| Procedure | Description | Number Submitted | Medicare Payment |
| 36416
|
COLLJ CAPILLARY BLOOD SPEC
|
XXXX
|
-
|
| 82962
|
GLUCOSE BLOOD TEST
|
XXXX
|
$X.XX
|
| 36415
|
ROUTINE VENIPUNCTURE
|
XXX
|
$XXX
|
| 93005
|
ELECTROCARDIOGRAM TRACING
|
XXX
|
$XXXX.XX
|
| 85025
|
COMPLETE CBC W/AUTO DIFF WBC
|
XXX
|
$XXX.XX
|
| 80053
|
COMPREHEN METABOLIC PANEL
|
XXX
|
$XXX.XX
|
| 64494
|
INJ PARAVERT F JNT L/S 2 LEV
|
XXX
|
-
|
| 62323
|
NJX INTERLAMINAR LMBR/SAC
|
XXX
|
$XXXXXX.XX
|
| 71046
|
X-RAY EXAM CHEST 2 VIEWS
|
XXX
|
$XXXXX.XX
|
| 87635
|
SARS-COV-2 COVID-19 AMP PRB
|
XXX
|
$XXXXX.XX
|
| 72131
|
CT LUMBAR SPINE W/O DYE
|
XXX
|
$XXXXX.XX
|
| 64636
|
DESTROY L/S FACET JNT ADDL
|
XXX
|
-
|
| 64493
|
INJ PARAVERT F JNT L/S 1 LEV
|
XXX
|
$XXXXXX.XX
|
| 72295
|
X-RAY OF LOWER SPINE DISK
|
XXX
|
$XXXXXX.XX
|
| 62290
|
NJX PX DISCOGRAPHY LUMBAR
|
XXX
|
-
|
| 64483
|
NJX AA&/STRD TFRM EPI L/S 1
|
XXX
|
$XXXXXX.XX
|
| 72148
|
MRI LUMBAR SPINE W/O DYE
|
XXX
|
$XXXXX.XX
|
| 64491
|
INJ PARAVERT F JNT C/T 2 LEV
|
XXX
|
-
|
| 86901
|
BLOOD TYPING SEROLOGIC RH(D)
|
XXX
|
-
|
| 86885
|
COOMBS TEST INDIRECT QUAL
|
XXX
|
$XXXX.XX
|
| 86900
|
BLOOD TYPING SEROLOGIC ABO
|
XXX
|
-
|
| 85610
|
PROTHROMBIN TIME
|
XXX
|
$X.XX
|
| 72020
|
X-RAY EXAM OF SPINE 1 VIEW
|
XXX
|
-
|
| 85730
|
THROMBOPLASTIN TIME PARTIAL
|
XXX
|
$XX.XX
|
| Procedure | Description | Number Submitted | Medicare Payment |
| J1100
|
Dexamethasone sodium phos
|
XXXXX
|
-
|
| J2704
|
Inj, propofol, 10 mg
|
XXXXX
|
-
|
| J2250
|
Inj midazolam hydrochloride
|
XXXX
|
-
|
| J3301
|
Triamcinolone acet inj nos
|
XXXX
|
-
|
| J2001
|
Lidocaine injection
|
XXXX
|
-
|
| J3010
|
Fentanyl citrate injection
|
XXXX
|
-
|
| J0690
|
Cefazolin sodium injection
|
XXXX
|
-
|
| J2405
|
Ondansetron hcl injection
|
XXXX
|
-
|
| J0702
|
Betamethasone acet&sod phosp
|
XXX
|
-
|
| J0330
|
Succinycholine chloride inj
|
XXX
|
-
|
| J1885
|
Ketorolac tromethamine inj
|
XXX
|
-
|
| J0585
|
Injection,onabotulinumtoxina
|
XXX
|
$XXX.XX
|
| J3304
|
Inj triamcinolone ace xr 1mg
|
XXX
|
$XXXX.XX
|
| J1170
|
Hydromorphone injection
|
XXX
|
-
|
