Listas para Publicar en el Portal-1 (2) - Triple-S Salud
Listas para Publicar en el Portal-1 (2) - Triple-S Salud
Listas para Publicar en el Portal-1 (2) - Triple-S Salud
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Procedure &<br />
Place of Service<br />
Tarifas<br />
Servicios de <strong>Salud</strong><br />
Description Fee<br />
92250-26 fundus phtgrphy i&r $2.74<br />
92250-TC fundus phtgrphy i&r $4.56<br />
92260-00 ophthalmodynamometry $11.41<br />
92265-00 ndl oculoemg 1+ eo musc 1/ou i&r $107.25<br />
92265-26 ndl oculoemg 1+ eo musc 1/ou i&r $25.74<br />
92265-TC ndl oculoemg 1+ eo musc 1/ou i&r $42.90<br />
92270-00 <strong>el</strong>ectro-oculograpy i&r $39.00<br />
92270-26 <strong>el</strong>ectro-oculograpy i&r $9.36<br />
92270-TC <strong>el</strong>ectro-oculograpy i&r $15.60<br />
92275-00 <strong>el</strong>ectroretinograpy i&r $97.50<br />
92275-26 <strong>el</strong>ectroretinograpy i&r $25.74<br />
92275-TC <strong>el</strong>ectroretinograpy i&r $42.90<br />
92285-00 xtrnl oc phtgrphy i&r progress $11.41<br />
92285-26 xtrnl oc phtgrphy i&r progress $2.74<br />
92285-TC xtrnl oc phtgrphy i&r progress $4.56<br />
92286-00 spec ant sgm phtgrphy i&r speclr <strong>en</strong>doth<strong>el</strong>ial $42.12<br />
92286-26 spec ant sgm phtgrphy i&r speclr <strong>en</strong>doth<strong>el</strong>ial $10.11<br />
92286-TC spec ant sgm phtgrphy i&r speclr <strong>en</strong>doth<strong>el</strong>ial $16.85<br />
92287-00 spec ant sgm phtgrphy i&r fluorescein angrph $64.06<br />
92502-00 otolaryngologic xm anes $78.00<br />
92504-00 binoc mic $107.25<br />
92506-00 eval sp lang voice comunicaj&/aud $34.13<br />
92507-00 tx sp lang comunicaj pcx disorder indiv $21.94<br />
92511-00 nasopharyngoscopy w/<strong>en</strong>doscope spx $97.50<br />
92512-00 nsl funcj std $24.88<br />
92516-00 facial nrv funcj std $29.25<br />
92520-00 laryn funcj std $35.10<br />
92526-00 tx swlng dysf&/oral funcj feeding $25.40<br />
92533-00 caloric vstblr tst ea irrigation $30.71<br />
92541-00 spon nystagmus tst $21.94<br />
92541-26 spon nystagmus tst $5.27<br />
92541-TC spon nystagmus tst $8.78<br />
92542-00 posal nystagmus tst $21.94<br />
92542-26 posal nystagmus tst $5.27<br />
92542-TC posal nystagmus tst $8.78<br />
92543-00 caloric vstblr tst ea irrigation rec $30.23<br />
92543-26 caloric vstblr tst ea irrigation rec $7.25<br />
92543-TC caloric vstblr tst ea irrigation rec $12.09<br />
92544-00 okn tst bidirec foveal/prph stimj rec $17.55<br />
92544-26 okn tst bidirec foveal/prph stimj rec $4.21<br />
92544-TC okn tst bidirec foveal/prph stimj rec $7.02<br />
92545-00 oscillating tracking tst w/rec $21.94<br />
92545-26 oscillating tracking tst w/rec $5.27<br />
92545-TC oscillating tracking tst w/rec $8.78<br />
92546-00 sinusoidal ver axis rotational tstg $21.94<br />
92546-26 sinusoidal ver axis rotational tstg $5.27<br />
92546-TC sinusoidal ver axis rotational tstg $8.78<br />
92547-00 use ver <strong>el</strong>trds $8.78<br />
92552-00 pure tone audiomtry air only $10.73<br />
92553-00 pure tone audiomtry air&b1 $13.16<br />
107
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