Short Description Outside state ambulance serv Noninterest escort in non er Interest escort in non er Nonemergency transport taxi Nonemergency transport bus Noner transport mini-bus Noner transport wheelch van Nonemergency transport air Noner transport case worker Transport parking fees/tolls Noner transport lodgng recip Noner transport meals recip Noner transport lodgng escrt Noner transport meals escort Neonatal emergency transport Basic life support mileage Basic support routine suppls Bls defibrillation supplies Advanced life support mileag Als defibrillation supplies Als iv drug therapy supplies Als esophageal intub suppls Als routine disposble suppls Ambulance waiting 1/2 hr Ambulance 02 life sustaining Extra ambulance attendant Ground mileage Als 1 Als1-emergency Bls Bls-emergency Fixed wing air transport Rotary wing air transport Pi volunteer ambulance co Als 2 Specialty care transport Fixed wing air mileage Rotary wing air mileage Noncovered ambulance mileage Ambulance response/treatment Unlisted ambulance service 1 cc sterile syringe&needle 2 cc sterile syringe&needle 3 cc sterile syringe&needle 5+ cc sterile syringe&needle Nonneedle injection device Supp for self-adm injections Non coring needle or stylet 20+ cc syringe only Sterile needle Sterile water/saline, 10 ml
Sterile water/saline, 500 ml Sterile saline or water Infusion pump refill kit Maint drug infus cath per wk Infusion supplies with pump Infusion supplies w/o pump Infus insulin pump non needl Infusion insulin pump needle Syringe w/needle insulin 3cc Alkalin batt for glucose mon J-cell batt for glucose mon Lithium batt for glucose mon Silvr oxide batt glucose mon Alcohol or peroxide per pint Alcohol wipes per box Betadine/phisohex solution Betadine/iodine swabs/wipes Chlorhexidine antisept Urine reagent strips/tablets Blood ketone test or strip Blood glucose/reagent strips Glucose monitor platforms Calibrator solution/chips Replace lensshield cartridge Lancet device each Lancets per box Cervical cap contraceptive Temporary tear duct plug Permanent tear duct plug Intratubal occlusion device Paraffin Diaphragm Male condom Female condom Spermicide Disposable endoscope sheath Brst prsths adhsv attchmnt Replacement breastpump tube Replacement breastpump adpt Replacement breastpump cap Replcmnt breast pump shield Replcmnt breast pump bottle Replcmnt breastpump lok ring Sacral nerve stim test lead Cath impl vasc access portal Implantable access syst perc Drug delivery system >=50 ml Drug delivery system 249cc Dialysat sol fld vol > 999cc Dialys sol fld vol > 1999cc Dialys sol fld vol > 2999cc Dialys sol fld vol > 3999cc Dialys sol fld vol > 4999cc Dialys sol fld vol > 5999cc Dialysate solution, non-dex Fistula cannulation set, ea Topical anesthetic, per gram Inj anesthetic per 10 ml Shunt accessory Art or venous blood tubing Comb art/venous blood tubing Dialysate sol test kit, each Dialysate conc pow per pack Dialysate conc sol add 10 ml
Modification diabetic shoe Diabetic deluxe shoe Compression form shoe insert Multi den insert direct form Multi den insert custom mold Wound warming wound cover Collagen based wound filler Collagen gel/paste wound fil Collagen dressing 1648 sq in Collagen dsg wound filler Silicone gel sheet, each Wound pouch each Alginate dressing 16 48 sq in Alginate drsg wound filler Composite drsg 16 48 sq in Contact layer 16 48 sq in Foam drsg 16 48 sq in w/o brdr Foam drg 16 48 sq in w/border Foam dressing wound filler Non-sterile gauze16 48 sq in Gauze 16 48 sq in w/border Gauze 16 48 in no w/sal w/o b Gauze 16 48 sq in water/salne Hydrogel dsg1648 sq in Hydrocolld drg 16 48 in w/o b Hydrocolld drg 16 48 in w/bdr
