SNO | Package Name | Category | A1 | A2 | A3 | A4 | A5 | A6 | S1 | S2 |
---|---|---|---|---|---|---|---|---|---|---|
554 | CMU0146 : BRACHYTHERAPY INTRACAVITARY HDR PER APPLICATION | RADIATION ONCOLOGY | 8200 | 8200 | 8200 | 8200 | 8200 | 8200 | 8200 | 8200 |
555 | CMU0147 : PALLIATIVE TREATMENT WITH PHOTONS /ELECTRONS - LINAC | RADIATION ONCOLOGY | 17500 | 17500 | 17500 | 17500 | 17500 | 17500 | 17500 | 17500 |
556 | CMU0148 : RADICAL TREATMENT WITH COBALT 60 EXTERNAL BEAM RT | RADIATION ONCOLOGY | 24800 | 24800 | 24800 | 24800 | 24800 | 24800 | 24800 | 24800 |
557 | CMU0149 : RADICAL TREATMENT WITH PHOTONS / ELECTRONS | RADIATION ONCOLOGY | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 |
558 | CMU0150 : BRACHYTHERAPY -INTRACAVITARY LDR PER APPLICATION | RADIATION ONCOLOGY | 5000 | 5000 | 5000 | 5000 | 5000 | 5000 | 5000 | 5000 |
559 | CMU0151 : ADJUVANT TREATMENT - CAN BE COMBINED ANY OTHER MODALITY OF TREAMENT - COBALT | RADIATION ONCOLOGY | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 | 20400 |
560 | CMU0152 : ADJUVANT TREATMENT WITH PHOTONS/ELECTRONS | RADIATION ONCOLOGY | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 | 36300 |
561 | CMU0153 : BRACHYTHERAPY INTERSTITIAL HDR ONE APPLICATION AND MULTIPLE / SURFACE BRACHYTHERAPY 3TO 5 FRACTIONS / INTRA LUMINAL BRACHYTHERAPY 3 FRACTIONS | RADIATION ONCOLOGY | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 |
562 | CMU0153 A : SURFACE BRACHYTHERAPY 3TO 5 FRACTIONS | RADIATION ONCOLOGY | 12000 | 12000 | 12000 | 12000 | 12000 | 12000 | 12000 | 12000 |
563 | CMU0153 B : INTRA LUMINAL BRACHYTHERAPY 3 FRACTIONS | RADIATION ONCOLOGY | 7000 | 7000 | 7000 | 7000 | 7000 | 7000 | 7000 | 7000 |
564 | CMU0153 C : BRACHYTHERAPY INTERSTITIAL HDR ONE APPLICATION AND MULTIPLE DOSE FRACTIONS | RADIATION ONCOLOGY | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 | 20000 |
565 | CMU0153 D : TNMSC RT- BRACHYTHERAPY INTERSTITIAL HDR ONE APPLICATION AND MULTIPLE DOSE FRACTIONS | RADIATION ONCOLOGY | 45000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
566 | CMU0154 : PALLIATIVE TREATMENT WITH COBALT 60 EXTERNAL BEAM RT | RADIATION ONCOLOGY | 11700 | 11700 | 11700 | 11700 | 11700 | 11700 | 11700 | 11700 |
567 | CMU0155 : SPECIALIZED RADIATION THERAPY - 3DCRT PACKAGE ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 | 71400 |
568 | CMU0155 A : SPECIALIZED RADIATION THERAPY - 3DCRT PACKAGE ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 55000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
569 | CMU0156 : SSPECIALIZED RADIATION THERAPY 3D CRT- RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 78800 | 78800 | 78800 | 78800 | 78800 | 78800 | 78800 | 78800 |
570 | CMU0156 A : SPECIALIZED RADIATION THERAPY 3D CRT- RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION)- TNMSC/GH ONLY | RADIATION ONCOLOGY | 65000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
571 | CMU0157 : SPECIALIZED RADIATION THERAPY - IMRT ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) | RADIATION ONCOLOGY | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 | 93500 |
572 | CMU0157 A : SPECIALIZED RADIATION THERAPY - IMRT ADJUVANT (INCLUDES AQUAPLAST MOULD, PLANNING CT FOR IMRT, CONTOURING, RT PLANNING, QA, EXECUTION) - TNMSC/GH ONLY | RADIATION ONCOLOGY | 75000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
573 | CMU0158 : SPECIALIZED RADIATION THERAPY - IMRT - RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) 34-40 FRACTIONS | RADIATION ONCOLOGY | 105000 | 105000 | 105000 | 105000 | 105000 | 105000 | 105000 | 105000 |
574 | CMU0158 A : SPECIALIZED RADIATION THERAPY - IMRT - RADICAL (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 90000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
575 | CMU0159 : SPECIALIZED RADIATION THERAPY - IMRT WITH IGRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
576 | CMU0159 A : SPECIALIZED RADIATION THERAPY - IMRT WITH IGRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 110000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
577 | CMU0160 : SPECIALIZED RADIATION THERAPY - RAPID ARC THERAPY (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 | 157500 |
578 | CMU0160 A : SPECIALIZED RADIATION THERAPY - RAPID ARC THERAPY (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) - TNMSC /GH ONLY | RADIATION ONCOLOGY | 110000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
579 | CMU0161 : BRACHYTHERAPY INTERSTITIAL LDR PER APPLICATION | RADIATION ONCOLOGY | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 |
580 | CMU0162 : TOTAL BODY RADIATION | RADIATION ONCOLOGY | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 | 44000 |
581 | CMU0163 : SPECIALIZED RADIATION THERAPY - SRS/SRT/SBRT (INCLUDES AQUAPLAST MOULD, PLANNINGCT, COUNTOURING, RT PLANNING & EXECUTION) | RADIATION ONCOLOGY | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 | 87500 |
582 | CMU0164 : CRANIOSPINAL RADIATION | RADIATION ONCOLOGY | 150000 | 150000 | 150000 | 150000 | 150000 | 150000 | 150000 | 150000 |
583 | CMU0165 : HEMOSTATIC RT - LINAC BASED | RADIATION ONCOLOGY | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 | 15000 |