| Procedure | Description | Number Submitted | Medicare Payment |
| 93005
|
ELECTROCARDIOGRAM TRACING
|
XXXX
|
$XXX.XX
|
| 80048
|
METABOLIC PANEL TOTAL CA
|
XXXX
|
$XXX.XX
|
| 36415
|
ROUTINE VENIPUNCTURE
|
XXXX
|
$XX
|
| 86901
|
BLOOD TYPING SEROLOGIC RH(D)
|
XXXX
|
-
|
| 86900
|
BLOOD TYPING SEROLOGIC ABO
|
XXXX
|
$XXXXXX.XX
|
| 87081
|
CULTURE SCREEN ONLY
|
XXXX
|
$X.XX
|
| 86850
|
RBC ANTIBODY SCREEN
|
XXXX
|
-
|
| 83036
|
HEMOGLOBIN GLYCOSYLATED A1C
|
XXXX
|
-
|
| 82575
|
CREATININE CLEARANCE TEST
|
XXXX
|
-
|
| 85025
|
COMPLETE CBC W/AUTO DIFF WBC
|
XXXX
|
$XX.X
|
| 85018
|
HEMOGLOBIN
|
XXXX
|
$X.XX
|
| 85014
|
HEMATOCRIT
|
XXXX
|
$X.XX
|
| 64636
|
DESTROY L/S FACET JNT ADDL
|
XXXX
|
-
|
| 81003
|
URINALYSIS AUTO W/O SCOPE
|
XXX
|
$X.XX
|
| 85610
|
PROTHROMBIN TIME
|
XXX
|
$X.XX
|
| 87426
|
SARSCOV CORONAVIRUS AG IA
|
XXX
|
$XXXXX.XX
|
| 85730
|
THROMBOPLASTIN TIME PARTIAL
|
XXX
|
-
|
| 82948
|
REAGENT STRIP/BLOOD GLUCOSE
|
XXX
|
-
|
| 85651
|
RBC SED RATE NONAUTOMATED
|
XXX
|
$XX.XX
|
| 62323
|
NJX INTERLAMINAR LMBR/SAC
|
XXX
|
$XXXXXX.XX
|
| 76000
|
FLUOROSCOPY <1 HR PHYS/QHP
|
XXX
|
$XXXX.XX
|
| 72148
|
MRI LUMBAR SPINE W/O DYE
|
XXX
|
$XXXXX.XX
|
| 81001
|
URINALYSIS AUTO W/SCOPE
|
XXX
|
$XX.XX
|
| 64635
|
DESTROY LUMB/SAC FACET JNT
|
XXX
|
$XXXXXX.XX
|
| 64493
|
INJ PARAVERT F JNT L/S 1 LEV
|
XXX
|
$XXXXXX.XX
|
| 64494
|
INJ PARAVERT F JNT L/S 2 LEV
|
XXX
|
-
|
| Procedure | Description | Number Submitted | Medicare Payment |
| J2795
|
Ropivacaine hcl injection
|
XXXXX
|
-
|
| J0171
|
Adrenalin epinephrine inject
|
XXXXX
|
-
|
| J1100
|
Dexamethasone sodium phos
|
XXXX
|
-
|
| J3301
|
Triamcinolone acet inj nos
|
XXXX
|
-
|
| J2250
|
Inj midazolam hydrochloride
|
XXXX
|
-
|
| J2704
|
Inj, propofol, 10 mg
|
XXXX
|
-
|
| J0690
|
Cefazolin sodium injection
|
XXXX
|
-
|
| J3010
|
Fentanyl citrate injection
|
XXXX
|
-
|
| J2405
|
Ondansetron hcl injection
|
XXXX
|
-
|
| J1738
|
Inj. meloxicam 1 mg
|
XXXX
|
$XXXX.XX
|
| J0461
|
Atropine sulfate injection
|
XXX
|
-
|
| J1885
|
Ketorolac tromethamine inj
|
XXX
|
-
|
