Freestanding Article 28 Rate Codes Subsumed by APGs
Prior to date subsumed, claims should be billed using rate codes below. Once rate codes subsumed, bill with appropriate APG rate code.
| Rate Code |
Rate Code Description | Date Subsumed |
Notes |
|---|---|---|---|
| 1226 | FITTING OF SPECTACLES; MONOFOCAL; BIFOCAL; MULTIFOCAL | 1/1/2011 | |
| 1227 | FITTING OF SPECTACLES PLUS EYEGLASS MATERIAL | 1/1/2011 | |
| 1601 | D&T PCAP INITIAL PRENATAL CARE VISIT | 9/1/2009 | |
| 1602 | D&T PCAP FOLLOW-UP PRENATAL CARE VISIT | 9/1/2009 | |
| 1603 | D&T PCAP POST-PARTUM CARE | 9/1/2009 | |
| 1610 | ALL INCLUSIVE | 9/1/2009 | |
| 1611 | ABORTION | 9/1/2009 | |
| 1612 | HOME TRANSFUSION | 9/1/2009 | |
| 1616 | CHC,WCC,PEDIATRIC | 9/1/2009 | |
| 1617 | FAMILY PLANNING | 9/1/2009 | |
| 1620 | DENTAL | 9/1/2009 | |
| 1622 | INITIAL VISIT (CLINIC) | 9/1/2009 | |
| 1623 | ANTEPARTUM VISIT | 9/1/2009 | |
| 1624 | LABOR | 9/1/2009 | |
| 1626 | POSTPARTUM HOME AND OFFICE VISITS | 9/1/2009 | |
| 1627 | COMP PHYS EXAM (SCHOOL HEALTH PROJECT) | 9/1/2009 | |
| 1628 | ROUTINE VISIT (SCHOOL HEALTH PROJ) | 9/1/2009 | |
| 1629 | PART-TIME CLINIC SERVICES | 9/1/2009 | |
| 1638 | TB CLINIC, CLS III PT DESIGNATION, INC PHYS | 9/1/2009 | |
| 1640 | TB CLINIC, CLS II PT DESIGNATION | 9/1/2009 | |
| 1641 | HEMODIALYSIS FACILITY SESSION | 9/1/2009 | |
| 1642 | HOME HEMODIALYSIS CAPD/CCPD WEEKLY | 9/1/2009 | |
| 1643 | HOME HEMODIALYSIS CAPD/CCPD DAILY | 9/1/2009 | |
| 1644 | HOME HEMODIALYSIS EXTENDED PERITONEAL 0-19 HRS | 9/1/2009 | |
| 1645 | HOME HEMODIALYSIS EXTENDED PERITONEAL 20-29 HRS | 9/1/2009 | |
| 1646 | HOME HEMODIALYSIS EXTENDED PERITONEAL 30 HRS/MORE | 9/1/2009 | |
| 1695 | HIV COUNSELING AND TESTING VISIT | 7/1/2011 | |
| 1696 | POST-TEST HIV COUNSELING VISIT - NEGATIVE RESULTS | 9/1/2009 | |
| 1697 | INITIAL COMP HIV MEDICAL EVALUATION VISIT | 9/1/2009 | |
| 1698 | DRUG/IMMUNOTHERAPY VISIT - HIV INFECTED PT. | 9/1/2009 | |
| 1699 | MONITORING VISIT - ASYMPTOMATIC HIV DISEASE | 9/1/2009 | |
| 1701 | PAS 1 - NERVE REPAIR | 9/1/2009 | |
| 1702 | PAS 2 - EYE THERAPEUTIC | 9/1/2009 | |
| 1703 | PAS 3 - EYE REPAIR | 9/1/2009 | |
| 1704 | PAS 4 - LENS REMOVE/REPLACE | 9/1/2009 | |
| 1705 | PAS 5 - EYE LASER THERAPEUTIC | 9/1/2009 | |
| 1706 | PAS 6 - EYE MUSCLE REPAIR | 9/1/2009 | |
| 1707 | PAS 7 - EYE REPAIR | 9/1/2009 | |
| 1708 | PAS 8 - EAR THERAPEUTIC | 9/1/2009 | |
| 1709 | PAS 9 - NASAL/PARANASAL THERAPEUTIC | 9/1/2009 | |
| 1710 | PAS 10 - RHINO/SEPTO PLASTY | 9/1/2009 | |
| 1711 | PAS 11 - TONSIL/ADENOID THERAPEUTIC | 9/1/2009 | |
| 1712 | PAS 12 - NASAL/TRACHEAL ENDOSCOPE | 9/1/2009 | |
| 1713 | PAS 13 - THORACIC DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1714 | PAS 14 - VASCULAR DIAGNOSTIC II | 9/1/2009 | |
| 1715 | PAS 15 - VASCULAR REPAIR | 9/1/2009 | |
| 1716 | PAS 16 - VASCULAR DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1717 | PAS 17 - UPPER G.I. DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1718 | PAS 18 - LOWER G.I. DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1719 | PAS 19 - RECTAL DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1720 | PAS 20 - HEPATIC DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1721 | PAS 21 - HEPATIC ENDOSCOPY | 9/1/2009 | |
| 1722 | PAS 22 - HERNIA REPAIR | 9/1/2009 | |
| 1723 | PAS 23 - CYSTOSCOPE | 9/1/2009 | |
| 1724 | PAS 24 - UROLOGICAL THERAPEUTIC | 9/1/2009 | |
| 1725 | PAS 25 - LITHOTRIPSY | 9/1/2009 | |
| 1726 | PAS 26 - MALE GENITAL DIAGNOSTIC | 9/1/2009 | |
| 1727 | PAS 27 - GENITO-URINARY REPAIR | 9/1/2009 | |
| 1728 | PAS 28 - MALE GENITAL THERAPEUTIC | 9/1/2009 | |
| 1729 | PAS 29 - LAPAROSCOPY | 9/1/2009 | |
| 1730 | PAS 30 - OVIDUCT DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1731 | PAS 31 - GYN DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1732 | PAS 32 - DILATION AND CURETTAGE | 9/1/2009 | |
| 1733 | PAS 33 - SOFT TISSUE REPAIR | 9/1/2009 | |
| 1734 | PAS 34 - BONE THERAPEUTIC | 9/1/2009 | |
| 1735 | PAS 35 - ARTHROSCOPY | 9/1/2009 | |
| 1736 | PAS 36 - BONE REPAIR | 9/1/2009 | |
| 1737 | PAS 37 - SOFT TISSUE THERAPY | 9/1/2009 | |
| 1738 | PAS 38 - BREAST DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1739 | PAS 39 - BREAST REPAIR | 9/1/2009 | |
| 1740 | PAS 40 - SKIN DIAGNOSTIC/THERAPEUTIC | 9/1/2009 | |
| 1741 | PAS 41 - SKIN REPAIR | 9/1/2009 | |
| 1742 | PAS 42 - UROLOGICAL DIAGNOSTIC | 9/1/2009 | |
| 1743 | ADDITIONAL SURGERY - PAS 1 | 9/1/2009 | |
| 1744 | ADDITIONAL SURGERY - PAS 2 | 9/1/2009 | |
| 1745 | ADDITIONAL SURGERY - PAS 3 | 9/1/2009 | |
| 1746 | ADDITIONAL SURGERY - PAS 4 | 9/1/2009 | |
| 1747 | ADDITIONAL SURGERY - PAS 5 | 9/1/2009 | |
| 1748 | ADDITIONAL SURGERY - PAS 6 | 9/1/2009 | |
| 1749 | ADDITIONAL SURGERY - PAS 7 | 9/1/2009 | |
| 1750 | ADDITIONAL SURGERY - PAS 8 | 9/1/2009 | |
| 1751 | ADDITIONAL SURGERY - PAS 9 | 9/1/2009 | |
| 1752 | ADDITIONAL SURGERY - PAS 10 | 9/1/2009 | |
| 1753 | ADDITIONAL SURGERY - PAS 11 | 9/1/2009 | |
| 1754 | ADDITIONAL SURGERY - PAS 12 | 9/1/2009 | |
| 1755 | ADDITIONAL SURGERY - PAS 13 | 9/1/2009 | |
| 1756 | ADDITIONAL SURGERY - PAS 14 | 9/1/2009 | |
| 1757 | ADDITIONAL SURGERY - PAS 15 | 9/1/2009 | |
| 1758 | ADDITIONAL SURGERY - PAS 16 | 9/1/2009 | |
| 1759 | ADDITIONAL SURGERY - PAS 17 | 9/1/2009 | |
| 1760 | ADDITIONAL SURGERY - PAS 18 | 9/1/2009 | |
| 1761 | ADDITIONAL SURGERY - PAS 19 | 9/1/2009 | |
| 1762 | ADDITIONAL SURGERY - PAS 20 | 9/1/2009 | |
| 1763 | ADDITIONAL SURGERY - PAS 21 | 9/1/2009 | |
| 1764 | ADDITIONAL SURGERY - PAS 22 | 9/1/2009 | |
| 1765 | ADDITIONAL SURGERY - PAS 23 | 9/1/2009 | |
| 1766 | ADDITIONAL SURGERY - PAS 24 | 9/1/2009 | |
| 1767 | ADDITIONAL SURGERY - PAS 25 | 9/1/2009 | |
| 1768 | ADDITIONAL SURGERY - PAS 26 | 9/1/2009 | |
| 1769 | ADDITIONAL SURGERY - PAS 27 | 9/1/2009 | |
| 1770 | ADDITIONAL SURGERY - PAS 28 | 9/1/2009 | |
| 1771 | ADDITIONAL SURGERY - PAS 29 | 9/1/2009 | |
| 1772 | ADDITIONAL SURGERY - PAS 30 | 9/1/2009 | |
| 1773 | ADDITIONAL SURGERY - PAS 31 | 9/1/2009 | |
| 1774 | ADDITIONAL SURGERY - PAS 32 | 9/1/2009 | |
| 1775 | ADDITIONAL SURGERY - PAS 33 | 9/1/2009 | |
| 1776 | ADDITIONAL SURGERY - PAS 34 | 9/1/2009 | |
| 1777 | ADDITIONAL SURGERY - PAS 35 | 9/1/2009 | |
| 1778 | ADDITIONAL SURGERY - PAS 36 | 9/1/2009 | |
| 1779 | ADDITIONAL SURGERY - PAS 37 | 9/1/2009 | |
| 1780 | ADDITIONAL SURGERY - PAS 38 | 9/1/2009 | |
| 1781 | ADDITIONAL SURGERY - PAS 39 | 9/1/2009 | |
| 1782 | ADDITIONAL SURGERY - PAS 40 | 9/1/2009 | |
| 1783 | ADDITIONAL SURGERY - PAS 41 | 9/1/2009 | |
| 1784 | ADDITIONAL SURGERY - PAS 42 | 9/1/2009 | |
| 1802 | POST-TEST HIV COUNSELING VST - POSITIVE RESULTS | 7/1/2011 | |
| 1804 | PAS GROUPER ACCESS CODE-PRINCIPAL PROCEDURE | 9/1/2009 | |
| 1805 | PAS GROUPER ACCESS CODE-ADDITIONAL PROCEDURE | 9/1/2009 | |
| 1806 | HEMO, EPO ADD-ON PER 1,000 UNITS | 9/1/2009 | |
| 2883 | RENAL OR HEMODIALYSIS | 9/1/2009 | |
| 3092 | CHEMO CLINIC SERVICE | 9/1/2009 | |
| 3107 | MONTHLY DIALYSIS SERVICES - MEDICARE CROSSOVER | 1/1/2012 | |
| 3109 | HIV COUNSELING VISIT (NO TESTING) | 7/1/2011 | |
| 3110 | CHAP SCREENING EXAMINATION | 9/1/2009 | |
| 4013 | FQHC INDIVIDUAL THRESHOLD VISIT[1] | 9/1/2009 | Only subsumed for FQHCs that opted into APGs |
| 6501 | PAC 1 DIAGNOSTIC INVESTIGATION EXAMS NEC | 9/1/2009 | |
| 6502 | PAC 2 DIAGNOSTIC INVEST WITH NUCL IMAGING | 9/1/2009 | |
| 6503 | PAC 3 DIAGNOSTIC INVEST WITH CAT IMAGING | 9/1/2009 | |
| 6504 | PAC 4 DIAGNOSTIC INVEST WITH MRI | 9/1/2009 | |
| 6505 | PAC 5 MANAGEMENT EXAM NEC | 9/1/2009 | |
| 6506 | PAC 6 MEDICATION ADMINISTRATION | 9/1/2009 | |
| 6507 | PAC 7 PEDITRC ANUAL WELCARE EXAM (AGE 3-17) | 9/1/2009 | |
| 6508 | PAC 8 ADULT ANUAL WELL CARE EXAM (AGE >17) | 9/1/2009 | |
| 6509 | PAC 9 FIRST PRENATAL - ROUTINE | 9/1/2009 | |
| 6510 | PAC 10 FIRST PRENATAL - COMPLICATED | 9/1/2009 | |
| 6511 | PAC 11 PRENATAL MGMNT REVISIT - COMPLICATED | 9/1/2009 | |
| 6512 | PAC 12 POST PARTUM MGMNT - COMPLICATED | 9/1/2009 | |
| 6513 | PAC 13 PRENATAL REVISIT WELL CARE - NORMAL | 9/1/2009 | |
| 6514 | PAC 14 POST PARTUM MGMNT - NORMAL | 9/1/2009 | |
| 6515 | PAC 15 NEONATAL & CONGENITAL DIAG INVEST | 9/1/2009 | |
| 6516 | PAC 16 MGMNT OF NEONATAL & CONGENITL PROB | 9/1/2009 | |
| 6517 | PAC 17 PEDIATRIC WELL CARE EXAM (AGE <3) | 9/1/2009 | |
| 6518 | PAC 18 FEMALE REPRODUCTIVE DIAG INVEST | 9/1/2009 | |
| 6519 | PAC 19 MGMNT OF FEMALE REPRODUCTIVE PROB | 9/1/2009 | |
| 6520 | PAC 20 ANNUAL GYNECOLOGICAL EXAM | 9/1/2009 | |
| 6521 | PAC 21 CONTRACEPTIVE WELL CARE EXAM | 9/1/2009 | |
| 6522 | PAC 22 ENT DIAG INVEST-ADULT (AGE >17) | 9/1/2009 | |
| 6523 | PAC 23 ENT DIAG INVEST-PEDIA (AGE 0-17) | 9/1/2009 | |
| 6524 | PAC 24 MGMNT OF ENT PROB-ADULT (AGE >17) | 9/1/2009 | |
| 6525 | PAC 25 MGMNT OF ENT PROB-PEDIA (AGE 0-17) | 9/1/2009 | |
| 6526 | PAC 26 OPHTHALMOLOGICAL SERVICES | 9/1/2009 | |
| 6527 | PAC 27 RESPRATRY DIAG INVEST-ADLT (AGE>17) | 9/1/2009 | |
| 6528 | PAC 28 RESP DIAG INVEST-PEDIA (AGE 0-17) | 9/1/2009 | |
| 6529 | PAC 29 MGMNT OF RESP PROB-ADULT (AGE>17) | 9/1/2009 | |
| 6530 | PAC 30 MGMNT OF RESP PROB-PEDIA (AGE 0-17) | 9/1/2009 | |
| 6531 | PAC 31 SYSTEMIC INFECTION DIAG INVEST | 9/1/2009 | |
| 6532 | PAC 32 MGMNT OF SYSTEMIC INFECTIONS | 9/1/2009 | |
| 6533 | PAC 33 GASTROINTESTINAL DIAG INVEST | 9/1/2009 | |
| 6534 | PAC 34 MGMT GSTRONTSTNL PROB-ADLT (AGE >17) | 9/1/2009 | |
| 6535 | PAC 35 MGMT GSTRONTSTNL PROB-PED (AGE 0-17) | 9/1/2009 | |
| 6536 | PAC 36 HEPATOBILIARY DIAG INVESTIGATION | 9/1/2009 | |
| 6537 | PAC 37 MGMNT OF HEPATOBILIARY PROB | 9/1/2009 | |
| 6538 | PAC 38 GENITO-UROLOGICAL DIAG INVEST | 9/1/2009 | |
| 6539 | PAC 39 MGMNT OF GENITO-UROLOGICAL PROB | 9/1/2009 | |
| 6540 | PAC 40 CARDIAC DIAG INVESTIGATION | 9/1/2009 | |
| 6541 | PAC 41 MANAGEMENT OF CARDIAC PROB | 9/1/2009 | |
| 6542 | PAC 42 ENDOCRINAL DIAG INVESTIGATION | 9/1/2009 | |
| 6543 | PAC 43 MGMNT OF OTHER ENDOCRINAL PROB | 9/1/2009 | |
| 6544 | PAC 44 MGMT OF DIABETES-PEDIATRC (AGE 0-17) | 9/1/2009 | |
| 6545 | PAC 45 MGMNT OF DIABETES-ADULT (AGE >17) | 9/1/2009 | |
| 6546 | PAC 46 SKIN & SOFT TISSUE DIAG INVEST | 9/1/2009 | |
| 6547 | PAC 47 INFLAMMATORY MUSC/SKEL DIAG INVEST | 9/1/2009 | |
| 6548 | PAC 48 OTHER MUSC/SKEL DIAG INVESTIGATION | 9/1/2009 | |
| 6549 | PAC 49 REHABILITATION THERAPY | 9/1/2009 | |
| 6550 | PAC 50 MGMNT OF SKIN & SOFT TISSUE PROB | 9/1/2009 | |
| 6551 | PAC 51 MANAGEMENT OF POISONING | 9/1/2009 | |
| 6552 | PAC 52 MGMNT OF INFLAMM MUSC/SKEL PROB | 9/1/2009 | |
| 6553 | PAC 53 MGMNT OF OTHER MUSC/SKEL PROB | 9/1/2009 | |
| 6554 | PAC 54 ONCOLOGICAL DIAG INVESTIGATION | 9/1/2009 | |
| 6555 | PAC 55 AIDS DIAG INVESTIGATION | 9/1/2009 | |
| 6556 | PAC 56 OTHER HEMATOLOGICAL DIAG INVEST | 9/1/2009 | |
| 6557 | PAC 57 THERAPEUTIC IV PUSH & CHEMO INJECT | 9/1/2009 | |
| 6558 | PAC 58 THERAPEUTIC INFUSIONS | 9/1/2009 | |
| 6559 | PAC 59 THERAPEUTIC RADIOTHERAPY | 9/1/2009 | |
| 6560 | PAC 60 ONCOLOGICAL MANAGEMENT | 9/1/2009 | |
| 6561 | PAC 61 MGMT OF ANEMIAS-PEDIATRC (AGE 0-17) | 9/1/2009 | |
| 6562 | PAC 62 MGMT OF ANEMIAS-ADULT (AGE >17) | 9/1/2009 | |
| 6563 | PAC 63 MGMT OF AIDS-PEDIATRIC (AGE 0-17) | 9/1/2009 | |
| 6564 | PAC 64 MGMT OF AIDS-ADULT (AGE>17) | 9/1/2009 | |
| 6565 | PAC 65 MGMNT OF OTHER HEMATOLOGICAL PROB | 9/1/2009 | |
| 6566 | PAC 66 NEURO & PSYCHO/SOCIAL DIAG INVEST | 9/1/2009 | |
| 6567 | PAC 67 SPEECH & HEARNG SVCS-ADULT (AGE >17) | 9/1/2009 | |
| 6568 | PAC 68 SPECH & HEARNGSVCS-PEDIA (AGE 0-17) | 9/1/2009 | |
| 6569 | PAC 69 NEUROLOGICAL & PSYCHO/SOCIAL MGMNT | 9/1/2009 | |
| 6570 | PAC 70 COUNSELING | 9/1/2009 | |
| 6571 | PAC 71 DIAG INVEST OF VASCULAR SYSTEMS | 9/1/2009 | |
| 7501 | PAC 1 MEDICARE CLAIM | 9/1/2009 | |
| 7502 | PAC 2 MEDICARE CLAIM | 9/1/2009 | |
| 7503 | PAC 3 MEDICARE CLAIM | 9/1/2009 | |
| 7504 | PAC 4 MEDICARE CLAIM | 9/1/2009 | |
| 7505 | PAC 5 MEDICARE CLAIM | 9/1/2009 | |
| 7506 | PAC 6 MEDICARE CLAIM | 9/1/2009 | |
| 7508 | PAC 8 MEDICARE CLAIM | 9/1/2009 | |
| 7509 | PAC 9 MEDICARE CLAIM | 9/1/2009 | |
| 7510 | PAC 10 MEDICARE CLAIM | 9/1/2009 | |
| 7511 | PAC 11 MEDICARE CLAIM | 9/1/2009 | |
| 7512 | PAC 12 MEDICARE CLAIM | 9/1/2009 | |
| 7513 | PAC 13 MEDICARE CLAIM | 9/1/2009 | |
| 7514 | PAC 14 MEDICARE CLAIM | 9/1/2009 | |
| 7515 | PAC 15 MEDICARE CLAIM | 9/1/2009 | |
| 7516 | PAC 16 MEDICARE CLAIM | 9/1/2009 | |
| 7517 | PAC 17 MEDICARE CLAIM | 9/1/2009 | |
| 7518 | PAC 18 MEDICARE CLAIM | 9/1/2009 | |
| 7519 | PAC 19 MEDICARE CLAIM | 9/1/2009 | |
| 7520 | PAC 20 MEDICARE CLAIM | 9/1/2009 | |
| 7521 | PAC 21 MEDICARE CLAIM | 9/1/2009 | |
| 7522 | PAC 22 MEDICARE CLAIM | 9/1/2009 | |
| 7524 | PAC 24 MEDICARE CLAIM | 9/1/2009 | |
| 7525 | PAC 25 MEDICARE CLAIM | 9/1/2009 | |
| 7526 | PAC 26 MEDICARE CLAIM | 9/1/2009 | |
| 7527 | PAC 27 MEDICARE CLAIM | 9/1/2009 | |
| 7529 | PAC 29 MEDICARE CLAIM | 9/1/2009 | |
| 7530 | PAC 30 MEDICARE CLAIM | 9/1/2009 | |
| 7531 | PAC 31 MEDICARE CLAIM | 9/1/2009 | |
| 7532 | PAC 32 MEDICARE CLAIM | 9/1/2009 | |
| 7533 | PAC 33 MEDICARE CLAIM | 9/1/2009 | |
| 7534 | PAC 34 MEDICARE CLAIM | 9/1/2009 | |
| 7535 | PAC 35 MEDICARE CLAIM | 9/1/2009 | |
| 7536 | PAC 36 MEDICARE CLAIM | 9/1/2009 | |
| 7537 | PAC 37 MEDICARE CLAIM | 9/1/2009 | |
| 7538 | PAC 38 MEDICARE CLAIM | 9/1/2009 | |
| 7539 | PAC 39 MEDICARE CLAIM | 9/1/2009 | |
| 7540 | PAC 40 MEDICARE CLAIM | 9/1/2009 | |
| 7541 | PAC 41 MEDICARE CLAIM | 9/1/2009 | |
| 7542 | PAC 42 MEDICARE CLAIM | 9/1/2009 | |
| 7543 | PAC 43 MEDICARE CLAIM | 9/1/2009 | |
| 7544 | PAC 44 MEDICARE CLAIM | 9/1/2009 | |
| 7545 | PAC 45 MEDICARE CLAIM | 9/1/2009 | |
| 7546 | PAC 46 MEDICARE CLAIM | 9/1/2009 | |
| 7547 | PAC 47 MEDICARE CLAIM | 9/1/2009 | |
| 7548 | PAC 48 MEDICARE CLAIM | 9/1/2009 | |
| 7549 | PAC 49 MEDICARE CLAIM | 9/1/2009 | |
| 7550 | PAC 50 MEDICARE CLAIM | 9/1/2009 | |
| 7551 | PAC 51 MEDICARE CLAIM | 9/1/2009 | |
| 7552 | PAC 52 MEDICARE CLAIM | 9/1/2009 | |
| 7553 | PAC 53 MEDICARE CLAIM | 9/1/2009 | |
| 7554 | PAC 54 MEDICARE CLAIM | 9/1/2009 | |
| 7555 | PAC 55 MEDICARE CLAIM | 9/1/2009 | |
| 7556 | PAC 56 MEDICARE CLAIM | 9/1/2009 | |
| 7557 | PAC 57 MEDICARE CLAIM | 9/1/2009 | |
| 7558 | PAC 58 MEDICARE CLAIM | 9/1/2009 | |
| 7559 | PAC 59 MEDICARE CLAIM | 9/1/2009 | |
| 7560 | PAC 60 MEDICARE CLAIM | 9/1/2009 | |
| 7561 | PAC 61 MEDICARE CLAIM | 9/1/2009 | |
| 7562 | PAC 62 MEDICARE CLAIM | 9/1/2009 | |
| 7564 | PAC 64 MEDICARE CLAIM | 9/1/2009 | |
| 7565 | PAC 65 MEDICARE CLAIM | 9/1/2009 | |
| 7566 | PAC 66 MEDICARE CLAIM | 9/1/2009 | |
| 7567 | PAC 67 MEDICARE CLAIM | 9/1/2009 | |
| 7568 | PAC 68 MEDICARE CLAIM | 9/1/2009 | |
| 7569 | PAC 69 MEDICARE CLAIM | 9/1/2009 | |
| 7570 | PAC 70 MEDICARE CLAIM | 9/1/2009 | |
| 7571 | PAC 71 MEDICARE CLAIM | 9/1/2009 |
