Wahiawa General Hospital - Price List for Shoppable Services

Prices Posted and Effective as of 12-29-2020

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Disclaimer: The Hospital determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary. Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise.

Service Description	Service Code	Cash Price	Rates
CT Scan
CT LUNG LOWDOSE SCREENING G0297/71250	HCPCS G0297	$248
CT scan	CPT 70450	$458
CT scan of abdomen and pelvis with contrast	CPT 74177	$2,718
CT scan of pelvis with contrast	CPT 72193	$1,011
Ct abd & pelv 1/> regns	CPT 74178	$3,533
Ct abd & pelvis w/o contrast	CPT 74176	$2,091
Ct angio abd&pelv w/o&w/dye	CPT 74174	$1,516
Ct angiography chest	CPT 71275	$1,264
Ct angiography head	CPT 70496	$1,011
Ct angiography neck	CPT 70498	$1,011
Ct chest spine w/o dye	CPT 72128	$1,460
Ct lower extremity w/dye	CPT 73701	$1,011
Ct lower extremity w/o dye	CPT 73700	$809
Ct lumbar spine w/o dye	CPT 72131	$1,460
Ct maxillofacial w/dye	CPT 70487	$758
Ct maxillofacial w/o dye	CPT 70486	$607
Ct neck spine w/o dye	CPT 72125	$1,460
Ct pelvis w/o dye	CPT 72192	$809
Ct soft tissue neck w/dye	CPT 70491	$758
Ct soft tissue neck w/o dye	CPT 70490	$607
Ct thorax dx c+	CPT 71260	$1,264
Ct thorax dx c-	CPT 71250	$1,011
Ct upper extremity w/dye	CPT 73201	$1,011
Ct upper extremity w/o dye	CPT 73200	$809
Cardiology
Cardiovascular stress test	CPT 93017	$995
Tte w/doppler complete	CPT 93306	$2,531
Clinic
Initial new patient preventative medicine evaluation (18-3... (Not Offered)	CPT 99385	-	-
Initial new patient preventative medicine evaluation (40-6... (Not Offered)	CPT 99386	-	-
New patient office or other outpatient visit, 30 min (Not Offered)	CPT 99203	-	-
New patient office or other outpatient visit, 45 min (Not Offered)	CPT 99204	-	-
New patient office or other outpatient visit, 60 min (Not Offered)	CPT 99205	-	-
Patient office consultation, 40 min (Not Offered)	CPT 99243	-	-
Patient office consultation, 60 min (Not Offered)	CPT 99244	-	-
EEG
Eeg awake and asleep	CPT 95819	$995
Sleep study (Not Offered)	CPT 95810	-	-
EKG
Ecg monit/reprt up to 48 hrs	CPT 93225	$315
Ecg monit/reprt up to 48 hrs	CPT 93226	$315
Electrocardiogram tracing	CPT 93005	$168
Electrocardiogram, routine, with interpretation and report (Not Offered)	CPT 93000	-	-
Emergency Room
Application long leg splint	CPT 29505	$271
Application lower leg splint	CPT 29515	$271
Application of finger splint	CPT 29130	$168
Apply forearm splint	CPT 29125	$210
Apply long arm splint	CPT 29105	$271
Clear outer ear canal	CPT 69200	$210
Control of nosebleed	CPT 30901	$210
Critical care addl 30 min	CPT 99292	$260
Critical care first hour	CPT 99291	$3,301
Drain/inj joint/bursa w/o us	CPT 20610	$587
Drainage of skin abscess	CPT 10060	$338
Drainage of skin abscess	CPT 10061	$622
Dress/debrid p-thick burn s	CPT 16020	$338
Dx lmbr spi pnxr	CPT 62270	$1,630
Emergency dept visit	CPT 99283	$986
Emergency dept visit	CPT 99284	$1,600
Emergency dept visit	CPT 99285	$2,344
Emergency dept visit	CPT 99282	$561
Emergency dept visit	CPT 99281	$309
Heart/lung resuscitation cpr	CPT 92950	$498
Hydrate iv infusion add-on	CPT 96361	$74
Hydration iv infusion init	CPT 96360	$382
Immunization admin	CPT 90471	$116
Insert emergency airway	CPT 31500	$536
Insert non-tunnel cv cath	CPT 36556	$1,966
Insert temp bladder cath	CPT 51702	$210
Insertion of chest tube	CPT 32551	$1,966
Mod sed same phys/qhp 5/>yrs	CPT 99152	$95
Njx aa&/strd other pn/branch	CPT 64450	$1,087
Njx aa&/strd trigeminal nrv	CPT 64400	$489
Puncture drainage of lesion	CPT 10160	$622
Removal of nail plate	CPT 11730	$338
Remove foreign body	CPT 10120	$622
Remove impacted ear wax uni	CPT 69209	$112
Rpr f/e/e/n/l/m 2.5 cm/<	CPT 12011	$338
Rpr f/e/e/n/l/m 2.6-5.0 cm	CPT 12013	$338
Rpr s/n/ax/gen/trk7.6-12.5cm	CPT 12004	$338
Rpr s/n/ax/gen/trnk 2.5cm/<	CPT 12001	$338
Rpr s/n/ax/gen/trnk2.6-7.5cm	CPT 12002	$338
Treat elbow dislocation	CPT 24640	$430
Treat fracture radius/ulna	CPT 25605	$1,350
Treat shoulder dislocation	CPT 23650	$430
Imaging
Abdomial ultrasound of pregnant uterus	CPT 76805	$458
Breast tomosynthesis bi	CPT 77063	$44
Breast tomosynthesis bi	CPT 77062	$67
Breast tomosynthesis uni	CPT 77061	$44
Bx breast 1st lesion us imag	CPT 19083	$2,696
Echo exam of abdomen	CPT 76705	$458
Echo guide for biopsy	CPT 76942	$852
Mammography of both breasts	CPT 77066	$678
Mammography of one breast	CPT 77065	$539
Mammography, screening, bilateral	CPT 77067	$583
Ob us < 14 wks single fetus	CPT 76801	$458
Ob us limited fetus(s)	CPT 76815	$229
Transvaginal us obstetric	CPT 76817	$458
Ultrasound breast complete	CPT 76641	$229
Ultrasound breast limited	CPT 76642	$124
Ultrasound of abdomen	CPT 76700	$572
Ultrasound pelvis through vagina	CPT 76830	$343
Us abdl aorta screen aaa	CPT 76706	$229
Us exam abdo back wall comp	CPT 76770	$572
Us exam abdo back wall lim	CPT 76775	$458
Us exam of head and neck	CPT 76536	$343
Us exam pelvic complete	CPT 76856	$343
Us exam scrotum	CPT 76870	$229
Us guide vascular access	CPT 76937	$245
Us lmtd jt/nonvasc xtr strux	CPT 76882	$229
Inpatient Procedures
Cardiac valve or cardiothoracic procedure with cardiac cat... (Not Offered)	DRG 216	-	-
Cervical spinal fusion without CC or MCC (Not Offered)	DRG 473	-	-
Major joint replacement or reattachment of lower extremity... (Not Offered)	DRG 470	-	-
Spinal fusion except cervical without MCC (Not Offered)	DRG 460	-	-
Uterine and adnexa procedures for non-malignancy without C... (Not Offered)	DRG 743	-	-
Laboratory
Acute hepatitis panel	CPT 80074	$294
Alpha-fetoprotein serum	CPT 82105	$104
Antinuclear antibodies	CPT 86038	$75
Antistreptolysin o titer	CPT 86060	$45
Assay dipropylacetic acd tot	CPT 80164	$84
Assay glucose blood quant	CPT 82947	$24
Assay of ammonia	CPT 82140	$90
Assay of amylase	CPT 82150	$40
Assay of blood lipoprotein	CPT 83721	$59
Assay of blood osmolality	CPT 83930	$41
Assay of blood/uric acid	CPT 84550	$28
Assay of ck (cpk)	CPT 82550	$80
Assay of creatinine	CPT 82565	$32
Assay of digoxin total	CPT 80162	$82
Assay of ferritin	CPT 82728	$84
Assay of folic acid serum	CPT 82746	$91
Assay of free thyroxine	CPT 84439	$56
Assay of iron	CPT 83540	$40
Assay of lactic acid	CPT 83605	$106
Assay of lipase	CPT 83690	$68
Assay of lithium	CPT 80178	$41
Assay of magnesium	CPT 83735	$66
Assay of natriuretic peptide	CPT 83880	$210
Assay of phenytoin total	CPT 80185	$82
Assay of phosphorus	CPT 84100	$47
Assay of prealbumin	CPT 84134	$90
Assay of protein other	CPT 84157	$23
Assay of protein serum	CPT 84155	$23
Assay of protein urine	CPT 84156	$23
Assay of serum albumin	CPT 82040	$31
Assay of serum potassium	CPT 84132	$28
Assay of serum sodium	CPT 84295	$30
Assay of triglycerides	CPT 84478	$35
Assay of urine creatinine	CPT 82570	$32
Assay of urine osmolality	CPT 83935	$42
Assay of urine sodium	CPT 84300	$30
Assay of vancomycin	CPT 80202	$84
Assay of vitamin b-1	CPT 84425	$131
Assay ph body fluid nos	CPT 83986	$22
Assay triiodothyronine (t3)	CPT 84480	$88
Automated platelet count	CPT 85049	$28
Basic metabolic panel	CPT 80048	$84
Bilirubin direct	CPT 82248	$31
Bilirubin total	CPT 82247	$31
Bl draw <3 yrs other vein	CPT 36406	$24
Blood culture for bacteria	CPT 87040	$64
Blood gases any combination	CPT 82803	$130
Blood test, clotting time	CPT 85610	$39
Blood test, comprehensive group of blood chemicals	CPT 80053	$104
Blood test, lipids	CPT 80061	$83
Blood test, thyroid stimulating hormone (TSH)	CPT 84443	$104
Blood type antigen donor ea	CPT 86902	$431
Blood typing serologic abo	CPT 86900	$525
Blood typing serologic rh(d)	CPT 86901	$159
Body fluid cell count	CPT 89051	$34
C diff amplified probe	CPT 87493	$217
C-reactive protein	CPT 86140	$32
Carcinoembryonic antigen	CPT 82378	$117
Chorionic gonadotropin assay	CPT 84703	$46
Chorionic gonadotropin test	CPT 84702	$93
Chylmd trach dna amp probe	CPT 87491	$217
Coagulation assessment blood test	CPT 85730	$37
Compatibility test antiglob	CPT 86922	$646
Compatibility test spin	CPT 86920	$646
Complete blood cell count (CBC), automated	CPT 85027	$80
Complete blood cell count (CBC), with differential white b...	CPT 85025	$96
Creatine mb fraction	CPT 82553	$114
Cultr bacteria except blood	CPT 87075	$58
Culture aerobic identify	CPT 87077	$50
Culture othr specimn aerobic	CPT 87070	$53
Culture screen only	CPT 87081	$41
Culture type immunologic	CPT 87147	$32
Detect agent nos dna amp	CPT 87798	$117
Drug screen quantalcohols	CPT 80320	$167
Drug scrn quan levetiracetam	CPT 80177	$82
Exam synovial fluid crystals	CPT 89060	$44
Feces culture aerobic bact	CPT 87045	$58
Fibrin degradation quant	CPT 85379	$63
Glucose other fluid	CPT 82945	$24
Glycosylated hemoglobin test	CPT 83036	$60
Hematocrit	CPT 85014	$15
Hemoglobin	CPT 85018	$15
Hep b surface antibody	CPT 86706	$66
Hepatitis b surface ag ia	CPT 87340	$64
Hepatitis c ab test	CPT 86803	$88
Heterophile antibody screen	CPT 86308	$32
Hiv-1 ag w/hiv-1&2 ab ag ia	CPT 87389	$149
Hsv dna amp probe	CPT 87529	$117
Immunoassay quant nos nonab	CPT 83520	$86
Immunoassay tumor ca 19-9	CPT 86301	$129
Influenza assay w/optic	CPT 87804	$83
Influenza dna amp probe	CPT 87502	$315
Iron binding test	CPT 83550	$54
Kidney function panel test	CPT 80069	$54
Lactate (ld) (ldh) enzyme	CPT 83615	$37
Leukocyte assessment fecal	CPT 89055	$26
Liver function blood test	CPT 80076	$50
Manual reticulocyte count	CPT 85044	$27
Microbe susceptible mic	CPT 87186	$53
Mumps antibody	CPT 86735	$81
Mycobacteria culture	CPT 87116	$67
N.gonorrhoeae dna amp prob	CPT 87591	$217
Nos each organism ag ia	CPT 87449	$74
Obstetric blood test panel (Not Offered)	CPT 80055	-	-
Occult bld feces 1-3 tests	CPT 82272	$21
Other source albumin quan ea	CPT 82042	$39
Ova and parasites smears	CPT 87177	$55
Protein e-phoresis serum	CPT 84165	$66
Protein e-phoresis/urine/csf	CPT 84166	$110
Rbc antibody screen	CPT 86850	$224
Rbc sed rate nonautomated	CPT 85651	$22
Rheumatoid factor quant	CPT 86431	$35
Routine venipuncture	CPT 36415	$24
Rubella antibody	CPT 86762	$89
Rubeola antibody	CPT 86765	$80
Smear complex stain	CPT 87209	$111
Smear fluorescent/acid stai	CPT 87206	$33
Smear gram stain	CPT 87205	$26
Smear wet mount saline/ink	CPT 87210	$29
Specimen infect agnt concntj	CPT 87015	$41
Strep a assay w/optic	CPT 87880	$83
Strep a dna amp probe	CPT 87651	$117
Syphilis test non-trep qual	CPT 86592	$26
Tissue exam by pathologist	CPT 88305	$224
Tissue exam by pathologist	CPT 88304	$224
Total cortisol	CPT 82533	$101
Total prostate-specific antigen (PSA) test	CPT 84153	$114
Total prostate-specific antigen (PSA) test	CPT 84153	$114
Total prostate-specific antigen (PSA) test (Not Offered)	CPT 84154	-	-
Ur albumin quantitative	CPT 82043	$36
Urinalysis test	CPT 81003	$14
Urinalysis test	CPT 81002	$17
Urinalysis test using microscope	CPT 81001	$39
Urinalysis test using microscope (Not Offered)	CPT 81000	-	-
Urine bacteria culture	CPT 87088	$50
Urine culture/colony count	CPT 87086	$50
Urine pregnancy test	CPT 81025	$43
Varicella-zoster antibody	CPT 86787	$80
Vitamin b-12	CPT 82607	$93
Vitamin d 25 hydroxy	CPT 82306	$183
Wbc antibody identification	CPT 86021	$74
Language Pathology
Evaluate swallowing function	CPT 92610	$586
Motion fluoroscopy/swallow	CPT 92611	$379
Oral function therapy	CPT 92526	$284
Speech sound lang comprehen	CPT 92523	$367
Speech/hearing therapy	CPT 92507	$91
MRI
MRI Scan (Not Offered)	CPT 70553	-	-
MRI scan of leg joint (Not Offered)	CPT 73721	-	-
MRI scan of lower spinal canal (Not Offered)	CPT 72148	-	-
Medical and Surgical Supplies
BLANKET BAIR HUGGER LOWER BODY	HCPCS E0215	$21
Cath impl vasc access portal	HCPCS A4300	$287
Cath insertion tray w/bag	HCPCS A4354	$27
Cath w/drainage 2-way latex	HCPCS A4314	$41
Foam drg <=16 sq in w/border	HCPCS A6212	$20
Infusion supplies with pump	HCPCS A4222	$23
Special supplies phys/qhp	CPT 99070	$98
Sterile water/saline, 500 ml	HCPCS A4217	$7
Surgical supplies	HCPCS A4649	$25
Transparent film <= 16 sq in	HCPCS A6257	$19
Nuclear Medicine
Hepatobil syst image w/drug	CPT 78227	$1,359
Hepatobiliary system imaging	CPT 78226	$1,048
Ht muscle image spect mult	CPT 78452	$3,608
Lung ventilat&perfus imaging	CPT 78582	$1,359
Tc99m maa	HCPCS A9540	$119
Tc99m mebrofenin	HCPCS A9537	$84
Tc99m medronate	HCPCS A9503	$81
Tc99m pertechnetate	HCPCS A9512	$4
Tc99m sestamibi	HCPCS A9500	$223
Technetium tc-99m aerosol	HCPCS A9567	$91
Other Diagnostic
Extracranial bilat study	CPT 93880	$697
Extremity study	CPT 93970	$697
Extremity study	CPT 93971	$343
Lower extremity study	CPT 93925	$697
Vascular study	CPT 93976	$229
Other Procedures and Observation
Withdrawal of arterial blood	CPT 36600	$210
Other Therapeutic
Blood transfusion service	CPT 36430	$1,126
Plasma 1 donor frz w/in 8 hr	HCPCS P9017	$121
Plasma fresh frozen	CPT 86927	$1,078
Rbc leukocytes reduced	HCPCS P9016	$294
Ther/diag concurrent inf	CPT 96368	$343
Ther/proph/diag inj iv push	CPT 96374	$287
Ther/proph/diag inj sc/im	CPT 96372	$116
Ther/proph/diag iv inf addon	CPT 96366	$191
Ther/proph/diag iv inf init	CPT 96365	$382
Tx/pro/dx inj new drug addon	CPT 96375	$191
Tx/pro/dx inj same drug adon	CPT 96376	$191
Tx/proph/dg addl seq iv inf	CPT 96367	$343
Psychiatric
Family psychotherapy, including patient, 50 min (Not Offered)	CPT 90847	-	-
Family psychotherapy, not including patient, 50 min (Not Offered)	CPT 90846	-	-
Group psychotherapy (Not Offered)	CPT 90853	-	-
Psychotherapy, 30 min (Not Offered)	CPT 90832	-	-
Psychotherapy, 45 min (Not Offered)	CPT 90834	-	-
Psychotherapy, 60 min (Not Offered)	CPT 90837	-	-
Pulmonary Function
Evaluation of wheezing	CPT 94060	$747
Measure blood oxygen level	CPT 94761	$444
Radiology
Dxa bone density axial	CPT 77080	$343
Fluoroguide for vein device	CPT 77001	$304
Fluoroscopy <1 hr phys/qhp	CPT 76000	$697
X-Ray of lower back	CPT 72110	$412
X-ray exam abdomen 1 view	CPT 74018	$186
X-ray exam abdomen 3+ views	CPT 74021	$343
X-ray exam chest 1 view	CPT 71045	$187
X-ray exam chest 2 views	CPT 71046	$224
X-ray exam complete abdomen	CPT 74022	$412
X-ray exam hip uni 1 view	CPT 73501	$186
X-ray exam hip uni 2-3 views	CPT 73502	$280
X-ray exam hips bi 2 views	CPT 73521	$343
X-ray exam knee 4 or more	CPT 73564	$268
X-ray exam l-s spine 2/3 vws	CPT 72100	$343
X-ray exam l-s spine bending	CPT 72114	$412
X-ray exam neck spine 2-3 vw	CPT 72040	$224
X-ray exam neck spine 4/5vws	CPT 72050	$343
X-ray exam neck spine 6/>vws	CPT 72052	$343
X-ray exam of ankle	CPT 73610	$280
X-ray exam of ankle	CPT 73600	$186
X-ray exam of collar bone	CPT 73000	$186
X-ray exam of elbow	CPT 73080	$280
X-ray exam of femur 2/>	CPT 73552	$186
X-ray exam of finger(s)	CPT 73140	$186
X-ray exam of foot	CPT 73630	$280
X-ray exam of foot	CPT 73620	$186
X-ray exam of forearm	CPT 73090	$186
X-ray exam of hand	CPT 73130	$412
X-ray exam of hand	CPT 73120	$343
X-ray exam of heel	CPT 73650	$186
X-ray exam of humerus	CPT 73060	$186
X-ray exam of knee 1 or 2	CPT 73560	$186
X-ray exam of knee 3	CPT 73562	$224
X-ray exam of lower leg	CPT 73590	$186
X-ray exam of nasal bones	CPT 70160	$186
X-ray exam of neck	CPT 70360	$186
X-ray exam of pelvis	CPT 72170	$343
X-ray exam of pelvis	CPT 72190	$515
X-ray exam of shoulder	CPT 73030	$280
X-ray exam of toe(s)	CPT 73660	$186
X-ray exam of wrist	CPT 73110	$280
X-ray exam of wrist	CPT 73100	$186
X-ray exam ribs uni 2 views	CPT 71100	$186
X-ray exam sacrum tailbone	CPT 72220	$186
X-ray exam thorac spine 2vws	CPT 72070	$343
X-ray exam thorac spine 3vws	CPT 72072	$412
X-ray exam unilat ribs/chest	CPT 71101	$343
X-ray nose to rectum	CPT 76010	$186
X-ray xm esophagus 1cntrst	CPT 74220	$758
X-ray xm sm int 1cntrst std	CPT 74250	$458
X-ray xm swlng funcj c+	CPT 74230	$343
Respiratory
Airway inhalation treatment	CPT 94640	$373
Cbt 1st hour	CPT 94644	$210
Chest wall manipulation	CPT 94668	$210
Pos airway pressure cpap	CPT 94660	$1,118
Vent mgmt inpat init day	CPT 94002	$2,073
Vent mgmt inpat subq day	CPT 94003	$2,073
Surgical Procedures
Abd paracentesis w/imaging	CPT 49083	$1,487
Aspirate pleura w/ imaging	CPT 32555	$1,225
Biopsy exam of esophagus, stomach or small bowel using an ...	CPT 43239	$439
Biopsy exam of large bowel using an endoscope (Not Offered)	CPT 45380	-	-
Biopsy of prostate gland (Not Offered)	CPT 55700	-	-
Diagnostic exam of esophagus, stomach or small bowel using... (Not Offered)	CPT 43235	-	-
Diagnostic exam of large bowel using an endoscope	CPT 45378	$439
Injection(s) of anesthetic into lower spine using imaging ... (Not Offered)	CPT 64483	-	-
Injection(s) of therapeutic substance (Not Offered)	CPT 62322	-	-
Injection(s) of therapeutic substance (Not Offered)	CPT 62323	-	-
Insertion of catheter into left heart for diagnosis (Not Offered)	CPT 93452	-	-
Insj picc rs&i 5 yr+	CPT 36573	$2,949
Obstetric care, planned cesarean delivery (Not Offered)	CPT 59510	-	-
Obstetric care, planned vaginal delivery (Not Offered)	CPT 59400	-	-
Obstetric care, planned vaginal delivery (post delivery by... (Not Offered)	CPT 59610	-	-
Removal of cataract with insertion of lens (Not Offered)	CPT 66984	-	-
Removal of gallbladder using an endoscope (Not Offered)	CPT 47562	-	-
Removal of one knee cartilage using an endoscope (Not Offered)	CPT 29881	-	-
Removal of one or more breast growth, open procedure (Not Offered)	CPT 19120	-	-
Removal of polyps or growths of large bowel using an endos...	CPT 45385	$840
Removal of recurring cataract in lens capsule using laser (Not Offered)	CPT 66821	-	-
Removal of tonsils and adenoid glands, patient younger tha... (Not Offered)	CPT 42820	-	-
Repair of groin hernia patient age 5 years or older (Not Offered)	CPT 49505	-	-
Shaving of shoulder bone using endoscope (Not Offered)	CPT 29826	-	-
Surgical removal of prostate and surrounding lymph nodes u... (Not Offered)	CPT 55866	-	-
Ultrasound examination of lower large bowel using an endos... (Not Offered)	CPT 45391	-	-
Therapy
Gait training therapy	CPT 97116	$98
Manual therapy 1/> regions	CPT 97140	$90
Neuromuscular reeducation	CPT 97112	$114
Orthotic mgmt&traing 1st enc	CPT 97760	$156
Ot eval low complex 30 min	CPT 97165	$296
Ot eval mod complex 45 min	CPT 97166	$296
Physical therapy, therapeutic exercise	CPT 97110	$99
Physical therapy, therapeutic exercise	CPT 97110	$99
Pt eval low complex 20 min	CPT 97161	$401
Pt eval mod complex 30 min	CPT 97162	$364
Pt re-eval est plan care	CPT 97164	$186
Self care mngment training	CPT 97535	$113
Therapeutic activities	CPT 97530	$134
Wheelchair mngment training	CPT 97542	$109
Uncategorized
Admin influenza virus vac	HCPCS G0008	$74
Admin pneumococcal vaccine	HCPCS G0009	$74