H2018 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 Routine Vision Care Short-Term Rehabilitation Therapy TMJ Disorder Treatment PSYSOC REHAB SVC, PER DIEM PSYSOC REHAB SVC, PER DIEM
H2019 Early Intervention Services 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 Routine Vision Care Short-Term Rehabilitation Therapy TMJ Disorder Treatment THER BEHAV SVC, PER 15 MIN THER BEHAV SVC, PER 15 MIN
H2020 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 Routine Vision Care Short-Term Rehabilitation Therapy TMJ Disorder Treatment THER BEHAV SVC, PER DIEM THER BEHAV SVC, PER DIEM
H2035 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 A/D TX PROGRAM, PER HOUR A/D TX PROGRAM, PER HOUR
J0133 Home Health Care Infertility Services Medical Care Outpatient Visits Prescription Drugs Radiation Therapy and Chemotherapy ACYCLOVIR INJECTION ACYCLOVIR INJECTION
J0172 Home Health Care Medical Care Outpatient Visits INJ, ADUCANUMAB-AVWA, 2 MG INJ, ADUCANUMAB-AVWA, 2 MG
J0179 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy INJ, BROLUCIZUMAB-DBLL, 1 MG INJ, BROLUCIZUMAB-DBLL, 1 MG
J0180 Home Health Care Medical Care Outpatient Visits AGALSIDASE BETA INJECTION AGALSIDASE BETA INJECTION
J0256 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy ALPHA 1 PROTEINASE INHIBITOR ALPHA 1 PROTEINASE INHIBITOR
J0282 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy AMIODARONE HCL AMIODARONE HCL