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CHI Medical Plan Nephropathy & Retinal Eye Exam Coding Sets

Exhibit B-1

Codes to Identify Nephropathy Screening or Monitoring Test or Evidence of Nephropathy

Value Set Name Code Definition Code System CKD Stage 4 N18.4 [N18.4] Chronic , ICD10CM stage 4 (severe) CKD Stage 4 585.4 Chr kidney dis stage IV ICD9CM ESRD 36147 ESRD CPT ESRD 36800 ESRD CPT ESRD 36810 ESRD CPT ESRD 36815 ESRD CPT ESRD 36818 ESRD CPT ESRD 36819 ESRD CPT ESRD 36820 ESRD CPT ESRD 36821 ESRD CPT ESRD 36831 ESRD CPT ESRD 36832 ESRD CPT ESRD 36833 ESRD CPT ESRD 90935 ESRD CPT ESRD 90937 ESRD CPT ESRD 90940 ESRD CPT ESRD 90945 ESRD CPT ESRD 90947 ESRD CPT ESRD 90957 ESRD CPT ESRD 90958 ESRD CPT ESRD 90959 ESRD CPT ESRD 90960 ESRD CPT ESRD 90961 ESRD CPT ESRD 90962 ESRD CPT ESRD 90965 ESRD CPT ESRD 90966 ESRD CPT ESRD 90969 ESRD CPT ESRD 90970 ESRD CPT ESRD 90989 ESRD CPT ESRD 90993 ESRD CPT ESRD 90997 ESRD CPT ESRD 90999 ESRD CPT ESRD 99512 ESRD CPT

1 61071060.6 ESRD G0257 Unscheduled or emergency HCPCS treatment for an esrd patient in a hospital outpatient department that is not certified as an esrd facility (G0257) ESRD S9339 Home ; peritoneal HCPCS dialysis, administrative services, professional services, care coordination and all necessary supplies and equipment (drugs and nursing visits coded separately), per diem (S9339) ESRD N18.5 [N18.5] Chronic , ICD10CM stage 5 ESRD N18.6 [N18.6] End stage renal disease ICD10CM ESRD Z91.15 [Z91.15] Patient's ICD10CM noncompliance with renal dialysis ESRD Z99.2 [Z99.2] Dependence on renal ICD10CM dialysis ESRD 3E1M39Z [3E1M39Z] Irrigation of ICD10PCS Peritoneal Cavity using Dialysate, Percutaneous Approach ESRD 5A1D00Z [5A1D00Z] Performance of ICD10PCS Urinary Filtration, Single ESRD 5A1D60Z [5A1D60Z] Performance of ICD10PCS Urinary Filtration, Multiple ESRD 585.5 Chron kidney dis stage V ICD9CM ESRD 585.6 End stage renal disease ICD9CM ESRD V45.11 Renal dialysis status ICD9CM ESRD V45.12 Noncmplnt w renal dialys ICD9CM ESRD 38.95 Ven cath renal dialysis ICD9PCS ESRD 39.27 Dialysis arteriovenostom ICD9PCS ESRD 39.42 Revis ren dialysis shunt ICD9PCS ESRD 39.43 Remov ren dialysis shunt ICD9PCS ESRD 39.53 Arterioven fistula rep ICD9PCS ESRD 39.93 Insert ves-to-ves cannul ICD9PCS ESRD 39.94 Replac ves-to-ves cannul ICD9PCS ESRD 39.95 Hemodialysis ICD9PCS ESRD 54.98 Peritoneal dialysis ICD9PCS ESRD 65 End-Stage Renal Disease POS Treatment Facility ESRD 0800 ESRD UBREV ESRD 0801 ESRD UBREV ESRD 0802 ESRD UBREV ESRD 0803 ESRD UBREV ESRD 0804 ESRD UBREV ESRD 0809 ESRD UBREV

2 61071060.6 ESRD 0820 ESRD UBREV ESRD 0821 ESRD UBREV ESRD 0822 ESRD UBREV ESRD 0823 ESRD UBREV ESRD 0824 ESRD UBREV ESRD 0825 ESRD UBREV ESRD 0829 ESRD UBREV ESRD 0830 ESRD UBREV ESRD 0831 ESRD UBREV ESRD 0832 ESRD UBREV ESRD 0833 ESRD UBREV ESRD 0834 ESRD UBREV ESRD 0835 ESRD UBREV ESRD 0839 ESRD UBREV ESRD 0840 ESRD UBREV ESRD 0841 ESRD UBREV ESRD 0842 ESRD UBREV ESRD 0843 ESRD UBREV ESRD 0844 ESRD UBREV ESRD 0845 ESRD UBREV ESRD 0849 ESRD UBREV ESRD 0850 ESRD UBREV ESRD 0851 ESRD UBREV ESRD 0852 ESRD UBREV ESRD 0853 ESRD UBREV ESRD 0854 ESRD UBREV ESRD 0855 ESRD UBREV ESRD 0859 ESRD UBREV ESRD 0880 ESRD UBREV ESRD 0881 ESRD UBREV ESRD 0882 ESRD UBREV ESRD 0889 ESRD UBREV ESRD 0720 ESRD UBTOB ESRD 0721 ESRD UBTOB ESRD 0722 ESRD UBTOB ESRD 0723 ESRD UBTOB ESRD 0724 ESRD UBTOB ESRD 0725 ESRD UBTOB ESRD 0727 ESRD UBTOB ESRD 0728 ESRD UBTOB ESRD 072A ESRD UBTOB ESRD 072B ESRD UBTOB ESRD 072C ESRD UBTOB ESRD 072D ESRD UBTOB ESRD 072E ESRD UBTOB ESRD 072F ESRD UBTOB ESRD 072G ESRD UBTOB ESRD 072H ESRD UBTOB ESRD 072I ESRD UBTOB

3 61071060.6 ESRD 072J ESRD UBTOB ESRD 072K ESRD UBTOB ESRD 072M ESRD UBTOB ESRD 072O ESRD UBTOB ESRD 072X ESRD UBTOB ESRD 072Y ESRD UBTOB ESRD 072Z ESRD UBTOB Kidney Transplant 50300 Kidney Transplant CPT Kidney Transplant 50320 Kidney Transplant CPT Kidney Transplant 50340 Kidney Transplant CPT Kidney Transplant 50360 Kidney Transplant CPT Kidney Transplant 50365 Kidney Transplant CPT Kidney Transplant 50370 Kidney Transplant CPT Kidney Transplant 50380 Kidney Transplant CPT Kidney Transplant S2065 Simultaneous pancreas kidney HCPCS transplantation (S2065) Kidney Transplant Z94.0 [Z94.0] Kidney transplant status ICD10CM Kidney Transplant 0TY00Z0 [0TY00Z0] Transplantation of ICD10PCS Right Kidney, Allogeneic, Open Approach Kidney Transplant 0TY00Z1 [0TY00Z1] Transplantation of ICD10PCS Right Kidney, Syngeneic, Open Approach Kidney Transplant 0TY00Z2 [0TY00Z2] Transplantation of ICD10PCS Right Kidney, Zooplastic, Open Approach Kidney Transplant 0TY10Z0 [0TY10Z0] Transplantation of ICD10PCS Left Kidney, Allogeneic, Open Approach Kidney Transplant 0TY10Z1 [0TY10Z1] Transplantation of ICD10PCS Left Kidney, Syngeneic, Open Approach Kidney Transplant 0TY10Z2 [0TY10Z2] Transplantation of ICD10PCS Left Kidney, Zooplastic, Open Approach Kidney Transplant V42.0 Kidney transplant status ICD9CM Kidney Transplant 55.61 Renal autotransplant ICD9PCS Kidney Transplant 55.69 Kidney transplant NEC ICD9PCS Kidney Transplant 0367 Kidney Transplant UBREV Nephropathy 3066F Nephropathy Treatment CPT Treatment Nephropathy 4010F Nephropathy Treatment CPT Treatment Nephropathy E08.21 [E08.21] Diabetes mellitus due ICD10CM Treatment to underlying condition with Nephropathy E08.22 [E08.22] Diabetes mellitus due ICD10CM Treatment to underlying condition with diabetic

4 61071060.6 Nephropathy E08.29 [E08.29] Diabetes mellitus due ICD10CM Treatment to underlying condition with other diabetic kidney complication Nephropathy E09.21 [E09.21] Drug or chemical ICD10CM Treatment induced diabetes mellitus with diabetic nephropathy Nephropathy E09.22 [E09.22] Drug or chemical ICD10CM Treatment induced diabetes mellitus with diabetic chronic kidney disease Nephropathy E09.29 [E09.29] Drug or chemical ICD10CM Treatment induced diabetes mellitus with other diabetic kidney complication Nephropathy E10.21 [E10.21] Type 1 diabetes ICD10CM Treatment mellitus with diabetic nephropathy Nephropathy E10.22 [E10.22] Type 1 diabetes ICD10CM Treatment mellitus with diabetic chronic kidney disease Nephropathy E10.29 [E10.29] Type 1 diabetes ICD10CM Treatment mellitus with other diabetic kidney complication Nephropathy E11.21 [E11.21] Type 2 diabetes ICD10CM Treatment mellitus with diabetic nephropathy Nephropathy E11.22 [E11.22] Type 2 diabetes ICD10CM Treatment mellitus with diabetic chronic kidney disease Nephropathy E11.29 [E11.29] Type 2 diabetes ICD10CM Treatment mellitus with other diabetic kidney complication Nephropathy E13.21 [E13.21] Other specified ICD10CM Treatment diabetes mellitus with diabetic nephropathy Nephropathy E13.22 [E13.22] Other specified ICD10CM Treatment diabetes mellitus with diabetic chronic kidney disease Nephropathy E13.29 [E13.29] Other specified ICD10CM Treatment diabetes mellitus with other diabetic kidney complication Nephropathy I12.0 [I12.0] Hypertensive chronic ICD10CM Treatment kidney disease with stage 5 chronic kidney disease or end stage renal disease Nephropathy I12.9 [I12.9] Hypertensive chronic ICD10CM Treatment kidney disease with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease

5 61071060.6 Nephropathy I13.0 [I13.0] Hypertensive and ICD10CM Treatment chronic kidney disease with heart failure and stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease Nephropathy I13.10 [I13.10] Hypertensive heart and ICD10CM Treatment chronic kidney disease without heart failure, with stage 1 through stage 4 chronic kidney disease, or unspecified chronic kidney disease Nephropathy I13.11 [I13.11] Hypertensive heart and ICD10CM Treatment chronic kidney disease without heart failure, with stage 5 chronic kidney disease, or end stage renal disease Nephropathy I13.2 [I13.2] Hypertensive heart and ICD10CM Treatment chronic kidney disease with heart failure and with stage 5 chronic kidney disease, or end stage renal disease Nephropathy I15.0 [I15.0] Renovascular ICD10CM Treatment Nephropathy I15.1 [I15.1] Hypertension secondary ICD10CM Treatment to other renal disorders Nephropathy N00.0 [N00.0] Acute nephritic ICD10CM Treatment with minor glomerular abnormality Nephropathy N00.1 [N00.1] Acute nephritic ICD10CM Treatment syndrome with focal and segmental glomerular lesions Nephropathy N00.2 [N00.2] Acute nephritic ICD10CM Treatment syndrome with diffuse membranous Nephropathy N00.3 [N00.3] Acute nephritic ICD10CM Treatment syndrome with diffuse mesangial proliferative glomerulonephritis Nephropathy N00.4 [N00.4] Acute nephritic ICD10CM Treatment syndrome with diffuse endocapillary proliferative glomerulonephritis Nephropathy N00.5 [N00.5] Acute nephritic ICD10CM Treatment syndrome with diffuse mesangiocapillary glomerulonephritis Nephropathy N00.6 [N00.6] Acute nephritic ICD10CM Treatment syndrome with dense deposit disease

6 61071060.6 Nephropathy N00.7 [N00.7] Acute nephritic ICD10CM Treatment syndrome with diffuse crescentic glomerulonephritis Nephropathy N00.8 [N00.8] Acute nephritic ICD10CM Treatment syndrome with other morphologic changes Nephropathy N00.9 [N00.9] Acute nephritic ICD10CM Treatment syndrome with unspecified morphologic changes Nephropathy N01.0 [N01.0] Rapidly progressive ICD10CM Treatment nephritic syndrome with minor glomerular abnormality Nephropathy N01.1 [N01.1] Rapidly progressive ICD10CM Treatment nephritic syndrome with focal and segmental glomerular lesions Nephropathy N01.2 [N01.2] Rapidly progressive ICD10CM Treatment nephritic syndrome with diffuse membranous glomerulonephritis Nephropathy N01.3 [N01.3] Rapidly progressive ICD10CM Treatment nephritic syndrome with diffuse mesangial proliferative glomerulonephritis Nephropathy N01.4 [N01.4] Rapidly progressive ICD10CM Treatment nephritic syndrome with diffuse endocapillary proliferative glomerulonephritis Nephropathy N01.5 [N01.5] Rapidly progressive ICD10CM Treatment nephritic syndrome with diffuse mesangiocapillary glomerulonephritis Nephropathy N01.6 [N01.6] Rapidly progressive ICD10CM Treatment nephritic syndrome with dense deposit disease Nephropathy N01.7 [N01.7] Rapidly progressive ICD10CM Treatment nephritic syndrome with diffuse crescentic glomerulonephritis Nephropathy N01.8 [N01.8] Rapidly progressive ICD10CM Treatment nephritic syndrome with other morphologic changes Nephropathy N01.9 [N01.9] Rapidly progressive ICD10CM Treatment nephritic syndrome with unspecified morphologic changes Nephropathy N02.0 [N02.0] Recurrent and ICD10CM Treatment persistent with minor glomerular abnormality Nephropathy N02.1 [N02.1] Recurrent and ICD10CM Treatment persistent hematuria with focal nd segmental glomerular lesions

7 61071060.6 Nephropathy N02.2 [N02.2] Recurrent and ICD10CM Treatment persistent hematuria with diffuse membranous glomerulonephritis Nephropathy N02.3 [N02.3] Recurrent and ICD10CM Treatment persistent hematuria with diffuse mesangial proliferative glomerulonephritis Nephropathy N02.4 [N02.4] Recurrent and ICD10CM Treatment persistent hematuria with diffuse endocapillary proliferative glomerulonephritis Nephropathy N02.5 [N02.5] Recurrent and ICD10CM Treatment persistent hematuria with diffuse mesangiocapillary glomerulonephritis Nephropathy N02.6 [N02.6] Recurrent and ICD10CM Treatment persistent hematuria with dense deposit disease Nephropathy N02.7 [N02.7] Recurrent and ICD10CM Treatment persistent hematuria with diffuse crescentic glomerulonephritis Nephropathy N02.8 [N02.8] Recurrent and ICD10CM Treatment persistent hematuria with other morphologic changes Nephropathy N02.9 [N02.9] Recurrent and ICD10CM Treatment persistent hematuria with unspecified morphologic changes Nephropathy N03.0 [N03.0] Chronic nephritic ICD10CM Treatment syndrome with minor glomerular abnormality Nephropathy N03.1 [N03.1] Chronic nephritic ICD10CM Treatment syndrome with focal and segmental glomerular lesions Nephropathy N03.2 [N03.2] Chronic nephritic ICD10CM Treatment syndrome with diffuse membranous glomerulonephritis Nephropathy N03.3 [N03.3] Chronic nephritic ICD10CM Treatment syndrome with diffuse mesangial proliferative glomerulonephritis Nephropathy N03.4 [N03.4] Chronic nephritic ICD10CM Treatment syndrome with diffuse endocapillary proliferative glomerulonephritis

8 61071060.6 Nephropathy N03.5 [N03.5] Chronic nephritic ICD10CM Treatment syndrome with diffuse mesangiocapillary glomerulonephritis Nephropathy N03.6 [N03.6] Chronic nephritic ICD10CM Treatment syndrome with dense deposit disease Nephropathy N03.7 [N03.7] Chronic nephritic ICD10CM Treatment syndrome with diffuse crescentic glomerulonephritis Nephropathy N03.8 [N03.8] Chronic nephritic ICD10CM Treatment syndrome with other morphologic changes Nephropathy N03.9 [N03.9] Chronic nephritic ICD10CM Treatment syndrome with unspecified morphologic changes Nephropathy N04.0 [N04.0] ICD10CM Treatment with minor glomerular abnormality Nephropathy N04.1 [N04.1] Nephrotic syndrome ICD10CM Treatment with focal and segmental glomerular lesions Nephropathy N04.2 [N04.2] Nephrotic syndrome ICD10CM Treatment with diffuse membranous glomerulonephritis Nephropathy N04.3 [N04.3] Nephrotic syndrome ICD10CM Treatment with diffuse mesangial proliferative glomerulonephritis Nephropathy N04.4 [N04.4] Nephrotic syndrome ICD10CM Treatment with diffuse endocapillary proliferative glomerulonephritis Nephropathy N04.5 [N04.5] Nephrotic syndrome ICD10CM Treatment with diffuse mesangiocapillary glomerulonephritis Nephropathy N04.6 [N04.6] Nephrotic syndrome ICD10CM Treatment with dense deposit disease Nephropathy N04.7 [N04.7] Nephrotic syndrome ICD10CM Treatment with diffuse crescentic glomerulonephritis Nephropathy N04.8 [N04.8] Nephrotic syndrome ICD10CM Treatment with other morphologic changes Nephropathy N04.9 [N04.9] Nephrotic syndrome ICD10CM Treatment with unspecified morphologic changes Nephropathy N05.0 [N05.0] Unspecified nephritic ICD10CM Treatment syndrome with minor glomerular abnormality Nephropathy N05.1 [N05.1] Unspecified nephritic ICD10CM Treatment syndrome with focal and segmental glomerular lesions

9 61071060.6 Nephropathy N05.2 [N05.2] Unspecified nephritic ICD10CM Treatment syndrome with diffuse membranous glomerulonephritis Nephropathy N05.3 [N05.3] Unspecified nephritic ICD10CM Treatment syndrome with diffuse mesangial proliferative glomerulonephritis Nephropathy N05.4 [N05.4] Unspecified nephritic ICD10CM Treatment syndrome with diffuse endocapillary proliferative glomerulonephritis Nephropathy N05.5 [N05.5] Unspecified nephritic ICD10CM Treatment syndrome with diffuse mesangiocapillary glomerulonephritis Nephropathy N05.6 [N05.6] Unspecified nephritic ICD10CM Treatment syndrome with dense deposit disease Nephropathy N05.7 [N05.7] Unspecified nephritic ICD10CM Treatment syndrome with diffuse crescentic glomerulonephritis Nephropathy N05.8 [N05.8] Unspecified nephritic ICD10CM Treatment syndrome with other morphologic changes Nephropathy N05.9 [N05.9] Unspecified nephritic ICD10CM Treatment syndrome with unspecified morphologic changes Nephropathy N06.0 [N06.0] Isolated ICD10CM Treatment with minor glomerular abnormality Nephropathy N06.1 [N06.1] Isolated proteinuria ICD10CM Treatment with focal and segmental glomerular lesions Nephropathy N06.2 [N06.2] Isolated proteinuria ICD10CM Treatment with diffuse membranous glomerulonephritis Nephropathy N06.3 [N06.3] Isolated proteinuria ICD10CM Treatment with diffuse mesangial proliferative glomerulonephritis Nephropathy N06.4 [N06.4] Isolated proteinuria ICD10CM Treatment with diffuse endocapillary proliferative glomerulonephritis Nephropathy N06.5 [N06.5] Isolated proteinuria ICD10CM Treatment with diffuse mesangiocapillary glomerulonephritis Nephropathy N06.6 [N06.6] Isolated proteinuria ICD10CM Treatment with dense deposit disease Nephropathy N06.7 [N06.7] Isolated proteinuria ICD10CM Treatment with diffuse crescentic glomerulonephritis

10 61071060.6 Nephropathy N06.8 [N06.8] Isolated proteinuria ICD10CM Treatment with other morphologic lesion Nephropathy N06.9 [N06.9] Isolated proteinuria ICD10CM Treatment with unspecified morphologic lesion Nephropathy N07.0 [N07.0] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with minor glomerular abnormality Nephropathy N07.1 [N07.1] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with focal and segmental glomerular lesions Nephropathy N07.2 [N07.2] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with diffuse membranous glomerulonephritis Nephropathy N07.3 [N07.3] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with diffuse mesangial proliferative glomerulonephritis Nephropathy N07.4 [N07.4] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with diffuse endocapillary proliferative glomerulonephritis Nephropathy N07.5 [N07.5] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with diffuse mesangiocapillary glomerulonephritis Nephropathy N07.6 [N07.6] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with dense deposit disease Nephropathy N07.7 [N07.7] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with diffuse crescentic glomerulonephritis Nephropathy N07.8 [N07.8] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with other morphologic lesions Nephropathy N07.9 [N07.9] Hereditary ICD10CM Treatment nephropathy, not elsewhere classified with unspecified morphologic lesions Nephropathy N08 [N08] Glomerular disorders in ICD10CM Treatment classified elsewhere Nephropathy N14.0 [N14.0] Analgesic nephropathy ICD10CM Treatment

11 61071060.6 Nephropathy N14.1 [N14.1] Nephropathy induced ICD10CM Treatment by other drugs, medicaments and biological substances Nephropathy N14.2 [N14.2] Nephropathy induced ICD10CM Treatment by unspecified drug, medicament or biological substance Nephropathy N14.3 [N14.3] Nephropathy induced ICD10CM Treatment by heavy metals Nephropathy N14.4 [N14.4] Toxic nephropathy, not ICD10CM Treatment elsewhere classified Nephropathy N17.0 [N17.0] Acute ICD10CM Treatment with tubular necrosis Nephropathy N17.1 [N17.1] Acute kidney failure ICD10CM Treatment with acute cortical necrosis Nephropathy N17.2 [N17.2] Acute kidney failure ICD10CM Treatment with medullary necrosis Nephropathy N17.8 [N17.8] Other acute kidney ICD10CM Treatment failure Nephropathy N17.9 [N17.9] Acute kidney failure, ICD10CM Treatment unspecified Nephropathy N18.1 [N18.1] Chronic kidney disease, ICD10CM Treatment stage 1 Nephropathy N18.2 [N18.2] Chronic kidney disease, ICD10CM Treatment stage 2 (mild) Nephropathy N18.3 [N18.3] Chronic kidney disease, ICD10CM Treatment stage 3 (moderate) Nephropathy N18.4 [N18.4] Chronic kidney disease, ICD10CM Treatment stage 4 (severe) Nephropathy N18.5 [N18.5] Chronic kidney disease, ICD10CM Treatment stage 5 Nephropathy N18.6 [N18.6] End stage renal disease ICD10CM Treatment Nephropathy N18.9 [N18.9] Chronic kidney disease, ICD10CM Treatment unspecified Nephropathy N19 [N19] Unspecified kidney failure ICD10CM Treatment Nephropathy N25.0 [N25.0] ICD10CM Treatment Nephropathy N25.1 [N25.1] Nephrogenic diabetes ICD10CM Treatment insipidus Nephropathy N25.81 [N25.81] Secondary ICD10CM Treatment hyperparathyroidism of renal origin Nephropathy N25.89 [N25.89] Other disorders ICD10CM Treatment resulting from impaired renal tubular function Nephropathy N25.9 [N25.9] Disorder resulting from ICD10CM Treatment impaired renal tubular function, unspecified

12 61071060.6 Nephropathy N26.1 [N26.1] Atrophy of kidney ICD10CM Treatment (terminal) Nephropathy N26.2 [N26.2] Page kidney ICD10CM Treatment Nephropathy N26.9 [N26.9] Renal sclerosis, ICD10CM Treatment unspecified Nephropathy Q60.0 [Q60.0] Renal agenesis, ICD10CM Treatment unilateral Nephropathy Q60.1 [Q60.1] Renal agenesis, bilateral ICD10CM Treatment Nephropathy Q60.2 [Q60.2] Renal agenesis, ICD10CM Treatment unspecified Nephropathy Q60.3 [Q60.3] Renal hypoplasia, ICD10CM Treatment unilateral Nephropathy Q60.4 [Q60.4] Renal hypoplasia, ICD10CM Treatment bilateral Nephropathy Q60.5 [Q60.5] Renal hypoplasia, ICD10CM Treatment unspecified Nephropathy Q60.6 [Q60.6] Potter's syndrome ICD10CM Treatment Nephropathy Q61.00 [Q61.00] Congenital renal cyst, ICD10CM Treatment unspecified Nephropathy Q61.01 [Q61.01] Congenital single renal ICD10CM Treatment cyst Nephropathy Q61.02 [Q61.02] Congenital multiple ICD10CM Treatment renal cysts Nephropathy Q61.11 [Q61.11] Cystic dilatation of ICD10CM Treatment collecting ducts Nephropathy Q61.19 [Q61.19] Other polycystic ICD10CM Treatment kidney, infantile type Nephropathy Q61.2 [Q61.2] Polycystic kidney, adult ICD10CM Treatment type Nephropathy Q61.3 [Q61.3] Polycystic kidney, ICD10CM Treatment unspecified Nephropathy Q61.4 [Q61.4] Renal dysplasia ICD10CM Treatment Nephropathy Q61.5 [Q61.5] Medullary cystic kidney ICD10CM Treatment Nephropathy Q61.8 [Q61.8] Other cystic kidney ICD10CM Treatment diseases Nephropathy Q61.9 [Q61.9] Cystic kidney disease, ICD10CM Treatment unspecified Nephropathy R80.0 [R80.0] Isolated proteinuria ICD10CM Treatment Nephropathy R80.1 [R80.1] Persistent proteinuria, ICD10CM Treatment unspecified Nephropathy R80.2 [R80.2] Orthostatic proteinuria, ICD10CM Treatment unspecified Nephropathy R80.3 [R80.3] Bence Jones proteinuria ICD10CM Treatment

13 61071060.6 Nephropathy R80.8 [R80.8] Other proteinuria ICD10CM Treatment Nephropathy R80.9 [R80.9] Proteinuria, unspecified ICD10CM Treatment Nephropathy 250.40 DMII renl nt st uncntrld ICD9CM Treatment Nephropathy 250.41 DMI renl nt st uncntrld ICD9CM Treatment Nephropathy 250.42 DMII renal uncntrld ICD9CM Treatment Nephropathy 250.43 DMI renal uncntrld ICD9CM Treatment Nephropathy 403.00 Mal hy kid w cr kid I-IV ICD9CM Treatment Nephropathy 403.01 Mal hyp kid w cr kid V ICD9CM Treatment Nephropathy 403.10 Ben hy kid w cr kid I-IV ICD9CM Treatment Nephropathy 403.11 Ben hyp kid w cr kid V ICD9CM Treatment Nephropathy 403.90 Hy kid NOS w cr kid I-IV ICD9CM Treatment Nephropathy 403.91 Hyp kid NOS w cr kid V ICD9CM Treatment Nephropathy 404.00 Mal hy ht/kd I-IV w/o hf ICD9CM Treatment Nephropathy 404.01 Mal hyp ht/kd I-IV w hf ICD9CM Treatment Nephropathy 404.02 Mal hy ht/kd st V w/o hf ICD9CM Treatment Nephropathy 404.03 Mal hyp ht/kd stg V w hf ICD9CM Treatment Nephropathy 404.10 Ben hy ht/kd I-IV w/o hf ICD9CM Treatment Nephropathy 404.11 Ben hyp ht/kd I-IV w hf ICD9CM Treatment Nephropathy 404.12 Ben hy ht/kd st V w/o hf ICD9CM Treatment Nephropathy 404.13 Ben hyp ht/kd stg V w hf ICD9CM Treatment Nephropathy 404.90 Hy ht/kd NOS I-IV w/o hf ICD9CM Treatment Nephropathy 404.91 Hyp ht/kd NOS I-IV w hf ICD9CM Treatment Nephropathy 404.92 Hy ht/kd NOS st V w/o hf ICD9CM Treatment Nephropathy 404.93 Hyp ht/kd NOS st V w hf ICD9CM Treatment Nephropathy 405.01 Mal renovasc hypertens ICD9CM Treatment

14 61071060.6 Nephropathy 405.11 Benign renovasc hyperten ICD9CM Treatment Nephropathy 405.91 Renovasc hypertension ICD9CM Treatment Nephropathy 580.0 Ac proliferat ICD9CM Treatment Nephropathy 580.4 Ac rapidly progr nephrit ICD9CM Treatment Nephropathy 580.81 Ac nephritis in oth dis ICD9CM Treatment Nephropathy 580.89 Acute nephritis NEC ICD9CM Treatment Nephropathy 580.9 Acute nephritis NOS ICD9CM Treatment Nephropathy 581.0 Nephrotic syn, prolifer ICD9CM Treatment Nephropathy 581.1 Epimembranous nephritis ICD9CM Treatment Nephropathy 581.2 Membranoprolif ICD9CM Treatment Nephropathy 581.3 Minimal change nephrosis ICD9CM Treatment Nephropathy 581.81 Nephrotic syn in oth dis ICD9CM Treatment Nephropathy 581.89 Nephrotic syndrome NEC ICD9CM Treatment Nephropathy 581.9 Nephrotic syndrome NOS ICD9CM Treatment Nephropathy 582.0 Chr proliferat nephritis ICD9CM Treatment Nephropathy 582.1 Chr membranous nephritis ICD9CM Treatment Nephropathy 582.2 Chr membranoprolif nephr ICD9CM Treatment Nephropathy 582.4 Chr rapid progr nephrit ICD9CM Treatment Nephropathy 582.81 Chr nephritis in oth dis ICD9CM Treatment Nephropathy 582.89 Chronic nephritis NEC ICD9CM Treatment Nephropathy 582.9 Chronic nephritis NOS ICD9CM Treatment Nephropathy 583.0 Proliferat nephritis NOS ICD9CM Treatment Nephropathy 583.1 Membranous nephritis NOS ICD9CM Treatment Nephropathy 583.2 Membranoprolif nephr NOS ICD9CM Treatment Nephropathy 583.4 Rapidly prog nephrit NOS ICD9CM Treatment

15 61071060.6 Nephropathy 583.6 Renal cort necrosis NOS ICD9CM Treatment Nephropathy 583.7 Nephr NOS/medull necros ICD9CM Treatment Nephropathy 583.81 Nephritis NOS in oth dis ICD9CM Treatment Nephropathy 583.89 Nephritis NEC ICD9CM Treatment Nephropathy 583.9 Nephritis NOS ICD9CM Treatment Nephropathy 584.5 Ac kidny fail, tubr necr ICD9CM Treatment Nephropathy 584.6 Ac kidny fail, cort necr ICD9CM Treatment Nephropathy 584.7 Ac kidny fail, medu necr ICD9CM Treatment Nephropathy 584.8 Acute kidney failure NEC ICD9CM Treatment Nephropathy 584.9 Acute kidney failure NOS ICD9CM Treatment Nephropathy 585.1 Chro kidney dis stage I ICD9CM Treatment Nephropathy 585.2 Chro kidney dis stage II ICD9CM Treatment Nephropathy 585.3 Chr kidney dis stage III ICD9CM Treatment Nephropathy 585.9 Chronic kidney dis NOS ICD9CM Treatment Nephropathy 586 Renal failure NOS ICD9CM Treatment Nephropathy 587 Renal sclerosis NOS ICD9CM Treatment Nephropathy 588.0 Renal osteodystrophy ICD9CM Treatment Nephropathy 588.1 Nephrogen diabetes insip ICD9CM Treatment Nephropathy 588.81 Sec hyperparathyrd-renal ICD9CM Treatment Nephropathy 588.89 Impair ren funct dis NEC ICD9CM Treatment Nephropathy 588.9 Impaired renal funct NOS ICD9CM Treatment Nephropathy 753.0 Renal agenesis ICD9CM Treatment Nephropathy 753.10 Cystic kidney diseas NOS ICD9CM Treatment Nephropathy 753.11 Congenital renal cyst ICD9CM Treatment Nephropathy 753.12 Polycystic kidney NOS ICD9CM Treatment Nephropathy 753.13 Polycyst kid-autosom dom ICD9CM Treatment

16 61071060.6 Nephropathy 753.14 Polycyst kid-autosom rec ICD9CM Treatment Nephropathy 753.15 Renal dysplasia ICD9CM Treatment Nephropathy 753.16 Medullary cystic kidney ICD9CM Treatment Nephropathy 753.17 Medullary sponge kidney ICD9CM Treatment Nephropathy 753.19 Cystic kidney diseas NEC ICD9CM Treatment Nephropathy 791.0 Proteinuria ICD9CM Treatment Tests 81000 Urine Protein Tests CPT Urine Protein Tests 81001 Urine Protein Tests CPT Urine Protein Tests 81002 Urine Protein Tests CPT Urine Protein Tests 81003 Urine Protein Tests CPT Urine Protein Tests 81005 Urine Protein Tests CPT Urine Protein Tests 82042 Urine Protein Tests CPT Urine Protein Tests 82043 Urine Protein Tests CPT Urine Protein Tests 82044 Urine Protein Tests CPT Urine Protein Tests 84156 Urine Protein Tests CPT Urine Protein Tests 3060F Urine Protein Tests CPT Urine Protein Tests 3061F Urine Protein Tests CPT Urine Protein Tests 3062F Urine Protein Tests CPT Urine Protein Tests 11218-5 Microalbumin [Mass/volume] in LOINC Urine by Test strip Urine Protein Tests 12842-1 Protein [Mass/volume] in 12 LOINC hour Urine Urine Protein Tests 13705-9 / [Mass LOINC Ratio] in 24 hour Urine Urine Protein Tests 13801-6 Protein/Creatinine [Mass Ratio] LOINC in 24 hour Urine Urine Protein Tests 14585-4 Albumin/Creatinine [Molar LOINC ratio] in Urine Urine Protein Tests 14956-7 Microalbumin [Mass/time] in 24 LOINC hour Urine Urine Protein Tests 14957-5 Microalbumin [Mass/volume] in LOINC Urine Urine Protein Tests 14958-3 Microalbumin/Creatinine [Mass LOINC Ratio] in 24 hour Urine Urine Protein Tests 14959-1 Microalbumin/Creatinine [Mass LOINC Ratio] in Urine Urine Protein Tests 1753-3 Albumin [Presence] in Urine LOINC Urine Protein Tests 1754-1 Albumin [Mass/volume] in LOINC Urine Urine Protein Tests 1755-8 Albumin [Mass/time] in 24 hour LOINC Urine Urine Protein Tests 1757-4 Albumin renal clearance in 24 LOINC hour Urine Protein Tests 18373-1 Protein [Mass/time] in 6 hour LOINC Urine

17 61071060.6 Urine Protein Tests 20454-5 Protein [Presence] in Urine by LOINC Test strip Urine Protein Tests 20621-9 Albumin/Creatinine [Presence] LOINC in Urine by Test strip Urine Protein Tests 21059-1 Albumin [Mass/volume] in 24 LOINC hour Urine Urine Protein Tests 21482-5 Protein [Mass/volume] in 24 LOINC hour Urine Urine Protein Tests 26801-1 Protein [Mass/time] in 12 hour LOINC Urine Urine Protein Tests 27298-9 Protein [Units/volume] in Urine LOINC Urine Protein Tests 2887-8 Protein [Presence] in Urine LOINC Urine Protein Tests 2888-6 Protein [Mass/volume] in Urine LOINC Urine Protein Tests 2889-4 Protein [Mass/time] in 24 hour LOINC Urine Urine Protein Tests 2890-2 Protein/Creatinine [Mass Ratio] LOINC in Urine Urine Protein Tests 30000-4 Microalbumin/Creatinine LOINC [Ratio] in Urine Urine Protein Tests 30001-2 Microalbumin/Creatinine LOINC [Ratio] in Urine by Test strip Urine Protein Tests 30003-8 Microalbumin [Mass/volume] in LOINC 24 hour Urine Urine Protein Tests 32209-9 Protein [Presence] in 24 hour LOINC Urine by Test strip Urine Protein Tests 32294-1 Albumin/Creatinine [Ratio] in LOINC Urine Urine Protein Tests 32551-4 Protein [Mass] in Urine LOINC collected for unspecified duration Urine Protein Tests 34366-5 Protein/Creatinine [Ratio] in LOINC Urine Urine Protein Tests 35663-4 Protein [Mass/volume] in Urine LOINC collected for unspecified duration Urine Protein Tests 40486-3 Protein/Creatinine [Ratio] in 24 LOINC hour Urine Urine Protein Tests 40662-9 Protein [Mass/time] in 12 hour LOINC Urine --resting Urine Protein Tests 40663-7 Protein [Mass/time] in 12 hour LOINC Urine --upright Urine Protein Tests 43605-5 Microalbumin [Mass/volume] in LOINC 4 hour Urine Urine Protein Tests 43606-3 Microalbumin [Mass/time] in 4 LOINC hour Urine Urine Protein Tests 43607-1 Microalbumin [Mass/time] in 12 LOINC hour Urine Urine Protein Tests 44292-1 Microalbumin/Creatinine [Mass LOINC Ratio] in 12 hour Urine Urine Protein Tests 47558-2 Microalbumin/Protein.total in LOINC 24 hour Urine

18 61071060.6 Urine Protein Tests 49023-5 Microalbumin [Mass/time] in LOINC Urine collected for unspecified duration Urine Protein Tests 50561-0 Protein [Mass/volume] in Urine LOINC by Automated test strip Urine Protein Tests 50949-7 Albumin [Presence] in Urine by LOINC Test strip Urine Protein Tests 53121-0 Protein [Mass/time] in 1 hour LOINC Urine Urine Protein Tests 53525-2 Protein [Presence] in Urine by LOINC SSA method Urine Protein Tests 53530-2 Microalbumin [Mass/volume] in LOINC 24 hour Urine by Detection limit <= 1.0 mg/L Urine Protein Tests 53531-0 Microalbumin [Mass/volume] in LOINC Urine by Detection limit <= 1.0 mg/L Urine Protein Tests 53532-8 Microalbumin [Mass/time] in 24 LOINC hour Urine by Detection limit <= 1.0 mg/L Urine Protein Tests 56553-1 Microalbumin [Mass/time] in 8 LOINC hour Urine Urine Protein Tests 57369-1 Microalbumin [Mass/volume] in LOINC 12 hour Urine Urine Protein Tests 57735-3 Protein [Presence] in Urine by LOINC Automated test strip Urine Protein Tests 5804-0 Protein [Mass/volume] in Urine LOINC by Test strip Urine Protein Tests 58448-2 Microalbumin ug/min LOINC [Mass/time] in 24 hour Urine Urine Protein Tests 58992-9 Protein [Mass/time] in 18 hour LOINC Urine Urine Protein Tests 59159-4 Microalbumin/Creatinine LOINC [Ratio] in 24 hour Urine Urine Protein Tests 60678-0 Protein/Creatinine [Mass Ratio] LOINC in 12 hour Urine Urine Protein Tests 63474-1 Microalbumin [Mass/time] in 18 LOINC hour Urine Urine Protein Tests 76401-9 Albumin/Creatinine [Ratio] in 24 LOINC hour Urine Urine Protein Tests 77158-4 Albumin [Moles/volume] in LOINC Urine by Detection limit <= 3.0 mg/L Urine Protein Tests 77253-3 Microalbumin/Creatinine LOINC [Ratio] in Urine by Detection limit <= 1.0 mg/L Urine Protein Tests 77254-1 Microalbumin/Creatinine LOINC [Ratio] in 24 hour Urine by Detection limit <= 1.0 mg/L Urine Protein Tests 9318-7 Albumin/Creatinine [Mass LOINC Ratio] in Urine

19 61071060.6 CDC-L: ACE Benazepril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Captopril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Enalapril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Enalapril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Fosinopril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Lisinopril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Moexipril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Perindopril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Quinapril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Ramipril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Trandolapril Angiotensin converting enzyme Medication Inhibitors/ARBs inhibitors CDC-L: ACE Azilsartan Angiotensin II inhibitors Medication Inhibitors/ARBs CDC-L: ACE Candesartan Angiotensin II inhibitors Medication Inhibitors/ARBs CDC-L: ACE Eprosartan Angiotensin II inhibitors Medication Inhibitors/ARBs CDC-L: ACE Irbesartan Angiotensin II inhibitors Medication Inhibitors/ARBs CDC-L: ACE Losartan Angiotensin II inhibitors Medication Inhibitors/ARBs CDC-L: ACE Olmesartan Angiotensin II inhibitors Medication Inhibitors/ARBs CDC-L: ACE Telmisartan Angiotensin II inhibitors Medication Inhibitors/ARBs CDC-L: ACE Valsartan Angiotensin II inhibitors Medication Inhibitors/ARBs CDC-L: ACE Aliskiren-valsartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Amlodipine-benazepril Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Amlodipine-hydrochlorothiazide-valsartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Amlodipine-hydrochlorothiazide-olmesartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Amlodipine-olmesartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Amlodipine-telmisartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Amlodipine-valsartan Antihypertensive combinations Medication Inhibitors/ARBs

20 61071060.6 CDC-L: ACE Azilsartan-chlorthalidone Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Benazepril-hydrochlorothiazide Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Candesartan-hydrochlorothiazide Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Captopril-hydrochlorothiazide Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Enalapril-hydrochlorothiazide Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Eprosartan-hydrochlorothiazide Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Fosinopril-hydrochlorothiazide Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Hydrochlorothiazide-irbesartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Hydrochlorothiazide-lisinopril Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Hydrochlorothiazide-losartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Hydrochlorothiazide-moexipril Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Hydrochlorothiazide-olmesartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Hydrochlorothiazide-quinapril Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Hydrochlorothiazide-telmisartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Hydrochlorothiazide-valsartan Antihypertensive combinations Medication Inhibitors/ARBs CDC-L: ACE Trandolapril-verapamil Antihypertensive combinations Medication Inhibitors/ARBs

21 61071060.6 Exhibit B-2

Codes to Identify Diabetic Eye Exam

Value Set Name Code Definition Code System Diabetes Mellitus Without E10.9 [E10.9] Type 1 diabetes mellitus without ICD10CM Complications complications Diabetes Mellitus Without E11.9 [E11.9] Type 2 diabetes mellitus without ICD10CM Complications complications Diabetes Mellitus Without E13.9 [E13.9] Other specified diabetes mellitus ICD10CM Complications without complications Diabetic Retinal Screening 67028 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67030 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67031 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67036 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67039 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67040 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67041 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67042 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67043 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67101 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67105 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67107 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67108 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67110 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67112 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67113 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67121 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67141 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67145 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67208 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67210 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67218 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67220 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67221 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67227 Diabetic Retinal Screening CPT Diabetic Retinal Screening 67228 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92002 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92004 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92012 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92014 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92018 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92019 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92134 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92225 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92226 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92227 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92228 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92230 Diabetic Retinal Screening CPT

22 61071060.6 Diabetic Retinal Screening 92235 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92240 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92250 Diabetic Retinal Screening CPT Diabetic Retinal Screening 92260 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99203 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99204 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99205 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99213 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99214 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99215 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99242 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99243 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99244 Diabetic Retinal Screening CPT Diabetic Retinal Screening 99245 Diabetic Retinal Screening CPT Diabetic Retinal Screening S0620 Routine ophthalmological examination including HCPCS refraction; new patient (S0620) Diabetic Retinal Screening S0621 Routine ophthalmological examination including HCPCS refraction; established patient (S0621) Diabetic Retinal Screening S3000 Diabetic indicator; retinal eye exam, dilated, HCPCS bilateral (S3000) Diabetic Retinal Screening Negative 3072F Diabetic Retinal Screening Negative CPT Diabetic Retinal Screening With Eye 2022F Diabetic Retinal Screening With Eye Care CPT Care Professional Professional Diabetic Retinal Screening With Eye 2024F Diabetic Retinal Screening With Eye Care CPT Care Professional Professional Diabetic Retinal Screening With Eye 2026F Diabetic Retinal Screening With Eye Care CPT Care Professional Professional Diabetic Retinal Screening With Eye Optometrist Provider Type Criteria; Provider Specialty must Provider Care Professional OR be present on Evaluation and Management Specialty Ophthalmologist claims charges count towards the numerator as an eye exam.

23 61071060.6