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 />
95973-00 <strong>el</strong>ec alys nstim pls g<strong>en</strong> cplx sc/perph ea 30 min $36.86<br />
95974-00 <strong>el</strong>ec alys nstim pls g<strong>en</strong> cplx crnl nrv 1st hr $117.00<br />
95975-00 <strong>el</strong>ec alys nstim pls g<strong>en</strong> cplx crnl nrv ea 30 min $68.45<br />
95978-00 <strong>el</strong>ec alys nstim pls g<strong>en</strong> cplx dp brn 1st hr $168.68<br />
95979-00 <strong>el</strong>ec alys nstim pls g<strong>en</strong> cplx dp brn ea 30 min $70.20<br />
95990-00 refill&maint<strong>en</strong>ance pump drug dlvr spinal/brain $39.47<br />
95991-00 rfl&main implt pmp/rsvr rx dlvr spi/brn by phys $33.54<br />
96105-00 assmt aphasia w/i&r pr hr $30.71<br />
96110-00 dev<strong>el</strong>opm<strong>en</strong>tal tstg lmtd w/i&r $6.68<br />
96111-00 dev<strong>el</strong>opm<strong>en</strong>tal tstg extnd w/i&r $30.71<br />
96155-00 hlth&behavior ivntj ea 15 min f2f fam w/o pt $17.55<br />
96401-00 chemotx admn subq/im non-hormonal anti-neo $30.71<br />
96402-00 chemotx admn subq/im hormonal anti-neo $25.01<br />
96405-00 chemotx admn ilesn up&w/7 < $25.35<br />
96406-00 chemotx admn ilesn > 7 $37.10<br />
96409-00 chemotx admn iv push tq 1/1st sbst/drug $30.71<br />
96411-00 chemotx admn iv push tq ea sbst/drug $30.71<br />
96413-00 chemotx admn iv nfs tq up 1 hr 1/1st sbst/drug $55.00<br />
96415-00 chemotherapy admn iv infusion tq ea hr $36.08<br />
96416-00 chemotx admn tq init prolng chemotx nfus pmp $43.88<br />
96417-00 chemotx admn iv nfs tq ea seql nfs to 1 hr $32.47<br />
96420-00 chemotx admn ia push tq $56.16<br />
96422-00 chemotx admn ia nfs tq up 1 hr $63.18<br />
96423-00 chemotherapy admn intraarterial infusion ea hr $35.10<br />
96425-00 chemotx admn ia nfs > 8 hr prtble impltbl pmp $49.14<br />
96440-00 chemotx admn pleural cavity req&w/thoracnts $84.24<br />
96446-00 chemotx admn prtl cavity port/cath $87.75<br />
96450-00 chemotx admn cns req&w/spi pnxr $65.33<br />
96521-00 rfl/main portable pmp $27.20<br />
96522-00 refill&maint<strong>en</strong>ance pump drug dlvr systemic $43.88<br />
96523-00 irrigation implanted vad for drug dlvr $15.80<br />
96567-00 pdt xtrnl appl light dstr les skn by activj rx $25.79<br />
96570-00 pdt ndsc abl abnor tiss via activj rx 30 min $42.12<br />
96571-00 pdt ndsc abl abnor tiss via activj rx a 15 min $21.06<br />
96900-00 actixh ultraviolet light $4.88<br />
96910-00 photochemotx tar&uvb/petrolatum/uvb $13.16<br />
96912-00 photochemotx psoral<strong>en</strong>s&ultraviolet puva $58.50<br />
96913-00 photochemotherapy dermatoses 4-8 hrs supervision $47.11<br />
97001-00 physical ther eval $24.38<br />
97002-00 Pt re-evaluation, physical ther re-eval $19.50<br />
97003-00 occupational ther eval $29.25<br />
97004-00 occupational ther re-eval $14.63<br />
97010-00 appl modality 1+ areas hot/cold packs $11.70<br />
97012-00 appl modality 1+ areas trcj mchnl $11.70<br />
97014-00 appl modality 1+ areas <strong>el</strong>ec stimj unattn $11.70<br />
97016-00 appl modality 1+ areas vasopneumatic dev $11.70<br />
97018-00 appl modality 1+ areas <strong>para</strong>ffin bath $11.70<br />
97022-00 appl modality 1+ areas wp $11.70<br />
97024-00 appl modality 1+ areas dthrm $11.70<br />
97026-00 appl modality 1+ areas infrared $11.70<br />
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