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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | Intracarporal Inj. (TCT) | 340020 | 50 | ||||
LAPAROSCOPIC - DIAGNOSTIC OF LIVER WITH BIOPSY | 340021 | 3040900 | 4,400.00 | ||||
LAPAROSCOPIC - DIAGNOSTIC OF LIVER WITHOUT | 30390-00[984] | 340022 | 3039000 | 3,200.00 | |||
BIOPSY | |||||||
0 | Treatment Program by Insulin Pump (Train.& Educ.) | 340023 | 1,000.00 | ||||
0 | U/S Duplex for Blood Vessels | 90911-00[1948] | 340024 | 9091100 | 300 | ||
0 | PERIAPICAL VIEW | 320213 | 80 | ||||
0 | PERIAPICAL X-RAY WITHOUT EXAM | 320214 | 40 | ||||
0 | PERIODONTAL FLAP SURGERY / ALLOGRAFT | 97232-00[456] | 320215 | 2,400.00 | |||
(DFDBA)/SITE | |||||||
0 | PERIODONTAL FLAP SURGERY / ALLOPLASTIC GRAFT | 97232-00[456] | 320216 | 2,560.00 | |||
MATERIALS/ SITE |
Intracarporal Inj. (TCT)
50
LAPAROSCOPIC - DIAGNOSTIC OF LIVER WITH BIOPSY
4,400.00
LAPAROSCOPIC - DIAGNOSTIC OF LIVER WITHOUT
3,200.00
BIOPSY
Treatment Program by Insulin Pump (Train.& Educ.)
1,000.00
U/S Duplex for Blood Vessels
300
PERIAPICAL VIEW
80
PERIAPICAL X-RAY WITHOUT EXAM
40
PERIODONTAL FLAP SURGERY / ALLOGRAFT
2,400.00
(DFDBA)/SITE
PERIODONTAL FLAP SURGERY / ALLOPLASTIC GRAFT
2,560.00
MATERIALS/ SITE
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