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G0378

Emergency Medical Outpatient Services
Inpatient Medical and Surgical Care in a General Hospital
Labs, X-Rays and Other Tests
Preventive Dental Care for Children
Maternity Services
Medical Care Outpatient Visits
Mental Health and Substance Use Treatment - Biologically Based Mental Conditions
Mental Health and Substance Use Treatment - Non-Biologically Based Mental Conditions
Mental Health and Substance Use Treatment - Alcoholism Treatment
TMJ Disorder Treatment
HOSPITAL OBSERVATION PER HR
HOSPITAL OBSERVATION PER HR

G0379

Emergency Medical Outpatient Services
Inpatient Medical and Surgical Care in a General Hospital
Labs, X-Rays and Other Tests
Preventive Dental Care for Children
Maternity Services
Medical Care Outpatient Visits
Mental Health and Substance Use Treatment - Biologically Based Mental Conditions
Mental Health and Substance Use Treatment - Non-Biologically Based Mental Conditions
Mental Health and Substance Use Treatment - Alcoholism Treatment
TMJ Disorder Treatment
DIRECT REFER HOSPITAL OBSERV
DIRECT REFER HOSPITAL OBSERV

G0402

INITIAL PREVENTIVE EXAM
INITIAL PREVENTIVE EXAM