Western Maine Health Menu
| Items | |||||
|---|---|---|---|---|---|
| Clinic Visit - Incision And Drainage Of Sperm Reservoir, Testis, Or Scrotal Area (54700) | $307.65 |
N/A
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| Clinic Visit - Incision And Drainage Of External Ear Abscess Or Blood Accumulation (69005) | $256.20 |
N/A
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| Clinic Visit - Incision And Drainage Of External Ear Abscess Or Blood Accumulation (69000) | $176.40 |
N/A
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| Clinic Visit - Incision And Drainage Of Ear Canal Abscess (69020) | $210.00 |
N/A
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| Clinic Visit - Incision And Drainage Of Abscess Of Female Genital Gland (56420) | $174.30 |
N/A
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| Clinic Visit - Incision And Drainage Of Abscess Of Female Genital Gland (510000479) | $87.15 |
N/A
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| Clinic Visit - Incision And Drainage Of Abscess Of Female Genital Area (56405) | $176.40 |
N/A
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| Clinic Visit - Incision And Drainage Of Abscess Of Female Genital Area (510000064) | $88.20 |
N/A
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| Clinic Visit - Hydration Infusion Into A Vein, Additional Hour (510000097) | $101.85 |
N/A
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| Clinic Visit - Hydration Infusion Into A Vein, 31 Minutes To 1 Hour (510000096) | $170.10 |
N/A
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| Clinic Visit - First Degree Local Burn Treatment (16000) | $112.35 |
N/A
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| Clinic Visit - First Degree Local Burn Treatment (510000473) | $56.70 |
N/A
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| Clinic Visit - Fine Needle Aspiration Of One Lesion Without Imaging Guidance (510000001) | $53.55 |
N/A
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| Clinic Visit - Fine Needle Aspiration Of Additional Lesion Without Imaging Guidance (10004) | $52.50 |
N/A
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| Clinic Visit - Exam Of The Nose And Throat Using Endoscope (510000328) | $30.45 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient, Visit Typically 40 Minutes (99215) | $364.35 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient, Visit Typically 25 Minutes (510000120) | $366.45 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient, Visit Typically 25 Minutes (99214) | $269.85 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (510000114) | $176.40 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient Visit, Typically 5 Minutes (99211) | $55.65 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient Visit, Typically 15 Minutes (510000117) | $263.55 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient Visit, Typically 15 Minutes (99213) | $180.60 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient Visit, Typically 10 Minutes (510000115) | $213.15 |
N/A
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| Clinic Visit - Established Patient Office Or Other Outpatient Visit, Typically 10 Minutes (99212) | $110.25 |
N/A
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| Clinic Visit - Emergent Insertion Of Breathing Tube Into Windpipe (31500) | $222.60 |
N/A
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| Clinic Visit - Dressing Change Or Removal Of Burn Tissue Small Area (510000035) | $457.80 |
N/A
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| Clinic Visit - Dressing Change Or Removal Of Burn Tissue Small Area (16020) | $82.95 |
N/A
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| Clinic Visit - Dressing Change Or Removal Of Burn Tissue Medium Area (16025) | $225.75 |
N/A
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| Clinic Visit - Dressing Change Or Removal Of Burn Tissue Medium Area (510000037) | $113.40 |
N/A
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| Clinic Visit - Dressing Change Or Removal Of Burn Tissue Large Area (16030) | $250.95 |
N/A
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| Clinic Visit - Drainage Of Wound Infection After Surgery, Complex (10180) | $273.00 |
N/A
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| Clinic Visit - Drainage Of Tonsil Abscess (42700) | $201.60 |
N/A
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| Clinic Visit - Drainage Of Tailbone Cyst, Simple (10080) | $118.65 |
N/A
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| Clinic Visit - Drainage Of Tailbone Cyst, Simple (510000005) | $60.90 |
N/A
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| Clinic Visit - Drainage Of Tailbone Cyst, Complicated (10081) | $298.20 |
N/A
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| Clinic Visit - Drainage Of Rectal Abscess (46040) | $584.85 |
N/A
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| Clinic Visit - Drainage Of Rectal Abscess (510000471) | $292.95 |
N/A
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| Clinic Visit - Drainage Of Rectal Abscess (46050) | $149.10 |
N/A
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| Clinic Visit - Drainage Of Rectal Abscess (510000055) | $74.55 |
N/A
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| Clinic Visit - Drainage Of Fluid-Filled Sac Of Upper Arm Or Elbow (23931) | $228.90 |
N/A
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| Clinic Visit - Drainage Of Fluid Accumulation, Blood Or Other Fluid (10140) | $178.50 |
N/A
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| Clinic Visit - Drainage Of Fluid Accumulation, Blood Or Other Fluid (510000008) | $89.25 |
N/A
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| Clinic Visit - Drainage Of Finger Abscess (26011) | $210.00 |
N/A
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| Clinic Visit - Drainage Of Finger Abscess (26010) | $185.85 |
N/A
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| Clinic Visit - Drainage Of Blood From Underneath Nail (11740) | $47.25 |
N/A
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| Clinic Visit - Drainage Of Abscess, Simple Or Single (510000003) | $393.75 |
N/A
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| Clinic Visit - Drainage Of Abscess, Simple Or Single (10060) | $118.65 |
N/A
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| Clinic Visit - Drainage Of Abscess, Complicated Or Multiple (510000004) | $431.55 |
N/A
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| Clinic Visit - Drainage Of Abscess, Complicated Or Multiple (10061) | $118.65 |
N/A
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| Clinic Visit - Drainage Of Abscess Or Blood Collection At Thigh Or Knee Region (27301) | $711.90 |
N/A
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| Clinic Visit - Drainage Of Abscess Or Blood Accumulation In Nose (30000) | $177.45 |
N/A
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| Clinic Visit - Drainage Of Abscess Or Blood Accumulation In Nasal Cartilage (30020) | $176.40 |
N/A
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| Clinic Visit - Dilation Of Narrowing Of Bladder Canal Male (53620) | $121.80 |
N/A
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| Clinic Visit - Diagnostic Exam Of Voice Box Using Endoscope (31575) | $97.65 |
N/A
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| Clinic Visit - Diagnostic Exam Of Voice Box Using Endoscope (31505) | $68.25 |
N/A
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| Clinic Visit - Diagnostic Exam Of Voice Box Using Endoscope (510000052) | $49.35 |
N/A
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| Clinic Visit - Diagnostic Exam Of Nasal Passages Using Endoscope (31231) | $111.30 |
N/A
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| Clinic Visit - Diagnostic Exam Of Anus And Cell Collection Using Endoscope (46600) | $58.80 |
N/A
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| Clinic Visit - Diagnostic Exam Of Anus And Cell Collection Using Endoscope (510000056) | $28.35 |
N/A
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| Clinic Visit - Continuous Heart Rhythm Recording Up To 48 Hours, Review And Interpretation By Qualified Professional (93227) | $349.65 |
N/A
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| Clinic Visit - Complex Wound Repair Of Scalp, Arms, Or Legs (13122) | $289.80 |
N/A
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| Clinic Visit - Complex Wound Repair Of Scalp, Arms, Or Legs (13121) | $289.80 |
N/A
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| Clinic Visit - Complex Wound Repair Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Hands, Or Feet (13132) | $463.05 |
N/A
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| Clinic Visit - Complex Wound Repair Of Forehead, Cheeks, Chin, Mouth, Neck, Underarms, Genitals, Hands, Or Feet (13131) | $359.10 |
N/A
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| Clinic Visit - Complex Wound Repair Of Eyelids, Nose, Ears, Or Lips (13152) | $484.05 |
N/A
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| Clinic Visit - Complex Control Of Nose Bleed (30903) | $153.30 |
N/A
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| Clinic Visit - Collection Of Blood Specimen From Implanted Venous Access Device (761000813) | $123.90 |
N/A
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| Clinic Visit - Collection Of Blood Specimen From Central Or Peripheral Venous Catheter (761000814) | $123.90 |
N/A
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| Clinic Visit - Closed Treatment Of Knee Cap Fracture (27520) | $266.70 |
N/A
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| Clinic Visit - Closed Treatment Of Fracture Of Bone Of Hand With Manipulation (26605) | $343.35 |
N/A
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| Clinic Visit - Closed Treatment Of Dislocation Of Toe Joint (28660) | $123.90 |
N/A
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| Clinic Visit - Closed Treatment Of Dislocation Of Knee Cap (27560) | $353.85 |
N/A
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| Clinic Visit - Closed Treatment Of Dislocated Hand Joint With Manipulation (26700) | $388.50 |
N/A
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| Clinic Visit - Closed Treatment Of Dislocated Foot Bone (28630) | $157.50 |
N/A
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| Clinic Visit - Closed Treatment Of Dislocated Finger Joint With Manipulation Under Anesthesia (26775) | $344.40 |
N/A
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| Clinic Visit - Closed Treatment Of Dislocated Finger Joint With Manipulation (26770) | $285.60 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Toe With Manipulation (28515) | $147.00 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Toe (28510) | $111.30 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Tailbone (27200) | $225.75 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Shin Bone (27750) | $433.65 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Or Growth Plate Separate Of Forearm Bone At Wrist With Manipulation (25605) | $532.35 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Hand Or Finger With Manipulation (26742) | $439.95 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Finger Or Thumb With Manipulation (26725) | $369.60 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Finger Or Thumb With Manipulation (26755) | $366.45 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Finger Or Thumb (26720) | $160.65 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Ankle With Manipulation (27818) | $595.35 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Ankle With Manipulation (27810) | $577.50 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Ankle With Manipulation (27788) | $483.00 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Ankle (27816) | $358.05 |
N/A
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| Clinic Visit - Closed Treatment Of Broken Ankle (27786) | $338.10 |
N/A
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| Clinic Visit - Closed Treatment Of Ankle Dislocation (27840) | $536.55 |
N/A
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| Clinic Visit - Chemotherapy Into Vein Using Push Technique, Each Additional Drug (510000103) | $294.00 |
N/A
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| Clinic Visit - Change Of Breathing Tube In Windpipe (31502) | $85.05 |
N/A
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| Clinic Visit - Bladder Irrigation Or Instillation (51700) | $72.45 |
N/A
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| Clinic Visit - Bladder Irrigation Or Instillation (510000058) | $37.80 |
N/A
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| Clinic Visit - Aspiration Or Injection Of Small Joint Or Joint Capsule With Ultrasound Guidance (20604) | $69.30 |
N/A
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| Clinic Visit - Aspiration Or Injection Of Small Joint Or Joint Capsule (20600) | $86.10 |
N/A
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| Clinic Visit - Aspiration Or Injection Of Medium Joint Or Joint Capsule With Ultrasound Guidance (20606) | $74.55 |
N/A
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| Clinic Visit - Aspiration Or Injection Of Medium Joint Or Joint Capsule (20605) | $77.70 |
N/A
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| Clinic Visit - Aspiration Or Injection Of Large Joint Or Joint Capsule With Ultrasound Guidance (20611) | $87.15 |
N/A
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| Clinic Visit - Aspiration Or Injection Of Large Joint Or Joint Capsule (20610) | $82.95 |
N/A
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| Clinic Visit - Aspiration Or Injection Of Large Joint Or Joint Capsule (510000049) | $42.00 |
N/A
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| Clinic Visit - Aspiration Or Injection Of Joint Cyst (20612) | $67.20 |
N/A
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| Clinic Visit - Aspiration Of Fluid Accumulation, Pus, Blood, Serum Or Other Fluid (10160) | $151.20 |
N/A
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| Clinic Visit - Aspiration Of Fluid Accumulation, Pus, Blood, Serum Or Other Fluid (510000134) | $75.60 |
N/A
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| Clinic Visit - Application Of Vein Wound Compression System Lower Leg Below Knee Including Ankle And Foot (510000450) | $243.60 |
N/A
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| Clinic Visit - Application Of Short Leg Splint (29515) | $79.80 |
N/A
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| Clinic Visit - Application Of Short Leg Cast (29405) | $88.20 |
N/A
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| Clinic Visit - Application Of Short Leg Cast (510000268) | $45.15 |
N/A
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| Clinic Visit - Application Of Non-Moveable, Short Arm Splint (29125) | $69.30 |
N/A
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| Clinic Visit - Application Of Non-Moveable, Hinged Finger Splint (29130) | $50.40 |
N/A
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| Clinic Visit - Application Of Non-Moveable, Hinged Finger Splint (510000050) | $25.20 |
N/A
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| Clinic Visit - Application Of Long Leg Splint (29505) | $77.70 |
N/A
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| Clinic Visit - Application Of Long Arm Splint (29105) | $92.40 |
N/A
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| Clinic Visit - Application Of Chemical Agent To Excessive Wound Tissue (510000042) | $263.55 |
N/A
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| Clinic Visit - Application Of Chemical Agent To Excessive Wound Tissue (17250) | $59.85 |
N/A
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| Clinic Visit - Advance Care Planning By The Physician Or Other Qualified Health Care Professional (99498) | $105.00 |
N/A
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| Clinic Visit - Advance Care Planning By The Physician Or Other Qualified Health Care Professional (99497) | $105.00 |
N/A
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| Chemotherapy - Prolonged Chemotherapy Infusion Into A Vein By Portable Or Implanted Pump For More Than 8 Hours (335000004) | $358.05 |
N/A
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| Chemotherapy - Non-Hormonal Anti-Neoplastic Chemotherapy Administration, Under The Skin Or Into Muscle (331000001) | $338.10 |
N/A
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| Chemotherapy - Non-Hormonal Anti-Neoplastic Chemotherapy Administration, Under The Skin Or Into Muscle (761000960) | $338.10 |
N/A
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| Chemotherapy - Irrigation Of Implanted Venous Access Drug Delivery Device (761000046) | $294.00 |
N/A
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| Chemotherapy - Infusion Of Different Chemotherapy Drug Or Substance Into A Vein Up To 1 Hour (335000012) | $317.10 |
N/A
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| Chemotherapy - Hormonal Anti-Neoplastic Chemotherapy Administration, Under The Skin Or Into Muscle (761000961) | $162.75 |
N/A
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| Chemotherapy - Hormonal Anti-Neoplastic Chemotherapy Administration, Under The Skin Or Into Muscle (331000002) | $162.75 |
N/A
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| Chemotherapy - Chemotherapy Into Vein Using Push Technique, Single Or Initial Drug (335000001) | $525.00 |
N/A
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| Chemotherapy - Chemotherapy Into Vein Using Push Technique, Single Or Initial Drug (331000004) | $525.00 |
N/A
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| Chemotherapy - Chemotherapy Into Vein Using Push Technique, Each Additional Drug (331000005) | $294.00 |
N/A
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| Chemotherapy - Chemotherapy Infusion Into A Vein For Up To 1 Hour, Initial Drug (335000002) | $670.95 |
N/A
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| Chemotherapy - Chemotherapy Infusion Into A Vein For Up To 1 Hour, Initial Drug (335000010) | $670.95 |
N/A
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| Chemotherapy - Chemotherapy Infusion Into A Vein For Additional Hour(S) (335000011) | $119.70 |
N/A
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| Chemotherapy - Chemotherapy Infusion Into A Vein For Additional Hour(S) (335000003) | $119.70 |
N/A
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| Cardiology - Ultrasound Exam Of Heart, Follow-Up Or Limited Study (483000005) | $905.10 |
N/A
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| Cardiology - Ultrasound Exam Of Heart, Follow-Up Or Limited Study (893308) | $905.10 |
N/A
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| Cardiology - Ultrasound Exam Of Heart, Follow-Up Or Limited Study (93308) | $584.85 |
N/A
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| Cardiology - Ultrasound Exam Of Heart Including Color-Depicted Blood Flow Rate, Direction, And Valve Function (483000022) | $1,787.10 |
N/A
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| Cardiology - Ultrasound Exam Of Heart Including Color-Depicted Blood Flow Rate, Direction, And Valve Function (893306) | $1,787.10 |
N/A
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| Cardiology - Ultrasound Exam Of Heart Including Color-Depicted Blood Flow Rate, Direction, And Valve Function (93306) | $1,303.05 |
N/A
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| Cardiology - Temporary Pacemaker To Regulate Heart Beat (92953) | $42.00 |
N/A
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| Cardiology - Nuclear Medicine Study Of Heart Muscle (80399T) | $105.00 |
N/A
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| Cardiology - Insertion Of Catheter Into Right Upper Heart Chamber And Pulmonary Artery For Monitoring (93503) | $273.00 |
N/A
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| Cardiology - Infusion Of Drug Into Vein To Dissolve Coronary Blood Clot (92977) | $684.60 |
N/A
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| Cardiology - External Shock To Heart To Regulate Heart Beat (92960) | $273.00 |
N/A
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| Cardiology - Exercise Or Drug-Induced Heart And Blood Vessel Stress Test With Ekg Monitoring, Tracing Only (482000001) | $457.80 |
N/A
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| Cardiology - Exercise Or Drug-Induced Heart And Blood Vessel Stress Test With Ekg Monitoring, Tracing Only (893017) | $457.80 |
N/A
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| Cardiology - Exercise Or Drug-Induced Heart And Blood Vessel Stress Test With Ekg Monitoring, Physician Supervision Only (93016) | $257.25 |
N/A
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| Cardiology - Exercise Or Drug-Induced Heart And Blood Vessel Stress Test With Ekg Monitoring, Interpretation And Report Only (93018) | $257.25 |
N/A
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| Cardiology - Attempt To Restart Heart And Lungs (92950) | $448.35 |
N/A
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| Cardiology - Ambulatory Blood Pressure Monitoring For 24 Hours Or Longer, Includes Scanning Analysis With Report (480000033) | $289.80 |
N/A
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| Cardiology - Ambulatory Blood Pressure Monitoring For 24 Hours Or Longer, Includes Scanning Analysis With Report (893788) | $289.80 |
N/A
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| Cardiology - Ambulatory Blood Pressure Monitoring For 24 Hours Or Longer, Includes Review With Interpretation And Report (93790) | $349.65 |
N/A
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| Cancer Treatment - Therapeutic Removal Of Whole Blood To Correct Blood Level Imbalance (280000024) | $222.60 |
N/A
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| Blood Processing & Storage - Volume Reduction Of Blood Product (390000029) | $264.60 |
N/A
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| Blood Processing & Storage - Transfusion Of Blood Or Blood Products (391000021) | $635.25 |
N/A
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| Blood Processing & Storage - Separation Of Blood Products (390000006) | $185.85 |
N/A
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| Blood Processing & Storage - Separation Of Blood Products (390000005) | $156.45 |
N/A
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| Blood Processing & Storage - Red Blood Cells - White Cells Reduced/cmv Negative/irradiated (390000039) | $1,264.20 |
N/A
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| Blood Processing & Storage - Red Blood Cells - White Cells Reduced (390000008) | $810.60 |
N/A
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| Blood Processing & Storage - Red Blood Cells - Irradiated/white Cells Reduced (390000037) | $905.10 |
N/A
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| Blood Processing & Storage - Red Blood Cells (390000015) | $55.00 |
N/A
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| Blood Processing & Storage - Pretreatment Of Serum For Antibody Tests (Differential Red Cell Absorption) (390000004) | $110.00 |
N/A
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| Blood Processing & Storage - Pretreatment Of Red Blood Cells For Antibody Tests (Enzyme Incubation) (390000003) | $67.00 |
N/A
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| Blood Processing & Storage - Pretreatment Of Red Blood Cells For Antibody Tests (Chemical Incubation) (390000002) | $64.00 |
N/A
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| Blood Processing & Storage - Platelets - Pheresis/white Cells Reduced/cmv Negative/ Irradiated (390000038) | $3,549.00 |
N/A
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| Blood Processing & Storage - Platelets - Pheresis/white Cells Reduced (390000011) | $3,187.80 |
N/A
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| Blood Processing & Storage - Platelets - Pheresis/irradiated/white Cells Reduced (390000018) | $3,282.30 |
N/A
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| Blood Processing & Storage - Miscellaneous Transfusion Procedure (390000028) | $327.60 |
N/A
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| Blood Processing & Storage - Fresh Frozen Plasma - Within 8 To 24 Hours Of Collection (390000036) | $352.80 |
N/A
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| Blood Processing & Storage - Fresh Frozen Plasma - Single Donor (390000010) | $352.80 |
N/A
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| Blood Processing & Storage - Cryoprecipitate (390000007) | $280.35 |
N/A
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| Blood Processing & Storage - Blending Of Blood Products From Multiple Sources (390000001) | $129.15 |
N/A
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| Blood Processing & Storage - Antihuman Globulin Antibody Analysis (Indirect Qualitative) (390000030) | $22.00 |
N/A
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| Blood Administration - Transfusion Of Blood Or Blood Products (391000001) | $635.25 |
N/A
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| Audiology - Exam Of The Nose And Throat Using Endoscope (92511) | $60.90 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Not Performing A Procedure, Patient 5 Years Of Age Or Older, First 15 Minutes (99155) | $133.35 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Not Performing A Procedure, Patient 5 Years Of Age Or Older, First 15 Minutes (99156) | $110.25 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Not Performing A Procedure, Patient 5 Years Of Age Or Older, First 15 Minutes (370000088) | $66.15 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Not Performing A Procedure, Patient 5 Years Of Age Or Older, First 15 Minutes (370000089) | $55.65 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Not Performing A Procedure, Each Additional 15 Minutes (99157) | $87.15 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Not Performing A Procedure, Each Additional 15 Minutes (370000090) | $43.05 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Also Performing A Procedure, Patient Younger Than 5 Years Of Age, First 15 Minutes (99151) | $40.95 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Also Performing A Procedure, Patient Younger Than 5 Years Of Age, First 15 Minutes (370000085) | $19.95 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Also Performing A Procedure, Patient 5 Years Of Age Or Older, First 15 Minutes (99152) | $28.35 |
N/A
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| Anesthesia - Moderate Sedation Services By Physician Also Performing A Procedure, Patient 5 Years Of Age Or Older, First 15 Minutes (370000086) | $14.70 |
N/A
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|
||
| Anesthesia - Moderate Sedation Services By Physician Also Performing A Procedure, Additional 15 Minutes (99153) | $23.10 |
N/A
|
|
||
| Anesthesia - Moderate Sedation Services By Physician Also Performing A Procedure, Additional 15 Minutes (370000087) | $12.60 |
N/A
|
|
||
| Anesthesia - Moderate Sedation For Gastrointestinal Endoscopy (370000091) | $14.70 |
N/A
|
|
||
| Anesthesia (370000057) | $452.55 |
N/A
|
|
||
| Anesthesia (370000059) | $63.00 |
N/A
|
|
||
| Ambulance - Specialty Care Transport (540000148) | $1,463.70 |
N/A
|
|
||
| Ambulance - Non-Emergency Wheelchair Van (540000149) | $64.05 |
N/A
|
|
||
| Ambulance - Ground Transport, Per Mile (521000193) | $42.00 |
N/A
|
|
||
| Ambulance - Basic Life Support, Non-Emergency Transport (521000196) | $643.65 |
N/A
|
|
||
| Ambulance - Basic Life Support, Emergency Transport (521000197) | $956.55 |
N/A
|
|
||
| Ambulance - Advanced Life Support, Non-Emergency Transport, Level I (521000194) | $834.75 |
N/A
|
|
||
| Ambulance - Advanced Life Support, Level Ii (521000198) | $1,463.70 |
N/A
|
|
||
| Ambulance - Advanced Life Support, Emergency Transport, Level I (521000195) | $1,210.65 |
N/A
|
|
||
| Ambulance (540000150) | $4.20 |
N/A
|
|
||
