PHILHEALTH CASE RATE PACKAGES
PRICE LIST

PRICE UPDATED
2/27/2023 UP TO PRESENT


renal disease NOS, Unspecified renal biopsy" without haemorrhage or perforation" wound)" classified Ankle and foot" Oesophageal reflux NOS" and vascular devices, implants and grafts" of foreign body" segmental sclerosis; Focal glomerulonephritis" disease" Hyperostosis of bones, except skull Other" strain of Acromioclavicular ligament" insecticides"

ICD10 Code

Cause of Morbidity (Underlying)

HB

PF

CASE RATE

N93.9 Abnormal uterine and vaginal bleeding, unspecified 4,620.00 1,980.00 6,600.00
A06.0 Acute amoebic dysentery;acute amoebiasis;intestinal amoebiasis nos 5,460.00 2,340.00 7,800.00
J20.9 Acute bronchitis, unspecified 3,640.00 1,560.00 5,200.00
A19.1 Acute miliary tuberculosis of multiple sites 13,741.00 5,889.00 19,630.00
N00.9 Acute nephritic syndrome including acute glomerular DISEASE 9,100.00 3,900.00 13,000.00
9,100.00 3,900.00 13,000.00
K85.9 Acute pancreatitis, unspecified 11,466.00 4,914.00 16,380.00
K27.3 "Acute Peptic/ Gastroduodenal ulcer, site unspecified, Without Haemorrage or perforation 5,551.00 2,379.00 7,930.00
4,270.00 1,830.00 6,100.00
D62 Acute posthaemorrhagic anaemia 7,000.00 3,000.00 10,000.00
N10 ACUTE TUBULO-INTERSTITIAL NEPHRITIS; PYELONEPHRITIS 9,100.00 3,900.00 13,000.00
I21.4 Acute subendocardial myocardial infarction 17,199.00 7,371.00 24,570.00
J06.9 Acute upper respiratory infection, unspecified;acute upper respiratory disease;upper respiratory infection nos 3,639.00 1,560.00 5,200.00
T78.4 Allergy, Unspecidified; Allergic reaction NOS 7,553.00 3,237.00 10,790.00
M45 Ankylosing spondylitis; Rheumatoid arthritis of spine 5,810.00 2,490.00 8,300.00
M24.6 Ankylosis of joint 8,372.00 3,588.00 11,960.00
I25.1 Atherosclerotic heart disease; Coronary Artery Disease 2,800.00 1,200.00 4,000.00
Q21.1 Atrial septal defect 10,556.00 4,524.00 15,080.00
G00.9 Bacterial meningitis, unspecified 23,387.00 10,023.00 33,410.00
P36.9 Bacterial sepsis of newborn, unspecified 8,190.00 3,510.00 11,700.00
R56.0 Febrile Convulsion 6,370.00 2,730.00 9,100.00
H81.1 BENIGN PAROXYMAL VERTIGO 5,187.00 2,223.00 7,410.00
l49.9 CARDIAC ARRHYTHMIA, UNSPECIFIED; CARDIAC ARRHYTHMIA NOS 11,102.00 4,758.00 15,860.00
C16.2 Malignant neoplasm of body of stomach 12,922.00 5,538.00 18,460.00
D43.0 Neoplasm of uncertain or unknown behaviour of brain, supratentorial 11,102.00 4,758.00 15,860.00
C50.9 MALIGNANT NEOPLASM OF BREAST, UNSPECIFIED 10,738.00 4,602.00 15,340.00
J45.90 Bronchial Asthma in Acute Exacerbation 13,832.00 5,928.00 19,760.00
T31.0 Burns involving less than 10% of body surface 7,735.00 3,315.00 11,050.00
K80.0 Calculus of gallbladder with acute cholecystitis 10,283.00 4,407.00 14,690.00
N20.0 Calculus of kidney 3,640.00 1,560.00 5,200.00
I49.9 Cardiac arrhythmia, unspecified;cardiac arrhythmia nos 11,102.00 4,758.00 15,860.00
L03.1 Cellulitis of other parts of limb 6,720.00 2,880.00 9,600.00
I63.9 Cerebral infarction, unspecified 19,600.00 8,400.00 28,000.00
K29.5 Chronic gastritis, unspecified; CHRONIC ANTRAL GASTRITIS; CHRONIC FUNDAL GASTRITIS 5,551.00 2,379.00 7,930.00
N18.5 Chronic Kidney Disease Stage V 10,150.00 4,350.00 14,500.00
J44.1 Chronic obstructive/ASTHMATIC/EMPHYSEMATOUS PULMONARY DISEASE WITH ACUTE EXACEBRATION. UNSPECIFIED 11,102.00 4,758.00 15,860.00
H65.2 Chronic serous otitis media; Chronic tubotympanal catarrh 7,098.00 3,042.00 10,140.00
S02.40 Closed Fracture of malar and maxillary bones 9,737.00 4,173.00 13,910.00
S06.00 Concussion; Commotio cerebri (without open intracranial wound) 8,007.00 3,432 11,440.00
6,160.00 2,640.00 8,800.00
P23.9 Congenital pneumonia 11,557.00 4,953.00 16,510.00
I50.0 Congestive heart failure 10,990.00 4,710.00 15,700.00
G95.2 Cord compression, unspecified 14,377.00 6,162.00 20,540.00
A97.1 DENGUE WITH WARNING SIGNS; DENGUE HAEMORRHAGIC FEVER WITH WARNING SIGNS 7,000.00 3,000.00 10,000.00
J18.92 COMMUNITY-ACQUIRED PNEUMONIA lll (MODERATE RISK) 13,650.00 5,5850 13,000.00
l63.9 CEREBRAL INFARCTION, UNSPECIFIED 19,600.00 8,400.00 28,000.00
A09.9 ACUTE GASTROENTERITIS 5,460.00 2,340.00 7,800.00
K09.1 Developmental (nonodontogenic) cysts of oral region 7,553.00 3,237.00 10,790.00
A01.0 TYPHOID FEVER 9,100.00 3,900.00 13,000.00
M18.5 CHRONIC KIDNEY DISEASE, STAGE 5 13,195.00 5,655.00 18,850.00
E87.8 OTHER DISORDERS OF ELECTROLYTE AND FLUID BALANCE, NOT ELSEWHERE CLASSIFIED; 7,734.00 3,315.00 11,050.00
l25.1 ATHEROSCLEROTIC HEART TDISEASE; CORONARY ARTERY DISEASE 3,639.00 1,560.00 5,200.00
N39.0 URINARY TRACT INFECTION, SITE NOT SPECIFIED 6,825.00 2,925.00 9,750.00
J90 PLEURAL EFFUSION, NOT ELSEWHERE CLASSIFIED; 12,922.00 5,538.00 18,460.00
D62 ACUTE POSTHAEMORRHAGIC ANAEMIA 9,100.00 9,900.00 13,000.00
E11.9 NON-INSULIN-DEPENDENT DIABETES MELLITUS WITHOUT COMPLICATIONS 3,639.00 1,560.00 5,200.00
l50.0 CONGESTIVE HEART FAILURE; CONGESTIVE HEART DISEASE 14,287.00 6,123.00 20,410.00
N93.9 ABNORMAL UTERINE AND VAGINA BLEEDING, UNSPECIFIED 6,006.00 2,574.00 8,580.00
l10.1 HYPERTENSION, STAGE ll 8,189.00 3,510.00 11,700.00
L103.1 Ceullitis of other parts of Limb, Axilla; Cellulitis of Hip;Cellulitis of Shoulder 8,736.00 3,744.00 12,480.00
I42.0 Dilated cardiomyopathy 12,194.00 5,226.00 17,420.00
L03.1 HIP;CELLUSITIC OF SHOULDER 8,736.00 3,744 3,835.00
K57.3 Diverticular disease of large intestine without perforation or abscess 8,645.00 3,705.00 12,350.00
N80.0 Endometriosis of uterus 7,007.00 3,003.00 10,010.00
N80.0 Expanded Newborn Care Package 3,185.00 650.00 3,835.00
C54.1 Malignant neoplasm of endometrium 10,374.00 4,446.00 14,820.00
G40.9 Epilepsy, unspecified 7,098.00 3,042.00 10,140.00
P00.8 Fetus and newborn affected by other maternal conditions 7,007.00 3,003.00 10,010.00
M60.27 Foreign body granuloma of soft tissue, not elsewhere classified ankle and foot 5,915.00 2,535.00 8,450.00
4,550.00 1,950.00 6,500.00
A09.9 GASTROENTERITIS AND COLITIS OF UNSCPECIFIED ORIGIN; NEONATAL DIARRHEA NOS 4,200.00 1,800.00 6,000.00
K21.9 Gasttro-oesophageal reflux disease without oesophagitis; oesophageal reflux nos 5,551.00 2,379.00 7,930.00
4,270.00 1,830.00 6,100.00
M10.90 Gout, unspecified, multiple sites 6,370.00 2,730.00 9,100.00
K82.1 Hydrops of gallbladder 8,918.00 3,822.00 12,740.00
I10.1 Hypertension, stage II 6,300.00 2,700.00 9,000.00
I11.9 Hypertensive heart disease without (congestive) heart failure 6,300.00 2,700.00 9,000.00
D69.3 Idiopathic thrombocytopenic purpura 11,648.00 4,992.00 16,640.00
I11.9 HYPERTENSIVE HEART DISEASE WITHOUT (CONGESTIVE) HEART FAILURE 8,190.00 3,510.00 11,700.00
T82.7 Infection and iflammatory reaction due to other cardiac and vascular devices, implants and grafts 9,373.00 4,017.00 13,390.00
7,210.00 3,090.00 10,300.00
S05.0 Injury of conjuctiva and corneal abrasion without mention of foreign body 8,008.00 3,432.00 11,440.00
6,160.00 2,640.00 8,800.00
I61.9 Intracerebral haemorrhage, unspecified 26,600.00 11,400.00 38,000.00
D25.9 Leiomyoma of uterus, unspecified 8,736.00 3,744.00 12,480.00
C19 Malignant neoplaasm of rectosigmoid junction; malignant neoplasm of colon with rectum 12,922.00 5,538.00 18,460.00
C34.9 Malignant neoplasm of Bronchus or lung, unspecified 13,286.00 5,694.00 18,980.00
C18.9 Malignant neoplasm of Colon, unspecified 12,922.00 5,538.00 18,460.00
G43.9 Migraine, unspecified 5,005.00 2,145.00 7,150.00
E44.1 Mild protein-energy malnutrition 10,647.00 4,563.00 15,210.00
M30.3 Mucocutaneous lymph node syndrome [Kawasaki] 12,558.00 5,382.00 17,940.00
S22.4 Multiple fracture of ribs 7,917.00 3,393.00 11,310.00
P59.9 Neonatal jaundice, unspecified 6,734.00 2,886.00 9,620.00
P39.3 Neonatal urinary tract infection 11,557.00 4,953.00 16,510.00
P07.3 OTHER PRETERM INFANTS 15,379.00 6,591.00 21,970.00
N04.1 Nephrotic syndrome : focal and segmental glomerular lesions; focal and segmental hyalinosis 9,100.00 3,900.00 13,000.00
7,000.00 3,000.00 10,000.00
E11.9 Non-Insulin Dependent Diabetes Mellitus (NIDDM) (Type II) 2,800.00 1,200.00 4,000.00
I85.0 Oesophageal varices with bleeding 11,921.00 5,109.00 17,030.00
N45.0 Orchitis, epididymitis and epididymo-orchitis with abscess 7,189.00 3,081.00 10,270.00
M86.9 OSTEOMYELITIS, UNSPECIFIED; INFECTION OF BONE NOS; PERIOSTITIS NOS 11,830.00 5,070.00 16,900.00
N83.2 Other and unspecified ovarian cysts 7,189.00 3,081.00 10,270.00
E87.8 Other disorders of electrolyte and fluid balance, not elsewhere classified 5,950.00 2,550.00 8,500.00
K56.4 Other impaction of intestine;enterolith;impaction of colon;imfaction of faecal 9,191.00 3,939.00 13,130.00
I67.9+G46.7* Other lancunar syndrome in unspecified cerebrovascular disease 13,832.00 5,928.00 19,760.00
10,640.00 4,560.00 15,200.00
P07.3 Other Preterm Infants 15,379.00 6,591.00 21,970.00
M85.88 Other specified disorders of bone desnity and structure; hyperostosis of bones. except skull OTHER 7,189.00 3,081.00 10,270.00
5,530.00 2,370.00 7,900.00
A48.8 Other specified bacterial diseases 8,099.00 3,471.00 11,570.00
A69.1 Other Vincent's infections; Acute Necrotizing Ulcerative Gingivostomatitis 6,160.00 2,640.00 8,800.00
C25.9 Malignant neoplasm of pancreas, unspecified 12,922.00 5,538.00 18,460.00
J90 Pleural Effusion, not elsewhere classified 9,940.00 4,260.00 14,200.00
J18.92 Pneumonia, moderate risk 10,500.00 4,500.00 15,000.00
M15.9 Polyarthrosis, unspecified 6,370.00 2,730.00 9,100.00
N95.0 Postmenopausal bleeding 5,460.00 2,340.00 7,800.00
A02.0 Salmonella enteritis 9,100.00 3,900.00 13,000.00
N70.9 Salpingitis and oophoritis, unspecified 8,190.00 3,510.00 11,700.00
A41.9 Septicaemia, unspecified 29,120.00 12,480.00 41,600.00
Z38.0 Singleton, born in hospital 2,450.00 500.00 2,950.00
S43.5 sprain and Strain of acromioclavicular joint; sprain and strain of acromioclavicular ligament 6,552.00 2,808.00 9,360.00
5,040.00 2,160.00 7,200.00
C08.0 Submandibular gland 10,465.00 4,485.00 14,950.00
S00.8 Superficial injury of other parts of head 3,639.00 1,560.00 5,200.00
B34.9 Viral Infection, unspecified 3,639.00 1,560.00 5,200.00
T60.0 Toxic effect of organophosphate and carbamate insecticides 5,824.00 2,496.00 8,320.00
4,480.00 1,920.00 6,400.00
K71.9 Toxic liver disease, unspecified 10,738.00 4,602.00 15,340.00
G45.9 Transient cerebral ischaemic attack, unspecified 6,643.00 2,847.00 9,490.00
A15.0 Tuberculosis of lung, confirmed by sputum microscopy with or without culture 8,918.00 3,822.00 12,740.00
A01.0 Typhoid fever 7,000.00 3,000.00 10,000.00
N39.0 Urinary tract infection, site not specified 5,250.00 2,250.00 7,500.00
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