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14
15
Line
Line
No.
Item
After-Care
Fee
No.
Item
After-Care
Fee
469. Mastoid - bilateral
3 wks. 225 00
602. Fixation of kidney
A. & A.
471. Antrotomy puncture with irrigation
10 00
603. Kidney calculi-removal
3 wks.
150 00
472. Antrotomy - window
3 wks.
50 00
604. Nephrotomy
3 wks.
100 00
473. Antrotomy - radical
A. & A.
605. Cystotomy
3 wks.
75 00
474. Antrotomy - subsequent irrigations
5 00
606. Cystoscopy without X-ray
25 00
475. Epistaxis, arrest of bleeding, office visit.
607. Cystoscopy including catherization ureters
35 00
476. Epistaxis, with electrocoagulation or electro-
608. External Urethrotomy
A. & A.
cauterization
10 00
609. Hydrocele - radical
3 wks.
50 00
477. Epistaxis, without electrocoagulation, office visit.
610. Hydrocele - tapping
10 00
478. Myringotomy, in office (puncture)
5.00
611. Orchidectomy
3 wks.
60 00
479. Nyringotomy, at hospital or home or other place
10 00
612. Epididymectomy
3 wks.
75 00
480. Subsequent office visits
3 00
(Lines 601 to 612 apply to all qualified surgeons
481. House visit, routine, for examination and opinion
5 00
with "A" rating or equivalent.)
482. Hospital visit, for ordinary visit, dressings and
observation
3 00
DERMATOLOGY
EYE
" SH " QUALIFICATION
" SE " QUALIFICATION
650. Complete office examination or consultation
10 00
525. Simple, office, eye check-up on referred patients,
650a. Check-up office examination of referred patient
5 00
mere observation (no refraction, no study of
651. Subsequent office examination or care
3 00
retina)
5 00
652. Subsequent care, with X-ray therapy
5 00
526. Compiete office examination or consultation without
653. Hospital visit
3 00
refraction
10 00
654. Neo-salvarsan, plus cost of drug
7 50
527. Special study, special test for permanent disability
and report
A. & A.
528. Refraction alone and prescription for glasses
7 50
PROCTOLOGY
529. Combined full examination (526 and 528) and re-
fraction and prescription for glasses
12 50
530. Subsequent office visit
3 00
" SM8 QUALIFICATION
531. Hospital visits
3 00
535. Foreign body embedded in cornea, removal of
5 00
664. Complete office examination or consultation
10 00
536. Removal of intra-ocular foreign body
21 days
100 00
665. Anal fissure, divulsion under anaesthesia
15 00
537. Removal of intra-orbital foreign body
21 days
100 00
666. Single fistula including 3 weeks after care
50 00
560. Primary suture of lid wounds
15 00
667. Multiple fistulae including 3 weeks after care
75 00
561. Iridectomy
10 days
60 00
668. Hemorrhoids, removal by injection, per visit
5 00
562. Cataract extraction
10 days
100 00
669. Hemorrhoids, external, single, 2 weeks after care
25 00
563. Muscle operation
A. & A.
670. Hemorrhoids, multiple external, 2 weeks after care.
50 00
564. Plastic lid operation
A. & A.
671. Hemorrhoids, internal, 2 weeks after care
50 00
568. Discission (needling) of cataract
10 days
75 00
672. Incision of thrombosed hemorrhoid
10 00
569. Operation for detachment of retina
10 days
100 00
673. Prolapse, anal, treatment by laparotomy including
570. Enucleation of eyeball
21 days
100 00
3 weeks after care
150 00
571. Evisceration of eyeball
21 days
100 00
674. Rectal resection, including 4 weeks after care
150 00
572. Conjunctivokeratoplasty for perforating wounds of
(Lines 664 to 674 apply to all qualified surgeons
eyeball
A. & A.
with "A" rating or equivalent.)
575. Glaucoma operation
10 days
100 00
576 Operation for strabismus
A. & A.
577. Dacryocystectomy
10 days
75 00
PHYSICAL THERAPY
578. Chalazion operation, either dissection or incision and
currettage
15 00
" SM1 " QUALIFICATION
UROLOGY
690. Per visit, inclusive of any and all modalities
3 00
(When total fees for physical therapy treatment
" SG " QUALIFICATION
approach the sum of $25.00, the physician
should file an additional C-4 report and re-
600. Neo-salvarsan plus cost of drug
7 50
quest authorization as prescribed in Section
601. Excision of kidney
3 wks. 150 00
13-A-5.)
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"ocrText": "14\n15\nLine\nLine\nNo.\nItem\nAfter-Care\nFee\nNo.\nItem\nAfter-Care\nFee\n469. Mastoid - bilateral\n3 wks. 225 00\n602. Fixation of kidney\nA. & A.\n471. Antrotomy puncture with irrigation\n10 00\n603. Kidney calculi-removal\n3 wks.\n150 00\n472. Antrotomy - window\n3 wks.\n50 00\n604. Nephrotomy\n3 wks.\n100 00\n473. Antrotomy - radical\nA. & A.\n605. Cystotomy\n3 wks.\n75 00\n474. Antrotomy - subsequent irrigations\n5 00\n606. Cystoscopy without X-ray\n25 00\n475. Epistaxis, arrest of bleeding, office visit.\n607. Cystoscopy including catherization ureters\n35 00\n476. Epistaxis, with electrocoagulation or electro-\n608. External Urethrotomy\nA. & A.\ncauterization\n10 00\n609. Hydrocele - radical\n3 wks.\n50 00\n477. Epistaxis, without electrocoagulation, office visit.\n610. Hydrocele - tapping\n10 00\n478. Myringotomy, in office (puncture)\n5.00\n611. Orchidectomy\n3 wks.\n60 00\n479. Nyringotomy, at hospital or home or other place\n10 00\n612. Epididymectomy\n3 wks.\n75 00\n480. Subsequent office visits\n3 00\n(Lines 601 to 612 apply to all qualified surgeons\n481. House visit, routine, for examination and opinion\n5 00\nwith \"A\" rating or equivalent.)\n482. Hospital visit, for ordinary visit, dressings and\nobservation\n3 00\nDERMATOLOGY\nEYE\n\" SH \" QUALIFICATION\n\" SE \" QUALIFICATION\n650. Complete office examination or consultation\n10 00\n525. Simple, office, eye check-up on referred patients,\n650a. Check-up office examination of referred patient\n5 00\nmere observation (no refraction, no study of\n651. Subsequent office examination or care\n3 00\nretina)\n5 00\n652. Subsequent care, with X-ray therapy\n5 00\n526. Compiete office examination or consultation without\n653. Hospital visit\n3 00\nrefraction\n10 00\n654. Neo-salvarsan, plus cost of drug\n7 50\n527. Special study, special test for permanent disability\nand report\nA. & A.\n528. Refraction alone and prescription for glasses\n7 50\nPROCTOLOGY\n529. Combined full examination (526 and 528) and re-\nfraction and prescription for glasses\n12 50\n530. Subsequent office visit\n3 00\n\" SM8 QUALIFICATION\n531. Hospital visits\n3 00\n535. Foreign body embedded in cornea, removal of\n5 00\n664. Complete office examination or consultation\n10 00\n536. Removal of intra-ocular foreign body\n21 days\n100 00\n665. Anal fissure, divulsion under anaesthesia\n15 00\n537. Removal of intra-orbital foreign body\n21 days\n100 00\n666. Single fistula including 3 weeks after care\n50 00\n560. Primary suture of lid wounds\n15 00\n667. Multiple fistulae including 3 weeks after care\n75 00\n561. Iridectomy\n10 days\n60 00\n668. Hemorrhoids, removal by injection, per visit\n5 00\n562. Cataract extraction\n10 days\n100 00\n669. Hemorrhoids, external, single, 2 weeks after care\n25 00\n563. Muscle operation\nA. & A.\n670. Hemorrhoids, multiple external, 2 weeks after care.\n50 00\n564. Plastic lid operation\nA. & A.\n671. Hemorrhoids, internal, 2 weeks after care\n50 00\n568. Discission (needling) of cataract\n10 days\n75 00\n672. Incision of thrombosed hemorrhoid\n10 00\n569. Operation for detachment of retina\n10 days\n100 00\n673. Prolapse, anal, treatment by laparotomy including\n570. Enucleation of eyeball\n21 days\n100 00\n3 weeks after care\n150 00\n571. Evisceration of eyeball\n21 days\n100 00\n674. Rectal resection, including 4 weeks after care\n150 00\n572. Conjunctivokeratoplasty for perforating wounds of\n(Lines 664 to 674 apply to all qualified surgeons\neyeball\nA. & A.\nwith \"A\" rating or equivalent.)\n575. Glaucoma operation\n10 days\n100 00\n576 Operation for strabismus\nA. & A.\n577. Dacryocystectomy\n10 days\n75 00\nPHYSICAL THERAPY\n578. Chalazion operation, either dissection or incision and\ncurrettage\n15 00\n\" SM1 \" QUALIFICATION\nUROLOGY\n690. Per visit, inclusive of any and all modalities\n3 00\n(When total fees for physical therapy treatment\n\" SG \" QUALIFICATION\napproach the sum of $25.00, the physician\nshould file an additional C-4 report and re-\n600. Neo-salvarsan plus cost of drug\n7 50\nquest authorization as prescribed in Section\n601. Excision of kidney\n3 wks. 150 00\n13-A-5.)"
}