rural health clinic price list

CDM Description 2020 Price
ACNE CRYOTHERAPY RHC 140.00
ACNE SURGERY MILIA CYSTS RHC 260.00
ADAPT BEHAVIOR TX PHYS QHP RHC 75.00
ADULT EDU NURSING PHYSICAL 50.00
ALCOHOL SUB ABUSE ASSESS RHC 45.00
ANNUAL NURSING FACILITY ASSESSMENT PRO ONLY 235.00
ANNUAL WELLNESS VISIT 2ND YR ON MC RHC 280.00
ANNUAL WELLNESS VISIT MC PATIENT RHC 415.00
ANOSCOPY DX W WO SPECIMEN RHC 237.00
ANTEPARTUM CARE ONLY 4 TO 6 VISITS RHC 1,122.00
ANTEPARTUM CARE ONLY 7 OR MORE VISITS RHC 1,997.00
ANTICOAG MGMT PT WARFARIN RHC 100.00
APP LONG ARM SPLINT RHC 210.00
APP OF FINGER SPLINT STATIC RHC 100.00
APP OF LNG LEG CAST WALKER OR AMBU TYPE RHC 335.00
APP OF SHORT ARM SPLINT STATIC RHC 155.00
APP OF SHORT LEG SPLINT RHC 175.00
APP TOPICAL FLUORIDE VARNISH RHC 25.00
ARTHROCENTESIS ASP OR INJ INTM JNT OR BURSA WO US RHC 125.00
ARTHROCENTESIS ASP OR INJ MAJ JNT OR BURSA WO US RHC 150.00
ARTHROCENTESIS ASP OR INJ SM JNT OR BURSA WO US RHC 120.00
ASSMT AND CARE PLN PT COG IMP RHC 620.00
AVUL OF NL PLT PART OR COMPL SMPL EA ADDL NL PLT RHC 84.00
AVUL OF NL PLT PART OR COMPL SMPL OR SGL RHC 260.00
BEHAVIOR COUNSEL OBESITY 15M RHC 65.00
BENIGN LESION PARING 4PLUS RHC 189.00
BENIGN LESION PARING RHC 144.00
BHV ID ASSMT BY PHYS QHP RHC 50.00
BLOOD GLUCOSE ACCU CHEK 13.00
BLOOD OCCULT TEST COLORECTAL POC 20.00
BRIEF CHECK IN BY MD QHP RHC 40.00
BRIEF EMOTIONAL BEHAV ASSMT RHC 15.00
BUN 14.00
BX OF CERVIX RHC 336.00
BX SOFT TISSUE BACK FLANK SUPERFICIAL RHC 605.00
BX VAGINAL MUCOSA SIMPLE RHC 229.00
BX VULVA OR PERINEUM EA ADDTL LESION RHC 93.00
BX VULVA PERINEUM 1 LESION RHC 216.00
CA SCREENING PELVIC AND BRST EXAM RHC 95.00
CAPILLARY BLOOD DRAW 9.00
CARE MGMT SVC BHVL HLTH COND RHC 115.00
CATHETERIZATION FOR SPECIMAN 15.00
CCM BHI BY RHC 20 MIN MO RHC 143.00
CDL DOT INDUSTRIAL PHYSICIAL 66.00
CDL RHC 66.00
CERVIC COLP W CERVIX BX RHC 369.00
CHEM CAUT GRANULATION TISSUE RHC 196.00
CHILD K TO 12 SCHOOL SPORTS PHYSICAL 35.00
CHRNC CARE MGMT SVC 30 MIN RHC 200.00
CHRON CARE MGMT SRVC 20 MIN RHC 100.00
CL TX FX PHALANX PHALANG W MANIP RHC 390.00
CL TX IP JNT DISL SNGL W MANIP WO ANESTH RHC 666.00
CL TX MC FX SGL WO MANIP EA BONE RHC 695.00
CL TX RAD HEAD SUBLX IN CHILD NURSEMAID ELBOW W MANIP RHC 312.00
CLSD TX ART FX MCP IP JNT WO MANIPUL RHC 545.00
CNTRL NSL HEM POSTERIOR W PKS OR CAUTERY INIT RHC 779.00
COLLECT BLOOD FROM IMPL VEN DEVICE RHC 56.00
COLPOSCOPY OF CERVIX RHC 286.00
COLPOSCOPY OF CERVIX W BX AND CURETT RHC 394.00
COLPOSCOPY OF CERVIX W EC CURETT RHC 347.00
COLPOSCOPY OF VAGINA RHC 300.00
COMM SVCS BY RHC FQHC 5 MIN RHC 35.00
COMP ASSES CARE PLAN CCM SVC RHC 155.00
CONTROL NASAL HEMORRHAGE ANT COMPLX RHC 526.00
CONTROL NASAL HEMORRHAGE ANT SMPL RHC 333.00
CREP FCE NCK AXIL GEN HDS FT 2.6 TO 7.5CM RHC 1,135.00
CREP SCLP ARMS LGS 2.6 TO 7.5 CM RHC 1,015.00
CREP SCLP ARMS LGS EA ADD 5 CM OR LESS RHC 320.00
CREP WD FCE NCK AXIL GEN HDS FT 1.1 TO 2.5CM RHC 920.00
CREP WD FCE NCK AXIL GEN HDS FT EA ADD 5CM OR LESS RHC 430.00
CREP WD SCLP ARM LGS 1.1 TO 2.5CM RHC 835.00
DEBRD EXZ INF SKIN 10 PERCENT BS RHC 135.00
DEBRD OF NAILS ANY METHOD 1 TO 5 RHC 80.00
DEBRD OF NAILS ANY METHOD 6 OR MORE RHC 110.00
DEBRD SUBQ TISSUE 1ST 20 SQ CM OR LESS RHC 292.00
DEBRD SUBQ TISSUE EA ADL 20 SQ CM RHC 100.00
DEBRIDE SKIN AT FX SITE RHC 1,190.00
DESTR MALG LES TRNK ARM LGS 0.5CM OR LESS RHC 230.00
DESTRUCT B9 LESION 15 OR MORE RHC 310.00
DESTRUCT B9 LESION UP TO 14 LESIONS RHC 260.00
DESTRUCT LESION PENIS SMPL CRYO RHC 340.00
DESTRUCT PREMALG 2 TO 14 LESION EA RHC 15.00
DESTRUCT PREMALG LESION 15 OR MORE RHC 367.00
DESTRUCT PREMALG LESION 1ST LESION RHC 160.00
DEVEL TST PHYS QHP 1ST HR RHC 332.00
DEVEL TST PHYS QHP EA ADDL RHC 149.00
DEVELOPMENTAL SCREEN W SCORE RHC 81.00
DR ABSC CYST HEMATOM DENTOALVEOLAR RHC 673.00
DR EXT EAR ABSCESS HEMATOMA SIMPLE RHC 436.00
DRESS DEBRD P THICK BURN INIT OR SUB SMALL RHC 195.00
EKG INT AND REP PROFEE RHC 21.00
EKG TRACING ONLY 12 LEAD OFFICE 113.00
ELECTROLYTES PANEL POC ISCHEM8 80051 53.00
ENDOMETRIAL BX WO CERVICAL DILATION RHC 260.00
ESCREEN 25.00
EVAC OF SUBUNGUAL HEMATOMA RHC 124.00
EXAM BIOPSY OF VAG W SCOPE RHC 404.00
EXC B9 LES MARG FCE EAR EYELD NSE LPS MM 0.6 TO 1.0CM RHC 400.00
EXC B9 LES MARG FCE EAR EYLD NSE LPS MM 0.5CM OR LESS RHC 325.00
EXC B9 LES W MARG SCLP NCK HND FT GENT 0.5CM OR LESS RHC 295.00
EXC B9 LES W MARG SCLP NCK HND FT GENT 0.6 TO 1.0CM RHC 375.00
EXC B9 LES W MARG SCLP NCK HND FT GENT 1.1 TO 2.0CM RHC 420.00
EXC B9 LES W MARG SCLP NCK HND FT GENT 2.1 TO 3.0CM RHC 480.00
EXC B9 LES W MARG SCLP NCK HND FT GENT 3.1 TO 4.0CM RHC 560.00
EXC B9 LES W MRG FCE EAR EYELD NSE LPS MM 1.1TO 2.0CM RHC 445.00
EXC B9 LES WMARG FCE EAR EYELD NSE LPS MM 2.1TO 3.0CM RHC 535.00
EXC B9 LESION MARG TRNK ARM LGS 0.5CM OR LESS RHC 295.00
EXC B9 LESION MARG TRNK ARM LGS 0.6 TO 1.0CM RHC 356.00
EXC B9 LESION MARG TRNK ARM LGS 1.1 TO 2.0CM RHC 395.00
EXC B9 LESION W MARG SCLP NCK HND FT GENT OVER 4.0CM RHC 805.00
EXC B9 LESION W MARG TRNK ARM LGS 2.1 TO 3.0CM RHC 460.00
EXC B9 LESION W MARG TRNK ARM LGS 3.1 TO 4.0CM RHC 520.00
EXC B9 LESION W MARG TRNK ARM LGS OVER 4.0CM RHC 750.00
EXC MALG LES W MRG FCE EAR EYLD NSE LPS MM 2.1TO3.0CM RHC 760.00
EXC MALG LES W MRG SCLP NCK HND FT GENT 0.6TO1.0CM RHC 545.00
EXC MALG LES W MRG SCLP NCK HND FT GENT 1.1TO2.0CM RHC 610.00
EXC MALG LESION MARG TRNK ARM LGS 0.6 TO 1.0CM RHC 540.00
EXC MALG LESION MARG TRNK ARM LGS 1.1 TO 2.0CM RHC 585.00
EXC MALIG LESION W MARG TRNK ARM LGS 2.1 TO 3.0CM RHC 675.00
EXC MLG LES WMRG FCE EAR EYLD NSE LPS MM 0.6 TO 1.0CM RHC 565.00
EXCISE BARTHOLINS GLAND OR CYST RHC 749.00
FAM ADAPT BHV TX GDN PHY QHP RHC 75.00
FETAL BIOPHYSICAL PROFILE W NON STRESS TEST 199.00
FETAL BIOPHYSICAL PROFILE W NON STRESS TEST PRO ONLY 134.00
FIT OR INSERT PESSARY RHC 180.00
FNA BX WO IMG GDN 1ST LES RHC 290.00
GRP NUTRITION THERAPY EA 30M RHC 41.00
HEMOGLOBIN A1C POC 35.00
HOME HEALTH PT CERTIFICATION PRO ONLY 130.00
HOME HEALTH PT RECERT PRO ONLY 100.00
HOME VISIT EST PATIENT MOD TO HIGH IMMED ATT RHC 435.00
HOME VISIT EST PATIENT MOD TO HIGH STABLE RHC 315.00
HOME VISIT ESTABLISHED PATIENT LIMITED RHC 140.00
HOME VISIT ESTABLISHED PATIENT LOW TO MOD RHC 210.00
HOME VISIT NEW PATIENT HIGH RHC 445.00
HOME VISIT NEW PATIENT LOW RHC 135.00
HOME VISIT NEW PATIENT MOD RHC 195.00
HOME VISIT NEW PATIENT MOD TO HIGH RHC 320.00
HOME VISIT NEW PATIENT UNSTABLE RHC 540.00
I AND D ABCESS COMPL OR MULTI RHC 495.00
I AND D ABCESS SMPL OR SNGL RHC 285.00
I AND D HEMATOMA SEROMA OR FLUID RHC 398.00
I AND D OF BARTHOLINS GLAND ABSCESS RHC 366.00
I AND D OF VULVA OR PERINEAL ABSCESS RHC 305.00
I AND D PERIRECTAL OR ISCHIAL ABCESS RHC 1,289.00
I AND D PILONIDAL CYST SMPL RHC 484.00
I STAT CHEM 8 CREATININE POC 29.00
I STAT CHEM 8 GLUCOSE POC 15.00
I STAT CHEM 8 HEMATOCRIT POC 33.00
I STAT CHEM 8 UREA NITROGEN POC 14.00
ICD DEVICE INTERROGATE RHC 113.00
IM ADMIN 1ST ONLY W COUNSELING RHC 25.00
IM ADMIN EACH ADDL W COUNSELING RHC 13.00
IMMUNOTHERAPY 2 OR GREATER INJECTIONS RHC 15.00
IMMUNOTHERAPY ONE INJECTION RHC 10.00
INC AND REM FB SQ COMPL RHC 650.00
INC AND REM FB SQ SMPL RHC 430.00
INCAL BX SKN EA SEP ADDL RHC 170.00
INCAL BX SKN SINGLE LES RHC 351.00
INCISE THROMBOSED HEMORRHOID EXT RHC 449.00
INFLUENZA IA W DIRECT OPTICAL OBS POC 42.00
INIT NUTRITION THERAPY EACH 15M PRO ONLY 89.00
INIT NUTRITION THERAPY EACH 15M RHC 89.00
INIT PM E M NEW PATIENT 1 TO 4 YRS PRO ONLY 162.00
INIT PM E M NEW PATIENT 12 TO 17 YRS PRO ONLY 162.00
INIT PM E M NEW PATIENT 18 TO 39 YRS PRO ONLY 162.00
INIT PM E M NEW PATIENT 40 TO 64 YRS PRO ONLY 162.00
INIT PM E M NEW PATIENT 5 TO 11 YRS PRO ONLY 162.00
INIT PM E M NEW PATIENT 65 AND OLDER PRO ONLY 162.00
INIT PM E M NEW PATIENT YOUNGER THAN 1 PRO ONLY 162.00
INIT PREVENTIVE EXAM NEW MC PATIENT RHC 400.00
INITIAL NURSING FACILITY CARE LOW PRO ONLY 225.00
INITIAL NURSING FACILITY HIGH PRO ONLY 410.00
INITIAL NURSING FACILITY MOD PRO ONLY 320.00
INJ SGL TENDON ORIGIN INSERTION RHC 150.00
INJ SGL TENDON SHTH OR LIGAMENT RHC 131.00
INJ TRIGGER POINT 1 OR 2 MUSCL RHC 135.00
INJECTION IM OR SUBSQ RHC 24.00
INSERT TEMP URINARY CATH INDWELL COMPLEX RHC 328.00
INSERT TEMP URINARY CATH INDWELL SIMPLE RHC 161.00
INSERT URINARY CATH NON INDWELLING RHC 127.00
INSERTION DRUG IMPLANT RHC 340.00
INSERTION OF IUD RHC 266.00
INTUBATION ET EMERGENCY PROC RHC 360.00
IREP WD FCE EAR EYLD NSE LPS MM 2.5CM OR LESS RHC 632.00
IREP WD FCE EAR EYLD NSE LPS MM 2.6 TO 5.0CM RHC 711.00
IREP WD FCE EARS EYLDS NSE LPS MUC MEM 5.1 TO 7.5CM RHC 832.00
IREP WD FCE EARS EYLDS NSE LPS MUC MEM 7.6 TO 12.5CM RHC 878.00
IREP WD NCK HNDS FEET EXTGEN 7.6 TO 12.5CM RHC 866.00
IREP WD NCK HNDS FT EXTGEN 12.6 TO 20.0 CM RHC 952.00
IREP WD NCK HNDS FT EXTGEN 2.5CM OR LESS RHC 587.00
IREP WD NCK HNDS FT EXTGEN 2.6 TO 7.5CM RHC 700.00
IREP WD SCLP AXL TRNK EXT EXCL HDS FT 12.6TO 20.0CM RHC 905.00
IREP WD SCLP AXL TRNK EXT EXCL HDS FT 2.5CM OR LESS RHC 585.00
IREP WD SCLP AXL TRNK EXT EXCL HDS FT 7.6 TO 12.5CM RHC 757.00
IREP WD SCLP AXLTRNK EXT EXCL HDS FT 2.6 TO 7.5CM RHC 715.00
IRRIGATION IMPLANTED VENOUS ACCESS DEVICE RHC 65.00
IV HYDRATION EACH ADDITIONAL HOUR RHC 35.00
IV HYDRATION INITIAL RHC 130.00
IV MED INFUSION EA ADDITIONAL HOUR RHC 51.00
IV MED INFUSION INITIAL RHC 166.00
IV MED PUSH EA ADDL SEQ SAME DRUG RHC 51.00
IV MED PUSH EA ADDL SEQUENTIAL NEW RHC 51.00
IV MED PUSH INITIAL RHC 130.00
MD DOCUMENT VISIT BY NPP OR PA PRO ONLY 23.00
MD SERVICE REQUIRED FOR PMD PRO ONLY 25.00
MINI NEB AIRWAY INHALATION TREATMENT RHC 45.00
MONO TEST POC 18.00
NJX ANES AND OR STRD GR OCPL NRV RHC 245.00
NJX ANES AND OR STRD SCIATIC NERVE RHC 325.00
NUBHVL XM PHY QHP EA ADDL HR RHC 206.00
NUBHVL XM PHYS QHP 1ST HR RHC 236.00
NURSING FACILITY DC DAY 30 MIN OR LESS PRO ONLY 180.00
NURSING FACILITY DC DAY MORE THAN 30 MIN PRO ONLY 260.00
OCCULT BLOOD FECES POC 12.00
OTHER ADMIN PHYSICIAL RHC 50.00
OUTPATIENT VISIT ESTABLISHED LEVEL 1 RHC 54.00
OUTPATIENT VISIT ESTABLISHED LEVEL 2 RHC 106.00
OUTPATIENT VISIT ESTABLISHED LEVEL 3 RHC 130.00
OUTPATIENT VISIT ESTABLISHED LEVEL 4 RHC 197.00
OUTPATIENT VISIT ESTABLISHED LEVEL 5 RHC 290.00
OUTPATIENT VISIT NEW LEVEL 1 RHC 90.00
OUTPATIENT VISIT NEW LEVEL 2 RHC 128.00
OUTPATIENT VISIT NEW LEVEL 3 RHC 165.00
OUTPATIENT VISIT NEW LEVEL 4 RHC 205.00
OUTPATIENT VISIT NEW LEVEL 5 RHC 489.00
PAP SCREENING OBTAINING AND CONVEYANCE RHC 104.00
PAPERWORK FEES RHC 25.00
PM RE E M EST PATIENT 1 TO 4 YRS PRO ONLY 120.00
PM RE E M EST PATIENT 12 TO 17 YRS PRO ONLY 120.00
PM RE E M EST PATIENT 18 TO 39 YRS PRO ONLY 120.00
PM RE E M EST PATIENT 40 TO 64 YRS PRO ONLY 120.00
PM RE E M EST PATIENT 5 TO 11 YRS PRO ONLY 120.00
PM RE E M EST PATIENT 65 PLUS PRO ONLY 120.00
PM RE E M EST PATIENT YOUNGER THAN 1 PRO ONLY 120.00
POSTPARTUM CARE ONLY RHC 492.00
PREGNANCY TEST URINE POC 27.00
PROF ALLERGEN IMMUNOTHERAPY 2 PLUS INJECT RHC 24.00
PROF ALLERGEN IMMUNOTHERAPY SNGL INJECT RHC 21.00
PROTHROMBIN TIME POC 16.00
PT FOCUSED HLTH RISK ASSMT RHC 150.00
PULMONARY STRESS TESTING RHC 195.00
PUNCH BX SKIN EA SEP ADDL RHC 145.00
PUNCH BX SKIN SINGLE LESION RHC 290.00
PUNCT ASP BREAST CYST INITIAL RHC 265.00
PUNCT ASP OF ABSC HEMATOMA BULLA OR CYST RHC 310.00
PURE TONE AUDIOMETRY AIR ONLY RHC 75.00
REASSESS NUTRITION THER EA 15M PRO ONLY 77.00
REASSESS NUTRITION THER EA 15M RHC 77.00
REFILL MAINT PUMP RESVR SYST RHC 274.00
REM FB EXT AUD CANAL WO ANES RHC 230.00
REM FB EXT EYE CONJUNCTIVAL EMBEDDED RHC 165.00
REM FB EXT EYE CONJUNCTIVAL SUPERFICIAL RHC 140.00
REM FB EXT EYE CORNEAL WO SLIT LAMP RHC 145.00
REM FB FOOT SQ RHC 615.00
REM FB INTRANASAL RHC 437.00
REM FB MUSCLE TENDON SHEATH SMPL RHC 494.00
REM IMPACTED CERUMEN 1 OR BOTH EARS RHC 116.00
REM OF NL BED PART OR COMPL FOR PERM REM RHC 417.00
REM SKIN TAGS UP TO OR EQUAL15 LESIONS RHC 215.00
REMOT IMAGE SUBMIT BY PT RHC 30.00
REMOVAL FOREIGN BODY FOOT DEEP RHC 1,130.00
REMOVAL FOREIGN BODY TRUNK RHC 100.00
REMOVAL OF BREAST LESION 1 OR MORE RHC 1,198.00
REMOVAL OF IMPACTED WAX MD RHC 125.00
REMOVE DRUG IMPLANT RHC 380.00
REMOVE IMPACTED EAR WAX UNI RHC 35.00
REMOVE IUD RHC 242.00
REMOVE SKIN TAGS ADDON EA ADD 10 LESIONS RHC 50.00
REMOVE W REINSERTION DRUG IMPLANT RHC 560.00
REPAIR NAIL BED RHC 453.00
ROUTIN OB CARE AFTER VAG DELIV RHC 5,402.00
ROUTINE OB CARE INCL AP C SECTION PPARTUM RHC 5,694.00
ROUTINE OB CARE RHC 5,137.00
ROUTINE VENIPUNCTURE 15.00
RSV AG DET WITH DIR OPTIC OBSV POC 66.00
SCHOOLS SPORTS PHYSICAL PREK TO 12 RHC 35.00
SCREEN PATH AUTO CERV VAG THIN LAYER BY MD RHC 78.00
SCREENING PURE TONE AIR ONLY RHC 69.00
SELF MEAS BP PT EDUCA TRAIN RHC 25.00
SHAVE SGL LES FCE EAR EYELD NSE LPS MM 0.6 TO 1.0CM RHC 320.00
SHAVE SGL LES FCE EAR EYLD NSE LPS MM LESS THAN 0.5CM RHC 270.00
SHAVE SGL LESION FCE EAR EYELD NSE LPS MM OVER 2.0CM RHC 440.00
SHAVE SGL LESION SCLP NCK HND FT GENT 0.5CM OR LESS RHC 244.00
SHAVE SGL LESION SCLP NCK HND FT GENT 0.6 TO 1.0CM RHC 290.00
SHAVE SGL LESION TRNK ARM LGS 0.5CM OR LESS RHC 230.00
SHAVE SGL LESION TRNK ARM LGS 0.6 TO 1.0CM RHC 281.00
SHAVE SGL LESION TRNK ARM LGS 1.1 TO 2.0CM RHC 331.00
SHAVE SGL LESION TRNK ARM LGS OVER 2.0CM RHC 370.00
SKIN TEST TB INTRADERMAL RHC 21.00
SLCTV WND DEBRD 20SQ CM OR LESS RHC 224.00
SLEEP LAB CANCELLATION FEE 106.00
SLEEP STDY UNATT RESP EFFORT RHC 410.00
SPECIMEN HANDLING OFFICE TO LAB POC 25.00
SPIROMETRY RHC 85.00
SPUN HEMATOCRIT POC 18.00
SREP WD FCE EAR EYLD NSE LPS MM 2.5CM OR LESS RHC 265.00
SREP WD FCE EAR EYLD NSE LPS MM 2.6 TO 5.0CM RHC 275.00
SREP WD FCE EAR EYLDS NSE LIPS MUC MEM 12.6 TO 20.0CM RHC 511.00
SREP WD FCE EAR EYLDS NSE LIPS MUC MEM 20.1 TO 30.0CM RHC 385.00
SREP WD FCE EARS EYLDS NSE LIPS MUC MEM 5.1 TO 7.5CM RHC 330.00
SREP WD FCE EARS EYLDS NSE LIPS MUC MEM 7.6 TO 12.5CM RHC 400.00
SREP WD FCE EARS EYLDS NSE LIPS MUC MEM OVER 30.0CM RHC 436.00
SREP WD SCLP NK AXIL EXGEN TRNK EXTR 12.6 TO 20.00CM RHC 403.00
SREP WD SCLP NK AXIL EXGEN TRNK EXTR 2.5CM OR LESS RHC 215.00
SREP WD SCLP NK AXIL EXGEN TRNK EXTR 2.6 TO 7.5CM RHC 265.00
SREP WD SCLP NK AXIL EXGEN TRNK EXTR 20.1 TO 30.00CM RHC 477.00
SREP WD SCLP NK AXIL EXGEN TRNK EXTR 7.6 TO 12.5CM RHC 310.00
SREP WD SCLP NK AXIL EXGEN TRNK EXTR OVER 30.0 CM RHC 546.00
STRAPPING FOOT OR ANKLE RHC 70.00
STRAPPING OF KNEE RHC 75.00
STRAPPING SHOULDER RHC 75.00
STREP IA  W DIRECT OPTICAL OBS POC 42.00
SUBSEQUENT NURSING FACILITY IMMEDIATE ATT PRO ONLY 330.00
SUBSEQUENT NURSING FACILITY MINOR COMPL PRO ONLY 170.00
SUBSEQUENT NURSING FACILITY SIGNIFICANT COMPL PRO ONLY 225.00
SUBSEQUENT NURSING FACILITY STABLE PRO ONLY 108.00
TANGNTL BX SKIN EA SEP ADDL RHC 125.00
TANGNTL BX SKIN SINGLE LES RHC 231.00
TELEHEALTH FACILITY FEE 42.00
TOBACCO CESSATION INTENSIVE GREATER THAN 10 MIN RHC 70.00
TOBACCO CESSATION INTERMED 3 TO 10 MIN RHC 40.00
TRANS CARE MGMT 14 DAY DISCH RHC 434.00
TRANS CARE MGMT 7 DAY DISCH RHC 572.00
TRIM DYSTROPHIC NAIL ANY NO W NM ABN RHC 60.00
TRIM NONDYSTROPHIC NAILS ANY NUMBER RHC 100.00
TX SUPERFICIAL WD DEHISCENCE SMPL CLOSE RHC 688.00
TX SUPERFICIAL WD DEHISCENCE SMPL CLOSE W PACK RHC 404.00
URINALYSIS AUTO WITHOUT MICROSCOPY POC 19.00
US GREATER THAN 14WKS EA ADDL FETUS TABD PRO ONLY OFFICE 124.00
US GREATER THAN 14WKS PREG TRANSABD PRO ONLY OFFICE 125.00
US OB DETAILED SNGL FETUS PRO ONLY OFFICE 241.00
US OB FOLLOW UP PER FETUS PRO ONLY OFFICE 109.00
US OB LIMITED 1 OR MORE FETUSES PRO ONLY OFFICE 82.00
US PELVIC NONOBSTETRIC COMPLETE PRO OFFICE ONLY 86.00
US TRANSVAGINAL PRO ONLY OFFICE 86.00
VACCINE ADMIN EA ADDL SINGLE OR COMBINATION RHC 59.00
VACCINE ADMINISTRATION HEPATITIS RHC 77.00
VACCINE ADMINISTRATION INFLUENZA RHC 59.00
VACCINE ADMINISTRATION PNEUMONIA RHC 59.00
VACCINE ADMINISTRATION SINGLE OR COMBINATION RHC 59.00
VAG DELIV AFTER CESARIAN INCL POSTOP TJHPRO 2,789.00
VAGINAL DELVERY ONLY INCL PPARTUM CARE OFFICE PRO NG 2,550.00
WEDGE EXC NAIL FOLD RHC 395.00