| GUAM MEMORIAL HOSPITAL AUTHORITY - FEE SCHEDULE | |||
| CHARGE CODE | CHARGE CODE DESCRIPTION | CHARGE PRICE | SERVICING DEPT. |
| AA00000 | ROOM & BOARD ICU | 1,272.84 | 3010 |
| 1600044 | FETAL NON-STRESS TEST | 128.96 | 4310 |
| 1600110 | ABC ROOM | 804.82 | 4310 |
| 3000038 | EEG PROLONGED | 140.99 | 7900 |
| 3000053 | EEG | 166.79 | 7900 |
| 3095816 | EEG RECORD AWAKE AND DROWSY | 348.00 | 7900 |
| 3095819 | EEG RECORD AWAKE AND SLEEP | 274.00 | 7900 |
| 3095822 | EEG RECORD COMA OR SLEEP | 295.00 | 7900 |
| 3096001 | ELECTRONYSTAMOGRAPHY | 165.38 | 7900 |
| 9300002 | EKG, TRACING 12-LEAD | 48.14 | 7900 |
| 9304007 | EKG, RHYTHM STRIP | 13.75 | 7900 |
| 9400001 | ECHO FOLLOW UP | 31.80 | 7900 |
| 9400042 | ECHOCARDIOGRAM, 2-D | 83.07 | 7900 |
| 9400154 | CARDIO STRESS TEST | 104.73 | 7900 |
| 9493312 | TRANSESOPHAGEAL ECHO, COMPREHENSIVE | 467.00 | 7900 |
| 9493318 | TEE, 2-D IMAGE ACQUISITION | 271.35 | 7900 |
| 9493321 | DOPPLER ECHO-PW/CW, FF-UP/LIMITED | 161.00 | 7900 |
| 9493350 | ECHO, 2-D INC STRESS TEST | 665.50 | 7900 |
| 9496001 | DOPPLER ECHO-COLOR FLOW MAP | 127.91 | 7900 |
| 9496002 | DOPPLER ECHO-PW/CW, COMP | 75.72 | 7900 |
| 1600300 | EPIDURAL ANEST MONITOR | 0.00 | ANESTHESIA-MD |
| MD00100 | ANESTH, SALIVARY GLAND | 0.00 | ANESTHESIA-MD |
| MD00102 | ANESTH, REPAIR OF CLEFT LIP | 0.00 | ANESTHESIA-MD |
| MD00103 | ANESTH FOR EYE, BLEPHAROPLASTY | 0.00 | ANESTHESIA-MD |
| MD00104 | ANESTH, ELECTROSHOCK | 0.00 | ANESTHESIA-MD |
| MD00120 | ANESTH, EAR SURGERY | 0.00 | ANESTHESIA-MD |
| MD00124 | ANESTH, EAR EXAM | 0.00 | ANESTHESIA-MD |
| MD00126 | ANESTH, TYMPANOTOMY | 0.00 | ANESTHESIA-MD |
| MD00140 | ANESTH, PROCEDURES ON EYE | 0.00 | ANESTHESIA-MD |
| MD00142 | ANESTH, LENS SURGERY | 0.00 | ANESTHESIA-MD |
| MD00144 | ANESTH, CORNEAL TRANSPLANT | 0.00 | ANESTHESIA-MD |
| MD00145 | ANESTH, VITRECTOMY | 0.00 | ANESTHESIA-MD |
| MD00147 | ANESTH, IRIDECTOMY | 0.00 | ANESTHESIA-MD |
| MD00148 | ANESTH, EYE EXAM | 0.00 | ANESTHESIA-MD |
| MD00160 | ANESTH, NOSE/SINUS SURGERY | 0.00 | ANESTHESIA-MD |
| MD00162 | ANESTH, NOSE/SINUS SURGERY | 0.00 | ANESTHESIA-MD |
| MD00164 | ANESTH, BIOPSY OF NOSE | 0.00 | ANESTHESIA-MD |
| MD00170 | ANESTH, PROCEDURE ON MOUTH | 0.00 | ANESTHESIA-MD |
| MD00172 | ANESTH, CLEFT PALATE REPAIR | 0.00 | ANESTHESIA-MD |
| MD00174 | ANESTH, PHARYNGEAL SURGERY | 0.00 | ANESTHESIA-MD |
| MD00176 | ANESTH, PHARYNGEAL SURGERY | 0.00 | ANESTHESIA-MD |
| MD00190 | ANESTH, FACIAL BONE SURGERY | 0.00 | ANESTHESIA-MD |
| MD00192 | ANESTH, FACIAL BONE SURGERY | 0.00 | ANESTHESIA-MD |
| MD00210 | ANESTH, OPEN HEAD SURGERY | 0.00 | ANESTHESIA-MD |
| MD00212 | ANESTH, SKULL DRAINAGE | 0.00 | ANESTHESIA-MD |
| MD00214 | ANESTH, SKULL DRAINAGE | 0.00 | ANESTHESIA-MD |
| MD00215 | ANESTH, SKULL, EXTRADURAL | 0.00 | ANESTHESIA-MD |
| MD00216 | ANESTH, HEAD VESSEL SURGERY | 0.00 | ANESTHESIA-MD |
| MD00218 | ANESTH, SPECIAL HEAD SURGERY | 0.00 | ANESTHESIA-MD |
| MD00220 | ANESTH, SPINAL FLUID SHUNT | 0.00 | ANESTHESIA-MD |
| MD00222 | ANESTH, HEAD NERVE SURGERY | 0.00 | ANESTHESIA-MD |
| MD00300 | ANESTH, HEAD/NECK/PTRUNK | 0.00 | ANESTHESIA-MD |
| MD00320 | ANESTH, NECK ORGAN SURGERY | 0.00 | ANESTHESIA-MD |
| MD00322 | ANESTH, BIOPSY OF THYROID | 0.00 | ANESTHESIA-MD |
| MD00350 | ANESTH, NECK VESSEL SURGERY | 0.00 | ANESTHESIA-MD |
| MD00352 | ANESTH, NECK VESSEL SURGERY | 0.00 | ANESTHESIA-MD |
| MD00400 | ANESTH, SKIN, EXT/PER/ATRUNK | 0.00 | ANESTHESIA-MD |
| MD00402 | ANESTH, SURGERY OF BREAST | 0.00 | ANESTHESIA-MD |
| MD00404 | ANESTH, SURGERY OF BREAST | 0.00 | ANESTHESIA-MD |
| MD00406 | ANESTH, SURGERY OF BREAST | 0.00 | ANESTHESIA-MD |
| MD00410 | ANESTH, CORRECT HEART RHYTHM | 0.00 | ANESTHESIA-MD |
| MD00450 | ANESTH, SURGERY OF SHOULDER | 0.00 | ANESTHESIA-MD |
| MD00452 | ANESTH, SURGERY OF SHOULDER | 0.00 | ANESTHESIA-MD |
| MD00454 | ANESTH, COLLARBONE BIOPSY | 0.00 | ANESTHESIA-MD |
| MD00470 | ANESTH, REMOVAL OF RIB | 0.00 | ANESTHESIA-MD |
| MD00472 | ANESTH, CHEST WALL REPAIR | 0.00 | ANESTHESIA-MD |
| MD00474 | ANESTH, SURGERY OF RIB(S) | 0.00 | ANESTHESIA-MD |
| MD00500 | ANESTH, ESOPHAGEAL SURGERY | 0.00 | ANESTHESIA-MD |
| MD00520 | ANESTH, CHEST PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD00522 | ANESTH, CHEST LINING BIOPSY | 0.00 | ANESTHESIA-MD |
| MD00524 | ANESTH, CHEST DRAINAGE | 0.00 | ANESTHESIA-MD |
| MD00528 | ANESTH, CHEST PARTITION VIEW | 0.00 | ANESTHESIA-MD |
| MD00529 | ANESTH, CHEST PARTITION VIEW | 0.00 | ANESTHESIA-MD |
| MD00530 | ANESTH, PACEMAKER INSERTION | 0.00 | ANESTHESIA-MD |
| MD00532 | ANESTH, VASCULAR ACCESS | 0.00 | ANESTHESIA-MD |
| MD00534 | ANESTH, CARDIOVERTER/DEFIB | 0.00 | ANESTHESIA-MD |
| MD00536 | ANESTH, ELECTROPHYSIOLOGIC PROC | 0.00 | ANESTHESIA-MD |
| MD00540 | ANESTH, CHEST SURGERY | 0.00 | ANESTHESIA-MD |
| MD00542 | ANESTH, RELEASE OF LUNG | 0.00 | ANESTHESIA-MD |
| MD00544 | ANESTH, CHEST LINING REMOVAL | 0.00 | ANESTHESIA-MD |
| MD00546 | ANESTH, LUNG, CHESTWALL SURG | 0.00 | ANESTHESIA-MD |
| MD00548 | ANESTH, TRACHEA, BRONCHI SURG | 0.00 | ANESTHESIA-MD |
| MD00560 | ANESTH, OPEN HEART SURGERY | 0.00 | ANESTHESIA-MD |
| MD00562 | ANESTH, OPEN HEART SURGERY | 0.00 | ANESTHESIA-MD |
| MD00580 | ANESTH HEART/LUNG TRANSPLANT | 0.00 | ANESTHESIA-MD |
| MD00600 | ANESTH, SPINE, CORD SURGERY | 0.00 | ANESTHESIA-MD |
| MD00604 | ANESTH, SURGERY OF VERTEBRA | 0.00 | ANESTHESIA-MD |
| MD00620 | ANESTH, SPINE, CORD SURGERY | 0.00 | ANESTHESIA-MD |
| MD00622 | ANESTH, REMOVAL OF NERVES | 0.00 | ANESTHESIA-MD |
| MD00630 | ANESTH, SPINE, CORD SURGERY | 0.00 | ANESTHESIA-MD |
| MD00632 | ANESTH, REMOVAL OF NERVES | 0.00 | ANESTHESIA-MD |
| MD00634 | ANESTH FOR CHEMONUCLEOLYSIS | 0.00 | ANESTHESIA-MD |
| MD00636 | DIAG, THERAPEUTIC LUMBAR PUNCTURE | 0.00 | ANESTHESIA-MD |
| MD00670 | ANESTH, SPINE, CORD SURGERY | 0.00 | ANESTHESIA-MD |
| MD00700 | ANESTH, ABDOMINAL WALL SURG | 0.00 | ANESTHESIA-MD |
| MD00702 | ANESTHESIA FOR LIVER BIOPSY | 0.00 | ANESTHESIA-MD |
| MD00730 | ANESTH, ABDOMINAL WALL SURG | 0.00 | ANESTHESIA-MD |
| MD00740 | ANESTH, UPPER GI VISUALIZE | 0.00 | ANESTHESIA-MD |
| MD00750 | ANESTH, REPAIR OF HERNIA | 0.00 | ANESTHESIA-MD |
| MD00752 | ANESTH, REPAIR OF HERNIA | 0.00 | ANESTHESIA-MD |
| MD00754 | ANESTH, REPAIR OF HERNIA | 0.00 | ANESTHESIA-MD |
| MD00756 | ANESTH, REPAIR OF HERNIA | 0.00 | ANESTHESIA-MD |
| MD00770 | ANESTH, BLOOD VESSEL REPAIR | 0.00 | ANESTHESIA-MD |
| MD00790 | ANESTH, SURG UPPER ABDOMEN | 0.00 | ANESTHESIA-MD |
| MD00792 | ANESTH, PART LIVER REMOVAL | 0.00 | ANESTHESIA-MD |
| MD00794 | ANESTH, PANCREAS REMOVAL | 0.00 | ANESTHESIA-MD |
| MD00796 | ANESTH, FOR LIVER TRANSPLANT | 0.00 | ANESTHESIA-MD |
| MD00800 | ANESTH, ABDOMINAL WALL SURG | 0.00 | ANESTHESIA-MD |
| MD00802 | ANESTH, FAT LAYER REMOVAL | 0.00 | ANESTHESIA-MD |
| MD00810 | ANESTH, LOW INTESTINE SCOPE | 0.00 | ANESTHESIA-MD |
| MD00820 | ANESTH, ABDOMINAL WALL SURG | 0.00 | ANESTHESIA-MD |
| MD00830 | ANESTH, REPAIR OF HERNIA | 0.00 | ANESTHESIA-MD |
| MD00832 | ANESTH, REPAIR OF HERNIA | 0.00 | ANESTHESIA-MD |
| MD00840 | ANESTH, SURG LOWER ABDOMEN | 0.00 | ANESTHESIA-MD |
| MD00842 | ANESTH, AMNIOCENTESIS | 0.00 | ANESTHESIA-MD |
| MD00844 | ANESTH, PELVIS SURGERY | 0.00 | ANESTHESIA-MD |
| MD00846 | ANESTH, HYSTERECTOMY | 0.00 | ANESTHESIA-MD |
| MD00848 | ANESTH, PELVIC ORGAN SURG | 0.00 | ANESTHESIA-MD |
| MD00851 | ANESTH, TUBAL LIGATION | 0.00 | ANESTHESIA-MD |
| MD00855 | ANESTH, HYSTERECTOMY | 0.00 | ANESTHESIA-MD |
| MD00857 | ANALGESIA, LABOR & C-SECTION | 0.00 | ANESTHESIA-MD |
| MD00860 | ANESTH, SURGERY OF ABDOMEN | 0.00 | ANESTHESIA-MD |
| MD00862 | ANESTH, KIDNEY/URETER SURG | 0.00 | ANESTHESIA-MD |
| MD00864 | ANESTH, REMOVAL OF BLADDER | 0.00 | ANESTHESIA-MD |
| MD00865 | RADICAL PROSTATECTOMY | 0.00 | ANESTHESIA-MD |
| MD00866 | ANESTH, REMOVAL OF ADRENAL | 0.00 | ANESTHESIA-MD |
| MD00868 | ANESTH, KIDNEY TRANSPLANT | 0.00 | ANESTHESIA-MD |
| MD00870 | ANESTH, BLADDER STONE SURG | 0.00 | ANESTHESIA-MD |
| MD00872 | ANESTH KIDNEY STONE DESTRUCT | 0.00 | ANESTHESIA-MD |
| MD00873 | ANESTH KIDNEY STONE DESTRUCT | 0.00 | ANESTHESIA-MD |
| MD00880 | ANESTH, ABDOMEN VESSEL SURG | 0.00 | ANESTHESIA-MD |
| MD00882 | ANESTH, MAJOR VEIN LIGATION | 0.00 | ANESTHESIA-MD |
| MD00884 | ANESTH, MAJOR VEIN REVISION | 0.00 | ANESTHESIA-MD |
| MD00900 | ANESTH, PERINEAL PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD00902 | ANESTH, ANORECTAL SURGERY | 0.00 | ANESTHESIA-MD |
| MD00904 | ANESTH, PERINEAL SURGERY | 0.00 | ANESTHESIA-MD |
| MD00906 | ANESTH, REMOVAL OF VULVA | 0.00 | ANESTHESIA-MD |
| MD00908 | ANESTH, REMOVAL OF PROSTATE | 0.00 | ANESTHESIA-MD |
| MD00910 | ANESTH, BLADDER SURGERY | 0.00 | ANESTHESIA-MD |
| MD00912 | ANESTH, BLADDER TUMOR SURG | 0.00 | ANESTHESIA-MD |
| MD00914 | ANESTH, REMOVAL OF PROSTATE | 0.00 | ANESTHESIA-MD |
| MD00916 | ANESTH, BLEEDING CONTROL | 0.00 | ANESTHESIA-MD |
| MD00918 | ANESTH, STONE REMOVAL | 0.00 | ANESTHESIA-MD |
| MD00920 | ANESTH, GENITALIA SURGERY | 0.00 | ANESTHESIA-MD |
| MD00922 | ANESTH, SPERM DUCT SURGERY | 0.00 | ANESTHESIA-MD |
| MD00924 | ANESTH, TESTIS EXPLORATION | 0.00 | ANESTHESIA-MD |
| MD00926 | ANESTH, REMOVAL OF TESTIS | 0.00 | ANESTHESIA-MD |
| MD00928 | ANESTH, REMOVAL OF TESTIS | 0.00 | ANESTHESIA-MD |
| MD00930 | ANESTH, TESTIS SUSPENSION | 0.00 | ANESTHESIA-MD |
| MD00932 | ANESTH, AMPUTATION OF PENIS | 0.00 | ANESTHESIA-MD |
| MD00934 | ANESTH, PENIS, NODES REMOVAL | 0.00 | ANESTHESIA-MD |
| MD00936 | ANESTH, PENIS, NODES REMOVAL | 0.00 | ANESTHESIA-MD |
| MD00938 | ANESTH, INSERT PENIS DEVICE | 0.00 | ANESTHESIA-MD |
| MD00940 | ANESTH, VAGINAL PROCEDURES | 0.00 | ANESTHESIA-MD |
| MD00942 | ANESTH, SURGERY ON VAGINA | 0.00 | ANESTHESIA-MD |
| MD00944 | ANESTH, VAGINAL HYSTERECTOMY | 0.00 | ANESTHESIA-MD |
| MD00946 | ANESTH, VAGINAL DELIVERY | 0.00 | ANESTHESIA-MD |
| MD00948 | ANESTH, REPAIR OF CERVIX | 0.00 | ANESTHESIA-MD |
| MD00950 | ANESTH, VAGINAL ENDOSCOPY | 0.00 | ANESTHESIA-MD |
| MD00952 | ANESTH, HYSTEROSCOPE/GRAPH | 0.00 | ANESTHESIA-MD |
| MD01112 | ANESTH, BONE MARROW ASPIRATION | 0.00 | ANESTHESIA-MD |
| MD01120 | ANESTH, PELVIS SURGERY | 0.00 | ANESTHESIA-MD |
| MD01130 | ANESTH, BODY CAST PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01140 | ANESTH, AMPUTATION AT PELVIS | 0.00 | ANESTHESIA-MD |
| MD01150 | ANESTH, PELVIC TUMOR SURGERY | 0.00 | ANESTHESIA-MD |
| MD01160 | ANESTH, PELVIS PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01170 | ANESTH, PELVIS SURGERY | 0.00 | ANESTHESIA-MD |
| MD01173 | ANESTH, FX REPAIR, PELVIS | 0.00 | ANESTHESIA-MD |
| MD01180 | ANESTH, PELVIS NERVE REMOVAL | 0.00 | ANESTHESIA-MD |
| MD01190 | ANESTH, PELVIS NERVE REMOVAL | 0.00 | ANESTHESIA-MD |
| MD01200 | ANESTH, HIP JOINT PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01202 | ANESTH, ARTHROSCOPY OF HIP | 0.00 | ANESTHESIA-MD |
| MD01210 | ANESTH, HIP JOINT SURGERY | 0.00 | ANESTHESIA-MD |
| MD01212 | ANESTH, HIP DISARTICULATION | 0.00 | ANESTHESIA-MD |
| MD01214 | ANESTH, REPLACEMENT OF HIP | 0.00 | ANESTHESIA-MD |
| MD01216 | REVISION, TOTAL HIP ARTHROPLASTY | 0.00 | ANESTHESIA-MD |
| MD01220 | ANESTH, PROCEDURE ON FEMUR | 0.00 | ANESTHESIA-MD |
| MD01230 | ANESTH, SURGERY OF FEMUR | 0.00 | ANESTHESIA-MD |
| MD01232 | ANESTH, AMPUTATION OF FEMUR | 0.00 | ANESTHESIA-MD |
| MD01234 | ANESTH, RADICAL FEMUR SURG | 0.00 | ANESTHESIA-MD |
| MD01250 | ANESTH, UPPER LEG SURGERY | 0.00 | ANESTHESIA-MD |
| MD01260 | ANESTH, UPPER LEG VEINS SURG | 0.00 | ANESTHESIA-MD |
| MD01270 | ANESTH, THIGH ARTERIES SURG | 0.00 | ANESTHESIA-MD |
| MD01272 | ANESTH, FEMORAL ARTERY SURG | 0.00 | ANESTHESIA-MD |
| MD01274 | ANESTH, FEMORAL EMBOLECTOMY | 0.00 | ANESTHESIA-MD |
| MD01320 | ANESTH, KNEE AREA SURGERY | 0.00 | ANESTHESIA-MD |
| MD01340 | ANESTH, KNEE AREA PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01360 | ANESTH, KNEE AREA SURGERY | 0.00 | ANESTHESIA-MD |
| MD01380 | ANESTH, KNEE JOINT PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01382 | ANESTH, KNEE ARTHROSCOPY | 0.00 | ANESTHESIA-MD |
| MD01390 | ANESTH, KNEE AREA PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01392 | ANESTH, KNEE AREA SURGERY | 0.00 | ANESTHESIA-MD |
| MD01400 | ANESTH, KNEE JOINT SURGERY | 0.00 | ANESTHESIA-MD |
| MD01402 | ANESTH, REPLACEMENT OF KNEE | 0.00 | ANESTHESIA-MD |
| MD01404 | ANESTH, AMPUTATION AT KNEE | 0.00 | ANESTHESIA-MD |
| MD01420 | ANESTH, KNEE JOINT CASTING | 0.00 | ANESTHESIA-MD |
| MD01430 | ANESTH, KNEE VEINS SURGERY | 0.00 | ANESTHESIA-MD |
| MD01432 | ANESTH, KNEE VESSEL SURG | 0.00 | ANESTHESIA-MD |
| MD01440 | ANESTH, KNEE ARTERIES SURG | 0.00 | ANESTHESIA-MD |
| MD01442 | ANESTH, KNEE ARTERY SURG | 0.00 | ANESTHESIA-MD |
| MD01444 | ANESTH, KNEE ARTERY REPAIR | 0.00 | ANESTHESIA-MD |
| MD01462 | ANESTH, LOWER LEG PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01464 | ANESTH, ANKLE ARTHROSCOPY | 0.00 | ANESTHESIA-MD |
| MD01470 | ANESTH, LOWER LEG SURGERY | 0.00 | ANESTHESIA-MD |
| MD01472 | ANESTH, ACHILLES TENDON SURG | 0.00 | ANESTHESIA-MD |
| MD01474 | ANESTH, LOWER LEG SURGERY | 0.00 | ANESTHESIA-MD |
| MD01480 | ANESTH, LOWER LEG BONE SURG | 0.00 | ANESTHESIA-MD |
| MD01482 | ANESTH, RADICAL LEG SURGERY | 0.00 | ANESTHESIA-MD |
| MD01484 | ANESTH, LOWER LEG REVISION | 0.00 | ANESTHESIA-MD |
| MD01486 | ANESTH, ANKLE REPLACEMENT | 0.00 | ANESTHESIA-MD |
| MD01490 | ANESTH, LOWER LEG CASTING | 0.00 | ANESTHESIA-MD |
| MD01500 | ANESTH, LEG ARTERIES SURG | 0.00 | ANESTHESIA-MD |
| MD01502 | ANESTH, LWR LEG EMBOLECTOMY | 0.00 | ANESTHESIA-MD |
| MD01520 | ANESTH, LOWER LEG VEIN SURG | 0.00 | ANESTHESIA-MD |
| MD01522 | ANESTH, LOWER LEG VEIN SURG | 0.00 | ANESTHESIA-MD |
| MD01610 | ANESTH, SURGERY OF SHOULDER | 0.00 | ANESTHESIA-MD |
| MD01620 | ANESTH, SHOULDER PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01622 | ANESTH, SHOULDER ARTHROSCOPY | 0.00 | ANESTHESIA-MD |
| MD01630 | ANESTH, SURGERY OF SHOULDER | 0.00 | ANESTHESIA-MD |
| MD01632 | ANESTH, SURGERY OF SHOULDER | 0.00 | ANESTHESIA-MD |
| MD01634 | ANESTH, SHOULDER JOINT AMPUT | 0.00 | ANESTHESIA-MD |
| MD01636 | ANESTH, FOREQUARTER AMPUT | 0.00 | ANESTHESIA-MD |
| MD01638 | ANESTH, SHOULDER REPLACEMENT | 0.00 | ANESTHESIA-MD |
| MD01650 | ANESTH, SHOULDER ARTERY SURG | 0.00 | ANESTHESIA-MD |
| MD01652 | ANESTH, SHOULDER VESSEL SURG | 0.00 | ANESTHESIA-MD |
| MD01654 | ANESTH, SHOULDER VESSEL SURG | 0.00 | ANESTHESIA-MD |
| MD01656 | ANESTH, ARM-LEG VESSEL SURG | 0.00 | ANESTHESIA-MD |
| MD01670 | ANESTH, SHOULDER VEIN SURG | 0.00 | ANESTHESIA-MD |
| MD01680 | ANESTH, SHOULDER CASTING | 0.00 | ANESTHESIA-MD |
| MD01682 | ANESTH, AIRPLANE CAST | 0.00 | ANESTHESIA-MD |
| MD01710 | ANESTH, ELBOW AREA SURGERY | 0.00 | ANESTHESIA-MD |
| MD01712 | ANESTH, UPPR ARM TENDON SURG | 0.00 | ANESTHESIA-MD |
| MD01714 | ANESTH, UPPR ARM TENDON SURG | 0.00 | ANESTHESIA-MD |
| MD01716 | ANESTH, BICEPS TENDON REPAIR | 0.00 | ANESTHESIA-MD |
| MD01730 | ANESTH, UPPR ARM PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01732 | ANESTH, ELBOW ARTHROSCOPY | 0.00 | ANESTHESIA-MD |
| MD01740 | ANESTH, UPPER ARM SURGERY | 0.00 | ANESTHESIA-MD |
| MD01742 | ANESTH, HUMERUS SURGERY | 0.00 | ANESTHESIA-MD |
| MD01744 | ANESTH, HUMERUS REPAIR | 0.00 | ANESTHESIA-MD |
| MD01756 | ANESTH, RADICAL HUMERUS SURG | 0.00 | ANESTHESIA-MD |
| MD01758 | ANESTH, HUMERAL LESION SURG | 0.00 | ANESTHESIA-MD |
| MD01760 | ANESTH, ELBOW REPLACEMENT | 0.00 | ANESTHESIA-MD |
| MD01770 | ANESTH, UPPR ARM ARTERY SURG | 0.00 | ANESTHESIA-MD |
| MD01772 | ANESTH, UPPR ARM EMBOLECTOMY | 0.00 | ANESTHESIA-MD |
| MD01780 | ANESTH, UPPER ARM VEIN SURG | 0.00 | ANESTHESIA-MD |
| MD01782 | ANESTH, UPPR ARM VEIN REPAIR | 0.00 | ANESTHESIA-MD |
| MD01784 | ANESTH, AV FISTULA REPAIR | 0.00 | ANESTHESIA-MD |
| MD01810 | ANESTH, LOWER ARM SURGERY | 0.00 | ANESTHESIA-MD |
| MD01820 | ANESTH, LOWER ARM PROCEDURE | 0.00 | ANESTHESIA-MD |
| MD01830 | ANESTH, LOWER ARM SURGERY | 0.00 | ANESTHESIA-MD |
| MD01832 | ANESTH, WRIST REPLACEMENT | 0.00 | ANESTHESIA-MD |
| MD01840 | ANESTH, LOWR ARM ARTERY SURG | 0.00 | ANESTHESIA-MD |
| MD01842 | ANESTH, LOWR ARM EMBOLECTOMY | 0.00 | ANESTHESIA-MD |
| MD01844 | ANESTH, VASCULAR SHUNT SURG | 0.00 | ANESTHESIA-MD |
| MD01850 | ANESTH, LOWER ARM VEIN SURG | 0.00 | ANESTHESIA-MD |
| MD01852 | ANESTH, LOWR ARM VEIN REPAIR | 0.00 | ANESTHESIA-MD |
| MD01860 | ANESTH, LOWER ARM CASTING | 0.00 | ANESTHESIA-MD |
| MD01904 | ANESTH, SKULL X-RAY INJECT | 0.00 | ANESTHESIA-MD |
| MD01906 | ANESTH, LUMBAR MYELOGRAPHY | 0.00 | ANESTHESIA-MD |
| MD01908 | ANESTH, CERVICAL MYELOGRAPHY | 0.00 | ANESTHESIA-MD |
| MD01910 | ANESTH, SKULL MYELOGRAPHY | 0.00 | ANESTHESIA-MD |
| MD01912 | ANESTH, LUMBAR DISKOGRAPHY | 0.00 | ANESTHESIA-MD |
| MD01914 | ANESTH, CERVICAL DISKOGRAPHY | 0.00 | ANESTHESIA-MD |
| MD01916 | ANESTH, HEAD ARTERIOGRAM | 0.00 | ANESTHESIA-MD |
| MD01918 | ANESTH, LIMB ARTERIOGRAM | 0.00 | ANESTHESIA-MD |
| MD01920 | ANESTH, CATHETERIZE HEART | 0.00 | ANESTHESIA-MD |
| MD01921 | ANESTH, VESSEL SURGERY | 0.00 | ANESTHESIA-MD |
| MD01922 | ANESTH, CAT OR MRI SCAN | 0.00 | ANESTHESIA-MD |
| MD01924 | ANES, THER INTERVEN RAD, ART | 0.00 | ANESTHESIA-MD |
| MD01931 | ANESTH, ARTERIAL SYSTEM | 0.00 | ANESTHESIA-MD |
| MD01951 | ANESTH, BURN, LESS 4 PERCENT | 0.00 | ANESTHESIA-MD |
| MD01952 | ANESTH, BURN, 4-9 PERCENT | 0.00 | ANESTHESIA-MD |
| MD01953 | ANESTH, BURN, EACH 9 PERCENT | 0.00 | ANESTHESIA-MD |
| MD01958 | ANESTH, ANTEPARTUM MANIPUL | 0.00 | ANESTHESIA-MD |
| MD01961 | ANESTH, CESAREAN SECTION | 0.00 | ANESTHESIA-MD |
| MD01964 | ANESTH, ABORTION PROCEDURES | 0.00 | ANESTHESIA-MD |
| MD01965 | ANESTH, INC/MISSED AB | 0.00 | ANESTHESIA-MD |
| MD01966 | ANESTH, INDUCED AB | 0.00 | ANESTHESIA-MD |
| MD01967 | ANESTH, VAGINAL DELIVERY | 0.00 | ANESTHESIA-MD |
| MD01968 | ANES/ANALG CS DELIVERY ADD-ON | 0.00 | ANESTHESIA-MD |
| MD01990 | SUPPORT FOR ORGAN DONORS | 0.00 | ANESTHESIA-MD |
| MD01991 | ANESTH, NERVE BLOCK/INJ | 0.00 | ANESTHESIA-MD |
| MD01996 | HOSP MANAGE CONT DRUG ADMIN | 0.00 | ANESTHESIA-MD |
| 4100068 | AGENTS-FLAXEDIL 10 CC | 8.62 | ANESTHESIOLOGY |
| 4100134 | AGENTS-PENTHRANE | 14.18 | ANESTHESIOLOGY |
| MD86077 | PHYSICIAN BLOOD BANK SERVICE | 85.76 | BLOOD BANK-MD |
| MD86078 | PHYSICIAN BLOOD BANK SERVICE | 107.20 | BLOOD BANK-MD |
| MD86079 | PHYSICIAN BLOOD BANK SERVICE | 96.48 | BLOOD BANK-MD |
| 5493797 | CARDIAC REHAB, O-P W/O EKG MONITOR | 55.37 | CARDIAC REHABILITATION |
| 5493798 | CARDIAC REHAB, O-P W/ EKG MONITOR | 64.59 | CARDIAC REHABILITATION |
| 5497110 | CARDIAC REHABILITATION, IN-PATIENT | 44.72 | CARDIAC REHABILITATION |
| 901056 | ANOSCOPE DISP | 9.03 | CHARGEABLE MEDICAL SUPPLIES |
| 901282 | CATHETER BARTHOLIN GLAND 10/12FR | 85.88 | CHARGEABLE MEDICAL SUPPLIES |
| 902000 | MORGAN MEDI-FLO LENS | 99.91 | CHARGEABLE MEDICAL SUPPLIES |
| 910202 | MORGAN LENS DELIVERY SET | 28.97 | CHARGEABLE MEDICAL SUPPLIES |
| 910942 | SET ADMIN GRAVITY FLOW | 31.89 | CHARGEABLE MEDICAL SUPPLIES |
| 911010 | SPONGE RHINO ROCKET XLGE | 73.69 | CHARGEABLE MEDICAL SUPPLIES |
| 911300 | SPONGE RHINO ROCKET SML | 50.10 | CHARGEABLE MEDICAL SUPPLIES |
| 911500 | SPONGE RHINO ROCHET MED | 56.51 | CHARGEABLE MEDICAL SUPPLIES |
| 911800 | SPONGE RHINO ROCKET LGE | 65.52 | CHARGEABLE MEDICAL SUPPLIES |
| 912140 | LARYNGEAL MASK AIRWAY S-4 | 205.61 | CHARGEABLE MEDICAL SUPPLIES |
| 912150 | LARYNGEAL MASK AIRWAY S-5 | 205.61 | CHARGEABLE MEDICAL SUPPLIES |
| 1310449 | CANNULA NASAL CPAP SZ-0 | 79.68 | CHARGEABLE MEDICAL SUPPLIES |
| 1310450 | CANNULA NASAL CPAP SZ-1 | 79.68 | CHARGEABLE MEDICAL SUPPLIES |
| 1310451 | CANNULA NASAL CPAP SZ-2 | 79.68 | CHARGEABLE MEDICAL SUPPLIES |
| 1332100 | TRAY PER-Q-CATH SINGLE-LUMEN 2.0FR | 197.69 | CHARGEABLE MEDICAL SUPPLIES |
| 1335000 | TRAY NEO V-CATH SINGLE-LUMEN 2.0FR | 502.15 | CHARGEABLE MEDICAL SUPPLIES |
| 1370742 | CATHETER SUCTION ARGYLE 10FR | 60.17 | CHARGEABLE MEDICAL SUPPLIES |
| 1395001 | PEDS INTUBATION KIT 3.0 | 25.77 | CHARGEABLE MEDICAL SUPPLIES |
| 1395002 | PEDS INTUBATION KIT 3.5 | 25.77 | CHARGEABLE MEDICAL SUPPLIES |
| 1395003 | IV PUMP SET (SYRINGE) | 26.88 | CHARGEABLE MEDICAL SUPPLIES |
| 1395004 | IV PUMP SET (TUBING) | 22.39 | CHARGEABLE MEDICAL SUPPLIES |
| 1395005 | MICROBORE 60" EXT SET | 8.78 | CHARGEABLE MEDICAL SUPPLIES |