Orange County NC Website
M anager's Recommended Fee Schedule- FY 2015-16 44 <br /> Manager's Recommended Fee Last <br /> Department/Program Description Current Fee Schedule for FY 2015-16* Revision <br /> 82465QW Cholesterol $11.00 2011 <br /> 82947QW Glucose andom $18.00 2006 <br /> 82950QW O'Sullivan $28.00 2007 <br /> 82951QW OGTT(3 R) $50.00 2006 <br /> 83036QW Hemoglobin AlC $21.00 2006 <br /> 85018QW Hemo obin $11.00 2009 <br /> 88175-90 Pa,Thin Pr (State Lab) $18.38 2012 <br /> D0145 Oral Evaluation<3 yo,with couttseling $55.00 2012 <br /> D 1206 Topical Fluoride A 1 $47.00 2012 <br /> Recode Employe Vadeella Titer C $78.00 2009 <br /> Recode Employee Measles ubeola NC Lab ter $48.00 2009 <br /> Recode Employee Mums Titer $50.00 2009 <br /> Recode Employee Rubella Titer $75.00 2009 <br /> G0008 Adm of Influenza Vaccine $18.00 2009 <br /> G0008 Admin.Influenza Vaccine-Medicare $18.00 2009 <br /> G0009 Adm of Pneumococcal Vaccine $18.00 2009 <br /> G0009 Admin.Pneumococcal Vaccine-Medicare $18.00 2009 <br /> G0108 DSME/DSMT Individual Assessment $22.00 2010 <br /> G0109 DSME/DSMT Grou Class $12.00 2010 <br /> G0270 Additional MD re nested MNT indiv-Medicare $25.00 2010 <br /> G0271 AdditiPM d MNT group-Medicare $13.00 2010 <br /> J1055 D <br /> $40.00 2012 <br /> J1200 Di henh draniine HCL/Benadryl up to 50 $6.00 2009 <br /> J2550 Promethazine rng $8.00 2009 <br /> J2790 Rho am Injection $88.00 2012 <br /> J3420 B-12 hiection $6.00 2009 <br /> J3490 17 Alpha-hydroxprogesterone $21.00 2012 <br /> 17300 Par and IUD $390.00 2012 <br /> J7302 Mirena IUD $745.23 2014 <br /> J7303 Nu $57.00 2008 <br /> J7307 Im lanon $698.99 2014 <br /> K Cefiniaxone Sodium/Roce hin er 250 $22.00 2008 <br /> Sorts Ph sical $44.00 2008 <br /> Cam Ph sical $44.00 2009 <br /> Colle e Ph sical $44.00 2009 <br /> I-693 Form $25.00 $0.00 2012 <br /> P Care Minimum Fee $20.00 2012 <br /> MNT Minimum Fee $20.00 2012 <br /> Adult Medicaid Co-pay $3.00 2010 <br /> 54993 10ral Contraceptive Pills $5.00 2012 <br /> 59465 IDiabetic manaement progrant,dietitian visit $35.00 2011 <br /> 59470 Nutritional course ,dietitian visit $35.00 2011 <br /> T 1002 RN Services up to 15 min. $21.00 2005 <br /> IS9442 Birt classes 8.69/1 hr block 2013 <br /> 90714 1 TD Vaccine 1$35.00 1 1 2013 <br /> * Any fee changes wi I I be included in this column; <br /> a bl ank besi de each f ee means there i s no f ee change i n FY 2015-16 Manager Recommended Fee Schedule <br />