Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 87526 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS G, AMPLIFIED $29.42 20060701 99999999 87527 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HEPATITIS G, QUANTIFICA $35.00 20060701 99999999 87528 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, D $16.81 20060701 99999999 87529 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, A $46.44 20060701 99999999 87530 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES SIMPLEX VIRUS, Q $59.20 20060701 99999999 87531 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES VIRUS-6, DIRECT $16.81 20060701 99999999 87532 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES VIRUS-6, AMPLIFI $29.42 20060701 99999999 87533 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HERPES VIRUS-6, QUANTIF $35.00 20060701 99999999 87534 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV- 1, DIRECT PROBE TEC $16.81 20060701 99999999 87535 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV- 1, AMPLIFIED PROBE $48.50 20060701 99999999 87536 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV- 1, QUANTIFICATION $117.59 20060701 99999999 87537 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV- 2, DIRECT PROBE TEC $16.81 20060701 99999999 87538 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV- 2, AMPLIFIED PROBE $29.42 20060701 99999999 87539 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); HIV- 2, QUANTIFICATION $35.91 20060701 99999999 87540 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); LEGIONELLA PNEUMOPHILA, $16.81 20060701 99999999 87541 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); LEGIONELLA PNEUMOPHILA, $29.42 20060701 99999999 87542 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); LEGIONELLA PNEUMOPHILA, $35.00 20060701 99999999 87550 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA SPECIES, D $16.81 20060701 99999999 87551 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA SPECIES, A $29.42 20060701 99999999 87552 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA SPECIES, Q $35.91 20060701 99999999 87555 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA TUBERCULOS $27.71 20060701 99999999 87556 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA TUBERCULOS $48.50 20060701 99999999 87557 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA TUBERCULOS $35.91 20060701 99999999 87560 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTR $27.71 20060701 99999999 87561 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTR $29.42 20060701 99999999 87562 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOBACTERIA AVIUM-INTR $35.91 20060701 99999999 87580 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, $16.81 20060701 99999999 87581 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, $29.42 20060701 99999999 87582 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); MYCOPLASMA PNEUMONIAE, $35.00 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 264
PROC-CODE DESC MAC BEG END 87590 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, $27.71 20060701 99999999 87591 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, $48.50 20060701 99999999 87592 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NEISSERIA GONORRHOEAE, $35.91 20060701 99999999 87620 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); PAPILLOMAVIRUS, HUMAN, $16.81 20060701 99999999 87621 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); PAPILLOMAVIRUS, HUMAN, $48.29 20060701 99999999 87622 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); PAPILLOMAVIRUS, HUMAN, $35.00 20060701 99999999 87640 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, $49.04 20070101 99999999 87641 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STAPHYLOCOCCUS AUREUS, $49.04 20070101 99999999 87650 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, $27.71 20060701 99999999 87651 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, $29.42 20060701 99999999 87652 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP A, $35.00 20060701 99999999 87653 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); STREPTOCOCCUS, GROUP B, $49.04 20070101 99999999 87660 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); TRICHOMONAS VAGINALIS, $20.17 20060701 99999999 87797 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NOT OTHERWISE SPECIFIED $28.02 20060701 99999999 87798 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NOT OTHERWISE SPECIFIED $48.50 20060701 99999999 87799 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA); NOT OTHERWISE SPECIFIED $35.91 20060701 99999999 87800 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; DIR $33.62 20060701 99999999 87801 INFECTIOUS AGENT DETECTION BY NUCLEIC ACID (DNA OR RNA), MULTIPLE ORGANISMS; AMP $58.84 20060701 99999999 87802 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATIO $10.06 20060701 99999999 87803 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATIO $16.58 20060701 99999999 87804 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATIO $16.58 20060701 99999999 87807 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL $16.58 20060701 99999999 87808 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATIO $16.58 20070101 99999999 87809 INFECTIOUS AGENT ANTIGEN DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATIO $16.76 20080101 99999999 87810 INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; CHLAM $16.58 20060701 99999999 87850 INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; NEISS $16.58 20060701 99999999 87880 INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; STREP $16.58 20060701 99999999 87899 INFECTIOUS AGENT DETECTION BY IMMUNOASSAY WITH DIRECT OPTICAL OBSERVATION; NOT O $16.58 20060701 99999999 87900 INFECTIOUS AGENT DRUG SUSCEPTIBILITY PHENOTYPE PREDICTION USING REGULARLY UPDATE $127.48 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 265
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