MEDICINE-MD
SERVICE CHARGE CODE	SERVICE DESCRIPTION	SERVICE CHARGE PRICE
MD90780	IV INFUSION THERAPY, 1 HOUR	121.14
MD90781	IV INFUSION, ADDITIONAL HOUR	84.69
MD90782	INJECTION, SC/IM	19.30
MD90783	INJECTION, IA	42.88
MD90784	INJECTION, IV	43.95
MD90788	INJECTION OF ANTIBIOTIC	26.80
MD90799	THER/PROPHYLACTIC/DX INJECT	0.00
MD90801	PSY DX INTERVIEW	187.60
MD90802	INTAC PSY DX INTERVIEW	182.24
MD90804	PSYTX, OFFICE, 20-30 MIN	97.55
MD90805	PSYTX, OFF, 20-30 MIN W/	116.85
MD90806	PSYTX, OFF, 45-50 MIN	137.22
MD90807	PSYTX, OFF, 45-50 MIN W/ E&M	159.73
MD90808	PSYTX, OFFICE, 75-80 MIN	216.54
MD90809	PSYTX, OFF, 75-80, W/ E&M	246.56
MD90810	INTAC PSYTX, OFF, 20-30 MIN	107.20
MD90811	INTAC PSYTX, 20-30, W/ E&M	127.57
MD90812	INTAC PSYTX, OFF, 45-50 MIN	146.86
MD90813	INTAC PSYTX, 45-50 MIN W/ E&M	169.38
MD90814	INTAC PSYTX, OFF, 75-80 MIN	220.83
MD90815	INTAC PSYTX, 75-80 W/ E&M	249.78
MD90816	PSYTX, HOSP, 20-30 MIN	101.84
MD90817	PSYTX, HOSP, 20-30 MIN W/ E&M	130.78
MD90818	PSYTX, HOSP, 45-50 MIN	152.22
MD90819	PSYTX, HOSP, 45-50 MIN W/ E&M	161.87
MD90821	PSYTX, HOSP, 75-80 MIN	241.20
MD90822	PSYTX, HOSP, 75-80 MIN W/ E&M	272.29
MD90823	INTAC PSYTX, HOSP, 20-30 MIN	111.49
MD90824	INTAC PSYTX, HSP 20-30 W/ E&M	142.58
MD90826	INTAC PSYTX, HOSP, 45-50 MIN	164.02
MD90827	INTAC PSYTX, HSP 45-50 W/ E&M	187.60
MD90828	INTAC PSYTX, HOSP, 75-80 MIN	265.86
MD90829	INTAC PSYTX, HSP 75-80 W/ E&M	273.36
MD90845	PSYCHOANALYSIS	137.22
MD90846	FAMILY PSYTX W/O PATIENT	151.15
MD90847	FAMILY PSYTX W/ PATIENT	160.80
MD90849	MULTIPLE FAMILY GROUP PSYTX	105.06
MD90853	GROUP PSYCHOTHERAPY	80.40
MD90857	INTAC GROUP PSYTX	75.04
MD90862	MEDICATION MANAGEMENT	84.69
MD90865	NARCOSYNTHESIS	235.84
MD90870	ELECTROCONVULSIVE THERAPY	201.54
MD90871	ELECTROCONVULSIVE THERAPY	259.42
MD90875	PSYCHOPHYSIOLOGICAL THERAPY	98.62
MD90876	PSYCHOPHYSIOLOGICAL THERAPY	154.37
MD90880	HYPNOTHERAPY	159.73
MD90882	ENVIRONMENTAL MANIPULATION	107.20
MD90885	PSY EVALUATION OF RECORDS	145.79
MD90887	CONSULTATION WITH FAMILY	154.37
MD90889	PREPARATION OF REPORT	114.70
MD90899	PSYCHIATRIC SERVICE/THERAPY	0.00
MD90901	BIOFEEDBACK TRAIN, ANY METH	91.12
MD90911	BIOFEEDBACK PERI/URO/RECTAL	164.02
MD90918	ESRD RELATED SERVICES, MONTH	915.49
MD90919	ESRD RELATED SERVICES, MONTH	731.10
MD90920	ESRD RELATED SERVICES, MONTH	557.44
MD90921	ESRD RELATED SERVICES, MONTH	407.36
MD90922	ESRD RELATED SERVICES, DAY	34.30
MD90923	ESRD RELATED SERVICES, DAY	32.16
MD90924	ESRD RELATED SERVICES, DAY	27.87
MD90925	ESRD RELATED SERVICES, DAY	19.30
MD90935	HEMODIALYSIS, ONE EVALUATION	268.00
MD90937	HEMODIALYSIS, REPEATED EVAL	502.77
MD90945	DIALYSIS, ONE EVALUATION	268.00
MD90947	DIALYSIS, REPEATED EVAL	428.80
MD90989	DIALYSIS TRAINING, COMPLETE	632.48
MD90993	DIALYSIS TRAINING, INCOMPL	124.35
MD90997	HEMOPERFUSION	519.92
MD90999	DIALYSIS PROCEDURE	0.00
MD91000	ESOPHAGEAL INTUBATION	115.78
MD91010	ESOPHAGUS MOTILITY STUDY	257.28
MD91011	ESOPHAGUS MOTILITY STUDY	335.54
MD91012	ESOPHAGUS MOTILITY STUDY	321.60
MD91020	GASTRIC MOTILITY	230.48
MD91030	ACID PERFUSION OF ESOPHAGUS	130.78
MD91052	GASTRIC ANALYSIS TEST	187.60
MD91055	GASTRIC INTUBATION FOR SMEAR	126.50
MD91060	GASTRIC SALINE LOAD TEST	81.47
MD91065	BREATH HYDROGEN TEST	155.44
MD91100	PASS INTESTINE BLEEDING TUBE	139.36
MD91105	GASTRIC INTUBATION TREATMENT	107.20
MD91122	ANAL PRESSURE RECORD	305.52
MD91299	GASTROENTEROLOGY PROCEDURE	0.00
MD92002	EYE EXAM, NEW PATIENT	80.40
MD92004	EYE EXAM, NEW PATIENT	93.26
MD92012	EYE EXAM ESTABLISHED PAT	62.18
MD92014	EYE EXAM & TREATMENT	88.98
MD92015	REFRACTION	26.80
MD92018	NEW EYE EXAM & TREATMENT	218.69
MD92019	EYE EXAM & TREATMENT	128.64
MD92020	SPECIAL EYE EVALUATION	48.24
MD92060	SPECIAL EYE EVALUATION	55.74
MD92065	ORTHOPTIC/PLEOPTIC TRAINING	49.31
MD92070	FITTING OF CONTACT LENS	171.52
MD92081	VISUAL FIELD EXAMINATION(S)	40.74
MD92082	VISUAL FIELD EXAMINATION(S)	69.68
MD92083	VISUAL FIELD EXAMINATION(S)	110.42
MD92100	SERIAL TONOMETRY EXAM(S)	45.02
MD92120	TONOGRAPHY & EYE EVALUATION	48.24
MD92130	WATER PROVOCATION TONOGRAPHY	68.61
MD92135	OPHTHALMIC DX IMAGING	41.81
MD92140	GLAUCOMA PROVOCATIVE TESTS	50.38
MD92225	SPECIAL EYE EXAM, INITIAL	71.82
MD92226	SPECIAL EYE EXAM, SUBSEQUENT	66.46
MD92230	EYE EXAM WITH PHOTOS	96.48
MD92235	EYE EXAM WITH PHOTOS	225.12
MD92240	ICG ANGIOGRAPHY	181.17
MD92250	EYE EXAM WITH PHOTOS	65.39
MD92260	OPHTHALMOSCOPY/DYNAMOMETRY	63.25
MD92265	EYE MUSCLE EVALUATION	101.84
MD92270	ELECTRO-OCULOGRAPHY	92.19
MD92275	ELECTRORETINOGRAPHY	147.94
MD92283	COLOR VISION EXAMINATION	53.60
MD92284	DARK ADAPTATION EYE EXAM	80.40
MD92285	EYE PHOTOGRAPHY	56.82
MD92286	INTERNAL EYE PHOTOGRAPHY	174.74
MD92287	INTERNAL EYE PHOTOGRAPHY	134.00
MD92310	CONTACT LENS FITTING	182.24
MD92311	CONTACT LENS FITTING	155.44
MD92312	CONTACT LENS FITTING	196.18
MD92313	CONTACT LENS FITTING	187.60
MD92314	PRESCRIPTION OF CONTACT LENS	0.00
MD92315	PRESCRIPTION OF CONTACT LENS	139.36
MD92316	PRESCRIPTION OF CONTACT LENS	0.00
MD92317	PRESCRIPTION OF CONTACT LENS	0.00
MD92325	MODIFICATION OF CONTACT LENS	34.30
MD92326	REPLACEMENT OF CONTACT LENS	86.83
MD92330	FITTING OF ARTIFICIAL EYE	0.00
MD92335	FITTING OF ARTIFICIAL EYE	0.00
MD92340	FITTING OF SPECTACLES	45.02
MD92341	FITTING OF SPECTACLES	55.74
MD92342	FITTING OF SPECTACLES	62.18
MD92352	SPECIAL SPECTACLES FITTING	37.52
MD92353	SPECIAL SPECTACLES FITTING	41.81
MD92354	SPECIAL SPECTACLES FITTING	0.00
MD92355	SPECIAL SPECTACLES FITTING	0.00
MD92358	EYE PROSTHESIS SERVICE	58.96
MD92370	REPAIR & ADJUST SPECTACLES	41.81
MD92371	REPAIR & ADJUST SPECTACLES	38.59
MD92390	SUPPLY OF SPECTACLES	0.00
MD92391	SUPPLY OF CONTACT LENSES	0.00
MD92392	SUPPLY OF LOW VISION AIDS	0.00
MD92393	SUPPLY OF ARTIFICIAL EYE	0.00
MD92395	SUPPLY OF SPECTACLES	0.00
MD92396	SUPPLY OF CONTACT LENSES	0.00
MD92499	EYE SERVICE OR PROCEDURE	0.00
MD92502	EAR AND THROAT EXAMINATION	241.20
MD92504	EAR MICROSCOPY EXAMINATION	58.96
MD92506	SPEECH/HEARING EVALUATION	121.14
MD92507	SPEECH/HEARING THERAPY	66.46
MD92508	SPEECH/HEARING THERAPY	42.88
MD92510	REHAB FOR EAR IMPLANT	216.54
MD92511	NASOPHARYNGOSCOPY	192.96
MD92512	NASAL FUNCTION STUDIES	107.20
MD92516	FACIAL NERVE FUNCTION TEST	101.84
MD92520	LARYNGEAL FUNCTION STUDIES	225.12
MD92525	ORAL FUNCTION EVALUATION	204.75
MD92526	ORAL FUNCTION THERAPY	98.62
MD92531	SPONTANEOUS NYSTAGMUS STUDY	45.02
MD92532	POSITIONAL NYSTAGMUS TEST	45.02
MD92533	CALORIC VESTIBULAR TEST	61.10
MD92534	OPTOKINETIC NYSTAGMUS TEST	58.96
MD92541	SPONTANEOUS NYSTAGMUS TEST	95.41
MD92542	POSITIONAL NYSTAGMUS TEST	87.90
MD92543	CALORIC VESTIBULAR TEST	90.05
MD92544	OPTOKINETIC NYSTAGMUS TEST	56.82
MD92545	OSCILLATING TRACKING TEST	56.82
MD92546	TORSION SWING RECORDING	69.68
MD92547	SUPPLEMENTAL ELECTRICAL TEST	56.82
MD92548	POSTUROGRAPHY	187.60
MD92551	PURE TONE HEARING TEST, AIR	28.94
MD92552	PURE TONE AUDIOMETRY, AIR	36.45
MD92553	AUDIOMETRY, AIR & BONE	49.31
MD92555	SPEECH THRESHOLD AUDIOMETRY	32.16
MD92556	SPEECH AUDIOMETRY, COMPLETE	48.24
MD92557	COMPREHENSIVE HEARING TEST	91.12
MD92559	GROUP AUDIOMETRIC TESTING	35.38
MD92560	BEKESY AUDIOMETRY, SCREEN	47.17
MD92561	BEKESY AUDIOMETRY, DIAGNOSIS	69.68
MD92562	LOUDNESS BALANCE TEST	35.38
MD92563	TONE DECAY HEARING TEST	30.02
MD92564	SISI HEARING TEST	37.52
MD92565	STENGER TEST, PURE TONE	36.45
MD92567	TYMPANOMETRY	32.16
MD92568	ACOUSTIC REFLEX TESTING	32.16
MD92569	ACOUSTIC REFLEX DECAY TEST	40.74
MD92571	FILTERED SPEECH HEARING TEST	31.09
MD92572	STAGGERED SPONDAIC WORD TEST	32.16
MD92573	LOMBARD TEST	24.66
MD92575	SENSORINEURAL ACUITY TEST	27.87
MD92576	SYNTHETIC SENTENCE TEST	30.02
MD92577	STENGER TEST, SPEECH	48.24
MD92579	VISUAL AUDIOMETRY (VRA)	85.76
MD92582	CONDITIONING PLAY AUDIOMETRY	63.25
MD92583	SELECT PICTURE AUDIOMETRY	64.32
MD92584	ELECTROCOCHLEOGRAPHY	187.60
MD92585	BRAINSTEM EVOKED AUDIOMETRY	294.80
MD92587	EVOKED AUDITORY TEST	115.78
MD92588	EVOKED AUDITORY TEST	138.29
MD92590	HEARING AID EXAM, ONE EAR	72.90
MD92591	HEARING AID EXAM, BOTH EARS	128.64
MD92592	HEARING AID CHECK, ONE EAR	37.52
MD92593	HEARING AID CHECK, BOTH EARS	51.46
MD92594	ELECTRO HEARNG AID TEST, ONE	32.16
MD92595	ELECTRO HEARNG AID TST, BOTH	31.09
MD92596	EAR PROTECTOR EVALUATION	42.88
MD92597	ORAL SPEECH DEVICE EVAL	168.30
MD92598	MODIFY ORAL SPEECH DEVICE	116.85
MD92599	ENT PROCEDURE/SERVICE	0.00
MD92950	HEART/LUNG RESUSCITATION CPR	450.24
MD92953	TEMPORARY EXTERNAL PACING	257.28
MD92960	CARDIOVERSION ELECTRIC, EXT	363.41
MD92961	CARDIOVERSION, ELECTRIC, INT	0.00
MD92970	CARDIOASSIST, INTERNAL	554.22
MD92971	CARDIOASSIST, EXTERNAL	222.98
MD92975	DISSOLVE CLOT, HEART VESSEL	1,243.52
MD92977	DISSOLVE CLOT, HEART VESSEL	677.50
MD92978	INTRAVASC US, HEART ADD-ON	495.26
MD92979	INTRAVASC US, HEART ADD-ON	305.52
MD92980	INSERT INTRACORONARY STENT	2,733.60
MD92981	INSERT INTRACORONARY STENT	1,125.60
MD92982	CORONARY ARTERY DILATION	2,768.98
MD92984	CORONARY ARTERY DILATION	1,144.90
MD92986	REVISION OF AORTIC VALVE	3,055.20
MD92987	REVISION OF MITRAL VALVE	2,717.52
MD92990	REVISION OF PULMONARY VALVE	2,465.60
MD92992	REVISION OF HEART CHAMBER	4,073.60
MD92993	REVISION OF HEART CHAMBER	4,073.60
MD92995	CORONARY ATHERECTOMY	3,058.42
MD92996	CORONARY ATHERECTOMY ADD-ON	881.18
MD92997	PUL ART BALLOON REPR, PERCUT	2,266.21
MD92998	PUL ART BALLOON REPR, PERCUT	877.97
MD93000	ELECTROCARDIOGRAM, COMPLETE	72.90
MD93005	ELECTROCARDIOGRAM, TRACING	47.17
MD93010	ELECTROCARDIOGRAM REPORT	45.02
MD93012	TRANSMISSION OF ECG	93.26
MD93014	REPORT ON TRANSMITTED ECG	47.17
MD93015	CARDIOVASCULAR STRESS TEST	326.96
MD93016	CARDIOVASCULAR STRESS TEST	88.98
MD93017	CARDIOVASCULAR STRESS TEST	134.00
MD93018	CARDIOVASCULAR STRESS TEST	147.94
MD93024	CARDIAC DRUG STRESS TEST	340.90
MD93040	RHYTHM ECG W/REPORT	37.52
MD93041	RHYTHM ECG, TRACING	30.02
MD93042	RHYTHM ECG, REPORT	26.80
MD93224	ECG MONITOR/REPORT, 24 HRS	350.54
MD93225	ECG MONITOR/RECORD, 24 HRS	134.00
MD93226	ECG MONITOR/REPORT, 24 HRS	159.73
MD93227	ECG MONITOR/REVIEW, 24 HRS	138.29
MD93230	ECG MONITOR/REPORT, 24 HRS	351.62
MD93231	ECG MONITOR/RECORD, 24 HRS	121.14
MD93232	ECG MONITOR/REPORT, 24 HRS	145.79
MD93233	ECG MONITOR/REVIEW, 24 HRS	140.43
MD93235	ECG MONITOR/REPORT, 24 HRS	321.60
MD93236	ECG MONITOR/REPORT, 24 HRS	186.53
MD93237	ECG MONITOR/REVIEW, 24 HRS	112.56
MD93268	ECG RECORD/REVIEW	254.06
MD93270	ECG RECORDING	106.13
MD93271	ECG/MONITORING AND ANALYSIS	172.59
MD93272	ECG/REVIEW, INTERPRET ONLY	82.54
MD93278	ECG/SIGNAL-AVERAGED	165.09
MD93303	ECHO TRANSTHORACIC	414.86
MD93304	ECHO TRANSTHORACIC	227.26
MD93307	ECHO EXAM OF HEART	417.01
MD93308	ECHO EXAM OF HEART	220.83
MD93312	ECHO EXAM OF HEART	536.00
MD93313	ECHO EXAM OF HEART	202.61
MD93314	ECHO EXAM OF HEART	402.00
MD93315	ECHO TRANSESOPHAGEAL	536.00
MD93316	ECHO TRANSESOPHAGEAL	110.42
MD93317	ECHO TRANSESOPHAGEAL	424.51
MD93320	DOPPLER ECHO EXAM, HEART	268.00
MD93321	DOPPLER ECHO EXAM, HEART	147.94
MD93325	DOPPLER COLOR FLOW ADD-ON	218.69
MD93350	ECHO EXAM OF HEART	667.86
MD93501	RIGHT HEART CATHETERIZATION	1,128.82
MD93503	INSERT/PLACE HEART CATHETERIZATION	642.13
MD93505	BIOPSY OF HEART LINING	755.76
MD93508	CATH PLACEMENT ANGIOGRAPHY	0.00
MD93510	LEFT HEART CATHETERIZATION	846.88
MD93511	LEFT HEART CATHETERIZATION	817.94
MD93514	LEFT HEART CATHETERIZATION	830.80
MD93524	LEFT HEART CATHETERIZATION	812.58
MD93526	RT & LT HEART CATHETERS	1,355.01
MD93527	RT & LT HEART CATHETERS	1,447.20
MD93528	RT & LT HEART CATHETERS	1,307.84
MD93529	RT, LT HEART CATHETERIZATION	911.20
MD93530	RT HEART CATH, CONGENITAL	716.10
MD93531	R & L HEART CATH, CONGENITAL	1,271.39
MD93532	R & L HEART CATH, CONGENITAL	1,567.26
MD93533	R & L HEART CATH, CONGENITAL	901.55
MD93539	INJECTION, CARDIAC CATH	321.60
MD93540	INJECTION, CARDIAC CATH	340.90
MD93541	INJECTION FOR LUNG ANGIOGRAM	413.79
MD93542	INJECTION FOR HEART X-RAYS	380.56
MD93543	INJECTION FOR HEART X-RAYS	383.78
MD93544	INJECTION FOR AORTOGRAPHY	380.56
MD93545	INJECT FOR CORONARY XRAYS	662.50
MD93555	IMAGING, CARDIAC CATH	117.92
MD93556	IMAGING, CARDIAC CATH	168.30
MD93561	CARDIAC OUTPUT MEASUREMENT	195.10
MD93562	CARDIAC OUTPUT MEASUREMENT	114.70
MD93571	HEART FLOW MEASURE RESERVE	642.13
MD93572	HEART FLOW MEASURE RESERVE	589.60
MD93600	BUNDLE OF HIS RECORDING	705.38
MD93602	INTRA-ATRIAL RECORDING	437.38
MD93603	RIGHT VENTRICULAR RECORDING	526.35
MD93609	MAP TACHYCARDIA, ADD-ON	1,193.14
MD93610	INTRA-ATRIAL PACING	576.74
MD93612	INTRAVENTRICULAR PACING	478.11
MD93615	ESOPHAGEAL RECORDING	123.28
MD93616	ESOPHAGEAL RECORDING	257.28
MD93618	HEART RHYTHM PACING	1,232.80
MD93619	ELECTROPHYSIOLOGY EVALUATION	2,409.86
MD93620	ELECTROPHYSIOLOGY EVALUATION	3,482.93
MD93621	ELECTROPHYSIOLOGY EVALUATION	2,676.78
MD93622	ELECTROPHYSIOLOGY EVALUATION	3,264.24
MD93623	STIMULATION, PACING HEART	482.40
MD93624	ELECTROPHYSIOLOGIC STUDY	1,474.00
MD93631	HEART PACING, MAPPING	1,845.98
MD93640	EVALUATION HEART DEVICE	1,600.50
MD93641	ELECTROPHYSIOLOGY EVALUATION	1,608.00
MD93642	ELECTROPHYSIOLOGY EVALUATION	1,569.41
MD93650	ABLATE HEART DYSRHYTHM FOCUS	2,982.30
MD93651	ABLATE HEART DYSRHYTHM FOCUS	3,244.94
MD93652	ABLATE HEART DYSRHYTHM FOCUS	3,302.83
MD93660	TILT TABLE EVALUATION	433.09
MD93720	TOTAL BODY PLETHYSMOGRAPHY	150.08
MD93721	PLETHYSMOGRAPHY TRACING	92.19
MD93722	PLETHYSMOGRAPHY REPORT	58.96
MD93724	ANALYZE PACEMAKER SYSTEM	0.00
MD93727	ANALYZE ILR SYSTEM	0.00
MD93731	ANALYZE PACEMAKER SYSTEM	76.11
MD93732	ANALYZE PACEMAKER SYSTEM	108.27
MD93733	TELEPHONE ANALY, PACEMAKER	72.90
MD93734	ANALYZE PACEMAKER SYSTEM	71.82
MD93735	ANALYZE PACEMAKER SYSTEM	88.98
MD93736	TELEPHONE ANALY, PACEMAKER	68.61
MD93740	TEMPERATURE GRADIENT STUDIES	95.41
MD93741	ANALYZE HT PACE DEVICE SNGL	0.00
MD93742	ANALYZE HT PACE DEVICE SNGL	0.00
MD93743	ANALYZE HT PACE DEVICE DUAL	0.00
MD93744	ANALYZE HT PACE DEVICE DUAL	0.00
MD93760	CEPHALIC THERMOGRAM	187.60
MD93762	PERIPHERAL THERMOGRAM	296.94
MD93770	MEASURE VENOUS PRESSURE	27.87
MD93784	BP RECORDING	324.82
MD93786	RECORD ONLY BP RECORDING	0.00
MD93788	SCAN ANALYSIS REPORT BP RECORDIN	0.00
MD93790	REVIEW/REPORT BP RECORDING	117.92
MD93797	CARDIAC REHAB	39.66
MD93798	CARDIAC REHAB/MONITOR	0.00
MD93799	CARDIOVASCULAR PROCEDURE	0.00
MD93875	EXTRACRANIAL STUDY	262.64
MD93880	EXTRACRANIAL STUDY	383.78
MD93882	EXTRACRANIAL STUDY	298.02
MD93886	INTRACRANIAL STUDY	423.44
MD93888	INTRACRANIAL STUDY	294.80
MD93922	EXTREMITY STUDY	177.95
MD93923	EXTREMITY STUDY	261.57
MD93924	EXTREMITY STUDY	321.60
MD93925	LOWER EXTREMITY STUDY	330.18
MD93926	LOWER EXTREMITY STUDY	224.05
MD93930	UPPER EXTREMITY STUDY	316.24
MD93931	UPPER EXTREMITY STUDY	232.62
MD93965	EXTREMITY STUDY	194.03
MD93970	EXTREMITY STUDY	340.90
MD93971	EXTREMITY STUDY	235.84
MD93975	VASCULAR STUDY	319.46
MD93976	VASCULAR STUDY	302.30
MD93978	VASCULAR STUDY	323.74
MD93979	VASCULAR STUDY	225.12
MD93980	PENILE VASCULAR STUDY	432.02
MD93981	PENILE VASCULAR STUDY	321.60
MD93990	DOPPLER FLOW TESTING	265.86
MD94010	BREATHING CAPACITY TEST	83.62
MD94014	PATIENT RECORDED SPIROMETRY	82.54
MD94015	PATIENT RECORDED SPIROMETRY	0.00
MD94016	REVIEW PATIENT SPIROMETRY	52.53
MD94060	EVALUATION OF WHEEZING	114.70
MD94070	EVALUATION OF WHEEZING	167.23
MD94150	VITAL CAPACITY TEST	30.02
MD94200	LUNG FUNCTION TEST (MBC/MVV)	50.38
MD94240	RESIDUAL LUNG CAPACITY	76.11
MD94250	EXPIRED GAS COLLECTION	26.80
MD94260	THORACIC GAS VOLUME	78.26
MD94350	LUNG NITROGEN WASHOUT CURVE	84.69
MD94360	MEASURE AIRFLOW RESISTANCE	69.68
MD94370	BREATH AIRWAY CLOSING VOLUME	48.24
MD94375	RESPIRATORY FLOW VOLUME LOOP	85.76
MD94400	CO2 BREATHING RESPONSE CURVE	122.21
MD94450	HYPOXIA RESPONSE CURVE	69.68
MD94620	PULMONARY STRESS TEST/SIMPLE	192.96
MD94621	PULM STRESS TEST/COMPLEX	146.86
MD94640	AIRWAY INHALATION TREATMENT	37.52
MD94642	AIRWAY INHALATION TREATMENT	35.38
MD94650	PRESSURE BREATHING (IPPB)	43.95
MD94651	PRESSURE BREATHING (IPPB)	41.81
MD94652	PRESSURE BREATHING (IPPB)	46.10
MD94656	INITIAL VENTILATOR MGMT	232.62
MD94657	CONTINUED VENTILATOR MGMT	160.80
MD94660	POS AIRWAY PRESSURE, CPAP	174.74
MD94662	NEG PRESS VENTILATION, CNP	112.56
MD94664	AEROSOL OR VAPOR INHALATIONS	50.38
MD94665	AEROSOL OR VAPOR INHALATIONS	45.02
MD94667	CHEST WALL MANIPULATION	61.10
MD94668	CHEST WALL MANIPULATION	45.02
MD94680	EXHALED AIR ANALYSIS, O2	116.85
MD94681	EXHALED AIR ANALYSIS, O2/CO2	138.29
MD94690	EXHALED AIR ANALYSIS	53.60
MD94720	MONOXIDE DIFFUSING CAPACITY	84.69
MD94725	MEMBRANE DIFFUSION CAPACITY	145.79
MD94750	PULMONARY COMPLIANCE STUDY	72.90
MD94760	MEASURE BLOOD OXYGEN LEVEL	34.30
MD94761	MEASURE BLOOD OXYGEN LEVEL	55.74
MD94762	MEASURE BLOOD OXYGEN LEVEL	69.68
MD94770	EXHALED CARBON DIOXIDE TEST	54.67
MD94772	BREATH RECORDING, INFANT	214.40
MD94799	PULMONARY SERVICE/PROCEDURE	0.00
MD95004	ALLERGY SKIN TESTS	8.58
MD95010	SENSITIVITY SKIN TESTS	21.44
MD95015	SENSITIVITY SKIN TESTS	21.44
MD95024	ALLERGY SKIN TESTS	11.79
MD95027	SKIN END POINT TITRATION	12.86
MD95028	ALLERGY SKIN TESTS	19.30
MD95044	ALLERGY PATCH TESTS	12.86
MD95052	PHOTO PATCH TEST(S)	12.86
MD95056	PHOTOSENSITIVITY TESTS	11.79
MD95060	EYE ALLERGY TESTS	20.37
MD95065	NOSE ALLERGY TEST	19.30
MD95070	BRONCHIAL ALLERGY TESTS	160.80
MD95071	BRONCHIAL ALLERGY TESTS	167.23
MD95075	INGESTION CHALLENGE TEST	144.72
MD95078	PROVOCATIVE TESTING	20.37
MD95115	IMMUNOTHERAPY, ONE INJECTION	15.01
MD95117	IMMUNOTHERAPY INJECTIONS	20.37
MD95120	IMMUNOTHERAPY, ONE INJECTION	18.22
MD95125	IMMUNOTHERAPY, MANY ANTIGENS	19.30
MD95130	IMMUNOTHERAPY, INSECT VENOM	31.09
MD95131	IMMUNOTHERAPY, INSECT VENOMS	38.59
MD95132	IMMUNOTHERAPY, INSECT VENOMS	47.17
MD95133	IMMUNOTHERAPY, INSECT VENOMS	61.10
MD95134	IMMUNOTHERAPY, INSECT VENOMS	63.25
MD95144	ANTIGEN THERAPY SERVICES	12.86
MD95145	ANTIGEN THERAPY SERVICES	24.66
MD95146	ANTIGEN THERAPY SERVICES	34.30
MD95147	ANTIGEN THERAPY SERVICES	48.24
MD95148	ANTIGEN THERAPY SERVICES	49.31
MD95149	ANTIGEN THERAPY SERVICES	61.10
MD95165	ANTIGEN THERAPY SERVICES	11.79
MD95170	ANTIGEN THERAPY SERVICES	26.80
MD95180	RAPID DESENSITIZATION	151.15
MD95199	ALLERGY IMMUNOLOGY SERVICES	0.00
MD95805	MULTIPLE SLEEP LATENCY TEST	482.40
MD95806	SLEEP STUDY, UNATTENDED	0.00
MD95807	SLEEP STUDY, ATTENDED	536.00
MD95808	POLYSOMNOGRAPHY, 1-3	596.03
MD95810	POLYSOMNOGRAPHY, 4 OR MORE	664.64
MD95811	POLYSOMNOGRAPHY W/ CPAP	896.19
MD95812	ELECTROENCEPHALOGRAM (EEG)	214.40
MD95813	ELECTROENCEPHALOGRAM (EEG)	240.13
MD95816	ELECTROENCEPHALOGRAM (EEG)	211.18
MD95819	ELECTROENCEPHALOGRAM (EEG)	160.80
MD95822	SLEEP ELECTROENCEPHALOGRAM	219.76
MD95824	ELECTROENCEPHALOGRAPHY	166.16
MD95827	NIGHT ELECTROENCEPHALOGRAM	281.94
MD95829	SURGERY ELECTROCORTICOGRAM	436.30
MD95830	INSERT ELECTRODES FOR EEG	184.38
MD95831	LIMB MUSCLE TESTING, MANUAL	58.96
MD95832	HAND MUSCLE TESTING, MANUAL	65.39
MD95833	BODY MUSCLE TESTING, MANUAL	107.20
MD95834	BODY MUSCLE TESTING, MANUAL	128.64
MD95851	RANGE OF MOTION MEASUREMENTS	54.67
MD95852	RANGE OF MOTION MEASUREMENTS	69.68
MD95857	TENSILON TEST	96.48
MD95858	TENSILON TEST & MYOGRAM	0.00
MD95860	MUSCLE TEST, ONE LIMB	214.40
MD95861	MUSCLE TEST, TWO LIMBS	319.46
MD95863	MUSCLE TEST, 3 LIMBS	409.50
MD95864	MUSCLE TEST, 4 LIMBS	482.40
MD95867	MUSCLE TEST, HEAD OR NECK	172.59
MD95868	MUSCLE TEST, HEAD OR NECK	243.34
MD95869	MUSCLE TEST, THOR PARASPINAL	129.71
MD95870	MUSCLE TEST, NON-PARASPINAL	0.00
MD95872	MUSCLE TEST, ONE FIBER	241.20
MD95875	LIMB EXERCISE TEST	115.78
MD95900	MOTOR NERVE CONDUCTION TEST	110.42
MD95903	MOTOR NERVE CONDUCTION TEST	146.86
MD95904	SENSE NERVE CONDUCTION TEST	109.34
MD95920	INTRAOP NERVE TEST ADD-ON	343.04
MD95921	AUTONOMIC NERV FUNCTION TEST	90.05
MD95922	AUTONOMIC NERV FUNCTION TEST	94.34
MD95923	AUTONOMIC NERV FUNCTION TEST	90.05
MD95925	SOMATOSENSORY TESTING	353.76
MD95926	SOMATOSENSORY TESTING	225.12
MD95927	SOMATOSENSORY TESTING	203.68
MD95930	VISUAL EVOKED POTENTIAL TEST	250.85
MD95933	BLINK REFLEX TEST	167.23
MD95934	H-REFLEX TEST	121.14
MD95936	H-REFLEX TEST	92.19
MD95937	NEUROMUSCULAR JUNCTION TEST	150.08
MD95950	AMBULATORY EEG MONITORING	574.59
MD95951	EEG MONITORING/VIDEORECORD	708.59
MD95953	EEG MONITORING/COMPUTER	651.78
MD95954	EEG MONITORING/GIVING DRUGS	301.23
MD95955	EEG DURING SURGERY	300.16
MD95956	EEG MONITORING, CABLE/RADIO	670.00
MD95957	EEG DIGITAL ANALYSIS	0.00
MD95958	EEG MONITORING/FUNCTION TEST	575.66
MD95961	ELECTRODE STIMULATION, BRAIN	360.19
MD95962	ELECTRODE STIM, BRAIN ADD-ON	362.34
MD95970	ANALYZE NEUROSTIM, NO PROG	38.59
MD95971	ANALYZE NEUROSTIM, SIMPLE	63.25
MD95972	ANALYZE NEUROSTIM, COMPLEX	116.85
MD95973	ANALYZE NEUROSTIM, COMPLEX	73.97
MD95974	CRANIAL NEUROSTIM, COMPLEX	239.06
MD95975	CRANIAL NEUROSTIM, COMPLEX	142.58
MD95999	NEUROLOGICAL PROCEDURE	0.00
MD96100	PSYCHOLOGICAL TESTING	142.58
MD96105	ASSESSMENT OF APHASIA	0.00
MD96110	DEVELOPMENTAL TEST, LIM	0.00
MD96111	DEVELOPMENTAL TEST, EXTEND	0.00
MD96115	NEUROBEHAVORIAL STATUS EXAM	0.00
MD96117	NEUROPSYCH TEST BATTERY	0.00
MD96400	CHEMOTHERAPY, SC/IM	32.16
MD96405	INTRALESIONAL CHEMO ADMIN	80.40
MD96406	INTRALESIONAL CHEMO ADMIN	108.27
MD96408	CHEMOTHERAPY, PUSH TECHNIQUE	78.26
MD96410	CHEMOTHERAPY, INFUSION METHOD	136.14
MD96412	CHEMO, INFUSE METHOD ADD-ON	88.98
MD96414	CHEMO, INFUSE METHOD ADD-ON	111.49
MD96420	CHEMOTHERAPY, PUSH TECHNIQUE	137.22
MD96422	CHEMOTHERAPY, INFUSION METHOD	134.00
MD96423	CHEMO, INFUSE METHOD ADD-ON	53.60
MD96425	CHEMOTHERAPY, INFUSION METHOD	80.40
MD96440	CHEMOTHERAPY, INTRACAVITARY	172.59
MD96445	CHEMOTHERAPY, INTRACAVITARY	244.42
MD96450	CHEMOTHERAPY, INTO CNS	189.74
MD96520	PUMP REFILLING, MAINTENANCE	87.90
MD96530	PUMP REFILLING, MAINTENANCE	109.34
MD96542	CHEMOTHERAPY INJECTION	166.16
MD96545	PROVIDE CHEMOTHERAPY AGENT	0.00
MD96549	CHEMOTHERAPY, UNSPECIFIED	0.00
MD96570	PHOTODYNAMIC TX, 30 MIN	0.00
MD96571	PHOTODYNAMIC TX, ADDL 15 MIN	0.00
MD96900	ULTRAVIOLET LIGHT THERAPY	26.80
MD96902	TRICHOGRAM	46.10
MD96910	PHOTOCHEMOTHERAPY WITH UV-B	38.59
MD96912	PHOTOCHEMOTHERAPY WITH UV-A	39.66
MD96913	PHOTOCHEMOTHERAPY, UV-A OR B	140.43
MD96999	DERMATOLOGICAL PROCEDURE	0.00
MD97001	PT EVALUATION	94.34
MD97002	PT RE-EVALUATION	37.52
MD97003	OT EVALUATION	72.90
MD97004	OT RE-EVALUATION	35.38
MD97010	HOT OR COLD PACKS THERAPY	27.87
MD97012	MECHANICAL TRACTION THERAPY	37.52
MD97014	ELECTRIC STIMULATION THERAPY	33.23
MD97016	VASOPNEUMATIC DEVICE THERAPY	41.81
MD97018	PARAFFIN BATH THERAPY	39.66
MD97020	MICROWAVE THERAPY	32.16
MD97022	WHIRLPOOL THERAPY	34.30
MD97024	DIATHERMY TREATMENT	32.16
MD97026	INFRARED THERAPY	18.22
MD97028	ULTRAVIOLET THERAPY	26.80
MD97032	ELECTRICAL STIMULATION	36.45
MD97033	ELECTRIC CURRENT THERAPY	51.46
MD97034	CONTRAST BATH THERAPY	26.80
MD97035	ULTRASOUND THERAPY	34.30
MD97036	HYDROTHERAPY	40.74
MD97039	PHYSICAL THERAPY TREATMENT	0.00
MD97110	THERAPEUTIC EXERCISES	42.88
MD97112	NEUROMUSCULAR REEDUCATION	42.88
MD97113	AQUATIC THERAPY/EXERCISES	46.10
MD97116	GAIT TRAINING THERAPY	42.88
MD97124	MASSAGE THERAPY	37.52
MD97139	PHYSICAL MEDICINE PROCEDURE	0.00
MD97140	MANUAL THERAPY	43.95
MD97150	GROUP THERAPEUTIC PROCEDURES	39.66
MD97504	ORTHOTIC TRAINING	39.66
MD97520	PROSTHETIC TRAINING	51.46
MD97530	THERAPEUTIC ACTIVITES	48.24
MD97535	SELF CARE MNGMENT TRAINING	46.10
MD97537	COMMUNITY/WORK REINTEGRATION	0.00
MD97542	WHEELCHAIR MNGEMENT TRAINING	35.38
MD97545	WORK HARDENING, 2 HOURS	157.58
MD97546	WORK HARDENING ADD-ON	81.47
MD97703	PROSTHETIC CHECKOUT	37.52
MD97750	PHYSICAL PERFORMANCE TEST	62.18
MD97770	COGNITIVE SKILLS DEVELOPMENT	62.18
MD97799	PHYSICAL MEDICINE PROCEDURE	0.00
MD98925	OSTEOPATHIC MANIPULATION	47.17
MD98926	OSTEOPATHIC MANIPULATION	67.54
MD98927	OSTEOPATHIC MANIPULATION	82.54
MD98928	OSTEOPATHIC MANIPULATION	106.13
MD98929	OSTEOPATHIC MANIPULATION	117.92
MD98940	CHIROPRACTIC MANIPULATION	41.81
MD98941	CHIROPRACTIC MANIPULATION	48.24
MD98942	CHIROPRACTIC MANIPULATION	62.18
MD98943	CHIROPRACTIC MANIPULATION	36.45
MD99000	SPECIMEN HANDLING	16.08
MD99001	SPECIMEN HANDLING	18.22
MD99002	DEVICE HANDLING	19.30
MD99024	POSTOP FOLLOW-UP VISIT	67.54
MD99050	MEDICAL SERVICES AFTER HRS	58.96
MD99052	MEDICAL SERVICES AT NIGHT	64.32
MD99054	MEDICAL SERVCS, UNUSUAL HRS	61.10
MD99056	NON-OFFICE MEDICAL SERVICES	80.40
MD99058	OFFICE EMERGENCY CARE	70.75
MD99070	SPECIAL SUPPLIES	0.00
MD99071	PATIENT EDUCATION MATERIALS	0.00
MD99075	MEDICAL TESTIMONY	444.88
MD99078	GROUP HEALTH EDUCATION	42.88
MD99080	SPECIAL REPORTS OR FORMS	53.60
MD99082	UNUSUAL PHYSICIAN TRAVEL	120.06
MD99090	COMPUTER DATA ANALYSIS	139.36
MD99100	SPECIAL ANESTHESIA SERVICE	0.00
MD99116	ANESTHESIA WITH HYPOTHERMIA	0.00
MD99135	SPECIAL ANESTHESIA PROCEDURE	0.00
MD99140	EMERGENCY ANESTHESIA	0.00
MD99141	SEDATION, IV/IM OR INHALANT	160.80
MD99142	SEDATION, ORAL/RECTAL/NASAL	0.00
MD99170	ANOGENITAL EXAM, CHILD	0.00
MD99173	VISUAL SCREENING TEST	0.00
MD99175	INDUCTION OF VOMITING	85.76
MD99183	HYPERBARIC OXYGEN THERAPY	203.68
MD99185	REGIONAL HYPOTHERMIA	53.60
MD99186	TOTAL BODY HYPOTHERMIA	156.51
MD99190	SPECIAL PUMP SERVICES	750.40
MD99191	SPECIAL PUMP SERVICES	428.80
MD99192	SPECIAL PUMP SERVICES	285.15
MD99195	PHLEBOTOMY	54.67
MD99199	SPECIAL SERVICE/PROC/REPORT	0.00