BILLING FACILITY FEES
Cost:_____Price charged:( ) A4550 Epidural Tray . A4649: Jelco . IV Kit: Tegaderm Dressing: Adaptor: Syringe: Needle: Pulse Ox: O2 + Nasal Tubing: Sterile Surgical Gloves: J2250 Versed per 1 mg . J3490 Marcaine .25% . J1040 Depo-Medrol 80 mg: J1030 Depo-Medrol 40mg . J3010 Fentanyl 2ml . A4645 Isovue 200mg Iodine: Revenue Codes ................
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