISARTICULATION 9935 9935

3396 INTFIX UPPER FEMORAL EPIPHYSIS INTFIX UPPER FEMORAL EPIPHYSIS 9935 9935

3397 OSTEOTOMY TIBIA WITH INTERNAL FIXATION OSTEOTOMY TIBIA WITH INTERNAL FIXATION 9935 9935

3398 ARTHROPLASTY PARTIAL ARTHROPLASTY PARTIAL 9935 9935

3399 KNEE CRUCIATE LIGAMENT REPAIR KNEE CRUCIATE LIGAMENT REPAIR 7000 7000

3400 A.C.L REPAIR (TRAVERA BAND) A.C.L REPAIR (TRAVERA BAND) 11175 11175

3401 A.C.L REPAIR (GORE-TAX BAND) A.C.L REPAIR (GORE-TAX BAND) 11175 11175

3402 PARTIAL KNEE REPLACEMENT PARTIAL KNEE REPLACEMENT 9935 9935

3403 CAVUS FOOT CORRECTION CAVUS FOOT CORRECTION 9935 9935

3404 AMPUTATION HAND/FORE QUARTER AMPUTATION HAND/FORE QUARTER 20000 20000

3405 HAND FINGER DEFORMITY CORRECT HAND FINGER DEFORMITY CORRECT 9935 9935

3406 MICRO DISCECTOMY MICRO DISCECTOMY 12500 12500

3407 RE. INSERTION OF HIP PROSTHESIS RE. INSERTION OF HIP PROSTHESIS 14900 14900

3408 TOTAL KNEE REPLACEMENT TOTAL KNEE REPLACEMENT 12500 12500

3409 TOTAL KNEE REVISION TOTAL KNEE REVISION 12500 12500

3410 HIP REPACEMENT TOTAL HIP REPACEMENT TOTAL 12500 12500

3411 BONE MARROW - ASPIRATION BONE MARROW - ASPIRATION 2895 2895

3412 SPINAL FUSION FOR SCOLIOSIS SPINAL FUSION FOR SCOLIOSIS 12500 12500

3413 ARTHROPLASTY SHOULDER/ELBOW/KNEE ARTHROPLASTY SHOULDER/ELBOW/KNEE 16000 16000

3414 TENDON RELEASE OF LOWER EXTREMITY TENDON RELEASE OF LOWER EXTREMITY 6000 6000

3415 ACL REVISION WITH MENISECTOMY ACL REVISION WITH MENISECTOMY 15000 15000

3416 BONE LENGTHEN OR SHORTEN BONE LENGTHEN OR SHORTEN 12500 12500

3417 EXCISION HETEROTROPIC OSSIFICATION EXCISION HETEROTROPIC OSSIFICATION 8500 8500

3418 CERVICAL MANIPULATION CERVICAL MANIPULATION 2500 2500

3419 CHIPS (4-10MM) 30CC TUTOPLAST CANCELLOUS CHIPS (4-10MM) 30CC TUTOPLAST CANCELLOUS 11000 11000

3420 POSTERIOR CRUSIATE LIGAMENT REPAIR POSTERIOR CRUSIATE LIGAMENT REPAIR 15000 15000

بيان نوع الخدمة 43 امراض الكلى NEPHRELOGY

بيان المجموعة 4343 امراض الكلى

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3539 KIDNEY PERITONEAL DIALYSIS DX KIDNEY PERITONEAL DIALYSIS DX 3725 3725

3540 RENAL DIALYSIS PER SESSION RENAL DIALYSIS PER SESSION 1240 1240

3541 EXPOSURE OF INTERNAL JUGULAR EXPOSURE OF INTERNAL JUGULAR 2480 2480

3542 HAEMODIALYSIS SESSEION ACUTE W/POST OBS HAEMODIALYSIS SESSEION ACUTE W/POST OBS 1985 1985

Page 108

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 43 امراض الكلى NEPHRELOGY

بيان المجموعة 4343 امراض الكلى

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3543 REGIONAL HEPARINIZATION REGIONAL HEPARINIZATION 365 365

3544 TENCKOFF CATHETER INSERTION TENCKOFF CATHETER INSERTION 3725 3725

3545 A.V. SHUNT INSERTION A.V. SHUNT INSERTION 4965 4965

3546 PERCUTANEOUS CENTRAL LINE INSERTION PERCUTANEOUS CENTRAL LINE INSERTION 1240 1240

3547 INSERTION CENTRAL LINE CUT DOWN INSERTION CENTRAL LINE CUT DOWN 2480 2480

3548 EMBOLECTOMY FOR POST GORTEX GRAFT/HAND EMBOLECTOMY FOR POST GORTEX GRAFT/HAND 5175 5175

3549 GORETEX GRAFT REMOVAL GORETEX GRAFT REMOVAL 7450 7450

3550 STRIPPING PLUS LIGATION STRIPPING PLUS LIGATION 6500 6500

3551 AV FISTULA AV FISTULA 9000 9000

3552 GORETEX GRAFT INSERTION GORETEX GRAFT INSERTION 7450 7450

3553 PERM - CATH. INSERTION PERM - CATH. INSERTION 3725 3725

3554 PERM - CATH. REMOVAL PERM - CATH. REMOVAL 1245 1245

3555 INSERTION OF DIALYSIS CATH.-MAHURKAR INSERTION OF DIALYSIS CATH.- MAHURKAR 520 520

بيان نوع الخدمة 44 جراحة الاعصاب NEUROSURGERY

بيان المجموعة 4444 جراحة الاعصاب

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3833 EXTRA LEVEL DISCECTOMY EXTRA LEVEL DISCECTOMY 8000 8000

3834 ELEVATION OF DEPRESSD SKULL FR ELEVATION OF DEPRESSD SKULL FR 4965 4965

3835 REMOVAL OF BRAIN ABSCESS REMOVAL OF BRAIN ABSCESS 5175 5175

3836 LATERAL CUTANEOUS DECOMPRESSION LATERAL CUTANEOUS DECOMPRESSION 4970 4970

3837 VENTRICULAR EXTERNAL DRAINAGE VENTRICULAR EXTERNAL DRAINAGE 3725 3725

3838 BURR HOLE + SUBDURAL HEMATOMA EVAC BURR HOLE + SUBDURAL HEMATOMA EVAC 4140 4140

3839 PEDICULAR SCREW FIXATION PEDICULAR SCREW FIXATION 13665 13665

3840 TRANSPEDICULAR FIXATION TRANSPEDICULAR FIXATION 20700 20700

3841 CERVICAL CAGE & PLATE FIXATION CERVICAL CAGE & PLATE FIXATION 13665 13665

3842 KYPO PLASTY KYPO PLASTY 10350 10350

3843 NEUROLYSIS OF NERVE NEUROLYSIS OF NERVE 4965 4965

3844 SPINE FUSION FRACTURE/DISLOCATION SPINE FUSION FRACTURE/DISLOCATION 11175 11175

3845 EXPLORATION OF WOUND LARGE EXPLORATION OF WOUND LARGE 3725 3725

3846 EXPLORATION OF SMALL WOUND EXPLORATION OF SMALL WOUND 1245 1245

3847 SURAL NERVE BIOPSY SURAL NERVE BIOPSY 4970 4970

3848 EXCISION OF INTRA MEDULLARY CYST EXCISION OF INTRA MEDULLARY CYST 7000 7000

3849 INSERTION OF CYSTOSUBARACHNOID SHUNT INSERTION OF CYSTOSUBARACHNOID SHUNT 18000 18000

3850 EPIDURAL INJECTION EPIDURAL INJECTION 5000 5000

3851 CARPAL TUNNEL SYNDROME CARPAL TUNNEL SYNDROME 5000 5000

3852 ULNAR NERVE TRANSPOSITION ULNAR NERVE TRANSPOSITION 18000 18000

3853 DURAL REPAIR, GRAFT DURAL REPAIR, GRAFT 6210 6210

3854 EVACUATION OF INTRACRANIAL HGE EVACUATION OF INTRACRANIAL HGE 7450 7450

3855 VENTRICULO-PERITONEAL SHUNT VENTRICULO-PERITONEAL SHUNT 9940 9940

3856 VENTRICULO-VENUS SHUNT VENTRICULO-VENUS SHUNT 9940 9940

3857 LUMBO PERITONEAL SHUNT LUMBO PERITONEAL SHUNT 8280 8280

Page 109

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 44 جراحة الاعصاب NEUROSURGERY

بيان المجموعة 4444 جراحة الاعصاب

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

3858 REPAIR OF MENINGOCELE REPAIR OF MENINGOCELE 8280 8280

3859 SKULL TONGS SKULL TONGS 3725 3725

3860 BILAT. EVACUATION OF SUBDURAL HEMAT. BILAT. EVACUATION OF SUBDURAL HEMAT. 6210 6210

3861 NERVE REPAIR NERVE REPAIR 875 875

3862 CRANIOTOMY, REMOVAL OF F.B. CRANIOTOMY, REMOVAL OF F.B. 9935 9935

3863 CRANIOPLASTY CRANIOPLASTY 9935 9935

3864 FORAMENOTOMY FORAMENOTOMY 8280 8280

3865 LAMINECTOMY LAMINECTOMY 9935 9935

3866 LAMINECTOMY & DISCECTOMY LAMINECTOMY & DISCECTOMY 11385 11385

3867 INTERNAL FIXATION OF CERVICAL SPINE INTERNAL FIXATION OF CERVICAL SPINE 11175 11175

3868 O-REDUCT/INTERFIX SPINE O-REDUCT/INTERFIX SPINE 11175 11175

3869 SURGERY FOR ANEURYSM IN BRAIN SURGERY FOR ANEURYSM IN BRAIN 11385 11385

3870 FENEFTRATION + DISCECTOMY FENEFTRATION + DISCECTOMY 11385 11385

3871 REMOVAL OF BRAIN TUMOR REMOVAL OF BRAIN TUMOR 11385 11385

3872 RECURRENT LUMBAR DISC RECURRENT LUMBAR DISC 13665 13665

3873 CERVICAL DISC CLOWARD OP. 1 LVL CERVICAL DISC CLOWARD OP. 1 LVL 11385 11385

3874 REMOVAL OF SPINAL TUMOR REMOVAL OF SPINAL TUMOR 11385 11385

3875 CORPECTOMY CORPECTOMY 12500 12500

3876 BRACHIAL PLEXUS EXPLORATION BRACHIAL PLEXUS EXPLORATION 12500 12500

3877 EXPLORATION OF SCIATIC NERVE EXPLORATION OF SCIATIC NERVE 12500 12500

3878 SUPRASELLAR HYPOPHYSECTOMY SUPRASELLAR HYPOPHYSECTOMY 11385 11385

3879 TRANSNASAL HYPOPHYSECTOMY TRANSNASAL HYPOPHYSECTOMY 13665 13665

3880 MICRO DISCECTOMY MICRO DISCECTOMY 11385 11385

بيان نوع الخدمة 45 فحوصات خاصه SPECIAL INVESTIGATION

بيان المجموعة 4545 فحوصات خاصة

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

150 medicals medicals 1000 1000 0

2466 SIALOGRAPHY SIALOGRAPHY 700 700

2467 FISTULOGRAM/SINOGRAM FISTULOGRAM/SINOGRAM 700 700

2468 HSG (HYSTEROSALPINGIOGRAPHY) HSG (HYSTEROSALPINGIOGRAPHY) 1000 1000

2469 TOMOGRAPHY TOMOGRAPHY 800 800

2470 MAMMOGRAM (2 BREAST) MAMMOGRAM (2 BREAST) 800 800

2471 MAMMOGRAPHY (1 BREAST) MAMMOGRAPHY (1 BREAST) 450 450

2472 MAMMOGRAM + U.S. BREAST MAMMOGRAM + U.S. BREAST 1780 1780

2473 DEXA (DENSITOMETRY) 1-REGION DEXA (DENSITOMETRY) 1-REGION 1700 1700

2474 DEXA (DENSITOMETRY) 2-REGION DEXA (DENSITOMETRY) 2-REGION 1700 1700

2475 TOTAL BODY COMPOSITION TOTAL BODY COMPOSITION 935 935

بيان نوع الخدمة 47 فتح ملف و التشخيص OPEN FILE AND DIGNOSIS

بيان المجموعة 4647 خدمات تجميلية make up

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

4650 فتح ملف و التشخيص OPEN FILE AND DIGNOSIS

Page 110

To Excle

بيان عن الخدمات الطبية المعتمدة لدى المنشأة واسعارها المبدئية

بيان نوع الخدمة 48 الاستخراج الجراحي والخدمہ الجراحيہ الاخر SURGICAL EXTRACTION AND OTHER SURGICAL S

بيان المجموعة 0 غير معرف غير معرف

كود الخدمة الاسم العربى الاسم اللاتيني السعر للنقدى سعر الادوية سعر شركات تخفيض %

169 تحسس الاطعمه تحسس الاطعمه 400

170

4529

العدد للخدمات