|
WASHIN6ION MEDICAID AND WASHINGTON 8ENEFff PLANS FOR THE UNINSURED BEHAMORAI. HEAI.TH PROFESSIONAL REIMBURSEMENTSCHEOULE
<br />lr.iLi
<br />hpr6mn'.3 ky6nFnenk: &':id h; D.bibd k.mj M r*"'"5t51
<br />lhibJ
<br />heroBdr, ] hvcnFnents: &t.ld h; D.tsibd hdn; Mpd ktsion hGnphr
<br />I
<br />hidJ hfl e*dr, I kr 6mp..nh:bmp'eh?netue hj6npt.henetoc krn; Med kdon Md .ompl.r r*'
<br />kyGmpn.nc:ehprch€nstue HtOmpr.henlt. e:m) M.d kisio Md conpl.r
<br />lcr/oP
<br />B29
<br />I'nibi 'ier6ild',3
<br />xeyompicnts.6mpFhFnrte hi6mp'eh.ns*. &:mi Mpd D*Bron Md compr.'
<br />lhidi
<br />hpr 6Ndt, I kr 6dp.cnk.6hp'.hFn\ile *:bdp'€h.nsto€ &rilj M.d k6'on Md hPl.r
<br />Flni@dil,I
<br />x€tentsn?nts:chp,ehenitue Hr:6mp,.h.ntn€ &rnj Med DRieion Md Gdplcr
<br />loesMAT/|P
<br />829
<br />I
<br />l.idi lipr 6Nnt, I kr6mFn€nts:6mp'.henrtue tu:6mptche
<br />lhiui
<br />het 6Ndt, i x€y6mFicnG:emp'.henrPeHr:6nptch..et€ krmj Med D*tsion Mdcomplcr
<br />Fhhhr
<br />c n. r kyemFnenB:ompEhen'tuch:6np,€hensh€ &.mj M.d hnion Md6mprer
<br />l2tsnrcP
<br />74.52
<br />lhiUi
<br />hp' 6ildr, I xerGmFnehb:6mp'.h.nttueHr,6mp,€hcnstue b,niMd k*n Htsh(bnphr
<br />lhiUi
<br />hpt 6sdl, I Xey6nFnpnL:emp'ehensh.t46mpr€h..rtu€ b,miMd h.Bbn HBhbnph\
<br />H{cnpr€h.nstu€ A.mjMd e.6ion Hbh6mPl.x
<br />lo,0/P
<br />lr.,hi
<br />rirr cond'. rxey6nFne.t:6mp'ch.nrto.k,Gop'ehcn!toe s:m:Md kruion H€hkdPrer
<br />lhidJ
<br />hpr 6.rutr, I &yGnFn.nh:edprehensde Hr,Gmp'.hrnlPe G.d,Md Dedion HBhbmpt*
<br />lhili.l
<br />her 6Ndt, sxey6nFne.B:6mp'phensi. H^,6f,prch€nrtue b,n:Md e!6'on tish6mpl.r
<br />lGe,MAr/@
<br />*ey 6mpne.E:6np'ehenr'. H^,GmptehentilF b,m:Md De(kion qiSh 6mpl.'
<br />lryqtP
<br />D255
<br />lh$.1
<br />lnetGdu[,3kybdFnenlt:6mpt.hent{c k;6mp'ehenttue Bam;Md DRkion Hlsh6nprd
<br />lFnos-"veerv6il,I
<br />q.".p..nb: Pbb kutHxi Ptob kut L,misttud Md De(trn r*'
<br />il,3 q(onFn.nts: Prcb kueHYi Pmb tr$ r',djSkM Md &.ftn
<br />l0r3/oP
<br />Itmasm(y
<br />eetviil,3 qconFn.nts: Pob kueHri P'ob rdu' &.d:svtud Md &.tun
<br />Itnasen.y
<br />kelviil, r kycodpi.nE: Pbb kurHri prcb r(us&.m:sutud Md &dn
<br />Ir*@kil,I
<br />kq(onFn.nb: P'ob rdutH{ t'ob kuerranjst&d Md &&ion
<br />|,1,s/P
<br />B23l
<br />lrmqen(veerv6il,
<br />I q(onpn.nts: P'ob ku! Hij pob r4u'6an:stM Md edion r--*
<br />Pro6 Faue ean)Md D* low Onpk
<br />l!!-as*y
<br />eplvbil,3 x€yempo^ents:&F.d Prob toiusH4bprnd Ptobr(ut&an;Md Dd bsGmpk
<br />l0f/oP
<br />lFm.rB.Rv
<br />ept vkil,r xerGnpon.nh:&Fnd Prob b(us H'jeF
<br />Itme'sdq
<br />eer v8il,3 xry6mponents:6p..d tuob ro(utH^juFnd P'obreur B.miMd DR bsbmp!r""
<br />lE6c'seniyeprvki,]xey6meon.nh:hFnd
<br />Prob ro(urHri&Fnd P'drd!r kimjMd 0( bwGnpL
<br />-lh-tr*y
<br />eNkt,r xetampon.nh:bFnd kob Io(ue kjbFnd P'ob raut k.mjMd Dft bwemph
<br />l,setoP
<br />23,t1
<br />8233 r-"
<br />Itmfl
<br />s.n.y 0eel vbi',3 kv&dponents:LFnd Prob to.us Hrjhp.nd Ptob r(ui &imiMd D* Md comDh
<br />P,ob fcui eamjMd Dft MdCompts
<br />lG,0/P
<br />fFms8mcy
<br />eer vkt.r xey6npon.nts:htsnd P,ob ro.u' hjktsnd Prob rcui B:mjMd Dr Md compa
<br />f**
<br />P.ob ttrus BihjMd 0- Mdco6pL
<br />lEmcrs.niyD.ptvnil,Jtey6neosnt:kFnd
<br />Prob roo! Hii&F.d Prob rtrut Ld:Md 0ec Mdcomph
<br />I :1 ::1'"1l'-':tlj:t:.::l: ::i::l'49,21
<br />I ::li:'.:Tt#:::;:::H ::;:T'iis5ws'recsdmc
<br />lu,8/oP
<br />l::l*'":'":m:j::;:::ldox;e,mjmdddsb.mdrcmpr.xis;@lnseriru.ndlo,r@dorhrrhs€veftypr6.n,4 lozo/rP
<br />l:l^n:..:'-:f;::::;::::ll::i::1,-',**"nd.ompre,iv;@une.r,nBand/o,r@.do'hderilqpre,€nil.s lc20/oP
<br />l::l*."::T"T#.:l:;::::ldoxjelm;mdd*hhnndrcmpr4iv;.oun,.rrnsand/o,c@.ddh,sfwnqere*dms ld'esr"
<br />IER rnil,3 rq cmoffi: debild Dx: dm d delion d coryl.lrq coKelhs {do..m'd orhd 6€ilv pldhs l rI es/oP
<br />I'obr.mbdmrinficdturbliktuil I
<br />J kyComFnrns:6mp'ehe.tR Hr,Comprh.Bk urmj Md 0erkn HiSh 6mpLr r"*123.93
<br />b,conprch.nrh&.mj Md e.hn Hr3h66pFr r*'"
<br />lrmflsenqo.etVkil,
<br />r hycohpienB omprch.n\b k;comp'.heniF tr.mi Md e,nn Hlsh 6mphr
<br />Hrjcomprchenrtu &:m; Md &.Ln HEhGhpbx r""
<br />k;ConpGhenrir &:nj Md ftdsn HEh6nPFr t**-
<br />lad€qenryo.etviil,
<br />I kycomFienB:6np'Pfi.nrk H\jConpteh.nsiE &rni Md edsn H!hGmpk,
<br />rbn&Min,3€n.nt
<br />lou/P
<br />157,39
<br />8291
<br />loidalcil€,
<br />EEtuilrn & Mmarm€it
<br />lo'dol(r€,
<br />Eerudbn & Mm4en€nr.rdd r roM'n
<br />Fe -r c.'., 4;hrbn & Man,senpnt. addl 30 Min
<br />lo13/oP
<br />I
<br />hiti nu6hB 6dhry d'€, ddnldkome hlbry;
<br />I
<br />rnilhr nu6hs hi,rq (,'€, dehild/.omp h\'oryi d€raidtomp d.mi ddbn m.hn3 ilnrd{osildnow codpknq
<br />l0r0/P
<br />r-*45,69
<br />|hldalilEh3hdqcre,debild^omPhtslory'dehild/(onp.xan;d*ibnmrlin3rk.islbNild/ow.omplex.q
<br />lhiDl
<br />nuBins 6i.lq i r€, dehid/(omp hktotr deuild/omp drmj d(kbn milns'rdrdrbtuild/ow.omPr.r'q
<br />lr'
<br />4s/oP
<br />t detrird/(omp hiltory; dehildtomp errm: dFirsn m*'ns*.i$trotu,'dlN (odpkilq
<br />f^t
<br />97,7t
<br />r-*
<br />I
<br />hidr nunins h6lrv ra,e ddilrd/omp hLrory d.hird/mmp er.n: dd6.n m.r inB {,aid{oN.d/o* (omprsi\
|