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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
(MOLTENO) | |||||||
1 | ASPIRATION OF VITREOUS BY POSTERIOR | 42740-01[204] | 420008 | 4274001 | Y | 9,900.00 | |
SCLEROTOMY1 | |||||||
1 | BIL PHACO CATARACT W/ IOL + ANTER. VITRECTOMY1 | 97]$42702-05[197]$42719-01[207] | 420009 | Y | 13,860.00 | ||
1 | BILATERAL EXCISION OF CHALAZION1 | 75-00[233]42575-00[ | 420010 | 4257500 | Y | 3,564.00 | |
1 | BILATERAL EXCISION OF LESION OF EYELID | 0-00[1620].31230-00[ | 420011 | 3123000 | Y | 4,131.00 | |
1 | BILATERAL EXTRA CAPSULAR CATARACT EXTRACTION (ECCE) WP | 98-04[199]$42698-04[ | 420012 | 4269804 | Y | 7,326.00 | |
1 | BILATERAL EXTRA CAPSULAR CATARACT EXTRACTION | 02-09[199]$42702-09[ | 420013 | 42700209 | Y | 10,395.00 | |
+ IOL | |||||||
1 | BILATERAL GLUCOMA PROCEDURE (AHMED VALVE IMPLANT)1 | 46-04[191]$42746-04[ | 420014 | 4274604 | Y | 6,534.00 | |
1 | BILATERAL INSERTION OF STENT INTO NASOLACRIMAL | 42599-01[249] | 420015 | 4259901 | Y | 4,950.00 | |
1 | BILATERAL INTRA CAPSULAR CATARACT EXTRACTION | 98-00[195].42698-00[ | 420016 | 4269800 | Y | 7,722.00 |
(MOLTENO)
ASPIRATION OF VITREOUS BY POSTERIOR
9,900.00
SCLEROTOMY1
BIL PHACO CATARACT W/ IOL + ANTER. VITRECTOMY1
13,860.00
BILATERAL EXCISION OF CHALAZION1
3,564.00
BILATERAL EXCISION OF LESION OF EYELID
4,131.00
BILATERAL EXTRA CAPSULAR CATARACT EXTRACTION (ECCE) WP
7,326.00
BILATERAL EXTRA CAPSULAR CATARACT EXTRACTION
10,395.00
+ IOL
BILATERAL GLUCOMA PROCEDURE (AHMED VALVE IMPLANT)1
6,534.00
BILATERAL INSERTION OF STENT INTO NASOLACRIMAL
4,950.00
BILATERAL INTRA CAPSULAR CATARACT EXTRACTION
7,722.00
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