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TIN#: Wheaton Partners, LLC
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| Item | Publications: | Quantity | Total | State/Locality | |
| #100 | 2026 CodeMap® PREMIER Package
Includes Item #101, #301, #601, #801 AND #1000 |
Price: $1595.00 | ____ | ________ | ________ |
| #101 | 2026 Medicare Reimbursement Manual for Lab and Pathology | Price: $595.00 | ____ | ________ | ________ |
| #201 | 2026 CodeMap® STANDARD Package
Includes Item #101, #301, #601, and #801 |
Price: $1295.00 | ____ | ________ | ________ |
| #301 | 2026 Medicare Medical Necessity Guide for Lab and Pathology | Price: $595.00 | ____ | ________ | ________ |
| #601 | 2026 CCI Guide for Lab and Pathology | Price: $595.00 | ____ | ________ | ________ |
| #801 | CodeMap® Briefing Subscription - 1 Year | Price: $315.00 | ____ | ________ | ________ |
| #1000 | CodeMap® Online Access-1 Year Subscription | Price: $895.00 | ____ | ________ | ________ |
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** Shipping and Handling (Outside Continental US and Overnight Delivery additional charge, call for details) |
$39.95** | ||||
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MAC A - Part A - Fiscal Intermediary
MAC B - Part B - Medicare Carrier |
TOTAL | ________ | |||
Bill to: (If different from order information)_________________________________________________
[ ] Payment Enclosed
[ ] PO#_____________________
Charge my [ ] MCard [ ] Visa [ ] AMEX [ ] Discover
Card Number:______________________________________ Exp:________________ CSC:____________
Name on Card:_______________________________
Signature:__________________________________