Q5115 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy INJ TRUXIMA 10 MG INJ TRUXIMA 10 MG
Q9991 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy BUPRENORPH XR 100 MG OR LESS BUPRENORPH XR 100 MG OR LESS
Q9992 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy BUPRENORPHINE XR OVER 100 MG BUPRENORPHINE XR OVER 100 MG
S0189 Home Health Care Medical Care Outpatient Visits Radiation Therapy and Chemotherapy TESTOSTERONE PELLET 75 MG TESTOSTERONE PELLET 75 MG
S0265 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 GENETIC COUNSEL 15 MINS GENETIC COUNSEL 15 MINS
S1040 Durable Medical Equipment Prosthetic Devices CRANIAL REMOLDING ORTHOSIS CRANIAL REMOLDING ORTHOSIS
S2083 Inpatient Medical and Surgical Care in a General Hospital Surgery as an Outpatient ADJUSTMENT GASTRIC BAND ADJUSTMENT GASTRIC BAND