Medicaid Fee Schedule without Mods 200801
Medicaid Fee Schedule without Mods 200801
Medicaid Fee Schedule without Mods 200801
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PROC-CODE DESC MAC BEG END<br />
83015 HEAVY METAL SCREEN (ARSENIC, BISMUTH, MERCURY, $19.80 20060701 99999999<br />
83018 HEAVY METAL SCREEN (ARSENIC, BISMUTH, MERCURY, $30.35 20060701 99999999<br />
83020 HEMOGLOBIN $17.80 20060701 99999999<br />
83021<br />
HEMOGLOBIN FRACTIONATION AND QUANTITATION;<br />
CHROMOTOGRAPHY (EG, A2, S, C, AND/OR $24.96 20060701 99999999<br />
83026 HEMOGLOBIN; BY COPPER SULFATE METHOD, NON-AUTOMATED $3.26 20060701 99999999<br />
83030 HEMOGLOBIN $11.43 20060701 99999999<br />
83033 HEMOGLOBIN $8.24 20060701 99999999<br />
83036 HEMOGLOBIN $13.42 20060701 99999999<br />
83045 HEMOGLOBIN $4.16 20060701 99999999<br />
83050 HEMOGLOBIN $10.12 20060701 99999999<br />
83051 HEMOGLOBIN $6.13 20060701 99999999<br />
83055 HEMOGLOBIN $4.12 20060701 99999999<br />
83060 HEMOGLOBIN $6.94 20060701 99999999<br />
83065 HEMOGLOBIN $5.77 20060701 99999999<br />
83068 HEMOGLOBIN $7.10 20060701 99999999<br />
83069 HEMOGLOBIN $3.31 20060701 99999999<br />
83070 HEMOSIDERIN, URINE $6.56 20060701 99999999<br />
83071 HEMOSIDERIN, RIA $5.77 20060701 99999999<br />
83080 B-HEXOSAMINIDASE, EACH ASSAY $23.31 20060701 99999999<br />
83088 HISTAMINE $40.81 20060701 99999999<br />
83090 HOMOCYSTINE $23.31 20060701 99999999<br />
83150 HOMOVANILLIC ACID (HVA), URINE $19.80 20060701 99999999<br />
83491 HYDROXYCORTICOSTEROIDS, 17- (17-OHCS) $14.68 20060701 99999999<br />
83497 HYDROXYINDOLACETIC ACID, 5-(HIAA), URINE $17.82 20060701 99999999<br />
83498 HYDROXYPROGESTERONE, 17-D, RIA $37.54 20060701 99999999<br />
83499 HYDROXYPROGESTERONE, 20- $21.13 20060701 99999999<br />
83500 HYDROXYPROLINE, URINE $18.99 20060701 99999999<br />
83505 HYDROXYPROLINE, URINE $20.38 20060701 99999999<br />
83516<br />
IMMUNOASSAY FOR ANALYTE OTHER THAN ANTIBODY OR<br />
INFECTIOUS AGENT ANTIGEN, QUALITA $15.95 20060701 99999999<br />
83518<br />
IMMUNOASSAY, FOR ANALYTE OTHER THAN ANTIBODY, QUALITATIVE<br />
OR SEMIQUANTITATIVE $11.72 20060701 99999999<br />
83519 IMMUNOASSAY, ANALYTE; BY RADIONUCLIDE TECHNIQUE (EG, RIA) $18.67 20060701 99999999<br />
83520 IMMUNOASSAY, ANALYTE; NOT OTHERWISE SPECIFIED $17.89 20060701 99999999<br />
83525 INSULIN, RIA $15.81 20060701 99999999<br />
83527 INSULIN; FREE $10.85 20060701 99999999<br />
83528 INTRINSIC FACTOR LEVEL $13.33 20060701 99999999<br />
83540 IRON, SERUM $8.95 20060701 99999999<br />
83550 IRON BINDING CAPACITY, SERUM $12.08 20060701 99999999<br />
83570 ISOCITRIC DEHYDROGENASE (IDH), BLOOD $7.42 20060701 99999999<br />
83582 KETOGENIC STEROIDS, URINE $11.88 20060701 99999999<br />
83586 KETOSTEROIDS, 17- (17-KS), BLOOD $10.73 20060701 99999999<br />
83593 KETOSTEROIDS, 17- (17-KS), URINE $22.05 20060701 99999999<br />
83605 LACTATE (LACTIC ACID) $14.76 20060701 99999999<br />
83615 LACTIC DEHYDROGENASE (LDH), BLOOD $8.35 20060701 99999999<br />
83625 LACTIC DEHYDROGENASE (LDH), BLOOD $10.73 20060701 99999999<br />
83630 LACTOFERRIN, FECAL, QUALITATIVE $16.45 20060701 99999999<br />
83631 LACTIC DEHYDROGENASE (LDH), CSF $16.45 20060701 99999999<br />
83632<br />
LACTOGEN, HUMAN PLACENTAL (HPL) CHORIONIC<br />
SOMATOMAMMOTROPIN, $16.94 20060701 99999999<br />
83633 LACTOSE, URINE $4.61 20060701 99999999<br />
83634 LACTOSE, URINE $9.66 20060701 99999999<br />
83655 LEAD, QUANTITATIVE $16.72 20060701 99999999<br />
83661 LECITHIN-SPHINGOMYELIN RATIO (L/S RATIO), AMNIOTIC FLUID $18.43 20060701 99999999<br />
83662 LECITHIN-SPHINGOMYELIN RATIO (L/S RATIO); FOAM STABILITY TEST $15.86 20060701 99999999<br />
Hawaii <strong>Medicaid</strong> <strong>Fee</strong> <strong>Schedule</strong> <strong>without</strong> <strong>Mods</strong> 01/2008 249