Service Description,Type,CPT,NCMC Price CADDO Factor V Leiden,AFC GENERIC ADD-ON,,61 Chest Physiotherapy Subsequent,AFC GENERIC ADD-ON,94668,105 RH Type Ref,AFC GENERIC ADD-ON,86901,36 Rh Typing [MDMH],AFC GENERIC ADD-ON,86901,36 MED-SUR SUPPLIES,Anesthesia Charges,,0 Bladder Scan Task Complete,Asmt/Tx/Monitoring,51798,237 ABO/Rh.,Blood Bank,86900,35 Antibody Screen Tube,Blood Bank,86850,96 Aph FFP ACDA,Blood Bank Product,,258 Aph FFP ACDA Dv Thawed,Blood Bank Product,,258 Aph RBC ACDA AS1 LR 1,Blood Bank Product,,396 Aph RBC ACDA AS1 LR 2,Blood Bank Product,,396 Cord Blood,Blood Bank,86900,35 Direct Antiglobulin Test 1,Blood Bank,86880,47 FFP CPD,Blood Bank Product,,258 Neonatal DAT 1,Blood Bank,86880,47 Platelets,Blood Bank,P9019,1030 Product Ready?,Blood Bank,,236 RBC AS5 LR Irr,Blood Bank Product,,396 RBC CP2D AS3 500 LR,Blood Bank Product,,396 RBC CPD AS1 500 LR,Blood Bank Product,,396 REF Antibody ID,Blood Bank,86870,309 REF Antibody Screen,Blood Bank,86850,96 REF Antigen Type,Blood Bank,84120,239 REF Crossmatch,Blood Bank,86920,115 Reference ABO/Rh,Blood Bank,86900,35 Reference DAT,Blood Bank,86880,47 Reference Elution,Blood Bank,86860,155 Rhogam Info,Blood Bank,,236 XM IS Interp,Blood Bank,86920,115 RT Holter Monitor 24hr - MS TECH CHARGE CADDO,Cardiac Tx/Procedures,93225,645 110 - ROOM-BOARD/PVT,Conversion Charges,,0 112 - OB/PVT,Conversion Charges,,0 160 - Other R&B,Conversion Charges,,0 170 - NURSERY,Conversion Charges,,0 250 - PHARMACY,Conversion Charges,,0 257 - DRGS/NONPSCRPT,Conversion Charges,,0 300 - LABORATORY,Conversion Charges,,0 301 - LAB/CHEMISTRY,Conversion Charges,,0 302 - LAB/IMMUNOLOGY,Conversion Charges,,0 305 - LAB/HEMATOLOGY,Conversion Charges,,0 306 - LAB/BACT-MICRO,Conversion Charges,,0 307 - LAB/UROLOGY,Conversion Charges,,0 309 - LAB/OTHER,Conversion Charges,,0 320 - DX X-RAY,Conversion Charges,,0 324 - DX X-RAY/CHEST,Conversion Charges,,0 329 - DX X-RAY/OTHER,Conversion Charges,,0 350 - CT SCAN,Conversion Charges,,0 351 - CT SCAN/HEAD,Conversion Charges,,0 360 - OR SERVICES,Conversion Charges,,0 381 - BLOOD/PKD RED,Conversion Charges,,0 390 - BLOOD/STOR-PROC,Conversion Charges,,0 402 - ULTRASOUND,Conversion Charges,,0 410 - RESPIRATORY SVC,Conversion Charges,,0 421 - PHYS THERP/VISIT,Conversion Charges,,0 424 - PHYS THERP/EVAL,Conversion Charges,,0 430 - OCCUPATION THER,Conversion Charges,,0 444 - SPEECH PATH/EVAL,Conversion Charges,,0 450 - EMERG ROOM PROFEE,Conversion Charges,,0 450 - EMERG ROOM ER,Conversion Charges,,0 460 - PULMONARY FUNC,Conversion Charges,,0 480 - CARDIOLOGY,Conversion Charges,,0 482 - STRESS TEST,Conversion Charges,,0 540 - AMBULANCE,Conversion Charges,,0 610 - MRI,Conversion Charges,,0 611 - MRI - BRAIN,Conversion Charges,,0 612 - MRI - SPINE,Conversion Charges,,0 615 - MRI-Head and neck,Conversion Charges,,0 636 - DRUGS/DETAIL CODE,Conversion Charges,,0 730 - EKG/ECG,Conversion Charges,,0 731 - HOLTER MONT,Conversion Charges,,0 750 - GASTR-INTS SVS,Conversion Charges,,0 761 - TREATMENT RM,Conversion Charges,,0 762 - OBSERVATION RM,Conversion Charges,,0 920 - OTHER DX SVS,Conversion Charges,,0 921 - PERI VASCUL LAB,Conversion Charges,,0 922 - EMG,Conversion Charges,,0 964 - PRO FEE/ANES CRNA,Conversion Charges,,0 981 - PRO FEE/ER,Conversion Charges,,0 "IV Injection, add new drug THERAPEUTIC OR DIAGNOSTIC",Critical Care,96375,103 IVP INJECTION therapeutic or diagnostic ER,Critical Care,96374,124 "96360 - HYDRATION, FIRST HOUR",Critical Care,96360,185 "96367 - IV tx, sequential infusion",Critical Care,96367,98 99281 - ED Level 1,Critical Care,99281,129 99282 - ED Level 2,Critical Care,99282,232 99283 - ED Level 3,Critical Care,99283,381 99284 - ED Level 4,Critical Care,99284,670 99285 - ED Level 5,Critical Care,99285,1030 H: 99291 - ED Critical Care,Critical Care,99291,1427 "IV THERAPY HYDRATION, EACH ADDITIONAL HOUR",Critical Care,96361,77 "ZZZ96365 - IV TX, FIRST HOUR",Critical Care,96365,309 "ZZZ96366 - IV TX, EACH ADDITIONAL HOUR/CRITICAL CARE",Critical Care,96366,72 "ZZZ96368 - IV tx, concurrent infusion",Critical Care,96368,62 zzz96372 - Subq/IM Injection,Critical Care,96372,62 99283 Level 3 Lynx Visit Level - BO,ER Charges,99283,381 ED Critical Care Level,ER Charges,99291,1427 ED Visit Level 1,ER Charges,99281,129 ED Visit Level 2,ER Charges,99282,232 ED Visit Level 4,ER Charges,99284,670 ED visit Level 5,ER Charges,99285,1030 TREATMENT OF WOUND DEHISCENCE WITH PACKING,ER Charges,12021,857 11606 EXC MAL TRK/ARM/LG > 4.0 CM,Emer Charges,11606,3650 ALS I NONERMERGENT Charge,Emer Charges,,675 ALS LEVEL 1 Charge,Emer Charges,,1250 ALS LEVEL 2 Charge,Emer Charges,,1525 AMBULANCE BLS RATE Charge,Emer Charges,,900 AMPUTATION FINGER/THUMB WITH CLOSURE CHARGE,Emer Charges,26951,3554 "ANOSCOPY, DIAGNOSTIC W/WO SPECIMEN CHARGE",Emer Charges,46600,118 APPLICATION CAST SHORT ARM CHARGE,Emer Charges,29075,381 APPLICATION CAST LONG ARM CHARGE,Emer Charges,29065,381 APPLICATION CAST LONG LEG CHARGE,Emer Charges,29345,381 APPLICATION CAST SHORT LEG CHARGE,Emer Charges,29405,381 APPLICATION LONG LEG SPLINT CHARGE,Emer Charges,29505,227 APPLICATION OF FINGER SPLINT STATIC CHARGE,Emer Charges,29130,191 APPLICATION OF LONG ARM SPLINT CHARGE,Emer Charges,29105,229 APPLICATION SHORT ARM SPLINT CHARGE,Emer Charges,29125,191 APPLICATION SHORT LEG SPLINT CHARGE,Emer Charges,29515,191 ARTHROCENTESIS INT. JOINT CHARGE,Emer Charges,20605,438 ARTHROCENTESIS MAJOR JOINT CHARGE,Emer Charges,20610,438 ARTHROCENTESIS SMALL JOINT CHARGE,Emer Charges,20600,438 "ASPIRATION OF ABSCESS,HEMATOMA OR CYST CHARGE",Emer Charges,10160,237 ASPIRATION OF BREAST CHARGE,Emer Charges,19000,757 AVULSION OF NAIL PLATE PARTIAL/COMPLETE Charge,Emer Charges,11730,165 BIOPSY OF SKIN SINGLE LESION CHARGE,Emer Charges,11100,252 BLADDER IRRIGTON SMPL LVG/INSTL CHARGE,Emer Charges,51700,340 BLEPHAROTOMY DRAIN ABS EYELID CHARGE,Emer Charges,67700,525 BLS NONEMERGENT Charge,Emer Charges,,550 BURN TREATMENT 1ST DEGREE INITIAL CHARGE,Emer Charges,16000,118 CASTING/STRAPPING MUSCULOSKELETAL CHARGE,Emer Charges,29799,165 CHANGE OF GASTROSTOMY TUBE W/O IMAGING OR ENDO CHARGE,Emer Charges,43760,479 CHEMICAL CAUTERIZATION GRAN TISSUE,Emer Charges,17250,252 CHEST TUBE INSERTION Charge,Emer Charges,32551,901 CIRCUMCISION 28 DAYS OLD OR LESS CHARGE,Emer Charges,54160,3289 CLOSED TREATMENT OF KNEE DISLOCATION REQUIRING ANESTHESIA CHARGE,Emer Charges,27550,1009 CLOSED TX METACARTPAL FX W/MANIP EA BONE CHARGE,Emer Charges,26605,263 CLOSED TX NASAL FRAC W/O STABLZ,Emer Charges,21315,2610 CLOSED TX SHOULDER DISLOCATION W MANIP W/O ANESTH CHARGE,Emer Charges,23650,263 CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,Emer Charges,23655,2472 COLPORRHAPHY SUTURE INJU VAGINA NON-OB CHARGE,Emer Charges,57200,3899 CONTROL NASAL HEMOR ANT;CMPLX Charge,Emer Charges,30903,315 CONTROL NASAL HEMOR POST;INIT Charge,Emer Charges,30905,300 "CONTROL NASAL HEMORRHAGE, ANTERIOR SMPL CAUTERY/PACKING CHARGE",Emer Charges,30901,290 DEBRIDEMENT SUBCU TISSUE 1ST 20 SQ CM OR < CHARGE,Emer Charges,11042,464 "DEBRIDEMENT ;SKIN,PARTIAL THICKNESS CHARGE",Emer Charges,97597,258 DEBRIDEMENT NAIL 1 TO 5 CHARGE,Emer Charges,11720,149 DEBRIDEMENT OPEN WOUND EACH ADDT'L 20 SQ CM />,Emer Charges,97598,464 DEBRIDEMENT SKIN/TISSUE/MUSCLE CHARGE,Emer Charges,11043,489 "DEBRIDEMENT SKIN, BONE AT FX SITE",Emer Charges,11012,1320 DERMABOND CHARGE,Emer Charges,G0168,90 DESTRUCTION LESION (2-14 LESIONS) ADD ON CHARGE,Emer Charges,17003,135 DESTRUCTION LESION (15 OR MORE LESIONS) CHARGE,Emer Charges,17004,453 DESTRUCTION LESION (FIRST LESION) CHARGE,Emer Charges,17000,144 DESTRUCTION MALIG LES F/E/E/N/L/M 0.5CM,Emer Charges,17280,330 DESTRUCTION MALIG LES S/N/H/F/G 1.1 - 2.0CM,Emer Charges,17272,330 DESTRUCTION OF INTERNAL HEMORRHOID CHARGE,Emer Charges,46930,1370 DIAGNOSTIC BONE MARROW BIOPSY (IES),Emer Charges,38221,505 DIAGNOSTIC BONE MARROW ASPIRATION(S),Emer Charges,38220,505 DILATATION OF THE ANAL SPHINTER CHARGE,Emer Charges,45905,1545 DILATION OF RECTUM CHARGE,Emer Charges,45910,3899 DISLOCATION KNEE W/O ANESTHESIA CHARGE,Emer Charges,27550,287 DISLOCATION OF ANKLE CLOSED CHARGE,Emer Charges,27840,788 DISLOCATION OF ELBOW CLOSED NUSREMAID CHARGE,Emer Charges,24640,287 DISLOCATION OF IPHAL JT W/O ANES CHARGE,Emer Charges,26770,287 DISLOCATION OF MCP CHARGE,Emer Charges,26700,268 DISLOCATION OF TOE W/O ANESTHESIA CHARGE,Emer Charges,28630,319 DISLOCATION OF WRIST CHARGE,Emer Charges,25675,287 DRAIN REPLACEMENT CHARGE,Emer Charges,17999,244 "DRAINAGE EXTERNAL EAR ABSCESS OR HEMATOMA SIMPLE, CADDO",Emer Charges,69000,457 "DRAINAGE OF MOUTH ABSCESS, CYST HEMATOMA SMPL",Emer Charges,40800,334 DRAINAGE SCROTAL WALL ABSCESS,Emer Charges,55100,1732 DRESS/ DEBRIDE PARTIAL THICK BURNS SMALL CHARGE,Emer Charges,16020,252 DRESS/ DEBRIDE PARTIAL THICK BURNS MEDIUM CHARGE,Emer Charges,16025,252 DRESS/ DEBRIDE PARTIAL THICK BURNS LARGE CHARGE,Emer Charges,16030,258 "EPIDERMAL AUTOGRAFT FA,SC,HAND,FEET,DIG CHARGE",Emer Charges,15115,767 EVACUATION OF SUBUNGUAL HEMATOMA CHARGE,Emer Charges,11740,98 EX BENIG H/F/NK/SP GREATER THAN 4CM CHARGE,Emer Charges,11426,3577 EX BENIGN LESION ] 4.0CM,Emer Charges,11406,2763 EX BENIGN LES S/H/FT/G 0.6 TO 1.0 CM CHARGE,Emer Charges,11421,1391 EX BENIGN LES TRK/A/LEG 0.5 CM OR LESS CHARGE,Emer Charges,11400,742 EX BENIGN LES TRK/A/LEG 0.6 TO 1.0 CM CHARGE,Emer Charges,11401,742 EX BENIGN LES TRK/A/LEG 1.1 TO 2.0 CM CHARGE,Emer Charges,11402,742 EX BENIGN LES TRK/A/LEG 2.1 TO 3.0 CM CHARGE,Emer Charges,11403,1391 EX BENIGN LES F/E/EY/N/L/MM 0.5 CM OR < CHARGE,Emer Charges,11440,742 EX BENIGN LES F/E/EY/N/L/MM 0.6 TO 1.0 CM CHARGE,Emer Charges,11441,742 EX BENIGN LES F/E/EY/N/L/MM 1.1 - 2.0 CM CHARGE,Emer Charges,11442,1391 EX BENIGN LES F/E/EY/N/L/MM 2.1 - 3.0 CM CHARGE,Emer Charges,11443,1391 EX BENIGN LES S/H/FT/G 0.5 CM OR LESS CHARGE,Emer Charges,11420,1391 EX BENIGN LES S/H/FT/G 1.1 TO 2.0 CM CHARGE,Emer Charges,11422,1391 EX BENIGN LES S/H/FT/G 2.1 TO 3.0 CM CHARGE,Emer Charges,11423,2850 EX BENIGN LESION TRK/A/LEG 3.1 TO 4.0,Emer Charges,,2060 EX BENIGN LESION F/E/EY/N/L/MM 3.1 TO 4.0CM,Emer Charges,11444,1884 EX MALIG LES F/E/E/N/L 3.1 - 4.0 CM,Emer Charges,11644,2884 EX MALIG LES TRK/A/L 0.5 CM OR LESS CHARGE,Emer Charges,11600,1391 EX MALIG LES TRK/A/L 0.6 TO 1.0 CM CHARGE,Emer Charges,11601,742 EX MALIG LES TRK/A/L 1.1 TO 2.0 CM CHARGE,Emer Charges,11602,742 EX MALIG LES TRK/A/L 2.1 TO 3.0 CM CHARGE,Emer Charges,11603,1391 EX OF ANAL LESION,Emer Charges,46922,3883 EXC F/E/E/N/L/MAL + MRG ]4CM,Emer Charges,11646,3758 EXC MALIG LESION F/E/E/N/L 3.1 - 4.0 CM CHARGE,Emer Charges,11643,1320 EXCISION MALIGNANT LESION F/E/E/N/L/MM 0.5 CM OR LESS CHARGE,Emer Charges,11640,742 EXCISION MALIGNANT LESION F/E/E/N/L/MM 0.6 TO 1.0 CM CHARGE,Emer Charges,11641,742 EXCISION MALIGNANT LESION F/E/E/N/L/MM 1.1 TO 2.0 CM CHARGE,Emer Charges,11642,742 EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM OR LESS CHARGE,Emer Charges,11620,1391 EXCISION MALIGNANT LESION S/N/H/F/G 0.6 TO 1.0 CM CHARGE,Emer Charges,11621,742 EXCISION MALIGNANT LESION S/N/H/F/G 1.0 TO 2.0 CM CHARGE,Emer Charges,11622,1391 EXCISION OF MALIG LESION S/N/H/FT/GENT OVER 4.0CM,Emer Charges,11626,3578 EXCISON (WEDGE)INGROWN TOENAIL CHARGE,Emer Charges,11765,144 EXCISON OF PILONIDAL CYST; SIMPLE CHARGE,Emer Charges,11770,3785 Ex Benign les trk/a/leg 3.1 to 4 cm,Emer Charges,11404,2362 FACIAL NERVE BLOCK CHARGE,Emer Charges,64402,417 FORESKIN MANI INC LYSIS ADH CHARGE,Emer Charges,54450,489 FRACTURE TX FINGER CLOSED W/O MANIPUL CHARGE,Emer Charges,26750,268 FRACTURE TX FINGER CLOSED W/MANIPULATION CHARGE,Emer Charges,26755,268 FRACTURE TX RAD/ULNA W/MANIP CHARGE,Emer Charges,25565,778 FRENULECTOMY CHARGE,Emer Charges,40819,1231 GASTRIC Decompression/NG Insertion,Emer Charges,43753,252 I & D BREAST COMPLEX CHARGE,Emer Charges,19020,3136 I & D COMPLEX POST OP WOUND INFECTION CHARGE,Emer Charges,10180,3136 I & D HEMATOMA SEROMA CHARGE,Emer Charges,10140,2039 I & D OF ABSCESS DENTOALVEOLAR STRUCTURE CHARGE,Emer Charges,41800,242 I & D PILONIDAL CYST COMPLICATED Charge,Emer Charges,10081,2045 I & D PILONIDAL CYST SIMPLE CHARGE,Emer Charges,10080,324 I & D RECTAL ABSCESS CHARGE,Emer Charges,46040,721 I & D SCROTUM CHARGE,Emer Charges,54700,721 I & D SIMPLE OR SINGLE CHARGE,Emer Charges,10060,242 I & D VULVA OR PERINEAL ABSCESS CHARGE,Emer Charges,56405,515 I V PUSH ADD ON (NEW DRUG) CHARGE,Emer Charges,96375,103 I& D ABSCESS PERITONSILLAR,Emer Charges,42700,626 I&D Bartholins gland abscess,Emer Charges,56420,361 I&D COMPLICATED OR MULTIPLE ABSCESS CHARGE,Emer Charges,10061,309 "I&D EXTERNAL EAR LESION, COMPLICATED",Emer Charges,69005,2300 I&D EXTERNAL EAR LESION COMPLICATED PROFEE,Emer Charges,69005,850 INC OF THROMBOSED HEMORRHOID EXTERNAL CHARGE,Emer Charges,46083,336 INCISION & REMOVAL FOREIGN BODY SIMPLE CHARGE,Emer Charges,10120,458 INCISION OF PILONIDAL CYST CHARGE,Emer Charges,10080,618 INJ GREATER OCCIPITAL NERVE CHARGE,Emer Charges,64405,729 INJ INTERCOSTAL NERVE SINGLE CHARGE,Emer Charges,64420,642 INJ SINGLE OR MULTIPLE TRIGGER POINTS 3 OR MORE,Emer Charges,20553,448 INJ TENDON SHEATH OR LIGAMENT SINGLE CHARGE,Emer Charges,20550,412 INJ TRIGGER POINT 1/2 MUSCLES CHARGE,Emer Charges,20552,412 "INJECTION ANESTHETIC TRIGEMINAL NERVE, ANY CHARGE",Emer Charges,64400,423 INSERT BLADDER CATHETER NON DWELLING CHARGE,Emer Charges,51701,116 INSERT TEMP BLADDER CATH INDWELLING CHARGE,Emer Charges,51702,113 INSERTION NON TUNNELED CVC 5 YRS OR > CHARGE,Emer Charges,36556,1833 INTRAOSSEOUS INFUSION NEEDLE PLACEMENT CHARGE,Emer Charges,36680,268 INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE CHARGE,Emer Charges,31500,376 IV HYDRATION ADD ON CHARGE,Emer Charges,96361,77 IV HYDRATION INITIAL CHARGE,Emer Charges,96360,185 IV INFUSION ADD ON TX/PROPH/DG CHARGE,Emer Charges,96366,72 IV INFUSION ADDL SEQ TX/DX CHARGE,Emer Charges,96367,98 "IV INFUSION TX/DX, UP TO 1 HOUR CHARGE",Emer Charges,96365,309 IV PUSH SINGLE OR INITIAL DRUG CHARGE,Emer Charges,96374,124 Inj. Anesthetic Agent sphenopalatine ganglion,Emer Charges,64505,450 Injection Lumbar Epidural Blood or Clot Patch,Emer Charges,62273,613 LYSIS PENILE ADHESIONS CHARGE,Emer Charges,54162,3760 MUSCLE BIOPSY SUPERFICIAL,Emer Charges,20200,2763 NERVE BLOCK PERIPHERAL,Emer Charges,64450,768 PORT A CATH REMOVAL TUNNELED CHARGE,Emer Charges,36589,747 PUNCTURE ASPIRATION (ABSCESS/HEMTOMA/CYS CHARGE,Emer Charges,10160,242 REM FB UPPER ARM OR ELBOW SUBCUT,Emer Charges,24200,961.3 REMOVAL (INCISON) FOREIGN BODY COMPLEX CHARGE,Emer Charges,10121,2827 REMOVAL FOREIGN BODY PHARYNX CHARGE,Emer Charges,42809,129 REMOVAL FOREIGN BODY EYE EXTERNAL CHARGE,Emer Charges,65205,206 "REMOVAL FOREIGN BODY, INCISIONAL SIMPLE CHARGE",Emer Charges,10120,453 REMOVAL FOREIGN BODY EAR EXTERNAL AUD CHARGE,Emer Charges,69200,108 REMOVAL IMPACTED CERUMEN 1 OR BOTH EARS CHARGE,Emer Charges,69210,112 REMOVAL OF FOREIGN BODY EXTERNAL EYE CORNEAL WITHOUT SLIT LAMP CHARGE,Emer Charges,65220,660 REMOVAL SKIN TAG MULTI UP TO 15 LESIONS CHARGE,Emer Charges,11200,206 REMOVE NASAL FOREIGN BODY,Emer Charges,30300,272 REPAIR CMPLX ADD ON F/GENTIALIA/H/FEET CHARGE,Emer Charges,13133,515 REPAIR COMPLEX 2.6 - 7.5 (TRUNK) CHARGE,Emer Charges,13101,824 REPAIR COMPLEX ADDITIONAL 5CM OR LESS CHARGE,Emer Charges,13102,717 REPAIR COMPLEX FOREHEAD/CHEEK/ETC TO 2.5 CHARGE,Emer Charges,13131,515 REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CHARGE,Emer Charges,13120,515 REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CHARGE,Emer Charges,13121,515 REPAIR COMPLEX TO 2.5 (TRUNK) CHARGE,Emer Charges,13100,824 "REPAIR COMPLEX, S/A AND/OR LEGS; EA ADD 5CM OR LESS",Emer Charges,13122,250 REPAIR CPX EYELID/NOSE/EAR/LIP 2.6-7.5 CHARGE,Emer Charges,13152,824 REPAIR CPX FOREHEAD/CHEEK ETC 2.6-7.5 CHARGE,Emer Charges,13132,824 REPAIR INERTM FACE/EAR/EYE 2.6-5.0 CHARGE,Emer Charges,12052,541 REPAIR INERTM FACE/EAR/EYE 7.6-12.5 CHARGE,Emer Charges,12054,258 REPAIR INTERM FACE/EAR/EYE 2.5 OR LESS CHARGE,Emer Charges,12051,541 REPAIR INTERM FACE/EAR/EYE 5.1-7.5 CHARGE,Emer Charges,12053,546 REPAIR INTERM NECK/HAND/FEET 2.5 OR LESS CHARGE,Emer Charges,12041,309 REPAIR INTERM NECK/HAND/FEET 2.6-7.5 CHARGE,Emer Charges,12042,515 REPAIR INTERM NECK/HAND/FEET 7.6-12.5 CHARGE,Emer Charges,12044,515 "REPAIR INTERM SCALP,TRUNK,EXTREM 2.5 CHARGE",Emer Charges,12031,541 REPAIR INTERM SCALP TRK EXTRE 2.6-7.5CM CHARGE,Emer Charges,12032,541 "REPAIR INTERM SCALP,TRK,EXTRE 12.6-20.0 CHARGE",Emer Charges,12035,361 REPAIR INTERM SCALP/A/TRK/EXT 20.1-30.0 CHARGE,Emer Charges,12036,525 REPAIR INTERME SCAPL TRK EXTRE 7.6-12.5 CHARGE,Emer Charges,12034,551 REPAIR LACERATION 2/3 TOUNGE CHARGE,Emer Charges,41250,191 REPAIR LACERATION OF TONGUE OVER 2.6 CHARGE,Emer Charges,41252,1231 REPAIR OF NAIL BED Charge,Emer Charges,11760,206 REPAIR SIMP 20.1-30 S/N/AX/TRK/EXT/EXGEN CHARGE,Emer Charges,12006,268 REPAIR SMP 12.6-20 SCALP/NECK/EXTREMITY CHARGE,Emer Charges,12005,258 REPAIR SMP 2.6-7.5 SCALP/NECK/EXT CHARGE,Emer Charges,12002,232 REPAIR SMP F/E/E/N/L/MM 2.6-5.0CM CHARGE,Emer Charges,12013,258 REPAIR SMP F/E/E/N/L/MM 5.1-7.5 CM CHARGE,Emer Charges,12014,258 REPAIR SMP F/E/E/N/L/MM 7.6-12.5 CM CHARGE,Emer Charges,12015,309 REPAIR SMP F/E/E/N/L/MM 12.6-20.0CM CHARGE,Emer Charges,12016,319 REPAIR SMPL 7.6-12.5 SCALP/NECK/EXTREMIT CHARGE,Emer Charges,12004,258 REPAIR SMPL F/E/E/N/L/MM 2.5 CHARGE,Emer Charges,12011,237 REPAIR SMPL TO 2.5CM SCALP/NECK/TRUNK CHARGE,Emer Charges,12001,206 "REPAIR, CPX EYELID/NOSE/EAR/LIP 0-1.0CM CHARGE",Emer Charges,,819 SHAVING LESION CHARGE,Emer Charges,11301,191 SHAVING OF LESION CHARGE,Emer Charges,11302,191 SHAVING SKIN LESION 0.5 CM OR LESS CHARGE,Emer Charges,11300,191 SHOULDER STRAPPING CHARGE,Emer Charges,29240,229 SPINAL PUNCTURE LUMBAR DIAGNOSTIC CHARGE,Emer Charges,62270,649 STRAPPING ANKLE AND/OR FOOT CHARGE,Emer Charges,29540,232 STRAPPING ELBOW OR WRIST CHARGE,Emer Charges,29260,229 STRAPPING HAND OR FINGER CHARGE,Emer Charges,29280,229 STRAPPING OF TOES CHARGE,Emer Charges,29550,175 STRAPPING; THORAX CHARGE,Emer Charges,29200,180 STRETCHING OF FORESKIN CHARGE,Emer Charges,55899,180 Skin split a-grft fac/nck/hf/g,Emer Charges,15120,3605 TETANUS DIPHTHERIA 7YR OR OLDER IM,Emer Charges,90714,37 THER/PROPH/DIAG INJ SC/IM,Emer Charges,96372,62 TRACHEOSTOMY CRICOTHYROID MEMBRANE CHARGE,Emer Charges,31605,1236 TREAT FRACTURE DISTAL RADIUS CHARGE,Emer Charges,25605,778 TX SUPERFICIAL WOUND DEHISCENCE SIMP CLOSURE CHARGE,Emer Charges,12020,953 Thoracentesis w/o imaging,Emer Charges,32554,1082 UNNA BOOT CHARGE,Emer Charges,29580,175 VENOUS CUTDOWN CHARGE,Emer Charges,36556,795 PEG TUBE REPLACEMENT CHARGE,GI Charge,,1751 (Extra) Lavender Tube SLH,General Lab,85379,124 ".Amphetamines Confirmation/Quantitation, Serum or Plasma ARUP",General Lab,88305,309 .Cocaine Metabolites by GC/MS REFLB,General Lab,,99 .Manual Differential 10,General Lab,85007,61 .Morphology,General Lab,85008,52 17-Alpha Hydroxyprogesterone REFLB,General Lab,83498,54 24 Hour Creatinine Clearance REFLB,General Lab,82575,87 24 Hour Urine Calcium REFLB,General Lab,82340,52 24 Hour Urine Chloride REFLB,General Lab,82436,46 24 Hour Urine Creatinine REFLB,General Lab,82570,46 24 Hour Urine Potassium REFLB,General Lab,84233,46 24 Hour Urine Protein REFLB,General Lab,84156,46 24 Hour Urine Sodium REFLB,General Lab,84300,46 24 Hour Urine Urea Nitrogen REFLB,General Lab,84540,46 24 Hour Urine Uric Acid REFLB,General Lab,84560,21 "5-Hydroxyindoleacetic Acid, U REFLB",General Lab,83497,41 AFB Smear and Culture REFLB,General Lab,87116,188 ANA REFLB,General Lab,86038,79 Acetaminophen REFLB,General Lab,80329,131 Acetone REFLB,General Lab,82009,48 "Adrenocorticotropic Hormone, P REFLB",General Lab,82024,124 Alanine Aminotransferase,General Lab,84460,72 Albumin Level,General Lab,82040,53 "Alcohol, Random Urine REFLB",General Lab,,124 Aldolase REFLB,General Lab,82085,31 Alk Phos Heat Fraction REFLB,General Lab,84075,21 Alkaline Phosphatase,General Lab,84075,72 Alpha-1-Antitrypsin REFLB,General Lab,82103,31 Ammonia Level,General Lab,82140,100 Ammonia REFLB,General Lab,82140,100 Amphetamine metabolites urine REFLB,General Lab,80324,117 Amylase Level,General Lab,82150,95 Amylase REFLAB,General Lab,82150,96 "Anaerobe Culture, Bacteria REFLB",General Lab,87075,103 Androstenedione REFLB,General Lab,82157,77 Angiotensin Converting Enzyme REFLB,General Lab,82164,237 Anti-Sm/RNP Ab (ENA) REFLB,General Lab,86235,62 Antithrombin III Antigen REFLB,General Lab,85300,69 Arterial Blood Gas.,General Lab,82803,321 Aspartate Aminotransferase,General Lab,84450,72 "Barbiturates, Ur w/ Confirm REFLB",General Lab,,134 "Barbiturates, Ur w/o Confirm REFLB",General Lab,,130 Basic Metabolic Panel,General Lab,80048,153 Basic Metabolic Panel2,General Lab,80048,153 Baso REFLB,General Lab,85027,103 Basophils (Absolute) REFLB,General Lab,85007,61 Benzodiazepine metabolites urine REFLB,General Lab,80346,134 Bilirubin Total,General Lab,82247,72 Bill Adsorption per Adsorption,General Lab,86970,453 Bill Antibody ID Standard Panel,General Lab,86870,309 Bill Blood Administration,General Lab,36430,605 Bill CLO Test,General Lab,87077,52 Bill Clinic CBC,General Lab,85025,133 Bill Clinic CMP,General Lab,80053,221 Bill Clinic Glucose FS,General Lab,82948,54 Bill Clinic Hemocult,General Lab,82270,27 Bill Clinic Influenza,General Lab,87804,77 Bill Clinic Monospot,General Lab,86308,46 Bill Clinic PT/INR,General Lab,85610,60 Bill Clinic Rapid Strep,General Lab,87430,60 Bill Clinic Renal,General Lab,80069,188 Bill Clinic SED Rate,General Lab,85651,48 Bill Clinic UA,General Lab,81000,21 Bill Clinic UPT,General Lab,81025,52 Bill Clinic Venipuncture,General Lab,36415,17 Bill Clinic Wet Prep,General Lab,87210,52 Bill Crossmatch Immed. Spin,General Lab,86920,115 Bill Elution Prep and Testing,General Lab,86860,155 Bill Irradiation.,General Lab,86945,58 Bill Lev V Surgical Path tissue exam,General Lab,88307,220 Bill Lifeshare Antigen Type Group I,General Lab,86905,258 Bill Lifeshare Antigen Type Group II,General Lab,86905,258 Bill Lifeshare Antigen Type Group III,General Lab,86905,258 Bill Lifeshare Antigen Type Group IV,General Lab,86905,258 Bill Manual Differential,General Lab,85007,61 Bill Morphology,General Lab,85008,52 "Bill Morphometric analysis, in situ hybridization",General Lab,88377,309 Bill Organism ID,General Lab,87077,26 Bill Rare Unit Fee,General Lab,,340 Bill Select Cell Panel,General Lab,86850,247 Bill Sensitivity,General Lab,87186,144 Bill Sickle Cell Screen,General Lab,85660,62 Bill Surgical Path Level 2,General Lab,88302,134 Bill Venipuncture,General Lab,36415,17 Blood Culture REFLB,General Lab,87040,94 "Blood Glucose, Capillary",General Lab,82948,27 Blood Smear w/ Man Diff,General Lab,85007,61 Blood Smear w/o Man Diff,General Lab,85008,52 Blood Urea Nitrogen,General Lab,84520,53 Body Fluid Albumin REFLB,General Lab,82042,136 Body Fluid Amylase REFLB,General Lab,82150,96 Body Fluid CEA Pleural Fluid REFLB,General Lab,82378,111 Body Fluid Cell Count w/ Diff REFLB,General Lab,89051,50 Body Fluid Cell Differential REFLB,General Lab,89051,50 Body Fluid Cholesterol REFLB,General Lab,82465,83 Body Fluid Crystal ID REFLB,General Lab,89060,57 Body Fluid Glucose REFLB,General Lab,82945,54 Body Fluid LDH REFLB,General Lab,83615,60 Body Fluid Protein REFLB,General Lab,84157,54 Body Fluid Specific Gravity REFLB,General Lab,84315,15 Body Fluid Triglyceride REFLB,General Lab,84478,46 Body Fluid pH REFLB,General Lab,83986,6 Brain Natriatic Peptide REFLB,General Lab,83880,352 Brain Natriuretic Peptide (BNP),General Lab,83880,307 C Difficile PCR REFLB,General Lab,87230,113 C Reactive Protein REFLB,General Lab,86140,52 C-Peptide REFLB,General Lab,84681,122 CBC w/ Auto Differential,General Lab,85025,132 CBC w/ Auto Differential REFLB,General Lab,85025,133 CBC w/ Manual Diff,General Lab,85007,164 CBC/Hemogram,General Lab,85027,103 CK and MMB Profile REFLB,General Lab,82553,88 CLO Test,General Lab,87077,52 CMP .,General Lab,80053,221 COLLECTION: Venous Draw,General Lab,36415,17 Calcium Level Total,General Lab,82310,144 Cancer Antigen 125 REFLB,General Lab,86304,113 "Cannabinoids, Ur w/ Confirm REFLB",General Lab,80299,101 Capillary Blood Gas.,General Lab,82803,180 Carbamazepine REFLB,General Lab,80156,113 Carbon Dioxide Level,General Lab,82374,53 Carcinoembryonic Antigen REFLB,General Lab,82378,111 Catecholamine Frac Free 24 Ur REFLB,General Lab,82384,168 "Catheter Culture, Bacteria REFLB",General Lab,87070,89 Chemistry 8 Profile REFLB,General Lab,80048,153 Chlamydia/GC PCR REFLB,General Lab,87798,117 Chloride Level,General Lab,82435,53 Cholesterol REFLB,General Lab,82465,83 Chromosome analysis: 20 - 25 cells,General Lab,88264,597 Clinitest,General Lab,81002,48 "Cocaine Metabolites by GC/MS, Urine REFLB",General Lab,80353,99 "Cocaine, Ur w/ Confirm REFLB",General Lab,,99 Comp Metabolic Panel REFLB,General Lab,80053,221 Comprehensive Metabolic Panel.,General Lab,80053,221 "Cortisol, Serum REFLB",General Lab,82533,103 Creatine Kinase,General Lab,82550,72 Creatine Kinase REFLB,General Lab,82550,72 Creatinine,General Lab,82565,53 Creatinine Random Urine REFLB,General Lab,82570,46 Cyclic Citrullinated Peptide Ab REFLB,General Lab,86200,49 Cytopathology Sel Cell Enh Tec/w Interp,General Lab,88112,309 D-Dimer REFLB,General Lab,85379,124 "DNA Double-Standed Ab, IgG REFLB",General Lab,86225,54 Decalcification proc (list separate in add to cod for surg path),General Lab,88311,72 Dehydroepiandrosterone PML,General Lab,88312,309 Dehydroepiandrosterone Sulfate REFLB,General Lab,82627,99 Depakene REFLB,General Lab,80164,102 "Diff, Pathology Review REFLB",General Lab,80500,196 Differential Morphology REFLB,General Lab,85008,52 "Differential, Whole Blood REFLB",General Lab,85007,61 Digoxin REFLB,General Lab,80162,107 Direct Bilirubin REFLB,General Lab,82248,41 Drug Screen Collection Fee,General Lab,,25 "Drug Screen, Qual.",General Lab,80305,82 ENZYME HISTOCHEMISTRY,General Lab,88319,111 Electrolyte Panel,General Lab,80051,111 Electrolyte Panel REFLB,General Lab,80051,111 Erythropoietin REFLB,General Lab,82668,155 Estradiol REFLB,General Lab,82670,118 Ethyl Alcohol REFLB,General Lab,80320,124 FSH Serum REFLB,General Lab,83001,98 FTA-ABS REFLB,General Lab,,39 Factor V Leiden Mutation REFLB,General Lab,81241,806 "Female Repro Culture, Bacteria REFLB",General Lab,87070,89 Fern Test,General Lab,89060,31 Ferritin REFLB,General Lab,82728,96 Fibrinogen REFLB,General Lab,85384,77 Flow cytometry cell surf marker techl only 1st,General Lab,88184,258 Flow cytometry cell surf marker techl only ea,General Lab,88185,155 Fluid Cell Count w/ Diff,General Lab,89051,50 Fluid Cell Count w/o Diff,General Lab,89050,50 "Fluid Culture, Bacteria REFLB",General Lab,87075,103 Fluid Gram Stain REFLB,General Lab,87205,38 Folate REFLAB,General Lab,82746,82 Folate REFLAB,General Lab,82746,82 Fungus Culture REFLB,General Lab,87101,98 Fungus Mount REFLB,General Lab,87206,57 G-6-PD Quantitative REFLB,General Lab,82955,62 GAD65 Glutamic Acid REFLB,General Lab,83519,361 Gamma Glutamyl Transferase REFLB,General Lab,82977,96 "General Culture, Bacteria REFLB",General Lab,87070,89 Gentamicin Peak REFLB,General Lab,80170,82 Gentamicin Trough REFLB,General Lab,80170,82 Gentamicin-Random Sample REFLB,General Lab,80170,82 Glucose Cerebrospinal Fluid,General Lab,82945,53 Glucose Level,General Lab,82947,53 Gram Stain REFLB,General Lab,87205,38 HDL Cholesterol REFLB,General Lab,83718,41 HISTOCHEMICAL STAINS ADD-ON,General Lab,88314,95 HIV Ab Screen Type 1/2 REFLB,General Lab,86703,77 "HSV 1,2 IgG, IgM PML",General Lab,87150,205 HSV General Culture REFLB,General Lab,87252,248 HSV Type 1/2 Ab IgG REFLB,General Lab,86695,46 Haptoglobin REFLB,General Lab,83010,103 Helicobacter Pylori Ab IgG REFLB,General Lab,86677,151 Helicobacter Pylori Ab IgM REFLB,General Lab,86677,151 "Helicobacter pylori Antigen, Feces REFLB",General Lab,87338,331 Hematocrit,General Lab,85014,25 Hemoglobin,General Lab,85018,26 Hepatic Panel 1,General Lab,80076,36 Hepatitis A IgM REFLB,General Lab,86709,21 Hepatitis B Core Total REFLB,General Lab,86704,41 Hepatitis B Core IgM AB REFLB,General Lab,86705,52 Hepatitis Bs Ab Quant REFLB,General Lab,86706,77 Hepatitis Bs Ag w/ Confirmation REFLB,General Lab,87340,57 Hepatitis C Ab REFLB,General Lab,86803,98 Hepatitis Profile REFLB,General Lab,80074,247 "Hgb, Glycolated REFLB",General Lab,83036,68 Homocysteine REFLB,General Lab,83090,160 IMMUNOHISTOCHEMISTRY/IMMUNOCYTOCHEMISTRY PER SPEC 1ST SGLE/MULTIPLEX ANTIB STAIN,General Lab,,175 Ictotest,General Lab,81002,41 Immunochitochemistry,General Lab,88342,294 "Immunoelectrophoresis, Urine",General Lab,88304,258 Immunoglob. Free Light Chain REFLB,General Lab,83883,361 Influenza A/B Rapid,General Lab,87804,77 Insulin REFLB,General Lab,86337,103 Insulin-Like Growth Factor 1 REFLB,General Lab,84305,72 Internat. Normalized Ratio PT REFLB,General Lab,85730,61 Iron REFLB,General Lab,83540,46 Iron REFLB,General Lab,83540,46 Ketone Serum,General Lab,82009,48 LDL Cholesterol - Direct REFLB,General Lab,83721,37 Lactate Dehydrogenase,General Lab,83615,60 Lactate Dehydrogenase REFLB,General Lab,83615,60 Lactic Acid,General Lab,83605,186 Lactic Acid REFLB,General Lab,83605,77 Lamotrigine REFLB,General Lab,80299,41 Lead REFLB,General Lab,83655,62 Lev III Surg Pat Gross & Micro Exam,General Lab,88304,258 "Level 1 Surgical pathology, gross exam only",General Lab,88300,464 Level IV Surg Path Gross & Micro Exam,General Lab,88305,309 Levetiracetam REFLB,General Lab,80299,185 Lipase Level,General Lab,83690,186 Lipase Level,General Lab,83690,186 Lipase REFLB,General Lab,83690,77 Lipid Panel REFLB,General Lab,80061,98 Lithium REFLB,General Lab,80178,61 Lupus Anticoagulan Evalutation REFLB,General Lab,85613,119 Luteinizing Hormone REFLB,General Lab,83002,98 Lyme Disease Serology REFLB,General Lab,86618,212 Magnesium Level,General Lab,83735,57 Magnesium REFLB,General Lab,83735,57 "Marijuana Metabolites (THC), Urine REFLB",General Lab,80349,101 "Metanephrines Fract, 24Hr Urine REFLB",General Lab,83835,230 "Methadone, Ur w/ Confirm REFLB",General Lab,,192 "Methadone, Ur w/o Confirm REFLB",General Lab,,95 "Methylmalonic Acid, QN, S REFLB",General Lab,83921,232 Microalbumin Random Urine REFLB,General Lab,82043,71 Misc Test REFLB,General Lab,,0 Mono Screen Rapid,General Lab,86308,46 Monoclonal Protein 24Hr Urine,General Lab,86335,37 Monoclonal Protein Random Urine REFLB,General Lab,86335,37 Myoglobin REFLB,General Lab,83874,113 Myoglobin Urine REFLB,General Lab,83874,113 Neonatal Bilirubin 1,General Lab,82247,72 Nicotine and Metabolites REFLB,General Lab,,132 Occult Blood Stool,General Lab,82272,27 Occult Blood Stool ll,General Lab,82272,27 Occult Blood Stool lll,General Lab,82272,27 Opiate metabolites urine REFLB,General Lab,80361,117 "PCP, Ur w/ Cofirm REFLB",General Lab,83992,198 "PCP, Ur w/o Confirm REFLB",General Lab,83992,198 PKU Panel REFLB,General Lab,84030,201 PTH Intact REFLB,General Lab,82310,77 Parasitic Exam (OCP) REFLB,General Lab,87177,59 Partial Thromboplastin Time,General Lab,85730,61 "Phencyclidine by GC/MS, Urine (PCP) REFLB",General Lab,83992,198 Phenobarbital REFLB,General Lab,80184,77 Phenytoin REFLB,General Lab,80185,87 Phospholip Ab Panel IgG/IgA/IgM REFLB,General Lab,86147,319 Phosphorus Level,General Lab,84100,53 Phosphorus REFLB,General Lab,84100,53 Platelet Count,General Lab,85049,114 Plavix P2Y12 Assay REFLB,General Lab,85576,103 Potassium Level,General Lab,84132,53 Potassium REFLB,General Lab,84132,53 Prealbumin REFLB,General Lab,84134,98 Pregnancy Test Urine,General Lab,81025,52 Procalcitonin REFLB,General Lab,84145,233 Proinsulin REFLB,General Lab,84206,177 Prolactin REFLB,General Lab,84146,124 Prostate Specific Antigen REFLB,General Lab,84153,98 Prostatic Acid Phosphatase REFLB,General Lab,84066,92 Protein C Activity REFLB,General Lab,85303,341 Protein Cerebrospinal Fluid,General Lab,84157,53 "Protein Electrophoresis, Serum REFLB",General Lab,84165,82 Protein S Activity REFLB,General Lab,85306,341 Protein Total,General Lab,84155,53 Prothrombin Time,General Lab,85610,60 Prothrombin Time w/ INR REFLB,General Lab,85610,60 Prothrombin Time REFLB,General Lab,85610,60 RPR REFLB,General Lab,86592,49 RSV Antigen,General Lab,87807,148 RSV Antigen REFLB,General Lab,87420,148 Random Urine Chloride REFLB,General Lab,82436,46 Random Urine Potassium REFLB,General Lab,84133,46 Random Urine Protein REFLB,General Lab,84156,46 Random Urine Sodium REFLB,General Lab,84300,46 Rapid Strep A,General Lab,,48 Rapid Strep A,General Lab,87880,48 Renal Panel.,General Lab,80069,188 "Respiratory Culture, Bacteria REFLB",General Lab,87075,103 Respiratory Gram Stain REFLB,General Lab,87205,38 Respiratory Syncytial Virus (RSV),General Lab,87420,148 Reticulocyte Count REFLB,General Lab,85045,40 Rheumatoid Factor REFLB,General Lab,86430,83 Rhogam Workup REFLB,General Lab,85461,236 Rotavirus Antigen REFLB,General Lab,86759,93 "Rubella Ab, IgG REFLB",General Lab,86317,82 "Rubeola (Measles) Ab, IgG REFLB",General Lab,86765,41 Salicylate REFLB,General Lab,80329,82 Sed Rate (ESR),General Lab,85651,48 Serum Osmolality REFLB,General Lab,83930,41 Sex Hormone Binding Globulin REFLB,General Lab,84270,74 Sodium Level,General Lab,84295,53 Source REFLB:,General Lab,87206,57 Special Stain incl interp & report group 1 for Micro,General Lab,88312,309 Special stain grp 2 i&r excpt micro/enz/imcyt&imhis,General Lab,88313,165 Specific Gravity REFLB,General Lab,84315,15 Specimen Description REFLB,General Lab,87101,98 Stone Analysis REFLB,General Lab,82365,83 "Stool Culture, Bacteria REFLB",General Lab,87045,103 Stool Gram Stain REFLB,General Lab,87205,38 Streptococcal Ab Profile REFLB,General Lab,86060,58 Syphilis IgG Antibody REFLAB,General Lab,86780,110 T3 Free REFLB,General Lab,84481,134 T3 Total REFLB,General Lab,84480,340 T3 Uptake (w/ Reflex T7) REFLB,General Lab,84479,63 T4 Free REFLB,General Lab,84439,77 T4 REFLB,General Lab,84436,63 T4 WK REFLB,General Lab,84436,63 T4 WK REFLB,General Lab,84479,63 TIBC WK,General Lab,83550,62 TIBC WK,General Lab,83550,62 TS Giardia/Cryptospor Ag Stool REFLB,General Lab,87329,103 TSH REFLB,General Lab,84443,92 TSH REFLB,General Lab,84443,92 "Testosterone, T Bioavail Free REFLB",General Lab,84402,161 "Testosterone, Total REFLB",General Lab,84403,134 Theophylline REFLB,General Lab,80198,88 Thyroglobulin Tumor Marker REFLB,General Lab,84432,52 Thyroid-Stimulating Immunoglob REFLB,General Lab,84445,206 Thyronine Uptake REFLB,General Lab,84479,63 Thyronine Uptake REFLB,General Lab,84436,63 Thyroperoxidase Ab REFLB,General Lab,86800,68 Tissue cul for neoplastic do:bone marrow blood cells,General Lab,88237,577 Total Bilirubin REFLB,General Lab,82247,72 Transferrin REFLB,General Lab,84466,82 Triglyceride REFLB,General Lab,84478,46 Trileptal REFLB,General Lab,80299,185 Troponin I,General Lab,84484,155 Troponin I REFLB,General Lab,84484,155 Troponin-iSTAT,General Lab,84484,155 UA Micro 7,General Lab,81015,41 UA Microscopic 8,General Lab,81015,21 UA w/ Culture if Ind.,General Lab,81001,60 Uric Acid REFLB,General Lab,84550,83 Urine Clinitest,General Lab,81002,48 "Urine Culture, Bacteria REFLB",General Lab,87086,85 Urine Dipstick,General Lab,81003,29 Urine Drug Screen w/ Confirmation REFLB,General Lab,,57 Urine Drug Screen Collection,General Lab,,25 Urine Gram Stain REFLB,General Lab,87205,38 Urine Ictotest,General Lab,81002,41 Urine Osmolality REFLB,General Lab,83935,41 Urine Pregnancy,General Lab,81025,52 Urine Pregnancy.,General Lab,81025,52 Vancomycin Lvl Peak,General Lab,80202,108 Vancomycin Lvl Random,General Lab,80202,108 Vancomycin Lvl Trough,General Lab,80202,108 Vancomycin Trough REFLB,General Lab,80202,108 Vanillylmandelic Acid Urine REFLB,General Lab,84585,113 Varicella-Zoster Ab (Immunity) REFLB,General Lab,86787,107 Venous Blood Gas.,General Lab,82803,321 Virus General Culture REFLB,General Lab,87252,248 Vitamin B 12 REFLB,General Lab,82607,85 Vitamin B12 REFLB,General Lab,82607,85 Vitamin D Total (25-OH) REFLB,General Lab,82306,258 Vitamine D 25-OH Hydroxy D2/D3 REFLB,General Lab,82306,52 "West Nile Virus IgG, IgM Serum REFLB",General Lab,86789,216 Wet Prep 1,General Lab,87210,52 White Blood Cells Stool REFLB,General Lab,89055,38 "Wound/Abcess Culture, Bacteria REFLB",General Lab,87075,103 hCG Qualitative REFLB,General Lab,81025,52 hCG Quantitative REFLB,General Lab,84702,77 HEPA PEDIATRIC,Immunization Charge,,0 HPV (human papillomavirus vaccine),Immunization Charge,,0 DISTORT PROD EVOKED OTOACOUSTIC EMIS LMT CHARGE CADDO,Labor and Delivery Charges,92587,149 INCUBATOR CHARGE CADDO,Labor and Delivery Charges,,87 IV INDUCTION/AUGMENT CHARGE CADDO,Labor and Delivery Charges,,131 LDR ROOM - LABOR CHARGE CADDO,Labor and Delivery Charges,,713 MONITOR FETAL INTERNAL CHARGE CADDO,Labor and Delivery Charges,,166 NON-STRESS TEST CHARGE CADDO,Labor and Delivery Charges,59025,247 NURSERY - DAILY CHARGE CADDO,Labor and Delivery Charges,,244 "OB PACK, PARTIAL CHARGE CADDO",Labor and Delivery Charges,,54 OBSERVATION TRIAGE W/EFM - EA ADD'L HR CHARGE CADDO,Labor and Delivery Charges,,41 OBSERVATION- DIRECT ADMIT CHARGE CADDO,Labor and Delivery Charges,,125 OBSERVATION- OB 1ST HR CHARGE CADDO,Labor and Delivery Charges,,199 OXYGEN-NEWBORN-HEATED AEROSOL SET-UP CHARGE CADDO,Labor and Delivery Charges,,80 PHOTOTHERAPY - PER DAY CHARGE CADDO,Labor and Delivery Charges,,53 RECOVERY - C-SECTION 1ST HOUR CHARGE CADDO,Labor and Delivery Charges,,230 RECOVERY - VAGINAL DELIVERY 1ST HOUR CHARGE CADDO,Labor and Delivery Charges,,136 RECOVERY - VAGINAL DELIVERY-EA.ADD'L 30 MIN CHARGE CADDO,Labor and Delivery Charges,,85 ROOM & BOARD - LDR DAILY CHARGE CADDO,Labor and Delivery Charges,,438 "TOCOLYTIC THERAPY, 24 HRS CHARGE CADDO",Labor and Delivery Charges,,105 ABD PARACENTESIS W/O IMAGING CHARGE CADDO,Misc Charges,49082,489 ANTEPARTUM MANIPULATION,Misc Charges,59412,3692 Abd Paracentesis Dx w/imaging,Misc Charges,49083,1008 CARDIOVERSION (ELEC) EXTERNAL CADDO,Misc Charges,92960,909 CENTRAL LINE PLACEMENT CHARGE CADDO,Misc Charges,36556,1015 COLONOSCOPY CHARGE CADDO,Misc Charges,,2060 Crossmatch IS CHARGE ONLY CADDO,Misc Charges,86920,115 DEBRIDEMENT BONE M&/F 20 SQ CM CHARGE CADDO,Misc Charges,11044,1406 ECXIS BENIG LESION F/E/EY/N/L/MM; OVER 4.0 CM,Misc Charges,11446,3648 EGD CHARGE CADDO,Misc Charges,,1751 ENDOMETRIAL BIOPSY W/WO BIOPSY,Misc Charges,58100,319 EX BENIGN LES TRK/A/LEG 0.6 TO 1.0 CM CADDO,Misc Charges,11401,304 EXCISION OF MULTI EXTERNAL ANAL TAGS CHARGE CADDO,Misc Charges,,670 Hydration IV Infusion Initial,Misc Charges,96360,258 IV INF ADD ON THER/PROPH/DIAG CHARGE CADDO,Misc Charges,96366,72 IV INFUSION ADDL SEQ TX/DX CHARGE CADDO,Misc Charges,96367,98 LARYNGOSCOPY FLEXIBLE FIBEROPTIC DIAGN CHARGE CADDO,Misc Charges,31575,345 LESION REMOVAL(ALL) CHARGE CADDO,Misc Charges,,188 LUMBAR PUNCTURE CHARGE.,Misc Charges,62270,412 NASAL PROCEDURE REMOVE PACKING CHARGE CADDO,Misc Charges,30999,206 NERVE CONDUCTION 5-6 STUDIES,Misc Charges,95909,1301 PEG TUBE REPLACEMENT CHARGE CADDO,Misc Charges,43760,479 PHLEBOTOMY BY MD FACILITY SIDE,Misc Charges,99195,165 PICC-PERIPHERALLY INSERTED CENTRAL CATHETER CHARGE CADDO,Misc Charges,36569,1262 PROCTOSIGMOIDOSCOPY RGD FB REMOVAL CHARGE CADDO,Misc Charges,45307,4043 REMOVAL IMPLANTABLE CARDIAC EVENT RECORDER CHARGE CADDO,Misc Charges,33284,1416 REMOVAL OF INTRAUTERINE DEVICE,Misc Charges,58301,505 SECONDARY CLOSURE SURG WOUND COMPLICATED CHARGE CADDO,Misc Charges,13160,3677 SHAVING SKIN LESION > 2.0 CM,Misc Charges,11303,361 SIGMOIDOSCOPY FLEXIBLE DIAGNOSTIC CHARGE CADDO,Misc Charges,45330,1123 SIGMOIDOSCOPY WITH BIOPSY SINGLE OR MULT CHARGE CADDO,Misc Charges,45331,1458 SYNCRONIZED CARDIOVERSION CHARGE CADDO,Misc Charges,,126 THER IV HYDRAYTION ADD ON CHARGE CADDO,Misc Charges,96361,77 THER IV PUSH ADD ON (NEW DRUG) CHARGE CADDO,Misc Charges,96375,98 THER/PROPH/DIAG INJ SC/IM CHARGE CADDO,Misc Charges,96372,62 THER/PROPH/DIAG IV HYDRATION CHARGE CADDO,Misc Charges,96360,185 TREATMENT ROOM CHARGE CADDO,Misc Charges,,120 "Ther/Proph/diag INJ, IV Push",Misc Charges,96374,98 Ther/proph/diag IV Infusion Initial,Misc Charges,96365,258 Thoracentesis CHARGE CADDO,Misc Charges,32555,1082 Tis trnfr f/c/c/m/n/a/g/h/f,Misc Charges,14040,4250 Treatment Room/Vasectomy,Misc Charges,55250,6850 "4409997 Behavioral counseling for obesity, 15min face-to-face",Nutrition Asmt/Tx/Monitoring,G0447,140 4409998 MNT Initial Assessment & interventions (1 per calendar yr),Nutrition Asmt/Tx/Monitoring,97802,41 4409999 MNT Re-Assessment & Interventions(each 15 min),Nutrition Asmt/Tx/Monitoring,97803,41 NUTRITIONIST COUNSEL/VISIT,Nutrition Asmt/Tx/Monitoring,,0 "Application of modality to 1 or more areas: electrical stimulation(manual), each 15min",OT Tx/Procedures,97032,50 Application of modality to 1 or more areas: ultrasound each 15 mins,OT Tx/Procedures,97018,35 FUNCTIONAL G-CODE,OT Tx/Procedures,,1 OT Cognitive Skills Development Charge CADDO,OT Tx/Procedures,97532,77 OT ED Training PT/Family/Caregiver 30 Min.,OT Tx/Procedures,98960,36 OT Evaluation High CHARGE CADDO,OT Tx/Procedures,97167,330 OT Evaluation Low CHARGE CADDO,OT Tx/Procedures,97165,225 OT Evaluation Mod CHARGE CADDO,OT Tx/Procedures,97166,275 OT Group Therapeutic Procedure,OT Tx/Procedures,97150,85 OT Neuromuscular Re-ED EA 15 MIN CHARGE CADDO,OT Tx/Procedures,97112,90 OT Orthotic MGT/Training 15 Min.,OT Tx/Procedures,97760,67 OT Prosthetic Training 15 Min.,OT Tx/Procedures,97761,36 OT Re-Evaluation CHARGE CADDO,OT Tx/Procedures,97168,250 OT Self-Care Management Ea 15 MIN CHARGE CADDO,OT Tx/Procedures,97535,88 OT Therapeutic Activities EA 15 MIN CHARGE CADDO,OT Tx/Procedures,97530,98 OT Therapeutic Exercise Ea 15 Min CHARGE CADDO,OT Tx/Procedures,97110,118 OT Wheelchair Management Charge CADDO,OT Tx/Procedures,97542,72 Sensory integrative techniq to enhance sensory processing and promote adapt respon to envi demand 1,OT Tx/Procedures,97533,65 OT Therapeutic Exercise Ea 15 Min CHARGE,Occupational Therapy Charges,97110,118 Bladder Scan ER,POC Asmt/Tx/Monitoring,51798,237 Bladder Scan Inpatient,POC Asmt/Tx/Monitoring,51798,237 Bladder Scan Outpatient,POC Asmt/Tx/Monitoring,51798,237 Blood Glucose Monitoring POC,POC Asmt/Tx/Monitoring,82948,27 Stool for Occult Blood Screening POC,POC Asmt/Tx/Monitoring,82272,127 "Application of modality to 1 or more areas: electrical stimulation(manual), each 15min",PT Tx/Procedures,97032,50 FUNCTIONAL G-CODE,PT Tx/Procedures,,1 Manual therapy techniques 1 or more regions each 15 mins,PT Tx/Procedures,97140,65 "Orthotic management & training upper ext, lower extremity and/or trunk each 15 mins",PT Tx/Procedures,97760,95 PT Prosthetic Training 15 Min.,PT Tx/Procedures,97761,95 PT Debridement/Dressing CHARGE CADDO,PT Tx/Procedures,97602,55 PT ED Training PT/Family/Caregiver 30 Min.,PT Tx/Procedures,98960,80 PT Evaluation High CHARGE,PT Tx/Procedures,97163,330 PT Evaluation Low CHARGE,PT Tx/Procedures,97161,225 PT Evaluation Mod CHARGE,PT Tx/Procedures,97162,275 PT Exercise Charge CADDO,PT Tx/Procedures,97110,100 PT Gait Training CHARGE,PT Tx/Procedures,97116,103 PT Infrared,PT Tx/Procedures,97026,40 PT Manual Therapy per 15 MIN CHARGE,PT Tx/Procedures,97140,95 PT Massage,PT Tx/Procedures,97124,55 PT Neuromuscular Re-ED EA 15 MIN CHARGE CADDO,PT Tx/Procedures,97112,65 PT Orthotic MGT/Training 15 Min.,PT Tx/Procedures,97760,95 "PT ROM Test, Extremity or Trunk",PT Tx/Procedures,95851,75 PT Re-Evaluation CHARGE,PT Tx/Procedures,97164,250 PT SM Whirlpool Charge CADDO,PT Tx/Procedures,97022,70 PT Therapeutic Activities EA 15 MIN CHARGE CADDO,PT Tx/Procedures,97530,98 PT Traction Mechanical,PT Tx/Procedures,97012,45 PT Vasopneumatic Devices,PT Tx/Procedures,97016,45 Physical performance test with written report each 15 mins,PT Tx/Procedures,97750,95 ST Evaluate Swallowing Function Charge CADDO,PT Tx/Procedures,92610,206 ST Evaluation of Speech Language CHARGE CADDO,PT Tx/Procedures,92523,309 Ultrasound therapy each 15 mins,PT Tx/Procedures,97035,40 99281 - Level 1 - Lynx Visit Level,Patient Care,99281,129 99282 - Level 2 - Lynx Visit Level,Patient Care,99282,232 99283 - Level 3 - Lynx Visit Level,Patient Care,99283,381 99284 - Level 4 - Lynx Visit Level,Patient Care,99284,670 99285 - Level 5 - Lynx Visit Level,Patient Care,99285,1030 99291 - Critical Care - Lynx Visit Level,Patient Care,99291,1427 Ambulance Mileage One,Patient Care,A0425,20 Ambulance Mileage Two,Patient Care,A0425,20 Bladder Scan Volume,Patient Care,51798,237 "Blood Glucose, Capillary POC",Patient Care,82948,27 Occult Blood Stool POC,Patient Care,82272,127 Oxygen Therapy,Patient Care,,31 SpO2,Patient Care,94760,72 ROOM/BED: Labor and Delivery,Person Management,,438 ROOM/BED: Nursery,Person Management,,244 ROOM/BED: Observation,Person Management,,36 ROOM/BED: Obstetrics,Person Management,,57 ROOM/BED: Private,Person Management,,438 ROOM/BED: Swing,Person Management,,309 10021 FINE NEEDLE ASPIRATION BX;W/IMAGING; 1ST LESION CCC,Procedure Charge,10021,930 Excision tumor soft tissue of back or flank subcutaneous less than 3 cm,Procedure Charge,21930,3193 "Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm",Procedure Charge,11606,1545 "Inj, Anesthetic Agent; Femoral Nerve, Single Charge",Procedure Charge,64447,824 "Injection anes illoniguinal iliohypogastric nrvs,",Procedure Charge,64425,1015 MUSCLE BIOPSY - BCE,Procedure Charge,20200,2362 Swallowing Funct ST w/CineRAD/VideoRAD,Procedure Charge,74230,1056 "WOUND CARE NON-SELECTIVE DEBRIDEMENT, CADDO",Procedure Charge,97602,240 BD Bone Density DEXA Study,Radiology,77080,361 CADDO MA CAD Screening,Radiology,77067,0 CADDO Multihance-Gadolidium,Radiology,,464 CADDO Omnipaque 300 - 100ML,Radiology,,335 CADDO Omnipaque 300 - 50ML,Radiology,,206 CADDO RediCat,Radiology,,STAT CADDO Visipaque 320,Radiology,,386 CT Abdomen w/ + w/o Contrast,Radiology,74170,2060 CT Abdomen w/ Contrast,Radiology,74160,1751 CT Abdomen w/o Contrast,Radiology,74150,1545 CT Abdomen/Pelvis w + w/o Contrast,Radiology,74178,3605 CT Abdomen/Pelvis w/ Contrast,Radiology,74177,3506 CT Abdomen/Pelvis w/o Contrast,Radiology,74176,3257 CT Angiography Abd Aorta + Iliofemoral,Radiology,74160,1754 CT Angiography Aorta w/ Runoff,Radiology,75635,2575 CT Ankle w/ + w/o Contrast Left,Radiology,73702,2266 CT Ankle w/ + w/o Contrast Right,Radiology,73702,2266 CT Ankle w/ Contrast Left,Radiology,73701,1597 CT Ankle w/ Contrast Right,Radiology,73701,1597 CT Ankle w/o Contrast Left,Radiology,73700,1503 CT Ankle w/o Contrast Right,Radiology,73700,1503 CT Bony Pelvis,Radiology,72192,1503 CT Chest W/O Contrast,Radiology,71250,1504 CT Chest W/WO Contrast,Radiology,71270,1854 CT Chest w/ Contrast,Radiology,71260,1754 CT Elbow w/ + w/o Contrast Left,Radiology,73202,2369 CT Elbow w/ + w/o Contrast Right,Radiology,73202,2369 CT Elbow w/ Contrast Left,Radiology,73201,1545 CT Elbow w/ Contrast Right,Radiology,73201,1545 CT Elbow w/o Contrast Left,Radiology,73200,1442 CT Elbow w/o Contrast Right,Radiology,73200,1442 CT Femur w/ + w/o Contrast Left,Radiology,73702,2266 CT Femur w/ + w/o Contrast Right,Radiology,73702,2266 CT Femur w/ Contrast Left,Radiology,73701,1597 CT Femur w/ Contrast Right,Radiology,73701,1597 CT Femur w/o Contrast Left,Radiology,73700,1503 CT Femur w/o Contrast Right,Radiology,73700,1503 CT Foot w/ + w/o Contrast Left,Radiology,73702,2266 CT Foot w/ + w/o Contrast Right,Radiology,73702,2266 CT Foot w/ Contrast Left,Radiology,73701,1597 CT Foot w/ Contrast Right,Radiology,73701,1597 CT Foot w/o Contrast Left,Radiology,73700,1503 CT Foot w/o Contrast Right,Radiology,73700,1503 CT Forearm w/ + w/o Contrast Left,Radiology,73202,2369 CT Forearm w/ + w/o Contrast Right,Radiology,73202,2369 CT Forearm w/ Contrast Left,Radiology,73201,1545 CT Forearm w/ Contrast Right,Radiology,73201,1545 CT Forearm w/o Contrast Left,Radiology,73200,1442 CT Forearm w/o Contrast Right,Radiology,73200,1442 CT Hand w/ + w/o Contrast Left,Radiology,73202,2369 CT Hand w/ + w/o Contrast Right,Radiology,73202,2369 CT Hand w/ Contrast Left,Radiology,73201,1545 CT Hand w/ Contrast Right,Radiology,73201,1545 CT Hand w/o Contrast Left,Radiology,73200,1442 CT Hand w/o Contrast Right,Radiology,73200,1442 CT Head or Brain w/ + w/o Contrast,Radiology,70470,2004 CT Head or Brain w/ Contrast,Radiology,70460,1751 CT Head or Brain w/o Contrast,Radiology,70450,1503 CT Hip w/ + w/o Contrast Left,Radiology,73702,2266 CT Hip w/ + w/o Contrast Right,Radiology,73702,2266 CT Hip w/ Contrast Left,Radiology,73701,1597 CT Hip w/ Contrast Right,Radiology,73701,1597 CT Hip w/o Contrast Left,Radiology,73700,1503 CT Hip w/o Contrast Right,Radiology,73700,1503 CT Humerus w/ + w/o Contrast Left,Radiology,73202,2369 CT Humerus w/ + w/o Contrast Right,Radiology,73202,2369 CT Humerus w/ Contrast Left,Radiology,73201,1545 CT Humerus w/ Contrast Right,Radiology,73201,1545 CT Humerus w/o Contrast Left,Radiology,73200,1442 CT Humerus w/o Contrast Right,Radiology,73200,1442 CT IAC w/ Contrast,Radiology,70481,1751 CT IAC w/o Contrast,Radiology,70480,1503 CT Knee w/ + w/o Contrast Left,Radiology,73702,2266 CT Knee w/ + w/o Contrast Right,Radiology,73702,2266 CT Knee w/ Contrast Left,Radiology,73701,1597 CT Knee w/ Contrast Right,Radiology,73701,1597 CT Knee w/o Contrast Left,Radiology,73700,1503 CT Knee w/o Contrast Right,Radiology,73700,1503 CT Maxillofacial w/ Contrast,Radiology,70487,175 CT Maxillofacial w/o Contrast,Radiology,70486,1503 CT Maxillofacial w/ + w/o Contrast,Radiology,70488,1854 CT Orbit Sella etc. w/o Contrast,Radiology,70480,1503 CT Orbit Sella etc. w/ + w/o Contrast,Radiology,70482,2004 CT PE Protocol Exam,Radiology,71275,2215 CT Pelvis w/ + w/o Contrast,Radiology,72194,2009 CT Pelvis w/ Contrast,Radiology,72193,1751 CT Pelvis w/o Contrast,Radiology,72192,1442 CT Renal Stone,Radiology,74176,3257 CT Shoulder w/ + w/o Contrast Left,Radiology,73202,2369 CT Shoulder w/ + w/o Contrast Right,Radiology,73202,2369 CT Shoulder w/ Contrast Left,Radiology,73201,1545 CT Shoulder w/ Contrast Right,Radiology,73201,1545 CT Shoulder w/o Contrast Left,Radiology,73200,1442 CT Shoulder w/o Contrast Right,Radiology,73200,1442 CT Sinus,Radiology,70486,1503 CT Soft Tissue Neck w/ + w/o Contrast,Radiology,70492,2266 CT Soft Tissue Neck w/ Contrast,Radiology,70491,1751 CT Soft Tissue Neck w/o Contrast,Radiology,70490,1503 CT Spine Cervical w/o Contrast,Radiology,72125,1597 CT Spine Cervical w/ Contrast,Radiology,72126,1803 CT Spine Lumbar w/o Contrast,Radiology,72131,1597 CT Spine Lumbar w/ Contrast,Radiology,72132,1803 CT Spine Thoracic w/o Contrast,Radiology,72128,1503 CT Spine Thoracic w/ Contrast,Radiology,72129,1803 CT Tibia/Fibula w/ + w/o Contrast Left,Radiology,73702,2266 CT Tibia/Fibula w/ + w/o Contrast Right,Radiology,73702,2266 CT Tibia/Fibula w/ Contrast Left,Radiology,73701,1597 CT Tibia/Fibula w/ Contrast Right,Radiology,73701,1597 CT Tibia/Fibula w/o Contrast Left,Radiology,73700,1503 CT Tibia/Fibula w/o Contrast Right,Radiology,73700,1503 CT Wrist w/ + w/o Contrast Left,Radiology,73202,2369 CT Wrist w/ + w/o Contrast Right,Radiology,73202,2369 CT Wrist w/ Contrast Left,Radiology,73201,1545 CT Wrist w/ Contrast Right,Radiology,73201,1545 CT Wrist w/o Contrast Left,Radiology,73200,1442 CT Wrist w/o Contrast Right,Radiology,73200,1442 MA Mammogram Routine Screening Left.,Radiology,77067,213 MA Mammogram Routine Screening Right.,Radiology,77067,213 MA Mammogram Routine Screening Bilat.,Radiology,77067,288 MRA Abdomen w/ + w/o Contrast,Radiology,74185,1236 MRA Abdomen w/ Contrast,Radiology,74185,1236 MRA Head w/o Contrast,Radiology,70544,1957 MRA Lower Ext w/ + w/o Contrast,Radiology,73725,1545 MRA Neck w/ + w/o Contrast,Radiology,70549,2163 MRA Neck w/ Contrast,Radiology,70548,2060 MRA Neck w/o Contrast,Radiology,70547,1957 MRI Abdomen w/ + w/o Contrast,Radiology,74183,2163 MRI Abdomen w/ Contrast,Radiology,74182,1236 MRI Abdomen w/o Contrast,Radiology,74181,1751 MRI Ankle w/ + w/o Contrast Left,Radiology,73723,3399 MRI Ankle w/ + w/o Contrast Right,Radiology,73723,3399 MRI Ankle w/ Contrast Left,Radiology,73722,2575 MRI Ankle w/ Contrast Right,Radiology,73722,2575 MRI Ankle w/o Contrast Left,Radiology,73721,2369 MRI Ankle w/o Contrast Right,Radiology,73721,2369 MRI Brain w/ + w/o Contrast,Radiology,70553,2575 MRI Brain w/ Contrast,Radiology,70552,2060 MRI Brain w/o Contrast,Radiology,70551,1957 MRI Chest w/ + w/o Contrast,Radiology,71552,2163 MRI Chest w/ Contrast,Radiology,71551,2060 MRI Chest w/o Contrast,Radiology,71550,1957 MRI Elbow w/ + w/o Contrast Left,Radiology,73223,2266 MRI Elbow w/ + w/o Contrast Right,Radiology,73223,2266 MRI Elbow w/ Contrast Left,Radiology,73222,1957 MRI Elbow w/ Contrast Right,Radiology,73222,1957 MRI Elbow w/o Contrast Left,Radiology,73221,1854 MRI Elbow w/o Contrast Right,Radiology,73221,1854 MRI Face Neck Orbit w/ + w/o Contrast,Radiology,70543,3399 MRI Face Neck Orbit w/ Contrast,Radiology,70542,2060 MRI Face Neck Orbit w/o Contrast,Radiology,70540,1957 MRI Femur w/ + w/o Contrast Left,Radiology,73720,2678 MRI Femur w/ + w/o Contrast Right,Radiology,73720,2678 MRI Femur w/ Contrast Left,Radiology,73719,2575 MRI Femur w/ Contrast Right,Radiology,73719,2575 MRI Femur w/o Contrast Left,Radiology,73718,2060 MRI Femur w/o Contrast Right,Radiology,73718,2060 MRI Foot w/ + w/o Contrast Left,Radiology,73720,2678 MRI Foot w/ + w/o Contrast Right,Radiology,73720,2678 MRI Foot w/ Contrast Left,Radiology,73719,2575 MRI Foot w/ Contrast Right,Radiology,73719,2575 MRI Foot w/o Contrast Left,Radiology,73718,2060 MRI Foot w/o Contrast Right,Radiology,73718,2060 MRI Forearm w/ + w/o Contrast Left,Radiology,73220,1957 MRI Forearm w/ + w/o Contrast Right,Radiology,73220,1957 MRI Forearm w/ Contrast Left,Radiology,73219,1751 MRI Forearm w/ Contrast Right,Radiology,73219,1751 MRI Forearm w/o Contrast Left,Radiology,73218,1648 MRI Forearm w/o Contrast Right,Radiology,73218,1648 MRI Hand w/ + w/o Contrast Left,Radiology,73220,1957 MRI Hand w/ + w/o Contrast Right,Radiology,73220,1957 MRI Hand w/ Contrast Left,Radiology,73219,1751 MRI Hand w/ Contrast Right,Radiology,73219,1751 MRI Hand w/o Contrast Left,Radiology,73218,1648 MRI Hand w/o Contrast Right,Radiology,73218,1648 MRI Hip w/ + w/o Contrast Left,Radiology,73723,3399 MRI Hip w/ + w/o Contrast Right,Radiology,73723,3399 MRI Hip w/ Contrast Left,Radiology,73722,2575 MRI Hip w/ Contrast Right,Radiology,73722,2575 MRI Hip w/o Contrast Left,Radiology,73721,2369 MRI Hip w/o Contrast Right,Radiology,73721,2369 MRI Humerus w/ + w/o Contrast Left,Radiology,73220,1957 MRI Humerus w/ + w/o Contrast Right,Radiology,73220,1957 MRI Humerus w/ Contrast Left,Radiology,73219,1751 MRI Humerus w/ Contrast Right,Radiology,73219,1751 MRI Humerus w/o Contrast Left,Radiology,73218,1648 MRI Humerus w/o Contrast Right,Radiology,73218,1648 MRI Knee w/ + w/o Contrast Left,Radiology,73723,3399 MRI Knee w/ + w/o Contrast Right,Radiology,73723,3399 MRI Knee w/ Contrast Left,Radiology,73722,2575 MRI Knee w/ Contrast Right,Radiology,73722,2575 MRI Knee w/o Contrast Left,Radiology,73721,2369 MRI Knee w/o Contrast Right,Radiology,73721,2369 MRI Pelvis w/ + w/o Contrast,Radiology,72197,2266 MRI Pelvis w/ Contrast,Radiology,72196,2163 MRI Pelvis w/o Contrast,Radiology,72195,2060 MRI Shoulder w/ + w/o Contrast Left,Radiology,73223,2266 MRI Shoulder w/ + w/o Contrast Right,Radiology,73223,2266 MRI Shoulder w/ Contrast Left,Radiology,73222,1957 MRI Shoulder w/ Contrast Right,Radiology,73222,1957 MRI Shoulder w/o Contrast Left,Radiology,73221,1854 MRI Shoulder w/o Contrast Right,Radiology,73221,1854 MRI Spine Cervical w/ Contrast,Radiology,72142,2163 MRI Spine Cervical w/o Contrast,Radiology,72141,1957 MRI Spine Cervical w/ + w/o Contrast,Radiology,72156,3399 MRI Spine Lumbar w/ Contrast,Radiology,72149,2060 MRI Spine Lumbar w/o Contrast,Radiology,72148,1957 MRI Spine Lumbar w/ + w/o Contrast,Radiology,72158,2575 MRI Spine Thoracic w/ Contrast,Radiology,72147,2060 MRI Spine Thoracic w/o Contrast,Radiology,72146,1957 MRI Spine Thoracic w/ + w/o Contrast,Radiology,72157,2369 MRI TMJ,Radiology,70336,1545 MRI Tibia/Fibula w/ + w/o Contrast Left,Radiology,73720,2678 MRI Tibia/Fibula w/ + w/o Contrast Right,Radiology,73720,2678 MRI Tibia/Fibula w/o Contrast Left,Radiology,73718,2060 MRI Tibia/Fibula w/o Contrast Right,Radiology,73718,2060 MRI Tibia/Fibula w/ Contrast Left,Radiology,73719,2575 MRI Tibia/Fibula w/ Contrast Right,Radiology,73719,2575 MRI Wrist w/ + w/o Contrast Left,Radiology,73223,2266 MRI Wrist w/ + w/o Contrast Right,Radiology,73223,2266 MRI Wrist w/ Contrast Left,Radiology,73222,1957 MRI Wrist w/ Contrast Right,Radiology,73222,1957 MRI Wrist w/o Contrast Left,Radiology,73221,1854 MRI Wrist w/o Contrast Right,Radiology,73221,1854 Radiology Exam,Radiology,73000,RT Radiology Exam,Radiology,73070,RT Radiology Exam,Radiology,73080,RT Radiology Exam,Radiology,73120,RT Radiology Exam,Radiology,,335 US Abdomen Complete,Radiology,76700,567 US Abdomen Limited,Radiology,76705,489 US Ankle Brachial Index,Radiology,93922,515 US Aorta Duplex Complete,Radiology,76770,438 US Art/Vein Abd/Pelvis/Scrotal Limited,Radiology,93976,412 US Art/Vein Abd/Pelvis/Scrotal Complete,Radiology,93975,464 US Biophysical Profile,Radiology,76818,299 US Bladder w/Pre and Post Void,Radiology,76857,438 US Breast Bilateral,Radiology,76641,309 US Breast Left,Radiology,76641,309 US Breast Left Complete,Radiology,76641,309 US Breast Left Limited,Radiology,,258 US Breast Left Limited,Radiology,76642,258 US Breast Right,Radiology,76641,309 US Breast Right Limited,Radiology,76642,258 US Breast Right Complete,Radiology,76641,309 US Carotid Doppler Bilateral,Radiology,93880,464 US Echocardiogram Complete,Radiology,93306,1555 US Gallbladder,Radiology,76705,489 US LE Arterial Duplex Bilateral,Radiology,93925,618 US LE Arterial Duplex Left,Radiology,93926,515 US LE Arterial Duplex Right,Radiology,93926,515 US LE Venous Duplex Bilateral,Radiology,93970,721 US LE Venous Duplex Left,Radiology,93971,412 US LE Venous Duplex Right,Radiology,93971,412 US OB < 14 Weeks Single,Radiology,76801,330 US OB < 14 Weeks Multi,Radiology,76802,438 US OB Complete,Radiology,76805,464 US OB Detailed Single,Radiology,76811,479 US Pelvis Non-OB Complete,Radiology,76856,438 US Pregnancy Follow Up,Radiology,76816,155 US Pregnancy Limited,Radiology,76815,155 US Pregnancy Transvaginal,Radiology,76817,206 US Renal,Radiology,76770,458 US Renal Doppler,Radiology,93975,464 US Scrotum (Contents),Radiology,76870,258 US Soft Tissue Buttock,Radiology,76882,139 US Soft Tissue Lower Back,Radiology,76882,139 US Soft Tissue Lower Extremity,Radiology,76882,139 US Soft Tissue Neck,Radiology,76882,139 US Soft Tissue Other Than Neck,Radiology,76882,139 US Soft Tissue Pelvic Wall,Radiology,76882,139 US Soft Tissue Perineum,Radiology,76882,139 US Soft Tissue Upper Extremity,Radiology,76882,139 US Soft Tissue Abdominal Wall,Radiology,76882,139 US Soft Tissue Axilla,Radiology,76882,139 US Soft Tissue Chest Wall,Radiology,76882,139 US Soft Tissue Groin,Radiology,76882,139 US Soft Tissue Upper Back,Radiology,76882,139 US TRANSVAGINAL,Radiology,76830,731 US Thyroid,Radiology,76536,439 US UE Arterial Duplex Bilateral,Radiology,93930,618 US UE Arterial Duplex Left,Radiology,93931,515 US UE Arterial Duplex Right,Radiology,93931,515 US UE Venous Duplex Bilateral,Radiology,93970,721 US UE Venous Duplex Left,Radiology,93971,412 US UE Venous Duplex Right,Radiology,93971,412 XR AC Joints w/ or w/o weights Bilateral,Radiology,73050,206 XR Abdomen 1 View,Radiology,74018,191 XR Abdomen 2 View,Radiology,74019,258 XR Abdomen 2 Views Portable,Radiology,74019,258 XR Abdomen Series w/ Chest1 View,Radiology,74022,283 XR Ankle 2 Views Left,Radiology,73600,155 XR Ankle 2 Views Right,Radiology,73600,155 XR Ankle Complete Left,Radiology,73610,180 XR Ankle Complete Right,Radiology,73610,180 XR Bone Age Studies,Radiology,77072,191 XR Bone Survey Complete (Mets),Radiology,77075,309 XR Bone Survey Complete,Radiology,77075,309 XR Bone Survey Infant,Radiology,77076,258 XR Calcaneous Left,Radiology,73650,155 XR Calcaneous Right,Radiology,73650,155 XR Chest 1 View,Radiology,71045,180 XR Chest 2 Views,Radiology,71046,206 XR Chest 4 Views,Radiology,71047,222 XR Clavicle Left,Radiology,73000,165 XR Clavicle Right,Radiology,73000,165 XR Coccyx,Radiology,72220,206 XR Elbow 2 Views Left,Radiology,73070,165 XR Elbow 2 Views Right,Radiology,73070,165 XR Elbow Complete Right,Radiology,73080,227 XR Elbow Complete Right,Radiology,73080,227 XR Facial Bones < 3 Views,Radiology,70140,144 XR Facial Bones Minimum 3 Views,Radiology,70150,258 XR Femur 1 View Left,Radiology,73551,191 XR Femur 1 View Right,Radiology,73551,191 XR Femur 2 Views Left,Radiology,73552,191 XR Femur 2 Views Right,Radiology,73552,191 XR Foot 2 Views Left,Radiology,73620,191 XR Foot 2 Views Right,Radiology,73620,191 XR Foot Complete Left,Radiology,73630,191 XR Foot Complete Right,Radiology,73630,191 XR Forearm 2 Views Left,Radiology,73090,180 XR Forearm 2 Views Right,Radiology,73090,180 XR Hand 2 Views Left,Radiology,73120,191 XR Hand 2 Views Right,Radiology,73120,191 XR Hand Complete Left,Radiology,73130,232 XR Hand Complete Right,Radiology,73130,232 XR Hip 1 View Left,Radiology,,165 XR Hip 1 View Lt w/ Pelvis,Radiology,73501,165 XR Hip 1 View Rt w/ Pelvis,Radiology,73501,165 XR Hip 2-3 Views Lt w/ Pelvis,Radiology,73502,165 XR Hip 2-3 Views Rt w/ Pelvis,Radiology,73502,165 XR Hip Min 4 Views Lt w/ Pelvis,Radiology,73503,180 XR Hip Min 4 Views Rt w/ Pelvis,Radiology,73503,180 XR Hips Bil w/ Pelvis 2 Views,Radiology,73521,180 XR Hips Bil w/ Pelvis 3-4 Views,Radiology,73522,191 XR Hips Bil w/ Pelvis Min 5 Views,Radiology,73523,200 XR Humerus Left,Radiology,73060,191 XR Humerus Right,Radiology,73060,191 XR IVP,Radiology,74400,613 XR Knee 3 Views Left,Radiology,73562,206 XR Knee 3 Views Right,Radiology,73562,206 XR Knee Complete Left,Radiology,73564,258 XR Knee Complete Right,Radiology,73564,258 XR Knee One or Two Views Left,Radiology,73560,180 XR Knee One or Two Views Right,Radiology,73560,180 XR Knee Standing AP Bilateral,Radiology,73565,206 XR Lower Extremity Infant Left,Radiology,73592,191 XR Lower Extremity Infant Right,Radiology,73592,191 XR Mandible Complete Minimum 4 Views,Radiology,70110,232 XR Nasal Bones Minimum 3 Views,Radiology,70160,206 XR Neck Soft Tissue,Radiology,70360,191 XR Orbits Complete Left,Radiology,70200,166 XR Orbits Complete Right,Radiology,70200,166 XR Patella Left,Radiology,73560,180 XR Patella Right,Radiology,73560,180 XR Pelvis 1 View,Radiology,72170,180 XR Ribs 2 Views Left,Radiology,71100,232 XR Ribs 2 Views Right,Radiology,71100,232 XR Ribs 3 Views Bilateral,Radiology,71110,335 XR Ribs w/ PA Chest Bilateral,Radiology,71111,407 XR Ribs w/ PA Chest Left,Radiology,71101,335 XR Ribs w/ PA Chest Right,Radiology,71101,335 XR Sacroiliac Joints,Radiology,72202,232 XR Sacrum,Radiology,72220,206 XR Scapula Left,Radiology,73010,180 XR Scapula Right,Radiology,73010,180 XR Shoulder 1 View Left,Radiology,73020,165 XR Shoulder 1 View Right,Radiology,73020,165 XR Shoulder 2 Views Left,Radiology,73030,206 XR Shoulder 2 Views Right,Radiology,73030,206 XR Shuntogram Non-Vascular,Radiology,75809,309 XR Sinuses Paranasal Complete,Radiology,70220,283 XR Sinuses Paranasal < 3 Views,Radiology,70210,206 XR Skull < 4 Views,Radiology,70250,258 XR Skull Complete,Radiology,70260,309 XR Small Bowel Series,Radiology,74250,386 XR Spine 1 View Cervical,Radiology,72020,213 XR Spine 1 View Lumbar,Radiology,72020,213 XR Spine 1 View Thoracic,Radiology,72020,213 XR Spine Cervical 2 or 3 Views,Radiology,72040,232 XR Spine Cervical Comp w/ Oblique,Radiology,72050,464 XR Spine Cervical Comp w/ Flex/Ext,Radiology,72052,489 XR Spine Cervical Flexion/Extension Only,Radiology,72040,232 XR Spine Entire 1 View,Radiology,72081,235 XR Spine Entire 2-3 Views,Radiology,72082,245 XR Spine Entire 4-5 Views,Radiology,72083,260 XR Spine Entire Min 6 Views,Radiology,72084,300 XR Spine Lumbosacral 2 or 3 Views,Radiology,72100,232 XR Spine Lumbosacral Minimum 4 Views,Radiology,72110,386 XR Spine Thoracic 2 Views,Radiology,72070,232 XR Spine Thoracic 3 Views,Radiology,72072,319 XR Spine Thoracolumbar 2 Views,Radiology,72080,232 XR Sternoclavicular Joint(s),Radiology,71048,232 XR Sternum Minimum 2 Views,Radiology,71120,206 XR Tibia/Fibula Left,Radiology,73590,191 XR Tibia/Fibula Right,Radiology,73590,191 XR Upper Extremity Infant Left,Radiology,73092,191 XR Upper Extremity Infant Right,Radiology,73092,191 XR Wrist 2 Views Right,Radiology,73100,206 XR Wrist 2 Views Left,Radiology,73100,206 XR Wrist Complete Right,Radiology,73110,232 XR Wrist Complete Left,Radiology,73110,232 XR Zygomatic Arches,Radiology,70150,151 ABG Draw (Resp),Respiratory Therapy,36415,44 Aerosol Treatment,Respiratory Therapy,94640,330 Bi-level Positive Airway Pressure,Respiratory Therapy,94660,425 Cardiopulmonary Resuscitation,Respiratory Therapy,92950,620 Cardiovascular Stress Test maximal/submaximal treadmill,Respiratory Therapy,93017,987 Chest Physiotherapy Subsequent,Respiratory Therapy,94668,105 Chest Physiotherapy,Respiratory Therapy,94667,335 Chest Physiotherapy Subsequent,Respiratory Therapy,94668,105 Continous Aerosol First Hour,Respiratory Therapy Charges,94644,330 Continous Aerosol Each Add Hour,Respiratory Therapy Charges,94645,280 EKG (Resp),Respiratory Therapy,93005,230 MSLT CHARGE CADDO,Respiratory Therapy Charges,95805,2129 Oxygen Hours,Respiratory Therapy Charges,,32 Pulmonary Function Testing Pre and Post,Respiratory Therapy,94060,475 Pulmonary Function Testing Pre,Respiratory Therapy,94010,323 RT Aerosol Treatment w/Pentamidine,Respiratory Therapy Charges,94642,360 RT Arterial Blood Gas CHARGE CADDO,Respiratory Therapy Charges,82803,195 RT Arterial Puncture D & H CHARGE CADDO,Respiratory Therapy Charges,36415,44 RT Ballard Cath Suction Procedure CHARGE CADDO,Respiratory Therapy Charges,94799,0.01 RT CATHETER ASPIRATION; NASOTRACHEAL CADDO,Respiratory Therapy Charges,31720,335 RT CPAP/BIPAP -- Set Up CHARGE,Respiratory Therapy Charges,94660,425 RT CPAP/BPAP -- Daily Main CHARGE,Respiratory Therapy Charges,94660,415 RT Continuous Overnight Pulse Oximetry,Respiratory Therapy Charges,94762,250 RT Drainage W/ Perc Subsequent CHARGE CADDO,Respiratory Therapy Charges,94668,105 RT EKG CHARGE CADDO,Respiratory Therapy Charges,93005,230 RT Handheld Nebulizer Treatment CHARGE CADDO,Respiratory Therapy Charges,94640,330 RT Holter Monitor 24 HR -- MS -- Tech CHARGE CADDO,Respiratory Therapy Charges,93225,645 RT Holter Monitor 72hr Ext ECG comp,Respiratory Therapy Charges,0295T,806 RT Holter Monitor 48hr-MS-Tech Charge Caddo,Respiratory Therapy Charges,93225,645 RT III Vent Day Management CHARGE CADDO,Respiratory Therapy Charges,94002,1455 RT MECHANICAL CHEST WALL OSCILLATION CPT CADDO,Respiratory Therapy Charges,94669,340 RT METER DOSE INHALER (MDI) TREATMENT CADDO,Respiratory Therapy Charges,94664,330 RT O2 SAT CHARGE,Respiratory Therapy Charges,94760,72 RT Oxygen Per Hour CHARGE,Respiratory Therapy Charges,,32 RT Percussion P/Tx CHARGE CADDO,Respiratory Therapy Charges,94667,335 RT Polysomnogram Routine CHARGE CADDO,Respiratory Therapy Charges,95810,2704 RT Polysomnogram with oxygen CHARGE,Respiratory Therapy Charges,95811,2704 RT Polysomnogram CPAP/BIPAP CHARGE CADDO,Respiratory Therapy Charges,95811,2704 RT Pre-Filled Humidifier CHARGE CADDO,Respiratory Therapy Charges,,29 RT Pulmonary Function W/O BD CHARGE CADDO,Respiratory Therapy Charges,94060,475 RT Pulmonary Function CHARGE CADDO,Respiratory Therapy Charges,94010,323 RT Qualifying Pulse Ox w/Multiple Determinations,Respiratory Therapy Charges,94761,125 RT Resuscitation (CPR) CHARGE CADDO,Respiratory Therapy Charges,92950,620 RT Sputum Induction CHARGE CADDO,Respiratory Therapy Charges,89220,379 RT Stress Test -- MS -- Tech CHARGE CADDO,Respiratory Therapy Charges,93017,987 RT Therapy Note,Respiratory Therapy Charges,94799,130 RT Tracheostomy Care,Respiratory Therapy Charges,94799,345 RT Vital Capacity CHARGE CADDO,Respiratory Therapy Charges,,98 Split Night CHARGE CADDO,Respiratory Therapy Charges,95811,2692 Ventilator Initial,Respiratory Therapy,94002,1455 Evaluation of speech sound production,SLP Tx/Procedures,92522,170 FUNCTIONAL G-CODE,SLP Tx/Procedures,,1 ST Speech/Hearing Treatment CHARGE CADDO,SLP Tx/Procedures,92507,180 ST TX of Swallowing Dysfunction for Feeding CHARGE CADDO,SLP Tx/Procedures,92526,155 ST Therapeutic Exercise Ea 15 Min CHARGE CADDO,SLP Tx/Procedures,97110,36 ST Use of Speech Device Service CHARGE CADDO,SLP Tx/Procedures,92609,103 Speech/hearing therapy,SLP Tx/Procedures,92507,140 Treatment of swallowing and/or oral function,SLP Tx/Procedures,92526,225 Sleep Study CADDO,Sleep Lab,95810,2692 Sleep Study CPAP/BIPAP CADDO,Sleep Lab,95811,2704 Sleep Study MSLT CADDO,Sleep Lab,95805,2704 Sleep Study Split Night CADDO,Sleep Lab,95811,2692 Sleep Study w/ Oxygen CADDO,Sleep Lab,95811,2692 Tx of Speech/Lang/Voice/Comm/Auditory Chg Medicaid,Speech/Audiology Charges,92507,140 Tx of Speech/Lang/Voice/Comm/Auditory - zzTx of Speech/Lang/Voice/Comm/Auditory Chg,Speech/Audiology Charges,92507,140 L/D EPIDURAL TRAY,Supplies,,123 L/D PUDENDAL TRAY,Supplies,,39 O/R 2 Baby Warmer,Supplies,,96 7731510 Level 1 BCE,Surgery Charges,,3090 7731530 Level 2 BCE,Surgery Charges,,3605 Cataract Extraction with Intraocular Lens Implantation,Surgery,,4378 Cesarean Section,Surgery,,3090 Colonoscopy,Surgery,,2060 Esophagogastroduodenoscopy,Surgery,,1751 Esophagogastroduodenoscopy and Colonoscopy,Surgery,,3811 INSERTION OF PESSARY INTRAVAGINAL SUPPORT DEVICE,Surgery Charges,57160,350 Level 1,Surgery Caselevel,,interval Level 2,Surgery Caselevel,,interval Level 3,Surgery Caselevel,,interval OR Level 3 Each Addl 15 Min-BCE,Surgery Charges,,4120 PEG Tube Insertion,Surgery,,1545 Portacath,Surgery,,1751 Proctoscopy,Surgery,,1030 Rhinoscopy,Surgery,,515 Sigmoidoscopy,Surgery,,1545 Bladder Scan,Task,51798,237