Transcription
Saint Peter's University Hospital Charge Description Master ListCharge 112592211260CPT/ HCPCS CODES9470S9470S9470S9470S9470Charge DescriptionCOMP MED NUTRITIONAL ASSESSMENTMEDICAL NUTRITIONAL REASSESSMENTMEDICAL NUTRITION INTERVENTIONNUTRITIONAL INIT CAL CNT ANALYSISNUTRITION ED FOR DIABETES 1-15MNENTERAL OSMOLITE 1.2 240MLENT 1.8 CAL RENAL 240ML SUPLENAENT 1.0 CAL FIB FORT 240 ML JEVITYENT ORAL 2.0 CAL FORM 240ML ROSS HNENT 1.5 CAL 240 ML PULMOCAREENT 1.5 CAL 240 ML NUTRIHEPORAL 1.0 CAL PED FORM 240ML PEDIASUREENT 1.0 CAL PROMOTE WITH FIBER RTH 1.0LORAL CLEAR LIQ SUPP 240 ML BOOST BREEZEORAL DIAB SUPPLEMENT GLUCERNA 1.0 240 MLENSURE ENLIVE 1.5 CAL 240 MLENSURE COMPACT 120 ML ORAL SUPPORAL GLUCERNA RTH 1.5 ENT DIAB SUPP 1LORAL GLUCERNA DIAB SUPP 1.5 CAL 240MLENT PEPTIDE BSD FOR 1.2 240ML VITAL AFENSURE PRE-SURGERY BEVERAGEENT 1 CAL FBR FOR JEVITY RTH 1.5LENTERAL DIAB FOR GLUCERNA RTH 1CAL 1.5LENTERAL OSMOLITE 1.2 1.5LENT 1 CAL HI PROMOTE W FIBER 240MLENT 1.5 CAL PULMOCARE RTH 1.0LENTERAL OR AL2.0 CALORIE NEPRO CANSENT 1.5 CAL H FIB JEVITY RTH 1.5 LITER BENT 1.5 CAL HI FIB JEVITY 240ML CARTONENSURE ORAL PUDDING SUPP 4OZENT 2 CAL FORMULA HN RTH 1 LITERENT PEDIASURE PEPTIDE 1 CAL 240 MLENT PEDIASURE PEPTIDE 1.5 CAL FOR 240 MLENTERAL 1.5 CAL WOUND 240 ML PIVOTLIQUID PROTEIN PROSTAT NO CARB 1 OZENTERAL 2.0 CAL FORMULA NEPRO RTH 1LENT PEPTIDE BASED FOR VITAL 1.5 L RTH 1LENTERAL 1.5 CAL WOUND PIVOT RTH 1LHIGH PROTEIN GELATIN, 4 OZ GELATEINENTERAL PEPTIDE PEDIASURE 1.0, 1L RTHBENECALORIE CALORIE & PROTEIN FOOD ENHANENT PEDIASURE WITHOUT FIBER - 240MLENTERAL DIABETIC GLUCERNA 1.0 240MLENTERAL PEDIASURE WITH FIBER - 240MLCharge .002.004.0012.0011.002.0011.002.001.001.001.00
7J1950J1200ENT KATE FARMS STANDARD 1.0NEOSTIGMINE50458-0306-11 RISPERIDONE57896-0101-01 ACETAMINOPHEN00000-6499-00 MMRV VACCINE SC49281-0589-05 MCV4 MENACWY VACCINE IM49281-0545-05 HIB PRP-T VACCINE 4 DOSE I00006-4045-00 GARDASIL 4VHPV 3 DOSE39822-9900-02 AMMONIA INH49281-0400-10 ADACEL TDAP VACCINE 7 YRS/00006-4963-41 HZV VACCINE LIVE SUBQ63739-0024-01 ASPIRIN 32500168-0111-09 BACITRACIN58160-0811-46 DTAP-HEP B-IPV VACCINE IM00517072001 BETAMETHASONE00409-7337-01 CEFTRIAXONE00517-0031-25 CYANOCOBALAMIN VIT B1200409-4902-34 GLUCOSE 50%70460-0001-01 CHOLERA VACCINE LIVE PO AD00904-2056-61 BENADRYL 00904-7590-60 FERROUS SULFATE 325MG63323-0010-20 GENTAMICIN 40 MG55390-0004-10 GLUCAGON RE13533-0636-05 HEP B IG IMFLUZONE QUAD PEDS PF 0.25 ML CY201800169-1833-11 REGULAR INS00009062601 DEPO-PROVERA 1MG00009-3073-01 DEPOMEDROL00009-0039-28 SOLUMEDROL60793-0700-10 BICILLIN L-A 100000 UNITS60793-0702-10 BICILLIN L-A 100000 UNITS00006-4837-03 PPSV23 VACC 2 YRS SUBQ/IM55390-0077-10 COMPAZINEPROPRANOLOL49281-0215-15 TD VACC NO PRESV 7 YRS IM42023-0104-01 1ML TB INTRADERMAL TEST42023-0104-01 1ML TB INTRADERMAL TEST 5958160-0821-11 HEPB VACCINE 3 DOSE ADULT09045-0313-60 PRENATAL PLUS00172-4431-49 MISOPROSTOL 20049281-0250-51 RABIES VACCINE IM00074-3642-03 LEUPROLIDE 7.5 MG00904-7914-61 IBUPROFEN 200 MG00074-3641-03 LEUPROLIDE53489-0146-01 SULFAMETHOX00182-1809-89 IBUPROFEN 400228-2127-50 CLONIDINE 000641-0376-25 BENADRYL 00100.0035.0011.0071.00
058160-0820-43 HEPB VACC 3 DOSE PED/ADOL00003-0293-05 TRIAMCINOLONE ACETONIDE 100536-1234-41 ASPIRIN MG 81 (OMED9)00409-7241-01 ADRENALIN EHEPA VACCINE ADULT IM 58160-0826-52ML100006-4827-00 VAR VACCINE LIVE SUBQ00006-4681-00 MMR VACCINE SC49281-0860-55 POLIOVIRUS IPV SC/IM00472-0831-60 ALBUTEROL 0RSV MAB IM N460574411401 UN 50MGHEPA VACC PED/ADOL 2 DOSE IM 58160-082560505-2581-03 AZITHROMYCIN 250 MG ORAL00173-0682-54 ALBUTEROL I00006-4943-00 PPSV23 VACC 2 YRS SUBQ/IM00006-4898-00 HIB-HEPB VACCINE IMPROCRIT - 2000 UNITS (NON ESRD USE)00009074630 DEPO-PROVERA 150MG55513-0190-01 NEULASTA42515-0001-01 INACTIVATED JE VACC IM58160-0840-11 DTAP VACCINE 7 YRS IM58160-0812-11 DTAP-IPV VACCINE 4-658160-0805-11 RV1 VACC 2 DOSE LIVE ORAL00059-3223-79 TESTOSTERONLAMINARIA JAPO49281-0510-05 DTAP-IPV/HIB VACCINE IM59676-0304-01 PROCRIT 400 (NON ESRD USE)13533-0631-02 RHOGAM FULL00169-7501-11 NOVOLOG00005-1971-02 PCV13 VACCINE IM58160-0877-46 FLUARIX GSK00407-7241-01 EPINEPHRINE58160-0842-51 BOOSTRIX TDAP VACCINE 7 YR00069-3140-19 AZITHROMYCIN 200 MG ORAL50242-0040-62 XOLAIR00310-0720-10 FASLODEX49281-0790-20 TYPHOID VACCINE IM58468-1849-04 THYROGEN49281-0915-01 YELLOW FEVER VACCINE SUBQHEP A/HEP B VACC ADULT IM 58160-0815-1160793-0701-10 2 ML BICILLIN LA59676-0302-01 PROCRIT - 2 (NON ESRD USE)55513-0546-10 NEUPOGEN 55513-0530-10 NEUPOGEN 00182-2092-01 DIPHENHYDRAFLUZONE CY2019/2020 49281-0419-88TD ADULT 17478-0131-01IMMUNIZATION ADMIN AAP MOC CPC GARDASILVFC 00517-4901-25 .0063.008.00210.00111.001.0050.00
29065190620J218290682J1071906209068170504-0126-02 VARICELLA-ZOSTER IG (VARIZFLUZONE HD CY2019/2020 492814058849281040365 0.5ML FLUZONE HD00006-4121-02 GARDASIL 9 2/3 DOSE IMMENB-4C VACC 2 DOSE IM BEXSERO .5 ML INJMEPOLIZUMAB (NUCALA) 00173-0881-01 1 VIAFLUBLOK 0.5 ML CY2019/202062756-0071-40 TESTOSTERONE CYPIONATE 1MGBEXSERO 58160-0976-0658160-0805-11 RV1 VACC 2 DOSE LIVE ORALIV STR WATER BTL1000ML #2F7114CATH AIRWAY EXCHANGE #G05880INDICATOR STEAM ATTEST #1291ID BAND YELLOW FALLS #505-14PACK PACEMAKER #SCV12PTSPAMICROFILTERS BLOOD #2C8750BAG FLUSH WASTE #K10-02735AFORCEP GRASPING 5F #12040ABDOMINOPLASTY SUPPORT SMALLADAPTER HOSE DBK9AQUAPLAST SHEET 6 X 18BRUSH CHANNEL OPENING BW10BCABLE TRANSDUCER ALINE 4257404CATH AIRWAY COOK EXCHANGE ACAECATH AIRWAY COOK EXCHANGE CCAECIRCUIT ISOTHERMAL BREATHNG INCOTTONOIDS SURG 1/4 X 1/4DETERGENT INSTRUMENT MILK 15GADETERGENT KART KLENZ 3 5GALDRAPE INCISE L&D 3MDRAPE LINGEMAN 3-N-1 #1-0425ELECTRODE LOOP 26 FR CUTTINGELECTRODE PEDI ZOLL MULTIFUNCELECTRODE THERATRODE #3214EXTENDER EXTERNAL TISSUEBAG DRAIN EXTERNAL W TUBINGFILTER HEMOFILTER HF400 CAVHDFILTER PRE STERIS A #A1501FILTER PRE STERIS B A1504FILTER STERIS AIR #A1503FILTER STERIS SUPERLIFEFOAM RESTON PADS 3M 1560MFORCEP BIOPSY CUP 3FRFORCEP BIOPSY URET #505-160FORCEP STONE GRASP #370-119FORCEP GRASPING 5.0FR X 70CGIRDLE FEM LRG BLACK #LGL-L-BGIRDLE FEM MED BLACK .00330.001000.001240.00680.00390.00170.00240.00
LE FEM SM BLACK #LGL-S-BGIRDLE FEM XL BLACK #LGL-XL-BGRAFT DERMA CARRIER SKIN 16LASER FIBER SLMLIN 365#840-893INFRATONE 30X5 #0624-084-30LITHOTRIPER MONOLITH MECHANICALLOOP CUT RESECTION WEDGE 24FRLOWER SAMPLE FLOW PATH 278MAMMARY SIZER SALINE 125CCMAMMARY SIZER SILICONE 225CCMAMMARY SIZER SILICONE 275CCMAMMARY SIZER SILICONE 375CCMAMMARY SIZER SILICONE 425SMAMMARY SIZER SILICONE 475SMAMMARY SIZERS SILICONE 325CCPAD KNEE ELECTRA KOOL #ST-012SPEN NEURO 2120-025PENCIL TRIPLE OPT HAND CONTROLPOUCH ENDO CATCHPROBE V-PACING CHANDLR#D98100HPROBE ULTRASONIC LITHONEPHROPROBE ULTRASONIC LITHROURETRORETRIEVER BILIARY POSITRAPSENSOR ABDOMINAL STAR SYNCSENSOR FINGER CLIP PULSE OXSENSOR ICP TELESLEEVE SEQUENT CALF 17 #L501-MSLEEVE SEQUENT FOOT LG #FG200RSLEEVE SEQUENT THIGH #DVT30SLING POLY THOMAS PILE SPLINTSPHINCTEROTOME CANULATNG20MMX5SPHINCTEROTOME RAPIDEXCH 20X35SPHINCTEROTOME RAPIDEXCH 30X5SPLINT DENVER LARGESTONE RETRIVER 11MM PLAIN TIPSTONE RETRIVER 11MM W FILIFORMSTONE RETRIVER 15MM PLAIN TIPSTONE RETRIVER 15MM W FILIFORMSTONE RETRIVER 8MM BASKET PLAISTONE RETRIVER 8MM BASKET W FALISTRAP WIDE 3IN #95-902STRIP SKIN TAPE TRACTIONSUTURE APPLIER O CHROMIC GUTSUTURE ASSIST ENDO #SW100SYRINGE INSULIN 30CC 309300SYSTEM ASAP BIOPSYSYSTEM ASAP BIOPSY 15GAX15CMSYSTEM ASAP BIOPSY 0330.00290.00600.00460.00410.00620.00600.00660.00
727002182700219270022227002262700227C1771SYSTEM ASAP BIOPSY 18GAX15CMSYSTEM INFLATION 15-101SYSTEM INFLATION #2796TAPE HYTAPE 1 INCHTIP APPLICATOR CURVED FLOSEALLOCATOR NERVE VARI STIM 3 85 6ALISTRAP REG 1.5IN #95-900SPHINCTEROTOME TRITOMESPEEDBAND SUPERVIEW 7AUTOTOME RAPID EXCHANGE RX44INSERT FOGARTYFORCEP TRIPODPACK VATS THORACIC #PHOCTHSPGPACK MAJOR VASCULARPACK VASCULAR ACCESSSPACK GYN LAPAROSCOP#SMA11GLSPDPACK MAJOR LITHOTO #SMA11MLSPEPACK T&A/NASALSINUS#SEN11TASPESTYLET COAXIAL DILAT #260120KIT MAJOR NECK #SOP11MNSPDKIT MAJOR PROCEDURE#SBA11MMSPDKIT MINOR GENERAL #SBA11MPSPDKIT LAPCHOLE #SLC11CSPEKIT BREAST #PGOCBBASPAKIT SPINE #SNE11SPSPFKIT LOWER EXTREMITY SOP11LESPEKIT UNILAT TOTALKNEE#SOP11UTSPKIT TOTAL HIP/HEMI #SOP11THSPKKIT SHOULDER #SOP11SHSPEKIT HAND WRIST ELBOWSOP11HWSPDKIT MAJOR PLASTIC #SEN11MPSPGKIT CYSTO/TUR #SBA11CTSPEKIT FEMDISTAL BYPASS#SCV11FPSPGELPORT DEVICE 120M #C8XX2PLASMA WAND EVAC70#EICA5872-01DRAPE FLUID WARMER #RAC5300KIT ACCESSORY AMS700 #72401850INVANCE MALE SLING SYSTEM #72403525CLIP RESOLUTIONCASSETTE P/D 4 PRONGGLIDECATH ANG 4X65 #CG415DETERGENT CRITI-KLENZ CONSYN DRILL BIT 3FLT3.2M 3010060SYN DRILL BIT 3FLT3.2M 3010100SYN DRILL BIT 3FLT3.2M 3010103SYN DRILL BIT PERC 2.8M 324214SYN DRILL CANNUL 4.3M/ 310.634SYN DRILL CANNUL 1000.00
9C1729C1729C2630C2630C1726C1729C1729SYN DRILL CANNUL 5.0MM 310.63TAPERTOME RAPID EXCHANGEPROTACK 5MM #174006KNOT TITANIUM #030510RELOAD ENDOPATH 12M GRN#GST60GRELOAD ENDOPATH 12M GLD#GST60DNEPHROSTOMY SET #450-110PACK BARIATRIC #PG40BTSPDELECTRODE CUT LOOP 22F 30DEGPOUCH EZCLOSE XXL 940ML#14527STRIP INDICATOR #LCC008ILLUMINATOR LIGHT MAT #SA3550FORCEP OPEN CURVED JAW 9APPLICATOR 15CM #20-5000SSENT GPH TRACH 8X80 #FTM08080SET CATH NEP RENTRY 14F#410104SET CATH SPRAPUB PERC STAMY14FSET CATH SPRAPUB PERC STAMY16FFORCEP BIOPSY CUP 3X115#G15054FILTER LUBRICANT DIFFUSER #ADLOOP CUTTING ANGLED #2714TAPE GLOW N TELL #1100-01SET CATH ILM URETRL 5F #G16746APPLICATOR SPRAY DUPLOREACH 35APPLICATOR SEALANT EXTENDR 22CFILTER PRISMAFLEX M100#8353520DETERGENT CRITI-KLENZ 5GADETERGENT KLENZINE 15GALDETERGENT KART KLENZ 3 15GUIDEWIRE STH .015 50CM #81322GUIDEWIRE J.35 #G01947GUIDEWIRE STRAI 015 #G02426GUIDEWIRE STRAIT 018 #G01955SET MINICAP PD TRANSFER 5DRESSING TEGADERM 2X2 #1624WCATH TROCAR 12FR #561027CATH TROCAR 16FR #561035CATH TROCAR 20FR #561043CATH TROCAR 8FR #560805CATH TROCAR 10FR #561019CATH FOLEY 14F 5C 2WY#016CATH THERMO SWAN #831HS75PCATH THERMO SWAN 7FR#143HTRAY MULTI LUMEN #AK-4570CATH JELCO SAF.PROT.18G #3055CATH OPAQUE SILICONE #2184.00CATH TEXAS YEE HA LRG #64CATH TEXAS YEE HA 200.0010.00100.0010.0050.00
1C1729C1726C1726CATH REPOGLE SUCT 10FR #2CATH RADIL ARTERYALINE#RA04020DRAIN CHEST THOR #3612-40KNEE IMMOBILE LRG#1050-20-03WOUND EVAC HEMOVAC #2500-00-10RESERVOIR KIT 100C7M#2571-0010RESERVOIR KIT 10MM #2572-0010SET INTUBATION COOK #G07647SET CENTRAL VENOS 4FR #G04035SET CENTRAL VENOUS 3FR #77617SET CENTRAL VENOUS 5FR #76693SET CENTRAL VENOUS 5FR #G03997SET CENTRAL VENOUS 7FR #G02961GUIDEWIRE J 018 #112289GUIDEWIRE J 025 #97758GUIDEWIRE J 035 #G01947GUIDEWIRE STRAI 015 #G024GUIDEWIRE STH 015X50CM #8GUIDEWIRE STRAIT 018 #G01SET CENTRAL VENOUS 5FR #G04134STAPLER SKIN 35 WIDE #PMW35TRAY PNEUMOTHRAX 8FR #AKTRAY TRANSFUSION EXCHGE #TRAY URINE METER 14FR #303014ATRAY URINE METER 16FR #30CATH PLUG W/COVER STR #000076TRAY FOLEY W/14FR CATH #907714TRAY FOLEY W/16FR CATH#300016ATRAY FOLEY W/18FR CATH#300018ATRAY CRICOTHYROTOMY #G04652TUBE TRACH CUFF FENN #6DFENTUBE TRACH CUFF FENN #10DFENTUBE TRACH CUFFLESS #6CFSTUBE TRACH CUFFLESS #8CFSTUBE TRACH UNCUFF #10CFSTUBE TRACH CUFFED #4DCTTUBE TRACH CUFFED #6DCTTUBE TRACH CUFFED #8DCTTUBE TRACH CUFFED #10DCTSET THORASEAL3 CHEST #713URIMETER W/DRAIN BAG #153214ASUTURE 3-0 CHROM #1638G(1638H)SUTURE 2-0 ETHIBOND #MX563SUTURE 8-0 SILK #7752GSUTURE 6-0 PROLENE #8305HKIT LAP CHOLI ETHICON #FNC41CATH BALLOON SYM3X2 4FR#10-320CATH BALLOON SYM .00810.00990.00870.00
7C1769C1751CATH FASTRACKER #161104SNARE GOOSE NECK 10M #GN1000SNARE GOOSE NECK 15M #GN1500SET PICLINE 4FR ADLT#RJ01SET CURRY RETRIE #118865SET PICLINE 5F ADULT #45-672CONTOUR EMBOLI 45 150CONTOUR EMBOLI 150 250CONTOUR EMBOLI 250 355CONTOUR EMBOLI 355 500CONTOUR EMBOLI 500 710CONTOUR EMBOLI 710 1000CONTOUR EMBOLI 1000 1180COIL MWCE 38 4 3 #39027NEEDLE TRANSLUMBAR #G0208SHEATH 6FR BALKAN #G07339SHEATH 7FR BALKAN #G10384CATH MEWISEN 5FR 10X65 #46-179CATH SET 3FR PICC #G08390GLIDECATH ANG 5FX65C #CG507CATH DAVIS 5FRX100CM #G08GLIDECATH ANG 5FRX100C #CGLIDECATH SIMS 5FX100C #CG511CATH H 1 5.5FR 100CM #G03CATH HN4 100CM #122913CATH FAST TRACKER #134108CATH RENAGADE #18-288CATH TRACKER 38 #105117CATH FAST PAK 4FR #6654-43CATH COBRA C2 4FX65C #G08GLIDECATH COBRA 4FX65C #CG409CATH COBRA 2 5FX65CM #56538CB2GLIDECATH COBRA 5FX65C #CG502CATH CENTRFLO PIG 4X70C#GCATH CENTRFLO 4X90C #G11151CATH PIGTAIL 5X70CM #G112CATH CENTRFLO 5X90C #G112CATH STRAIGHT 4FX70C #G09CATH STRAIGHT 5FX70C #G11CATH STRAIGHT 5FR 100CM#G11267CATH GROLLMAN 6.7F#G00175CATH MONTI SPECIAL #G0894CATH MEWISEN 5X100 #46-175CATH MEWISEN 5CMINF65CM 46-183CATH MIKAELSON 5FR #G09312GUIDEWIRE BENTSON #49-145CATH RDC 6 5FR #230609CATH RLG 5 5FR .00230.0050.0040.00110.0070.00
9C1726C1769C1769C1769C1894CATH SH 9FR #G28656CATH GUIDING MPI 8XL#19-823CATH GUIDING C2 8FR #19-826GUIDEWIRE GLIDE GOLD #GM1GUIDEWIRE KATSEN #46-196GUIDEWIRE XSTIFF 35 C #G0GUIDEWIRE TIP DEFLECT #G0GLIDEWIRE 035 #GS3508GLIDEWIRE 038 #GS3807GLIDEWIRE 018 #GR1806GLIDEWIRE 025 #GR2505GLIDEWIRE STRGHT 035 #GR3503GLIDEWIRE ANGLED 035 #GR3GUIDEWIRE ROSEN 035 #8944GUIDEWIRE ROSEN 038 #8945GUIDEWIRE TRANSCEND #46-8GUIDEWIRE ARROW #AW01700GUIDEWIRE ROSEN.035 #G012GUIDEWIRE EXC 35 STR #G00GUIDEWIRE EXCHANGE 038 #GGUIDEWIRE EXCHAGE CURV #0GUIDEWIRE LLT 038 #G00720GUIDEWIRE J 035 #G00562GUIDEWIRE 038 3J #G00568GUIDEWIRE 035 #49-153GUIDEWIRE 038 15J #G00579GUIDEWIRE V 18 #46-858GUIDEWIRE DASHER #234214GLIDECATH STH 5X65 #CG505GLIDECATH STH 5X100 #CG506GLIDEWIRE STR 035X260C #GGLIDEWIRE ANG 035X260C #GR3509CATH ALL PURP 8FR #27-134CATH ALL PURP 10FR #27-13CATH ALL PURP 12FR #27-13CATH ALL PURP 14FR #27-13CATH BILIARY COLP 10FR #GCATH BILIARY FLEX 12FR #2CATH BILIARY DRAIN 8.5F#GCATH BILIARY DRAIN 10FR#0CATH MULTIPURP 8.5F#G0720CATH MULTIPURP C/L 12F #GCATH SUMP VANSON 14FR #20DILATOR AMPLATZ RENAL #G1GUIDEWIRE ACCUSTICK #20-1GUIDEWIRE AMPLAT SSTIFF#4GUIDEWIRE TORQFLX 40CM #GINTRODUCER ACUSTIC 038 90.00100.0060.0080.00220.00
R GRENFIEL 12F#50-314NEEDLE BILIAR RING #11881SET GASTRO PERCUT #G05274SET GASTRO JEJUN ADLT #G0SET TRANSJUG ACCESS #G065SET PEEL A WAY 10FR #0739SET PEEL A WAY 8FR #G1443SET PEEL A WAY 9FR #20-606SET TRANSJUGULAR BX #G06427SET NEFF PERCUT ACCES #GCATH BILIARY DRAIN 14F#27CATH RINGBILARY DRIN 8F#GSET MICROPUNC INTRO 4FR#GSET MIRCOPUNCH 5FR #G4386SET DENNY INTRO 4FR #G115SET DENNY INTRO 4.5FR #G1SET DENNY INTRO 5.5FR #G1SET LIVER ACCESS BIOP #G0SET THALQICK ABSCESS #G06341CATH BALLOON DI 4X2 5F #16-417CATH BALLOON DI 4X2 5F #16-418CATH BALLOON DI 5X2 5F #1CATH BALLOON DI 6X2 5F #16-457CATH BALLOON DI 7X2 5F #16-477CATH BALLOON DI 4X4 5F #16-423CATH BALLOON DI 5X4 5F #1CATH BALLOON DI 6X4 5F#16-463CATH BALLOON DI 7X4 5F#16-483CATH BALLOON DI 8X3 5F#16-501CATH BALLOON DI 9X4 5.8F16-517CATH BALLOON DI 10X4 5F#16-525CATH BALLOON DI 5X4 5F#16-444CATH BALLOON DI 8X4 5F#16-505CATH BALLOON DI 4X4 5F#16-424CATH BALLOON TRX 10 7F#22-110CATH BALLOON OCC 7FR #17-102CATH BALLOON XXL12X4 5F#14-510CATH BALLOON XXL14X4 5F#14-514CATH BALLOON BMX 7X4 5F#12-543CATH BALLOON BMX8X4 5FR#12-552CATH BALLOON SYM 4X4 4F#10-353CATH BALLOON SYM 5X2 4F#10-331NEEDLE BIOPSY T18G X9NEEDLE BIOPSY T18G X15NEEDLE BIOPSY T20G X6NEEDLE BIOPSY T20G X9NEEDLE BIOPSY T20G X15NEEDLE BIOPSY #ACT18G 70.00100.0090.00100.0090.00110.00120.00
6C1729C1729C1751C1887C1729C1760C1769NEEDLE BIOPSY #ACT20GX11NEEDLE TURN BIOP 22GX5 #GNEEDLE TURN BIOP 22GX20#GCOIL MWCE-38 5 8 #39034SET THALQICK ABCESS 12F#GSET THALQICK ABCES 14FR#GGUIDEWIRE TERUMO RADIO #GGUIDEWIRE 035 STRAIGHT #GCATH PIGTAIL 6FR 110CM #6CATH JL4 PROFLO 6FR #10015GUIDEWIRE WHOLY HITORQ J#GUIDEWIRE 025 #G00467CATH MOD NO TORQ 6F#SRD6596CATH PIGTAIL STORQ 6F#532CATH MULTI A2 CATH #532-6CATH AL2 SUPTORQUE #532-6CATH INTERN MAM STORQ #532-660CATH RCB 6FR STORQUE #532CATH AR1 SUPTORQUE #533-641CATH CORONART STORQ#534-5CATH MP A2 5FR INFINI#534-542TCATH ALI 5FR INF #534-545TCATH AL2 5FR SUPTORQ #534-546TCATH AR MOD 5F INFINI#534-548TCATH AL2 6F STORQ #532-645CATH ARII MOD 6F #533-643CATH CORNART5.2FSTORQ#534-518TCATH A2 MP 6F STORQ #533-642CATH CORN LFT 6F STORQ#532-672CATH PROFLO NOTORQ 6F #9234GUIDEWIRE EXCHG STR 035 #GUIDEWIRE .035 #G00651GUIDEWIRE CURVED 025 #G00CATH PGTL 6F STORQ #532-6CATH MUTLI A2 7F #527-742CATH MULTI A2 7F #527-787CATH AR1 PROFLO 6FR #6457CATH A2 MP STORQ #534-644TCATH NEPHRO FLEX 8F #27-1CATH NEPHRO FLEX 10F #27CATH BILIARY FLEX 8F #27CATH BILIARY FLEX 10F #27TUBE-T MCLEAN STOCK #206353CATH 3DRC 5FR 100CM #534-576TCATH SRC 5F INFINI #534-574TCATH PGTL 5.2F STORQ #534-550SVASOSEAL ELITE #74300GLIDEWIRE SS 50.00150.00
6C1751C1726C1726CATH RCB 5FR #534-570TCATH LCB 5FR 100CM #534-572TINTRODUCER PEELAWAY 7FR #405108INTRODUCER PEELAWAY 9FR #405116INTRODUCER PEELAWAY 10FR #405120ANIGO-SEAL 6FR VIP #61013ANIGO-SEAL 8FR STS #610131AIRWAY LARYNGEAL MASKAIRWAY NASOPHAR 16 FRAIRWAY NASOPHARYNGEAL 20FRAIRWAY NASOPHARYNGEAL 22FRAIRWAY NASOPHARAIRWAY NASOPHAR 10FRAIRWAY NASOPHAR 12FRAIRWAY NASOPHARYNGEAL 14FRAIRWAY NASOPHARYNGEL 30 FRARTHROWAND 3.5 X 90 DEGREEBAG EXTERNAL DRAIN #82-1702CATH BALLOON DILIT MAXFORC 8BALLOON DILITATIONTTSMAXFORC15BALLOON RETRIEVAL 3 LUMEN 11.5CATH BALLOON UROMAX #225-122BALLOON UROMA X 2.7FRBANDAGE ESMARK 6X12 5610 12BANDING LIGATOR SPDBAND SPRVIEBASKET GEMINI STONE 330-104BASKET STONE PERSUER #340-104BASKET SEGURA 2.4FR MINI 0 TIPBASKET STONE RETRIEVAL 380-112BASKET SEGURA OVER WIRE 320 10BASKET SPIRAL BILIARYPROBE FOGARTY BLN 5F #410235FBLADE 2.0 FULL RADIUS BLADEBLADE BRAZOL NEXGENTIP SCISSOR HOOK SWITCHBLADEBOWL CEMENT MIX QUICK VACBRACE KNEE ELS #11-0965-13066BRACE LEG ELS#11-0968-9-06000BRUSH RX CYTOLOGY #4500BUR ROUND CUT MEDIUM 1.5MMBUR ROUND LARGEBUR ROUND X-LONG 4MM #5093-128BUR SIDE CUT 1 5 X 7 5MM CARCANNULA 4.5 W/FLUID SEAL #3480CANNULA RAPID EXCHG TAPERED ERCATH ANGIO DES 14GA X 1 1/4CATH AORTIC OCCLUSSIONCATH BALLOON XXL 184 00340.00890.00200.0010.00390.00950.00
9C1729CATH BALLOON SYM 2.5X2CATH BALLOON SYM 3X4CATH BALLOON SYM 3.5X4CATH BALLOON DI 4 X 10 5FR 75CCATH BALLOON DI 5X4.5FR 75CATH BALLOON DIL CRE 10X1CATH BALLOON DIL CRE 12X1CATH BALLOON DIL CRE 15-18MCATH BALLOON DIL CRE 18-320CATH BALLOON DIL CRE 6X7X8CATH BALLOON DIL CRE 9-10MMCATH BALLOON MARSHAL 10 X 4CATH BALLOON MARSHAL 7 X 4CATH BALLOON MARSHAL 8 X 4CATH BALLOON MARSHAL 8 X 8CATH BARTHOLIN GLAND WORDCATH CHOLANGIOGRAM 4.5FRCATH FOLEY COUDE16F5C#0102SI16CATH FOLEY CNCIL18F5C#0196SI18CATH FOLEY CNCIL20F5C#0196SI20CATH FOLEY CNCIL22F5C#0196SI22CATH DBL LUMEN VENOUS SET 4FRCATH DILATION BALLOON 10MMCATH DILATION BALLOON 18MM 54FCATH DOUBLE LUMEN 4 FRCATH APPLICATION DUPLOCATH 35CATH EMBOL 5.5FR #12TLW805F35CATH ESPH GASTRIC CCEDC20CATH FOGARTY EMB 2FR #120602FCATH FOGARTY EMB 3FR #120803FCATH FOGARTY EMB 4FR #120804FCATH FOGARTY EMB 5FR #120805FCATH FOGARTY EMB 6FR #120CATH FOLEY SIL 6F1.5C#17000306CATH FOLEY 14F 30C2WY#0166SI14CATH FOLEY 16F 30C2WY#0166V16SCATH FOLEY 16F 30C3WY#0167SI16CATH FOLEY 18F 30C2WY#0166SI18CATH FOLEY 22F 30C2WY#0166SI22CATH FOLEY 22F 5C 2WY#0165SI22CATH FOLEY 24F 30C3WY#0167SI24CATH FOLEY 8FR 3CC 2WAY SILICOCATH FOLEY SILICONE 14FR 5CC 2CATH GLIDE ANGLED TAPER#32-136CATH GLIDE STRAIGHT CG505CATH GUIDING BRITE TIP 9FRCATH HEYMAN 20FR #021120CATH HEYMAN 4FR 030.00260.00170.00380.0030.00350.00
8CATH HEYMAN FIL 4FRCATH INNERVISION VENTRICULARCATH INTRDCSET PERCTNS 8FR 88CATH IRRIGATION PRUITT 4FRCATH IRRIGATION PRUITT 6FRCATH IV JELCO 16GA #3042CATH MULTI ACCESS #1900CATH NEPHROSTOMY 14FRCATH OLIVE TIP 4FRCATH OPENEND 4.0FRCATH OPENEND 8.0FRCATH PACEPORT 7.5FR #831HF5CATH PACING BIPO BALLOON TE6FRCATH PASSER SUBCUTANEOUSCATH PER CENTRAL VENOUS 3.0 FRCATH PER CENTRAL VENOUS 4.0FRCATH PEZZER 12FR #064012CATH PEZZER 14FR #064014CATH RED RUBBER 12FR #PRU112CATH RED RUBBER 20FR #PRU120CATH RED RUBBER 22FR 2130CATH RED RUBBER 24FR DC63CATH RED RUBBER 26FR DC63CATH RED RUBBER 28FR DC64CATH RED RUBBER 32FRCATH RED RUBBER 34FRCATH RED RUBBER 36FRCATH RETRIEVAL 11.5MM RAPID EXCATH RETRIEVAL 15
Charge Code CPT/ HCPCS CODE Charge Description Charge Amount 2200032 S9470 COMP MED NUTRITIONAL ASSESSMENT 189.00 . 2210024 ORAL DIAB SUPPLEMENT GLUCERNA 1.0 240 ML 1.00 2210202 ENSURE ENLIVE 1.5 CAL
