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Cost Estimator
Dahl Memorial
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Code
Description
ADMIN SARSCOV2 100MCG/0.5ML 1ST
ADMIN SARSCOV2 100MCG/0.5ML 2ND
12035
LAC INTERMED TRUNK/LIMB 12.6-20CM
24670
FX TREATMENT ULNAR PROXIMAL CLOSED
36430
TRANSFUSION BLOOD OR BLOOD COMPON
90460
VACCINE ADMIN INITIAL AGES 0-18
90461
ADMIN IMMUNIZ ADD'L AGES 0-18 W/ PHY
90461
VACCINE ADMIN ADD'L AGES 0-18
90471
VACCINE ADMIN INITIAL AGES 19 >
90472
VACCINE ADMIN ADD'L AGES 19 >
94010
PFT-BREATHING CAPACITY TEST
94011
PEDIATRIC SPIROMETRY
94012
ADULT SPIROMETRY W/ BRONCHODIALATOR
94060
SPIROMETRY
99221
HOSPITAL OR OBS ADMIT LEVEL 1 BREIF
99222
HOSPITAL ADMIT LEVEL 2 INTERMED
99223
HOSPITAL OR OB ADMIT LVL 3 COMPLICATED
99231
INPATIENT DAILY VISIT LEVEL 1
99232
INPATIENT DAILY VISIT LEVEL 2
99233
INPATIENT DAILY VISIT LEVEL 3
99234
OBSERVATION INPT LOW COMPLEXITY
99235
OBSERVATION INPT MODERATE COMPLEXI
99236
OBSERVATION INPT HIGH COMPLEXITY
99238
HOSPITAL DISCHARGE 30 MINS OR LESS
99239
HOSPITAL DISCHARGE 30 MINS OR MORE
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