SNO | Package Name | Category | A1 | A2 | A3 | A4 | A5 | A6 | S1 | S2 |
---|---|---|---|---|---|---|---|---|---|---|
1540 | CMU0547 A : SLE- PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE OR TACROLIMUS OR HYDROXYCHLOROQUINE | RHEUMATOLOGY | 16800 | 15100 | 13600 | 12250 | 11000 | 9900 | 16800 | 12250 |
1541 | CMU0547 B : SLE- PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE OR TACROLIMUS OR HYDROXYCHLOROQUINE/ MYCOPHENOLATE MOFETIL | RHEUMATOLOGY | 27300 | 24550 | 22100 | 19900 | 17900 | 16100 | 27300 | 19900 |
1542 | CMU0548 : SLE -WITH INTERNAL ORGAN INVOLVEMENT ON PULSE CYCLOPHOSPHAMIDE THERAPY | RHEUMATOLOGY | 22100 | 19900 | 17900 | 16100 | 14500 | 13050 | 22100 | 16100 |
1543 | CMU0549 : SLE WITH COMPLICATIONS | RHEUMATOLOGY | 50000 | 45000 | 40500 | 36450 | 32800 | 29500 | 50000 | 36450 |
1544 | CMU0550 : SCLERODERMA RENAL CRISIS | RHEUMATOLOGY | 18900 | 17000 | 15300 | 13800 | 12400 | 11150 | 18900 | 13800 |
1545 | CMU0551 : SJOGRENS SYNDROME- PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE OR TACROLIMUS OR HYDROXYCHLOROQUINE, PULSE CYCLOPHOSPHAMIDE THERAPY/MYCOPHENOLATE MOFETIL INDUCTION/MYCOPHENOLATE MOFETIL MAINTENANCE/ WITH GANGRENE ON IV PROSTACYCLIN/ PNEUMOCOCCAL VACCINATION | RHEUMATOLOGY | 21000 | 18900 | 17000 | 15300 | 13800 | 12400 | 21000 | 15300 |
1546 | CMU0552 : SYSTEMIC SCLEROSIS -METHOTREXATE OR AZATHIOPRINE OR HYDROXYCHLOROQUINE/PULSE CYCLOPHOSPHAMIDE THERAPY/MYCOPHENOLATE MOFETIL INDUCTION/MYCOPHENOLATE MOFETIL MAINTENANCE/ WITH GANGRENE ON IV PROSTACYCLIN | RHEUMATOLOGY | 26300 | 23650 | 21300 | 19150 | 17250 | 15550 | 26300 | 19150 |
1547 | CMU0553 : ACUTE RHEUMATIC FEVER / ACUTE EXACERBATION OF CHRONIC RHEUMATIC CONDITIONS | RHEUMATOLOGY | 15000 | 13500 | 12150 | 10950 | 9850 | 8850 | 15000 | 10950 |
1548 | CMU0554 : ANTIPHOSPHOLIPID SYNDROME (PRIMARY / SECONDARY) | RHEUMATOLOGY | 16500 | 14850 | 13350 | 12050 | 10850 | 9750 | 16500 | 12050 |
1549 | CMU0555 : CATASTROPHIC ANTIPHOSPHOLIPID SYNDROME | RHEUMATOLOGY | 50000 | 45000 | 40500 | 36450 | 32800 | 29500 | 50000 | 36450 |
1709 | CMU0652 A-I : MIXED CONNECTIVE TISSUE DISEASE-(METHOTREXATE OR AZATHIOPRINE OR HYDROXY CHLOROQUINE/ PULSE CYCLOPHOSPHAMIDE THERAPY | RHEUMATOLOGY | 16800 | 15100 | 13600 | 12250 | 11000 | 9900 | 16800 | 12250 |
1710 | CMU0652 A-I-a-i : MIXED CONNECTIVE TISSUE DISEASE- PULSE CYCLOPHOSPHAMIDE THERAPY | RHEUMATOLOGY | 3200 | 2900 | 2600 | 2350 | 2100 | 1900 | 3200 | 2350 |
1712 | CMU0652 A-I-b-i : MIXED CONNECTIVE TISSUE DISEASE-METHOTREXATE OR AZATHIOPRINE OR HYDROXY CHLOROQUINE | RHEUMATOLOGY | 3200 | 2900 | 2600 | 2350 | 2100 | 1900 | 3200 | 2350 |
1715 | CMU0652 A-I-i : MIXED CONNECTIVE TISSUE DISEASE-(METHOTREXATE OR AZATHIOPRINE OR HYDROXY CHLOROQUINE/ PULSE CYCLOPHOSPHAMIDE THERAPY (INCLUDING DIAGNOSTIC EVALUATION - 1ST TIME) | RHEUMATOLOGY | 16800 | 15100 | 13600 | 12250 | 11000 | 9900 | 16800 | 12250 |
1716 | CMU0652 B : MIXED CONNECTIVE TISSUE DISEASE-(METHOTREXATE OR AZATHIOPRINE OR HYDROXY CHLOROQUINE/ PULSE CYCLOPHOSPHAMIDE THERAPY/ MYCOPHENOLATE MOFETIL INDUCTION/MYCOPHENOLATE MOFETIL MAINTENANCE/ WITH GANGRENE ON IV PROSTACYCLIN/ PNEUMOCOCCAL VACCINATION ) | RHEUMATOLOGY | 30000 | 27000 | 24300 | 21850 | 19700 | 17700 | 30000 | 21850 |
1717 | CMU0652 B-I-a : MYCOPHENOLATE MOFETIL INDUCTION | RHEUMATOLOGY | 6300 | 5650 | 5100 | 4600 | 4150 | 3700 | 6300 | 4600 |
1718 | CMU0652 B-I-b : MYCOPHENOLATE MOFETIL MAINTENANCE | RHEUMATOLOGY | 3200 | 2900 | 2600 | 2350 | 2100 | 1900 | 3200 | 2350 |
1719 | CMU0652 B-I-c : MIXED CONNECTIVE TISSUE DISEASE - WITH GANGRENE ON IV PROSTACYCLIN | RHEUMATOLOGY | 7400 | 6650 | 6000 | 5400 | 4850 | 4350 | 7400 | 5400 |
1720 | CMU0652 B-I-d : MIXED CONNECTIVE TISSUE DISEASE - PNEUMOCOCCAL VACCINATION | RHEUMATOLOGY | 5300 | 4750 | 4300 | 3850 | 3500 | 3150 | 5300 | 3850 |
1721 | CMU0652 B-I-e : MIXED CONNECTIVE TISSUE DISEASE-(METHOTREXATE OR AZATHIOPRINE OR HYDROXY CHLOROQUINE/ PULSE CYCLOPHOSPHAMIDE THERAPY/ MYCOPHENOLATE MOFETIL INDUCTION/MYCOPHENOLATE MOFETIL MAINTENANCE/ WITH GANGRENE ON IV PROSTACYCLIN/ PNEUMOCOCCAL VACCINA | RHEUMATOLOGY | 30000 | 27000 | 24300 | 21850 | 19700 | 17700 | 30000 | 21850 |
1727 | CMU0653 A-I : VASCULITIS (PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE/ PULSE CYCLOPHOSPHAMIDE THERAPY ) | RHEUMATOLOGY | 13200 | 11900 | 10700 | 9600 | 8650 | 7800 | 13200 | 9600 |
1728 | CMU0653 A-I-a : VASCULITIS - PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE | RHEUMATOLOGY | 3200 | 2900 | 2600 | 2350 | 2100 | 1900 | 3200 | 2350 |
1729 | CMU0653 A-I-b : VASCULITIS - PULSE CYCLOPHOSPHAMIDE THERAPY | RHEUMATOLOGY | 3200 | 2900 | 2600 | 2350 | 2100 | 1900 | 3200 | 2350 |
1730 | CMU0653 A-I-c : VASCULITIS (PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE/ PULSE CYCLOPHOSPHAMIDE THERAPY ) (INCLUDING DIAGNOSTIC EVALUATION - 1ST TIME) | RHEUMATOLOGY | 13200 | 11900 | 10700 | 9600 | 8650 | 7800 | 13200 | 9600 |
1735 | CMU0653 B-I : VASCULITIS (PREDNISOLONE OR METHOTREXATE OR AZATHIOPRINE/ PULSE CYCLOPHOSPHAMIDE THERAPY / INTERNAL ORGAN INVOLVEMENT REQUIRING INTRAVENOUS IMMUNOGLOBULIN/ MYCOPHENOLATE MOFETIL INDUCTION/MYCOPHENOLATE MOFETIL MAINTENANCE/ PNEUMOCOCCAL VACCINATION) | RHEUMATOLOGY | 200000 | 180000 | 162000 | 145800 | 131200 | 118100 | 200000 | 145800 |
2910 | CMU0987 -II : ACUTE DISSEMINATED ENCEPHALOMYELITIS | RHEUMATOLOGY | 58300 | 52450 | 47200 | 42500 | 38250 | 34450 | 58300 | 42500 |
2911 | CMU0988 : MULTIPLE SCLEROSIS (INCLUDING RELAPSE) | RHEUMATOLOGY | 17500 | 15750 | 14200 | 12750 | 11500 | 10350 | 17500 | 12750 |