Approved w.e.f Code NAME OF PACKAGE STDB DLX SUITE Package Includes: Name of Investigation Package Excludes:

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Approved w.e.f. 11-06-2016 265 CORONARY ANGIOGRAPHY NORMAL RISK. 18,000 20,000 24,000 25,000 35,500 10858 CORONARY ANGIOGRAPHY NORMAL RISK (OUT OF HOURS) 28,000 30,500 35,000 37,000 48,000 3102 CORONARY ANGIOGRAPHY HIGH RISK / PRIMARY CAG 28,000 30,500 35,000 37,000 48,000 10859 CORONARY ANGIOGRAPHY HIGH RISK / PRIMARY CAG (OUT OF HOURS) 34,500 37,000 41,500 43,500 55,000 8700 PERIPHERAL ANGIOGRAPHY - CAROTID / RENAL / UPERLIMB / LOWER LIMB 18,000 20,000 24,000 25,000 35,500 8701 PERIPHERAL ANGIOGRAPHY WITH CAG 23,000 26,000 30,500 32,500 43,000 1) Cath procedure routine Consumables including 50ml of Omnipaque non ionic dye (except Cournand & NIH Catheters, if & when required) 2) Cardiologist Consultation Fees (Except from the patients admitted through Emergency Department) 3) Cath Lab Charges. 4) Room Rent for 2 days (including 1 day in ICU). 5) Medicines worth TK.500.00 6) Routine Test as listed below (one unit each) : Creatinine - Serum Electrolytes ( NA,K,CL,HCO3) - Serum 7) Nursing Service Charges / Out of Hours Nursing Service Charges - For Nomal Risk - 2 Units & for High Risk - 3 units @1,000/- each 8) Out of Hours Technician Service Charges - for either normal or high risk 1 Unit @ 1,500/- 1) Any Other Test / Investigation If Done Which will be Charged extra. 2) Medicines (more than TK.500) & consumables other than Cath procedure consumables. 3) Echo & CSA If Done Will Be Charged Separately. 4) Room Tariff as Applicable In The Ward after Two days. 5) VCD (TK.1500) to be paid for by patient if he/she wants a copy. 6) Physiotherapy, Any other procedures & Services.

Approved w.e.f. 11-06-2016 3456 CORONARY ANGIOPLASTY WITHOUT STENTING 71,500 75,500 94,000 99,000 115,500 3457 CORONARY ANGIOPLASTY WITH STENTING (SVD) 71,500 75,500 94,000 99,000 115,500 8702 CORONARY ANGIOPLASTY WITH STENTING (DVD) 76,500 91,500 99,500 105,500 122,500 8703 CORONARY ANGIOPLASTY WITH STENTING (TVD / CTO) 81,500 97,500 106,000 112,500 130,500 10860 CORONARY ANGIOPLASTY NORMAL RISK - SVD (OUT OF HOURS) 108,000 112,000 120,000 126,000 140,000 10861 CORONARY ANGIOPLASTY NORMAL RISK - DVD (OUT OF HOURS) 125,000 129,000 137,000 143,000 157,000 10862 CORONARY ANGIOPLASTY NORMAL RISK - TVD / CTO (OUT OF HOURS) 140,000 144,000 152,000 158,000 172,000 3458 PTCA - HIGH RISK / PRIMARY ANGIOPLASTY - SVD 108,000 112,000 120,000 126,000 140,000 10863 PTCA - HIGH RISK / PRIMARY ANGIOPLASTY - DVD 125,000 129,000 137,000 143,000 157,000 10864 PTCA - HIGH RISK / PRIMARY ANGIOPLASTY - TVD / CTO 140,000 144,000 152,000 158,000 172,000 8717 PTCA - HIGH RISK / PRIMARY ANGIOPLASTY - SVD (OUT OF HOURS) 140,000 145,000 155,000 163,000 173,000 10865 PTCA - HIGH RISK / PRIMARY ANGIOPLASTY - DVD (OUT OF HOURS) 157,000 162,000 172,000 180,000 190,000 10866 PTCA - HIGH RISK / PRIMARY ANGIOPLASTY - TVD / CTO (OUT OF HOURS) 172,000 177,000 187,000 195,000 205,000 3459 PERIPHERAL ANGIOPLASTY 77,500 93,500 100,500 105,500 131,500 3460 ABANDONED PTCA 50,000 57,500 64,500 69,000 100,000 2) Three days Room Rent 2 Days in ward and 1 Day in ICU. For High Risk / Primary Angioplasty - 3 days CCU. For failed PTCA 1 one day room rent is included. 3) Cath Lab Charges 4) Routine consumables including 150ml of Omnipaque (non ionic dye) 5) Medicines worth Tk. 4500.00 7) Nursing Service Charges / Out of Hours Nursing Service Charges - For Nomal Risk - 2 Units & for High Risk - 3 units @1,000/- each 8) Out of Hours Technician Service Charges - for either normal or high risk 1 Unit @ 1,500/- 1) Investigation If Done Will Be Charged Separately. 2) VCD (TK.1500) to be paid for by patient if he/she wants a copy. 3) Physiotherapy, Any other procedures & Services. 4) COST OF STENT/STENTS IS/ARE EXTRA.

Approved w.e.f. 11-06-2016 5971 CORONARY ANGIOGRAPHY & ANGIOPLASTY WITHOUT STENTING 88,500 94,000 117,000 122,500 149,500 5972 CORONARY ANGIOGRAPHY & ANGIOPLASTY WITH STENTING (SVD) 88,500 94,000 117,000 122,500 149,500 8704 CORONARY ANGIOGRAPHY & ANGIOPLASTY WITH STENTING (DVD) 88,500 94,000 117,000 122,500 149,500 8705 CORONARY ANGIOGRAPHY & ANGIOPLASTY WITH STENTING (TVD / CTO) 98,500 116,500 129,000 135,500 164,500 10867 CORONARY ANGIOGRAPHY & ANGIOPLASTY NORMAL RISK - SVD (OUT OF HOURS) 132,500 139,000 151,500 159,500 184,500 10868 CORONARY ANGIOGRAPHY & ANGIOPLASTY NORMAL RISK - DVD (OUT OF HOURS) 149,500 156,000 168,500 176,500 201,500 10869 CORONARY ANGIOGRAPHY & ANGIOPLASTY NORMAL RISK - TVD / CTO (OUT OF HOURS) 164,500 171,000 183,500 191,500 216,500 5973 HIGH RISK - CAG & PTCA / PRIMARY CAG & PTCA -SVD 136,000 142,500 155,000 163,000 188,000 10870 HIGH RISK - CAG & PTCA / PRIMARY CAG & PTCA - DVD 153,000 159,500 172,000 180,000 205,000 10871 HIGH RISK - CAG & PTCA / PRIMARY CAG & PTCA -TVD / CTO 168,000 174,500 187,000 195,000 220,000 8718 HIGH RISK - CAG & PTCA / PRIMARY CAG & PTCA - SVD (OUT OF HOURS) 170,000 177,500 192,000 202,000 223,500 10872 HIGH RISK - CAG & PTCA / PRIMARY CAG & PTCA - DVD (OUT OF HOURS) 187,000 194,500 209,000 219,000 240,500 10873 HIGH RISK - CAG & PTCA / PRIMARY CAG & PTCA - TVD / CTO (OUT OF HOURS) 202,000 209,500 224,000 234,000 255,500 5974 CORONARY ANGIOGRAPHY & PERIPHERAL ANGIOPLASTY 94,500 112,500 123,000 129,000 165,500 5975 CORONARY ANGIOGRAPHY & ABANDONED PTCA 67,000 76,000 87,500 92,500 134,000 2) Cath procedure routine Consumables including 150ml of Omnipaque non ionic dye (except Cournand & NIH Catheters, if & when required) 3) Five days Room Rent 3 Days in ward and 2 Day in ICU. For High Risk / Primary CAG & PTCA - 2 Days in ward and 3 days CCU.For failed PTCA 1 one day room rent is included. 4) Cath Lab Charges 5) Medicines worth Tk. 5000.00 6) Routine Test as listed below (one unit each) : Creatinine - Serum Electrolytes ( NA,K,CL,HCO3) - Serum 7) Nursing Service Charges / Out of Hours Nursing Service Charges - For Nomal Risk - 2 Units & for High Risk - 3 units @1,000/- each 8) Out of Hours Technician Service Charges - for either normal or high risk 1 Unit @ 1,500/- 9) In case of CAG + PTCA in same sitting, only 2 units for normal risk or 3 units for high risk of nursing & 1 unit of technician (out of hours) service charge shall be applicable. 1) Any Other Test / Investigation If Done Will Be Charged Separately. 2) VCD (TK.1500) to be paid for by patient if he/she wants a copy. 3) Echo & CSA If Done Will Be Charged Separately. 4) Room rent will be Applicable after three days. 5) Physiotherapy, Any other procedures & Services. 6) Medicines (more than TK.3500) & consumables other than Cath procedure consumables. 7) COST OF STENT/STENTS IS/ARE EXTRA.

Approved w.e.f. 21-01-2015 3463 PULMONARY/MITRAL/AORTIC VALVULOPLASTY 51,000 62,500 71,000 76,000 94,500 1) Room For 2 Days including one day in ICU. 2) Medicine worth Tk. 3000.00 & routine Consumables including 50 ml of non ionic Omnipaque 3) Cath Lab Charges. 4) Cardiologist Consultation Fees (Except from the patients admitted through Emergency Department) 5) Cost of Balloon - 25% of Balloon Cost 6) Nursing Service Charges 1) Stay Beyond two days will be charged according to the Room / ICU tariffs. 2) Any Other Test / Investigation If Done will be Charged Separately. 3) VCD (TK.1500) to be paid for by patient if he/she wants a copy.

Approved w.e.f. 21-01-2015 4051 ELECTRO PHYSIOLOGY STUDY 120,500 127,500 135,500 141,000 175,500 Package includes: 1) Three ECG & One X-Ray Chest P.A View 2) Cardiologist Consultation Fees (Except from the patients admitted through Emergency Department) 3) Three days Room Rent 2 Days in ward and 1 Day in ICU. 4) Cath Lab Charges 5) Routine consumables including 150ml of Omnipaque (non ionic dye) 6) Medicines worth Tk. 5500.00 7) Routine Test: Creatinine Urea Electrolytes Glucose ( R) 8) Nursing Service Charges BT CT (HB, TLC, DLCC, ESR) Platelet Count & APTT/ PTTK ANTI HIV ( I&II) ELISA/ HBS AG (ELISA)/ HBS 1) Any other Test / Investigation if done will be charged separately. 2) VCD (TK.1500) to be paid for by patient if he/she wants a copy. 3) Physiotherapy, Any other procedures & Services. 4) COST OF STENT/STENTS IS/ARE EXTRA AT ACTUALS.

Approved w.e.f. 21-01-2015 4052 RIGHT & LEFT HEART STUDY 19,500 23,500 25,500 27,000 39,500 1) Cath procedure routine Consumables including 50ml of Omnipaque non ionic dye 2) Cardiologist Consultation Fees (Except from the patients admitted through Emergency Department) 3) Cath Lab Charges. 4) Room Rent for 2 days (including 1 day in ICU). 5) Medicines worth Tk. 2000.00 6) Nursing Service Charges 1) Any Other Test / Investigation If Done Which will be Charged extra. 2) Medicines (more than TK.500) & consumables more than TK 1500. 3) Echo & CSA If Done Will Be Charged Separately. 4) Room Tariff as Applicable In the ward after Two days. 5) VCD (TK.1500) to be paid for by patient if he/she wants a copy. 6) Physiotherapy, Any other procedures & Services.

Approved w.e.f. 19-06-2016 4035 TEMPORARY PACEMAKER IMPLANTATION 16,000 16,000 16,000 16,000 16,000 8706 TEMPORARY PACEMAKER IMPLANTATION - URGENT 20,000 20,000 20,000 20,000 20,000 10879 TEMPORARY PACEMAKER IMPLANTATION - URGENT (OUT OF HOURS) 27,000 27,000 27,000 27,000 27,000 4036 IABP INSERTION 17,500 17,500 17,500 17,500 17,500 2) Cath Lab Charges 3) Pace Maker Lead - 20% Lead Cost 4) Nursing Service Charges / Out of Hours Nursing Service Charges - 2 Units @ 1,000/- each 5) Out of Hours Technician Service Charges - 1 Unit @ 1,500/- 1) Any Test / Investigation If Done Will Be Charged Separately. 2) Room rent 3) Medicines 4) Physiotherapy, Any other procedures & Services. 5) COSTS OF PACEMAKER/CONSUMABLES (FOR IABP) ARE EXTRA.

Approved w.e.f. 11-06-2016 4037 PERMANENT PACEMAKER IMPLANTATION (SINGLE CHAMBER) 62,000 70,500 78,500 83,500 127,000 4038 PERMANENT PACEMAKER IMPLANTATION (DUAL CHAMBER) 62,000 70,500 78,500 83,500 127,000 4039 BI-VENTRICULAR PPI 96,000 105,000 112,500 118,500 161,000 6574 AICD 78,500 87,000 95,500 100,500 143,000 10857 PERMANENT PACEMAKER IMPLANTATION - SINGLE CHAMBER (OUT OF HOURS) 71,500 80,500 88,500 93,500 137,500 10856 PERMANENT PACEMAKER IMPLANTATION - DUAL CHAMBER (OUT OF HOURS) 71,500 80,500 88,500 93,500 137,500 2) Five days Room Rent 3 Day in ward and 2 Day in ICU Cath Lab Charges 3) Routine cath consumables 4) Routine Test as listed below (one unit each) Creatinine - Serum Electrolytes ( NA,K,CL,HCO3) - Serum Glucose (Random) ECG Chest AP (X-ray) 5) Nursing Service Charges / Out of Hours Nursing Service Charges - 3 Units @ 1,500/- each 6) Out of Hours Technician Service Charges - 1 Unit @ 2,000/- 1) Any Other Test / Investigation If Done Will Be Charged Separately. 2) Physiotherapy, Any other procedures & Services. 3) COSTS OF PACEMAKER ARE EXTRA.

Approved w.e.f. 21-01-2015 7812 ASD DEVICE CLOSURE / PDA DEVICE CLOSURE 55,500 69,000 74,000 77,000 94,500 8707 IVC FILTER 40,000 49,500 53,000 55,000 68,500 2) Two days Room Rent 1 Day in ward and 1 Day in ICU Cath Lab Charges 3) Routine cath consumables 4) Medicines worth Tk. 2250.00 5) Routine Test as listed below (one unit each) Creatinine - Serum 6) Nursing Service Charges 1) Any Other Test / Investigation If Done Will Be Charged Separately. 2) Physiotherapy, Any other procedures & Services 3) COSTS OF AMPLATZER SEPTAL OCCLUDER,ASD DEVICE CLOSURE DELIVERY SYSTEM & SIZING