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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | APPLICATION - LONG LEG SLING | 96091-00[1870] | 620062 | 9609100 | 400 | ||
0 | APPLICATION - SHORT ARM CAST (SYNTHETIC). | 96091-00[1870] | 620063 | 9609100 | 320 | ||
0 | APPLICATION - SHORT ARM SLAB/ CAST (PLASTER). | 96091-00[1870] | 620064 | 9609100 | 280 | ||
0 | APPLICATION - SHORT ARM SPLINT | 96091-00[1870] | 620065 | 9609100 | 280 | ||
0 | APPLICATION - SHORT LEG CAST (PLASTER). | 96091-00[1870] | 620066 | 9609100 | 480 | ||
0 | APPLICATION - SHORT LEG CAST (SYNTHETIC). | 96091-00[1870] | 620067 | 9609100 | 560 | ||
0 | APPLICATION - SHORT LEG SLAB (PLASTER) | 96091-00[1870] | 620068 | 9609100 | 280 | ||
0 | APPLICATION - SPICA CAST, HIP OR SHOULDER | 47540-00[1870] | 620069 | 4754000 | 2,000.00 | ||
(PLASTER) | |||||||
0 | APPLICATION - SPICA CAST, HIP OR SHOULDER (SYNTHETIC) | 47540-00[1870] | 620070 | 4754000 | 2,400.00 | ||
0 | APPLICATION - SPINAL JACKET (SYNTHETIC) | 47708-00[1870] | 620071 | 4770800 | 2,800.00 | ||
0 | APPLICATION - SPLINT, FINGER | 97773-00[177] | 620072 | 9777300 | 200 |
APPLICATION - LONG LEG SLING
400
APPLICATION - SHORT ARM CAST (SYNTHETIC).
320
APPLICATION - SHORT ARM SLAB/ CAST (PLASTER).
280
APPLICATION - SHORT ARM SPLINT
280
APPLICATION - SHORT LEG CAST (PLASTER).
480
APPLICATION - SHORT LEG CAST (SYNTHETIC).
560
APPLICATION - SHORT LEG SLAB (PLASTER)
280
APPLICATION - SPICA CAST, HIP OR SHOULDER
2,000.00
(PLASTER)
APPLICATION - SPICA CAST, HIP OR SHOULDER (SYNTHETIC)
2,400.00
APPLICATION - SPINAL JACKET (SYNTHETIC)
2,800.00
APPLICATION - SPLINT, FINGER
200
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