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E2208

Durable Medical Equipment

Home Health Care

CYLINDER TANK CARRIER

CYLINDER TANK CARRIER

E2209

Durable Medical Equipment

Home Health Care

ARM TROUGH EACH

ARM TROUGH EACH

E2210

Durable Medical Equipment

WHEELCHAIR BEARINGS

WHEELCHAIR BEARINGS

E2211

Durable Medical Equipment

Home Health Care

PNEUMATIC PROPULSION TIRE

PNEUMATIC PROPULSION TIRE

E2213

Durable Medical Equipment

Home Health Care

PNEUMATIC PROP TIRE Insert

PNEUMATIC PROP TIRE Insert

E2219

Durable Medical Equipment

Home Health Care

FOAM CASTER TIRE ANY SIZE EA

FOAM CASTER TIRE ANY SIZE EA

G0382

Emergency Medical Outpatient Services

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

LEV 3 HOSP TYPE B ED VISIT

LEV 3 HOSP TYPE B ED VISIT

G0390

Emergency Medical Outpatient Services

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

TRAUMA RESPONS W/HOSP CRITI

TRAUMA RESPONS W/HOSP CRITI

G0397

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

ALCOHOL/SUBS INTERV >30 MIN

ALCOHOL/SUBS INTERV >30 MIN

G0402

INITIAL PREVENTIVE EXAM

INITIAL PREVENTIVE EXAM