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
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Procedure &<br />
Place of Service<br />
Tarifas<br />
Servicios de <strong>Salud</strong><br />
Description Fee<br />
62192-00 crtj shunt sarach/sdrl-prtl-pleural oth $975.00<br />
62194-00 rplcmt/irrg sarach/sdrl cath $300.00<br />
62200-00 v<strong>en</strong>triculocisternostomy 3rd vntrc $1,089.00<br />
62201-00 v<strong>en</strong>triculocisternostomy 3rd vntrc neurondsc $670.00<br />
62220-00 crtj shunt v<strong>en</strong>triculo-atr-jug-aur $936.00<br />
62223-00 crtj shunt v<strong>en</strong>triculo-prtl-pleural oth $1,316.25<br />
62225-00 rplcmt/irrigation v<strong>en</strong>tr cath $328.00<br />
62230-00 rplcmt/revj csf shunt valve/cath shunt sys $585.00<br />
62252-00 reprgrmg prgrbl cerebsp shunt $70.00<br />
62252-26 reprgrmg prgrbl cerebsp shunt $16.80<br />
62252-TC reprgrmg prgrbl cerebsp shunt $28.00<br />
62256-00 rmvl compl cerebsp flu shunt sys w/o rplcmt $292.50<br />
62258-00 rmvl compl csf shunt sys w/rplcmt $1,000.00<br />
62263-00 prq lss edrl ads sln njx/mchnl loclzj 2+ d $395.18<br />
62264-00 prq lss edrl ads sln njx/mchnl loclzj 1 d $420.30<br />
62268-00 prq aspir spi cord cst/syrinx $224.00<br />
62269-00 bx spi cord prq ndl $225.00<br />
62270-00 spi pnxr lmbr dx $19.50<br />
62272-00 spinal puncture ther drain cerebrospinal fluid $19.50<br />
62273-00 njx edrl bld/clot patch $100.43<br />
62280-00 njx/nfs nulyt sbst sbst sarach $182.84<br />
62281-00 njx/nfs nulyt sbst edrl crv/thrc $173.68<br />
62282-00 njx/nfs nulyt sbst edrl lmbr sac $66.69<br />
62284-00 injection procedure my<strong>el</strong>ography/ct spinal $97.50<br />
62287-00 dcmprn perq nucleus pulposus 1/> lev<strong>el</strong>s lumbar $660.00<br />
62290-00 njx diskograpy ea lvl lmbr $97.50<br />
62291-00 njx diskograpy ea lvl crv/thrc $117.00<br />
62292-00 njx chemonucleolss diskograpy 1+ lmbr $507.00<br />
62294-00 njx artl occlusion arv<strong>en</strong> malfrmj spi $460.00<br />
62310-00 njx c+-dx/ther sbst edrl/sarach crv/thrc $128.93<br />
62311-00 njx c+-dx/ther sbst edrl/sarach lmbr sac $109.35<br />
62318-00 njx nfs/bolus dx/sbst edrl/sarach crv/thrc $59.67<br />
62319-00 njx nfs/bolus dx/sbst edrl/sarach lmbr sac $121.81<br />
62350-00 impltj revj/rpsg ithcl/edrl cath pmp w/o lam $323.00<br />
62351-00 impltj revj/rpsg ithcl/edrl cath w/lam $449.48<br />
62355-00 rmvl previously implted ithcl/edrl cath $253.50<br />
62360-00 impltj/rplcmt ithcl/edrl drug nfs subq rsvr $126.00<br />
62361-00 impltj/rplcmt ithcl/edrl nfs non-prgrbl pmp $239.00<br />
62362-00 impltj/rplcmt ithcl/edrl drug nfs prgrbl pmp $314.00<br />
62365-00 rmvl subq rsvr/pmp $259.00<br />
62367-00 <strong>el</strong>ec alys prgrbl pmp w/o reprgrmg $21.41<br />
62368-00 <strong>el</strong>ec alys prgrbl pmp reprgrmg $52.68<br />
63001-00 lam w/o facetec foramot/dskc 1/2 vrt seg crv $975.00<br />
63003-00 lam w/o ffd 1/2 vrt seg thrc $975.00<br />
63005-00 lam w/o ffd 1/2 vrt seg lmbr $877.50<br />
63011-00 lam w/o ffd 1/2 vrt seg sac $1,840.00<br />
63012-00 lam w/rmvl abnormal facets lmbr $1,840.00<br />
63015-00 lam w/o ffd > 2 vrt seg crv $1,379.63<br />
63016-00 lam w/o ffd > 2 vrt seg thrc $1,209.00<br />
63017-00 lam w/o ffd > 2 vrt seg lmbr $1,267.50<br />
91
Change language