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NUMC-CDM-Jan2019.Pdf Charge Code Charge Description Charge 0301001 D.R.Ceaserean Sect $11,302.20 0301002 D.R. D&C $2,692.50 0301003 D.R. Insert Lamnaria $873.81 0301004 D.R. Salting $1,626.87 0301005 D.R. Vag Delivery $8,073.00 0301009 D.R. Prep Room Visit $383.62 0301010 D.R.Pstprtm Tubal Lg $2,749.34 0301011 D.R.Shirodkar $3,892.36 0301012 D.R. H.I.P. Laser Tr $838.30 0301013 D.R. H.I.P. Cryothrp $838.30 0301014 D.R. Vbac $3,500.77 0301015 D.R. C/S After Attempt Vbac $3,648.06 0301016 D.R. Low Forceps Delivery $9,149.40 0301017 D.R. Vacuum Assisted Delivery $9,149.40 0301018 Dr Del. Other Ntrl/Artfcl Open $9,149.40 0302001 L.R. Nst/Oct Intl Te $547.02 0302002 L.R. Nst/Oct Sbsq Te $500.00 0302050 Antepartum Care 7> Visits Only $1,666.26 0401001 P-F Spromtry Vol Vnt $427.34 0401002 Spirometry Bef&Aft Bronchdilat $788.64 0401005 P-F Diffus(Sin.Brth) $438.03 0401006 P-F Flow Vol Loop $725.49 0401010 P-F Compliance Study $1,387.63 0401012 P-F Art Punc&Bld Col $315.70 0401013 P-F Intr Arterial Ca $320.77 0401016 P-F Laryn&Trachescpy $1,234.64 0401017 P-F Bronchoscopy $3,979.48 0401018 P-F Brnchscpy&Brshng $3,979.48 0401019 Bronchoscopy W/Biopsy(S) $3,979.48 0401020 P-F Brnc&Biop&Brshng $3,979.48 0401021 Bronchoscopy/Lung Bx Each $7,863.33 0401022 P-F Trnsthor Ne Biop $4,051.10 0401023 P-F Pleural Biopsy $4,051.10 0401034 P-F Bronc Provac Tst $725.49 0401035 ASPIRATE PLEURA W/O IMAGING $2,152.80 0401044 Bronchoscopy/Needle Bx Each $6,558.51 0401046 P-F Lungfunc Mbc/Mvv $300.32 0401048 P-F Airway Inhal Trt $491.92 0401051 P-F Pos Airway Press $491.92 0401054 P-F Pulse Oximetry Single $261.00 0401055 P-F Pulse Oximetry Multiple $347.11 0401057 P-F Neg Press Ventilation, Cnp $1,504.81 0401064 Tracheostomy, Planned $5,323.87 0401065 Transtracheal Introduction $3,416.49 0401066 Thoracoscopy Dx;Lngs&Pl W/O Bx $10,380.80 0401100 Pulm Funct Tst Plethysmograp $725.49 0401110 Evaluate Pt Use Of Inhaler $491.92 0401120 Pulm Function Test By Gas $427.34 0401125 Thoracoscopy W/Bx Infiltrate $10,380.80 0401130 Thoracoscopy W/Bx Nodule $10,380.80 0401135 Thoracoscopy W/Bx Pleura $10,380.80 0401140 Chemo - Pleural Cav W Thorac $427.34 0401145 Dx Bronchoscope/Lavage $3,415.42 0401150 Bronchoscopy Clear Airways $3,415.42 0401155 Bronchoscopy Reclear Airways $1,234.64 0401160 Bronchoscopy W/Fb Removal $3,415.42 0401200 Bronchoscopy/Lung Bx Addl $147.47 0401201 Bronchoscopy/Needle Bx Addl $188.37 0401202 Pulmonary Stress; Complex $725.49 0401203 Co Expired Gas By Ir $725.49 0401204 Aspirate Pleura W/ Imaging $2,152.80 0401205 Ih Bronch Challenge; W Histami $1,305.68 0401206 Total Vital Capacity $427.33 0401207 INSERT PLEURAL CATH $7,168.82 0401208 PULMONARY BI SELECTIVE ANGIO $8,954.42 0401209 Exhaled Nitric Oxide Meas $89.44 0401210 tabacco-use counsel 3-10mins $91.81 0401211 SURFACTANT ADMIN THRU TUBE $510.06 0401212 Unlisted Pulmonary Svc $400.40 0401213 EXERCISE TST BRNCSPSM $832.00 0401214 PULMONARY STRESS TESTING $832.00 0501001 Ambulance Emerg Serv $117.03 0501002 Amb Patient Transprt $0.00 0501003 Amb Basic Life Suppt Per Mile $18.22 0501004 Amb Advanc Life Suppt Per Mile $18.22 0501005 Amb Als Non-Emerg Trans Lvl 1 $870.59 0501006 Amb Als Emerg Trans Level 1 $870.59 0501007 Amb Bls Non-Emerg Transport $632.92 0501008 Amb Bls Emergency Transport $632.92 0501009 Amb Adv Life Support Level 2 $870.59 0501010 Amb Specialty Care Transport $870.59 0501011 Amb Noncovd Mileage Per Mile $14.21 0701004 Ekg Holter Monitor $621.02 0702001 Ekg (12 Leads) $185.00 0702002 Ekg Ecg Stress Test $747.78 0702003 Ekg Thal.Stress Test $290.12 0702004 Ekg Ecg Rhythm Strip $184.71 0702008 Ekg Holter Monitor $388.78 0702009 Ekg Echocard M Mode $548.78 0702010 Ekg Echocard-Realtme $390.74 0702011 Ekg Echocrd M+realtm $548.78 0702012 Ekg Dopplr Echo Puls/Cont Wave $571.83 0702013 Ekg Rd/Int Hlth $184.07 0702014 Ekg Telemetry Montr $319.70 0702015 Echocrd/Transesophagl W/Probe $919.88 0702016 Plcmt Of Transesoph Probe Only $919.88 0702017 Imag Acquis Interp&Report Only $737.89 0702018 Doppler Echo Color Flow $515.23 0702019 Echcrd Rest&Stress W/Mon&Intrp $1,646.89 0702020 Ekg Signal Avg Electrocardiogr $301.95 0702021 Ekg Occ Health Ekg $184.07 0702022 Ekg Rhythm Ecg With Report $71.04 0702023 Ekg Ecg Monitor/Report <=48 Hr $390.74 0702025 Ekg Echo Transesophageal $919.88 0702026 Ekg Cardiovascular Stress Test $284.17 0702029 Ekg Echo Exam Of Heart $548.78 0702030 Ekg Echo Transthoracic $1,646.89 0702031 Ekg Trnsthrac Echo Congen Anom $919.88 0702032 Ekg Transthoracic Echo Limited $548.78 0702034 Ekg Routine Ecg W/Interp&Rept $77.50 0702035 Tte W/Doppler, Complete $1,646.89 0702036 Inj Perflutren Lip Micros,1 Ml $120.30 0702037 Tte W Or Wo Fol Wcon,Doppler $1,097.93 0702038 Tte W Or W/O Contr,Cont Ecg $1,097.93 0702039 Echocard Doppler Cont Wave F/U $490.84 0702041 Echo Bubble Study $574.28 0702110 12 Lead Ekg; Int & Rep $26.92 0702200 Remote 30 Day Ecg Tech Supp $2,263.67 0702201 Remote Pt 30 Day Ecg Rev/Repor $44.26 0702202 Ecg/Monitoring And Analysis $656.60 0702203 Icd Device Progr Eval Mult $90.42 0702204 Pm Device Progr Eval Multi $76.43 0702205 Icd Device Progr Eval 1 Sngl $113.42 0702206 Icd Device Progr Eval Dual $129.17 0702207 Pm Device Progr Eval Sngl $59.21 0702208 Ilr Device Eval Progr $110.87 0702209 Ecg Up To 48 Hrs Scanning Anal $141.01 0702210 Pm Dev Interogate Remote <=90 $99.03 0702211 Pm Device Eval In Person $129.17 0702212 Microvolt T-Wave Assess $467.16 0702214 Ext Ecg Recording $509.14 0702215 Ext Ecg Complete $509.14 0702216 Ext Ecg Scan W/Report $509.14 0702217 Cptr Dbs Alys Car Elec Dta $530.67 0801200 Eeg 41-60 Minutes $698.59 0801201 Eeg Over 1 Hour $585.56 0801202 Eeg Awake & Drowsy $585.56 0801203 Eeg Awake & Asleep $585.56 0801204 Eeg Coma Or Sleep Only $585.56 0801205 Eeg; Cerebral Silence $698.59 0801206 Eeg All Night Recording $1,418.70 0801207 Tensilon Test $411.18 0801208 Muscle Test 1 Limb $162.54 0801209 Muscle Test 2 Limbs $411.18 0801210 Muscle Test 3 Limbs $465.00 0801211 Muscle Test 4 Limbs $518.82 0801212 Emg Cran Nerv - Unilat $411.18 0801213 Needle Emg Cranial Nrv; Bilat $411.18 0801214 N Emg;Thoracic Musc Not T1/T12 $170.83 0801215 Musc Tst Nonparaspinal 1extrem $172.22 0801216 Musc Tst Done W/Nerv Tst Lim $57.05 0801217 Musc Test Done W/N Test Comp $141.01 0801219 Cerebr Seiz 16/> Ch; Ea 24 Hrs $2,779.26 0801220 Cerebr Seiz Port 16ch;Ea 24hrs $1,418.70 0801221 Eeg Monitoring/Giving Drugs $522.08 0801222 Eeg During Noncranial Surg $163.61 0801223 Cerebr Seizure Eeg Ea 24 Hrs $1,418.70 0801224 Digital Analysis Of Eeg $324.00 0801225 Sls-Eps; Periph Nrv; Up Limbs $698.59 0801226 Blink Reflex Test $162.54 0801227 Neuromusc Junction Tst Ea Nerv $170.83 0801228 Canalith Repositioning Proc $134.56 0801229 Auditory Ep - Comprehensive $698.59 0801230 Auditory Ep - Limited $411.18 0801231 Vep ; Checkerbd/Flash $411.18 0801232 Somatosensory Testing $698.59 0801233 Nvr Cndj Tst 1-2 Studies $411.18 0801234 Nrv Cndj Tst 3-4 Studies $698.59 0801235 Nrv Cndj Tst 5-6 Studies $752.41 0801236 Nrv Cndj Test 7-8 Studies $806.23 0801237 Nrv Cndj Test 9-10 Studies $860.05 0801238 Nrv Cndj Test 11-12 Studies $913.87 0801239 Nrv Cndj Test 13/> Studies $967.69 0801240 Sls-Eps; Periph Nrv; Lwr Limbs $411.18 0802055 Guide Nerv Destr Needle Emg $62.43 1012248 KIT FIXTR FIX EXT STD PROCALL $0.00 1102001 I.P.R.A. Charge $155.97 1203003 Card Ekg Rd/Int Hlth $184.07 1203004 Card Std Transmitter $468.88 1203005 Card Periocard.Initl $724.63 1203006 Card Periocard.Subsq $724.63 1203008 Countershock (Cardioversion) $614.99 1203009 Card Ergonovine Test $902.24 1203010 Card Systolic Tm Int $362.32 1203011 Card Flouroscopy <=1hr $698.15 1203012 Card Rt Hrt Cath-Lab $8,390.54 1203014 Card Endocard Biopsy $2,958.95 1203015 Card Left Heart Cath $8,390.54 1203016 Card Rt&Lft Hrt Cath $8,390.54 1203018 Card Ventrclgrphy-Rt $1,112.62 1203019 Card Ventrclgrphy-Lt $852.51 1203020 Card Aortography $468.88 1203021 LEFT HRT CATH W/VENTRCLGRPHY $8,390.54 1203022 Lt Cth,Vnt&Coron An $8,390.54 1203025 Lt Cth,Vnt,An&Aor R2 D 11/6/92 $0.00 1203028 Card Output Dilution $305.48 1203029 Card His Bundle $6,185.60 1203030 Card Intr-Atrial Rec $6,185.60 1203031 Card Intr-Vent Recrd $2,401.24 1203032 Comb Intrcard Record $2,401.24 1203033 Card Intr-Atrl Pacng $6,185.60 1203034 Card Intr-Vnt Pacing $6,185.60 1203035 Card His Bundl Pace $6,185.60 1203036 Arhythmia Elec Pace $4,511.20 1203038 Arhyth Elec Pace-Lim $2,401.24 1203041 Dual Chbr Teletrans <=90 Days $85.25 1203042 Electrcl Anal.Inhous $129.17 1203044 Elec Anal.
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