Qmmc Citizens Charter 11-28-13

89
The Quirino Memorial Medical Center Citizen’s Charter

Transcript of Qmmc Citizens Charter 11-28-13

Page 1: Qmmc Citizens Charter 11-28-13

The Quirino Memorial Medical Center

Citizen’s Charter

Table of Contents

Page 2: Qmmc Citizens Charter 11-28-13

Message 3

QMMC Prayer 4

Mission and Vision 5

Performance Pledge 6

Feedback and Redress Mechanism 7

List of QMMC Frontline Services 8

Emergency Medicine 10

Medical Consultation 13

Laboratory Diagnostic Examination 15

Medical Imaging Diagnostic Examination 19

Dental Service 21

Pharmaceutical Service 23

Administrative Services 25

Ward Admission 25

Billing 27

Cashier 29

Social Service 31

Medical Records Issuance 33

Feedback Form 35

Annex A – Table of Fees 37

QMMC Hymn 64

Page 3: Qmmc Citizens Charter 11-28-13

Message

It is with deep gratitude that we receive the trust and confidence you have given us to address your health and medical concerns. We consider this a sacred duty to ensure that you receive the best medical care and service that this Medical Center can provide. Rest assured that we will continue to be vigilant in attending to all your concerns and suggestions, with the end in view of continuously improving the quality of our service. For we always believe that you, our clients, deserve nothing less than the best we can offer.

Thank you and God bless.

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QMMC Prayer

Heavenly Father, grant us Your grace to love our work in the service of our country. May we always do it conscientiously, even if we don’t receive much appreciation.

Lord, help us be honest in all our transactions, observing Your Divine laws on justice and truth. Let me be friendly and helpful to all who come to our office.

Lord, don’t let me take advantage of our position to get something at the expense of others. May we never be tempted to enrich ourselves with money or property which belongs to our government.

May I always remember that honesty is the best policy and that ill-gotten wealth cannot make me happy. I must set the interest of the community above those of any party, the interest of the nation above those of the community and fidelity to You above everything else.

Bless my country and this institution, Quirino Memorial Medical Center, and keep it in peace. Amen

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Mission

A tertiary hospital providing safe, accessible and

affordable quality specialized health care that is

dynamically responsive to the needs of its patients.

Vision

A leading government tertiary hospital renowned for

its excellence in health care and unwavering

commitment to the health care needs of the Filipino

people.

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Performance Pledge

We, the Officials and Employees of Quirino Memorial Medical Center commit ourselves to provide:

Q – uality medical care and service to all our clients,U – nceasing public health service twenty four hours a day, seven days a week, without any break to ensure that immediate and resolute medical care is available anytime,I – mmediate action to all concerns raised by the client regarding service performance of any officer or employee of this medical center, especially through our Public Assistance Desk and Institution Hotline numbers,R – e-engineered and streamlined steps in the provision of frontline services for a high quality and efficient medical service,I – nstitutionalized special lanes in the service of pregnant women, senior citizens and persons with disabilities,N – ew and up- to- date medical equipments and devices to ensure that our clients are given the best medical care that our resources can accommodate,O – utstanding, courteous, honest and caring hospital personnel with the single and united intention to promote the health and well- being of our clients.

This we pledge because you, our beloved clients, deserve nothing less.

“SERVICE WITH A HEART”

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Feedback and Redress Mechanism

Please let us know how we have served you by doing any of the

following:

Accomplish our Feedback Form available in the offices and put this at the drop box at the Public Assistance Desk

Send your feedback through text at 09178358976

Talk to our Medical Center Chief

If you are not satisfied with our service, your written/verbal reports shall

immediately be attended to by the Office of the Medical Center Chief.

THANK YOU for helping us improve our services.

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QMMC Frontline Services

Type of Frontline Service

Fees Forms Processing Time

Person-in-charge

Emergency Medical Service

Depends on the Diagnostic Exam./Medical Procedure Performed

Medical Form

10-30 mins.

Medical Officer

Medical Consultation

P150.00 Medical Form

Green Card

10 mins. Medical Officer

Laboratory Diagnostic Examination

Please Refer to the Table of Lab. Fees in the Annex

Laboratory Request Form

4 hours Medical Technologist

Medical Imaging Diagnostic Examination

Please Refer to the Table of Fees in the Annex

Request Form

1 Working day

Radiation Tech.

Dental Service Please Refer to the Table of Fees in the Annex

Medical Form

30 mins-1 hour

Dentist

Pharmaceutical Please Charge 3-5 mins. Pharmacist

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Service Refer to the Table of Fees in the Annex

Slip

Ward Admission None Medical Form

15 mins. Admission Staff

Billing None Green Card 5 mins. Billing ClerkCashier Depends

on the item/s used and /or service/s performed

Charge Slip

5 mins. Cashier Clerk

Social Service None Green card 10 mins. Social Service Staff

Provision of Medical Records

Please Refer to the Table of Fees in the Annex

Official Receipt

4-8 mins Records Section Staff

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Emergency Medical Service

Schedule of Availability of Service

Monday – Sunday

8:00 am to 8:00 am

Who can avail of the service?

All persons requiring emergency medical attention in order to prevent possible loss of life.

What are the requirements?

As much medical history that the client or client relative can provide in order to accurately diagnose the condition of the patient.

Duration:

15 to 25 minutes.

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Provision of Emergency Medical Service

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits self to triage medical exam.

Greets client/client relative and inquires on the history of the concerned illness/medical condition

5-10 mins.

Medical Officer/Nurse

None Registration Form

2 Proceeds to specific medical unit that will address health concern.

Performs thorough medical exam. to secure initial medical diagnosis, as well as issue requests for diagnostic exam. if warranted

5- 10 mins.

Medical Officer

None Medical Form

3 Submits self to diagnostic exam.

Secures specimen from client/perform diagnostic exam on the client

30 mins.-1 hour

Paramedical Staff

Please to schedule of fees at the Annex

Exam. Request Form

4 Evaluation of the diagnostic exam resultand issuance of directive to address the medical concern

5-10 mins.

Medical officer None Diagnostic Result Form

Medical record

5 Compliance with the medical directive

Assessment of the accuracy of medical diagnosis and the prognosis of patient

30 mins Medical Officer

None Medical Record

6 Prepare for discharge or admission to the

Send the client home or have him admitted

30 mins. Medical Officer

None May go home slip

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hospital ward for further treatment

Billing Staff

Cashier

AdmittingStaff

Admission slip

Official receipt

Page 13: Qmmc Citizens Charter 11-28-13

Medical Consultation

Schedule of Availability of Service

Monday to Friday

8:00 am to 5:00 pm (No meal break)

Who May Avail of the Service?

Any person requiring non-emergency medical assistance.

What are the Requirements?

1. Registration Form

2. Medical Record

Duration:

20 mins. to 40 mins.

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Provision of Medical Consultation

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Secures registration as health client

Issue the required form for the accomplishment of client

1 min. OPD Clerk 150.00 RegistrationForm

2 Proceeds to the designated OPD clinic

Releases the client medical record/form and directs him to the appropriate OPD clinic

5 mins. OPD Records Staff

None Medical Record Form

3 Submits self to requisite medical exam

Undertake diagnostic exam

Assesses and diagnose the medical condition of the client

Requires performance of diagnostic exam if deemed appropriate

10 mins.

1 working day

Medical officer

Paramedical Staff

None

Please refer to the table of fee in the Annex

Medical Record Form

Request for Diagnostic exam

4 Submits result of diagnostic exams

Assesses results of diagnostic exam and issues medical directive to address the medical issue at hand

10 mins Medical Officer

None Diagnostic Exam Result Form

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Laboratory Diagnostic Examination

Schedule of Availability of Service

Monday to Sunday

8:00 am to 8:00 am (without meal break)

Who Can Avail of the Service?

1. Admitted patients, including those in the Emergency Room

2. Out-patients

What are the Requirements?

1. For admitted and Emergency Room patients:1.1 Laboratory exam request form1.2 Appropriately collected specimen from patient

2. For out-patients:2.1 Laboratory exam request form2.2 Official Receipt of payment2.3 (Optional) Appropriately collected specimen from patient

Duration:

1. For Emergency Medicine Department patients – 1 hour

2. For Admitted patients – 4 hours

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3. Out-patients – one (1) working day

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Provision of Medical Laboratory Diagnostic Exam

A. Emergency Room Patients

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits to blood extraction/specimen collection as required by Medical Officer

Secure patient specimen for laboratory exam based on the requested diagnostic exam

15 mins Medical Officer/Nurse

None Lab. Request form

2 Submission of collected specimen to the Laboratory

8 mins Nurse/Nurse Aide

None Charge Slip

3 Processing of specimen submitted for exam

Depends on type of exam:- Blood tests/Bld. Chem1 hr- Urine/Stool1 hr-PeripheralBlood smear-3 working days-GramStain/AFB1 working day-Culture and Sensi.7 days

Laboratory Staff

None Lab. Request form/Charge slip

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-Biopsy7 working days- Autopsy30 working days

4 Receives lab result Release of lab. Result/s

5 mins. Lab. Staff Please refer to the Lab. Schedule of fees at the Annex

None

B. Admitted Patients

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits to blood extraction/specimen collection as required by Medical Officer

Secure patient specimen for laboratory exam based on the requested diagnostic exam

15 mins Medical Officer/Nurse/Medical Technologist

None Lab. Request form/Charge Slip

2 Submission of collected specimen to the Laboratory

8 mins Nurse/Nurse Aide/Medical Technologist

None Lab. Request/Charge Slip

3 Processing of specimen submitted for exam

Depends on type of exam:- Blood tests/Bld. Chem4 hrs- Urine/Sto

Laboratory Staff

None Lab. Request form/Charge slip

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ol4 hrs-PeripheralBlood smear-3 working days-GramStain/AFB1 working day-Culture and Sensi.7 days-Biopsy7 working days- Autopsy30 working days

4 Receives lab. result Release of lab. Result/s

5 mins. Lab. Staff Please refer to the Lab. Schedule of fees at the Annex

None

C. Out-patients

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits laboratory request form

Accomplish the Charge Slip based on the exams. Requested in the

2 mins. Information Staff

None Duly accomplishedLaboratory Request Form

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Laboratory Request Form

2 Payment of Laboratory Fee

Receives payment for the Laboratory Examination to be performed and issuance of the requisite Official Receipt

3 mins. Cashier None Lab. Request form/Charge Slip

3 Submits to blood extraction/specimen collection as required by Medical Officer

Secure patient specimen for laboratory exam based on the requested diagnostic exam

5 mins Nurse/Medical Technologist

None Lab. Request form/Charge Slip and Official Receipt

4 Processing of specimen submitted for exam

Depends on type of exam:- Blood tests/Bld. Chem4 hrs- Urine/Stool4 hrs-PeripheralBlood smear-3 working days-GramStain/AFB1 working

Laboratory Staff

None Lab. Request form/Charge slip

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day-Culture and Sensi.7 days-Biopsy7 working days- Autopsy30 working days

5 Receives lab. result Release of lab. Result/s

5 mins. Lab. Staff Please refer to the Lab. Schedule of fees at the Annex

None

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Medical Imaging Diagnostic Exam

Schedule of Availability of Service

Monday to Sunday

8:00 am to 8:00 am (no meal break)

Who Can Avail of the Service?

1. Admitted patients, including those in the Emergency Room

2. Out-patients

What are the Requirements?

1. For admitted and Emergency Room patients:1.1 Med. Imaging exam request form

2. For out-patients:2.1 Med. Imaging request form2.2 Official Receipt of payment

Duration:

After three (3) working days

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Provision of Medical Imaging Diagnostic Examination

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits self to medical imaging diagnostic examination

Greets client and explains the procedure to be undertaken

10 mins Medical Imaging Staff

Please refer to attach Annex on fees

Med. Imaging Request formO.R.

2 Actually perform the medical imaging exam

10 mins. Medical Imaging Staff

None

3 Assist client outside the exam room and instructs client to come beck after 3 working days for the result.

5 mins Medical Imaging Staff

None

4 Secures copy of the Medical Imaging exam

Reads the Med. Imaging raw data result for appropriate interpretation and issuance of the result

15 mins. Medical Officers and Medical Imaging Staff

None Official Receipt

Page 24: Qmmc Citizens Charter 11-28-13

DENTAL SERVICE

Schedule of Availability of Service

Monday to Friday

8:00 am to 4:00 pm (No meal break)

Who Can Avail of the Service?

All patients requiring dental service.

What are the Requirements?

1. Medical Form

2. Green Card Registration Form

3. Official Receipt

Duration:

1 hour per client

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Provision of Dental Service

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits self to dental service

Greets client and explains the dental process upon which he will be subjected

10 mins Dental Service Staff

Please see attached Annex for fees

Medical FormOfficial Receipt

2 Performs dental procedure

50 mins Dental Medical Officer

3 Receives after dental process health instruction prior to leaving the clinic

Provides health instruction pertinent to the dental procedure conducted

10 mins Dental Medical Officer/Dental Service Staff

Page 26: Qmmc Citizens Charter 11-28-13

Pharmaceutical Service

Schedule of Availability of Service

Monday to Sunday

8:00 am to 8:00 am (No meal break)

Who can Avail of the Service?

All clients requiring provision of pharmaceutical/medical products.

What are the Requirements?

1. Prescription for medical/pharmaceutical products duly signed by physician.2. Official Receipt of payment made to procure the subject products.

Duration:

11 mins.

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Provision of Pharmaceutical Products

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits prescription form to the Pharmacy Section

Greets client and receives and verifies prescription form submitted

2 mins. Pharmacy Staff

Prescription Form

2 Issues charged slip to patient detailing the amount of payment required

3 mins Pharmacy Staff

Charge Slip Form

3 Pays the required amount

Receives payment for the pharmaceutical product requested

3 mins Cashier Please refer to the Annex on Fees

Official Receipt

4 Receives the appropriate pharmaceutical product

Provides the requested pharmaceutical product

3 mins Pharmacy Staff

Page 28: Qmmc Citizens Charter 11-28-13

Administrative Services

Ward Admission Service

Schedule of Availability of Service

Monday to Sunday

8:00 a.m. to 8:00 p.m. (No meal break)

Who Can Avail of the Service?

All clients who require hospital admission as determined by their respective physicians.

What are the Requirements?

1. Duly accomplished Admission Slip

Duration:

40 mins.

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Provision of Ward Admission Service

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits Admission Slip to the Staff

Greets client and verifies the data appearing in the Admission Slip of the client

5 mins Admitting Staff

None Admission Slip

2 Encodes appropriate data and eventually issue the Clinical Cover Sheet to the client

5 mins. Admitting Staff

None Clinical Cover Slip

3 Receives Clinical Cover Slip from Admitting Staff

Coordinates with Ward Personnel (Nurse) to prepare designated room assigned to the client

5 mins Admitting Staff

Nurse

None

4 Proceeds to either:1. Ward of Origin (ER or OPD)2. Directly to the assigned room (Pay clients)

Back in the original ward (OPD or ER), the Client Chart shall be duly accomplished by the Nurse

30 mins Nurse None Client Chart

5 Submits self to room admission

Secures assistance from the Utility Worker to accompany and assists client to their designated room.

5 mins Utility Worker None

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Billing Service

Schedule of Availability of Service

Monday to Sunday

8:00 a.m. to 8:00 a.m. (No meal break)

Who Can Avail of the Service?

All clients who is about to pay a certain service or product to the hospital.

What are the Requirements?

1. Registration Card or Green Card

Duration:

10 mins.

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Provision of Billing Service

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits Green Card with request to secure Hospital Billing Statement

Greets client and encodes Client Hospital Number and accordingly print the data on clients outstanding hospital bill

10 mins. Billing Staff None Green Card

2 Receives copy of the Hospital Billing Statement

Issues a copy of the Hospital Billing Statement appurtenant with the Client

3 mins Billing Staff None

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Cashier Service

Schedule of Availability of Service

Monday to Sunday

8:00 AM to 8:00 AM (No meal break)

Who Can Avail of the Service?

All clients/client representatives that will pay for hospital services received and/or products procured.

What are the Requirements?

1. Charged slip2. Hospital bill

Duration:

5 mins.

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Provision of Cashier Service

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Presents themselves before the Cashier Section and submits charge slip

Greets client, and receives and verifies charge slip presented by client

3 mins Cashier None Charge slip

2 Provides required amount as appearing in the Charge slip

Receives appropriate payment and issues the requisite official receipt

2 mins. Cashier None Official Receipt

Page 34: Qmmc Citizens Charter 11-28-13

Social Service

Schedule of Availability of Service

Monday to Sunday

8:00 AM to 8:00 AM (No meal break)

Who Can Avail of the Service?

1. Any client requiring financial assistance to help settle their respective hospital bills.2. Referral from Political Leaders that have financial assistance fund reserved for clients of the hospital.3. Those requiring counseling and emotional assistance.

What are the Requirements?

1. Hospital Bill and/or Charge Slip

Duration:

45 mins.

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Provision of Social Service

Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Presents themselves before the Social Service Staff

Greets client and verifies documents submitted

5 mins. Social Service Staff

None Registration Form

Hospital Bill or Charge Slip

2 Details relevant information required by the Social Service Staff

Conducts interview relevant to the request of the client

30 mins Social Service Staff

None

3 Receives the appropriate counseling provided by the Social Service Staff

Provides appropriate counseling pertinent with the issue at hand and determines the appropriate classification of the client relative to their request for financial assistance

10 mins. Social Service Staff

None

Medical Records Issuance

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Schedule of Availability of Service

Monday to Friday

8:00 AM to 5:00 PM (No meal break)

Who Can Avail of the Service?

All clients requiring a copy of their respective medical records.

What are the Requirements?

1. Registration Form

Duration:

10 mins.

Issuance of Medical Records

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Step Client ServiceProvider

ResponseTime

Person/s-In-charge

Fees Forms

1 Submits registration form/green card

Greets client and receives card then instructs client to accomplish a medical records request form

10 mins Medical Records Staff

None Medical Records Request Form

Registration Form

2 Waits at the waiting lounge while the Staff accomplishes their request

Search for the required documents in the storage shelves

10 mins Medical Records Staff

None

3 Receives the requested document after presenting the official receipt issued upon payment of the required fee at the Cashier

Issues the requested document/s

15 mins. Medical Records Staff

Please refer to the Annex on Fees

Official receipt

CLIENT FEEDBACK FORM

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Name/Pangalan:

Surname/Apelyido First Name/Pangalan M.I.

Address/Tirahan:

Phone Number/Telepono:

Email Address:

Comment, Compliment, or Complaint/Papuri, Komento o Reklamo

(Continue at the back or a separate sheet if required/Ipagpatuloy sa likod o sa panibagong papel kung kailangan):

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When and where did the incident happen/Kailan at saan po nangyari ang insidente:

How can we serve you in this regard/Paano po namin kayo mapagsisilbihan tungkol dito

___________________________ ________________

Signature/Lagda Date/Petsa

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ANNEX A

Price Lists

Medical Laboratory Fees

CLINICAL CHEMISTRY EXAMINATIONSFBS/RBS 170.00 17.00HBA1C 440.00 44.00

CREATININE 120.00 12.00BUN 110.00 11.00

URIC ACID 120.00 12.0024 HRS URINE CREA

CLEARANCE180.00 18.00

24 HRS URINE PROTEIN

150.00 15.00

OGCT 170.00 17.00OGTT 330.00 33.00

AMYLASE 170.00 17.00LIPASE 170.00 17.00

SODIUM (serum/urine) 170.00 17.00POTASSIUM (serum/urine)

180.00 18.00

Chloride 170.00 17.00Total Protein 110.00 11.00

Albumin 120.00 12.00TPAG 190.00 19.00

Calcium 140.00 14.00Phosporous 180.00 18.00Magnesium 200.00 20.00

24hr Urine Crea Clearance 180.00

18.00

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24hr Urine Protein 150.00 15.00OGCT 170.00 17.00OGTT 330.00 33.00

FLUID EXAM 210.00 21.00HEMATOLOGY

CBC Plt Count 190.00 19.00Protime 270.00 27.00APTT 270.00 27.00CT/BT 130.00 13.00ESR 60.00 60.00

Hgb/Hct 100.00 10.00Differential Count 100.00 10.00

LE Preparation 270.00 27.00Platelet Count 110.00 11.00

Malarial Smear 110.00 11.00Retic Count 120.00 12.00

Osmotic Fragility Test 130.00 13.00Bone Marrow Aspirate 300.00 30.00

Peripheral Blood Smear 140.00 14.00BACTERIOLOGY

Culture & Sensitivity (Automated) 910.00

91.00

Culture & Sensitivity (Conventional) 560.00

56.00

Fungal Culture 250.00 25.00Gram Stain 95.00 9.50

AFB 95.00 9.50India Ink 95.00 9.50

WET Mount 95.00 9.50KOH 95.00 9.50CLINICAL MICROSCOPY

Urinalysis 80.00 8.00Urine Ketone 80.00 8.00

Urine Micral Test 600.00 6.00

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Urine Specific Gravity 80.00 8.00Fecalysis 70.00 7.00

Occult Blood test 65.00 6.50Scoth tape swab 90.00 9.00Conc Technique 90.00 9.00

APT'S Test 70.00 7.00Sperm Analysis 150.00 15.00

THC/MET Drug test 250.00 25.00BLOOD BANK

ABO Typing w/ Rh 160.00 16.00Cross-matching 280.00 28.00Coomb’s Test 330.00 33.00

Donor Screening 930.00 93.00Component Preparation 700.00 70.00

Red Cell Washing 680.00 68.00RPR 170.00 17.00

AHCV 600.00 60.00HIV Screening 600.00 60.00

BLOOD ACCOUNTWhole Blood* No Donor 1,500.00 150.00

* with 1 Donor 800.00 80.00* with 2 Donor 200.00 20.00

Component (FFP,Plt Conc.,Cro ppt)

* No Donor 700.00 70.00* with 1 Donor 450.00 45.00* with 2 Donor 130.00 13.00Packed RBC* No Donor 1,100.00 110.00

* with 1 Donor 700.00 70.00* with 2 Donor 130.00 13.00Satellite Unit

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* No Donor ( 1 aliquot) 600.00 60.00* with 1 Donor (2 aliquot) 450.00 45.00* with 2 Donor (2 aliquot) 130.00 13.00

IMMUNOLOGY/SEROLOGYHepa Profile 4,600.00 460.00

HBSAg 490.00 49.00Anti HBS 350.00 35.00HBEAg 750.00 75.00AHBE 740.00 74.00

AHBCIgM 740.00 74.00AHAVIgM 840.00 84.00

AHCV 600.00 60.00TSH 350.00 35.00T3 350.00 35.00T4 350.00 35.00

FT3 350.00 35.00FT4 350.00 35.00

Troponin I 740.00 74.00CRP 290.00 29.00ASO 160.00 16.00C3 510.00 51.00

AFP 740.00 74.00BHCG 540.00 54.00CEA 740.00 74.00PSA 1,040.00 104.00

CA-125 1,200.00 120.00Rapid Test Syphilis 170.00 17.00Rapid Test Dengue 990.00 99.00Rapid Test S. Typhi 600.00 60.00Rapid Test Malaria 660.00 66.00

Rapid Test Leptospira 600.00 60.00HISTOPATHOLOGY

Procedure Reading Fee

Processing Fee

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Biopsy (small) 250.00 285.00Biopsy (large) 500.00 315.00

Cytology/FNAB 250.00 285.00Pap’s Smear 80.00 80.00

Frozen Section (Service)

1,500.00 800.00

Frozen Section (Pay)

2,500.00 1,500.00

DENTAL PROCEDURES

Preventive DentistryOral Prophylaxis 150.00

Fissure Sealant (per tooth) 200.00Temporary Filling 100.00

Posterior (Amalgam) 200.00Anterior/Posterior Light Cure 250.00

Curative DentistryAlveoplasty (per quadrant) 150.00Odontectomy (Impacted) 1,500.00

Tooth Extraction (per tooth) 100.00

MEDICAL RECORDS

Birth Certificate 50.00Medical Certificate 50.00Certified True Copy 50.00

Delayed Birth Certificate 100.00Medico-legal Certificate 100.00

For SSS/Insurance 100.00

DEPARTMENT OF MEDICAL IMAGING FEES

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CT Scana) Head, Orbits, Sella, PNS, Temporal, Neck

3,600.00

b) Chest 4,900.00c) Lower/Upper Abdomen 4,700.00d) Whole Abdomen 7,100.00e) Spine (per region) 3,600.00f) Adrenals 3,600.00g) Extremities 3,600.00h) Nasopharynx 4,200.00i) CT Angiography (Brain/Pulmonary/Renal/Triphasic)

9,500.00

j) Angiography (Thoracic/Abdominal Aorta)

11,900.00

k) 3D Reconstruction, Skull 3,600.00l) Biopsy with previous scan 6,900.00m) Biopsy without previous scan 9,600.00

Radiology ProceduresI. Skeletal System1. Ankle joint 385.002. Clavicle 360.003. Elbow Joint 360.004. Femur/Thigh 420.005. Foot 384.006. Forearm/Radius/Ulna 290.007. Hand 290.008. Hip Joint 495.009. Humerus (2 v’s)/Arm 375.0010. Knee joint/Patella 360.0011. Leg/Tibia/Fibula 375.0012.Pelvis/Frog Leg 350.0013. Scapula (2 v’s) 340.0014. Shoulder joint (2 v’s) 295.0015. Shoulder joint (3 v’s) 400.00

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16. Skeletal Survey 2,640.0017. Sternum (2 v’s) 290.0018.Thoracic cage 300.0019. Wrist 375.00II. Thoracic Content1. Cardiac series 530.002. Heart and Lungs-Adult 265.003. Heart and Lungs-Pedia 205.004. Lordotic/Cone Down View 160.005. Baby Gram 950.00III. Abdomen1. Plain Abdomen – Adult/Pedia (2 v’s)

400.00

2. Plain KUB 205.00IV. Biliary System1. EROP 2,640.002. Oral 788.003. HOC 1,140.004. Percutaneous Transhep (PTC) 2,545.005. T-Tube Cholcagiogram 795.00IV. Gastro-intestinal Tract1. Barium Enema-adult/pedia 1,500.002. Esophagogram-Barium Swallow 660.003. Hypotonic 720.004. Oral Chole GI 1,030.005. Self Bowel Series 1,980.006. UGI Bowel Series 1,382.00V. Head1. Facial Bones/Waters 265.002. mastoids (4 v’s) 530.003. Maxilla/Mandible (2 v’s) Panoramic

460.00

4. Nasal Bone 300.005. Optic Foramen (R & L) 480.00

Page 47: Qmmc Citizens Charter 11-28-13

6. Orbit (2 v’s) 480.007. PNS (4 v’s) 530.008. Skull (APL)/TOWNS 340.009. Temporamandible TMJ (4 v’s) 530.0010. Zygoma/SMV 265.00VI. Neck1. Foreign Body (2 v’s) 265.002. Soft tissue cervical (2 v’s) 265.00VII. Obstetrical1. Hysterosalphingography 820.002. Pelvimetry 435.00VIII. Urinary System1. Cystography 1,060.002. Drip Infusion (IVP) 1,875.003. Hypertensive (IVP) 1,560.004. IVP with VCUB 1,190.005. IVP-Adult 1,190.006. IVP-Pedia 1,125.007. PCNL 1,875.008. Retrograde Pyelography 1,490.009. Urethography 1,105.0010. Voiding Cystourethrography 1,120.00IX. Vertebral Column1. Cervical (2 v’s) 255.002.Cervical (4 v’s) 460.003. Lumbosacral (4 v’s) 400.004. Sacrum or Coccyx (2 v’s) 265.005. Scoliotic series 865.006. Thoracic (2 v’s) 400.007. Thoraco Lumbar 795.00X. Miscellaneous1. Angiography 1,320.002. Colonogarm 1,850.003. Imperforate anus/Inventogram 1,300.00

Page 48: Qmmc Citizens Charter 11-28-13

4. Mobile C Arm Flouroscopy 600.005. Myelography 1,850.006. Sinugraphy/Fistulogram 1,300.00

Ultrasound1. Spleen, Liver, Right Lower Quadrant, Pancreas, Chest, Gallbladder

300.00

2. Small parts (Parotid, Auricular, Mandibular, Submandibular)

460.00

3. Thyroid Glands/Neck mass 380.004. Kidneys/Renal 460.005. Adrenals 505.006. Abdominal Aorta 460.007. KUB (Full bladder) 600.008. HBT (Fasting/NPO) 460.009. TRUS/Prostate 460.0010. Transcranial UTZ 505.0011. Scrotal/Testis 580.0012. Breast 520.0013. Pelvis (TAS) 460.0014. Upper Abdomen 1,060.0015. Lower Abdomen 600.0016. Whole Abdomen 1,660.0017. Guided Cyst Aspiration 2,880.0018. Guided Cyst 2,880.00

2D Echocardiogram1.Plain 1,320.002. Complete with Doppler 2,160.00

Doppler1. Venous/Arterial 2,160.002. Carotid 1,152.00

MRI Procedures1. Cranial 5,100.002. Cervical, Thoracic, Lumbosacral 5,100.00

Page 49: Qmmc Citizens Charter 11-28-13

3. Chest/Upper & Lower Abdomen 5,300.004. Brain 5,300.005. Whole Abdomen 7,800.00

Pharmacy Price Lists

Drugs and MedicinesAcetylcysteine 200 mg sachet 13.00Acetylcysteine 600 mg efferv tab 49.50Acetylcysteine 100mg/ml amp 98.50Acetazolamide 250mg tab 25.00Acyclovir 400 mg tab 29.00Acyclovir 800 mg tab 81.50Alfuzosine10mg OD tab 77.50Allopurinol 100 mg tab 1.00Allopurinol 300 mg tab 3.00Aluminum Mg OH bottle 28.50Amikacin 250 mg vial 26.00Amiodarone 50mg/ml amp 320.00Amiodarone 200mg tab 19.50Amino acid 6% vl 585.00Amino Acid Glucose 1,000 kcal 4,225.00Amino Acid Glucose 1,400 kcal 5,070.00Aminophylline 25mg/ml amp 39.00Amlodipine 10 mg tab 6.50Amlodipine 5 mg tab 4.50Amoxicillin 100 mg drops 23.50Amoxicillin 250 mg/ml susp 38.00Amoxicillin 500mg cap 2.50Ampicillin 500 mg vial 6.50Ascorbic acid 100mg/ml syrup 120ml 23.50Ascorbic acid 500mg tab 1.50Ascorbic acid 100mg/ml drops 18.50Aspirin 30mg tab 1.50

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Aspirin 80mg tab 1.50Atenolol 50mg tab 1.50Atracurium 323.50ATS 1,500 u 25.50AtSo4 amp 7.50Atropine Sulphate eye drops 272.00Azithromycin 500 mg tab 130.00Barium Sulfate 544.00Bacillus clausii oral susp 27.50Betahistine 16mg tablet 23.50Betahistine 24mg tablet 53.00Betamethasone cream 5g 69.00Biperiden 2mg tab 5.00Bisacodyl supp 24.50Bisacodyl 5mg tab 1.50Budesonide resp.250mcg/ml, 2ml 37.50Budesonide resp.500mcg/ml, 2ml 173.00Bupivacaine (H) 220.00Butamirate citrate 50mg tab 16.00Bupivacaine (I) 131.00Butorphanol 434.00Calcium Carbonate tab 3.00Calcium Gluconate amp 23.50Captopril 25 mg tab 1.50Carbachol vial 0.01%, 1.5ml 655.50Carbamazepine Syrup 149.50Carbamazepine 200mg tab 2.00Carboplatin 10mg/5ml vial 1,365.00Cefalexin 500mg cap 3.50Cefalexin 100mg/ml drops 36.50Cefazolin 1g vial 26.00Cefipime 1 gm vial 819.00Cefipime 2 gm vial 1,950.00Cefipime 500mg vial 1,232.50Cefotaxime 1 g vial 40.50Cefoxitin 1g vial 410.00Ceftazidime 1g vial 44.00Ceftriaxone 1g vial 41.00Cefuroxime 750mg vial 35.50

Page 51: Qmmc Citizens Charter 11-28-13

Cefuroxime 1.5g vial 233.50Cefuroxime 500mg cap 20.00Celecoxib 200 mg cap 21.00Celecoxib 400 mg cap 29.00Cetirizine 10mg tab 2.00Chloramphenicol 500mg cap 2.50Chloramphenicol 1g vial 20.00Chloramphenicol 125mg/ml, 60ml susp 32.50Chloramphenicol 0.5% 5mg/ml opthalmic drops 114.50Chlorpromazine HCl 100mg tab 4.00Cinnarizine 75mg tab 110.50Cinnarizine 25mg tab 3.00Ciprofloxacin 500mg tab 2.50Ciprofloxacin 200mg/ml vial 390.00Cisplatin vial 682.50Clarithromycin 500mg OD tab 136.50Clarithromycin 500mg tab 33.00Clarithromycin 125mg/ml susp 283.50Clindamycin 150 mg cap 2.50Clindamycin 300mg cap 6.00Clindamycin 150mg/ml, 4ml amp 207.00Clonazepam 2mg tab 9.50Clonidine tab 29.50Clopidogrel 75 mg tab 15.50Cloxacillin 500mg cap 4.50Cloxacillin 125mg/ml, 60ml suspension 25.00Co-Amoxyclav 312.5mg/ml, 60ml susp 260.00Co-Amoxyclav 625mg tab 11.00Conjugated Estrogen 0.625mg tab 31.50Cotrimoxazole 800mg/160mg tab 1.50Cotrimoxazole 200+40mg/5ml susp 14.50Cyclophosphamide 500mg vial 214.50D 10 W 500ml 63.00D10 W 3 ml amp 18.50D5 0.3 NaCl 500ml 20.00

Page 52: Qmmc Citizens Charter 11-28-13

D5 LR 1L 20.00D5 LR 1L (Baxter) 104.00D5 LR 500 ml 34.00D5 NM 1L 20.00D5 NSS 1 L 38.00D5 NSS 500ml 46.50D5 NSS 500ml (glass bottle) 136.50D5 W 1L 20.00D5 W 1L (glass bottle) 156.00D50 W 50 cc vial 32.50D5IMB 500ml 20.00D5W 500 ml 20.00D5W 500 ml glass bot. 117.00Desflurane 240ml 12,303.50Dexamethasone 4mg/ml amp 28.50Dexamethasone 4mg tab 29.00Dextran 500ml 292.50Diazepam 10mg tab 16.00Dexamethasone opthalmic drops 278.00Diazepam 5mg/ml amp 103.00Diazepam tab. 16.00Diclofenac 50mg tab 1.00Diclofenac 100mg SR tab 10.00Diclofenac amp 10.50Diclofenac 25mg/ml amp 5.00Digoxin 500mcg/ml amp 155.50Digoxin 250mcg tab 5.50Diltiazem 60mg tab 11.50Dipenhydramine 50 mg cap 1.50Dipenhydramine amp 136.50Distilled Water 50ml 23.50Dobutamine amp 465.50Domperidone 10mg tab 30.00Dopamine amp 188.50Doxycycline 100 mg cap 2.00Doxurubicin 50mg/ml vial 1,365.00Dydrogesterone 10mg tab 48.50Enoxaparine 0.4ml 651.00Enoxaparine 0.6ml 853.50

Page 53: Qmmc Citizens Charter 11-28-13

Ephedrine amp 51.00Epinephrine amp 47.00Epoiten 4000iu 715.00Erythromycin 200mg/5ml susp 60ml 68.00Erythromycin eye ointment 117.00Etoposide 20mg/5ml vial 591.50Etoposide 20mg/5ml vial 559.00Famotidine 20mg/mlamp 87.00Etoposide Vial 585.00Felodipine 10 mg tab 17.50Felodipine 2.5 mg tab 27.50Felodipine 5 mg tab 12.00Fenofibrate 100mg cap 32.50Fenofibrate 300mg cap 45.50Fentanyl 110.50Ferrous Sulfate tab 2.50Finasteride 5mg tab 45.50Fluconazole 150mg tab 188.50Fluconazole 150mg tab 192.50Fluorouracil 50mg/ml vial 114.50Fluoxetine 20mg cap 88.50Folic acid 500mg cap 5.50Formeterol + Budesonide Inhaler 1,175.00Fucidate sodium ointment 2%. 5g 227.50Fucithalmic opth drps 1% 333.00Furosemide 20mg/2ml amp 6.50Furosemide 40mg tab 1.50Gabapentin 100mg tab 19.50Gabapentin 300mg tab 27.50Gentamycin opth drops 3% 130.00Gentamycin 40mg/ml amp 7.00Gentamycin 0.3 opthalmic solution 130.00Glibenclamide 5mg tab 5.50Gliclazide 80 mg tab 7.50Gliclazide 30 mg MR tab 7.50Glipizide 5mg tab 9.00Glyceril Trinitrate 1mg/ml, 10ml amp 338.50Haloperidol 5mg/ml 46.00Haloperidol 5mg tab 6.00

Page 54: Qmmc Citizens Charter 11-28-13

Haloperidol 5mg/ml amp 254.50Heparin 1000iu/ml vial 162.50Human Albumin 20%, 50ml 2,593.50Human Insulin Basal 2,434.00Human Insulin (Glargline) Penlet 802.50Human Insulin [I] 300.00Human Insulin [R] 354.00Human Insulin 70/30 300.00Human Insulin Penlet (Lantus) 802.50Human Insulin vial (Lantus) 1,200.00Hydralazine 20mg/ml amp 260.00Hydroxyethyl 6% (VOLUVEN) 819.00Hydroxyethyl 10% (HAESTERIL) 1,059.00Hydrocortisone 100 mg vial 47.00Hydrocortisone 250 mg vial 56.00Hydrocortisone 5g cream 149.50Hydroxyzine 25mg tab 24.00Hydroxyzine 10mg tab 12.00Hyoscine NBBr 20mg/ml amp 17.00Hyoscine NBBr 10mg tab 2.50Imipenem 500mg vial 952.00Intra-Ocular Irr.Sol 500ml 647.50Iopamiro 50ml 1,430.00Irbesartan 150 mg tab 24.50Irbesartan + Hydrochlorthiazide 150 mg tab 25.50Irbesartan 300 mg tab 40.00Irbesartan + Hydrochlorothiazide 300 mg tab 41.50Ibuprofen 200mg tab 6.50Isoflurane 1,820.00Isoniazid 200mg/5ml 120ml susp 64.00Isosorbide 30 mg durules tab 20.00Isosorbide 60 mg durules tab 25.00Isosorbide Dinitrate 5mg tab 12.00Isosorbide Dinitrate 10mg tab 13.00Isosorbide Dinitrate 1mg/ml amp 490.00Isotonic Nacl 50ml vial 34.00Isotonic Nacl 10ml vial 13.00

Page 55: Qmmc Citizens Charter 11-28-13

Isoxsuprine 5mg/ml amp 97.50Isoxsuprine 10mg tab 15.00Ketamine vial 99.50Ketoconazole cream 5g 135.00Ketoprofen 100 mg vial 161.50Ketorolac 30mg/ml amp. 13.00Lactulose 120ml bottle 112.00Lactulose 60ml bottle 73.00Lagundi 250mg tab 2.00Latanoprost (Xalatan) 50mcg/ml 1,389.00Lanzoprazole 30mg tab 95.00Levofloxacin 500mg tab 26.00Levothyroxine 100 mcg tab 11.00Levothyroxine 50 mcg tab 5.50Lidocaine HCl 2% , 50ml vial 23.50Lidocaine 2% polyamp 6.50Loratadine 10mg tab 4.00Losartan+Hydrochlorothiazide 50mg tab 13.00Losartan Potasium 50mg tab 8.00Magnesium Sulfate amp 26.00Mannitol 500ml 68.00Medroxyprogesterone 10mg tab 25.00Mebendazole syrup 27.50Mebendazole 50mg tab 97.50Medroxyprogesterone vial 68.00Mefenamic acid 500mg cap 1.50Meglumine Ioxithalamate30cc 567.00Meglumine Ioxithalamate50cc 741.00Meropenem 1g vial 747.50Meropenem 500 mg vl 435.50Metformin 500 mg tab 2.00Methotrexate 25mg/ml vial 188.50Methotrexate 2.5mg tab 10.50Methyldopa 250mg tab 16.85Methylergometrine amp 200mcg/ml 49.50Methylergometrine amp 49.50Methylergometrine 125mcg tab 22.50Methylprednisolone 4 mg tab 8.00

Page 56: Qmmc Citizens Charter 11-28-13

Methylprednisolone 16 mg tab 31.50Methylprednisolone 40mg/ml vial 330.00Metoclopramide 5mg/ml amp 6.50Metoclopramide 10mg tab 2.50Metoprolol 50mg tab 2.50Metoprolol 100mg tab 3.00Metronidazole 500mg tab 1.50MetronIdazole 125mg/5ml susp 21.50Metronidazole vial 27.00Midazolam 5mg/ml amp 132.50Midazolam 15 mg tab 32.50Mono/dibasic Na Phosphate (Phosphosoda) 176.50Monobasic Na (Fleet Enema) 227.50Montelukast 10mg tab 32.50Morphine amp 31.00Morphine tab 12.00Multivitamins-OB 7.50Multivitamin+Minerals tab 6.50Multivitamin+Phospholipid Forte cap 30.50Multivitamins syrup 120ml 62.50Mupirocin ointment 175.50Nalbuphine 10mg/ml amp 58.50Naloxone 20mcg/ml (pedia) amp 357.50Naloxone 400mcg/ml (adult) amp 486.50Naproxen 550mg tab 9.00Neomycin+Polymyxin Sulfate otic drops 182.00Nicardepine 10mg/10ml amp 673.50Nicardepine 2mg/2ml amp 149.50Nifedipine 10 mg tab 4.00Nifedipine 5 mg tab 2.00Nifedipine 20mg tab 22.50Nifedipine 30mg tab 30.50Nimodipine 30mg tab 27.00Nitroglycerin patch 62.00Noradrenaline/Norepinephrine amp 371.00Nystatin susp, 30ml 444.00Nystatin susp, 30ml 416.00

Page 57: Qmmc Citizens Charter 11-28-13

Ofloxacin 200mg tab 4.00Ofloxacin 400mg tab 4.00Ofloxacin Otic drops 162.50Ofloxacin 200mg/100ml vial 376.00Omeprazole 20 mg tab 5.50Omeprazole 40 mg tab 45.50Omeprazole 40mg/ml vial 166.00Ondansentron 8mg amp 526.00ORS Powder 6.50Oxacillin 500mg vial 27.00Oxytocin 10 iu/ml amp 26.00Paracetamol 250mg/ml syrup 22.00Paracetamol 250 mg suppository 10.50Paracetamol 100mg/ml drops 21.50Paracetamol 500 mg tab 0.50Pen-G 1 mil vial 7.00Pen-G 5 mil vial 13.50Peritonial Dialysis 1.5% 1L 68.00Peritonial Dialysis 4.25% 1L 71.50Permetrin Lotion 188.00Pethidine 50mg/ml vial 2,510.00Phenobarbital 130mg/ml amp 546.00Phenobarbital 60mg or 1 grain tab 2.50Phenobarbital 30mg or 1/2 grain tab 1.85Phenobarbital 15mg or 1 grain tab 1.45Phenylpropanolamine 6.25mg/ml drops 22.50Phenylpropanolamine 6.25mg/ml syrup 23.50Phenylephrine HCl eye drops 361.00Phenytoin Na 500mg/ml amp 519.50Phenytoin Na 100mg cap 16.00Phytomenadione 100mg/ml amp 26.00Piperacillin 2g/250 vial 136.00Piperacillin 4g/500 vial 240.00PLR 1L 20.00PLR 500ml 65.00PNSS 1L 20.00PNSS 1L glass bot. 146.00

Page 58: Qmmc Citizens Charter 11-28-13

PNSS 1L (Baxter) 104.00PNSS 500ml 20.00PNSS 500ml glass bot. 131.00Potassium chloride 2meq/ml vial 22.00Potassium chloride tab 25.00Prednisone 5mg tab 1.50Prednisone 10mg tab 5.50Prednisone 20mg tab 4.50Propanolol 10mg tab 6.50Propanolol 40mg tab 13.00Propofol amp 103.00Pyrantel pamoate bottle 138.00Pyrazinamide susp. 83.50Ranitidine 150 mg tab 3.00Ranitidine 300mg tab 5.00Ranitidine 25mg/ml amp 8.50Rifampicin 200mg/5ml syrup 120ml 169.00Rocuronium 50mg/5ml vial 498.00Salbutamol Inhaler 90.00Salbutamol nebules 6.00Salbutamol 2mg tab. 0.75Salbutamol 2mg/5ml syrup 45.50Salbutamol+Ipratropium nebules 23.00Salbutamol+Ipratropium inhaler 520.00Salmeterol+Fluticasone inhaler (Seretide) 695.00Sambong 250mg tab 2.00Sertraline 50mg tab 42.00Sevoflurane 8,645.00Silver Sulfadiazine Jar 1,053.00Silver Sulfadiazine 20g tube 195.00Simvastatin 10 mg tab 5.00Simvastatin 20 mg tab 2.00Simvastatin 40 mg tab 11.00Sodium Bicarbonate 1 meq/ml, 50ml vial 91.00Sodium Chloride 20ml vial 32.50Sodium Thiopenthal vial 507.00Spironolactone 25 mg tab 11.00

Page 59: Qmmc Citizens Charter 11-28-13

Spironolactone 50 mg tab 32.00Streptokinase 1.5mg vial 7,410.00Succinylcholine 20mg/ml vial 347.00Sulbactam/Ampicillin 750mg vial 143.00Suxamethonium HCl 20mg vial 257.50Streptokinase 1.5mg vial 7,020.00TAB amp 32.50Tamoxifen 20mg tab 12.00Telmisartan 40mg tab 26.00Telmisartan 40mg tab+HCTZ 12.5mg tab 25.00Telmisartan 80mg tab 44.50Telmisartan 80mg tab+HCTZ 12.5mg tab 44.50Terazocin 1 mg tab 58.50Terazocin 2 mg tab 87.50Terbutaline neb. 15.50Streptokinase 1.5mg vial 7,020.00Tetracaine 20mg amp 598.50Tiotropium 18mcg for inhalation cap 88.00Tobramycin opth drops 240.50Tobramycin-Dexamethasone eye ointment 344.50Tobramycin-Dexamethasone opth drops 214.50Tramadol 50mg/ml amp 26.00Tramadol 50mg cap 6.00Tranexamic 100mg/ml amp 42.00Tranexamic 500mg cap 10.50Tropicamide 0.5% opthalmic drops 352.00Vaccine, FLU 429.00Vaccine, PPD 684.00Vaccine, Hepa B 500.00Vaccine, Immunoglobulin Rabbies 5,070.00Vaccine, Pneumonia 1,000.00Vaccine, Verorab 1,261.00Valproic acid 250mg/5ml syrup 661.50Vancomycin 500mg vial 682.50Vecuronium amp 471.50

Page 60: Qmmc Citizens Charter 11-28-13

Vitamin B1B6B12 tab 1.50Vitamin B1B6B12 amp 97.50Zolpidem 10 mg tab 44.50Vitamin B-Complex 97.50

Medical SuppliesALCOHOL 500ML 57.50ALCOHOL 60ML 14.00ALCON-10 527.50AQUAPACK 156.00ASEPTO SYRINGE 60ML 21.00AUTOCLAVE GLOVES 6 1/2 28.50AUTOCLAVE GLOVES 7 28.50AUTOCLAVE GLOVES 7 1/2 28.50BACILLUS CLAUSII 61.00BLOODSET 23.50ALCOHOL 500ML 57.50BONE WAX 76.00CHROMIC 0 W/ NEEDLE 46.50CHROMIC 1-0 W/ NEEDLE 46.00CHROMIC 2-0 DOUBLE ARM 78.00CHROMIC 2-0 W/ CUTTING 47.50CHROMIC 2-0 W/ NEEDLE 49.00CHROMIC 2-0 W/O NEEDLE 54.00CHROMIC 3-0 W/ NEEDLE 49.00CHROMIC 4-0 W/ NEEDLE 50.00CORE CATHETER FOR PERITONEAL DIALYSIS 3,715.00COLOSTOMY BAG 26.00CONDOM CATHETHER (LARGE) 14.00CORE CATHETER FOR PERITONEAL DIALYSIS 3,715.00COLOSTOMY BAG 26.00DAFILON 4-0 62.00DEXON 4-0 ROUND NEEDLE (VICRYL) 173.50DISPOSABLE NEEDLE #19 1.50DISPOSABLE NEEDLE #21 1.50DISPOSABLE NEEDLE #23 1.50

Page 61: Qmmc Citizens Charter 11-28-13

DISPOSABLE NEEDLE #25 1.50COLOSTOMY BAG 26.00DISPOSABLE NEEDLE #26 1.50DISPOSABLE SYRINGE 10cc 3.50DISPOSABLE SYRINGE 1cc 4.00DISPOSABLE SYRINGE 20cc 6.50DISPOSABLE SYRINGE 30cc 7.50DISPOSABLE SYRINGE 3cc 3.50DISPOSABLE SYRINGE 50cc 32.50DISPOSABLE SYRINGE 5cc 4.00DISTILLED H2O 1L 104.00ECG LEADS 7.00ELASTIC BANDAGE 3.5" 21.00ELASTIC BANDAGE 3.5" 17.00ELASTIC BANDAGE 4" 21.00ELASTIC BANDAGE 6" 30.00ENDOTRACHEAL TUBE 2.5 47.00ENDOTRACHEAL TUBE 3.0 40.00ENDOTRACHEAL TUBE 3.5 40.00ENDOTRACHEAL TUBE 4.0 40.50ENDOTRACHEAL TUBE 4.5 40.50ENDOTRACHEAL TUBE 5.0 70.50ENDOTRACHEAL TUBE 5.5 70.50ENDOTRACHEAL TUBE 6.0 70.50ENDOTRACHEAL TUBE 6.5 70.50ENDOTRACHEAL TUBE 7.0 60.00ENDOTRACHEAL TUBE 7.5 60.00ENDOTRACHEAL TUBE 8.0 63.00ENDOTRACHEAL TUBE 8.5 65.00EPIDURAL CATETHER G18 390.00EPIDURAL CATETHER SET W/ Toughy 669.50EYE PADS 5.00FACE MASK 2.00FIBER GLASS CAST 2" 370.50FIBER GLASS CAST 3" 416.00FIBER GLASS CAST 5" 535.50FOLEY CATETHER Fr.10 22.00FOLEY CATETHER Fr.12 19.50

Page 62: Qmmc Citizens Charter 11-28-13

FOLEY CATETHER Fr.14 22.00FOLEY CATETHER Fr.16 22.00GLUCOSE TEST STRIP 15.00HEMODIALYSIS CATHETER F12x16cm 5,570.00HEMODIALYSIS CATHETER F11.5x6.2in 4,810.00HEPLOCK 18.50HYDROGEN PEROXIDE 120ML 19.50I.V. CATETHER G16 12.00I.V. CATETHER G18 11.50I.V. CATETHER G20 11.50I.V. CATETHER G22 11.50I.V. CATETHER G24 13.00I.V. SET FOR PEDIA 159.00HEMODIALYSIS CATHETER F12x16cm 5,570.00I.V. SET FOR ADULT 143.50INSULIN SYRINGE 1cc 10.50I.V. CATETHER G26 20.00INSULIN SYRINGE 1CC 10.50JACKSON PRATT 850.00L - FUSION SET 1,014.00LEMON GLYCERIN SWAB 21.00LIDOCAINE+PRILOCAINE HCl(EMLA) 361.00LIGATING CLIPS (MEDIUM-LARGE) 4,680.00MAXON 0 230.00MAXON 1 300.00Methylhydroxypropylcellulose (Artelac) 351.00MICROPORE 36.00MONOBASIC Na ( Fleet enema ) 227.50MONOCRYL 1-10 187.50NEBULIZING KIT 53.50NEURO SPONGES 1,017.00NGT Fr.10 x 120cm 6.50NGT Fr.12 x 120cm 6.50

Page 63: Qmmc Citizens Charter 11-28-13

NGT Fr.14 x 140cm 6.50NGT Fr.16 x 140cm 6.50NGT Fr.18 x 140cm 6.50NGT Fr.8 X 40cm 6.50NGT Fr.8 X 100cm 19.50NGT Fr.5X 40cm 6.50OPTIMARK 10ml 2,600.00OPTIMARK 20ml 4,420.00OPSITE POST-OP (dressing) 171.50OXYGEN CANNULA (ADULT) 13.00OXYGEN CANNULA (PEDIA) 13.00OXYGEN FACE MASK (ADULT) 29.00OXYGEN FACE MASK (PEDIA) 28.50PD TRANSFER SET 494.00PENLET 3.50PHOSPHOSODA 234.00PLASTER OF PARIS 91.00POVIDONE IODINE GARGLE 59.00PREGNANCY TEST 21.00PROLENE 2-0 224.00PROLENE MESH 3,263.00ROLL GAUZE BANDAGE 4X10 12.50SAFEHANDS GLOVES 6.5 130.00SAFEHANDS GLOVES 7.0 130.00SAFIL 0- W/ ROUND NEEDLE 195.00SAFIL 1- W/ ROUND NEEDLE 205.00SAFIL 2- W/ ROUND NEEDLE 148.50SAFIL 3- W/ ROUND NEEDLE 43.50SAFIL 4- W/ ROUND NEEDLE 165.50SAFIL 4- W/ CUTTING NEEDLE 190.00SILK 2-0 W/ CUTTING NEEDLE 105.50SILK 2-0 W/ ROUND NEEDLE 49.00SILK 2-0 W/O NEEDLE 98.00SILK 3-0 W/ CUTTING NEEDLE 98.50SILK 3-0 W/ ROUND NEEDLE 43.50SILK 3-0 W/O NEEDLE 46.50SILK 4-0 W/ CUTTING NEEDLE 98.50SILK 4-0 W/ ROUND NEEDLE 49.00SILK 4-0 W/O NEEDLE 98.50

Page 64: Qmmc Citizens Charter 11-28-13

SILK 5-0 W/ CUTTING NEEDLE 50.40SILK 5-0 W/ ROUND NEEDLE 49.00SILK 6-0 W/ CUTTING NEEDLE 54.50SOLUSET 130.00SPINAL NEEDLE #18 60.00SPINAL NEEDLE #25 78.00SPINAL NEEDLE #27 110.50SPIROMETER 546.00SUBCLAVIAN DOUBLE/TRIPLE LUMEN 3,900.00SUBCLAVIAN DOUBLE LUMEN 2,600.00SUCTION CATETHER Fr. 10 6.00SUCTION CATETHER Fr. 12 6.00SUCTION CATETHER Fr. 14 6.00SUCTION CATETHER Fr. 16 6.00SUCTION CATETHER Fr. 18 8.00SUCTION CATETHER Fr. 5 6.00SUCTION CATETHER Fr. 8 6.00SURGICAL BLADE #10 4.00SURGICAL BLADE #11 4.00SURGICAL BLADE #15 4.00SVS 19 4.50SVS 21 4.50SVS 25 4.50T - PIECE NEB KIT 530.50TEGADERM (A) 47.00TEGADERM (P) 24.00THORACIC CATHETER Fr. 24 161.50THORACIC CATHETER Fr. 28 156.00THORACIC CATHETER Fr. 32 156.00THORACIC CATHETER Fr. 36 156.00TISSUE PAPER 7.50TOUHY NEEDLE G18 292.50TRACHEOSTOMY TUBE 6.0 2,925.00TRACHEOSTOMY TUBE 7.0 2,730.00TRACHEOSTOMY TUBE 7.5 2,730.00TRACHEOSTOMY TUBE 8.0 2,730.00URINE BAG 13.00VASELINIZED GAUZE 10X10 61.00

Page 65: Qmmc Citizens Charter 11-28-13

(BACTIGRAS)VICRYL 4-0 W/ CUTTING NEEDLE 198.00V - 34 ADULT 19.50V - 37 PEDIA 21.00VICRYL 0 W/ NEEDLE 190.00VICRYL 2-0 W/ ROUND NEEDLE 162.50VICRYL 3-0 W/ ROUND NEEDLE 129.00VICRYL 4-0 W/ CUTTING NEEDLE 102.50VICRYL 5-0 1,024.00VICRYL 6-0 1,024.00VISCOAT 2,131.00WADDING SHEET 28.50WEE BAG 4.503 WAY STOP COCK 36.50

Supplementary FormulaENSURE 407.00ISOCAL 442.00NUTREN FIBER 684.00NUTREN OPTIMUM 409.50NUTREN DIABETES 520.00NUTREN DIABETES 836.50PEPTAMEN 1,197.50NUTREN JUNIOR 318.50

MS PackABDOMINAL PACK 1,580.00ABDOMINAL BINDER 250.00CIRCUMCISSION PACK 200.00D & C PACK 350.00FNAB 55.00I.V PACK ADULT 80.00I.V PACK PEDIA 80.00INCISION DRAINAGE PACK 65.00LTCS W/O BINDER 1,515.00LTCS W/ BINDER 1,765.00NEW BORN BABY PACK 190.00NSD PACK 325.00OB-GYNE KIT 385.00SKIN TEST FOR DENTAL 10.00

Page 66: Qmmc Citizens Charter 11-28-13

SPINAL PACK 200.00STANDARD DRESSING PACK 30.00STANDARD EXCISION BIOPSY 150.00THIRD SOLUTION PACK 80.00VALSARTAN 80mg TAB 27.00VALSARTAN 160mg TAB 39.50NEW BORN BABY PACK 190.00

Page 67: Qmmc Citizens Charter 11-28-13

QMMC HYMN

Paglilingkod sa kapwaAng pangunahing tungkulin

Mahusay na programa sa pangkalusuganAt ibayong pagkalinga

Mayaman man o mahirapAy paglilingkuran ng sapat

Anumang sakit o malubhang karamdamanAy bibigyan ng tiyak na lunas

Chorus:Mula ngayon hanggan sa kinabukasan

Tungkulin ay buong pusong gagampananIto ang tapat at tanging sandigan

Sa QMMC ang bayan ay paglilingkuran

Bridge:Ito an gaming tanging layunin

Mahusay at ligtas na pagamutanMakabago at wastong kasangkapan

Mga kawaning may sapat na kakayahan

(Repeat Chorus twice)

Outro:

Page 68: Qmmc Citizens Charter 11-28-13

Sa QMMC…Sa QMMC…

Sa QMMC ang bayan ay . . . Paglilingkuran