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 />
66850-00 rmvl l<strong>en</strong>s matrl phacofragm<strong>en</strong>tation aspir $775.13<br />
66852-00 rmvl l<strong>en</strong>s matrl pars plna appr +-vtrc $570.38<br />
66920-00 rmvl l<strong>en</strong>s matrl icapsl $780.00<br />
66930-00 removal l<strong>en</strong>s matrl intracapsular dislocated l<strong>en</strong>s $780.00<br />
66940-00 rmvl l<strong>en</strong>s matrl xcapsl $780.00<br />
66982-00 xcapsl ctrc rmvl insj l<strong>en</strong>s prosth 1 stg $588.80<br />
66983-00 icapsl ctrc xtrj insj io l<strong>en</strong>s prosth 1 stg $1,150.50<br />
66984-00 cataract removal insertion of l<strong>en</strong>s $680.00<br />
66985-00 insj io l<strong>en</strong>s prosth x w/cncrnt rmvl $975.00<br />
66986-00 exchng io l<strong>en</strong>s $640.58<br />
67005-00 rmvl vts ant appr prtl rmvl $585.00<br />
67010-00 rmvl vts ant appr stot rmvl vtrc $1,160.25<br />
67015-00 aspir/rls flu pars plna $292.50<br />
67025-00 njx vts sub pars plna/limbal spx $429.00<br />
67027-00 impltj intravitreal drug dlvr sys rmvl vts $534.30<br />
67028-00 intravitreal njx pharmacologic agt spx $143.33<br />
67030-00 dscj vts strands pars plna $341.25<br />
67031-00 severing vts strands laser 1+ stgs $561.60<br />
67036-00 vtrc mchnl pars plna $1,238.25<br />
67039-00 vtrc mchnl pars plna focal <strong>en</strong>dolaser pc $1,667.25<br />
67040-00 vtrc mchnl pars plna <strong>en</strong>dolaser panrta pc $1,198.28<br />
67041-00 vitrectomy pars plana remove preretinal membrane $851.76<br />
67042-00 vitrectomy pars plana remove int memb retina $1,310.40<br />
67043-00 vitrectomy pars plana remove subretinal membrane $1,310.40<br />
67101-00 rpr rta dtchmnt 1+ sess crtx/dthrm +-drg $438.75<br />
67105-00 rpr rta dtchmnt 1+ sess pc +-drg subrta $975.00<br />
67107-00 rpr rta dtchmnt scll buckling +-implt $975.00<br />
67108-00 rpr rta dtchmnt w/vtrc any meth $1,355.25<br />
67110-00 rpr rta dtchmnt njx air/oth gas $556.73<br />
67112-00 rpr rta dtchmnt scll buckling/vtrc pt $1,101.75<br />
67113-00 rpr complex retina detach vitrectomy & memb pe<strong>el</strong> $975.00<br />
67115-00 rls <strong>en</strong>circling matrl $390.00<br />
67120-00 rmvl implted matrl post sgm eo $390.00<br />
67121-00 rmvl implted matrl post sgm io $360.75<br />
67141-00 proph rta dtchmnt w/o drg 1+ sess crtx dthrm $390.00<br />
67145-00 proph rta dtchmnt w/o drg 1+ sess $390.00<br />
67208-00 dstrj loclzd les retina 1+ sess crtx dthrm $403.65<br />
67210-00 dstrj loclzd les retina 1+ sess pc $448.50<br />
67218-00 dstrj les retina 1+ sess radj impltj $624.00<br />
67220-00 dstrj les choroid pc 1+ sess $438.75<br />
67221-00 dstrj les choroid pdt $228.15<br />
67225-00 dstrj les choroid pdt 2nd eye 1 sess $22.82<br />
67227-00 destruction retinopathy 1+ sess diathermy $516.75<br />
67228-00 ext<strong>en</strong>sive retinopathy 1+ sess photocoagulation $516.75<br />
67229-00 ext<strong>en</strong>sive retinopathy 1+ sess preterm infant $637.94<br />
67250-00 scll rnfcmt spx w/o grf $711.75<br />
67255-00 scll rnfcmt spx w/grf $755.63<br />
67311-00 strabismus recession/rescj 1 hrzntl musc $585.00<br />
67312-00 strabismus recession/rescj 2 hrzntl musc $585.00<br />
67314-00 strabismus recession/rescj 1 ver musc $526.50<br />
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