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S9372

Home Health Care
HT INJ ANTICOAG DIEM
HT INJ ANTICOAG DIEM

S9373

Home Health Care
HIT HYDRA TOTAL DIEM
HIT HYDRA TOTAL DIEM

S9374

Home Health Care
HIT HYDRA 1 LITER DIEM
HIT HYDRA 1 LITER DIEM

S2068

Inpatient Medical and Surgical Care in a General Hospital
Surgery as an Outpatient
BREAST DIEP OR SIEA FLAP
BREAST DIEP OR SIEA FLAP

S3005

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
Routine Vision Care
Short-Term Rehabilitation Therapy
TMJ Disorder Treatment
EVAL SELF-ASSESS DEPRESSION
EVAL SELF-ASSESS DEPRESSION

S4016

Infertility Services
FROZEN IVF CASE RATE
FROZEN IVF CASE RATE

S4018

Infertility Services
F EMB TRNS CANC CASE RATE
F EMB TRNS CANC CASE RATE

S4042

Medical Care Outpatient Visits
OVULATION MGMT PER CYCLE
OVULATION MGMT PER CYCLE

S5101

ADULT DAY CARE PER HALF DAY
ADULT DAY CARE PER HALF DAY

S5102

ADULT DAY CARE PER DIEM
ADULT DAY CARE PER DIEM

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