Uttar Pradesh University of Medical Sciences

Saifai Etawah UP-206130

Hospital Charges

SR.NO. SERVICE NAME SERVICE CODE AMOUNT (Rs.)
BLOOD BANK
1 3D CBCT ON PAPER SER1109 500.00
2 3D CBCT WITH FILM SER1108 750.00
3 ACCLUSAL (DENTAL X-RAY) SER0065 35.00
4 APEXIFICATION / APEXOGENESIS ( BELOW 14 YEAR) SER0271 100.00
5 APICAL REPOSITION FLAP SURGERY (PER SEGMENT) SER0202 500.00
6 APICOCETOMY SER0223 250.00
7 APICOCETOMY (ADDITIONAL PER TOOTH) SER0224 100.00
8 APICOETOMY SER0019 250.00
9 APICOETOMY(250+ADDITIONAL 100+100+100) SER0055 550.00
10 APICOETOMY(250+ADDITIONAL RS.100 FOR ONE TOOTH) SER0020 350.00
11 APICOETOMY(250+ADDITIONAL RS.200 FOR TWO TEETH) SER0021 450.00
12 BALANCE SCALING SER0081 125.00
13 BELOW 14 YEARS  TEMPORARY FILLING SER0230 20.00
14 BELOW 14 YEARS GIC FILLING SER0228 100.00
15 BELOW 14 YEARS LIGHT CURE FILLING SER0229 200.00
16 BICUSPDIZATION (PER TOOTH) SER0209 250.00
17 BIOPSY SER0236 60.00
18 BITE GUARD SER0246 500.00
19 BITE PLATE APPLIANCE SER0078 350.00
20 BLEACHING OF TEETH (PER SEGMENT) SER0233 500.00
21 BLEACHING TRAY CONSTRUCTION (PER SEGMENT) SER0234 200.00
22 BONDING PER TOOTH (PER TOOTH) SER0274 250.00
23 CAPPING(FPD) SER0182 700.00
24 CAST PARTIAL DENTURE SER0249 1000.00
25 CEPHALOGRAM ON PAPER SER1107 150.00
26 CEPHALOGRAM WITH FILM SER1106 200.00
27 COMPLETE DENTURE SER0058 1500.00
28 CORONALLY ADVANCE FLAP SURGERY (PER SEGMENT) SER0201 500.00
29 CROWN LENGTHENING (PER TOOTH) SER0203 350.00
30 CYST ENUCLEATION SER0255 350.00
31 CYST MARSUPIALIZATION SER0256 350.00
32 DENTAL BIOPSY SER0080 60.00
33 DENTURE REPAIR  COLD CURE SER0240 200.00
34 DENTURE REPAIR  HEAT CURE SER0241 300.00
35 DEPIGMENTATION PER SEGMENT SER0215 350.00
36 DIAGNOSTIC WORKING MODELS SER0183 50.00
37 DISTAL MOLAR SURGERY (PER SEGMENT) SER0205 350.00
38 ENDO-PERIO SURGERY (PER TOOTH) SER0220 150.00
39 ENDO-PERIO SURGERY DECIDUOUS (PER TOOTH) SER0222 100.00
40 ENDO-PERIO SURGERY MULTIROOTED (PER TOOTH) SER0221 300.00
41 EXCISION OF JAW TUMOUR SER0257 1000.00
42 EXTRA ORAL DIGITAL X -RAY 50 SER0076 50.00
43 EXTRACTION OF FOUR TEETH SER0049 100.00
44 EXTRACTION OF ONE TEETH BLOW 14 SER0168 10.00
45 EXTRACTION OF ONE TOOTH SER0046 25.00
46 EXTRACTION OF THREE TEETH SER0048 75.00
47 EXTRACTION OF TWO TEETH SER0047 50.00
48 FILLING (GLASS IONOMER GIC) FOR FOUR TEETH SER0029 400.00
49 FILLING (GLASS IONOMER GIC) FOR ONE TOOTH SER0026 100.00
50 FILLING (GLASS IONOMER GIC) FOR THREE TEETH SER0028 300.00
51 FILLING (GLASS IONOMER GIC) FOR TWO TEETH SER0027 200.00
52 FILLING (LIGHT CURE) RESTORATION FOR FOUR TEETH SER0033 800.00
53 FILLING (LIGHT CURE) RESTORATION FOR ONE TOOTH SER0030 200.00
54 FILLING (LIGHT CURE) RESTORATION FOR THREE TEETH SER0032 600.00
55 FILLING (LIGHT CURE) RESTORATION FOR TWO TEETH SER0031 400.00
56 FILLING (SILVER ALLOY) FOR FOUR TEETH SER0025 160.00
57 FILLING (SILVER ALLOY) FOR ONE TOOTH SER0022 40.00
58 FILLING (SILVER ALLOY) FOR THREE TEETH SER0024 120.00
59 FILLING (SILVER ALLOY) FOR TWO TEETH SER0023 80.00
60 FILLING LIGHT CURE SER0083 200.00
61 FLUORIDE APPLICATION SER0264 50.00
62 FLUORIDE VARNISH SER0263 100.00
63 FRACTURE MANDIBLE CLOSED REDUCTION SER0051 350.00
64 FRENECTOMY SER0192 350.00
65 FRENOTOMY SER0193 350.00
66 GIC FILLING SER0066 100.00
67 GINGIVECTOMY (PER SEGMENT) SER0195 245.00
68 GINGIVOPLASTY ( PER SEGMENT) SER0196 240.00
69 GTR MEMBRANE (PER TOOTH) SER0214 500.00
70 HALF DENTURE (SINGLE) SER0238 900.00
71 HEMISECTION (PER TOOTH) SER0207 250.00
72 IMPACTED CAVINE EXPOSED / REMOVAL SER0060 500.00
73 IMPACTED MANDIBULAR !!! MOLAR SER0062 500.00
74 IMPACTED MAXILLARY !!! MOLAR SER0063 850.00
75 IMPLANT OVERDENTURE SER0253 1500.00
76 IMPLANT PROSTHESES SER0251 1000.00
77 IMPLANT SURGERY SER0237 1000.00
78 INTERMAXILLARY FIXATION SER0254 350.00
79 IOPA SER1110 50.00
80 LASER SER0219 350.00
81 LINGUAL ARCH / RMF SER0275 270.00
82 LINGUAL FRENUM REMOVAL SER0194 350.00
83 LIP REPOSITIONING SURGERY SER0218 5000.00
84 LOWER DENTURE (HALF CD) SER0075 900.00
85 MAJOR ORAL SURGERY SER0259 1000.00
86 MAXILLOFACIAL PROSTHESES SER0250 1000.00
87 MINOR ORAL SURGERY SER0258 350.00
88 MINOR ORAL SURGICAL PROCEDURE SER0052 350.00
89 MODIFIED WIDMAN FLAP SURGERY ( PER SEGMENT) SER0200 500.00
90 NATURAL TOOTH PONTIC (PER TOOTH) SER0191 500.00
91 OBTURATOR SER0248 500.00
92 OCCLUSAL SER1104 100.00
93 OPEN FLAP DEBRIDEMENT (FLAP SURGERY) PER SEGMENT SER0198 500.00
94 OPERCULECTOMY (PER SEGMENT) SER0204 350.00
95 OPG ON PAPER SER1113 150.00
96 OPG WITH FILM SER1112 200.00
97 ORAL SURGICAL SPLINTING SER0260 1000.00
98 ORTHODENTIC APPLIANCE SER0079 350.00
99 ORTHODONTIC FIX TREATMENT SER0247 5000.00
100 ORTHODONTIC FUNCTIONAL APPLIANCE SER0273 600.00
101 OSSEOUS BONE GRAFT (PARTICULATE) PER TOOTH SER0213 500.00
102 PAPILLA PRESERVATION FLAP SURGERY ( PER SEGMENT) SER0199 500.00
103 PAPILLA RECONSTRUCTION PER TOOTH SER0216 750.00
104 PAPILLOPLASTY (PER SEGMENT) SER0197 150.00
105 PERIO PROSTHESIS (PER SEGMENT) SER0212 245.00
106 PIT & FISSURE SEALANT SER0270 50.00
107 PNS ON FILM SER1126 200.00
108 PNS ON PAPER SER1105 150.00
109 POST & CORE (PER TOOTH) SER0245 300.00
110 PRIMARY STAINLESS STEEL CROWN PER UNIT SER1357 400.00
111 PULP CAPPING SER0085 50.00
112 PULP CAPPING (PER TOOTH) SER0265 100.00
113 PULP CAPPING BELOW 14 YEARS OF AGE SER0266 50.00
114 PULPOTOMY SER0084 100.00
115 PULPOTOMY (FOUR TEETH) SER0086 400.00
116 PULPOTOMY (PER TOOTH) SER0267 100.00
117 RADISECTOMY (PER TOOTH) SER0232 350.00
118 RECEMENTATION (PER TOOTH) SER0244 50.00
119 REIMPLANTATION (PER TOOTH) SER0231 300.00
120 RELINING / REBASING (PER DENTURE PLATE) SER0242 200.00
121 REMOVABLE APPLIANCE(PER PLATE) SER0235 350.00
122 REMOVABLE PARTIAL DENTURE (PER TOOTH) SER0239 150.00
123 REPAIRING DENTURE SER0082 200.00
124 RESSECTIVE OSSEOUS SURGERY (PER SEGMENT) SER0206 500.00
125 RIDGE AUGMENTATION SER0217 4000.00
126 ROOT CANAL TREATMENT (ANTERIOR)  FOUR TEETH SER0041 800.00
127 ROOT CANAL TREATMENT (ANTERIOR) ONE TOOTH SER0038 200.00
128 ROOT CANAL TREATMENT (ANTERIOR) THREE TEETH SER0040 600.00
129 ROOT CANAL TREATMENT (ANTERIOR) TWO TEETH SER0039 400.00
130 ROOT CANAL TREATMENT (POSTERIOR) FOUR TEETH SER0045 1200.00
131 ROOT CANAL TREATMENT (POSTERIOR) ONE TOOTH SER0042 300.00
132 ROOT CANAL TREATMENT (POSTERIOR) THREE TEETH SER0044 900.00
133 ROOT CANAL TREATMENT (POSTERIOR) TWO TEETH SER0043 600.00
134 ROOT RESECTION (PER TOOTH) SER0208 250.00
135 RPD 150 SER0073 150.00
136 RPD 225 SER0061 225.00
137 RPD 300 SER0071 300.00
138 RPD 375 SER0072 375.00
139 RPD 525 SER0070 525.00
140 RPD 600 SER0069 600.00
141 RPD 825 SER0068 825.00
142 RPD TOOTH (UG CLINIC) SER0064 150.00
143 RVG SER1111 25.00
144 SCALING (ULTRA SONIC) SER0018 175.00
145 Scaling 50 SER0167 50.00
146 SILVER FILLING SER0067 40.00
147 SILVER FILLING 80 SER0077 80.00
148 SINGLE COMPLETE DENTURE (PG CLINIC) SER0074 900.00
149 SOFT LINING APPLICATION SER0243 600.00
150 SOFT TISSUE GRAFT (ALLOGRAFT) PER TOOTH SER0211 200.00
151 SOFT TISSUE GRAFT (AUTOGRAFT) PER TOOTH SER0210 500.00
152 SPACE MAINTAINER (FOR BOTH SIDE) SER0269 175.00
153 SPACE MAINTAINER (FOR ONE SIDE) SER0268 100.00
154 SPLINTING - DENTAL SER0056 245.00
155 TEETH MOUSEE APPLICATION SER0272 50.00
156 TEMPORARY FILLING CEMENT FOR FOUR TEETH SER0037 80.00
157 TEMPORARY FILLING CEMENT FOR ONE TOOTH SER0034 20.00
158 TEMPORARY FILLING CEMENT FOR THREE TEETH SER0036 60.00
159 TEMPORARY FILLING CEMENT FOR TWO TEETH SER0035 40.00
160 TMJ LAVAGE  (EACH) SER0262 500.00
161 TMJ OCCLUSAL SPLINT SER0252 300.00
162 TMJ SURGERY (EACH) SER0261 2000.00
163 TOOTH FILLING GIC FILLING (PER TOOTH) SER0226 100.00
164 TOOTH FILLING LIGHT CURE FILLING (PER TOOTH) SER0227 200.00
165 TOOTH FILLING SILVER ALLOY FILLING (PER TOOTH) SER0225 40.00
DGP
1 BREAKAGE CHARGES SER0173 0.00
2 DUPLICATE GATE PASS SER0171 50.00
3 FINE SER0174 0.00
4 TOBACCO CHARGES SER0172 100.00
DIALYSIS
1 DIALYSIS CHARGES. SER0368 1250.00
2 DOUBLE LUMEN CATHETER SER0165 1500.00
3 HAEMODIALYSIS WITH SURGICAL SUNDRIES - DOUBLE SER0016 2700.00
4 HAEMODIALYSIS WITH SURGICAL SUNDRIES - SINGLE SER0015 1700.00
5 HAEMODIALYSIS WITH SURGICAL SUNDRIES. SER0369 1250.00
6 INJ. ERITHROPROTEIN SER0152 200.00
7 SINGLE LUMEN CATHETER SER0166 500.00
ECG
1 ECG SER0169 68.00