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PROVISION IDS<br />

ATVO ALLERGY TESTING/VISION TEST OP<br />

ATXO ALLERGY TESTING/XRAY - OP<br />

AUTO AUTOPSY<br />

AZMA ASTHMA KITS<br />

BAMI BLOOD ADMINISTRATION - IP<br />

BAMO BLOOD ADMINISTRATION - OP<br />

BANK BANKING<br />

BCHI BENIGN CHEMOTHERAPY - IP<br />

BCHO BENIGN CHEMOTHERAPY - OP<br />

BDRI BLOOD DERIVATIVES - IP<br />

BDRO BLOOD DERIVATIVES - OP<br />

BIOI BIOFEEDBACK - IP<br />

BIOO BIOFEEDBACK - OP<br />

BIRD BIRTHING CENTER CARE - DEPENDENT<br />

BIRH BIRTHING CENTER<br />

BIRM BIRTHING CENTER CARE - MEMBER<br />

BIRS BIRTHING CENTER CARE - SPOUSE<br />

BLCI BLOOD COMPONENTS - IP<br />

BLCO BLOOD COMPONENTS - OP<br />

BLDI BLOOD - IP<br />

BLDO BLOOD - OP<br />

BODI Bone Density Inpatient<br />

BODO Bone Density Outpatient<br />

BPRI BLOOD PROCESSING - IP<br />

BPRO BLOOD PROCESSING - OP<br />

BRCI BLOOD RELATED CHARGES - IP<br />

BRCO BLOOD RELATED CHARGES - OP<br />

BRRI BENIGN RADIUM / RADON THERAPY - IP<br />

BRRO BENIGN RADIUM / RADON THERAPY - OP<br />

BRTI BENIGN RADIOISOTOPE THERAPY - IP<br />

BRTO BENIGN RADIOISOTOPE THERAPY - OP<br />

BRXI BENIGN CHEMOTHERAPY DRUGS - IP<br />

BRXO BENIGN CHEMOTHERAPY DRUGS - OP<br />

BXTI BENIGN XRAY THERAPY - IP<br />

BXTO BENIGN XRAY THERAPY - OP<br />

CARD CARDIAC CARE<br />

CATI CAT SCAN INPATIENT<br />

CATO CAT SCAN OUTPATIENT<br />

CCFI COORDINATED CARE FEE IP<br />

CCFM COORDINATED CARE FEE MISC<br />

CCFO COORDINATED CARE FEE OP<br />

CDIS CONGENITAL SURGERY IP - SPECIAL LEVEL<br />

CDMP CHEMOTHERAPY OP DIAG MED PROCEDURE<br />

CDOS CONGENITAL SURGERY OP - SPECIAL LEVEL<br />

CDRG CHEMOTHERAPY OP / DRUGS<br />

CDSI CONGENITAL DEFECTS SURGERY - IP<br />

CDSO CONGENITAL DEFECTS SURGERY - OP<br />

CESC 213D - CORRECTIVE EYE SURGERY - COVERED<br />

CESN 213D - CORRECTIVE EYE SURGERY - NON-COVERED<br />

CFOV CHEMOTHERAPY FOLLOW-UP OFFICE VISIT<br />

CFTI CASE FINDING TESTS - IP<br />

CFTO CASE FINDING TESTS - OP<br />

Updated: 9/21/2012

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