senarai kadar caj yang telah mendapat kelulusan … fileptj : jk.36 : jabatan perkhidmatan radiologi...

PTJ : JK.36 : JABATAN PERKHIDMATAN

RADIOLOGI (JRAD)

Sub PTJ : JK.36.01 : MAMMOGRAM

NoID

ChargeItem Charge Code / Name

Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

1 672

10672 - MAMMOGRAM - HOOKWIRE

LOCALISATION 100.00 200.00 355.00 0

2 673

10673 - MAMMOGRAM - STEREOTACTIC

BIOPSY 425.00 850.00 2,246.00 0

3 674 10674 - MA_USGUIDED-BIOPSY 100.00 200.00 251.00 0

4 675 10675 - MA_DUCTOGRAM 50.00 100.00 176.00 0

5 6170 15903 - MA_MAMMOGRAM 50.00 100.00 174.00 0

6 6183 15916 - MA_ULTRASOUND 3D (ABVS) 50.00 100.00 148.00 0

7 6185 15918 - MA_STEREO BARD BIOPSY 100.00 200.00 344.00 0

8 6188 15920 - MA_ULTRASOUND BREAST 10.00 20.00 124.00 0

9 8398 10676 - MA_USFNAC 100.00 200.00 220.00 0

10 8928

18382 - MA_MAMMOGRAM DAN

U/SOUND 50.00 100.00 260.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.02 : CT SCAN

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

1 707 10707 - CT SCAN - NECK WITH CONTRAST 225.00 450.00 762.00 0

2 746 10746 - CT_PARANASAL SINUSES 225.00 450.00 631.00 0

3 764 10764 - CT_CTA - ABDOMINAL AORTA 300.00 600.00 668.00 0

4 765 10765 - CT_CTA - THORACIC AORTA 300.00 600.00 668.00 0

5 766 10766 - CT_CTA - CIRCLE OF WILLIS 300.00 600.00 668.00 0

6 767 10767 - CT_CTA - INT JUGULAR VEIN 300.00 600.00 601.00 0

7 768 10768 - CT_CTA - UPPER LIMB 300.00 600.00 735.00 0

8 769 10769 - CT_CTA - LOWER LIMB 300.00 600.00 735.00 0

9 770 10770 - CT_CTA - INF VENA CAVA 300.00 600.00 601.00 0

10 771 10771 - CT_CTA - CORONARY 450.00 900.00 735.00 0

11 772 10772 - CT_CTA - CEREBRAL VESSEL 300.00 600.00 735.00 0

12 776 10776 - CT_BASE OF SKULL 200.00 400.00 763.00 0

13 777 10777 - CT_NECK 200.00 400.00 762.00 0

SENARAI KADAR CAJ YANG TELAH MENDAPAT KELULUSAN

( JABATAN RADIOLOGI )

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

14 778 10778 - CT_TEMPORAL BONE 200.00 400.00 601.00 0

15 781 10781 - CT_3D SKULL 200.00 400.00 601.00 0

16 822 10822 - CT_DRAINAGE 225.00 450.00 934.00 0

17 6246 15977 - CT_BRAIN 200.00 400.00 601.00 0

18 8469 17928 - CT_SHOULDER 200.00 400.00 601.00 0

19 8470 17929 - CT_BRAIN - KONTRAS 225.00 450.00 631.00 0

20 8471 17930 - CT_ORBITS 200.00 400.00 601.00 0

21 8472 17931 - CT_ORBITS - KONTRAS 225.00 450.00 631.00 0

22 8473 17932 - CT_PIT FOSSA 200.00 400.00 601.00 0

23 8474 17933 - CT_PIT FOSSA - KONTRAS 225.00 450.00 630.00 0

24 8475 17934 - CT_POSTNASAL SPACE 200.00 400.00 601.00 0

25 8476 17935 - CT_POSTNASAL SPACE - KONTRAS 225.00 450.00 630.00 0

26 8477

17936 - CT_PARANASAL SINUSES -

KONTRAS 225.00 450.00 630.00 0

27 8478 17938 - CT_TEMPORAL BONE - KONTRAS 225.00 450.00 601.00 0

28 8480 17939 - CT_BASE OF SKULL - KONTRAS 225.00 450.00 763.00 0

29 8481 17940 - CT_FACIAL BONE 200.00 400.00 601.00 0

30 8483 17943 - CT_THORAX 200.00 400.00 601.00 0

31 8485 17944 - CT_THORAX - KONTRAS 225.00 450.00 763.00 0

32 8487

17946 -

CT_NECK/THORAX/ABDOMEN/PELVIS -

KONTRAS 325.00 650.00 825.00 0

33 8492

17951 - CT_THORAX/ABDOMEN/PELVIS -

KONTRAS 275.00 550.00 825.00 0

34 8493 17952 - CT_NECK/THORAX - KONTRAS 275.00 550.00 762.00 0

35 8496 17955 - CT_ABDOMEN KONTRAS 225.00 450.00 825.00 0

36 8497 17956 - CT_ADRENAL - KONTRAS 225.00 450.00 825.00 0

37 8498 17957 - CT_HEPATOBILIARY - KONTRAS 225.00 450.00 825.00 0

38 8500 17958 - CT_KIDNEY - KONTRAS 225.00 450.00 825.00 0

39 8501 17960 - CT_ LIVER - KONTRAS 225.00 450.00 825.00 0

40 8503 17962 - CT_ CTU 200.00 400.00 601.00 0

41 8509 17968 - CT_WHOLE BODY 200.00 400.00 601.00 0

42 8510 17970 - CT_BIOPSY 200.00 400.00 812.00 0

43 8512 17971 - CT_CERVICAL SPINE 200.00 400.00 601.00 0

44 8514 17973 - CT_THORACIC SPINE 200.00 400.00 601.00 0

45 8516 17975 - CT_THORACIC SPINE - KONTRAS 225.00 450.00 660.00 0

46 8517 17977 - CT_ LUMBAR SPINE 200.00 400.00 601.00 0

47 8519

17979 - CT_LUMBOSACRAL SPINE -

KONTRAS 225.00 450.00 601.00 0

48 8521 17980 - CT_WHOLE SPINE - KONTRAS 225.00 450.00 601.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

49 8524 17983 - CT_CTA - CAROTID 300.00 600.00 772.00 0

50 8526 17985 - CT_CTA - AORTA 300.00 600.00 772.00 0

51 8528 17986 - CT_CTA - LIVER 300.00 600.00 772.00 0

52 8530 17989 - CT_CTA - PULMONARY 300.00 600.00 772.00 0

53 8533 17991 - CT_SHOULDER - BOTH 250.00 500.00 601.00 0

54 8534 17992 - CT_HUMERUS - BOTH 250.00 500.00 601.00 0

55 8535 17993 - CT_HUMERUS 200.00 400.00 601.00 0

56 8536 17994 - CT_ ELBOW - BOTH 250.00 500.00 601.00 0

57 8537 17995 - CT_ ELBOW 200.00 400.00 601.00 0

58 8539 17998 - CT_RADIUS/ULNA - BOTH 250.00 500.00 601.00 0

59 8541 17999 - CT_ RADIUS/ULNA 200.00 400.00 601.00 0

60 8542 18000 - CT_ WRIST - BOTH 250.00 500.00 601.00 0

61 8543 18001 - CT_ WRIST 200.00 400.00 601.00 0

62 8544 18002 - CT_HAND - BOTH 250.00 500.00 601.00 0

63 8545 18003 - CT_HAND 200.00 400.00 601.00 0

64 8546 18004 - CT_HIP - BOTH 250.00 500.00 601.00 0

65 8547 18005 - CT_FEMUR - BOTH 250.00 500.00 601.00 0

66 8548 18006 - CT_FEMUR 200.00 400.00 601.00 0

67 8549 18007 - CT_TIBIA/FIBULA - BOTH 250.00 500.00 601.00 0

68 8550 18008 - CT_TIBIA/FIBULA 200.00 400.00 601.00 0

69 8551 18009 - CT_KNEE - BOTH 250.00 500.00 601.00 0

70 8552 18010 - CT_KNEE 200.00 400.00 601.00 0

71 8553 18011 - CT_ANKLE - BOTH 250.00 500.00 601.00 0

72 8554 18012 - CT_ ANKLE 200.00 400.00 601.00 0

73 8555 18013 - CT_ FEET - BOTH 250.00 500.00 601.00 0

74 8556 18014 - CT_ FOOT 200.00 400.00 601.00 0

75 8557 18015 - CT_CALCANEUM - BOTH 250.00 500.00 601.00 0

76 8558 18016 - CT_CALCANEUM 250.00 500.00 601.00 0

77 8559

18017 -

CT_BRAIN/NECK/THORAX/ABDOMEN/PELVI 350.00 700.00 825.00 0

78 8560 18019 - CT_ IVU 275.00 550.00 825.00 0

79 8562 18020 - CT_CTA - PERFUSION 350.00 700.00 927.00 0

80 8564 18022 - CT_NECK - KONTRAS 225.00 450.00 762.00 0

81 8566 18024 - CT_COLONOSCOPY 225.00 450.00 603.00 0

82 8568 18026 - CT_PELVIS 200.00 400.00 601.00 0

83 8570 18028 - CT_PELVIS - KONTRAS 225.00 450.00 825.00 0

84 8572 18030 - CT_WHOLE BODY - KONTRAS 225.00 450.00 825.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

85 8574 18032 - CT_FLURO 200.00 400.00 601.00 0

86 8576 18034 - CT_MYELO-CERVICAL 225.00 450.00 726.00 0

87 8578 18036 - CT_MYELO-CISTERNOGRAPHY 225.00 450.00 722.00 0

88 8579 18037 - CT_ MYELO-LUMBAR 225.00 450.00 726.00 0

89 8581 18039 - CT_MYELO-THORACIC 225.00 450.00 726.00 0

90 8582 18040 - CT_CERVICAL SPINE - KONTRAS 225.00 450.00 653.00 0

91 8584 18042 - CT_LUMBAR SPINE - KONTRAS 225.00 450.00 630.00 0

92 8587 18045 - CT_ LUMBOSACRAL SPINE 200.00 400.00 601.00 0

93 8589 18046 - CT_WHOLE SPINE 200.00 400.00 601.00 0

94 8592 18049 - CT_HIP 200.00 400.00 601.00 0

95 8830 18285 - CT_ABDOMEN 200.00 400.00 825.00 0

96 8831 18286 - CT_PANCREAS - KONTRAS 225.00 450.00 825.00 0

97 8901 10693 - CT BRAIN WITH CONTRAST 275.00 550.00 630.00 0

98 8925 18377 - CT_BRAIN/NECK - KONTRAS 275.00 550.00 630.00 0

PTJ :JK.36 : JABATAN PERKHIDMATAN

RADIOLOGI (JRAD)

Sub PTJ : JK.36.03 : MRI

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

1 929 10929 - MR_BRAIN - FUNCTIONAL 500.00 1,000.00 1,100.00 0

2 931 10931 - MR_NECK 325.00 650.00 836.00 0

3 933 10933 - MR_PARANASAL SINUSES 325.00 650.00 836.00 0

4 952 10952 - MR_TMJ 325.00 650.00 838.00 0

5 954 10954 - MR_THORAX 325.00 650.00 836.00 0

6 980 10980 - MR_PELVIS 325.00 650.00 836.00 0

7 8600 18056 - MR_BRAIN 325.00 650.00 836.00 0

8 8601 18058 - MR_BRAIN FUNCTIONAL - KONTRAS 500.00 1,000.00 1,100.00 0

9 8605 18062 - MR_ORBIT 325.00 650.00 836.00 0

10 8607 18064 - MR_PIT FOSSA 325.00 650.00 836.00 0

11 8609 18066 - MR_BASE OF SKULL 325.00 650.00 836.00 0

12 8610 18067 - MR_BRACHIAL PLEXUS 325.00 650.00 836.00 0

13 8627 18084 - MR_ABDOMEN 325.00 650.00 836.00 0

14 8628 18085 - MR_ADRENALS 325.00 650.00 836.00 0

15 8630 18087 - MR_LIVER 325.00 650.00 836.00 0

16 8631 18088 - MR_KIDNEYS 325.00 650.00 836.00 0

17 8632 18089 - MR_PANCREAS 325.00 650.00 836.00 0

18 8637 18094 - MR_UROGRAPHY 325.00 650.00 836.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

19 8639 18096 - MR_ MRCP 325.00 650.00 836.00 0

20 8641 18097 - MR_ENTEROGRAPHY 400.00 800.00 836.00 0

21 8647 18104 - MR_HSG 325.00 650.00 836.00 0

22 8648 18105 - MR_PROSTATE 325.00 650.00 836.00 0

23 8649 18107 - MR_ANO FISTULA 325.00 650.00 845.00 0

24 8650 18108 - MR_PENIS 375.00 750.00 918.00 0

25 8652 18110 - MR_SPECTROSCOPY - KONTRAS 375.00 750.00 918.00 0

26 8654 18112 - MR_CAROTID - KONTRAS 400.00 800.00 1,014.00 0

27 8655 18113 - MR_CERVICAL SPINE 325.00 650.00 836.00 0

28 8701 18160 - MR_CERVICOTHORACIC SPINE 325.00 650.00 836.00 0

29 8702 18161 - MR_THORACIC SPINE 325.00 650.00 836.00 0

30 8703 18162 - MR_THORACOLUMBAR SPINE 325.00 650.00 836.00 0

31 8704 16876 - MR_LUMBOSACRAL SPINE 325.00 650.00 836.00 0

32 8705 18163 - MR_WHOLE SPINE 325.00 650.00 836.00 0

33 8706 18164 - MR_MYELOGRAPHY 325.00 650.00 836.00 0

34 8707 18165 - MR_SHOULDER 325.00 650.00 836.00 0

35 8708 18166 - MR_SHOULDER BOTH 325.00 650.00 836.00 0

36 8709 18167 - MR_HUMERUS 325.00 650.00 836.00 0

37 8710 18168 - MR_HUMERUS BOTH 400.00 800.00 836.00 0

38 8711 18169 - MR_HUMERUS BOTH - KONTRAS 400.00 800.00 918.00 0

39 8712 18170 - MR_ELBOW 325.00 650.00 836.00 0

40 8713 18171 - MR_ELBOW BOTH 400.00 800.00 836.00 0

41 8714 18172 - MR_ELBOW BOTH - KONTRAS 400.00 800.00 918.00 0

42 8715 18173 - MR_RAD/ULNA 325.00 650.00 836.00 0

43 8716 18174 - MR_RAD/ULNA BOTH 400.00 800.00 836.00 0

44 8717 18175 - MR_RAD/ULNA BOTH - KONTRAS 400.00 800.00 918.00 0

45 8718 18176 - MR_WRIST 325.00 650.00 836.00 0

46 8719 18177 - MR_WRIST BOTH 400.00 800.00 836.00 0

47 8720 18178 - MR_WRIST BOTH - KONTRAS 400.00 800.00 918.00 0

48 8721 18179 - MR_HAND 325.00 650.00 836.00 0

49 8722 18180 - MR_HAND BOTH 400.00 800.00 836.00 0

50 8723 18181 - MR_HAND BOTH - KONTRAS 400.00 800.00 918.00 0

51 8724 18182 - MR_HIP JOINT 325.00 650.00 836.00 0

52 8725 18183 - MR_HIP JOINT BOTH 400.00 800.00 836.00 0

53 8726 18184 - MR_HIP JOINT BOTH - KONTRAS 400.00 800.00 918.00 0

54 8727 18185 - MR_FEMUR 325.00 650.00 836.00 0

55 8728 18186 - MR_FEMUR BOTH 400.00 800.00 836.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

56 8729 18187 - MR_FEMUR BOTH - KONTRAS 400.00 800.00 918.00 0

57 8730 18188 - MR_KNEE 325.00 650.00 836.00 0

58 8731 18189 - MR_KNEE BOTH 400.00 800.00 836.00 0

59 8732 18190 - MR_KNEE BOTH - KONTRAS 400.00 800.00 918.00 0

60 8733 18191 - MR_TIBIA/FIBULA 325.00 650.00 836.00 0

61 8734 18192 - MR_TIBIA/FIBULA(L) 325.00 650.00 836.00 0

62 8735 18193 - MR_TIBIA/FIBULA BOTH - KONTRAS 400.00 800.00 918.00 0

63 8736 18194 - MR_ANKLE 325.00 650.00 836.00 0

64 8737 18195 - MR_ANKLE BOTH 400.00 800.00 836.00 0

65 8738 18196 - MR_ANKLE BOTH - KONTRAS 400.00 800.00 918.00 0

66 8739 18197 - MR_FOOT 325.00 650.00 836.00 0

67 8740 18198 - MR_ FEET BOTH 400.00 800.00 836.00 0

68 8741 18199 - MR_FEET BOTH - KONTRAS 400.00 800.00 918.00 0

69 8742 18200 - MR_ARTHROGRAM 325.00 650.00 918.00 0

70 8743 18201 - MR_ARTHROGRAM BOTH 400.00 800.00 836.00 0

71 8744

18202 - MR_ARTHROGRAM BOTH -

KONTRAS 400.00 800.00 836.00 0

72 8745 18203 - MR_BRAIN T2 RELAXOMETRY 375.00 750.00 918.00 0

73 8746 18204 - MR_BRAIN TRACTOGRAPHY 375.00 750.00 918.00 0

74 8747 18205 - MR_BRAIN CSF FLOW STUDY 375.00 750.00 918.00 0

75 8748 18206 - MR_BRAIN VESSELS FLOW STUDY 375.00 750.00 918.00 0

76 8750 18208 - MR_ORBIT - KONTRAS 350.00 700.00 918.00 0

77 8832 18287 - MR_PIT FOSSA - KONTRAS 350.00 700.00 918.00 0

78 8833 18288 - MR_CP ANGLE/IAC - KONTRAS 350.00 700.00 918.00 0

79 8834 18289 - MR_TMJ - KONTRAS 350.00 700.00 921.00 0

80 8835

18290 - MR_PARANASAL SINUSES -

KONTRAS 350.00 700.00 918.00 0

81 8836 18291 - MR_BASE OF SKULL - KONTRAS 350.00 700.00 918.00 0

82 8837 18292 - MR_NECK - KONTRAS 350.00 700.00 918.00 0

83 8838 18293 - MR_BRACHIAL PLEXUS - KONTRAS 350.00 700.00 918.00 0

84 8839 18294 - MR_THORAX - KONTRAS 350.00 700.00 918.00 0

85 8840 18295 - MR_BREAST 325.00 650.00 1,014.00 0

86 8841 18296 - MR_BREAST - KONTRAS 350.00 700.00 1,014.00 0

87 8842 18297 - MR_ABDOMEN - KONTRAS 350.00 700.00 918.00 0

88 8843 18298 - MR_ADRENALS - KONTRAS 350.00 700.00 918.00 0

89 8844 18299 - MR_LIVER - KONTRAS 350.00 700.00 1,791.00 0

90 8845 18300 - MR_KIDNEYS - KONTRAS 350.00 700.00 1,014.00 0

91 8846 18301 - MR_PANCREAS - KONTRAS 350.00 700.00 918.00 0

92 8847 18302 - MR_UROGRAPHY - KONTRAS 350.00 700.00 918.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

93 8848 18303 - MR_MRCP - KONTRAS 350.00 700.00 918.00 0

94 8849 18304 - MR_PELVIS - KONTRAS 350.00 700.00 918.00 0

95 8850 18305 - MR_HSG - KONTRAS 350.00 700.00 918.00 0

96 8851 18306 - MR_PROSTATE - KONTRAS 350.00 700.00 1,014.00 0

97 8852 18307 - MR_TESTIS - KONTRAS 350.00 700.00 918.00 0

98 8853 18308 - MR_ANO FISTULA - KONTRAS 350.00 700.00 927.00 0

99 8855 18309 - MR_PENIS - KONTRAS 350.00 700.00 836.00 0

100 8857 18311 - MR_MRA/V BRAIN - TOF 350.00 700.00 918.00 0

101 8858 18312 - MR_MRA/V BRAIN - KONTRAS 400.00 800.00 1,014.00 0

102 8859 18313 - MR_CAROTID - TOF 350.00 700.00 918.00 0

103 8860 18314 - MR_MRA ARCH AORTA 375.00 750.00 1,014.00 0

104 8861 18315 - MR_MRA THORACIC AORTA 375.00 750.00 1,014.00 0

105 8862 18316 - MR_MRA PULMONARY 375.00 750.00 1,014.00 0

106 8863 18317 - MR_MRA ABDOMINAL AORTA 375.00 750.00 1,014.00 0

107 8864 18318 - MR_MRA RENAL 375.00 750.00 1,014.00 0

108 8865 18319 - MR_MRA UPPER LIMB RIGHT 375.00 750.00 1,014.00 0

109 8866 18320 - MR_MRA UPPER LIMB LEFT 375.00 750.00 1,014.00 0

110 8867 18321 - MR_MRA UPPER LIMB BOTH 375.00 750.00 1,014.00 0

111 8868 18322 - MR_MRV IJV 375.00 750.00 1,014.00 0

112 8869 18323 - MR_MRV VENA CAVA 375.00 750.00 1,014.00 0

113 8870 18324 - MR_CERVICAL SPINE 325.00 650.00 836.00 0

114 8871 18325 - MR_CERVICAL SPINE - KONTRAS 350.00 700.00 918.00 0

115 8873

18327 - MR_CERVICOTHORACIC SPINE -

KONTRAS 350.00 700.00 918.00 0

116 8874 18328 - MR_THORACIC SPINE - KONTRAS 350.00 700.00 918.00 0

117 8875

18329 - MR_THORACOLUMBAR SPINE -

KONTRAS 350.00 700.00 918.00 0

118 8876

18330 - MR_LUMBOSACRAL SPINE -

KONTRAS 350.00 700.00 918.00 0

119 8877 18331 - MR_WHOLE SPINE - KONTRAS 350.00 700.00 918.00 0

120 8878 18332 - MR_MYELOGRAPHY - KONTRAS 350.00 700.00 918.00 0

121 8879 18333 - MR_SHOULDER - KONTRAS 350.00 700.00 918.00 0

122 8880 18334 - MR_SHOULDER BOTH - KONTRAS 350.00 700.00 918.00 0

123 8881 18335 - MR_HUMERUS - KONTRAS 350.00 700.00 918.00 0

124 8882 18336 - MR_RAD/ULNA - KONTRAS 350.00 700.00 918.00 0

125 8883 18337 - MR_WRIST - KONTRAS 350.00 700.00 918.00 0

126 8884 18338 - MR_HAND - KONTRAS 350.00 700.00 918.00 0

127 8885 18339 - MR_HIP JOINT - KONTRAS 350.00 700.00 918.00 0

128 8886 18340 - MR_FEMUR - KONTRAS 350.00 700.00 918.00 0

129 8887 18341 - MR_TIBIA/FIBULA - KONTRAS 325.00 700.00 918.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

130 8888 18342 - MR_ANKLE - KONTRAS 350.00 700.00 918.00 0

131 8889 18343 - MR_FOOT - KONTRAS 350.00 700.00 918.00 0

132 8890 18344 - MR_ARTHROGRAM - KONTRAS 350.00 700.00 918.00 0

133 8902 18355 - MR_THORAX T2* LIVER & HEART 325.00 650.00 1,053.00 0

134 8903 18356 - MR_BRAIN - KONTRAS 350.00 700.00 918.00 0

135 8921 18373 - MR_TESTIS 325.00 650.00 836.00 0

136 8922 18374 - MR_ELBOW - KONTRAS 350.00 700.00 918.00 0

137 8923 18375 - MR_KNEE - KONTRAS 350.00 700.00 918.00 0

138 9095 10956 - MR_CARDIAC 325.00 650.00 875.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.04 : X RAY

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

1 8751 18209 - XR_SKELETAL SURVEY 50.00 100.00 106.00 0

2 8752 18210 - XR_CERVICAL 20.00 40.00 102.00 0

3 8753 18211 - XR_THORACIC 20.00 40.00 104.00 0

4 8754 18212 - XR_T/LUMBAR 20.00 40.00 104.00 0

5 8755 18213 - XR_LUMBAR 20.00 40.00 104.00 0

6 8758 18214 - XR_L/SACRAL 20.00 40.00 104.00 0

7 8759 18215 - XR_SACRUM 20.00 40.00 104.00 0

8 8760 18216 - XR_COCCYX 20.00 40.00 104.00 0

9 8761 18217 - XR_WHOLE SPINE 20.00 40.00 102.00 0

10 8762 18218 - XR_CLAVICLE BOTH 20.00 40.00 101.00 0

11 8763 18219 - XR_SCAPULAR BOTH 20.00 40.00 113.00 0

12 8764 18220 - XR_SHOULDER BOTH 20.00 40.00 113.00 0

13 8765 18221 - XR_HUMERUS BOTH 20.00 40.00 113.00 0

14 8766 18222 - XR_ELBOW BOTH 20.00 40.00 113.00 0

15 8767 18223 - XR_RAD/ULNA BOTH 20.00 40.00 113.00 0

16 8768 18224 - XR_WRIST BOTH 20.00 40.00 113.00 0

17 8769 18225 - XR_SCAPHOID BOTH 20.00 40.00 113.00 0

18 8770 18226 - XR_HAND BOTH 20.00 40.00 112.00 0

19 8771 18227 - XR_HIP BOTH 20.00 40.00 115.00 0

20 8772 18228 - XR_FEMUR BOTH 20.00 40.00 113.00 0

21 8773 18229 - XR_KNEE BOTH 20.00 40.00 113.00 0

22 8774 18230 - XR_PATELLA BOTH 20.00 40.00 113.00 0

23 8775 18231 - XR_TIB/FIB 12.50 25.00 101.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

24 8776 18232 - XR_TIB/FIB BOTH 20.00 40.00 113.00 0

25 8777 18233 - XR_ANKLE BOTH 20.00 40.00 113.00 0

26 8778 18234 - XR_FEET BOTH 20.00 40.00 113.00 0

27 8779 18235 - XR_CALCANEUM BOTH 20.00 40.00 113.00 0

28 8780 18236 - XR_SCANOGRAM BOTH 20.00 40.00 102.00 0

29 8781 18237 - XR_SXR 12.50 25.00 101.00 0

30 8782 18238 - XR_PIT FOSSA 12.50 25.00 102.00 0

31 8783 18239 - XR_OPTIC FORAMENA 12.50 25.00 102.00 0

32 8784 18240 - XR_ORBIT 12.50 25.00 102.00 0

33 8785 18241 - XR_IAM 12.50 25.00 102.00 0

34 8786 18242 - XR_MANDIBLE 12.50 25.00 102.00 0

35 8787 18243 - XR_MASTOIDS 17.50 35.00 102.00 0

36 8788 18244 - XR_FACIAL BONES 12.50 25.00 102.00 0

37 8789 18245 - XR_MAXILLA 12.50 25.00 102.00 0

38 8790 18246 - XR_POST NASAL SPACE 12.50 25.00 101.00 0

39 8791 18247 - XR_NECK 17.50 35.00 102.00 0

40 8792 18248 - XR_CHEST 12.50 25.00 102.00 0

41 8793 18249 - XR_STERNUM 12.50 25.00 102.00 0

42 8794 18250 - XR_PRONOGRAM 12.50 25.00 102.00 0

43 8795 18251 - XR_CLAVICLE 12.50 25.00 101.00 0

44 8796 18252 - XR_SCAPULAR 12.50 25.00 101.00 0

45 8797 18253 - XR_SHOULDER 12.50 25.00 101.00 0

46 8798 18254 - XR_ST/CLAVICULAR JOINT 12.50 25.00 101.00 0

47 8799 18255 - XR_HUMERUS 12.50 25.00 101.00 0

48 8800 18256 - XR_ELBOW 12.50 25.00 101.00 0

49 8801 18257 - XR_RAD/ULNA 12.50 25.00 101.00 0

50 8802 18258 - XR_WRIST 12.50 25.00 101.00 0

51 8803 18259 - XR_SCAPHOID 12.50 25.00 101.00 0

52 8804 18260 - XR_HAND 12.50 25.00 101.00 0

53 8805 18261 - XR_FINGER 12.50 25.00 101.00 0

54 8806 18262 - XR_PELVIC 12.50 25.00 102.00 0

55 8807 18263 - XR_SACRO ILLIAC JOINT 12.50 25.00 104.00 0

56 8808 18264 - XR_HIP JOINT 12.50 25.00 102.00 0

57 8809 18265 - XR_FEMUR 12.50 25.00 101.00 0

58 8810 18266 - XR_KNEE 12.50 25.00 101.00 0

59 8811 18267 - XR_PATELLA 12.50 25.00 101.00 0

60 8812 18268 - XR_ANKLE 12.50 25.00 101.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

61 8813 18269 - XR_FOOT 12.50 25.00 101.00 0

62 8814 18270 - XR_CALCANEUM 12.50 25.00 101.00 0

63 8891 18345 - XR_NASAL BONE 12.50 25.00 101.00 0

64 8892 18346 - XR_COCHLEAR IMPLANT 12.50 25.00 102.00 0

65 8893 18347 - XR_PARANASAL SINUSES 12.50 25.00 102.00 0

66 8894 18348 - XR_ABDOMEN 12.50 25.00 102.00 0

67 8895 18349 - XR_KUB 12.50 25.00 102.00 0

68 8896 18350 - XR_ELP 12.50 25.00 102.00 0

69 8924 18376 - XR_UG-CLAVICLE (BOTH) 20.00 40.00 113.00 0

70 8926 18378 - XR_TOES 12.50 25.00 101.00 0

71 8927 18379 - XR_SCANOGRAM LL 12.50 25.00 102.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.05 : ULTRASOUND

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

1 1193 11193 - US_OK 432 INJECTION 50.00 100.00 366.00 0

2 1194 11194 - US_BLEOMYCIN INJECTION 50.00 100.00 366.00 0

3 1195 11195 - US_CHEST 25.00 50.00 152.00 0

4 1200 11200 - US_HEPATOBILIARY 25.00 50.00 152.00 0

5 8479 17937 - US_BRAIN 25.00 50.00 163.00 0

6 8482 17941 - US_ THYROID 25.00 50.00 152.00 0

7 8484 17942 - US_NECK 25.00 50.00 152.00 0

8 8486 17945 - US_ BREAST 25.00 50.00 152.00 0

9 8488 17947 - US_UPPER ABDOMEN 25.00 50.00 152.00 0

10 8489 17948 - US_ABDOMEN 25.00 50.00 163.00 0

11 8490 17949 - US_PELVIS 25.00 50.00 141.00 0

12 8491 17950 - US_ KUB 25.00 50.00 152.00 0

13 8494 17953 - US_SCROTUM/TESTIS/PENIS 25.00 50.00 141.00 0

14 8495 17954 - US_ENDOANAL 50.00 100.00 196.00 0

15 8499 17959 - US_MUSCULAR SKELETAL 25.00 50.00 163.00 0

16 8502 17961 - US_MUSCULAR SKELETAL BOTH 45.00 90.00 196.00 0

17 8504 17963 - US_SCAPULAR 25.00 50.00 163.00 0

18 8505 17964 - US_SCAPULAR BOTH 45.00 90.00 196.00 0

19 8506 17965 - US_CLAVICLE 25.00 50.00 163.00 0

20 8507 17966 - US_CLAVICLE BOTH 45.00 90.00 196.00 0

21 8508 17967 - US_SHOULDER 25.00 50.00 141.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

22 8511 17969 - US_SHOULDER BOTH 45.00 90.00 196.00 0

23 8513 17972 - US_ST/CLAVICULAR JOINT 25.00 50.00 163.00 0

24 8515 17974 - US_ELBOW 25.00 50.00 163.00 0

25 8518 17976 - US_ELBOW BOTH 45.00 90.00 196.00 0

26 8520 17978 - US_WRIST 25.00 50.00 163.00 0

27 8522 17981 - US_WRIST BOTH 45.00 90.00 196.00 0

28 8523 17982 - US_HAND 25.00 50.00 163.00 0

29 8525 17984 - US_HAND BOTH 45.00 90.00 196.00 0

30 8527 17987 - US_FINGER 25.00 50.00 163.00 0

31 8529 17988 - US_FINGER BOTH 45.00 90.00 163.00 0

32 8531 17990 - US_BIOPSY THYROID 100.00 200.00 515.00 0

33 8538 17996 - US_BIOPSY KIDNEY 100.00 200.00 515.00 0

34 8540 17997 - US_BIOPSY LIVER 100.00 200.00 515.00 0

35 8561 18018 - US_FNAC THYROID 100.00 200.00 368.00 0

36 8563 18021 - US_FNAC KIDNEY 100.00 200.00 411.00 0

37 8565 18023 - US_FNAC LIVER 100.00 200.00 411.00 0

38 8567 18025 - US_ASPIRATION/PERC.DRAIN 100.00 200.00 385.00 0

39 8569 18027 - US_DOPPLER 75.00 150.00 273.00 0

40 8571 18029 - US_BOTULINUM TOXIN INJECTION 50.00 100.00 328.00 0

41 8573 18031 - US_FLUID LOCALIZATION 50.00 100.00 152.00 0

42 8575

18033 - US_ECHO-CONTRAST SONOGRAPHY

IV 50.00 100.00 515.00 0

43 8577 18035 - US_SALIVARY GLAND 25.00 50.00 163.00 0

44 8580

18038 - US_ECHO-CONTRAST SONOGRAPHY

MCU 50.00 100.00 515.00 0

45 8583

18041 - US_REDUCTION OF

INTUSSUSCEPTION 50.00 100.00 382.00 0

46 8897 18351 - US_HUMERUS 25.00 50.00 163.00 0

47 8898 18352 - US_HUMERUS (BOTH) 45.00 90.00 196.00 0

48 8899 18353 - UL-RAD/ULNA 25.00 50.00 163.00 0

49 8900 18354 - UL-RAD/ULNA (BOTH) 45.00 90.00 196.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.06 : FLUROSKOPI

No ID

ChargeItem Charge Code / Name Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)1 1220 11220 - FL_DISTAL LOPOGRAM 50.00 100.00 576.00 0

2 1222 11222 - FL_GASTROGRAFFIN STUDY 50.00 100.00 551.00 0

3 1236 11236 - FL_SINOGRAM 50.00 100.00 462.00 0

4 1239 11239 - FL_T-TUBE CHOLANGIOGRAM 50.00 100.00 506.00 0

5 1248 11248 - FL_DIAPHRAGM 50.00 100.00 301.00 0

6 8586 18044 - FL_BA SWALLOW 50.00 100.00 343.00 0

7 8588 18043 - FL_ARTHROGRAM 50.00 100.00 440.00 0

8 8590 18047 - FL_VFSS 50.00 100.00 402.00 0

9 8591 18048 - FL_BA MEAL 50.00 100.00 518.00 0

10 8593 18050 - FL_BA MEAL FT 50.00 100.00 518.00 0

11 8594 18051 - FL_BA ENEMA 50.00 100.00 516.00 0

12 8595 18052 - FL_SMALL BOWEL ENEMA 50.00 100.00 518.00 0

13 8596 18053 - FL_OESOPHAGEAL DILATATION 50.00 100.00 343.00 0

14 8597 18054 - FL_LOCM SWALLOW 50.00 100.00 435.00 0

15 8598 18055 - FL_SIALOGRAM 50.00 100.00 462.00 0

16 8599 18057 - FL_CYSTOGRAM 50.00 100.00 440.00 0

17 8602 18059 - FL_DACRYOCYSTOGRAM 75.00 150.00 462.00 0

18 8603 18060 - FL_FISTULOGRAM 175.00 350.00 576.00 0

19 8604 18061 - FL_GENITOGRAM 50.00 100.00 421.00 0

20 8606 18063 - FL_HSG 50.00 100.00 377.00 0

21 8608 18065 - FL_MCU 50.00 100.00 487.00 0

22 8611 18068 - FL_PROCTOGRAM 50.00 100.00 637.00 0

23 8612 18069 - FL_TUBOGRAM 50.00 100.00 506.00 0

24 8613 18070 - FL_VENOGRAM 50.00 100.00 506.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.08 : IVU

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

1 1313 11313 - I/V UROGRAM 40.00 80.00 160.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.10 : MOBILE XR

No ID


Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)1 1364 11364 - MX_KUB 20.00 40.00 179.00 0

2 8614 18072 - MX _SXR 20.00 40.00 179.00 0

3 8616 18073 - MX _NASAL BONE 20.00 40.00 179.00 0

4 8617 18074 - MX_PIT FOSSA 20.00 40.00 179.00 0

5 8618 18075 - MX_ORBIT 20.00 40.00 179.00 0

6 8619 18076 - MX_PARANASAL 20.00 40.00 179.00 0

7 8620 18077 - MX_MASTOID 20.00 40.00 179.00 0

8 8621 18078 - MX_MANDIBLE 20.00 40.00 179.00 0

9 8622 18079 - MX_MAXILLA 20.00 40.00 179.00 0

10 8623 18080 - MX_TMJ 20.00 40.00 179.00 0

11 8624 18081 - MX_NECK 20.00 40.00 179.00 0

12 8625 18082 - MX_STERNUM 20.00 40.00 179.00 0

13 8626 18083 - MX_CHEST 20.00 40.00 179.00 0

14 8629 18086 - MX _ABDOMEN 20.00 40.00 179.00 0

15 8633 18090 - MX_PELVIS 20.00 40.00 179.00 0

16 8634 18091 - MX_SACRO ILLIAC JOINT 20.00 40.00 179.00 0

17 8635 18092 - MX_CERVICAL 25.00 50.00 179.00 0

18 8636 18093 - MX_THORACIC 20.00 40.00 179.00 0

19 8638 18095 - MX_THORACOLUMBAR 20.00 40.00 179.00 0

20 8640 18098 - MX_LUMBOSACRAL 20.00 40.00 179.00 0

21 8642 18099 - MX_COCCYX 20.00 40.00 179.00 0

22 8643 18100 - MX_WHOLE SPINE 20.00 40.00 179.00 0

23 8644 18101 - MX_CLAVICLE 20.00 40.00 179.00 0

24 8645 18102 - MX_CLAVICLE BOTH 20.00 40.00 179.00 0

25 8646 18103 - MX_SCAPULAR 20.00 40.00 179.00 0

26 8656 18114 - MX_SCAPULAR BOTH 20.00 40.00 179.00 0

27 8657 18115 - MX_STERNOCLAVICULAR JOINT 20.00 40.00 179.00 0

28 8658 18116 - MX_SHOULDER 20.00 40.00 179.00 0

29 8659 18117 - MX_SHOULDER BOTH 20.00 40.00 179.00 0

30 8660 18118 - MX_HUMERUS 20.00 40.00 179.00 0

31 8661 18119 - MX_HUMERUS BOTH 20.00 40.00 179.00 0

32 8662 18120 - MX_ELBOW 20.00 40.00 179.00 0

33 8663 18121 - MX_ELBOW BOTH 20.00 40.00 179.00 0

34 8664 18122 - MX_RADIUS/ULNA 20.00 40.00 179.00 0

35 8665 18123 - MX_RADIUS/ULNA BOTH 20.00 40.00 179.00 0

36 8666 18124 - MX_WRIST 20.00 40.00 179.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

37 8667 18125 - MX_WRIST BOTH 20.00 40.00 179.00 0

38 8668 18126 - MX_HAND 20.00 40.00 179.00 0

39 8669 18127 - MX_HAND BOTH 20.00 40.00 179.00 0

40 8670 18128 - MX_FINGER 20.00 40.00 179.00 0

41 8671 18129 - MX_FINGER BOTH 20.00 40.00 179.00 0

42 8672 18130 - MX_HIP JOINT 20.00 40.00 179.00 0

43 8673 18131 - MX_HIP JOINT BOTH 20.00 40.00 179.00 0

44 8674 18132 - MX_FEMUR 20.00 40.00 179.00 0

45 8675 18133 - MX_FEMUR BOTH 20.00 40.00 179.00 0

46 8676 18134 - MX_KNEE 20.00 40.00 179.00 0

47 8677 18135 - MX_KNEE BOTH 20.00 40.00 179.00 0

48 8678 18137 - MX_PATELLA 20.00 40.00 179.00 0

49 8679 18138 - MX_PATELLA BOTH 20.00 40.00 179.00 0

50 8680 18139 - MX_TIBIA/FIBULA 20.00 40.00 179.00 0

51 8681 18140 - MX_TIBIA/FIBULA BOTH 20.00 40.00 179.00 0

52 8682 18141 - MX_ANKLE 20.00 40.00 179.00 0

53 8683 18142 - MX_ANKLE BOTH 20.00 40.00 179.00 0

54 8684 18143 - MX_CALCANEUM 20.00 40.00 179.00 0

55 8685 18144 - MX_CANCANEUM BOTH 20.00 40.00 179.00 0

56 8686 18145 - MX_FOOT 20.00 40.00 179.00 0

57 8687 18146 - MX_ FEET BOTH 20.00 40.00 179.00 0

58 8688 18147 - MX_SKELETAL SURVEY 20.00 40.00 179.00 0

59 8689 18148 - MX_PRONOGRAM 20.00 40.00 179.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.12 : CBCT

No ID


Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)1 8690 18149 - OPG_ORTHOGONAL 30.00 60.00 131.00 0

2 8691 18150 - OPG_INCISOR 30.00 60.00 131.00 0

3 8692 18151 - CBCT_SINUSES 30.00 60.00 197.00 0

4 8693 18152 - CBCT_TMJ 30.00 60.00 197.00 0

5 8694 18153 - CBCT_OCCLUSION 50.00 100.00 197.00 0

6 8695 18154 - CBCT_MANDIBLE 50.00 100.00 197.00 0

7 8696 18155 - CBCT_MAXILLA 50.00 100.00 197.00 0

8 8697 18156 - CBCT_FULL SIZE 50.00 100.00 197.00 0

9 8698 18157 - CBCT_D MODE 50.00 100.00 197.00 0

10 8699 18158 - CBCT_S MODE 50.00 100.00 197.00 0

11 8700 18159 - CBCT_FREE FOV 50.00 100.00 197.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.13 : IT-PACS

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

1 827 10827 - SALINAN CAKERA PADAT (CD) 30.00 30.00 33.00 0

2 1006 11006 - DUPLICATE FILM UTK 40.00 40.00 44.00 0


RADIOLOGI (JRAD)

Sub PTJ : JK.36.11 : EIR (ENDOVASULAR

INTERVENTIONAL RADIOLOGY

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

1 5810

15558 - EIR - AGB03 - CT/MRI GUIDED

BIOPSY (IES) 540.00 1,080.00 2,365.00 0

2 5812

15560 - EIR - AGB05 - FLUROSCOPICALLY

GUIDED DRAINAGE OF FLUID COLLECTION 490.00 980.00 2,145.00 0

3 5909

15646 - EIR - AGB13 - PERCUTANEOUS

DILATATION OF BILIARY STRICTURE UNDER

IMAGING CONTROL 1,275.00 2,550.00 5,610.00 0

4 5912

15648 - EIR - AGB15 - INSERTION OF

FIDUCIAL OR TUMOUR MARKER (USING

COILS) 700.00 1,400.00 3,108.00 0

5 5915

15650 - EIR - AGM02 - FLUROSCOPICALLY

GUIDED DISCECTOMY (LASER) 850.00 1,700.00 3,878.00 0

6 5920

15656 - EIR - AGM03 - CT GUIDED

DISCECTOMY (INCLUDING LASER) 1,105.00 2,210.00 4,868.00 0

7 5921

15658 - EIR - AGM04 - FLUROSCOPICALLY

GUIDED PERCUTANEOUS VERTEBROPLASTY

WITH SET 995.00 1,990.00 4,373.00 0

8 5924

15661 - EIR - AGM05 - FLUOROSCOPICALLY

GUIDED PERCUTANEOUS VERTEBROPLASTY, 1,280.00 2,560.00 5,638.00 0

9 5926

15663 - EIR - AGM07 - CT GUIDED

PERCUTANEOUS VERTEBROPLASTY 1,630.00 3,260.00 7,178.00 0

10 5928

15664 - EIR - AGM08 - FLUOROSCOPIC

GUIDED KYPHOPLASTY 1,630.00 3,260.00 7,178.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

11 5930

15666 - EIR - AGM11 - IMAGE GUIDED

PERCUTAENOUS INTRA-ARTICULAR

STEROID INJECTION 820.00 1,640.00 3,603.00 0

12 5932


FACET JOINT INJECTION 775.00 1,550.00 3,410.00 0

13 5934


PERCUTAENOUS TRANSDISCAL RF

ABLATION, PRE LEVEL 995.00 1,990.00 4,373.00 0

14 5935


PERCUTANEOUS RADIOFREQUENCY

ANNULOPLASTY, PER LEVEL 975.00 1,950.00 4,290.00 0

15 5939


PERCUTANEOUS SYMPATHECTOMY:

RADIOFREQUENCY, THORACIC 1,050.00 2,100.00 4,620.00 0

16 5940


PERCUTANEOUS SYMPATHECTOMY:

RADIOFREQUENCY, LUMBAR, SPLANCHNIC

NERVE 995.00 1,990.00 4,373.00 0

17 5945


DORSAL ROOT GANGLION BLOCK, EACH

ADDITIONAL LEVEL 475.00 950.00 2,090.00 0

18 5947


RADIOFREQUENCY ABLATION: FACET OR

SACROILIAC JOINTS 930.00 1,860.00 4,098.00 0

19 5948


RADIOFREQUENCY ABLATION: DORSAL

ROOT GANGLION, CERVICAL 930.00 1,860.00 4,098.00 0

20 5972


PERIPHERAL NERVE ABLATION,

RADIOFREQUENCY OR CHEMICAL, PER

LESION 585.00 1,170.00 2,580.00 0

21 5974

15711 - EIR - AGT01 - INSERTION OF

TRACHEO-BRONCHIAL METALLIC STENT

UNDER IMAGING 980.00 1,960.00 4,318.00 0

22 5976

15712 - EIR - AGT01A - INSERTION OF

TRACHEO BRONCHIOL ONE BALLOON ( KOD

BARU) 1,180.00 2,360.00 5,198.00 0

23 5980

15717 - EIR - AGT05 - EMBOLIZATION OF

BRONCHIAL ARTERY WITHOUT

MICROCATHETER 1,175.00 2,350.00 5,170.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

24 5983

15719 - EIR - AGT05A - EMBOLIZATON OF

BRONCIOL ARTERY ONE MICROCATHETER

WITH TWO EMBOLIC AGENT( KOD BARU) 1,750.00 3,500.00 7,700.00 0

25 5985

15721 - EIR - AGT05B - EMBOLIZATON OF

BRONCIOL ARTERY TWO MICROCATHETER

WITH FOUR EMBOLIC AGENT( KOD BARU) 2,250.00 4,500.00 9,900.00 0

26 5987

15723 - EIR - AGT05C - EMBOLIZATON OF

BRONCIOL ARTERY THREE MICROCATHETER

WITH SIX EMBOLIC AGENT( KOD BARU) 2,750.00 5,500.00 12,100.00 0

27 5988

15724 - EIR - AGT06 - PULMONARY

ANGIOGRAM 1,375.00 2,750.00 6,050.00 0

28 5989

15725 - EIR - AGT07 - STEREOTECTIC

RADIOSURGERY ANGIOGRAM, EXCLUDING

CT/MR PLANNING 1,000.00 2,000.00 4,840.00 0

29 5991

15727 - EIR - AGG02 - PERCUTANEOUS

GASTROJEJUNOSTOMY 970.00 1,940.00 4,259.00 0

30 5996

15732 - EIR - AGG06 - IMAGE GUIDED

PANCREATIC PSEUDO CYST DRAINAGE 350.00 700.00 1,540.00 0

31 6000

15736 - EIR - AGG09 - MESENTERIC

ANGIOGRAM: SUPERSELECTIVE, WITH

TERTIARY BRANCH CANNULATION,

INCLUDIING BRONCHIAL 1,300.00 2,600.00 5,720.00 0

32 6001


ANGIOGRAM AND EMBOLISATION 2,150.00 4,300.00 9,460.00 0

33 6002

15738 - EIR - AGG11 - UTERINE ARTERY

EMBOLIZATION (KOD BARU) 1,245.00 2,490.00 5,473.00 0

34 6005

15741 - EIR - AGH04 - PERCUTANEOUS

INSERTION METALIC BILLIARY

ENDOPROSTHESIS STENT (CAJ ALAT

BERASINGAN) 1,170.00 2,340.00 5,148.00 0

35 6022

15757 - EIR - AGH15 - TRANS ARTERIAL

CHEMO-EMBOLISATION HEPATIC

TUMOURS (TACE) 700.00 1,400.00 2,558.00 0

36 6027

15762 - EIR - AGH16C - TRANSARTERIAL

CHEMO EMBOLISATION HEPATIC TUMOR

THREE BEADS TWO MICROCATHETER( KOD

BARU) 3,960.00 7,920.00 17,415.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

37 6028

15763 - EIR - AGH17 - TRANSJUGULAR

INTRAHEPATIC PORTO-SYSTEMIC SHUNT

(TIPSS) 2,050.00 4,100.00 9,021.00 0

38 6033

15768 - EIR - AGN02 - PERCUTANEOUS

NEPHROSTOMY, 2 SIDES 795.00 1,590.00 3,493.00 0

39 6036


URETERIC BALLON DILATATION, 2 SIDES 1,245.00 2,490.00 5,473.00 0

40 6037

15772 - EIR - AGN07 - ANTEGRADE

URETERIC STENTING, 1 SIDE 1,045.00 2,090.00 4,593.00 0

41 6039


REMOVAL OF STONE 1,250.00 2,500.00 5,500.00 0

42 6044

15779 - EIR - AGN20 - INRAD - RETRIEVAL

OF FOREIGN BODY UNDER X-RAY

GUIDANCE, NON CRITICAL SYSTEMS 1,420.00 2,840.00 6,243.00 0

43 6045

15780 - EIR - AGN21 - RETRIEVAL OF

FOREIGN BODY UNDER IMAGE GUIDANCE,

COMPLEX, NEUROVASCULAR, PULMONARY

OR OTHER CRITICAL ORGANS 2,000.00 4,000.00 8,800.00 0

44 6046

15781 - EIR - AGN22 - OCCLUSION OF

FISTULA UNDER IMAGING CONTROL 1,145.00 2,290.00 5,033.00 0

45 6047

15782 - EIR - AGN23 - RENAL ARTERY

ANGIOPLASTY 2,150.00 4,300.00 9,460.00 0

46 6048

15783 - EIR - AGN24 - RENAL

EMBOLISATION (KOD BARU) 1,825.00 3,650.00 8,030.00 0

47 6049

15784 - EIR - AGN25 - RENAL ARTERY

ANGIOPLASTY WITH INSERTION OF STENT

(CAJ ALAT BERASINGAN) 2,300.00 4,600.00 10,120.00 0

48 6050

15785 - EIR - AGP01A - ANGIOPLASTY WITH

1 BALLOON 1,275.00 2,550.00 5,610.00 0

49 6051

15786 - EIR - AGP01B - ANGIOPLASTY WITH

2 BALLOON 1,525.00 3,050.00 6,710.00 0

50 6052

15787 - EIR - AGP01C - ANGIOPLASTY WITH

3 BALLOON 1,775.00 3,550.00 7,810.00 0

51 6053


1 CUTTING BALLOON 1,650.00 3,300.00 7,260.00 0

52 6054


1 CUTTING BALLOON AND ONE STANDARD

BALLOON 1,900.00 3,800.00 8,360.00 0

53 6055

15790 - EIR - AGP02C - ANGIOPLASTY WITH

2 CUTTING BALLOON AND ONE STANDARD

BALLOON 2,400.00 4,800.00 10,560.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

54 6056

15791 - EIR - AGP05 - ANGIOPLASTY WITH

INSERTION OF METALLIC STENT (CAJ ALAT

BERASINGAN) 1,225.00 2,450.00 5,390.00 0

55 6057


STENT AND BALLOON (CAJ ALAT

BERASINGAN) 1,475.00 2,950.00 6,490.00 0

56 6059


DRUG ELUTING STENT AND BALLOON (CAJ

ALAT BERASINGAN) 1,550.00 3,100.00 6,820.00 0

57 6060

15794 - EIR - AGP07A - EMERGENCY

ANGIOPLASTY WITH STENT GRAFT AND

BALLOON( KOD BARU) 2,600.00 5,200.00 11,440.00 0

58 6064

15798 - EIR - AGP10C - TEVAR WITH STENT(

KOD BARU) 2,225.00 4,450.00 9,791.00 0

59 6065

15799 - EIR - AGP11A - ANGIOPLASTY OF

ILIAC ARTERY WITH BALLOON( KOD BARU) 1,400.00 2,800.00 6,160.00 0

60 6066

15800 - EIR - AGP11B - ANGIOPLASTY OF

ILIAC ARTERY WITH STENT AND BALLOON

(CAJ ALAT BERASINGAN) 1,625.00 3,250.00 7,150.00 0

61 6071

15804 - EIR - AGP16A - PERPHERAL

EMBOLIZATION WITH 1 MICROATHETER 1

PVA 1 MICROCOIL 1 GLUE( KOD BARU) 1,620.00 3,240.00 7,123.00 0

62 6072

15805 - EIR - AGP16B - PERPHERAL



63 6073

15806 - EIR - AGP16C - PERPHERAL



64 6074

15807 - EIR - AGP17 - PERIPHERAL

ANGIOGRAM, SELECTIVE, PER SIDE 760.00 1,520.00 3,343.00 0

65 6075

15808 - EIR - AGP17A - PERIPHERAL

ARTERIO BLOCKAGE WITH 1 STENT 1,200.00 2,400.00 5,280.00 0

66 6076

15809 - EIR - AGP18A - PERCUTANEOUS

EMBOLIZATION AVM PERIPHERALL WITH

GLUE 1,000.00 2,000.00 4,400.00 0

67 6077

15810 - EIR - AGP18B - PERCUTANEOUS


TWO CO POLIMER EMBOLIC AGENT ( KOD

BARU) 2,400.00 4,800.00 10,560.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

68 6078

15811 - EIR - AGP18C - PERCUTANEOUS


TWO PVA ( KOD BARU) 1,275.00 2,550.00 5,610.00 0

69 6079

15812 - EIR - AGP18D - PERCUTANEOUS


SCLEROSANT 1,150.00 2,300.00 5,060.00 0

70 6085

15818 - EIR - AGA02 - CEREBRAL

ANGIOPLASTY WITH INSERTION OF

METALLIC STENT (INTRACRANIAL) (CAS

ALAT BERASINGAN) 4,000.00 8,000.00 17,766.00 0

71 6086

15819 - EIR - AGA02A - CEREBRAL

ANGIOPLASTY WITH INSERTION OF

METALLIC STENT (COMPLEX)

(INTRACRANIAL) ***** 4,500.00 9,000.00 20,296.00 0

72 6087

15820 - EIR - AGA04 - INTRACRANIAL CLOT

RETRIEVAL, NOT INCLUDING ADJUNCTIVE

PROCEDURE 9,210.00 18,420.00 28,931.00 0

73 6088

15821 - EIR - AGA04A - INTRACRANIAL CLOT

RETRIEVAL, NOT INCLUDING ADJUNCTIVE

PROCEDURE COMPLEX (KOD BARU) 10,290.00 20,580.00 45,266.00 0

74 6090

15824 - EIR - AGA05A -

INTRACRANIAL/SKULL BASE TUMOUR

EMBOLIZATION COMPLEX 4,790.00 9,580.00 21,066.00 0

75 6097

15830 - EIR - AGA09 - EMBOLISATION OF

CAROTICO-CAVERNOUS FISTULAS

(CCFS)STANDARD ***** 2,650.00 5,300.00 11,613.00 0

76 6098


CAROTICO-CAVERNOUS FISTULAS (CCFS)

COMPLEX (CAS ALAT BERASINGAN) 4,000.00 8,000.00 17,876.00 0

77 6099


DURAL AVFS (CAS ALAT BERASINGAN) 3,200.00 6,400.00 14,253.00 0

78 6100

15833 - EIR - AGA11A - EMBOLISATION OF

DURAL AVF`S COMPLEX (CAS ALAT

BERASINGAN) 3,750.00 7,500.00 16,501.00 0

79 6102


INTRACRANIAL AVM COMPLEX (CAS ALAT

BERASINGAN) 5,500.00 11,000.00 24,201.00 0

80 6103

15836 - EIR - AGA12B - EMBOLIZATION OF

INTRACRANIAL AVM VERY COMPLEX (CAS

ALAT BERASINGAN) 5,500.00 11,000.00 24,311.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

81 6105


ANEURYSM WITH BALLOON REMODELLING

(KOD BARU) 7,490.00 14,980.00 32,953.00 0

82 6107


ANEURYSM WITH INTRACRANIAL STENT

(CAS ALAT BERASINGAN) 4,050.00 8,100.00 17,876.00 0

83 6108



COMPLEX (CAS ALAT BERASINGAN) 4,450.00 8,900.00 19,636.00 0

84 6109

15842 - EIR- AGA20B - EMBOLISATION OF


VERY COMPLEX (CAS ALAT BERASINGAN) 4,450.00 8,900.00 19,636.00 0

85 6110

15843 - EIR - AGA21 - CEREBRAL

ANGIOGRAM 945.00 1,890.00 4,153.00 0

86 6111

15844 - EIR - AGA21A - CEREBRAL

ANGIOGRAM COMPLEX WITH 6 VESSEL

(KOD BARU) 1,125.00 2,250.00 4,950.00 0

87 6113

15846 - EIR - AGA23 - CAROTID AND

CEREBRAL ANGIOGRAM 1,075.00 2,150.00 4,730.00 0

88 6115

15848 - EIR - AGA25 - MYELOGRAM (NOT

INCLUDING CT MYELOGRAM) 995.00 1,990.00 4,373.00 0

89 6117

15850 - EIR - AGA27 - EMBOLIZATION OF

SPINAL AVM (KOD BARU) 3,390.00 6,780.00 14,913.00 0

90 6119

15851 - EIR - AGA27A - EMBOLIZATION OF

SPINAL AVM COMPLEX (KOD BARU) 5,240.00 10,480.00 23,046.00 0

91 6120


VASCULAR HEAD AND NECK TUMOR

/LESION 2,300.00 4,600.00 10,265.00 0

92 6122


VASCULAR MALFORMATION OF HEAD AND

NECK (KOD BARU) 2,300.00 4,600.00 10,265.00 0

93 6123 15856 - EIR - AGA30 - VASO CT (KOD BARU) 350.00 700.00 1,623.00 0

94 6126

15859 - EIR - AGV01B - IVC FILTER SET

RETRIEVEL ( KOD BARU) 1,345.00 2,690.00 5,913.00 0

95 6134

15867 - EIR - AGV04B - RETRIEVEL OF

FORIGN BODY WITH 2 SNARE KIT 1,735.00 3,470.00 7,625.00 0

96 6135

15868 - EIR - AGV05 - PERMENANT

CATHETER INSERTION 920.00 1,840.00 4,043.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

97 6140 15873 - EIR - AGV12 - CATHETER REMOVAL 370.00 740.00 1,623.00 0

98 6141

15874 - EIR - AGV13 - HICKMAN LINE

REMOVAL 395.00 790.00 1,733.00 0

99 6143

15876 - EIR - AGV15A - INFERIOR PETROSAL

SAMPLING ( KOD BARU) (IPSS) WITH

MICROCATHETER 1,460.00 2,920.00 6,415.00 0

100 6145

15878 - EIR - AGV17 - VENOUS SAMPLING:

COMPLEX, ARTERIAL STIMULATED,

PANCREATIC, PARATHYROID 1,070.00 2,140.00 4,703.00 0

101 6146

15879 - EIR - AGV17A - ARTERIAL

STIMULATED VENOUS ( KOD BARU)

SAMPLING (ASVS) WITH MICROCATHETER 1,370.00 2,740.00 6,023.00 0

102 6147 15880 - EIR - AGV22 - FISTULOGRAM 370.00 740.00 1,623.00 0

103 6148 15881 - EIR - AGV23 - CATHETOGRAM 370.00 740.00 1,623.00 0

104 6450

16167 - AGP12A - "ANGIOPLASTY LOWER

LIMB SFA WITH ONE BALLOON 1,400.00 2,800.00 6,160.00 0

105 6451

16168 - EIR - AGP12B - ANGIOPLASTY

LOWER LIMB SFA WITH TWO BALLOON 1,600.00 3,200.00 7,040.00 0

106 6452

16169 - EIR - AGP12C - ANGIOPLASTY

LOWER LIMB SFA WITH STENT AND

BALLOON ( KOD BARU) 1,575.00 3,150.00 6,930.00 0

107 6454

16170 - EIR - AGP13A - ANGIOPLASTY

LOWER LIMB BELOW THE KNEE WITH 1

BALLOON 1,375.00 2,750.00 6,050.00 0

108 6458

16174 - AGP13B - ANGIOPLASTY LOWER

LIMB BELOW THE KNEE WITH 2 BALLOON 1,575.00 3,150.00 6,930.00 0

109 6460

16176 - EIR - AGP13C - ANGIOPLASTY


DRUG ELUTING BALLOON AND 1 STANDARD

BALLOON 2,700.00 5,400.00 11,880.00 0

110 6461

16177 - EIR - AGP13D - ANGIOPLASTY



BALLOON 3,950.00 7,900.00 17,380.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

111 8161


GUIDED BIOPSY (IES) 412.50 825.00 1,815.00 0

112 8165

15557 - EIR - AGB02 - ULTRASOUND

GUIDED BIOPSY FNAC (IES) 587.50 1,175.00 2,585.00 0

113 8169

15559 - EIR - AGB04 -

TRANSJUGULAR/TRANSLUMINAL PLUGGED

BIOPSY (IES) 737.50 1,475.00 3,245.00 0

114 8171


GUIDED DRAINAGE OF FLUID COLLECTION:

COMPLEX, RETROPERITONEAL, US OR CT

ASSISTANCE 812.50 1,625.00 3,575.00 0

115 8172

15562 - EIR - AGB07 - ULTRASOUND

GUIDED DRAINAGE OF FLUID COLLECTION

(SIMPLE) 612.50 1,225.00 2,695.00 0

116 8174

15600 - EIR - AGB08 - CT/MRI GUIDED

DRAINAGE OF FLUID COLLECTION (SIMPLE) 837.50 1,675.00 3,685.00 0

117 8175

15603 - EIR - AGB09 - INTRACAVITORY

FIBRINOLYSIS 762.50 1,525.00 3,355.00 0

118 8176

15609 - EIR - AGB10 - INTRACAVITORY

FIBRINOLYSIS, INCLUDING DRAINAGES 787.50 1,575.00 3,465.00 0

119 8177

15644 - EIR - AGB11 - PERCUTANEOUS

PLEURODESIS 612.50 1,225.00 2,695.00 0

120 8178

15645 - EIR - AGB12 - CHANGE OF

DRAINAGE CATHETER 417.50 835.00 1,837.00 0

121 8179


PERCUTANEOUS THROACIC

SYMPATHECTOMY, NEUROLYTIC 737.50 1,475.00 3,245.00 0

122 8180


PERCUTANEOUS SYMPATHECTOMY INCL.

LUMBAR AND CELIAC PLEXUS 737.50 1,475.00 3,245.00 0

123 8181


PERIPHERAL JOINT INJECTION OF

SUBSTANCE 487.50 975.00 2,145.00 0

124 8182


DORSAL ROOT GANGLION BLOCK, SINGLE

LEVEL, LA OR NEUROLYTIC 712.50 1,425.00 3,135.00 0

125 8183


RADIOFREQUENCY ABLATION: DORSAL

ROOT GANGLION, LUMBER/THORACIC 837.50 1,675.00 3,685.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

126 8184


INJECTION, LA OR NEUROLYTIC:

SPHENOPALATINE OR TRIGEMINAL

GANGLION, 1 SIDE 737.50 1,475.00 3,245.00 0

127 8185

15693 - EIR -AGM27 - IMAGE GUIDED

RADIOFREQUENCY ABLATION:

SPHENOPALATINE OR TRIGEMINAL

GANGLION, 1 SIDE 762.50 1,525.00 3,355.00 0

128 8187


INJECTION, LA OR NEUROLYTIC: SUPERIOR

CERVICAL GANGLION, 1 SIDE 737.50 1,475.00 3,245.00 0

129 8188


RADIOFREQUENCY ABLATION: SUPERIOR

CERVICAL GANGLION 762.50 1,525.00 3,355.00 0

130 8190


STELLATE GANGLION ABLATION,

NEUROLYTIC 737.50 1,475.00 3,245.00 0

131 8192


STELLATE GANGLION ABLATION,

RADIOFREQUENCY 837.50 1,675.00 3,685.00 0

132 8193


EPIDURAL INJECTION: CERVICAL/THORACIC 612.50 1,225.00 2,695.00 0

133 8194


EPIDURAL INJECTION: LUMBAR 462.50 925.00 2,030.00 0

134 8195


PERCUTANEOUS EPIDURAL ELECTRODE

INSERTION 832.50 1,665.00 3,658.00 0

135 8196


INTRATHECAL DRUG INJECTION 537.50 1,075.00 2,365.00 0

136 8197

15709 - EIR - AGM43 - DISCOGRAPHY, 1

LEVEL 737.50 1,475.00 3,245.00 0

137 8198

15713 - EIR - AGT02 - INSERTION OF

OESOPHAGEAL METALLIC STENT UNDER

IMAGING CONTROL 912.50 1,825.00 4,015.00 0

138 8200

15714 - EIR - AGT02A - INSERTION OF

OESOPHAGEAL WITH BALLOON ( KOD

BARU) 1,112.50 2,225.00 4,895.00 0

139 8201

15715 - EIR - AGT03 - IMAGE GUIDED

OCCLUSION FOR BRONCHOPLEURAL

FISTULA 1,127.50 2,255.00 4,958.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

140 8202

15726 - EIR - AGG01 - PERCUNTANEOUS

GASTROSTOMY 737.50 1,475.00 3,245.00 0

141 8203


BALLOON DILATATION 957.50 1,915.00 4,208.00 0

142 8204


INSERTION OF METALLIC STENT

(OESOPHAGEAL, COLONIC, GASTRIC,

DUODENAL) 1,087.50 2,175.00 4,785.00 0

143 8212

15733 - EIR - AGG07 - VISCERAL

ANGIOGRAM: HEPATIC OR RENAL 737.50 1,475.00 3,245.00 0

144 8213


ANGIOGRAM, NON-SELECTIVE

CANNULATION 737.50 1,475.00 3,245.00 0

145 8214


CHOLECYSTOTOMY 612.50 1,225.00 2,695.00 0

146 8215

15740 - EIR - AGH02 - PERCUT.

TRANSHEPATIC BILIARY DRAINAGE (PTBD) 957.50 1,915.00 4,208.00 0

147 8216


INSERTION PLASTIC BILIARY

ENDOPROSTHESIS 1,207.50 2,415.00 5,308.00 0

148 8217

15752 - EIR - AGH10 - IMAGE GUIDED

ABLATION OF TUMOUR CHEMICAL

(ALCOHOL/ACETIC ACID) 687.50 1,375.00 3,025.00 0

149 8218

15753 - EIR - AGH11 - IMAGE GUIDED

PERTUCANEOUS TUMOUR ABLATION

THERAPY: CHEMICAL, 2-3 LESIONS 762.50 1,525.00 3,355.00 0

150 8219

15754 - EIR - AGH11A - IMAGE GUIDED

PERCUTANEOUS TUMOR ABLATION

THERAPHY NEDDLE (CAJ ALAT BERASINGAN) 687.50 1,375.00 3,025.00 0

151 8220



THERAPHY CRYO NEEDLE( KOD BARU) 762.50 1,525.00 3,355.00 0

152 8221



THERAPHY MICROWAVE ONE NEEDLE( KOD

BARU) 687.50 1,375.00 3,025.00 0

153 8222

15758 - EIR - AGH15A - TRANSARTERIAL


ONE MICROCATHETER( KOD BARU) 1,257.50 2,515.00 5,528.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

154 8223

15759 - EIR - AGH15B - TRANSARTERIAL


TWO MICROCATHETER( KOD BARU) 1,632.50 3,265.00 7,178.00 0

155 8224

15760 - EIR - AGH16A - TRANSARTERIAL


ONE BEADS ONE MICROCATHETER( KOD

BARU) 2,257.50 4,515.00 9,928.00 0

156 8225

15761 - EIR - AGH16B - TRANSARTERIAL


TWO BEADS ONE MICROCATHETER( KOD

BARU) 3,332.50 6,665.00 14,656.00 0

157 8226

15764 - EIR - AGH18 - PERCUT. DILATATION

OF BILIARY STRICTURE IMAGE GUIDED 1,377.50 2,755.00 6,062.00 0

158 8227


TRANSHEPATIC CHOLANGIOGRAM, PTC 537.50 1,075.00 2,365.00 0

159 8228


CHOLECYSTOGRAM 462.50 925.00 2,035.00 0

160 8229


NEPHROSTOMY (SIMPLE) 562.50 1,125.00 2,475.00 0

161 8230


URETERIC BALLON DILATATION, 1 SIDE 1,087.50 2,175.00 4,785.00 0

162 8231

15773 - EIR - AGN08 - ANTEGRADE

URETERIC STENTING, 2 SIDES 1,432.50 2,865.00 6,298.00 0

163 8232

15775 - EIR - AGN11 - IMAGE GUIDED CYST

ABLATION 782.50 1,565.00 3,438.00 0

164 8233

15777 - EIR - AGN16 - CYST ABLATION

UNDER IMAGING CONTROL, 1 LESION 757.50 1,515.00 3,328.00 0

165 8234

15778 - EIR - AGN19 - IMAGE GUIDED CYST

ASPIRATION, PER CYST 757.50 1,515.00 3,328.00 0

166 8235


STENT GRAFT AND BALLOON (CAJ ALAT

BERASINGAN) 1,612.50 3,225.00 7,095.00 0

167 8236

15796 - EIR - AGP10A - EVAR AND TEVAR (

KOD BARU) 2,627.50 5,255.00 11,551.00 0

168 8237

15797 - EIR - AGP10B - EVAR WITH STENT(

KOD BARU) 2,327.50 4,655.00 10,231.00 0

NoID


Senior

Citizen (RM)

Normal

(RM)

Non-Citizen

(RM)

JKM

(RM)

169 8238

16179 - EIR - AGP13E - ANGIOPLASTY



BALLOON( KOD BARU) 5,352.50 10,705.00 23,548.00 0

170 8240 15801 - EIR - AGP14 - AORTOGRAM 612.50 1,225.00 2,695.00 0

171 8241


ARTERIOGRAM 662.50 1,325.00 2,915.00 0

172 8243


ANGIOGRAM, NON-SELECTIVE, FLUSH

AORTIC INJECTION 687.50 1,375.00 3,025.00 0

187 8268

15864 - EIR - AGV04 - RETRIEVAL OF

FOREIGN BODY UNDER X-RAY CONTROL

WITHOUT SNARE 1,197.50 2,395.00 5,264.00 0

188 8269

15865 - EIR - AGV04A - RETRIEVEL OF

FORIGN BODY WITH 1 SNARE KIT 1,207.50 2,415.00 5,308.00 0

189 8270

15869 - EIR - AGV06 - READJUSTMENT

PERMENANT CATHETRER 587.50 1,175.00 2,585.00 0

190 8271 15870 - EIR - AGV08 - CHEMOPORT 937.50 1,875.00 4,125.00 0

191 8272

15871 - EIR - AGV09 - PORT PLACEMENT:

ARTERIAL, WITHOUT

EMBOLIZATION/ARTERIAL REMODELING 1,012.50 2,025.00 4,455.00 0

192 8273 15872 - EIR - AGV11 - PORT REMOVAL 387.50 775.00 1,705.00 0

193 8274

15875 - EIR - AGV15 - INFERIOR PETROSAL

VENOUS SAMPLING 1,007.50 2,015.00 4,428.00 0

194 8276

15877 - EIR - AGV16 - VENOUS SAMPLING:

STANDARD, ADRENAL, OVARIAN 812.50 1,625.00 3,575.00 0

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