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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | SWANGANZ CATHETER | 13818-00[657] | 120023 | 500 | |||
0 | THORACOCENTESIS | 38800-00[560] | 120024 | 250 | |||
0 | UMBILICAL CATH.ARTERIAL | 13303-00[694] | 120025 | 380 | |||
0 | UMBILICAL CATH.VENOUS | 13300-02[738] | 120026 | 380 | |||
VENTILATOR PER DAY | 92209-00[570] | 120027 | 92209 | 400 | |||
VENTILATOR: 12 HOURS | 92209-00[570] | 120028 | 92209 | 240 | |||
3 | IMMATURITYEXTREME-PER DAY | 120029 | Y | 3,750.00 | |||
1 | N.I.C.U. PER DAY | 120030 | Y | 3,750.00 | |||
1 | C.C.U. PER DAY | 120031 | Y | 3,750.00 | |||
1 | I.C.U. PER DAY | 120032 | Y | 3,750.00 | |||
ambulance + nursse or technician + doctor (inside city) | 140001 | 1,300.00 | |||||
ambulance + nursse or technician + doctor out side city up to | 140002 | 1,200.00 |
SWANGANZ CATHETER
500
THORACOCENTESIS
250
UMBILICAL CATH.ARTERIAL
380
UMBILICAL CATH.VENOUS
380
VENTILATOR PER DAY
400
VENTILATOR: 12 HOURS
240
IMMATURITYEXTREME-PER DAY
3,750.00
N.I.C.U. PER DAY
3,750.00
C.C.U. PER DAY
3,750.00
I.C.U. PER DAY
3,750.00
ambulance + nursse or technician + doctor (inside city)
1,300.00
ambulance + nursse or technician + doctor out side city up to
1,200.00
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