Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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: MOH Category - XML Representation

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="moh-category"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2022-08-08T13:04:40.59+03:00"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem moh-category</b></p><a name="moh-category"> </a><a name="hcmoh-category"> </a><a name="moh-category-en-US"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1; Last updated: 2022-08-08 13:04:40+0300</p></div><p>This case-sensitive code system <code>http://nphies.sa/terminology/CodeSystem/moh-category</code> provides <b>a fragment</b> that includes following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td></tr><tr><td style="white-space:nowrap">650426<a name="moh-category-650426"> </a></td><td>Release Of Carpal Tunnel Syndrom General Anaesthesia</td></tr><tr><td style="white-space:nowrap">506060<a name="moh-category-506060"> </a></td><td>C &amp; S Prostrate</td></tr><tr><td style="white-space:nowrap">650424<a name="moh-category-650424"> </a></td><td>Release Of Carpal Tunnel Syndrome Regional Anaesthesia</td></tr><tr><td style="white-space:nowrap">75-34.50<a name="moh-category-75-34.4650"> </a></td><td>Pleurectomy</td></tr><tr><td style="white-space:nowrap">K57200<a name="moh-category-K57200"> </a></td><td>Suturing of Vaginal Tear</td></tr><tr><td style="white-space:nowrap">650422<a name="moh-category-650422"> </a></td><td>Release Of Carpal Tunnel Syndrome Local Anaesthesia</td></tr><tr><td style="white-space:nowrap">518046<a name="moh-category-518046"> </a></td><td>Vasopressin (Adh)</td></tr><tr><td style="white-space:nowrap">650420<a name="moh-category-650420"> </a></td><td>Theco-Peritoneal Shunt</td></tr><tr><td style="white-space:nowrap">518048<a name="moh-category-518048"> </a></td><td>5-Hiaa</td></tr><tr><td style="white-space:nowrap">U80172<a name="moh-category-U80172"> </a></td><td>Gold</td></tr><tr><td style="white-space:nowrap">T76020<a name="moh-category-T76020"> </a></td><td>Skeletal Survey</td></tr><tr><td style="white-space:nowrap">U80170<a name="moh-category-U80170"> </a></td><td>Gentamycin</td></tr><tr><td style="white-space:nowrap">518044<a name="moh-category-518044"> </a></td><td>17-Ketosteriods, Urine</td></tr><tr><td style="white-space:nowrap">518086<a name="moh-category-518086"> </a></td><td>Oestradiol</td></tr><tr><td style="white-space:nowrap">750906<a name="moh-category-750906"> </a></td><td>Telengiectasia Treatment, Legs, Medium Area -Per Session (Skincare)</td></tr><tr><td style="white-space:nowrap">518088<a name="moh-category-518088"> </a></td><td>Digoxin</td></tr><tr><td style="white-space:nowrap">650428<a name="moh-category-650428"> </a></td><td>Release Of Ulnar Nerve Entrapment At Wrist</td></tr><tr><td style="white-space:nowrap">800026<a name="moh-category-800026"> </a></td><td>Socket Reconstruction</td></tr><tr><td style="white-space:nowrap">518082<a name="moh-category-518082"> </a></td><td>Ft3</td></tr><tr><td style="white-space:nowrap">U80168<a name="moh-category-U80168"> </a></td><td>Ethosuximide</td></tr><tr><td style="white-space:nowrap">518040<a name="moh-category-518040"> </a></td><td>17-Hydroxycortisoteriods, Urine</td></tr><tr><td style="white-space:nowrap">518084<a name="moh-category-518084"> </a></td><td>T B G</td></tr><tr><td style="white-space:nowrap">U80166<a name="moh-category-U80166"> </a></td><td>Doxepin</td></tr><tr><td style="white-space:nowrap">750908<a name="moh-category-750908"> </a></td><td>Telengiectasia Treatment, Legs, Large Area -Per Session (Skincare)</td></tr><tr><td style="white-space:nowrap">U80164<a name="moh-category-U80164"> </a></td><td>Depakine Level (Valproic Acid)</td></tr><tr><td style="white-space:nowrap">518080<a name="moh-category-518080"> </a></td><td>Chromosomal Analysis</td></tr><tr><td style="white-space:nowrap">800024<a name="moh-category-800024"> </a></td><td>Thyroid Orbital Decompression (Both Eyes)</td></tr><tr><td style="white-space:nowrap">U84520<a name="moh-category-U84520"> </a></td><td>Bun</td></tr><tr><td style="white-space:nowrap">750902<a name="moh-category-750902"> </a></td><td>Laser Facial Rejuvenation - Per Session (Skincare)</td></tr><tr><td style="white-space:nowrap">650430<a name="moh-category-650430"> </a></td><td>Release Of Cubital Tunnel Syndrome</td></tr><tr><td style="white-space:nowrap">750904<a name="moh-category-750904"> </a></td><td>Telengiectasia Treatment, Legs, Small Area -Per Session (Skincare)</td></tr><tr><td style="white-space:nowrap">E42420<a name="moh-category-E42420"> </a></td><td>Parotidectomy total</td></tr><tr><td style="white-space:nowrap">650416<a name="moh-category-650416"> </a></td><td>Repair Of Meningomyelocele Major</td></tr><tr><td style="white-space:nowrap">800028<a name="moh-category-800028"> </a></td><td>Enucl. With Hydroxy. Orbital</td></tr><tr><td style="white-space:nowrap">650414<a name="moh-category-650414"> </a></td><td>Repair Of Meningomyelocele, Minor Defect</td></tr><tr><td style="white-space:nowrap">506068<a name="moh-category-506068"> </a></td><td>C &amp; S Swine Flu (H1N1)</td></tr><tr><td style="white-space:nowrap">506066<a name="moh-category-506066"> </a></td><td>C &amp; S Semen</td></tr><tr><td style="white-space:nowrap">75-34.02<a name="moh-category-75-34.4602"> </a></td><td>Thoracotomy, exploratory</td></tr><tr><td style="white-space:nowrap">U82784<a name="moh-category-U82784"> </a></td><td>IGA/IGM/IGD/IGG</td></tr><tr><td style="white-space:nowrap">U82785<a name="moh-category-U82785"> </a></td><td>IGE</td></tr><tr><td style="white-space:nowrap">K57210<a name="moh-category-K57210"> </a></td><td>Colpo Perineorraphy</td></tr><tr><td style="white-space:nowrap">800022<a name="moh-category-800022"> </a></td><td>Thyroid Orbital Decompression (One Eye)</td></tr><tr><td style="white-space:nowrap">650412<a name="moh-category-650412"> </a></td><td>Posterior Fusion And Stabilization</td></tr><tr><td style="white-space:nowrap">202080<a name="moh-category-202080"> </a></td><td>Long Term Care (Ltc) - Per Day Package</td></tr><tr><td style="white-space:nowrap">650410<a name="moh-category-650410"> </a></td><td>Anterior Or Anterolateral Verteb, Resection And Stabilization</td></tr><tr><td style="white-space:nowrap">506062<a name="moh-category-506062"> </a></td><td>Fern Test</td></tr><tr><td style="white-space:nowrap">U80162<a name="moh-category-U80162"> </a></td><td>Digoxin - Lanoxin</td></tr><tr><td style="white-space:nowrap">800020<a name="moh-category-800020"> </a></td><td>Optic Nerve Sheath Fenes – Onsf</td></tr><tr><td style="white-space:nowrap">D92250<a name="moh-category-D92250"> </a></td><td>Fundus Photography with interpretation</td></tr><tr><td style="white-space:nowrap">518074<a name="moh-category-518074"> </a></td><td>Insulin, Serum</td></tr><tr><td style="white-space:nowrap">506050<a name="moh-category-506050"> </a></td><td>C &amp; S Umbilical</td></tr><tr><td style="white-space:nowrap">650418<a name="moh-category-650418"> </a></td><td>Repair Of Occult Spinal Dysraphism</td></tr><tr><td style="white-space:nowrap">518038<a name="moh-category-518038"> </a></td><td>Cortisol</td></tr><tr><td style="white-space:nowrap">518076<a name="moh-category-518076"> </a></td><td>C-Peptide, Serum</td></tr><tr><td style="white-space:nowrap">518034<a name="moh-category-518034"> </a></td><td>Vitamine D</td></tr><tr><td style="white-space:nowrap">518070<a name="moh-category-518070"> </a></td><td>Vitamine B12, Serum</td></tr><tr><td style="white-space:nowrap">U80156<a name="moh-category-U80156"> </a></td><td>Tegretol Level - Carbamazipene</td></tr><tr><td style="white-space:nowrap">518036<a name="moh-category-518036"> </a></td><td>Acth</td></tr><tr><td style="white-space:nowrap">518072<a name="moh-category-518072"> </a></td><td>Haptoglobin</td></tr><tr><td style="white-space:nowrap">518030<a name="moh-category-518030"> </a></td><td>Free T4</td></tr><tr><td style="white-space:nowrap">U80152<a name="moh-category-U80152"> </a></td><td>Amitriptyline</td></tr><tr><td style="white-space:nowrap">518032<a name="moh-category-518032"> </a></td><td>Calcitonin</td></tr><tr><td style="white-space:nowrap">U84512<a name="moh-category-U84512"> </a></td><td>Triponin Qualitiative</td></tr><tr><td style="white-space:nowrap">750096<a name="moh-category-750096"> </a></td><td>Patch Test (Skincare)</td></tr><tr><td style="white-space:nowrap">800034<a name="moh-category-800034"> </a></td><td>Drill Of Hyder. Imp. With Artif.</td></tr><tr><td style="white-space:nowrap">750094<a name="moh-category-750094"> </a></td><td>Dermabrasion (Skincare)</td></tr><tr><td style="white-space:nowrap">506058<a name="moh-category-506058"> </a></td><td>C &amp; S Conjunctiva</td></tr><tr><td style="white-space:nowrap">U84550<a name="moh-category-U84550"> </a></td><td>Uric Acid</td></tr><tr><td style="white-space:nowrap">750910<a name="moh-category-750910"> </a></td><td>Telengiectasia Treatment, Face, Few Area -Per Session (Skincare)</td></tr><tr><td style="white-space:nowrap">650442<a name="moh-category-650442"> </a></td><td>Old Perineural Nerve Repair</td></tr><tr><td style="white-space:nowrap">E49080<a name="moh-category-E49080"> </a></td><td>Peritoneal lavage</td></tr><tr><td style="white-space:nowrap">506056<a name="moh-category-506056"> </a></td><td>C &amp; S Axilla</td></tr><tr><td style="white-space:nowrap">U80194<a name="moh-category-U80194"> </a></td><td>Quinidine</td></tr><tr><td style="white-space:nowrap">750912<a name="moh-category-750912"> </a></td><td>Telengiectasia Treatment, Face, Multiple Area -Per Session (Skincare)</td></tr><tr><td style="white-space:nowrap">U80192<a name="moh-category-U80192"> </a></td><td>N-Acetylprocainamide</td></tr><tr><td style="white-space:nowrap">800032<a name="moh-category-800032"> </a></td><td>Impl. Of Hydr. Orb. In Enucl.</td></tr><tr><td style="white-space:nowrap">U80190<a name="moh-category-U80190"> </a></td><td>Procainamide</td></tr><tr><td style="white-space:nowrap">202090<a name="moh-category-202090"> </a></td><td>Icu/Nicu/Picu Per Day Package</td></tr><tr><td style="white-space:nowrap">750092<a name="moh-category-750092"> </a></td><td>Comedon Extraction - Large Area (Skincare)</td></tr><tr><td style="white-space:nowrap">U82775<a name="moh-category-U82775"> </a></td><td>Galactose-1-Phosphate-Uridyltransferase</td></tr><tr><td style="white-space:nowrap">750090<a name="moh-category-750090"> </a></td><td>Comedon Extraction - Medium Area (Skincare)</td></tr><tr><td style="white-space:nowrap">U80188<a name="moh-category-U80188"> </a></td><td>Primidone</td></tr><tr><td style="white-space:nowrap">506054<a name="moh-category-506054"> </a></td><td>C &amp; S Skin</td></tr><tr><td style="white-space:nowrap">U80186<a name="moh-category-U80186"> </a></td><td>Phenytoin - Free</td></tr><tr><td style="white-space:nowrap">U82776<a name="moh-category-U82776"> </a></td><td>Galactose-1-Phosphate</td></tr><tr><td style="white-space:nowrap">U80185<a name="moh-category-U80185"> </a></td><td>Phenytoin - Epanutin Level Total</td></tr><tr><td style="white-space:nowrap">U84545<a name="moh-category-U84545"> </a></td><td>Urea Clearance</td></tr><tr><td style="white-space:nowrap">800030<a name="moh-category-800030"> </a></td><td>Implan. Of Reg. In Enuc. Evisc.</td></tr><tr><td style="white-space:nowrap">650438<a name="moh-category-650438"> </a></td><td>Interfasicular Repair</td></tr><tr><td style="white-space:nowrap">650436<a name="moh-category-650436"> </a></td><td>Nerve Neurolysis</td></tr><tr><td style="white-space:nowrap">506052<a name="moh-category-506052"> </a></td><td>C &amp; S Rectal</td></tr><tr><td style="white-space:nowrap">650434<a name="moh-category-650434"> </a></td><td>Surgery For Unusual Nerve Entrapment Or Injury</td></tr><tr><td style="white-space:nowrap">U84540<a name="moh-category-U84540"> </a></td><td>Urine Urea Nitrogen</td></tr><tr><td style="white-space:nowrap">650404<a name="moh-category-650404"> </a></td><td>Excision Of Lesions Intraspinal Intradural – Lumbar</td></tr><tr><td style="white-space:nowrap">650432<a name="moh-category-650432"> </a></td><td>Brachial Plexus Decompression</td></tr><tr><td style="white-space:nowrap">U80184<a name="moh-category-U80184"> </a></td><td>Phenobarbital - Gardinal Level</td></tr><tr><td style="white-space:nowrap">650402<a name="moh-category-650402"> </a></td><td>Excision Of Lesions Intraspinal Extradural – Cervical</td></tr><tr><td style="white-space:nowrap">518096<a name="moh-category-518096"> </a></td><td>Trypsin</td></tr><tr><td style="white-space:nowrap">650400<a name="moh-category-650400"> </a></td><td>Excision Of Lesions Intraspinal Extradural – Dorsal</td></tr><tr><td style="white-space:nowrap">518098<a name="moh-category-518098"> </a></td><td>Carbamazepine (Tegretol)</td></tr><tr><td style="white-space:nowrap">518068<a name="moh-category-518068"> </a></td><td>Folic Acid, Serum</td></tr><tr><td style="white-space:nowrap">518092<a name="moh-category-518092"> </a></td><td>Dibucaine Inhibition Of Pseudocholinesterase</td></tr><tr><td style="white-space:nowrap">U80150<a name="moh-category-U80150"> </a></td><td>Amikacin</td></tr><tr><td style="white-space:nowrap">D92235<a name="moh-category-D92235"> </a></td><td>Flouroscene Angiography</td></tr><tr><td style="white-space:nowrap">518064<a name="moh-category-518064"> </a></td><td>Tranferritin, Serum</td></tr><tr><td style="white-space:nowrap">U80178<a name="moh-category-U80178"> </a></td><td>Lithium level</td></tr><tr><td style="white-space:nowrap">650408<a name="moh-category-650408"> </a></td><td>Excision Of Lesions Intraspinal Intradural – Cervical</td></tr><tr><td style="white-space:nowrap">U80176<a name="moh-category-U80176"> </a></td><td>Lidocaine</td></tr><tr><td style="white-space:nowrap">518066<a name="moh-category-518066"> </a></td><td>Ferritin, Serum</td></tr><tr><td style="white-space:nowrap">U80174<a name="moh-category-U80174"> </a></td><td>Imipramine</td></tr><tr><td style="white-space:nowrap">650406<a name="moh-category-650406"> </a></td><td>Excision Of Lesions Intraspinal Intradural – Dorsal</td></tr><tr><td style="white-space:nowrap">518090<a name="moh-category-518090"> </a></td><td>Cystic Fibrosis</td></tr><tr><td style="white-space:nowrap">518060<a name="moh-category-518060"> </a></td><td>Alpha-Fetoprotein</td></tr><tr><td style="white-space:nowrap">650440<a name="moh-category-650440"> </a></td><td>Direct Perineural Nerve Repair</td></tr><tr><td style="white-space:nowrap">800004<a name="moh-category-800004"> </a></td><td>Orbital Tumour Biopsy+Histopathology Analysis</td></tr><tr><td style="white-space:nowrap">518062<a name="moh-category-518062"> </a></td><td>Carcinembryonic Antigen (Cea)</td></tr><tr><td style="white-space:nowrap">800002<a name="moh-category-800002"> </a></td><td>Orbital Exploration</td></tr><tr><td style="white-space:nowrap">800008<a name="moh-category-800008"> </a></td><td>Reconstruction Of Orbital Base Fracture</td></tr><tr><td style="white-space:nowrap">800006<a name="moh-category-800006"> </a></td><td>Orbital Tumour Excision+Histopathology Analysis</td></tr><tr><td style="white-space:nowrap">710002<a name="moh-category-710002"> </a></td><td>Polishing Of Teeth (Prophylaxis)</td></tr><tr><td style="white-space:nowrap">704098<a name="moh-category-704098"> </a></td><td>Periodontal Root Planning (Less Than 6 Teeth)</td></tr><tr><td style="white-space:nowrap">710006<a name="moh-category-710006"> </a></td><td>Oral Prophylaxis: With Flouride (2 Visits-Children</td></tr><tr><td style="white-space:nowrap">710004<a name="moh-category-710004"> </a></td><td>Scaling &amp; Polishing</td></tr><tr><td style="white-space:nowrap">704096<a name="moh-category-704096"> </a></td><td>Periodontal Root Planning (Entire Mouth)</td></tr><tr><td style="white-space:nowrap">T74290<a name="moh-category-T74290"> </a></td><td>Oral Cholecystogram/Gall Bladder</td></tr><tr><td style="white-space:nowrap">716084<a name="moh-category-716084"> </a></td><td>Adding Tooth To Partial Denture To Replace Extracted Tooth-Each Tooth(Not Involv</td></tr><tr><td style="white-space:nowrap">518056<a name="moh-category-518056"> </a></td><td>Metanephrines, Urine</td></tr><tr><td style="white-space:nowrap">518058<a name="moh-category-518058"> </a></td><td>Catecholanines, 24 Hours Urine</td></tr><tr><td style="white-space:nowrap">460298<a name="moh-category-460298"> </a></td><td>Dp-Oto-Ecuastic Emission</td></tr><tr><td style="white-space:nowrap">716082<a name="moh-category-716082"> </a></td><td>Repair Of Broken Complete Or Partial Denture - No Teeth Damaged</td></tr><tr><td style="white-space:nowrap">518052<a name="moh-category-518052"> </a></td><td>Vanillymandelic Acid (Vma), Urine</td></tr><tr><td style="white-space:nowrap">460296<a name="moh-category-460296"> </a></td><td>Follow Up Tympanometry</td></tr><tr><td style="white-space:nowrap">518054<a name="moh-category-518054"> </a></td><td>Homovanillic Acid Urine</td></tr><tr><td style="white-space:nowrap">716080<a name="moh-category-716080"> </a></td><td>Paratial Denture Adjustment</td></tr><tr><td style="white-space:nowrap">800014<a name="moh-category-800014"> </a></td><td>Enucleation Or Evisceration=Prosth.Implant</td></tr><tr><td style="white-space:nowrap">825246<a name="moh-category-825246"> </a></td><td>Penile Prosthesis With Implant (Malleable)</td></tr><tr><td style="white-space:nowrap">108-35.50<a name="moh-category-108-35.4650"> </a></td><td>Repair, septa, atrial and ventricular, with prosthesis</td></tr><tr><td style="white-space:nowrap">800012<a name="moh-category-800012"> </a></td><td>Enucleation Or Evisceration Of Eye Ball</td></tr><tr><td style="white-space:nowrap">825248<a name="moh-category-825248"> </a></td><td>Penilse Prosthesis With Implant (Inflatable)</td></tr><tr><td style="white-space:nowrap">518050<a name="moh-category-518050"> </a></td><td>Human Growth Hormone</td></tr><tr><td style="white-space:nowrap">308-58.93<a name="moh-category-308-58.4693"> </a></td><td>Implantation, artificial urinary sphincter</td></tr><tr><td style="white-space:nowrap">800018<a name="moh-category-800018"> </a></td><td>Posterior Orbital Tumour</td></tr><tr><td style="white-space:nowrap">716088<a name="moh-category-716088"> </a></td><td>Chair - Side Relining (Complete Denture)Chair - Side Relining (Complete Denture)</td></tr><tr><td style="white-space:nowrap">716086<a name="moh-category-716086"> </a></td><td>Adding Tooth To Partial Denture To Replace Extracted Tooth(Involving Clasp Or Ab</td></tr><tr><td style="white-space:nowrap">800016<a name="moh-category-800016"> </a></td><td>Posterior Orbital Exploration</td></tr><tr><td style="white-space:nowrap">704094<a name="moh-category-704094"> </a></td><td>Membrane / Bone Grafts - Per Tooth</td></tr><tr><td style="white-space:nowrap">800010<a name="moh-category-800010"> </a></td><td>Exentration</td></tr><tr><td style="white-space:nowrap">704092<a name="moh-category-704092"> </a></td><td>Gingivectomy And Treatment (Fewer Than 5 Teeth)</td></tr><tr><td style="white-space:nowrap">825240<a name="moh-category-825240"> </a></td><td>Diverticulectomy</td></tr><tr><td style="white-space:nowrap">704090<a name="moh-category-704090"> </a></td><td>Gingivectomy Or Gingioplasty - Per Quadrant</td></tr><tr><td style="white-space:nowrap">825242<a name="moh-category-825242"> </a></td><td>Urs &amp; Stone Extraction</td></tr><tr><td style="white-space:nowrap">825244<a name="moh-category-825244"> </a></td><td>Cystoscopy + Removal Of Djs Under G.A.</td></tr><tr><td style="white-space:nowrap">G29870<a name="moh-category-G29870"> </a></td><td>Arthroscopy (Diagnostic) Knee</td></tr><tr><td style="white-space:nowrap">E43621<a name="moh-category-E43621"> </a></td><td>Subtotal gastrectomy</td></tr><tr><td style="white-space:nowrap">716072<a name="moh-category-716072"> </a></td><td>Upper Chrome Cobalt Partial Denture (1-3 Teeth / Unilateral)</td></tr><tr><td style="white-space:nowrap">704058<a name="moh-category-704058"> </a></td><td>Vestibuloplasty/Sulcus Deepening (Per Jaw)</td></tr><tr><td style="white-space:nowrap">716070<a name="moh-category-716070"> </a></td><td>Acrylic Partial Denture (4-7 Teeth)</td></tr><tr><td style="white-space:nowrap">704056<a name="moh-category-704056"> </a></td><td>Removal Of Lorus Palatinus Or Mandibularis</td></tr><tr><td style="white-space:nowrap">518196<a name="moh-category-518196"> </a></td><td>Galactose 1 Phosphate Uridyltrasferase (Quantative</td></tr><tr><td style="white-space:nowrap">810102<a name="moh-category-810102"> </a></td><td>Microlaryngoscopy</td></tr><tr><td style="white-space:nowrap">518198<a name="moh-category-518198"> </a></td><td>Ionized Calcium</td></tr><tr><td style="white-space:nowrap">704054<a name="moh-category-704054"> </a></td><td>Post Extraction Complication:Dressing (Opd)</td></tr><tr><td style="white-space:nowrap">518192<a name="moh-category-518192"> </a></td><td>Galactosemia Screening</td></tr><tr><td style="white-space:nowrap">810104<a name="moh-category-810104"> </a></td><td>Microlaryngosurgery</td></tr><tr><td style="white-space:nowrap">825236<a name="moh-category-825236"> </a></td><td>Epididymectomy</td></tr><tr><td style="white-space:nowrap">704052<a name="moh-category-704052"> </a></td><td>Post Surgical Extraction:Drsyspicules Removal</td></tr><tr><td style="white-space:nowrap">716078<a name="moh-category-716078"> </a></td><td>Complete Denture Adjustment</td></tr><tr><td style="white-space:nowrap">518194<a name="moh-category-518194"> </a></td><td>Amino Acid Screening</td></tr><tr><td style="white-space:nowrap">810106<a name="moh-category-810106"> </a></td><td>Larynx Laser Surgery</td></tr><tr><td style="white-space:nowrap">825238<a name="moh-category-825238"> </a></td><td>Cystoscopy And Lithlapexy</td></tr><tr><td style="white-space:nowrap">716040<a name="moh-category-716040"> </a></td><td>Chrome Cobalt Partial 4-7 Teeth</td></tr><tr><td style="white-space:nowrap">716076<a name="moh-category-716076"> </a></td><td>Bite Guard (Bite Raising Appliance)</td></tr><tr><td style="white-space:nowrap">108-35.42<a name="moh-category-108-35.4642"> </a></td><td>Creation, septal defect, in heart</td></tr><tr><td style="white-space:nowrap">108-35.91<a name="moh-category-108-35.4691"> </a></td><td>Transposition, interatrial, venous return</td></tr><tr><td style="white-space:nowrap">716074<a name="moh-category-716074"> </a></td><td>Upper Chrome Cobalt Partial Denture (3 Or More Teeth Bilateral)</td></tr><tr><td style="white-space:nowrap">108-35.92<a name="moh-category-108-35.4692"> </a></td><td>Creation, conduit, between right ventricle,</td></tr><tr><td style="white-space:nowrap">501-81.22<a name="moh-category-501-81.4622"> </a></td><td>Arthrodesis,knee</td></tr><tr><td style="white-space:nowrap">U84630<a name="moh-category-U84630"> </a></td><td>Zinc</td></tr><tr><td style="white-space:nowrap">108-35.93<a name="moh-category-108-35.4693"> </a></td><td>Creation, conduit, between left ventricle,</td></tr><tr><td style="white-space:nowrap">825230<a name="moh-category-825230"> </a></td><td>Vasal Reversal</td></tr><tr><td style="white-space:nowrap">825232<a name="moh-category-825232"> </a></td><td>Vasoepididymostomy</td></tr><tr><td style="white-space:nowrap">716048<a name="moh-category-716048"> </a></td><td>Porcelain Set For Complete Dentures (Additional)</td></tr><tr><td style="white-space:nowrap">825234<a name="moh-category-825234"> </a></td><td>Vasovasostomy</td></tr><tr><td style="white-space:nowrap">108-35.94<a name="moh-category-108-35.4694"> </a></td><td>Creation, conduit, between atrium,</td></tr><tr><td style="white-space:nowrap">460276<a name="moh-category-460276"> </a></td><td>Foreign Body Removal L.A. (Throat)</td></tr><tr><td style="white-space:nowrap">460274<a name="moh-category-460274"> </a></td><td>Incision + Drainage Of Quinzy (L.A)</td></tr><tr><td style="white-space:nowrap">H94240<a name="moh-category-H94240"> </a></td><td>Lung Volume - Helium Dilution</td></tr><tr><td style="white-space:nowrap">460278<a name="moh-category-460278"> </a></td><td>Fine Needle Aspiration Cytology</td></tr><tr><td style="white-space:nowrap">108-35.95<a name="moh-category-108-35.4695"> </a></td><td>Revision, corrective procedure, heart</td></tr><tr><td style="white-space:nowrap">460280<a name="moh-category-460280"> </a></td><td>Somnoplasty Tounge - Clinic (1St Stage)</td></tr><tr><td style="white-space:nowrap">716046<a name="moh-category-716046"> </a></td><td>Other Corrective Procedures (Per 1/4 Hour)</td></tr><tr><td style="white-space:nowrap">825224<a name="moh-category-825224"> </a></td><td>Repair Of Urethral Injuries</td></tr><tr><td style="white-space:nowrap">716044<a name="moh-category-716044"> </a></td><td>Ceka Attachment Per Piece</td></tr><tr><td style="white-space:nowrap">U82009<a name="moh-category-U82009"> </a></td><td>Acetone Total</td></tr><tr><td style="white-space:nowrap">825226<a name="moh-category-825226"> </a></td><td>Urethroplasty One Stage</td></tr><tr><td style="white-space:nowrap">500004<a name="moh-category-500004"> </a></td><td>Glucose (Serum) Random</td></tr><tr><td style="white-space:nowrap">460284<a name="moh-category-460284"> </a></td><td>Pure Tone Audiometry (Air &amp; Bone)</td></tr><tr><td style="white-space:nowrap">825228<a name="moh-category-825228"> </a></td><td>Urethroplasty Two Stages</td></tr><tr><td style="white-space:nowrap">716042<a name="moh-category-716042"> </a></td><td>Chrome Cobalt Partial 8-12 Teeth</td></tr><tr><td style="white-space:nowrap">108-35.31<a name="moh-category-108-35.4631"> </a></td><td>Operation, papillary muscle</td></tr><tr><td style="white-space:nowrap">500002<a name="moh-category-500002"> </a></td><td>Glucose (Serum) Fasting</td></tr><tr><td style="white-space:nowrap">108-35.32<a name="moh-category-108-35.4632"> </a></td><td>Operation, Chordae tendinae</td></tr><tr><td style="white-space:nowrap">460282<a name="moh-category-460282"> </a></td><td>Somnoplasty Tounge - Clinic (2Nd Stage)</td></tr><tr><td style="white-space:nowrap">704050<a name="moh-category-704050"> </a></td><td>Alveolectomy (Per Quadrant)</td></tr><tr><td style="white-space:nowrap">L90810<a name="moh-category-L90810"> </a></td><td>Psychotheraphy Interactive</td></tr><tr><td style="white-space:nowrap">810110<a name="moh-category-810110"> </a></td><td>Laser Tonsillectomy</td></tr><tr><td style="white-space:nowrap">137202<a name="moh-category-137202"> </a></td><td>Child Anxiety Manifest Level</td></tr><tr><td style="white-space:nowrap">704068<a name="moh-category-704068"> </a></td><td>Surgical Exposure Of Impacted Or Unerrupted Tooth</td></tr><tr><td style="white-space:nowrap">825220<a name="moh-category-825220"> </a></td><td>Radical Prostatectomy</td></tr><tr><td style="white-space:nowrap">810112<a name="moh-category-810112"> </a></td><td>Tonsillectomy</td></tr><tr><td style="white-space:nowrap">825222<a name="moh-category-825222"> </a></td><td>Repair Of Hypospadias Two Stages</td></tr><tr><td style="white-space:nowrap">704066<a name="moh-category-704066"> </a></td><td>Tooth Extraction Additional Each + L.A..</td></tr><tr><td style="white-space:nowrap">137208<a name="moh-category-137208"> </a></td><td>Mmpi Sub Scale</td></tr><tr><td style="white-space:nowrap">36-14.27<a name="moh-category-36-14.4627"> </a></td><td>Destruction, chorioretinal lesion, adiation sources</td></tr><tr><td style="white-space:nowrap">137204<a name="moh-category-137204"> </a></td><td>Child Behaviour Check List</td></tr><tr><td style="white-space:nowrap">G29894<a name="moh-category-G29894"> </a></td><td>Arthroscopy (Diagnostic) Ankle</td></tr><tr><td style="white-space:nowrap">810114<a name="moh-category-810114"> </a></td><td>Pan-Endoscopy (Triple Procedure)</td></tr><tr><td style="white-space:nowrap">137206<a name="moh-category-137206"> </a></td><td>Middle Sex Scale</td></tr><tr><td style="white-space:nowrap">36-14.26<a name="moh-category-36-14.4626"> </a></td><td>Destruction, chorioretinal lesion, by radiation therapy</td></tr><tr><td style="white-space:nowrap">716094<a name="moh-category-716094"> </a></td><td>Laboratory Relining (Partial Denture)</td></tr><tr><td style="white-space:nowrap">704064<a name="moh-category-704064"> </a></td><td>Alveolar Ridge Grafting Per Jaw</td></tr><tr><td style="white-space:nowrap">460288<a name="moh-category-460288"> </a></td><td>Tone Decay Test</td></tr><tr><td style="white-space:nowrap">810116<a name="moh-category-810116"> </a></td><td>Hypopharyngoscopy &amp; Foreign Body Removal</td></tr><tr><td style="white-space:nowrap">716092<a name="moh-category-716092"> </a></td><td>Laboratory Relining (Complete Denture)</td></tr><tr><td style="white-space:nowrap">704062<a name="moh-category-704062"> </a></td><td>Other Undefined Surgical Procedures Per 15 Minutes</td></tr><tr><td style="white-space:nowrap">460286<a name="moh-category-460286"> </a></td><td>Follow Up Pure Tone Audiometry (Air &amp; Bone)</td></tr><tr><td style="white-space:nowrap">T76770<a name="moh-category-T76770"> </a></td><td>Ultra Sound - Retroperitoneal</td></tr><tr><td style="white-space:nowrap">L96100<a name="moh-category-L96100"> </a></td><td>Psychological Test</td></tr><tr><td style="white-space:nowrap">108-35.80<a name="moh-category-108-35.4680"> </a></td><td>Repair, total, certain congenital cardiac anomalies</td></tr><tr><td style="white-space:nowrap">716036<a name="moh-category-716036"> </a></td><td>Chrome Cobalt Full Denture: Upper And Lower</td></tr><tr><td style="white-space:nowrap">716090<a name="moh-category-716090"> </a></td><td>Chair - Side Relining (Partial Denture)</td></tr><tr><td style="white-space:nowrap">716034<a name="moh-category-716034"> </a></td><td>Rebasing (Upper Or Lower)</td></tr><tr><td style="white-space:nowrap">X1005<a name="moh-category-X1005"> </a></td><td>Ventilator Per Day</td></tr><tr><td style="white-space:nowrap">460290<a name="moh-category-460290"> </a></td><td>Ablb</td></tr><tr><td style="white-space:nowrap">716032<a name="moh-category-716032"> </a></td><td>Changing Teeth In Old Chrome - Partial</td></tr><tr><td style="white-space:nowrap">825214<a name="moh-category-825214"> </a></td><td>Iliocystoplasty</td></tr><tr><td style="white-space:nowrap">X1004<a name="moh-category-X1004"> </a></td><td>Oxy Hood Per Day</td></tr><tr><td style="white-space:nowrap">L90804<a name="moh-category-L90804"> </a></td><td>Individual psycho therapy insight oriented</td></tr><tr><td style="white-space:nowrap">X1003<a name="moh-category-X1003"> </a></td><td>Mist Tent Per Day</td></tr><tr><td style="white-space:nowrap">716030<a name="moh-category-716030"> </a></td><td>Splints/Guards</td></tr><tr><td style="white-space:nowrap">U80299<a name="moh-category-U80299"> </a></td><td>Amphotericin B Level</td></tr><tr><td style="white-space:nowrap">X1002<a name="moh-category-X1002"> </a></td><td>Oxygen Inhalation Per Day</td></tr><tr><td style="white-space:nowrap">X1001<a name="moh-category-X1001"> </a></td><td>Oxygen Inhalation - Per Hour X1001</td></tr><tr><td style="white-space:nowrap">825216<a name="moh-category-825216"> </a></td><td>Insertion Of Penile Prothesis</td></tr><tr><td style="white-space:nowrap">704060<a name="moh-category-704060"> </a></td><td>Apicoectomy (Per Tooth Excluding Rct)</td></tr><tr><td style="white-space:nowrap">716098<a name="moh-category-716098"> </a></td><td>Lower Chrome Cobalt Partial Denture (3 Or More Teeth / Bilateral)</td></tr><tr><td style="white-space:nowrap">810108<a name="moh-category-810108"> </a></td><td>Adenoidectomy</td></tr><tr><td style="white-space:nowrap">460294<a name="moh-category-460294"> </a></td><td>Audiological Assessment</td></tr><tr><td style="white-space:nowrap">716038<a name="moh-category-716038"> </a></td><td>Chrome Cobalt Partial 1-3 Teeth</td></tr><tr><td style="white-space:nowrap">825218<a name="moh-category-825218"> </a></td><td>Radical Cystectomy</td></tr><tr><td style="white-space:nowrap">148-46.92<a name="moh-category-148-46.4692"> </a></td><td>Myotomy, colon, other parts</td></tr><tr><td style="white-space:nowrap">716096<a name="moh-category-716096"> </a></td><td>Lower Chrome Cobalt Partial Denture (1-3 Teeth / Unilateral)</td></tr><tr><td style="white-space:nowrap">460292<a name="moh-category-460292"> </a></td><td>Strenger Test</td></tr><tr><td style="white-space:nowrap">512002<a name="moh-category-512002"> </a></td><td>Hemoglobin Electrophoresis</td></tr><tr><td style="white-space:nowrap">137212<a name="moh-category-137212"> </a></td><td>Beck Depression Inventory</td></tr><tr><td style="white-space:nowrap">704078<a name="moh-category-704078"> </a></td><td>Ridge Extension (Augmentation Per Arch)</td></tr><tr><td style="white-space:nowrap">137214<a name="moh-category-137214"> </a></td><td>Performance Anxiety Scale</td></tr><tr><td style="white-space:nowrap">825210<a name="moh-category-825210"> </a></td><td>Excision Of Ureterocele And Reimplantation Of Ureter</td></tr><tr><td style="white-space:nowrap">704076<a name="moh-category-704076"> </a></td><td>Biopsy Of Extra Oral Tissues</td></tr><tr><td style="white-space:nowrap">137210<a name="moh-category-137210"> </a></td><td>Self Esteem Inventory</td></tr><tr><td style="white-space:nowrap">704074<a name="moh-category-704074"> </a></td><td>Biopsy Of Oral Tissue (Soft)</td></tr><tr><td style="white-space:nowrap">825212<a name="moh-category-825212"> </a></td><td>Ileal Ureter</td></tr><tr><td style="white-space:nowrap">512004<a name="moh-category-512004"> </a></td><td>Protein Electrophoresis (Serum, Csf, Urine)</td></tr><tr><td style="white-space:nowrap">716062<a name="moh-category-716062"> </a></td><td>Denture - Complete Lower (Chrome Cobbalt)</td></tr><tr><td style="white-space:nowrap">128100<a name="moh-category-128100"> </a></td><td>Schanz Screw</td></tr><tr><td style="white-space:nowrap">500018<a name="moh-category-500018"> </a></td><td>Creatinine Urine (Random)</td></tr><tr><td style="white-space:nowrap">128102<a name="moh-category-128102"> </a></td><td>Malleolar Screw</td></tr><tr><td style="white-space:nowrap">716060<a name="moh-category-716060"> </a></td><td>Denture - Complete Upper (Chrome Cobbalt)</td></tr><tr><td style="white-space:nowrap">I92590<a name="moh-category-I92590"> </a></td><td>Hearing Aid adjustment &amp; Evaluation Unilateral</td></tr><tr><td style="white-space:nowrap">800758<a name="moh-category-800758"> </a></td><td>Laser Trabeculoplasty</td></tr><tr><td style="white-space:nowrap">128104<a name="moh-category-128104"> </a></td><td>Partial Hip - Thomson Hip Prothesis</td></tr><tr><td style="white-space:nowrap">108-35.70<a name="moh-category-108-35.4670"> </a></td><td>Repair, septa, atrial, ventricular, unspecified</td></tr><tr><td style="white-space:nowrap">I92591<a name="moh-category-I92591"> </a></td><td>Hearing aid Adjustment &amp; Evaluation Bilateral</td></tr><tr><td style="white-space:nowrap">800762<a name="moh-category-800762"> </a></td><td>Photo. Kera. Astigm - Pak Vizx</td></tr><tr><td style="white-space:nowrap">128106<a name="moh-category-128106"> </a></td><td>Penning Mini External Fixator</td></tr><tr><td style="white-space:nowrap">500022<a name="moh-category-500022"> </a></td><td>Uric Acid (Serum)</td></tr><tr><td style="white-space:nowrap">850240<a name="moh-category-850240"> </a></td><td>Laparascopic Salpingo-Oophorectomy (Bilateral)</td></tr><tr><td style="white-space:nowrap">800760<a name="moh-category-800760"> </a></td><td>Phototherapeutic Keratectomy (P.T.K.) One Eye</td></tr><tr><td style="white-space:nowrap">850242<a name="moh-category-850242"> </a></td><td>Diagnostic Laparascopy + New Ostia Of Fallopian Tube (Unilateral)</td></tr><tr><td style="white-space:nowrap">716068<a name="moh-category-716068"> </a></td><td>Acrylic Partial Denture (1-3 Teeth)</td></tr><tr><td style="white-space:nowrap">850244<a name="moh-category-850244"> </a></td><td>Diagnostic Laparascopy + New Ostia Of Fallopian Tube (Bilateral)</td></tr><tr><td style="white-space:nowrap">T73700<a name="moh-category-T73700"> </a></td><td>CT LO EXT without Contrast</td></tr><tr><td style="white-space:nowrap">500020<a name="moh-category-500020"> </a></td><td>Creatinine Clearance</td></tr><tr><td style="white-space:nowrap">500027<a name="moh-category-500027"> </a></td><td>Globulin</td></tr><tr><td style="white-space:nowrap">716066<a name="moh-category-716066"> </a></td><td>Denture - Immediate Lower Complete</td></tr><tr><td style="white-space:nowrap">500026<a name="moh-category-500026"> </a></td><td>Albumin</td></tr><tr><td style="white-space:nowrap">716064<a name="moh-category-716064"> </a></td><td>Denture - Immediate Uper Complete</td></tr><tr><td style="white-space:nowrap">640020<a name="moh-category-640020"> </a></td><td>Ptca (Per.Tr.Coronory Angioplasty) - Sv +2 Stents</td></tr><tr><td style="white-space:nowrap">500024<a name="moh-category-500024"> </a></td><td>Total Protein, Serum</td></tr><tr><td style="white-space:nowrap">K59025<a name="moh-category-K59025"> </a></td><td>CTG less than an hour</td></tr><tr><td style="white-space:nowrap">704072<a name="moh-category-704072"> </a></td><td>Biopsy Of Oral Tissue (Hard)</td></tr><tr><td style="white-space:nowrap">T73701<a name="moh-category-T73701"> </a></td><td>CT Scan Knee Lower Ext with Contrast</td></tr><tr><td style="white-space:nowrap">850236<a name="moh-category-850236"> </a></td><td>Laparascopic Checking Of Tubal Patency</td></tr><tr><td style="white-space:nowrap">K57240<a name="moh-category-K57240"> </a></td><td>Anterior Colporrhapy &amp; Repair Cystocele</td></tr><tr><td style="white-space:nowrap">850238<a name="moh-category-850238"> </a></td><td>Laparascopic Salpingo-Oophorectomy (Unilateral)</td></tr><tr><td style="white-space:nowrap">H43450<a name="moh-category-H43450"> </a></td><td>Oesophageal Dilation</td></tr><tr><td style="white-space:nowrap">110-37.12<a name="moh-category-110-37.4612"> </a></td><td>Pericardiotomy</td></tr><tr><td style="white-space:nowrap">810220<a name="moh-category-810220"> </a></td><td>Labyrinthectomy</td></tr><tr><td style="white-space:nowrap">640022<a name="moh-category-640022"> </a></td><td>Ptca (Per.Tr.Coronory Angioplasty) - Dv + Stent</td></tr><tr><td style="white-space:nowrap">650018C<a name="moh-category-650018C"> </a></td><td>Microguide Wire</td></tr><tr><td style="white-space:nowrap">U85384<a name="moh-category-U85384"> </a></td><td>Fibrinogen</td></tr><tr><td style="white-space:nowrap">750074<a name="moh-category-750074"> </a></td><td>Electro Cautery - Multiple Lesion (Skincare)</td></tr><tr><td style="white-space:nowrap">750232<a name="moh-category-750232"> </a></td><td>Brow Lift (Skincare)</td></tr><tr><td style="white-space:nowrap">810222<a name="moh-category-810222"> </a></td><td>Vestibular Neurectomy</td></tr><tr><td style="white-space:nowrap">750072<a name="moh-category-750072"> </a></td><td>Electro Cautery - Few Lesion (Skincare)</td></tr><tr><td style="white-space:nowrap">810224<a name="moh-category-810224"> </a></td><td>Facial Nerve Surgery</td></tr><tr><td style="white-space:nowrap">110014<a name="moh-category-110014"> </a></td><td>Orthofix Rental (Per Day)</td></tr><tr><td style="white-space:nowrap">810226<a name="moh-category-810226"> </a></td><td>Ossiculoplasty</td></tr><tr><td style="white-space:nowrap">300226<a name="moh-category-300226"> </a></td><td>Thyroid Imaging</td></tr><tr><td style="white-space:nowrap">110012<a name="moh-category-110012"> </a></td><td>Orthofix</td></tr><tr><td style="white-space:nowrap">650018A<a name="moh-category-650018A"> </a></td><td>Each Additional : Coil</td></tr><tr><td style="white-space:nowrap">I69210<a name="moh-category-I69210"> </a></td><td>Ear Wash</td></tr><tr><td style="white-space:nowrap">650018B<a name="moh-category-650018B"> </a></td><td>Microcatheter</td></tr><tr><td style="white-space:nowrap">300224<a name="moh-category-300224"> </a></td><td>X-Ray Film Copy Cash (Nett) Each</td></tr><tr><td style="white-space:nowrap">38-12.14<a name="moh-category-38-12.4614"> </a></td><td>Subtotal or complete iridectomy for melanoma</td></tr><tr><td style="white-space:nowrap">704014<a name="moh-category-704014"> </a></td><td>Surgical Extraction - Complex (Bone Removal)</td></tr><tr><td style="white-space:nowrap">D92283<a name="moh-category-D92283"> </a></td><td>Color vision exam</td></tr><tr><td style="white-space:nowrap">750070<a name="moh-category-750070"> </a></td><td>Electrolysis Per Session (Skincare)</td></tr><tr><td style="white-space:nowrap">650026A<a name="moh-category-650026A"> </a></td><td>Each Additional : Coil</td></tr><tr><td style="white-space:nowrap">202004<a name="moh-category-202004"> </a></td><td>Private Room Per Day</td></tr><tr><td style="white-space:nowrap">202002<a name="moh-category-202002"> </a></td><td>Suite Room Per Day</td></tr><tr><td style="white-space:nowrap">650026B<a name="moh-category-650026B"> </a></td><td>Microcatheter</td></tr><tr><td style="white-space:nowrap">704012<a name="moh-category-704012"> </a></td><td>Surgical Extraction - Simple</td></tr><tr><td style="white-space:nowrap">304032<a name="moh-category-304032"> </a></td><td>Colour Doppler Sonography Breast (Two)</td></tr><tr><td style="white-space:nowrap">650026C<a name="moh-category-650026C"> </a></td><td>Microguide Wire</td></tr><tr><td style="white-space:nowrap">704010<a name="moh-category-704010"> </a></td><td>Removal Of Teeth (Soft Tissue) + La</td></tr><tr><td style="white-space:nowrap">304030<a name="moh-category-304030"> </a></td><td>Colour Doppler Sonography Breast (One)</td></tr><tr><td style="white-space:nowrap">524008<a name="moh-category-524008"> </a></td><td>Anti Sperm Antibody</td></tr><tr><td style="white-space:nowrap">704018<a name="moh-category-704018"> </a></td><td>Removal Of Teeth (Completely Bony) + L.A.</td></tr><tr><td style="white-space:nowrap">810140<a name="moh-category-810140"> </a></td><td>Cleft Palate Repair</td></tr><tr><td style="white-space:nowrap">704016<a name="moh-category-704016"> </a></td><td>Removal Of Teeth (Partially Bony) + L.A.</td></tr><tr><td style="white-space:nowrap">710018<a name="moh-category-710018"> </a></td><td>Topical Application Of Flouride -2 Vis (Ex Prophylaxis)</td></tr><tr><td style="white-space:nowrap">524012<a name="moh-category-524012"> </a></td><td>Osteocalcin</td></tr><tr><td style="white-space:nowrap">U80202<a name="moh-category-U80202"> </a></td><td>Vancomycin</td></tr><tr><td style="white-space:nowrap">716004<a name="moh-category-716004"> </a></td><td>Partial Denture 1-3 Teeth</td></tr><tr><td style="white-space:nowrap">500044<a name="moh-category-500044"> </a></td><td>Sgpt (Alt)</td></tr><tr><td style="white-space:nowrap">137018<a name="moh-category-137018"> </a></td><td>Psychological Assessment- Category 2 - Anxiety</td></tr><tr><td style="white-space:nowrap">U80200<a name="moh-category-U80200"> </a></td><td>Tobramycin</td></tr><tr><td style="white-space:nowrap">716002<a name="moh-category-716002"> </a></td><td>Complete Dentures</td></tr><tr><td style="white-space:nowrap">500042<a name="moh-category-500042"> </a></td><td>Sgot (Ast)</td></tr><tr><td style="white-space:nowrap">524016<a name="moh-category-524016"> </a></td><td>Hydroxproline Total</td></tr><tr><td style="white-space:nowrap">500048<a name="moh-category-500048"> </a></td><td>Alkaline Phosphatase</td></tr><tr><td style="white-space:nowrap">500046<a name="moh-category-500046"> </a></td><td>Ggt</td></tr><tr><td style="white-space:nowrap">716008<a name="moh-category-716008"> </a></td><td>Partial Denture 8-12 Teeth</td></tr><tr><td style="white-space:nowrap">500040<a name="moh-category-500040"> </a></td><td>Total And Direct Biliburin</td></tr><tr><td style="white-space:nowrap">524010<a name="moh-category-524010"> </a></td><td>Thyroid Uptake</td></tr><tr><td style="white-space:nowrap">716006<a name="moh-category-716006"> </a></td><td>Partial Denture 4-7 Teeth</td></tr><tr><td style="white-space:nowrap">704024<a name="moh-category-704024"> </a></td><td>Cyst Operation</td></tr><tr><td style="white-space:nowrap">704022<a name="moh-category-704022"> </a></td><td>Suturing - Large Area</td></tr><tr><td style="white-space:nowrap">704020<a name="moh-category-704020"> </a></td><td>Suturing - Small Area (2-3 Sutures)</td></tr><tr><td style="white-space:nowrap">500028<a name="moh-category-500028"> </a></td><td>Osmolarity, Serum / Urine</td></tr><tr><td style="white-space:nowrap">U88162<a name="moh-category-U88162"> </a></td><td>Cytology ( Fine Needle Aspiration )</td></tr><tr><td style="white-space:nowrap">T74150<a name="moh-category-T74150"> </a></td><td>CT Scan Abdomen</td></tr><tr><td style="white-space:nowrap">704028<a name="moh-category-704028"> </a></td><td>Incision And Drainage Of Abscess - Extraoral</td></tr><tr><td style="white-space:nowrap">704026<a name="moh-category-704026"> </a></td><td>Incision And Drainage Of Abscess - Intraoral</td></tr><tr><td style="white-space:nowrap">500034<a name="moh-category-500034"> </a></td><td>Total Bilirubin</td></tr><tr><td style="white-space:nowrap">500032<a name="moh-category-500032"> </a></td><td>Albumin/Globumin Ratio</td></tr><tr><td style="white-space:nowrap">500038<a name="moh-category-500038"> </a></td><td>Direct Bilirubin</td></tr><tr><td style="white-space:nowrap">500036<a name="moh-category-500036"> </a></td><td>Total Biliburin, Neonatal</td></tr><tr><td style="white-space:nowrap">500030<a name="moh-category-500030"> </a></td><td>Plasma Globumin</td></tr><tr><td style="white-space:nowrap">650024B<a name="moh-category-650024B"> </a></td><td>Microcatheter</td></tr><tr><td style="white-space:nowrap">650024C<a name="moh-category-650024C"> </a></td><td>Microguide Wire</td></tr><tr><td style="white-space:nowrap">524020<a name="moh-category-524020"> </a></td><td>Factor Viii</td></tr><tr><td style="white-space:nowrap">704036<a name="moh-category-704036"> </a></td><td>Pericoronal Flap Removal - Simple</td></tr><tr><td style="white-space:nowrap">650028B<a name="moh-category-650028B"> </a></td><td>Microguide Wire</td></tr><tr><td style="white-space:nowrap">810122<a name="moh-category-810122"> </a></td><td>Plastic Surgery Of Throat</td></tr><tr><td style="white-space:nowrap">704034<a name="moh-category-704034"> </a></td><td>Closure Of Oro-Antral Fistula</td></tr><tr><td style="white-space:nowrap">810124<a name="moh-category-810124"> </a></td><td>Tumor Surgery Of Throat</td></tr><tr><td style="white-space:nowrap">I30400<a name="moh-category-I30400"> </a></td><td>Rhinoplasty</td></tr><tr><td style="white-space:nowrap">704032<a name="moh-category-704032"> </a></td><td>Wiring Fractured Jaw - Complex</td></tr><tr><td style="white-space:nowrap">U84560<a name="moh-category-U84560"> </a></td><td>Urine Uric Acid</td></tr><tr><td style="white-space:nowrap">704070<a name="moh-category-704070"> </a></td><td>Surgical Removal Of Suprenumerary Tooth</td></tr><tr><td style="white-space:nowrap">850246<a name="moh-category-850246"> </a></td><td>Diagnostic Laparascopy + Canalization Of Tube</td></tr><tr><td style="white-space:nowrap">36-14.41<a name="moh-category-36-14.4641"> </a></td><td>Scleral buckling with implant, f vitreous substitute</td></tr><tr><td style="white-space:nowrap">U80198<a name="moh-category-U80198"> </a></td><td>Theophyline</td></tr><tr><td style="white-space:nowrap">704088<a name="moh-category-704088"> </a></td><td>Excision Of Hyperplastic Tissue (Per Arch)</td></tr><tr><td style="white-space:nowrap">U80196<a name="moh-category-U80196"> </a></td><td>Acetylsalicylic Acid</td></tr><tr><td style="white-space:nowrap">36-14.49<a name="moh-category-36-14.4649"> </a></td><td>Scleral buckling with vitrectomy, membranectomy, ion</td></tr><tr><td style="white-space:nowrap">640024<a name="moh-category-640024"> </a></td><td>Ptca (Per.Tr.Coronory Angioplasty) - Dv + 2 Stents</td></tr><tr><td style="white-space:nowrap">704086<a name="moh-category-704086"> </a></td><td>Release Of Tounge Tie</td></tr><tr><td style="white-space:nowrap">750230<a name="moh-category-750230"> </a></td><td>Otoplasty - Ear Reshaping (Skincare)</td></tr><tr><td style="white-space:nowrap">704084<a name="moh-category-704084"> </a></td><td>Excision Of Bengin Tumour - Lesion Diameter Over 1 Cm</td></tr><tr><td style="white-space:nowrap">303-56.92<a name="moh-category-303-56.4692"> </a></td><td>Implantation, electronic uteral stimulator</td></tr><tr><td style="white-space:nowrap">716050<a name="moh-category-716050"> </a></td><td>Isosit Injection Moulded Denture</td></tr><tr><td style="white-space:nowrap">218-78.37<a name="moh-category-218-78.4637"> </a></td><td>Lengthening bone, tibia and fibula</td></tr><tr><td style="white-space:nowrap">353-40.53<a name="moh-category-353-40.4653"> </a></td><td>Excision, lymph node - iliac, radical</td></tr><tr><td style="white-space:nowrap">353-40.52<a name="moh-category-353-40.4652"> </a></td><td>Excision, lymph node - periaortic, radical</td></tr><tr><td style="white-space:nowrap">500008<a name="moh-category-500008"> </a></td><td>Glucose Tolerance Test</td></tr><tr><td style="white-space:nowrap">173030<a name="moh-category-173030"> </a></td><td>Activated Clotting Time</td></tr><tr><td style="white-space:nowrap">500006<a name="moh-category-500006"> </a></td><td>Glucose (Serum) 2Hpp</td></tr><tr><td style="white-space:nowrap">300228<a name="moh-category-300228"> </a></td><td>Chest Pa / Erect</td></tr><tr><td style="white-space:nowrap">650474<a name="moh-category-650474"> </a></td><td>Microscopic Brain Excision Of Epileptic Focus</td></tr><tr><td style="white-space:nowrap">353-40.54<a name="moh-category-353-40.4654"> </a></td><td>Dissection, groin, radical</td></tr><tr><td style="white-space:nowrap">716058<a name="moh-category-716058"> </a></td><td>Denture - Complere Lower (Acrylic)</td></tr><tr><td style="white-space:nowrap">1099700<a name="moh-category-1099700"> </a></td><td>Ang cor1ca 107-88.55 Angiocardiogram- coronary, 1 catheter</td></tr><tr><td style="white-space:nowrap">500012<a name="moh-category-500012"> </a></td><td>Bun</td></tr><tr><td style="white-space:nowrap">640062<a name="moh-category-640062"> </a></td><td>E.T.Suction</td></tr><tr><td style="white-space:nowrap">640064<a name="moh-category-640064"> </a></td><td>Infusion Syringe Pump</td></tr><tr><td style="white-space:nowrap">304036<a name="moh-category-304036"> </a></td><td>Colour Doppler Sonography Brain(Through Fontanell)</td></tr><tr><td style="white-space:nowrap">108-35.60<a name="moh-category-108-35.4660"> </a></td><td>Repair, septa, atrial, ventricular, with tissue graft</td></tr><tr><td style="white-space:nowrap">800146<a name="moh-category-800146"> </a></td><td>Unilat. Ptosis Repair+Fresh</td></tr><tr><td style="white-space:nowrap">810218<a name="moh-category-810218"> </a></td><td>Endolymphatic Shunt</td></tr><tr><td style="white-space:nowrap">716056<a name="moh-category-716056"> </a></td><td>Denture - Complete Upper (Acrylic)</td></tr><tr><td style="white-space:nowrap">650472<a name="moh-category-650472"> </a></td><td>Ct Guided Aspiration Of Intra-Cerebral</td></tr><tr><td style="white-space:nowrap">518126<a name="moh-category-518126"> </a></td><td>Fructose Test</td></tr><tr><td style="white-space:nowrap">500010<a name="moh-category-500010"> </a></td><td>Glucose ( Glucometer) Test</td></tr><tr><td style="white-space:nowrap">304034<a name="moh-category-304034"> </a></td><td>Colour Doppler Sonography Testicular W/Out Doppler - T</td></tr><tr><td style="white-space:nowrap">800144<a name="moh-category-800144"> </a></td><td>Bilateral Sim. Ptosis Repair</td></tr><tr><td style="white-space:nowrap">716054<a name="moh-category-716054"> </a></td><td>Tissue Conditioning Material</td></tr><tr><td style="white-space:nowrap">I30300<a name="moh-category-I30300"> </a></td><td>Removal of foreign body- Nose</td></tr><tr><td style="white-space:nowrap">191-50.40<a name="moh-category-191-50.4640"> </a></td><td>Hepatectomy, total</td></tr><tr><td style="white-space:nowrap">500016<a name="moh-category-500016"> </a></td><td>Creatinine, Serum</td></tr><tr><td style="white-space:nowrap">300192<a name="moh-category-300192"> </a></td><td>Forearm (Ulna/Radius) 2 Views</td></tr><tr><td style="white-space:nowrap">716052<a name="moh-category-716052"> </a></td><td>Refixing Tooth In Denture Or Hairline Cracks</td></tr><tr><td style="white-space:nowrap">800148<a name="moh-category-800148"> </a></td><td>Bil. Ptosis Repair+Fresh Fasc.</td></tr><tr><td style="white-space:nowrap">518128<a name="moh-category-518128"> </a></td><td>Mast (Allergy Screen)</td></tr><tr><td style="white-space:nowrap">300190<a name="moh-category-300190"> </a></td><td>Forearm (Ulna/Radius) 1 View</td></tr><tr><td style="white-space:nowrap">518122<a name="moh-category-518122"> </a></td><td>Prostate Specific Antigen</td></tr><tr><td style="white-space:nowrap">300196<a name="moh-category-300196"> </a></td><td>Scaphoid - 1 View</td></tr><tr><td style="white-space:nowrap">460218<a name="moh-category-460218"> </a></td><td>Sinsus Puncture</td></tr><tr><td style="white-space:nowrap">518124<a name="moh-category-518124"> </a></td><td>Lithium</td></tr><tr><td style="white-space:nowrap">D68520<a name="moh-category-D68520"> </a></td><td>Dacryocystectomy</td></tr><tr><td style="white-space:nowrap">710020<a name="moh-category-710020"> </a></td><td>Follow-Up (Period)</td></tr><tr><td style="white-space:nowrap">710024<a name="moh-category-710024"> </a></td><td>Flap Operation</td></tr><tr><td style="white-space:nowrap">460216<a name="moh-category-460216"> </a></td><td>Cryoturbinectomy</td></tr><tr><td style="white-space:nowrap">U86430<a name="moh-category-U86430"> </a></td><td>Rheumatoid Factor</td></tr><tr><td style="white-space:nowrap">130504<a name="moh-category-130504"> </a></td><td>Occupational Therapy (One Part)</td></tr><tr><td style="white-space:nowrap">460210<a name="moh-category-460210"> </a></td><td>Foreign Body Removal</td></tr><tr><td style="white-space:nowrap">130502<a name="moh-category-130502"> </a></td><td>Occupational Therapy (More Than One Part)</td></tr><tr><td style="white-space:nowrap">M15780<a name="moh-category-M15780"> </a></td><td>Dermabrasion Face</td></tr><tr><td style="white-space:nowrap">460214<a name="moh-category-460214"> </a></td><td>Electrical Cautry</td></tr><tr><td style="white-space:nowrap">130506<a name="moh-category-130506"> </a></td><td>Occupational Therapy &amp; Physiotherapy (One Sitting)</td></tr><tr><td style="white-space:nowrap">460212<a name="moh-category-460212"> </a></td><td>Chemical Cautry</td></tr><tr><td style="white-space:nowrap">T73620<a name="moh-category-T73620"> </a></td><td>Foot Oscalcis - 2 Views</td></tr><tr><td style="white-space:nowrap">N97116<a name="moh-category-N97116"> </a></td><td>GAIT training</td></tr><tr><td style="white-space:nowrap">106002<a name="moh-category-106002"> </a></td><td>Ambulance Fee Less Than 50 Kms</td></tr><tr><td style="white-space:nowrap">H91105<a name="moh-category-H91105"> </a></td><td>Gastric Lavage</td></tr><tr><td style="white-space:nowrap">460228<a name="moh-category-460228"> </a></td><td>Somnoplasty Turbinate - Clinic</td></tr><tr><td style="white-space:nowrap">825190<a name="moh-category-825190"> </a></td><td>Repair Of Ureteral Injuries</td></tr><tr><td style="white-space:nowrap">810126<a name="moh-category-810126"> </a></td><td>Tracheostomy</td></tr><tr><td style="white-space:nowrap">106006<a name="moh-category-106006"> </a></td><td>Ambulance Fee More Than 100 Kms Less Than 250 Kms</td></tr><tr><td style="white-space:nowrap">825192<a name="moh-category-825192"> </a></td><td>Retropubic Prostatectomy</td></tr><tr><td style="white-space:nowrap">106004<a name="moh-category-106004"> </a></td><td>Ambulance Fee More Than 50 Kms Less Than 100 Kms</td></tr><tr><td style="white-space:nowrap">460222<a name="moh-category-460222"> </a></td><td>Epistaxis Nasal Pack</td></tr><tr><td style="white-space:nowrap">I69405<a name="moh-category-I69405"> </a></td><td>Eustachian Catheterization</td></tr><tr><td style="white-space:nowrap">825274<a name="moh-category-825274"> </a></td><td>Trans Obturator Tape Insertion</td></tr><tr><td style="white-space:nowrap">110-37.24<a name="moh-category-110-37.4624"> </a></td><td>Biopsy, pericardium</td></tr><tr><td style="white-space:nowrap">825278<a name="moh-category-825278"> </a></td><td>Trans Vaginal Tape Insertion (Tot)</td></tr><tr><td style="white-space:nowrap">518108<a name="moh-category-518108"> </a></td><td>Trop T.</td></tr><tr><td style="white-space:nowrap">U84590<a name="moh-category-U84590"> </a></td><td>Vitamin A (Retinol)</td></tr><tr><td style="white-space:nowrap">518106<a name="moh-category-518106"> </a></td><td>Microalbuminuria</td></tr><tr><td style="white-space:nowrap">104-35.20<a name="moh-category-104-35.4620"> </a></td><td>Replacement,heart valve</td></tr><tr><td style="white-space:nowrap">U84585<a name="moh-category-U84585"> </a></td><td>Vanillyl Mandelic Acid (NMA, Urine)</td></tr><tr><td style="white-space:nowrap">110-37.31<a name="moh-category-110-37.4631"> </a></td><td>Pericardiectomy</td></tr><tr><td style="white-space:nowrap">104-35.33<a name="moh-category-104-35.4633"> </a></td><td>Annulopasty</td></tr><tr><td style="white-space:nowrap">110-37.40<a name="moh-category-110-37.4640"> </a></td><td>Repair, heart and pericardium</td></tr><tr><td style="white-space:nowrap">U84578<a name="moh-category-U84578"> </a></td><td>Urine Urobilinogen</td></tr><tr><td style="white-space:nowrap">40-14.60<a name="moh-category-40-14.4660"> </a></td><td>Removal of surgically implanted material from posterior, separate procedure)</td></tr><tr><td style="white-space:nowrap">U85060<a name="moh-category-U85060"> </a></td><td>Peripheral Smear</td></tr><tr><td style="white-space:nowrap">304072<a name="moh-category-304072"> </a></td><td>Colour Doppler Femoral Artery (Unilateral)</td></tr><tr><td style="white-space:nowrap">T76856<a name="moh-category-T76856"> </a></td><td>Ultra Sound - Pelvis</td></tr><tr><td style="white-space:nowrap">304070<a name="moh-category-304070"> </a></td><td>Colour Doppler Brachial Artery (Bilateral)</td></tr><tr><td style="white-space:nowrap">304076<a name="moh-category-304076"> </a></td><td>Colour Doppler Peripheral Veins (One Limb)</td></tr><tr><td style="white-space:nowrap">304074<a name="moh-category-304074"> </a></td><td>Colour Doppler Femoral Artery (Bilateral)</td></tr><tr><td style="white-space:nowrap">K56740<a name="moh-category-K56740"> </a></td><td>Excision of Bartholin Cyst</td></tr><tr><td style="white-space:nowrap">304078<a name="moh-category-304078"> </a></td><td>Colour Doppler Peripheral Veins (Two Limbs)</td></tr><tr><td style="white-space:nowrap">840004<a name="moh-category-840004"> </a></td><td>Closed Reduction Of Dislocation And P.O.P</td></tr><tr><td style="white-space:nowrap">840002<a name="moh-category-840002"> </a></td><td>Excision Of Ganglion</td></tr><tr><td style="white-space:nowrap">115-37.85<a name="moh-category-115-37.4685"> </a></td><td>Replacement any type pacemaker,single chamber device</td></tr><tr><td style="white-space:nowrap">840008<a name="moh-category-840008"> </a></td><td>Tendon Release Of Wrist</td></tr><tr><td style="white-space:nowrap">115-37.83<a name="moh-category-115-37.4683"> </a></td><td>Insertion dual chamber device, initial</td></tr><tr><td style="white-space:nowrap">840006<a name="moh-category-840006"> </a></td><td>Tendon Release Of Fingers</td></tr><tr><td style="white-space:nowrap">115-37.82<a name="moh-category-115-37.4682"> </a></td><td>Insertion, single chamber device, initial rate responsive</td></tr><tr><td style="white-space:nowrap">115-37.80<a name="moh-category-115-37.4680"> </a></td><td>Insertion, permanent pacemaker, initial</td></tr><tr><td style="white-space:nowrap">U85048<a name="moh-category-U85048"> </a></td><td>White Blood Cell Count Only</td></tr><tr><td style="white-space:nowrap">F54640<a name="moh-category-F54640"> </a></td><td>Orchipexy, bilateral</td></tr><tr><td style="white-space:nowrap">840012<a name="moh-category-840012"> </a></td><td>Closed Reduction Of Fracture Dislocation</td></tr><tr><td style="white-space:nowrap">115-37.87<a name="moh-category-115-37.4687"> </a></td><td>Replacement any type pacemaker,dual chamber device</td></tr><tr><td style="white-space:nowrap">840018<a name="moh-category-840018"> </a></td><td>Closed Fracture Small Bones Of Hand Or Foot</td></tr><tr><td style="white-space:nowrap">840016<a name="moh-category-840016"> </a></td><td>Menisectomy Or Excisin Of Cyst Of The Knee Joint</td></tr><tr><td style="white-space:nowrap">E40701<a name="moh-category-E40701"> </a></td><td>Repair cleft lip</td></tr><tr><td style="white-space:nowrap">800836<a name="moh-category-800836"> </a></td><td>Ch- Draniage ( Outside Hospital)</td></tr><tr><td style="white-space:nowrap">800834<a name="moh-category-800834"> </a></td><td>Ch-Drainage ( Inside Hospita )</td></tr><tr><td style="white-space:nowrap">117-37.74<a name="moh-category-117-37.4674"> </a></td><td>Insertion or replacement epicardial pacemaker, -37.74</td></tr><tr><td style="white-space:nowrap">117-37.75<a name="moh-category-117-37.4675"> </a></td><td>Revision,pacemaker lead,electrode</td></tr><tr><td style="white-space:nowrap">117-37.76<a name="moh-category-117-37.4676"> </a></td><td>Replacement,transvenous atrial/ventr pacemaker lead</td></tr><tr><td style="white-space:nowrap">800838<a name="moh-category-800838"> </a></td><td>Graft Replacment (Inhospital)</td></tr><tr><td style="white-space:nowrap">117-37.77<a name="moh-category-117-37.4677"> </a></td><td>Removal ,pacemaker leads/electrodes w/o replacement</td></tr><tr><td style="white-space:nowrap">304050<a name="moh-category-304050"> </a></td><td>Colour Doppler Renal Artery</td></tr><tr><td style="white-space:nowrap">202102<a name="moh-category-202102"> </a></td><td>Disposables I.C.U.</td></tr><tr><td style="white-space:nowrap">800840<a name="moh-category-800840"> </a></td><td>Balloon Dacyoplasty</td></tr><tr><td style="white-space:nowrap">U82803<a name="moh-category-U82803"> </a></td><td>U82803 Blood Gases</td></tr><tr><td style="white-space:nowrap">304054<a name="moh-category-304054"> </a></td><td>Colour Doppler Portal System</td></tr><tr><td style="white-space:nowrap">800844<a name="moh-category-800844"> </a></td><td>Collagen Plug</td></tr><tr><td style="white-space:nowrap">T76830<a name="moh-category-T76830"> </a></td><td>Ultra Sound - Transvaginal</td></tr><tr><td style="white-space:nowrap">304052<a name="moh-category-304052"> </a></td><td>Colour Doppler Hepatic Artery</td></tr><tr><td style="white-space:nowrap">800842<a name="moh-category-800842"> </a></td><td>Amniotic Membrane Graft</td></tr><tr><td style="white-space:nowrap">304058<a name="moh-category-304058"> </a></td><td>Colour Doppler Iliac Vessels</td></tr><tr><td style="white-space:nowrap">840022<a name="moh-category-840022"> </a></td><td>Reconstruction Of Amputated Finger W/O Grafting</td></tr><tr><td style="white-space:nowrap">304056<a name="moh-category-304056"> </a></td><td>Colour Doppler Aortic</td></tr><tr><td style="white-space:nowrap">840020<a name="moh-category-840020"> </a></td><td>Pop To Simple Fracture Without Displacement</td></tr><tr><td style="white-space:nowrap">840026<a name="moh-category-840026"> </a></td><td>Correction Of Hallux Valgus</td></tr><tr><td style="white-space:nowrap">840024<a name="moh-category-840024"> </a></td><td>Closed Reduction Of Dislocated Phalanges</td></tr><tr><td style="white-space:nowrap">840028<a name="moh-category-840028"> </a></td><td>Arthrodesis Of The Big Toe</td></tr><tr><td style="white-space:nowrap">117-37.89<a name="moh-category-117-37.4689"> </a></td><td>Revision or removal pacemaker device</td></tr><tr><td style="white-space:nowrap">800848<a name="moh-category-800848"> </a></td><td>Anterior Chamber Reformation Post Operative (Inside Hospital)</td></tr><tr><td style="white-space:nowrap">202108<a name="moh-category-202108"> </a></td><td>Cardiac Care Unit (Ccu)</td></tr><tr><td style="white-space:nowrap">800846<a name="moh-category-800846"> </a></td><td>Unilateral Punctural Occlusion</td></tr><tr><td style="white-space:nowrap">202106<a name="moh-category-202106"> </a></td><td>Disposables Nicu</td></tr><tr><td style="white-space:nowrap">202104<a name="moh-category-202104"> </a></td><td>Isolation Disposables Per Day</td></tr><tr><td style="white-space:nowrap">800850<a name="moh-category-800850"> </a></td><td>Anterior Chamber Reformation Post Operative (Outside Hospital)</td></tr><tr><td style="white-space:nowrap">304060<a name="moh-category-304060"> </a></td><td>Colour Doppler Testicular Artery</td></tr><tr><td style="white-space:nowrap">304064<a name="moh-category-304064"> </a></td><td>Colour Doppler Carotid Artery (Unilateral)</td></tr><tr><td style="white-space:nowrap">202110<a name="moh-category-202110"> </a></td><td>Pediatric Icu (Picu)</td></tr><tr><td style="white-space:nowrap">T71134<a name="moh-category-T71134"> </a></td><td>Chest 4 Views with Fluroscopy</td></tr><tr><td style="white-space:nowrap">304062<a name="moh-category-304062"> </a></td><td>Colour Doppler Veins (Varices)</td></tr><tr><td style="white-space:nowrap">304068<a name="moh-category-304068"> </a></td><td>Colour Doppler Brachial Artery (Unilateral)</td></tr><tr><td style="white-space:nowrap">840030<a name="moh-category-840030"> </a></td><td>Pop For Correction Of Foot Deformity</td></tr><tr><td style="white-space:nowrap">304066<a name="moh-category-304066"> </a></td><td>Colour Doppler Carotid Artery (Bilateral)</td></tr><tr><td style="white-space:nowrap">840036<a name="moh-category-840036"> </a></td><td>Fracture Of Coles</td></tr><tr><td style="white-space:nowrap">840034<a name="moh-category-840034"> </a></td><td>Excision Of Olecranon Bursa</td></tr><tr><td style="white-space:nowrap">U85260<a name="moh-category-U85260"> </a></td><td>Factor 10</td></tr><tr><td style="white-space:nowrap">L90871<a name="moh-category-L90871"> </a></td><td>Electro convulsive therapy (ECT) multiple seizures</td></tr><tr><td style="white-space:nowrap">U86592<a name="moh-category-U86592"> </a></td><td>VDRL/RPR</td></tr><tr><td style="white-space:nowrap">U86593<a name="moh-category-U86593"> </a></td><td>RPR TITER</td></tr><tr><td style="white-space:nowrap">208062<a name="moh-category-208062"> </a></td><td>Narrow Band Nb-Uvb</td></tr><tr><td style="white-space:nowrap">137216<a name="moh-category-137216"> </a></td><td>Self Assessment Scale</td></tr><tr><td style="white-space:nowrap">704134<a name="moh-category-704134"> </a></td><td>Reduction Of Complicated Middle/Upper Face Fracture</td></tr><tr><td style="white-space:nowrap">G24130<a name="moh-category-G24130"> </a></td><td>Excision of radial head</td></tr><tr><td style="white-space:nowrap">652004<a name="moh-category-652004"> </a></td><td>Cabg &amp; Tissue Aortic Valve Replacement</td></tr><tr><td style="white-space:nowrap">137218<a name="moh-category-137218"> </a></td><td>Eating Disorder Scale</td></tr><tr><td style="white-space:nowrap">L90870<a name="moh-category-L90870"> </a></td><td>Electro Convulsive Therapy (ECT) Single seizure</td></tr><tr><td style="white-space:nowrap">201-39.26<a name="moh-category-201-39.4626"> </a></td><td>Bypass, vascular, intra-abdominal</td></tr><tr><td style="white-space:nowrap">652006<a name="moh-category-652006"> </a></td><td>Cabg &amp; Mechanical Aortic Valve</td></tr><tr><td style="white-space:nowrap">825202<a name="moh-category-825202"> </a></td><td>Turp</td></tr><tr><td style="white-space:nowrap">518006<a name="moh-category-518006"> </a></td><td>Progesterone</td></tr><tr><td style="white-space:nowrap">825204<a name="moh-category-825204"> </a></td><td>Ureteroscope</td></tr><tr><td style="white-space:nowrap">U86674<a name="moh-category-U86674"> </a></td><td>Giardia Lamblia ABS.</td></tr><tr><td style="white-space:nowrap">112-35.96<a name="moh-category-112-35.4696"> </a></td><td>Valvuloplasty, percutaneous</td></tr><tr><td style="white-space:nowrap">518008<a name="moh-category-518008"> </a></td><td>Pregnandiol</td></tr><tr><td style="white-space:nowrap">825208<a name="moh-category-825208"> </a></td><td>Boari Flap</td></tr><tr><td style="white-space:nowrap">L90875<a name="moh-category-L90875"> </a></td><td>Bio Feedback Therapy</td></tr><tr><td style="white-space:nowrap">137222<a name="moh-category-137222"> </a></td><td>Anorexia Nervosa Scale</td></tr><tr><td style="white-space:nowrap">H85095<a name="moh-category-H85095"> </a></td><td>Bone Marrow - Aspiration</td></tr><tr><td style="white-space:nowrap">137224<a name="moh-category-137224"> </a></td><td>Bender Gestalat Scale</td></tr><tr><td style="white-space:nowrap">U84600<a name="moh-category-U84600"> </a></td><td>Alcohol Isopropanol</td></tr><tr><td style="white-space:nowrap">173028<a name="moh-category-173028"> </a></td><td>Sodium Profiling</td></tr><tr><td style="white-space:nowrap">825200<a name="moh-category-825200"> </a></td><td>Tuna</td></tr><tr><td style="white-space:nowrap">U86622<a name="moh-category-U86622"> </a></td><td>Brucella Agglutination Test</td></tr><tr><td style="white-space:nowrap">173024<a name="moh-category-173024"> </a></td><td>Surgical Revision Of Fistula</td></tr><tr><td style="white-space:nowrap">300230<a name="moh-category-300230"> </a></td><td>Chest Ap / Supine</td></tr><tr><td style="white-space:nowrap">173026<a name="moh-category-173026"> </a></td><td>Bone Biopsy</td></tr><tr><td style="white-space:nowrap">173020<a name="moh-category-173020"> </a></td><td>Creation Of A V Fistula</td></tr><tr><td style="white-space:nowrap">300234<a name="moh-category-300234"> </a></td><td>Chest Lat. Decubitus</td></tr><tr><td style="white-space:nowrap">173022<a name="moh-category-173022"> </a></td><td>Insertion Of Central Vascular Catheter(Femoral/Subclavian/Jugular)</td></tr><tr><td style="white-space:nowrap">U84490<a name="moh-category-U84490"> </a></td><td>Stool for Trypsin Activity</td></tr><tr><td style="white-space:nowrap">300232<a name="moh-category-300232"> </a></td><td>Chest. Lat. View</td></tr><tr><td style="white-space:nowrap">I69200<a name="moh-category-I69200"> </a></td><td>Removal FB Impacted Ear</td></tr><tr><td style="white-space:nowrap">128022<a name="moh-category-128022"> </a></td><td>Spoon Plate 6 Holes Each</td></tr><tr><td style="white-space:nowrap">300238<a name="moh-category-300238"> </a></td><td>Ribs Ap</td></tr><tr><td style="white-space:nowrap">704030<a name="moh-category-704030"> </a></td><td>Wiring Fractured Jaw - Simple</td></tr><tr><td style="white-space:nowrap">128024<a name="moh-category-128024"> </a></td><td>Cancelleus Bone Screws</td></tr><tr><td style="white-space:nowrap">300236<a name="moh-category-300236"> </a></td><td>Chest Pa / Lat. View</td></tr><tr><td style="white-space:nowrap">T76090<a name="moh-category-T76090"> </a></td><td>Mamography ( 1 Breast )</td></tr><tr><td style="white-space:nowrap">128026<a name="moh-category-128026"> </a></td><td>Cortex Bone Screws</td></tr><tr><td style="white-space:nowrap">K56810<a name="moh-category-K56810"> </a></td><td>Perineoplasty</td></tr><tr><td style="white-space:nowrap">128028<a name="moh-category-128028"> </a></td><td>Malleable Bone Screws</td></tr><tr><td style="white-space:nowrap">173018<a name="moh-category-173018"> </a></td><td>Plasma Pheresis / Exchange Per Session</td></tr><tr><td style="white-space:nowrap">P-211<a name="moh-category-P-211"> </a></td><td>Stapedectomy</td></tr><tr><td style="white-space:nowrap">300240<a name="moh-category-300240"> </a></td><td>Ribs Ap / Oblique</td></tr><tr><td style="white-space:nowrap">P-212<a name="moh-category-P-212"> </a></td><td>P-212 Adenoidectomy</td></tr><tr><td style="white-space:nowrap">173014<a name="moh-category-173014"> </a></td><td>Haemodiafilteration 4 To 12 Hours - Per Session</td></tr><tr><td style="white-space:nowrap">T70360<a name="moh-category-T70360"> </a></td><td>NECK - Soft Tissue</td></tr><tr><td style="white-space:nowrap">U83586<a name="moh-category-U83586"> </a></td><td>17-Ketosteroids</td></tr><tr><td style="white-space:nowrap">128020<a name="moh-category-128020"> </a></td><td>Broad Dynamic Comp Plate 14 Holes Each</td></tr><tr><td style="white-space:nowrap">173016<a name="moh-category-173016"> </a></td><td>Continous Arteriovenous Haemofiltration 12 To 24 Hours Per Session</td></tr><tr><td style="white-space:nowrap">U86615<a name="moh-category-U86615"> </a></td><td>Pertussis Bordetella</td></tr><tr><td style="white-space:nowrap">300244<a name="moh-category-300244"> </a></td><td>Shoulder Ap / Lat.</td></tr><tr><td style="white-space:nowrap">173010<a name="moh-category-173010"> </a></td><td>Permicath</td></tr><tr><td style="white-space:nowrap">300242<a name="moh-category-300242"> </a></td><td>Shoulder Ap</td></tr><tr><td style="white-space:nowrap">173012<a name="moh-category-173012"> </a></td><td>Subclavian Double Lumen</td></tr><tr><td style="white-space:nowrap">300204<a name="moh-category-300204"> </a></td><td>Skeletal Survey</td></tr><tr><td style="white-space:nowrap">173050<a name="moh-category-173050"> </a></td><td>Acid Concentrate ( Litre)</td></tr><tr><td style="white-space:nowrap">300202<a name="moh-category-300202"> </a></td><td>Pattela - 1 View</td></tr><tr><td style="white-space:nowrap">T76080<a name="moh-category-T76080"> </a></td><td>Fistulogram/Sinogram</td></tr><tr><td style="white-space:nowrap">173052<a name="moh-category-173052"> </a></td><td>Insertion Of Perma Cath Tunnel Line</td></tr><tr><td style="white-space:nowrap">300208<a name="moh-category-300208"> </a></td><td>Mcu (Along With Ivp)</td></tr><tr><td style="white-space:nowrap">300206<a name="moh-category-300206"> </a></td><td>Intra-Operative Choloangiogram (I.O.C)</td></tr><tr><td style="white-space:nowrap">212002<a name="moh-category-212002"> </a></td><td>Operation Fine Major - Doctor Fees</td></tr><tr><td style="white-space:nowrap">300207<a name="moh-category-300207"> </a></td><td>Mcu (Micuratug Urethrogram)</td></tr><tr><td style="white-space:nowrap">506008<a name="moh-category-506008"> </a></td><td>T.B.Culture</td></tr><tr><td style="white-space:nowrap">K56800<a name="moh-category-K56800"> </a></td><td>Plastic Repair of Introitus</td></tr><tr><td style="white-space:nowrap">506006<a name="moh-category-506006"> </a></td><td>Anaerobic Culture</td></tr><tr><td style="white-space:nowrap">506004<a name="moh-category-506004"> </a></td><td>Routine Culture, Mycology</td></tr><tr><td style="white-space:nowrap">640066<a name="moh-category-640066"> </a></td><td>Intubation</td></tr><tr><td style="white-space:nowrap">810302<a name="moh-category-810302"> </a></td><td>Thyroidectomy</td></tr><tr><td style="white-space:nowrap">840038<a name="moh-category-840038"> </a></td><td>Amputation Of Finger Or Toe</td></tr><tr><td style="white-space:nowrap">640140<a name="moh-category-640140"> </a></td><td>Mitral Balloon Valuloplasty</td></tr><tr><td style="white-space:nowrap">49-25.30<a name="moh-category-49-25.4630"> </a></td><td>Glossectomy - complete</td></tr><tr><td style="white-space:nowrap">116-37.87<a name="moh-category-116-37.4687"> </a></td><td>Replacement any type pacemaker,dual chamber device</td></tr><tr><td style="white-space:nowrap">750112<a name="moh-category-750112"> </a></td><td>Punch Graft - Medium Area (Skincare)</td></tr><tr><td style="white-space:nowrap">304038<a name="moh-category-304038"> </a></td><td>Colour Doppler Sonography Neck Lesions</td></tr><tr><td style="white-space:nowrap">640142<a name="moh-category-640142"> </a></td><td>Bronchial Artery Angiography</td></tr><tr><td style="white-space:nowrap">K57250<a name="moh-category-K57250"> </a></td><td>Posterior Colporrhaphy &amp; Repair Eectocele</td></tr><tr><td style="white-space:nowrap">750110<a name="moh-category-750110"> </a></td><td>Punch Graft - Small Area (Skincare)</td></tr><tr><td style="white-space:nowrap">750086<a name="moh-category-750086"> </a></td><td>Excision Of Mole - Large (Skincare)</td></tr><tr><td style="white-space:nowrap">810232<a name="moh-category-810232"> </a></td><td>Laser Ear Surgery</td></tr><tr><td style="white-space:nowrap">110008<a name="moh-category-110008"> </a></td><td>Wheel Chair - Rental (Per Day)</td></tr><tr><td style="white-space:nowrap">750084<a name="moh-category-750084"> </a></td><td>Excision Of Mole - Medium (Skincare)</td></tr><tr><td style="white-space:nowrap">810234<a name="moh-category-810234"> </a></td><td>Mastoid Abscess Drainage Under G.A.</td></tr><tr><td style="white-space:nowrap">110006<a name="moh-category-110006"> </a></td><td>Wheel Chair - Deposit</td></tr><tr><td style="white-space:nowrap">810236<a name="moh-category-810236"> </a></td><td>Ear Foreign Body Removal Under G.A.</td></tr><tr><td style="white-space:nowrap">110004<a name="moh-category-110004"> </a></td><td>Crutches - Rental (Per Day)</td></tr><tr><td style="white-space:nowrap">750088<a name="moh-category-750088"> </a></td><td>Comedon Extraction - Small Area (Skincare)</td></tr><tr><td style="white-space:nowrap">810238<a name="moh-category-810238"> </a></td><td>Suction Clearance Under G.A.</td></tr><tr><td style="white-space:nowrap">110002<a name="moh-category-110002"> </a></td><td>Crutches Deposit</td></tr><tr><td style="white-space:nowrap">202007<a name="moh-category-202007"> </a></td><td>Semi-Suite Room Per Day</td></tr><tr><td style="white-space:nowrap">750082<a name="moh-category-750082"> </a></td><td>Excision Of Mole - Small (Skincare)</td></tr><tr><td style="white-space:nowrap">202008<a name="moh-category-202008"> </a></td><td>Paediatric Ward</td></tr><tr><td style="white-space:nowrap">810230<a name="moh-category-810230"> </a></td><td>Implantable Hearing Aid</td></tr><tr><td style="white-space:nowrap">202006<a name="moh-category-202006"> </a></td><td>Semi-Private Room Per Day</td></tr><tr><td style="white-space:nowrap">202014<a name="moh-category-202014"> </a></td><td>Special Nurse 24 Hours</td></tr><tr><td style="white-space:nowrap">202012<a name="moh-category-202012"> </a></td><td>Nursery</td></tr><tr><td style="white-space:nowrap">202010<a name="moh-category-202010"> </a></td><td>Infant Incubator</td></tr><tr><td style="white-space:nowrap">304042<a name="moh-category-304042"> </a></td><td>Colour Doppler Vaginal Ultrasound With Doppler Study</td></tr><tr><td style="white-space:nowrap">304040<a name="moh-category-304040"> </a></td><td>Colour Doppler Vaginal Ultrasound Exam W/Out Dopp.Study</td></tr><tr><td style="white-space:nowrap">810228<a name="moh-category-810228"> </a></td><td>Second Stage Of Two Stage Tympanoplasty</td></tr><tr><td style="white-space:nowrap">110010<a name="moh-category-110010"> </a></td><td>Walking Stick</td></tr><tr><td style="white-space:nowrap">54-20.92<a name="moh-category-54-20.4692"> </a></td><td>Revision, Mastoidectomy</td></tr><tr><td style="white-space:nowrap">304044<a name="moh-category-304044"> </a></td><td>Colour Doppler Pregnancy Umbilical Artery Placental Flow Ovarian &amp; Uterian</td></tr><tr><td style="white-space:nowrap">K57260<a name="moh-category-K57260"> </a></td><td>Combined Antero Posterior Colporraphy</td></tr><tr><td style="white-space:nowrap">304008<a name="moh-category-304008"> </a></td><td>Colour Doppler Hip Joint (Two)</td></tr><tr><td style="white-space:nowrap">750050<a name="moh-category-750050"> </a></td><td>Puva Per Session (Skincare)</td></tr><tr><td style="white-space:nowrap">810202<a name="moh-category-810202"> </a></td><td>Unilateral Myringatomy (G.A.)</td></tr><tr><td style="white-space:nowrap">810204<a name="moh-category-810204"> </a></td><td>Bilateral Myringatomy (G.A.)</td></tr><tr><td style="white-space:nowrap">750054<a name="moh-category-750054"> </a></td><td>Eye Brow Transplant (Skincare)</td></tr><tr><td style="white-space:nowrap">D92260<a name="moh-category-D92260"> </a></td><td>Ophthalmodynametry</td></tr><tr><td style="white-space:nowrap">202018<a name="moh-category-202018"> </a></td><td>Isolation Room</td></tr><tr><td style="white-space:nowrap">202016<a name="moh-category-202016"> </a></td><td>Intensive Care Unit (Icu)</td></tr><tr><td style="white-space:nowrap">202026<a name="moh-category-202026"> </a></td><td>Head Box(Neo-Natal Care)</td></tr><tr><td style="white-space:nowrap">U82725<a name="moh-category-U82725"> </a></td><td>Fatty Acids Nonesterified</td></tr><tr><td style="white-space:nowrap">202024<a name="moh-category-202024"> </a></td><td>Observation Room Er / Or Recovery More Than 6 Hour</td></tr><tr><td style="white-space:nowrap">304010<a name="moh-category-304010"> </a></td><td>Colour Doppler Knee Joint (One)</td></tr><tr><td style="white-space:nowrap">U82728<a name="moh-category-U82728"> </a></td><td>Ferritin</td></tr><tr><td style="white-space:nowrap">202022<a name="moh-category-202022"> </a></td><td>Observation Room Er / Or Recovery Less Than 6 Hour</td></tr><tr><td style="white-space:nowrap">202020<a name="moh-category-202020"> </a></td><td>Guest Board &amp; Lodging</td></tr><tr><td style="white-space:nowrap">304014<a name="moh-category-304014"> </a></td><td>Colour Doppler Wrist J - Carpal T (One)</td></tr><tr><td style="white-space:nowrap">304012<a name="moh-category-304012"> </a></td><td>Colour Doppler Knee Joint (Two)</td></tr><tr><td style="white-space:nowrap">304018<a name="moh-category-304018"> </a></td><td>Colour Doppler Muscles (One Limb)</td></tr><tr><td style="white-space:nowrap">304016<a name="moh-category-304016"> </a></td><td>Colour Doppler Wrist J - Carpal T (Two)</td></tr><tr><td style="white-space:nowrap">750064<a name="moh-category-750064"> </a></td><td>Trichogram (Skincare)</td></tr><tr><td style="white-space:nowrap">214014<a name="moh-category-214014"> </a></td><td>Operation Room Charges Simple</td></tr><tr><td style="white-space:nowrap">810210<a name="moh-category-810210"> </a></td><td>Myringoplasty</td></tr><tr><td style="white-space:nowrap">750062<a name="moh-category-750062"> </a></td><td>Skin Biopsy (Skincare)</td></tr><tr><td style="white-space:nowrap">810212<a name="moh-category-810212"> </a></td><td>Tympanoplasty + Mastoidectomy</td></tr><tr><td style="white-space:nowrap">650478<a name="moh-category-650478"> </a></td><td>Craniectomy, Brain Dissection &amp; Haematoma Evaucation</td></tr><tr><td style="white-space:nowrap">750068<a name="moh-category-750068"> </a></td><td>Cryo Cautery - Multiple Lesion (Skincare)</td></tr><tr><td style="white-space:nowrap">214010<a name="moh-category-214010"> </a></td><td>Operation Room Charges Medium</td></tr><tr><td style="white-space:nowrap">810214<a name="moh-category-810214"> </a></td><td>Radical Mastoidectomy</td></tr><tr><td style="white-space:nowrap">650476<a name="moh-category-650476"> </a></td><td>Microscopic Total Suprasellar Tumour Excision Through Subfrontal Approach With F</td></tr><tr><td style="white-space:nowrap">750066<a name="moh-category-750066"> </a></td><td>Cryo Cautery - Few Lesion (Skincare)</td></tr><tr><td style="white-space:nowrap">214012<a name="moh-category-214012"> </a></td><td>Operation Room Charges Minor</td></tr><tr><td style="white-space:nowrap">E60280<a name="moh-category-E60280"> </a></td><td>Thyro glossal cyst excision</td></tr><tr><td style="white-space:nowrap">810216<a name="moh-category-810216"> </a></td><td>Stapedectomy</td></tr><tr><td style="white-space:nowrap">T76872<a name="moh-category-T76872"> </a></td><td>Ultra Sound Trans Rectal</td></tr><tr><td style="white-space:nowrap">T76870<a name="moh-category-T76870"> </a></td><td>Ultra Sound - Scrotum and Content</td></tr><tr><td style="white-space:nowrap">750060<a name="moh-category-750060"> </a></td><td>Facial Cleansing Skin Care (Skincare)</td></tr><tr><td style="white-space:nowrap">202034<a name="moh-category-202034"> </a></td><td>Companion Charges With Child Per Day</td></tr><tr><td style="white-space:nowrap">202032<a name="moh-category-202032"> </a></td><td>Extra Lunch/Dinner Tray</td></tr><tr><td style="white-space:nowrap">304020<a name="moh-category-304020"> </a></td><td>Colour Doppler Muscles (Two Limbs)</td></tr><tr><td style="white-space:nowrap">202030<a name="moh-category-202030"> </a></td><td>Nursing Care Per Day</td></tr><tr><td style="white-space:nowrap">810206<a name="moh-category-810206"> </a></td><td>Unilateral Myringatomy &amp; Grommet (G.A.)</td></tr><tr><td style="white-space:nowrap">304024<a name="moh-category-304024"> </a></td><td>Colour Doppler Tendons (Two)</td></tr><tr><td style="white-space:nowrap">810208<a name="moh-category-810208"> </a></td><td>Bilateral Myringatomy &amp; Grommet (G.A.)</td></tr><tr><td style="white-space:nowrap">304022<a name="moh-category-304022"> </a></td><td>Colour Doppler Tendons (One)</td></tr><tr><td style="white-space:nowrap">49-25.40<a name="moh-category-49-25.4640"> </a></td><td>Glossectomy - radical</td></tr><tr><td style="white-space:nowrap">304028<a name="moh-category-304028"> </a></td><td>Colour Doppler Bones (Two Limbs)</td></tr><tr><td style="white-space:nowrap">214006<a name="moh-category-214006"> </a></td><td>Operation Room Charges Fine Major</td></tr><tr><td style="white-space:nowrap">304026<a name="moh-category-304026"> </a></td><td>Colour Doppler Bones (One Limb)</td></tr><tr><td style="white-space:nowrap">214008<a name="moh-category-214008"> </a></td><td>Operation Room Charges Major</td></tr><tr><td style="white-space:nowrap">650038A<a name="moh-category-650038A"> </a></td><td>Each Additional : Coil</td></tr><tr><td style="white-space:nowrap">650038B<a name="moh-category-650038B"> </a></td><td>Microcatheter</td></tr><tr><td style="white-space:nowrap">650038C<a name="moh-category-650038C"> </a></td><td>Microguide Wire</td></tr><tr><td style="white-space:nowrap">650268<a name="moh-category-650268"> </a></td><td>Repair Of Scalp Injury Under General Anaesthesia</td></tr><tr><td style="white-space:nowrap">650266<a name="moh-category-650266"> </a></td><td>Excision Of Scalp Swelling Or Tumour</td></tr><tr><td style="white-space:nowrap">526308<a name="moh-category-526308"> </a></td><td>Phenol</td></tr><tr><td style="white-space:nowrap">7-86.06<a name="moh-category-7-86.4606"> </a></td><td>Insertion - infusion pump, totally implantable</td></tr><tr><td style="white-space:nowrap">526312<a name="moh-category-526312"> </a></td><td>Adrenal Cortex Abs</td></tr><tr><td style="white-space:nowrap">526310<a name="moh-category-526310"> </a></td><td>Ccp</td></tr><tr><td style="white-space:nowrap">526316<a name="moh-category-526316"> </a></td><td>C-1 Esterase Inhibitor</td></tr><tr><td style="white-space:nowrap">526314<a name="moh-category-526314"> </a></td><td>Anti Ccp Abs</td></tr><tr><td style="white-space:nowrap">112002<a name="moh-category-112002"> </a></td><td>Mortuary Rent Per Day</td></tr><tr><td style="white-space:nowrap">650276<a name="moh-category-650276"> </a></td><td>Repair Of Skull Fracture With Damaged Brain Tissue</td></tr><tr><td style="white-space:nowrap">U82980<a name="moh-category-U82980"> </a></td><td>Glutethimide</td></tr><tr><td style="white-space:nowrap">650274<a name="moh-category-650274"> </a></td><td>Repair Of Compound Skull Fracture</td></tr><tr><td style="white-space:nowrap">650272<a name="moh-category-650272"> </a></td><td>Repair Of Simple Skull Fracture</td></tr><tr><td style="white-space:nowrap">I30100<a name="moh-category-I30100"> </a></td><td>Nose, EUA, Biopsy</td></tr><tr><td style="white-space:nowrap">650270<a name="moh-category-650270"> </a></td><td>Excision Of Skull Vault Tumour</td></tr><tr><td style="white-space:nowrap">650258<a name="moh-category-650258"> </a></td><td>Craniotomy And Excision Of Clival Tumour</td></tr><tr><td style="white-space:nowrap">650256<a name="moh-category-650256"> </a></td><td>Craniotomy And Excision Of C P Angle Tumour</td></tr><tr><td style="white-space:nowrap">526318<a name="moh-category-526318"> </a></td><td>Aldolase</td></tr><tr><td style="white-space:nowrap">U82977<a name="moh-category-U82977"> </a></td><td>GGT (Gamma G.T.)</td></tr><tr><td style="white-space:nowrap">U82979<a name="moh-category-U82979"> </a></td><td>Glutathione Reductase</td></tr><tr><td style="white-space:nowrap">650262<a name="moh-category-650262"> </a></td><td>Craniotomy And Evacuation Of Acute Subdural Hematoma</td></tr><tr><td style="white-space:nowrap">650036C<a name="moh-category-650036C"> </a></td><td>Microguide Wire</td></tr><tr><td style="white-space:nowrap">500014<a name="moh-category-500014"> </a></td><td>Ammonia</td></tr><tr><td style="white-space:nowrap">303222<a name="moh-category-303222"> </a></td><td>Ct Cardiac Angiography</td></tr><tr><td style="white-space:nowrap">H47000<a name="moh-category-H47000"> </a></td><td>Liver Biopsy</td></tr><tr><td style="white-space:nowrap">704082<a name="moh-category-704082"> </a></td><td>Excision Of Bengin Tumour - Lesion Diameter Upto 1Cm</td></tr><tr><td style="white-space:nowrap">704080<a name="moh-category-704080"> </a></td><td>Bone Grafting (Synthetic / Pop)</td></tr><tr><td style="white-space:nowrap">300194<a name="moh-category-300194"> </a></td><td>T.Tube Cholanglogram</td></tr><tr><td style="white-space:nowrap">800142<a name="moh-category-800142"> </a></td><td>Exci. Of Lid Tum=Rec. Us Flao</td></tr><tr><td style="white-space:nowrap">303226<a name="moh-category-303226"> </a></td><td>Ct Virtual Colonography &amp; Polyp Detection</td></tr><tr><td style="white-space:nowrap">137024<a name="moh-category-137024"> </a></td><td>Psychological Assessment- Category 2 - Personality</td></tr><tr><td style="white-space:nowrap">303224<a name="moh-category-303224"> </a></td><td>Ct Brain Perfusion Studies</td></tr><tr><td style="white-space:nowrap">800140<a name="moh-category-800140"> </a></td><td>Exci. Of Lid Tumour With Com. Re</td></tr><tr><td style="white-space:nowrap">300198<a name="moh-category-300198"> </a></td><td>Heel - 1 View</td></tr><tr><td style="white-space:nowrap">1099699<a name="moh-category-1099699"> </a></td><td>Ang R&amp;L-H 107-88.54 Angiocardiogram- right and &amp; heart</td></tr><tr><td style="white-space:nowrap">460220<a name="moh-category-460220"> </a></td><td>Intra Nasal Mucosal Allergy T.</td></tr><tr><td style="white-space:nowrap">710022<a name="moh-category-710022"> </a></td><td>Other Preventive Procedures: Per 15 Minutes</td></tr><tr><td style="white-space:nowrap">I92553<a name="moh-category-I92553"> </a></td><td>Speech audiometry air &amp; bone</td></tr><tr><td style="white-space:nowrap">710028<a name="moh-category-710028"> </a></td><td>Pit &amp; Fissure Sealant - Per Tooth</td></tr><tr><td style="white-space:nowrap">208064<a name="moh-category-208064"> </a></td><td>Removal Of Skin Tag 1 To 3</td></tr><tr><td style="white-space:nowrap">460226<a name="moh-category-460226"> </a></td><td>Follow Up-Sinus Endoscopy (One Year )</td></tr><tr><td style="white-space:nowrap">750030<a name="moh-category-750030"> </a></td><td>Hair Transplantation (300-400) Graft (Skincare)</td></tr><tr><td style="white-space:nowrap">460224<a name="moh-category-460224"> </a></td><td>Follow Up Sinus Endoscopy (One Time)</td></tr><tr><td style="white-space:nowrap">N97124<a name="moh-category-N97124"> </a></td><td>N97124 Massage Therapy</td></tr><tr><td style="white-space:nowrap">T73610<a name="moh-category-T73610"> </a></td><td>Ankle - 3 Views</td></tr><tr><td style="white-space:nowrap">T71250<a name="moh-category-T71250"> </a></td><td>CT Thorax without Contrast</td></tr><tr><td style="white-space:nowrap">U82055<a name="moh-category-U82055"> </a></td><td>Alcohol, Ethyl</td></tr><tr><td style="white-space:nowrap">825194<a name="moh-category-825194"> </a></td><td>Simple Cystectomy</td></tr><tr><td style="white-space:nowrap">825196<a name="moh-category-825196"> </a></td><td>Simple Nephrectomy</td></tr><tr><td style="white-space:nowrap">652008<a name="moh-category-652008"> </a></td><td>Cabg &amp; Tissue Mitral Valve</td></tr><tr><td style="white-space:nowrap">825198<a name="moh-category-825198"> </a></td><td>Transvesical Prostatectomy</td></tr><tr><td style="white-space:nowrap">652010<a name="moh-category-652010"> </a></td><td>Cabg &amp; Mechanical Mitral Valve</td></tr><tr><td style="white-space:nowrap">T73615<a name="moh-category-T73615"> </a></td><td>Ankle Arthrography</td></tr><tr><td style="white-space:nowrap">840160<a name="moh-category-840160"> </a></td><td>Amputations : Upper Limbs</td></tr><tr><td style="white-space:nowrap">302008<a name="moh-category-302008"> </a></td><td>Antenatal Scan</td></tr><tr><td style="white-space:nowrap">652012<a name="moh-category-652012"> </a></td><td>Cabg &amp; Double Tissue Valve</td></tr><tr><td style="white-space:nowrap">652014<a name="moh-category-652014"> </a></td><td>Cabg &amp; Double Mechanical Valve</td></tr><tr><td style="white-space:nowrap">840164<a name="moh-category-840164"> </a></td><td>Arthroclesis, Shoulder</td></tr><tr><td style="white-space:nowrap">750226<a name="moh-category-750226"> </a></td><td>Complete Cleft Lip (Skincare)</td></tr><tr><td style="white-space:nowrap">518002<a name="moh-category-518002"> </a></td><td>Estrogen</td></tr><tr><td style="white-space:nowrap">640014<a name="moh-category-640014"> </a></td><td>Ptca (Per.Tr.Coronory Angioplasty) - Dv</td></tr><tr><td style="white-space:nowrap">840162<a name="moh-category-840162"> </a></td><td>Arthrodesis 1 Big Joint – Hip, Knee (Subtalar:Ankle), Foot : Triple</td></tr><tr><td style="white-space:nowrap">518004<a name="moh-category-518004"> </a></td><td>Estradiol</td></tr><tr><td style="white-space:nowrap">750224<a name="moh-category-750224"> </a></td><td>In-Complete Cleft Lip (Skincare)</td></tr><tr><td style="white-space:nowrap">506028<a name="moh-category-506028"> </a></td><td>Haemoglobin H (For Alpha Thalassemia)</td></tr><tr><td style="white-space:nowrap">137220<a name="moh-category-137220"> </a></td><td>Bulimia Nervosa Scale</td></tr><tr><td style="white-space:nowrap">506026<a name="moh-category-506026"> </a></td><td>Food Testing For Coliforms</td></tr><tr><td style="white-space:nowrap">506024<a name="moh-category-506024"> </a></td><td>Water Testing: Routine Bacteriological Analysis</td></tr><tr><td style="white-space:nowrap">U86664<a name="moh-category-U86664"> </a></td><td>Epstein BARR Nuclear AG.</td></tr><tr><td style="white-space:nowrap">506022<a name="moh-category-506022"> </a></td><td>Skin Scrapping Microscopy For Herpes</td></tr><tr><td style="white-space:nowrap">ICU<a name="moh-category-ICU"> </a></td><td>ICU Services Adult/Pediatric Incl cost Provide ICU Services, Adult/Pediatric (after 2 to 4 weeks of admission in ICU,if no active interventions patient will be converted to long term condition -definition will be applicable)
* Medication above 350 SR per day as per SFDA price list, Blood &amp; blood products, MRI, CT, ECHO, Doppler , CRRT , Surgical and endoscopic procedure are  an excluded services.
To get re-imbused for medication above the daily limit, submission must include a list of details medications as per SFDA codes and pricelist</td></tr><tr><td style="white-space:nowrap">810128<a name="moh-category-810128"> </a></td><td>Incision &amp; Drainage Of Quinsy Under G.A.</td></tr><tr><td style="white-space:nowrap">G29830<a name="moh-category-G29830"> </a></td><td>Arthroscopy (Diagnostic) Elbow</td></tr><tr><td style="white-space:nowrap">137226<a name="moh-category-137226"> </a></td><td>A D H D Scale</td></tr><tr><td style="white-space:nowrap">137228<a name="moh-category-137228"> </a></td><td>Brief Psychotherapy 6 Sessions</td></tr><tr><td style="white-space:nowrap">506020<a name="moh-category-506020"> </a></td><td>Direct Fungal Wet Mount</td></tr><tr><td style="white-space:nowrap">518150<a name="moh-category-518150"> </a></td><td>Beta Hcg</td></tr><tr><td style="white-space:nowrap">P-210<a name="moh-category-P-210"> </a></td><td>Tympanoplasty</td></tr><tr><td style="white-space:nowrap">650028A<a name="moh-category-650028A"> </a></td><td>Each Additional: Microcatheter</td></tr><tr><td style="white-space:nowrap">G29800<a name="moh-category-G29800"> </a></td><td>Arthroscopy (Diagnostic) TM joint</td></tr><tr><td style="white-space:nowrap">704038<a name="moh-category-704038"> </a></td><td>Pericoronal Flap Removal - Complex</td></tr><tr><td style="white-space:nowrap">810120<a name="moh-category-810120"> </a></td><td>Bronchoscopy</td></tr><tr><td style="white-space:nowrap">T74710<a name="moh-category-T74710"> </a></td><td>Pelvimetry - 2 Views</td></tr><tr><td style="white-space:nowrap">353-71.50<a name="moh-category-353-71.4650"> </a></td><td>Vulvectomy, radical</td></tr><tr><td style="white-space:nowrap">U86644<a name="moh-category-U86644"> </a></td><td>Cytomegalo Virus Screening-IGG</td></tr><tr><td style="white-space:nowrap">156-42.84<a name="moh-category-156-42.4684"> </a></td><td>Repair, fistula, esophageal, other</td></tr><tr><td style="white-space:nowrap">156-42.85<a name="moh-category-156-42.4685"> </a></td><td>Repair, esophageal, stricture</td></tr><tr><td style="white-space:nowrap">173046<a name="moh-category-173046"> </a></td><td>Dialyser</td></tr><tr><td style="white-space:nowrap">640068<a name="moh-category-640068"> </a></td><td>Intubasion - Elective</td></tr><tr><td style="white-space:nowrap">506002<a name="moh-category-506002"> </a></td><td>C &amp; S (Culture &amp; Sensitivity)</td></tr><tr><td style="white-space:nowrap">U86645<a name="moh-category-U86645"> </a></td><td>Cytomegalo Virus Screening-IGM</td></tr><tr><td style="white-space:nowrap">173048<a name="moh-category-173048"> </a></td><td>Sodium Bicarbonate ( Litre)</td></tr><tr><td style="white-space:nowrap">U86648<a name="moh-category-U86648"> </a></td><td>Diptheria Antitoxin</td></tr><tr><td style="white-space:nowrap">800814<a name="moh-category-800814"> </a></td><td>Gluocoma Cyclo Photo – Coagulation ( Cbc)</td></tr><tr><td style="white-space:nowrap">173042<a name="moh-category-173042"> </a></td><td>Permanent Peritoneal Cathetor</td></tr><tr><td style="white-space:nowrap">173044<a name="moh-category-173044"> </a></td><td>Acute Peritoneal Cathetor</td></tr><tr><td style="white-space:nowrap">840100<a name="moh-category-840100"> </a></td><td>Fracture Vetebrae</td></tr><tr><td style="white-space:nowrap">800812<a name="moh-category-800812"> </a></td><td>Conjunctival Revision (Inside Hospital)</td></tr><tr><td style="white-space:nowrap">650260<a name="moh-category-650260"> </a></td><td>Craniotomy And Excision Of Foramen Mangum Tumour</td></tr><tr><td style="white-space:nowrap">840106<a name="moh-category-840106"> </a></td><td>Removal K-Wires Without Incision Under G.A.</td></tr><tr><td style="white-space:nowrap">K57160<a name="moh-category-K57160"> </a></td><td>Insertion of Pessary</td></tr><tr><td style="white-space:nowrap">T76070<a name="moh-category-T76070"> </a></td><td>CT Bone Density Study</td></tr><tr><td style="white-space:nowrap">173040<a name="moh-category-173040"> </a></td><td>Central Venous Pressure Monitoring</td></tr><tr><td style="white-space:nowrap">840108<a name="moh-category-840108"> </a></td><td>Application Of Hip Spica Muga + Uii</td></tr><tr><td style="white-space:nowrap">1099698<a name="moh-category-1099698"> </a></td><td>Ang L-H 107-88.53 Angiocardiogram- left heart</td></tr><tr><td style="white-space:nowrap">303228<a name="moh-category-303228"> </a></td><td>Ct Virtual Bronchoscopy</td></tr><tr><td style="white-space:nowrap">1099697<a name="moh-category-1099697"> </a></td><td>Ang R-H 107-88.52 Angiocardiogram- right heart</td></tr><tr><td style="white-space:nowrap">1099696<a name="moh-category-1099696"> </a></td><td>Cath R&amp;L-H 107-37.23 Catheterization cardiac, combined right and left heart</td></tr><tr><td style="white-space:nowrap">650228<a name="moh-category-650228"> </a></td><td>Endoscopy For The Management Of Hydrocephalus</td></tr><tr><td style="white-space:nowrap">U86308<a name="moh-category-U86308"> </a></td><td>Monotest (Paul Bunnel Test)</td></tr><tr><td style="white-space:nowrap">1099695<a name="moh-category-1099695"> </a></td><td>Cath L-H 107-37.22 Catheterization cardiac, left heart</td></tr><tr><td style="white-space:nowrap">830072<a name="moh-category-830072"> </a></td><td>Cervical Polypectomy</td></tr><tr><td style="white-space:nowrap">1099694<a name="moh-category-1099694"> </a></td><td>Cath R-H 107-37.21 Catheterization cardiac, right heart</td></tr><tr><td style="white-space:nowrap">650226<a name="moh-category-650226"> </a></td><td>Ventriculo-Peritoneal Shunt Insertion</td></tr><tr><td style="white-space:nowrap">L95881<a name="moh-category-L95881"> </a></td><td>Developmental testing</td></tr><tr><td style="white-space:nowrap">830074<a name="moh-category-830074"> </a></td><td>Oophrectomy</td></tr><tr><td style="white-space:nowrap">650224<a name="moh-category-650224"> </a></td><td>Brachial Plexus Repair</td></tr><tr><td style="white-space:nowrap">750354<a name="moh-category-750354"> </a></td><td>Erbium Laser - Single Treatment (Skincare)</td></tr><tr><td style="white-space:nowrap">650222<a name="moh-category-650222"> </a></td><td>Release Of Carpal Tunnel Syndrome</td></tr><tr><td style="white-space:nowrap">208066<a name="moh-category-208066"> </a></td><td>Removal Of Skin Tag 4 To 10</td></tr><tr><td style="white-space:nowrap">704132<a name="moh-category-704132"> </a></td><td>Reduction Of Simple / Middle Face Fractures + Plating</td></tr><tr><td style="white-space:nowrap">L95883<a name="moh-category-L95883"> </a></td><td>Neuro Psychological Testing Battery</td></tr><tr><td style="white-space:nowrap">750352<a name="moh-category-750352"> </a></td><td>Laser Test (Skincare)</td></tr><tr><td style="white-space:nowrap">K57288<a name="moh-category-K57288"> </a></td><td>Sling Operation</td></tr><tr><td style="white-space:nowrap">208068<a name="moh-category-208068"> </a></td><td>Removal Of Skin Tag More Than 10</td></tr><tr><td style="white-space:nowrap">704130<a name="moh-category-704130"> </a></td><td>Reduction Of Fractured Zygomatic Arch</td></tr><tr><td style="white-space:nowrap">712080<a name="moh-category-712080"> </a></td><td>Treatment Plan - C</td></tr><tr><td style="white-space:nowrap">750034<a name="moh-category-750034"> </a></td><td>Hair Transplantation (500-600) Graft (Skincare)</td></tr><tr><td style="white-space:nowrap">140070<a name="moh-category-140070"> </a></td><td>Ercp - With Placement Of Stent</td></tr><tr><td style="white-space:nowrap">140072<a name="moh-category-140072"> </a></td><td>Ercp - With Nasobilliary Drainage Tube</td></tr><tr><td style="white-space:nowrap">140074<a name="moh-category-140074"> </a></td><td>Ercp - With Mechanical Lithotripsy</td></tr><tr><td style="white-space:nowrap">N97034<a name="moh-category-N97034"> </a></td><td>Contrast bath, each 15 minutes</td></tr><tr><td style="white-space:nowrap">140066<a name="moh-category-140066"> </a></td><td>Ercp - With Sphincterotomy With Or Without Removal Of Stone</td></tr><tr><td style="white-space:nowrap">N97035<a name="moh-category-N97035"> </a></td><td>Ultrasound, each 15 minutes</td></tr><tr><td style="white-space:nowrap">140068<a name="moh-category-140068"> </a></td><td>Ercp - With Use Of Retrieval Ballon</td></tr><tr><td style="white-space:nowrap">H94760<a name="moh-category-H94760"> </a></td><td>Pulse Oximetry</td></tr><tr><td style="white-space:nowrap">712082<a name="moh-category-712082"> </a></td><td>Treatment Plan - D</td></tr><tr><td style="white-space:nowrap">712084<a name="moh-category-712084"> </a></td><td>Treatment Plan - E</td></tr><tr><td style="white-space:nowrap">U86588<a name="moh-category-U86588"> </a></td><td>Smart Test (Strep A)</td></tr><tr><td style="white-space:nowrap">208060<a name="moh-category-208060"> </a></td><td>Testicular Puncture</td></tr><tr><td style="white-space:nowrap">E36450<a name="moh-category-E36450"> </a></td><td>Exchange transfusion</td></tr><tr><td style="white-space:nowrap">750360<a name="moh-category-750360"> </a></td><td>Erbium Laser - More Than Ten Pcs (Skincare)</td></tr><tr><td style="white-space:nowrap">U85250<a name="moh-category-U85250"> </a></td><td>Factor 9</td></tr><tr><td style="white-space:nowrap">750364<a name="moh-category-750364"> </a></td><td>Dye Laser Per Session Medium Area 5-10 Cm (Skincare)</td></tr><tr><td style="white-space:nowrap">WD9215<a name="moh-category-WD9215"> </a></td><td>Local Anaesthesia</td></tr><tr><td style="white-space:nowrap">750362<a name="moh-category-750362"> </a></td><td>Dye Laser Per Session Small Area 2-5 Cm (Skincare)</td></tr><tr><td style="white-space:nowrap">WD9210<a name="moh-category-WD9210"> </a></td><td>Dental Anaesthesia w/o Surgery</td></tr><tr><td style="white-space:nowrap">WD9211<a name="moh-category-WD9211"> </a></td><td>Regional Block Anaesthesia</td></tr><tr><td style="white-space:nowrap">712074<a name="moh-category-712074"> </a></td><td>Space Retainer Removable - Follow Up</td></tr><tr><td style="white-space:nowrap">712076<a name="moh-category-712076"> </a></td><td>Treatment Plan - A</td></tr><tr><td style="white-space:nowrap">T75710<a name="moh-category-T75710"> </a></td><td>Angiography - Extremity Unilateral</td></tr><tr><td style="white-space:nowrap">712070<a name="moh-category-712070"> </a></td><td>Space Retainer - Fixed</td></tr><tr><td style="white-space:nowrap">712072<a name="moh-category-712072"> </a></td><td>Space Retainer - Removable</td></tr><tr><td style="white-space:nowrap">U85246<a name="moh-category-U85246"> </a></td><td>Factor 8 Associated AG.</td></tr><tr><td style="white-space:nowrap">750358<a name="moh-category-750358"> </a></td><td>Erbium Laser - More Than Five Pcs (Skincare)</td></tr><tr><td style="white-space:nowrap">U85245<a name="moh-category-U85245"> </a></td><td>Factor 8 Ristocetin Cofactor</td></tr><tr><td style="white-space:nowrap">750356<a name="moh-category-750356"> </a></td><td>Erbium Laser - Less Than Three Pcs (Skincare)</td></tr><tr><td style="white-space:nowrap">712078<a name="moh-category-712078"> </a></td><td>Treatment Plan - B</td></tr><tr><td style="white-space:nowrap">T75716<a name="moh-category-T75716"> </a></td><td>Angiography - Extremity Bilateral</td></tr><tr><td style="white-space:nowrap">750332<a name="moh-category-750332"> </a></td><td>Liposuction Upper Back (Skincare)</td></tr><tr><td style="white-space:nowrap">750330<a name="moh-category-750330"> </a></td><td>Liposuction Lower Back (Skincare)</td></tr><tr><td style="white-space:nowrap">U85280<a name="moh-category-U85280"> </a></td><td>Factor 12</td></tr><tr><td style="white-space:nowrap">N97014<a name="moh-category-N97014"> </a></td><td>Electrical Stimulation (Unattended)</td></tr><tr><td style="white-space:nowrap">N97012<a name="moh-category-N97012"> </a></td><td>Traction, Mechanical</td></tr><tr><td style="white-space:nowrap">N97010<a name="moh-category-N97010"> </a></td><td>Application of modality to 1or more area;hot/cold pack</td></tr><tr><td style="white-space:nowrap">U88305<a name="moh-category-U88305"> </a></td><td>Gross and Micro Exam Level IV</td></tr><tr><td style="white-space:nowrap">750324<a name="moh-category-750324"> </a></td><td>Liposuction Gynocomastia - Large (Skincare)</td></tr><tr><td style="white-space:nowrap">U88304<a name="moh-category-U88304"> </a></td><td>Gross and Micro Exam Level III</td></tr><tr><td style="white-space:nowrap">750322<a name="moh-category-750322"> </a></td><td>Liposuction Gynocomastia - Medium (Skincare)</td></tr><tr><td style="white-space:nowrap">N97018<a name="moh-category-N97018"> </a></td><td>Paraffin Bath</td></tr><tr><td style="white-space:nowrap">750328<a name="moh-category-750328"> </a></td><td>Liposuction Buttock (Skincare)</td></tr><tr><td style="white-space:nowrap">U88309<a name="moh-category-U88309"> </a></td><td>Gross and Micro Exam Level VI</td></tr><tr><td style="white-space:nowrap">N97016<a name="moh-category-N97016"> </a></td><td>Vasopneumatic Devices</td></tr><tr><td style="white-space:nowrap">U88307<a name="moh-category-U88307"> </a></td><td>Gross and Micro Exam Level V</td></tr><tr><td style="white-space:nowrap">750326<a name="moh-category-750326"> </a></td><td>Liposuction Flanks (Skincare)</td></tr><tr><td style="white-space:nowrap">U85270<a name="moh-category-U85270"> </a></td><td>Factor 11</td></tr><tr><td style="white-space:nowrap">U88302<a name="moh-category-U88302"> </a></td><td>Gross and Micro Exam Level II</td></tr><tr><td style="white-space:nowrap">750342<a name="moh-category-750342"> </a></td><td>Full Abdominoplasty - Large (Skincare)</td></tr><tr><td style="white-space:nowrap">U88300<a name="moh-category-U88300"> </a></td><td>Histopathology (Frozen Section)</td></tr><tr><td style="white-space:nowrap">750340<a name="moh-category-750340"> </a></td><td>Full Abdominoplasty - Small (Skincare)</td></tr><tr><td style="white-space:nowrap">E39502<a name="moh-category-E39502"> </a></td><td>Paraesophageal hiatus hernia repair trans abdominal</td></tr><tr><td style="white-space:nowrap">N97026<a name="moh-category-N97026"> </a></td><td>Infra Red</td></tr><tr><td style="white-space:nowrap">N97024<a name="moh-category-N97024"> </a></td><td>Diathermy</td></tr><tr><td style="white-space:nowrap">N97022<a name="moh-category-N97022"> </a></td><td>Whirlpool</td></tr><tr><td style="white-space:nowrap">N97020<a name="moh-category-N97020"> </a></td><td>Microwave</td></tr><tr><td style="white-space:nowrap">750336<a name="moh-category-750336"> </a></td><td>Liposuction Chin (Skincare)</td></tr><tr><td style="white-space:nowrap">750334<a name="moh-category-750334"> </a></td><td>Liposuction Arms (Skincare)</td></tr><tr><td style="white-space:nowrap">750338<a name="moh-category-750338"> </a></td><td>Mini Abdominoplasty (Skincare)</td></tr><tr><td style="white-space:nowrap">N97028<a name="moh-category-N97028"> </a></td><td>Ultra Violet</td></tr><tr><td style="white-space:nowrap">840238<a name="moh-category-840238"> </a></td><td>Application Of Splints, Slabs, Pop Without Reduction</td></tr><tr><td style="white-space:nowrap">840236<a name="moh-category-840236"> </a></td><td>Removal Of F.B. Superficial</td></tr><tr><td style="white-space:nowrap">830030<a name="moh-category-830030"> </a></td><td>Polypectomy Fract. Curretage</td></tr><tr><td style="white-space:nowrap">750310<a name="moh-category-750310"> </a></td><td>Liposuction Lateral Thighs (Small-Medium) (Skincare)</td></tr><tr><td style="white-space:nowrap">T74440<a name="moh-category-T74440"> </a></td><td>Vasography</td></tr><tr><td style="white-space:nowrap">T73110<a name="moh-category-T73110"> </a></td><td>Wrist - 3 Views</td></tr><tr><td style="white-space:nowrap">830036<a name="moh-category-830036"> </a></td><td>Posterior Colpoperineorrhaphy</td></tr><tr><td style="white-space:nowrap">830038<a name="moh-category-830038"> </a></td><td>Anterior Colpoperineorrhaphy</td></tr><tr><td style="white-space:nowrap">830032<a name="moh-category-830032"> </a></td><td>Douglas Pouch Abscess Drainage</td></tr><tr><td style="white-space:nowrap">140030<a name="moh-category-140030"> </a></td><td>Sclerotherapy (Oesophagus)</td></tr><tr><td style="white-space:nowrap">140020<a name="moh-category-140020"> </a></td><td>Laryngo-Bronoscopy/Diagnostic</td></tr><tr><td style="white-space:nowrap">140022<a name="moh-category-140022"> </a></td><td>Laryngo-Bronoscopy/Diagnostic + Biopsy</td></tr><tr><td style="white-space:nowrap">750308<a name="moh-category-750308"> </a></td><td>Liposuction Abdomen -Large (Skincare)</td></tr><tr><td style="white-space:nowrap">140024<a name="moh-category-140024"> </a></td><td>Laryngo-Bronoscopy/Diagnostic + Film</td></tr><tr><td style="white-space:nowrap">830028<a name="moh-category-830028"> </a></td><td>Laparascopy (Not For Infertility Investigations) Diagnostic</td></tr><tr><td style="white-space:nowrap">T73100<a name="moh-category-T73100"> </a></td><td>Wrist - 2 Views</td></tr><tr><td style="white-space:nowrap">140026<a name="moh-category-140026"> </a></td><td>Colonoscopy</td></tr><tr><td style="white-space:nowrap">140028<a name="moh-category-140028"> </a></td><td>Endoscopy Under L.A.</td></tr><tr><td style="white-space:nowrap">840242<a name="moh-category-840242"> </a></td><td>Terminalisation</td></tr><tr><td style="white-space:nowrap">750302<a name="moh-category-750302"> </a></td><td>Liposuction (Skincare)</td></tr><tr><td style="white-space:nowrap">840240<a name="moh-category-840240"> </a></td><td>C.R. Of Fractures Or Dislocations Without Anaesthesia + Application Of Pop</td></tr><tr><td style="white-space:nowrap">840246<a name="moh-category-840246"> </a></td><td>O.R. + If Of Single Bone Except Fracture Neck, Femur, Torch, Fracture And Fractu</td></tr><tr><td style="white-space:nowrap">750306<a name="moh-category-750306"> </a></td><td>Liposuction Abdomen - Medium (Skincare)</td></tr><tr><td style="white-space:nowrap">712048<a name="moh-category-712048"> </a></td><td>Expansion Of Lower Mandible, Crozat Appliance</td></tr><tr><td style="white-space:nowrap">840244<a name="moh-category-840244"> </a></td><td>Wound Toilet &amp; Debridment</td></tr><tr><td style="white-space:nowrap">750304<a name="moh-category-750304"> </a></td><td>Liposuction Abdomen - Small (Skincare)</td></tr><tr><td style="white-space:nowrap">840248<a name="moh-category-840248"> </a></td><td>Cervical Disc Prolapse- Desectomy + Decompression</td></tr><tr><td style="white-space:nowrap">750320<a name="moh-category-750320"> </a></td><td>Liposuction Gynocomastia - Small (Skincare)</td></tr><tr><td style="white-space:nowrap">825180<a name="moh-category-825180"> </a></td><td>Pyeloplasty</td></tr><tr><td style="white-space:nowrap">830024<a name="moh-category-830024"> </a></td><td>Caesarian Delivery (With Normal Baby)</td></tr><tr><td style="white-space:nowrap">T74430<a name="moh-category-T74430"> </a></td><td>Cystography</td></tr><tr><td style="white-space:nowrap">G23410<a name="moh-category-G23410"> </a></td><td>Repair of rotator cuff</td></tr><tr><td style="white-space:nowrap">830026<a name="moh-category-830026"> </a></td><td>Shirodkar Suture</td></tr><tr><td style="white-space:nowrap">825182<a name="moh-category-825182"> </a></td><td>Removal Of Penile Prosthesis</td></tr><tr><td style="white-space:nowrap">302007<a name="moh-category-302007"> </a></td><td>Ultrasound Obstetric Level Iii</td></tr><tr><td style="white-space:nowrap">I69436<a name="moh-category-I69436"> </a></td><td>Gromet Sheppard vent tube, fluoroplastic</td></tr><tr><td style="white-space:nowrap">T73600<a name="moh-category-T73600"> </a></td><td>Ankle - 2 Views</td></tr><tr><td style="white-space:nowrap">640016<a name="moh-category-640016"> </a></td><td>Ptca (Per.Tr.Coronory Angioplasty) - Tv</td></tr><tr><td style="white-space:nowrap">U82088<a name="moh-category-U82088"> </a></td><td>Aldosterone</td></tr><tr><td style="white-space:nowrap">136006<a name="moh-category-136006"> </a></td><td>Air Mist Therapy</td></tr><tr><td style="white-space:nowrap">840168<a name="moh-category-840168"> </a></td><td>Benign Bone Tumours : Curretage Bone Grafting</td></tr><tr><td style="white-space:nowrap">U86668<a name="moh-category-U86668"> </a></td><td>Francisella Tularensis ABS.</td></tr><tr><td style="white-space:nowrap">T76938<a name="moh-category-T76938"> </a></td><td>Ultra Sound Guided Aspiration Cyst</td></tr><tr><td style="white-space:nowrap">640018<a name="moh-category-640018"> </a></td><td>Ptca (Per.Tr.Coronory Angioplasty - Sv + Stent</td></tr><tr><td style="white-space:nowrap">840166<a name="moh-category-840166"> </a></td><td>Arthroscopy Diagnostic + Proceed</td></tr><tr><td style="white-space:nowrap">750228<a name="moh-category-750228"> </a></td><td>Forehead Lift (Skincare)</td></tr><tr><td style="white-space:nowrap">U86663<a name="moh-category-U86663"> </a></td><td>EB Virus(Epstein Barr Virus) IGM IFA</td></tr><tr><td style="white-space:nowrap">650020B<a name="moh-category-650020B"> </a></td><td>Microcatheter</td></tr><tr><td style="white-space:nowrap">506018<a name="moh-category-506018"> </a></td><td>Glemsa Staining</td></tr><tr><td style="white-space:nowrap">506016<a name="moh-category-506016"> </a></td><td>Methylene Blue Staining</td></tr><tr><td style="white-space:nowrap">506014<a name="moh-category-506014"> </a></td><td>Acid Fast Staining</td></tr><tr><td style="white-space:nowrap">500067<a name="moh-category-500067"> </a></td><td>Electrolytes (Na, K, C1) Urine</td></tr><tr><td style="white-space:nowrap">P-208<a name="moh-category-P-208"> </a></td><td>Septoplasty</td></tr><tr><td style="white-space:nowrap">716026<a name="moh-category-716026"> </a></td><td>Relining Upper Or Lower Denture</td></tr><tr><td style="white-space:nowrap">P-209<a name="moh-category-P-209"> </a></td><td>Polypectomy</td></tr><tr><td style="white-space:nowrap">500066<a name="moh-category-500066"> </a></td><td>Sodium, Serum Or Urine</td></tr><tr><td style="white-space:nowrap">128012<a name="moh-category-128012"> </a></td><td>Broad Dynamic Comp Plate 7 Holes Each</td></tr><tr><td style="white-space:nowrap">716024<a name="moh-category-716024"> </a></td><td>Immediate Complete Dentures (Requiring Relining)</td></tr><tr><td style="white-space:nowrap">U84481<a name="moh-category-U84481"> </a></td><td>T3 (Free T3)</td></tr><tr><td style="white-space:nowrap">500064<a name="moh-category-500064"> </a></td><td>Total Co2</td></tr><tr><td style="white-space:nowrap">U84480<a name="moh-category-U84480"> </a></td><td>T3</td></tr><tr><td style="white-space:nowrap">128014<a name="moh-category-128014"> </a></td><td>Broad Dynamic Comp Plate 8 Holes Each</td></tr><tr><td style="white-space:nowrap">716022<a name="moh-category-716022"> </a></td><td>Additional Casted Clasp-Gold Or Metal</td></tr><tr><td style="white-space:nowrap">P-204<a name="moh-category-P-204"> </a></td><td>Sinus washout - Bilateral</td></tr><tr><td style="white-space:nowrap">716020<a name="moh-category-716020"> </a></td><td>Tooth Additional (Each)</td></tr><tr><td style="white-space:nowrap">500068<a name="moh-category-500068"> </a></td><td>Total Cholesterol</td></tr><tr><td style="white-space:nowrap">P-205<a name="moh-category-P-205"> </a></td><td>Removal of nasal foreign body</td></tr><tr><td style="white-space:nowrap">810118<a name="moh-category-810118"> </a></td><td>Esophagoscopy</td></tr><tr><td style="white-space:nowrap">500063<a name="moh-category-500063"> </a></td><td>Electrolytes (Na, K, C1) Serum</td></tr><tr><td style="white-space:nowrap">128016<a name="moh-category-128016"> </a></td><td>Broad Dynamic Comp Plate 9 Holes Each</td></tr><tr><td style="white-space:nowrap">500062<a name="moh-category-500062"> </a></td><td>Lipase</td></tr><tr><td style="white-space:nowrap">P-206<a name="moh-category-P-206"> </a></td><td>Tonsillectomy</td></tr><tr><td style="white-space:nowrap">P-207<a name="moh-category-P-207"> </a></td><td>Tonsillectomy &amp; Adenoidectomy</td></tr><tr><td style="white-space:nowrap">810304<a name="moh-category-810304"> </a></td><td>Total Laryngectomy</td></tr><tr><td style="white-space:nowrap">U84484<a name="moh-category-U84484"> </a></td><td>CDT ( Cardiac Troponin )</td></tr><tr><td style="white-space:nowrap">128018<a name="moh-category-128018"> </a></td><td>Broad Dynamic Comp Plate 12 Holes Each</td></tr><tr><td style="white-space:nowrap">800818<a name="moh-category-800818"> </a></td><td>Iol Repositioning ( Inside Hospital)</td></tr><tr><td style="white-space:nowrap">P-200<a name="moh-category-P-200"> </a></td><td>Laryngoscopy + Biopsy</td></tr><tr><td style="white-space:nowrap">800816<a name="moh-category-800816"> </a></td><td>Gluocoma Ext+ Drang Implant</td></tr><tr><td style="white-space:nowrap">P-201<a name="moh-category-P-201"> </a></td><td>Myringotomy and insertion of Gromet - Unilateral</td></tr><tr><td style="white-space:nowrap">110-37.91<a name="moh-category-110-37.4691"> </a></td><td>Massage, cardiac, open chest</td></tr><tr><td style="white-space:nowrap">P-202<a name="moh-category-P-202"> </a></td><td>Myringotomy and insertion of Gromet - Bilateral</td></tr><tr><td style="white-space:nowrap">P-203<a name="moh-category-P-203"> </a></td><td>Sinus washout - Unilateral</td></tr><tr><td style="white-space:nowrap">650036D<a name="moh-category-650036D"> </a></td><td>Detachable Balloon</td></tr><tr><td style="white-space:nowrap">128010<a name="moh-category-128010"> </a></td><td>Broad Dynamic Comp. Plate 6 Holes Each</td></tr><tr><td style="white-space:nowrap">N.2<a name="moh-category-N.462"> </a></td><td>NICU Second week (SR/Day) N.2 Exlusion as above</td></tr><tr><td style="white-space:nowrap">E38100<a name="moh-category-E38100"> </a></td><td>Splenectomy</td></tr><tr><td style="white-space:nowrap">830096<a name="moh-category-830096"> </a></td><td>Removal Of Circulage / Shirodkar Suture</td></tr><tr><td style="white-space:nowrap">N.1<a name="moh-category-N.461"> </a></td><td>NICU First week (SR/Day) N.1
* Medication above 350 SR per day as per SFDA price list, Blood &amp; blood products, MRI, CT, ECHO, Doppler , CRRT , Surgical and endoscopic procedure are  an excluded service
To get re-imbused for medication above the daily limit, submission must include a list of details medications as per SFDA codes and pricelist</td></tr><tr><td style="white-space:nowrap">640000<a name="moh-category-640000"> </a></td><td>Catheterization Left Heart</td></tr><tr><td style="white-space:nowrap">497-81.08<a name="moh-category-497-81.4608"> </a></td><td>Fusion,posterior,lumbar/lumbosacral</td></tr><tr><td style="white-space:nowrap">T93882<a name="moh-category-T93882"> </a></td><td>U/S Doppler Carotid Unilateral</td></tr><tr><td style="white-space:nowrap">N.4<a name="moh-category-N.464"> </a></td><td>NICU Fourth week (SR/Day) N.4  Exlusion as above</td></tr><tr><td style="white-space:nowrap">U83505<a name="moh-category-U83505"> </a></td><td>Hydroxyproline, Total</td></tr><tr><td style="white-space:nowrap">800158<a name="moh-category-800158"> </a></td><td>Unilateral Tarsal Strip With Graft</td></tr><tr><td style="white-space:nowrap">800156<a name="moh-category-800156"> </a></td><td>Bilateral Tarsal Strip</td></tr><tr><td style="white-space:nowrap">800150<a name="moh-category-800150"> </a></td><td>Unil. Levator Mus. Recession</td></tr><tr><td style="white-space:nowrap">303232<a name="moh-category-303232"> </a></td><td>Ct Carotid &amp; Vertebral Arteries Angiography</td></tr><tr><td style="white-space:nowrap">303230<a name="moh-category-303230"> </a></td><td>Ct Cerebral Arteries Angiography</td></tr><tr><td style="white-space:nowrap">137020<a name="moh-category-137020"> </a></td><td>Psychological Assessment- Category 2 - Ocd</td></tr><tr><td style="white-space:nowrap">U83500<a name="moh-category-U83500"> </a></td><td>Hydroxyproline, Free</td></tr><tr><td style="white-space:nowrap">800154<a name="moh-category-800154"> </a></td><td>Unilateral Tarsal Strip</td></tr><tr><td style="white-space:nowrap">303236<a name="moh-category-303236"> </a></td><td>Ct Pulmonary Arteries Angiography</td></tr><tr><td style="white-space:nowrap">800152<a name="moh-category-800152"> </a></td><td>Bil. Levator Mus. Recession</td></tr><tr><td style="white-space:nowrap">303234<a name="moh-category-303234"> </a></td><td>Ct Aorta &amp; Mesenteric Arteries Angiography</td></tr><tr><td style="white-space:nowrap">710026<a name="moh-category-710026"> </a></td><td>Periodontal Bone Grafting Implant/Bony Detect</td></tr><tr><td style="white-space:nowrap">T73090<a name="moh-category-T73090"> </a></td><td>ULNA Radius (Forearm) - 2 Views</td></tr><tr><td style="white-space:nowrap">830070<a name="moh-category-830070"> </a></td><td>Abdominal Sling For Congenital Prolapse</td></tr><tr><td style="white-space:nowrap">800124<a name="moh-category-800124"> </a></td><td>Eye Plastic Surgery</td></tr><tr><td style="white-space:nowrap">800122<a name="moh-category-800122"> </a></td><td>Trichiasis Repair (Both Eyes)</td></tr><tr><td style="white-space:nowrap">800128<a name="moh-category-800128"> </a></td><td>Repair Of Simple Lid+Explora</td></tr><tr><td style="white-space:nowrap">830076<a name="moh-category-830076"> </a></td><td>Removal Of Iucd Under Ga</td></tr><tr><td style="white-space:nowrap">750032<a name="moh-category-750032"> </a></td><td>Hair Transplantation (400-500) Graft (Skincare)</td></tr><tr><td style="white-space:nowrap">830078<a name="moh-category-830078"> </a></td><td>Salpingectomy / Salpingostomy</td></tr><tr><td style="white-space:nowrap">U82943<a name="moh-category-U82943"> </a></td><td>Glucagon (P)</td></tr><tr><td style="white-space:nowrap">U82947<a name="moh-category-U82947"> </a></td><td>Glucose Quantitative Blood /CSF</td></tr><tr><td style="white-space:nowrap">137022<a name="moh-category-137022"> </a></td><td>Psychological Assessment- Category 2 - Panic &amp; Phobia</td></tr><tr><td style="white-space:nowrap">650232<a name="moh-category-650232"> </a></td><td>Spinal Stenosis : Inter Laminar Decompression / Laminectomy With Discectomy</td></tr><tr><td style="white-space:nowrap">I92562<a name="moh-category-I92562"> </a></td><td>ABLB-Alternate Binaural Loudness Balance</td></tr><tr><td style="white-space:nowrap">710008<a name="moh-category-710008"> </a></td><td>Gingival Currettage - Per Quadrant</td></tr><tr><td style="white-space:nowrap">I92563<a name="moh-category-I92563"> </a></td><td>Tone decay test</td></tr><tr><td style="white-space:nowrap">830020<a name="moh-category-830020"> </a></td><td>Vacuum Delivery (With Normal Baby)</td></tr><tr><td style="white-space:nowrap">825184<a name="moh-category-825184"> </a></td><td>Repair Of Fracture Penis</td></tr><tr><td style="white-space:nowrap">830022<a name="moh-category-830022"> </a></td><td>Breech Delivery (With Normal Baby)</td></tr><tr><td style="white-space:nowrap">U85290<a name="moh-category-U85290"> </a></td><td>Factor 13</td></tr><tr><td style="white-space:nowrap">825186<a name="moh-category-825186"> </a></td><td>Repair Of Renal Injuries</td></tr><tr><td style="white-space:nowrap">825188<a name="moh-category-825188"> </a></td><td>Repair Of Ruptured Urethra Or Bladder</td></tr><tr><td style="white-space:nowrap">136008<a name="moh-category-136008"> </a></td><td>Breathing Exercise</td></tr></table></div>
  </text>
  <url value="http://nphies.sa/terminology/CodeSystem/moh-category"/>
  <version value="0.3.0"/>
  <name value="MOH_Category"/>
  <title value="MOH Category"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2025-06-23T22:09:21+03:00"/>
  <publisher value="HL7 Saudi Arabia"/>
  <contact>
    <name value="HL7 Saudi Arabia"/>
    <telecom>
      <system value="url"/>
      <value value="http://test-project.org/test-publisher"/>
    </telecom>
  </contact>
  <description value="These are MOH-specific billing codes."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="SA"/>
      <display value="Saudi Arabia"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Ministry of Health Saudi Arabia (https://www.moh.gov.sa)"/>
  <caseSensitive value="true"/>
  <compositional value="false"/>
  <versionNeeded value="false"/>
  <content value="fragment"/>
  <concept>
    <code value="650426"/>
    <display value="Release Of Carpal Tunnel Syndrom General Anaesthesia"/>
  </concept>
  <concept>
    <code value="506060"/>
    <display value="C &amp; S Prostrate"/>
  </concept>
  <concept>
    <code value="650424"/>
    <display value="Release Of Carpal Tunnel Syndrome Regional Anaesthesia"/>
  </concept>
  <concept>
    <code value="75-34.50"/>
    <display value="Pleurectomy"/>
  </concept>
  <concept>
    <code value="K57200"/>
    <display value="Suturing of Vaginal Tear"/>
  </concept>
  <concept>
    <code value="650422"/>
    <display value="Release Of Carpal Tunnel Syndrome Local Anaesthesia"/>
  </concept>
  <concept>
    <code value="518046"/>
    <display value="Vasopressin (Adh)"/>
  </concept>
  <concept>
    <code value="650420"/>
    <display value="Theco-Peritoneal Shunt"/>
  </concept>
  <concept>
    <code value="518048"/>
    <display value="5-Hiaa"/>
  </concept>
  <concept>
    <code value="U80172"/>
    <display value="Gold"/>
  </concept>
  <concept>
    <code value="T76020"/>
    <display value="Skeletal Survey"/>
  </concept>
  <concept>
    <code value="U80170"/>
    <display value="Gentamycin"/>
  </concept>
  <concept>
    <code value="518044"/>
    <display value="17-Ketosteriods, Urine"/>
  </concept>
  <concept>
    <code value="518086"/>
    <display value="Oestradiol"/>
  </concept>
  <concept>
    <code value="750906"/>
    <display
             value="Telengiectasia Treatment, Legs, Medium Area -Per Session (Skincare)"/>
  </concept>
  <concept>
    <code value="518088"/>
    <display value="Digoxin"/>
  </concept>
  <concept>
    <code value="650428"/>
    <display value="Release Of Ulnar Nerve Entrapment At Wrist"/>
  </concept>
  <concept>
    <code value="800026"/>
    <display value="Socket Reconstruction"/>
  </concept>
  <concept>
    <code value="518082"/>
    <display value="Ft3"/>
  </concept>
  <concept>
    <code value="U80168"/>
    <display value="Ethosuximide"/>
  </concept>
  <concept>
    <code value="518040"/>
    <display value="17-Hydroxycortisoteriods, Urine"/>
  </concept>
  <concept>
    <code value="518084"/>
    <display value="T B G"/>
  </concept>
  <concept>
    <code value="U80166"/>
    <display value="Doxepin"/>
  </concept>
  <concept>
    <code value="750908"/>
    <display
             value="Telengiectasia Treatment, Legs, Large Area -Per Session (Skincare)"/>
  </concept>
  <concept>
    <code value="U80164"/>
    <display value="Depakine Level (Valproic Acid)"/>
  </concept>
  <concept>
    <code value="518080"/>
    <display value="Chromosomal Analysis"/>
  </concept>
  <concept>
    <code value="800024"/>
    <display value="Thyroid Orbital Decompression (Both Eyes)"/>
  </concept>
  <concept>
    <code value="U84520"/>
    <display value="Bun"/>
  </concept>
  <concept>
    <code value="750902"/>
    <display value="Laser Facial Rejuvenation - Per Session (Skincare)"/>
  </concept>
  <concept>
    <code value="650430"/>
    <display value="Release Of Cubital Tunnel Syndrome"/>
  </concept>
  <concept>
    <code value="750904"/>
    <display
             value="Telengiectasia Treatment, Legs, Small Area -Per Session (Skincare)"/>
  </concept>
  <concept>
    <code value="E42420"/>
    <display value="Parotidectomy total"/>
  </concept>
  <concept>
    <code value="650416"/>
    <display value="Repair Of Meningomyelocele Major"/>
  </concept>
  <concept>
    <code value="800028"/>
    <display value="Enucl. With Hydroxy. Orbital"/>
  </concept>
  <concept>
    <code value="650414"/>
    <display value="Repair Of Meningomyelocele, Minor Defect"/>
  </concept>
  <concept>
    <code value="506068"/>
    <display value="C &amp; S Swine Flu (H1N1)"/>
  </concept>
  <concept>
    <code value="506066"/>
    <display value="C &amp; S Semen"/>
  </concept>
  <concept>
    <code value="75-34.02"/>
    <display value="Thoracotomy, exploratory"/>
  </concept>
  <concept>
    <code value="U82784"/>
    <display value="IGA/IGM/IGD/IGG"/>
  </concept>
  <concept>
    <code value="U82785"/>
    <display value="IGE"/>
  </concept>
  <concept>
    <code value="K57210"/>
    <display value="Colpo Perineorraphy"/>
  </concept>
  <concept>
    <code value="800022"/>
    <display value="Thyroid Orbital Decompression (One Eye)"/>
  </concept>
  <concept>
    <code value="650412"/>
    <display value="Posterior Fusion And Stabilization"/>
  </concept>
  <concept>
    <code value="202080"/>
    <display value="Long Term Care (Ltc) - Per Day Package"/>
  </concept>
  <concept>
    <code value="650410"/>
    <display
             value="Anterior Or Anterolateral Verteb, Resection And Stabilization"/>
  </concept>
  <concept>
    <code value="506062"/>
    <display value="Fern Test"/>
  </concept>
  <concept>
    <code value="U80162"/>
    <display value="Digoxin - Lanoxin"/>
  </concept>
  <concept>
    <code value="800020"/>
    <display value="Optic Nerve Sheath Fenes – Onsf"/>
  </concept>
  <concept>
    <code value="D92250"/>
    <display value="Fundus Photography with interpretation"/>
  </concept>
  <concept>
    <code value="518074"/>
    <display value="Insulin, Serum"/>
  </concept>
  <concept>
    <code value="506050"/>
    <display value="C &amp; S Umbilical"/>
  </concept>
  <concept>
    <code value="650418"/>
    <display value="Repair Of Occult Spinal Dysraphism"/>
  </concept>
  <concept>
    <code value="518038"/>
    <display value="Cortisol"/>
  </concept>
  <concept>
    <code value="518076"/>
    <display value="C-Peptide, Serum"/>
  </concept>
  <concept>
    <code value="518034"/>
    <display value="Vitamine D"/>
  </concept>
  <concept>
    <code value="518070"/>
    <display value="Vitamine B12, Serum"/>
  </concept>
  <concept>
    <code value="U80156"/>
    <display value="Tegretol Level - Carbamazipene"/>
  </concept>
  <concept>
    <code value="518036"/>
    <display value="Acth"/>
  </concept>
  <concept>
    <code value="518072"/>
    <display value="Haptoglobin"/>
  </concept>
  <concept>
    <code value="518030"/>
    <display value="Free T4"/>
  </concept>
  <concept>
    <code value="U80152"/>
    <display value="Amitriptyline"/>
  </concept>
  <concept>
    <code value="518032"/>
    <display value="Calcitonin"/>
  </concept>
  <concept>
    <code value="U84512"/>
    <display value="Triponin Qualitiative"/>
  </concept>
  <concept>
    <code value="750096"/>
    <display value="Patch Test (Skincare)"/>
  </concept>
  <concept>
    <code value="800034"/>
    <display value="Drill Of Hyder. Imp. With Artif."/>
  </concept>
  <concept>
    <code value="750094"/>
    <display value="Dermabrasion (Skincare)"/>
  </concept>
  <concept>
    <code value="506058"/>
    <display value="C &amp; S Conjunctiva"/>
  </concept>
  <concept>
    <code value="U84550"/>
    <display value="Uric Acid"/>
  </concept>
  <concept>
    <code value="750910"/>
    <display
             value="Telengiectasia Treatment, Face, Few Area -Per Session (Skincare)"/>
  </concept>
  <concept>
    <code value="650442"/>
    <display value="Old Perineural Nerve Repair"/>
  </concept>
  <concept>
    <code value="E49080"/>
    <display value="Peritoneal lavage"/>
  </concept>
  <concept>
    <code value="506056"/>
    <display value="C &amp; S Axilla"/>
  </concept>
  <concept>
    <code value="U80194"/>
    <display value="Quinidine"/>
  </concept>
  <concept>
    <code value="750912"/>
    <display
             value="Telengiectasia Treatment, Face, Multiple Area -Per Session (Skincare)"/>
  </concept>
  <concept>
    <code value="U80192"/>
    <display value="N-Acetylprocainamide"/>
  </concept>
  <concept>
    <code value="800032"/>
    <display value="Impl. Of Hydr. Orb. In Enucl."/>
  </concept>
  <concept>
    <code value="U80190"/>
    <display value="Procainamide"/>
  </concept>
  <concept>
    <code value="202090"/>
    <display value="Icu/Nicu/Picu Per Day Package"/>
  </concept>
  <concept>
    <code value="750092"/>
    <display value="Comedon Extraction - Large Area (Skincare)"/>
  </concept>
  <concept>
    <code value="U82775"/>
    <display value="Galactose-1-Phosphate-Uridyltransferase"/>
  </concept>
  <concept>
    <code value="750090"/>
    <display value="Comedon Extraction - Medium Area (Skincare)"/>
  </concept>
  <concept>
    <code value="U80188"/>
    <display value="Primidone"/>
  </concept>
  <concept>
    <code value="506054"/>
    <display value="C &amp; S Skin"/>
  </concept>
  <concept>
    <code value="U80186"/>
    <display value="Phenytoin - Free"/>
  </concept>
  <concept>
    <code value="U82776"/>
    <display value="Galactose-1-Phosphate"/>
  </concept>
  <concept>
    <code value="U80185"/>
    <display value="Phenytoin - Epanutin Level Total"/>
  </concept>
  <concept>
    <code value="U84545"/>
    <display value="Urea Clearance"/>
  </concept>
  <concept>
    <code value="800030"/>
    <display value="Implan. Of Reg. In Enuc. Evisc."/>
  </concept>
  <concept>
    <code value="650438"/>
    <display value="Interfasicular Repair"/>
  </concept>
  <concept>
    <code value="650436"/>
    <display value="Nerve Neurolysis"/>
  </concept>
  <concept>
    <code value="506052"/>
    <display value="C &amp; S Rectal"/>
  </concept>
  <concept>
    <code value="650434"/>
    <display value="Surgery For Unusual Nerve Entrapment Or Injury"/>
  </concept>
  <concept>
    <code value="U84540"/>
    <display value="Urine Urea Nitrogen"/>
  </concept>
  <concept>
    <code value="650404"/>
    <display value="Excision Of Lesions Intraspinal Intradural – Lumbar"/>
  </concept>
  <concept>
    <code value="650432"/>
    <display value="Brachial Plexus Decompression"/>
  </concept>
  <concept>
    <code value="U80184"/>
    <display value="Phenobarbital - Gardinal Level"/>
  </concept>
  <concept>
    <code value="650402"/>
    <display value="Excision Of Lesions Intraspinal Extradural – Cervical"/>
  </concept>
  <concept>
    <code value="518096"/>
    <display value="Trypsin"/>
  </concept>
  <concept>
    <code value="650400"/>
    <display value="Excision Of Lesions Intraspinal Extradural – Dorsal"/>
  </concept>
  <concept>
    <code value="518098"/>
    <display value="Carbamazepine (Tegretol)"/>
  </concept>
  <concept>
    <code value="518068"/>
    <display value="Folic Acid, Serum"/>
  </concept>
  <concept>
    <code value="518092"/>
    <display value="Dibucaine Inhibition Of Pseudocholinesterase"/>
  </concept>
  <concept>
    <code value="U80150"/>
    <display value="Amikacin"/>
  </concept>
  <concept>
    <code value="D92235"/>
    <display value="Flouroscene Angiography"/>
  </concept>
  <concept>
    <code value="518064"/>
    <display value="Tranferritin, Serum"/>
  </concept>
  <concept>
    <code value="U80178"/>
    <display value="Lithium level"/>
  </concept>
  <concept>
    <code value="650408"/>
    <display value="Excision Of Lesions Intraspinal Intradural – Cervical"/>
  </concept>
  <concept>
    <code value="U80176"/>
    <display value="Lidocaine"/>
  </concept>
  <concept>
    <code value="518066"/>
    <display value="Ferritin, Serum"/>
  </concept>
  <concept>
    <code value="U80174"/>
    <display value="Imipramine"/>
  </concept>
  <concept>
    <code value="650406"/>
    <display value="Excision Of Lesions Intraspinal Intradural – Dorsal"/>
  </concept>
  <concept>
    <code value="518090"/>
    <display value="Cystic Fibrosis"/>
  </concept>
  <concept>
    <code value="518060"/>
    <display value="Alpha-Fetoprotein"/>
  </concept>
  <concept>
    <code value="650440"/>
    <display value="Direct Perineural Nerve Repair"/>
  </concept>
  <concept>
    <code value="800004"/>
    <display value="Orbital Tumour Biopsy+Histopathology Analysis"/>
  </concept>
  <concept>
    <code value="518062"/>
    <display value="Carcinembryonic Antigen (Cea)"/>
  </concept>
  <concept>
    <code value="800002"/>
    <display value="Orbital Exploration"/>
  </concept>
  <concept>
    <code value="800008"/>
    <display value="Reconstruction Of Orbital Base Fracture"/>
  </concept>
  <concept>
    <code value="800006"/>
    <display value="Orbital Tumour Excision+Histopathology Analysis"/>
  </concept>
  <concept>
    <code value="710002"/>
    <display value="Polishing Of Teeth (Prophylaxis)"/>
  </concept>
  <concept>
    <code value="704098"/>
    <display value="Periodontal Root Planning (Less Than 6 Teeth)"/>
  </concept>
  <concept>
    <code value="710006"/>
    <display value="Oral Prophylaxis: With Flouride (2 Visits-Children"/>
  </concept>
  <concept>
    <code value="710004"/>
    <display value="Scaling &amp; Polishing"/>
  </concept>
  <concept>
    <code value="704096"/>
    <display value="Periodontal Root Planning (Entire Mouth)"/>
  </concept>
  <concept>
    <code value="T74290"/>
    <display value="Oral Cholecystogram/Gall Bladder"/>
  </concept>
  <concept>
    <code value="716084"/>
    <display
             value="Adding Tooth To Partial Denture To Replace Extracted Tooth-Each Tooth(Not Involv"/>
  </concept>
  <concept>
    <code value="518056"/>
    <display value="Metanephrines, Urine"/>
  </concept>
  <concept>
    <code value="518058"/>
    <display value="Catecholanines, 24 Hours Urine"/>
  </concept>
  <concept>
    <code value="460298"/>
    <display value="Dp-Oto-Ecuastic Emission"/>
  </concept>
  <concept>
    <code value="716082"/>
    <display
             value="Repair Of Broken Complete Or Partial Denture - No Teeth Damaged"/>
  </concept>
  <concept>
    <code value="518052"/>
    <display value="Vanillymandelic Acid (Vma), Urine"/>
  </concept>
  <concept>
    <code value="460296"/>
    <display value="Follow Up Tympanometry"/>
  </concept>
  <concept>
    <code value="518054"/>
    <display value="Homovanillic Acid Urine"/>
  </concept>
  <concept>
    <code value="716080"/>
    <display value="Paratial Denture Adjustment"/>
  </concept>
  <concept>
    <code value="800014"/>
    <display value="Enucleation Or Evisceration=Prosth.Implant"/>
  </concept>
  <concept>
    <code value="825246"/>
    <display value="Penile Prosthesis With Implant (Malleable)"/>
  </concept>
  <concept>
    <code value="108-35.50"/>
    <display value="Repair, septa, atrial and ventricular, with prosthesis"/>
  </concept>
  <concept>
    <code value="800012"/>
    <display value="Enucleation Or Evisceration Of Eye Ball"/>
  </concept>
  <concept>
    <code value="825248"/>
    <display value="Penilse Prosthesis With Implant (Inflatable)"/>
  </concept>
  <concept>
    <code value="518050"/>
    <display value="Human Growth Hormone"/>
  </concept>
  <concept>
    <code value="308-58.93"/>
    <display value="Implantation, artificial urinary sphincter"/>
  </concept>
  <concept>
    <code value="800018"/>
    <display value="Posterior Orbital Tumour"/>
  </concept>
  <concept>
    <code value="716088"/>
    <display
             value="Chair - Side Relining (Complete Denture)Chair - Side Relining (Complete Denture)"/>
  </concept>
  <concept>
    <code value="716086"/>
    <display
             value="Adding Tooth To Partial Denture To Replace Extracted Tooth(Involving Clasp Or Ab"/>
  </concept>
  <concept>
    <code value="800016"/>
    <display value="Posterior Orbital Exploration"/>
  </concept>
  <concept>
    <code value="704094"/>
    <display value="Membrane / Bone Grafts - Per Tooth"/>
  </concept>
  <concept>
    <code value="800010"/>
    <display value="Exentration"/>
  </concept>
  <concept>
    <code value="704092"/>
    <display value="Gingivectomy And Treatment (Fewer Than 5 Teeth)"/>
  </concept>
  <concept>
    <code value="825240"/>
    <display value="Diverticulectomy"/>
  </concept>
  <concept>
    <code value="704090"/>
    <display value="Gingivectomy Or Gingioplasty - Per Quadrant"/>
  </concept>
  <concept>
    <code value="825242"/>
    <display value="Urs &amp; Stone Extraction"/>
  </concept>
  <concept>
    <code value="825244"/>
    <display value="Cystoscopy + Removal Of Djs Under G.A."/>
  </concept>
  <concept>
    <code value="G29870"/>
    <display value="Arthroscopy (Diagnostic) Knee"/>
  </concept>
  <concept>
    <code value="E43621"/>
    <display value="Subtotal gastrectomy"/>
  </concept>
  <concept>
    <code value="716072"/>
    <display
             value="Upper Chrome Cobalt Partial Denture (1-3 Teeth / Unilateral)"/>
  </concept>
  <concept>
    <code value="704058"/>
    <display value="Vestibuloplasty/Sulcus Deepening (Per Jaw)"/>
  </concept>
  <concept>
    <code value="716070"/>
    <display value="Acrylic Partial Denture (4-7 Teeth)"/>
  </concept>
  <concept>
    <code value="704056"/>
    <display value="Removal Of Lorus Palatinus Or Mandibularis"/>
  </concept>
  <concept>
    <code value="518196"/>
    <display value="Galactose 1 Phosphate Uridyltrasferase (Quantative"/>
  </concept>
  <concept>
    <code value="810102"/>
    <display value="Microlaryngoscopy"/>
  </concept>
  <concept>
    <code value="518198"/>
    <display value="Ionized Calcium"/>
  </concept>
  <concept>
    <code value="704054"/>
    <display value="Post Extraction Complication:Dressing (Opd)"/>
  </concept>
  <concept>
    <code value="518192"/>
    <display value="Galactosemia Screening"/>
  </concept>
  <concept>
    <code value="810104"/>
    <display value="Microlaryngosurgery"/>
  </concept>
  <concept>
    <code value="825236"/>
    <display value="Epididymectomy"/>
  </concept>
  <concept>
    <code value="704052"/>
    <display value="Post Surgical Extraction:Drsyspicules Removal"/>
  </concept>
  <concept>
    <code value="716078"/>
    <display value="Complete Denture Adjustment"/>
  </concept>
  <concept>
    <code value="518194"/>
    <display value="Amino Acid Screening"/>
  </concept>
  <concept>
    <code value="810106"/>
    <display value="Larynx Laser Surgery"/>
  </concept>
  <concept>
    <code value="825238"/>
    <display value="Cystoscopy And Lithlapexy"/>
  </concept>
  <concept>
    <code value="716040"/>
    <display value="Chrome Cobalt Partial 4-7 Teeth"/>
  </concept>
  <concept>
    <code value="716076"/>
    <display value="Bite Guard (Bite Raising Appliance)"/>
  </concept>
  <concept>
    <code value="108-35.42"/>
    <display value="Creation, septal defect, in heart"/>
  </concept>
  <concept>
    <code value="108-35.91"/>
    <display value="Transposition, interatrial, venous return"/>
  </concept>
  <concept>
    <code value="716074"/>
    <display
             value="Upper Chrome Cobalt Partial Denture (3 Or More Teeth Bilateral)"/>
  </concept>
  <concept>
    <code value="108-35.92"/>
    <display value="Creation, conduit, between right ventricle,"/>
  </concept>
  <concept>
    <code value="501-81.22"/>
    <display value="Arthrodesis,knee"/>
  </concept>
  <concept>
    <code value="U84630"/>
    <display value="Zinc"/>
  </concept>
  <concept>
    <code value="108-35.93"/>
    <display value="Creation, conduit, between left ventricle,"/>
  </concept>
  <concept>
    <code value="825230"/>
    <display value="Vasal Reversal"/>
  </concept>
  <concept>
    <code value="825232"/>
    <display value="Vasoepididymostomy"/>
  </concept>
  <concept>
    <code value="716048"/>
    <display value="Porcelain Set For Complete Dentures (Additional)"/>
  </concept>
  <concept>
    <code value="825234"/>
    <display value="Vasovasostomy"/>
  </concept>
  <concept>
    <code value="108-35.94"/>
    <display value="Creation, conduit, between atrium,"/>
  </concept>
  <concept>
    <code value="460276"/>
    <display value="Foreign Body Removal L.A. (Throat)"/>
  </concept>
  <concept>
    <code value="460274"/>
    <display value="Incision + Drainage Of Quinzy (L.A)"/>
  </concept>
  <concept>
    <code value="H94240"/>
    <display value="Lung Volume - Helium Dilution"/>
  </concept>
  <concept>
    <code value="460278"/>
    <display value="Fine Needle Aspiration Cytology"/>
  </concept>
  <concept>
    <code value="108-35.95"/>
    <display value="Revision, corrective procedure, heart"/>
  </concept>
  <concept>
    <code value="460280"/>
    <display value="Somnoplasty Tounge - Clinic (1St Stage)"/>
  </concept>
  <concept>
    <code value="716046"/>
    <display value="Other Corrective Procedures (Per 1/4 Hour)"/>
  </concept>
  <concept>
    <code value="825224"/>
    <display value="Repair Of Urethral Injuries"/>
  </concept>
  <concept>
    <code value="716044"/>
    <display value="Ceka Attachment Per Piece"/>
  </concept>
  <concept>
    <code value="U82009"/>
    <display value="Acetone Total"/>
  </concept>
  <concept>
    <code value="825226"/>
    <display value="Urethroplasty One Stage"/>
  </concept>
  <concept>
    <code value="500004"/>
    <display value="Glucose (Serum) Random"/>
  </concept>
  <concept>
    <code value="460284"/>
    <display value="Pure Tone Audiometry (Air &amp; Bone)"/>
  </concept>
  <concept>
    <code value="825228"/>
    <display value="Urethroplasty Two Stages"/>
  </concept>
  <concept>
    <code value="716042"/>
    <display value="Chrome Cobalt Partial 8-12 Teeth"/>
  </concept>
  <concept>
    <code value="108-35.31"/>
    <display value="Operation, papillary muscle"/>
  </concept>
  <concept>
    <code value="500002"/>
    <display value="Glucose (Serum) Fasting"/>
  </concept>
  <concept>
    <code value="108-35.32"/>
    <display value="Operation, Chordae tendinae"/>
  </concept>
  <concept>
    <code value="460282"/>
    <display value="Somnoplasty Tounge - Clinic (2Nd Stage)"/>
  </concept>
  <concept>
    <code value="704050"/>
    <display value="Alveolectomy (Per Quadrant)"/>
  </concept>
  <concept>
    <code value="L90810"/>
    <display value="Psychotheraphy Interactive"/>
  </concept>
  <concept>
    <code value="810110"/>
    <display value="Laser Tonsillectomy"/>
  </concept>
  <concept>
    <code value="137202"/>
    <display value="Child Anxiety Manifest Level"/>
  </concept>
  <concept>
    <code value="704068"/>
    <display value="Surgical Exposure Of Impacted Or Unerrupted Tooth"/>
  </concept>
  <concept>
    <code value="825220"/>
    <display value="Radical Prostatectomy"/>
  </concept>
  <concept>
    <code value="810112"/>
    <display value="Tonsillectomy"/>
  </concept>
  <concept>
    <code value="825222"/>
    <display value="Repair Of Hypospadias Two Stages"/>
  </concept>
  <concept>
    <code value="704066"/>
    <display value="Tooth Extraction Additional Each + L.A.."/>
  </concept>
  <concept>
    <code value="137208"/>
    <display value="Mmpi Sub Scale"/>
  </concept>
  <concept>
    <code value="36-14.27"/>
    <display value="Destruction, chorioretinal lesion, adiation sources"/>
  </concept>
  <concept>
    <code value="137204"/>
    <display value="Child Behaviour Check List"/>
  </concept>
  <concept>
    <code value="G29894"/>
    <display value="Arthroscopy (Diagnostic) Ankle"/>
  </concept>
  <concept>
    <code value="810114"/>
    <display value="Pan-Endoscopy (Triple Procedure)"/>
  </concept>
  <concept>
    <code value="137206"/>
    <display value="Middle Sex Scale"/>
  </concept>
  <concept>
    <code value="36-14.26"/>
    <display value="Destruction, chorioretinal lesion, by radiation therapy"/>
  </concept>
  <concept>
    <code value="716094"/>
    <display value="Laboratory Relining (Partial Denture)"/>
  </concept>
  <concept>
    <code value="704064"/>
    <display value="Alveolar Ridge Grafting Per Jaw"/>
  </concept>
  <concept>
    <code value="460288"/>
    <display value="Tone Decay Test"/>
  </concept>
  <concept>
    <code value="810116"/>
    <display value="Hypopharyngoscopy &amp; Foreign Body Removal"/>
  </concept>
  <concept>
    <code value="716092"/>
    <display value="Laboratory Relining (Complete Denture)"/>
  </concept>
  <concept>
    <code value="704062"/>
    <display value="Other Undefined Surgical Procedures Per 15 Minutes"/>
  </concept>
  <concept>
    <code value="460286"/>
    <display value="Follow Up Pure Tone Audiometry (Air &amp; Bone)"/>
  </concept>
  <concept>
    <code value="T76770"/>
    <display value="Ultra Sound - Retroperitoneal"/>
  </concept>
  <concept>
    <code value="L96100"/>
    <display value="Psychological Test"/>
  </concept>
  <concept>
    <code value="108-35.80"/>
    <display value="Repair, total, certain congenital cardiac anomalies"/>
  </concept>
  <concept>
    <code value="716036"/>
    <display value="Chrome Cobalt Full Denture: Upper And Lower"/>
  </concept>
  <concept>
    <code value="716090"/>
    <display value="Chair - Side Relining (Partial Denture)"/>
  </concept>
  <concept>
    <code value="716034"/>
    <display value="Rebasing (Upper Or Lower)"/>
  </concept>
  <concept>
    <code value="X1005"/>
    <display value="Ventilator Per Day"/>
  </concept>
  <concept>
    <code value="460290"/>
    <display value="Ablb"/>
  </concept>
  <concept>
    <code value="716032"/>
    <display value="Changing Teeth In Old Chrome - Partial"/>
  </concept>
  <concept>
    <code value="825214"/>
    <display value="Iliocystoplasty"/>
  </concept>
  <concept>
    <code value="X1004"/>
    <display value="Oxy Hood Per Day"/>
  </concept>
  <concept>
    <code value="L90804"/>
    <display value="Individual psycho therapy insight oriented"/>
  </concept>
  <concept>
    <code value="X1003"/>
    <display value="Mist Tent Per Day"/>
  </concept>
  <concept>
    <code value="716030"/>
    <display value="Splints/Guards"/>
  </concept>
  <concept>
    <code value="U80299"/>
    <display value="Amphotericin B Level"/>
  </concept>
  <concept>
    <code value="X1002"/>
    <display value="Oxygen Inhalation Per Day"/>
  </concept>
  <concept>
    <code value="X1001"/>
    <display value="Oxygen Inhalation - Per Hour X1001"/>
  </concept>
  <concept>
    <code value="825216"/>
    <display value="Insertion Of Penile Prothesis"/>
  </concept>
  <concept>
    <code value="704060"/>
    <display value="Apicoectomy (Per Tooth Excluding Rct)"/>
  </concept>
  <concept>
    <code value="716098"/>
    <display
             value="Lower Chrome Cobalt Partial Denture (3 Or More Teeth / Bilateral)"/>
  </concept>
  <concept>
    <code value="810108"/>
    <display value="Adenoidectomy"/>
  </concept>
  <concept>
    <code value="460294"/>
    <display value="Audiological Assessment"/>
  </concept>
  <concept>
    <code value="716038"/>
    <display value="Chrome Cobalt Partial 1-3 Teeth"/>
  </concept>
  <concept>
    <code value="825218"/>
    <display value="Radical Cystectomy"/>
  </concept>
  <concept>
    <code value="148-46.92"/>
    <display value="Myotomy, colon, other parts"/>
  </concept>
  <concept>
    <code value="716096"/>
    <display
             value="Lower Chrome Cobalt Partial Denture (1-3 Teeth / Unilateral)"/>
  </concept>
  <concept>
    <code value="460292"/>
    <display value="Strenger Test"/>
  </concept>
  <concept>
    <code value="512002"/>
    <display value="Hemoglobin Electrophoresis"/>
  </concept>
  <concept>
    <code value="137212"/>
    <display value="Beck Depression Inventory"/>
  </concept>
  <concept>
    <code value="704078"/>
    <display value="Ridge Extension (Augmentation Per Arch)"/>
  </concept>
  <concept>
    <code value="137214"/>
    <display value="Performance Anxiety Scale"/>
  </concept>
  <concept>
    <code value="825210"/>
    <display value="Excision Of Ureterocele And Reimplantation Of Ureter"/>
  </concept>
  <concept>
    <code value="704076"/>
    <display value="Biopsy Of Extra Oral Tissues"/>
  </concept>
  <concept>
    <code value="137210"/>
    <display value="Self Esteem Inventory"/>
  </concept>
  <concept>
    <code value="704074"/>
    <display value="Biopsy Of Oral Tissue (Soft)"/>
  </concept>
  <concept>
    <code value="825212"/>
    <display value="Ileal Ureter"/>
  </concept>
  <concept>
    <code value="512004"/>
    <display value="Protein Electrophoresis (Serum, Csf, Urine)"/>
  </concept>
  <concept>
    <code value="716062"/>
    <display value="Denture - Complete Lower (Chrome Cobbalt)"/>
  </concept>
  <concept>
    <code value="128100"/>
    <display value="Schanz Screw"/>
  </concept>
  <concept>
    <code value="500018"/>
    <display value="Creatinine Urine (Random)"/>
  </concept>
  <concept>
    <code value="128102"/>
    <display value="Malleolar Screw"/>
  </concept>
  <concept>
    <code value="716060"/>
    <display value="Denture - Complete Upper (Chrome Cobbalt)"/>
  </concept>
  <concept>
    <code value="I92590"/>
    <display value="Hearing Aid adjustment &amp; Evaluation Unilateral"/>
  </concept>
  <concept>
    <code value="800758"/>
    <display value="Laser Trabeculoplasty"/>
  </concept>
  <concept>
    <code value="128104"/>
    <display value="Partial Hip - Thomson Hip Prothesis"/>
  </concept>
  <concept>
    <code value="108-35.70"/>
    <display value="Repair, septa, atrial, ventricular, unspecified"/>
  </concept>
  <concept>
    <code value="I92591"/>
    <display value="Hearing aid Adjustment &amp; Evaluation Bilateral"/>
  </concept>
  <concept>
    <code value="800762"/>
    <display value="Photo. Kera. Astigm - Pak Vizx"/>
  </concept>
  <concept>
    <code value="128106"/>
    <display value="Penning Mini External Fixator"/>
  </concept>
  <concept>
    <code value="500022"/>
    <display value="Uric Acid (Serum)"/>
  </concept>
  <concept>
    <code value="850240"/>
    <display value="Laparascopic Salpingo-Oophorectomy (Bilateral)"/>
  </concept>
  <concept>
    <code value="800760"/>
    <display value="Phototherapeutic Keratectomy (P.T.K.) One Eye"/>
  </concept>
  <concept>
    <code value="850242"/>
    <display
             value="Diagnostic Laparascopy + New Ostia Of Fallopian Tube (Unilateral)"/>
  </concept>
  <concept>
    <code value="716068"/>
    <display value="Acrylic Partial Denture (1-3 Teeth)"/>
  </concept>
  <concept>
    <code value="850244"/>
    <display
             value="Diagnostic Laparascopy + New Ostia Of Fallopian Tube (Bilateral)"/>
  </concept>
  <concept>
    <code value="T73700"/>
    <display value="CT LO EXT without Contrast"/>
  </concept>
  <concept>
    <code value="500020"/>
    <display value="Creatinine Clearance"/>
  </concept>
  <concept>
    <code value="500027"/>
    <display value="Globulin"/>
  </concept>
  <concept>
    <code value="716066"/>
    <display value="Denture - Immediate Lower Complete"/>
  </concept>
  <concept>
    <code value="500026"/>
    <display value="Albumin"/>
  </concept>
  <concept>
    <code value="716064"/>
    <display value="Denture - Immediate Uper Complete"/>
  </concept>
  <concept>
    <code value="640020"/>
    <display value="Ptca (Per.Tr.Coronory Angioplasty) - Sv +2 Stents"/>
  </concept>
  <concept>
    <code value="500024"/>
    <display value="Total Protein, Serum"/>
  </concept>
  <concept>
    <code value="K59025"/>
    <display value="CTG less than an hour"/>
  </concept>
  <concept>
    <code value="704072"/>
    <display value="Biopsy Of Oral Tissue (Hard)"/>
  </concept>
  <concept>
    <code value="T73701"/>
    <display value="CT Scan Knee Lower Ext with Contrast"/>
  </concept>
  <concept>
    <code value="850236"/>
    <display value="Laparascopic Checking Of Tubal Patency"/>
  </concept>
  <concept>
    <code value="K57240"/>
    <display value="Anterior Colporrhapy &amp; Repair Cystocele"/>
  </concept>
  <concept>
    <code value="850238"/>
    <display value="Laparascopic Salpingo-Oophorectomy (Unilateral)"/>
  </concept>
  <concept>
    <code value="H43450"/>
    <display value="Oesophageal Dilation"/>
  </concept>
  <concept>
    <code value="110-37.12"/>
    <display value="Pericardiotomy"/>
  </concept>
  <concept>
    <code value="810220"/>
    <display value="Labyrinthectomy"/>
  </concept>
  <concept>
    <code value="640022"/>
    <display value="Ptca (Per.Tr.Coronory Angioplasty) - Dv + Stent"/>
  </concept>
  <concept>
    <code value="650018C"/>
    <display value="Microguide Wire"/>
  </concept>
  <concept>
    <code value="U85384"/>
    <display value="Fibrinogen"/>
  </concept>
  <concept>
    <code value="750074"/>
    <display value="Electro Cautery - Multiple Lesion (Skincare)"/>
  </concept>
  <concept>
    <code value="750232"/>
    <display value="Brow Lift (Skincare)"/>
  </concept>
  <concept>
    <code value="810222"/>
    <display value="Vestibular Neurectomy"/>
  </concept>
  <concept>
    <code value="750072"/>
    <display value="Electro Cautery - Few Lesion (Skincare)"/>
  </concept>
  <concept>
    <code value="810224"/>
    <display value="Facial Nerve Surgery"/>
  </concept>
  <concept>
    <code value="110014"/>
    <display value="Orthofix Rental (Per Day)"/>
  </concept>
  <concept>
    <code value="810226"/>
    <display value="Ossiculoplasty"/>
  </concept>
  <concept>
    <code value="300226"/>
    <display value="Thyroid Imaging"/>
  </concept>
  <concept>
    <code value="110012"/>
    <display value="Orthofix"/>
  </concept>
  <concept>
    <code value="650018A"/>
    <display value="Each Additional : Coil"/>
  </concept>
  <concept>
    <code value="I69210"/>
    <display value="Ear Wash"/>
  </concept>
  <concept>
    <code value="650018B"/>
    <display value="Microcatheter"/>
  </concept>
  <concept>
    <code value="300224"/>
    <display value="X-Ray Film Copy Cash (Nett) Each"/>
  </concept>
  <concept>
    <code value="38-12.14"/>
    <display value="Subtotal or complete iridectomy for melanoma"/>
  </concept>
  <concept>
    <code value="704014"/>
    <display value="Surgical Extraction - Complex (Bone Removal)"/>
  </concept>
  <concept>
    <code value="D92283"/>
    <display value="Color vision exam"/>
  </concept>
  <concept>
    <code value="750070"/>
    <display value="Electrolysis Per Session (Skincare)"/>
  </concept>
  <concept>
    <code value="650026A"/>
    <display value="Each Additional : Coil"/>
  </concept>
  <concept>
    <code value="202004"/>
    <display value="Private Room Per Day"/>
  </concept>
  <concept>
    <code value="202002"/>
    <display value="Suite Room Per Day"/>
  </concept>
  <concept>
    <code value="650026B"/>
    <display value="Microcatheter"/>
  </concept>
  <concept>
    <code value="704012"/>
    <display value="Surgical Extraction - Simple"/>
  </concept>
  <concept>
    <code value="304032"/>
    <display value="Colour Doppler Sonography Breast (Two)"/>
  </concept>
  <concept>
    <code value="650026C"/>
    <display value="Microguide Wire"/>
  </concept>
  <concept>
    <code value="704010"/>
    <display value="Removal Of Teeth (Soft Tissue) + La"/>
  </concept>
  <concept>
    <code value="304030"/>
    <display value="Colour Doppler Sonography Breast (One)"/>
  </concept>
  <concept>
    <code value="524008"/>
    <display value="Anti Sperm Antibody"/>
  </concept>
  <concept>
    <code value="704018"/>
    <display value="Removal Of Teeth (Completely Bony) + L.A."/>
  </concept>
  <concept>
    <code value="810140"/>
    <display value="Cleft Palate Repair"/>
  </concept>
  <concept>
    <code value="704016"/>
    <display value="Removal Of Teeth (Partially Bony) + L.A."/>
  </concept>
  <concept>
    <code value="710018"/>
    <display value="Topical Application Of Flouride -2 Vis (Ex Prophylaxis)"/>
  </concept>
  <concept>
    <code value="524012"/>
    <display value="Osteocalcin"/>
  </concept>
  <concept>
    <code value="U80202"/>
    <display value="Vancomycin"/>
  </concept>
  <concept>
    <code value="716004"/>
    <display value="Partial Denture 1-3 Teeth"/>
  </concept>
  <concept>
    <code value="500044"/>
    <display value="Sgpt (Alt)"/>
  </concept>
  <concept>
    <code value="137018"/>
    <display value="Psychological Assessment- Category 2 - Anxiety"/>
  </concept>
  <concept>
    <code value="U80200"/>
    <display value="Tobramycin"/>
  </concept>
  <concept>
    <code value="716002"/>
    <display value="Complete Dentures"/>
  </concept>
  <concept>
    <code value="500042"/>
    <display value="Sgot (Ast)"/>
  </concept>
  <concept>
    <code value="524016"/>
    <display value="Hydroxproline Total"/>
  </concept>
  <concept>
    <code value="500048"/>
    <display value="Alkaline Phosphatase"/>
  </concept>
  <concept>
    <code value="500046"/>
    <display value="Ggt"/>
  </concept>
  <concept>
    <code value="716008"/>
    <display value="Partial Denture 8-12 Teeth"/>
  </concept>
  <concept>
    <code value="500040"/>
    <display value="Total And Direct Biliburin"/>
  </concept>
  <concept>
    <code value="524010"/>
    <display value="Thyroid Uptake"/>
  </concept>
  <concept>
    <code value="716006"/>
    <display value="Partial Denture 4-7 Teeth"/>
  </concept>
  <concept>
    <code value="704024"/>
    <display value="Cyst Operation"/>
  </concept>
  <concept>
    <code value="704022"/>
    <display value="Suturing - Large Area"/>
  </concept>
  <concept>
    <code value="704020"/>
    <display value="Suturing - Small Area (2-3 Sutures)"/>
  </concept>
  <concept>
    <code value="500028"/>
    <display value="Osmolarity, Serum / Urine"/>
  </concept>
  <concept>
    <code value="U88162"/>
    <display value="Cytology ( Fine Needle Aspiration )"/>
  </concept>
  <concept>
    <code value="T74150"/>
    <display value="CT Scan Abdomen"/>
  </concept>
  <concept>
    <code value="704028"/>
    <display value="Incision And Drainage Of Abscess - Extraoral"/>
  </concept>
  <concept>
    <code value="704026"/>
    <display value="Incision And Drainage Of Abscess - Intraoral"/>
  </concept>
  <concept>
    <code value="500034"/>
    <display value="Total Bilirubin"/>
  </concept>
  <concept>
    <code value="500032"/>
    <display value="Albumin/Globumin Ratio"/>
  </concept>
  <concept>
    <code value="500038"/>
    <display value="Direct Bilirubin"/>
  </concept>
  <concept>
    <code value="500036"/>
    <display value="Total Biliburin, Neonatal"/>
  </concept>
  <concept>
    <code value="500030"/>
    <display value="Plasma Globumin"/>
  </concept>
  <concept>
    <code value="650024B"/>
    <display value="Microcatheter"/>
  </concept>
  <concept>
    <code value="650024C"/>
    <display value="Microguide Wire"/>
  </concept>
  <concept>
    <code value="524020"/>
    <display value="Factor Viii"/>
  </concept>
  <concept>
    <code value="704036"/>
    <display value="Pericoronal Flap Removal - Simple"/>
  </concept>
  <concept>
    <code value="650028B"/>
    <display value="Microguide Wire"/>
  </concept>
  <concept>
    <code value="810122"/>
    <display value="Plastic Surgery Of Throat"/>
  </concept>
  <concept>
    <code value="704034"/>
    <display value="Closure Of Oro-Antral Fistula"/>
  </concept>
  <concept>
    <code value="810124"/>
    <display value="Tumor Surgery Of Throat"/>
  </concept>
  <concept>
    <code value="I30400"/>
    <display value="Rhinoplasty"/>
  </concept>
  <concept>
    <code value="704032"/>
    <display value="Wiring Fractured Jaw - Complex"/>
  </concept>
  <concept>
    <code value="U84560"/>
    <display value="Urine Uric Acid"/>
  </concept>
  <concept>
    <code value="704070"/>
    <display value="Surgical Removal Of Suprenumerary Tooth"/>
  </concept>
  <concept>
    <code value="850246"/>
    <display value="Diagnostic Laparascopy + Canalization Of Tube"/>
  </concept>
  <concept>
    <code value="36-14.41"/>
    <display value="Scleral buckling with implant, f vitreous substitute"/>
  </concept>
  <concept>
    <code value="U80198"/>
    <display value="Theophyline"/>
  </concept>
  <concept>
    <code value="704088"/>
    <display value="Excision Of Hyperplastic Tissue (Per Arch)"/>
  </concept>
  <concept>
    <code value="U80196"/>
    <display value="Acetylsalicylic Acid"/>
  </concept>
  <concept>
    <code value="36-14.49"/>
    <display value="Scleral buckling with vitrectomy, membranectomy, ion"/>
  </concept>
  <concept>
    <code value="640024"/>
    <display value="Ptca (Per.Tr.Coronory Angioplasty) - Dv + 2 Stents"/>
  </concept>
  <concept>
    <code value="704086"/>
    <display value="Release Of Tounge Tie"/>
  </concept>
  <concept>
    <code value="750230"/>
    <display value="Otoplasty - Ear Reshaping (Skincare)"/>
  </concept>
  <concept>
    <code value="704084"/>
    <display value="Excision Of Bengin Tumour - Lesion Diameter Over 1 Cm"/>
  </concept>
  <concept>
    <code value="303-56.92"/>
    <display value="Implantation, electronic uteral stimulator"/>
  </concept>
  <concept>
    <code value="716050"/>
    <display value="Isosit Injection Moulded Denture"/>
  </concept>
  <concept>
    <code value="218-78.37"/>
    <display value="Lengthening bone, tibia and fibula"/>
  </concept>
  <concept>
    <code value="353-40.53"/>
    <display value="Excision, lymph node - iliac, radical"/>
  </concept>
  <concept>
    <code value="353-40.52"/>
    <display value="Excision, lymph node - periaortic, radical"/>
  </concept>
  <concept>
    <code value="500008"/>
    <display value="Glucose Tolerance Test"/>
  </concept>
  <concept>
    <code value="173030"/>
    <display value="Activated Clotting Time"/>
  </concept>
  <concept>
    <code value="500006"/>
    <display value="Glucose (Serum) 2Hpp"/>
  </concept>
  <concept>
    <code value="300228"/>
    <display value="Chest Pa / Erect"/>
  </concept>
  <concept>
    <code value="650474"/>
    <display value="Microscopic Brain Excision Of Epileptic Focus"/>
  </concept>
  <concept>
    <code value="353-40.54"/>
    <display value="Dissection, groin, radical"/>
  </concept>
  <concept>
    <code value="716058"/>
    <display value="Denture - Complere Lower (Acrylic)"/>
  </concept>
  <concept>
    <code value="1099700"/>
    <display
             value="Ang cor1ca 107-88.55 Angiocardiogram- coronary, 1 catheter"/>
  </concept>
  <concept>
    <code value="500012"/>
    <display value="Bun"/>
  </concept>
  <concept>
    <code value="640062"/>
    <display value="E.T.Suction"/>
  </concept>
  <concept>
    <code value="640064"/>
    <display value="Infusion Syringe Pump"/>
  </concept>
  <concept>
    <code value="304036"/>
    <display value="Colour Doppler Sonography Brain(Through Fontanell)"/>
  </concept>
  <concept>
    <code value="108-35.60"/>
    <display value="Repair, septa, atrial, ventricular, with tissue graft"/>
  </concept>
  <concept>
    <code value="800146"/>
    <display value="Unilat. Ptosis Repair+Fresh"/>
  </concept>
  <concept>
    <code value="810218"/>
    <display value="Endolymphatic Shunt"/>
  </concept>
  <concept>
    <code value="716056"/>
    <display value="Denture - Complete Upper (Acrylic)"/>
  </concept>
  <concept>
    <code value="650472"/>
    <display value="Ct Guided Aspiration Of Intra-Cerebral"/>
  </concept>
  <concept>
    <code value="518126"/>
    <display value="Fructose Test"/>
  </concept>
  <concept>
    <code value="500010"/>
    <display value="Glucose ( Glucometer) Test"/>
  </concept>
  <concept>
    <code value="304034"/>
    <display value="Colour Doppler Sonography Testicular W/Out Doppler - T"/>
  </concept>
  <concept>
    <code value="800144"/>
    <display value="Bilateral Sim. Ptosis Repair"/>
  </concept>
  <concept>
    <code value="716054"/>
    <display value="Tissue Conditioning Material"/>
  </concept>
  <concept>
    <code value="I30300"/>
    <display value="Removal of foreign body- Nose"/>
  </concept>
  <concept>
    <code value="191-50.40"/>
    <display value="Hepatectomy, total"/>
  </concept>
  <concept>
    <code value="500016"/>
    <display value="Creatinine, Serum"/>
  </concept>
  <concept>
    <code value="300192"/>
    <display value="Forearm (Ulna/Radius) 2 Views"/>
  </concept>
  <concept>
    <code value="716052"/>
    <display value="Refixing Tooth In Denture Or Hairline Cracks"/>
  </concept>
  <concept>
    <code value="800148"/>
    <display value="Bil. Ptosis Repair+Fresh Fasc."/>
  </concept>
  <concept>
    <code value="518128"/>
    <display value="Mast (Allergy Screen)"/>
  </concept>
  <concept>
    <code value="300190"/>
    <display value="Forearm (Ulna/Radius) 1 View"/>
  </concept>
  <concept>
    <code value="518122"/>
    <display value="Prostate Specific Antigen"/>
  </concept>
  <concept>
    <code value="300196"/>
    <display value="Scaphoid - 1 View"/>
  </concept>
  <concept>
    <code value="460218"/>
    <display value="Sinsus Puncture"/>
  </concept>
  <concept>
    <code value="518124"/>
    <display value="Lithium"/>
  </concept>
  <concept>
    <code value="D68520"/>
    <display value="Dacryocystectomy"/>
  </concept>
  <concept>
    <code value="710020"/>
    <display value="Follow-Up (Period)"/>
  </concept>
  <concept>
    <code value="710024"/>
    <display value="Flap Operation"/>
  </concept>
  <concept>
    <code value="460216"/>
    <display value="Cryoturbinectomy"/>
  </concept>
  <concept>
    <code value="U86430"/>
    <display value="Rheumatoid Factor"/>
  </concept>
  <concept>
    <code value="130504"/>
    <display value="Occupational Therapy (One Part)"/>
  </concept>
  <concept>
    <code value="460210"/>
    <display value="Foreign Body Removal"/>
  </concept>
  <concept>
    <code value="130502"/>
    <display value="Occupational Therapy (More Than One Part)"/>
  </concept>
  <concept>
    <code value="M15780"/>
    <display value="Dermabrasion Face"/>
  </concept>
  <concept>
    <code value="460214"/>
    <display value="Electrical Cautry"/>
  </concept>
  <concept>
    <code value="130506"/>
    <display value="Occupational Therapy &amp; Physiotherapy (One Sitting)"/>
  </concept>
  <concept>
    <code value="460212"/>
    <display value="Chemical Cautry"/>
  </concept>
  <concept>
    <code value="T73620"/>
    <display value="Foot Oscalcis - 2 Views"/>
  </concept>
  <concept>
    <code value="N97116"/>
    <display value="GAIT training"/>
  </concept>
  <concept>
    <code value="106002"/>
    <display value="Ambulance Fee Less Than 50 Kms"/>
  </concept>
  <concept>
    <code value="H91105"/>
    <display value="Gastric Lavage"/>
  </concept>
  <concept>
    <code value="460228"/>
    <display value="Somnoplasty Turbinate - Clinic"/>
  </concept>
  <concept>
    <code value="825190"/>
    <display value="Repair Of Ureteral Injuries"/>
  </concept>
  <concept>
    <code value="810126"/>
    <display value="Tracheostomy"/>
  </concept>
  <concept>
    <code value="106006"/>
    <display value="Ambulance Fee More Than 100 Kms Less Than 250 Kms"/>
  </concept>
  <concept>
    <code value="825192"/>
    <display value="Retropubic Prostatectomy"/>
  </concept>
  <concept>
    <code value="106004"/>
    <display value="Ambulance Fee More Than 50 Kms Less Than 100 Kms"/>
  </concept>
  <concept>
    <code value="460222"/>
    <display value="Epistaxis Nasal Pack"/>
  </concept>
  <concept>
    <code value="I69405"/>
    <display value="Eustachian Catheterization"/>
  </concept>
  <concept>
    <code value="825274"/>
    <display value="Trans Obturator Tape Insertion"/>
  </concept>
  <concept>
    <code value="110-37.24"/>
    <display value="Biopsy, pericardium"/>
  </concept>
  <concept>
    <code value="825278"/>
    <display value="Trans Vaginal Tape Insertion (Tot)"/>
  </concept>
  <concept>
    <code value="518108"/>
    <display value="Trop T."/>
  </concept>
  <concept>
    <code value="U84590"/>
    <display value="Vitamin A (Retinol)"/>
  </concept>
  <concept>
    <code value="518106"/>
    <display value="Microalbuminuria"/>
  </concept>
  <concept>
    <code value="104-35.20"/>
    <display value="Replacement,heart valve"/>
  </concept>
  <concept>
    <code value="U84585"/>
    <display value="Vanillyl Mandelic Acid (NMA, Urine)"/>
  </concept>
  <concept>
    <code value="110-37.31"/>
    <display value="Pericardiectomy"/>
  </concept>
  <concept>
    <code value="104-35.33"/>
    <display value="Annulopasty"/>
  </concept>
  <concept>
    <code value="110-37.40"/>
    <display value="Repair, heart and pericardium"/>
  </concept>
  <concept>
    <code value="U84578"/>
    <display value="Urine Urobilinogen"/>
  </concept>
  <concept>
    <code value="40-14.60"/>
    <display
             value="Removal of surgically implanted material from posterior, separate procedure)"/>
  </concept>
  <concept>
    <code value="U85060"/>
    <display value="Peripheral Smear"/>
  </concept>
  <concept>
    <code value="304072"/>
    <display value="Colour Doppler Femoral Artery (Unilateral)"/>
  </concept>
  <concept>
    <code value="T76856"/>
    <display value="Ultra Sound - Pelvis"/>
  </concept>
  <concept>
    <code value="304070"/>
    <display value="Colour Doppler Brachial Artery (Bilateral)"/>
  </concept>
  <concept>
    <code value="304076"/>
    <display value="Colour Doppler Peripheral Veins (One Limb)"/>
  </concept>
  <concept>
    <code value="304074"/>
    <display value="Colour Doppler Femoral Artery (Bilateral)"/>
  </concept>
  <concept>
    <code value="K56740"/>
    <display value="Excision of Bartholin Cyst"/>
  </concept>
  <concept>
    <code value="304078"/>
    <display value="Colour Doppler Peripheral Veins (Two Limbs)"/>
  </concept>
  <concept>
    <code value="840004"/>
    <display value="Closed Reduction Of Dislocation And P.O.P"/>
  </concept>
  <concept>
    <code value="840002"/>
    <display value="Excision Of Ganglion"/>
  </concept>
  <concept>
    <code value="115-37.85"/>
    <display value="Replacement any type pacemaker,single chamber device"/>
  </concept>
  <concept>
    <code value="840008"/>
    <display value="Tendon Release Of Wrist"/>
  </concept>
  <concept>
    <code value="115-37.83"/>
    <display value="Insertion dual chamber device, initial"/>
  </concept>
  <concept>
    <code value="840006"/>
    <display value="Tendon Release Of Fingers"/>
  </concept>
  <concept>
    <code value="115-37.82"/>
    <display
             value="Insertion, single chamber device, initial rate responsive"/>
  </concept>
  <concept>
    <code value="115-37.80"/>
    <display value="Insertion, permanent pacemaker, initial"/>
  </concept>
  <concept>
    <code value="U85048"/>
    <display value="White Blood Cell Count Only"/>
  </concept>
  <concept>
    <code value="F54640"/>
    <display value="Orchipexy, bilateral"/>
  </concept>
  <concept>
    <code value="840012"/>
    <display value="Closed Reduction Of Fracture Dislocation"/>
  </concept>
  <concept>
    <code value="115-37.87"/>
    <display value="Replacement any type pacemaker,dual chamber device"/>
  </concept>
  <concept>
    <code value="840018"/>
    <display value="Closed Fracture Small Bones Of Hand Or Foot"/>
  </concept>
  <concept>
    <code value="840016"/>
    <display value="Menisectomy Or Excisin Of Cyst Of The Knee Joint"/>
  </concept>
  <concept>
    <code value="E40701"/>
    <display value="Repair cleft lip"/>
  </concept>
  <concept>
    <code value="800836"/>
    <display value="Ch- Draniage ( Outside Hospital)"/>
  </concept>
  <concept>
    <code value="800834"/>
    <display value="Ch-Drainage ( Inside Hospita )"/>
  </concept>
  <concept>
    <code value="117-37.74"/>
    <display value="Insertion or replacement epicardial pacemaker, -37.74"/>
  </concept>
  <concept>
    <code value="117-37.75"/>
    <display value="Revision,pacemaker lead,electrode"/>
  </concept>
  <concept>
    <code value="117-37.76"/>
    <display value="Replacement,transvenous atrial/ventr pacemaker lead"/>
  </concept>
  <concept>
    <code value="800838"/>
    <display value="Graft Replacment (Inhospital)"/>
  </concept>
  <concept>
    <code value="117-37.77"/>
    <display value="Removal ,pacemaker leads/electrodes w/o replacement"/>
  </concept>
  <concept>
    <code value="304050"/>
    <display value="Colour Doppler Renal Artery"/>
  </concept>
  <concept>
    <code value="202102"/>
    <display value="Disposables I.C.U."/>
  </concept>
  <concept>
    <code value="800840"/>
    <display value="Balloon Dacyoplasty"/>
  </concept>
  <concept>
    <code value="U82803"/>
    <display value="U82803 Blood Gases"/>
  </concept>
  <concept>
    <code value="304054"/>
    <display value="Colour Doppler Portal System"/>
  </concept>
  <concept>
    <code value="800844"/>
    <display value="Collagen Plug"/>
  </concept>
  <concept>
    <code value="T76830"/>
    <display value="Ultra Sound - Transvaginal"/>
  </concept>
  <concept>
    <code value="304052"/>
    <display value="Colour Doppler Hepatic Artery"/>
  </concept>
  <concept>
    <code value="800842"/>
    <display value="Amniotic Membrane Graft"/>
  </concept>
  <concept>
    <code value="304058"/>
    <display value="Colour Doppler Iliac Vessels"/>
  </concept>
  <concept>
    <code value="840022"/>
    <display value="Reconstruction Of Amputated Finger W/O Grafting"/>
  </concept>
  <concept>
    <code value="304056"/>
    <display value="Colour Doppler Aortic"/>
  </concept>
  <concept>
    <code value="840020"/>
    <display value="Pop To Simple Fracture Without Displacement"/>
  </concept>
  <concept>
    <code value="840026"/>
    <display value="Correction Of Hallux Valgus"/>
  </concept>
  <concept>
    <code value="840024"/>
    <display value="Closed Reduction Of Dislocated Phalanges"/>
  </concept>
  <concept>
    <code value="840028"/>
    <display value="Arthrodesis Of The Big Toe"/>
  </concept>
  <concept>
    <code value="117-37.89"/>
    <display value="Revision or removal pacemaker device"/>
  </concept>
  <concept>
    <code value="800848"/>
    <display
             value="Anterior Chamber Reformation Post Operative (Inside Hospital)"/>
  </concept>
  <concept>
    <code value="202108"/>
    <display value="Cardiac Care Unit (Ccu)"/>
  </concept>
  <concept>
    <code value="800846"/>
    <display value="Unilateral Punctural Occlusion"/>
  </concept>
  <concept>
    <code value="202106"/>
    <display value="Disposables Nicu"/>
  </concept>
  <concept>
    <code value="202104"/>
    <display value="Isolation Disposables Per Day"/>
  </concept>
  <concept>
    <code value="800850"/>
    <display
             value="Anterior Chamber Reformation Post Operative (Outside Hospital)"/>
  </concept>
  <concept>
    <code value="304060"/>
    <display value="Colour Doppler Testicular Artery"/>
  </concept>
  <concept>
    <code value="304064"/>
    <display value="Colour Doppler Carotid Artery (Unilateral)"/>
  </concept>
  <concept>
    <code value="202110"/>
    <display value="Pediatric Icu (Picu)"/>
  </concept>
  <concept>
    <code value="T71134"/>
    <display value="Chest 4 Views with Fluroscopy"/>
  </concept>
  <concept>
    <code value="304062"/>
    <display value="Colour Doppler Veins (Varices)"/>
  </concept>
  <concept>
    <code value="304068"/>
    <display value="Colour Doppler Brachial Artery (Unilateral)"/>
  </concept>
  <concept>
    <code value="840030"/>
    <display value="Pop For Correction Of Foot Deformity"/>
  </concept>
  <concept>
    <code value="304066"/>
    <display value="Colour Doppler Carotid Artery (Bilateral)"/>
  </concept>
  <concept>
    <code value="840036"/>
    <display value="Fracture Of Coles"/>
  </concept>
  <concept>
    <code value="840034"/>
    <display value="Excision Of Olecranon Bursa"/>
  </concept>
  <concept>
    <code value="U85260"/>
    <display value="Factor 10"/>
  </concept>
  <concept>
    <code value="L90871"/>
    <display value="Electro convulsive therapy (ECT) multiple seizures"/>
  </concept>
  <concept>
    <code value="U86592"/>
    <display value="VDRL/RPR"/>
  </concept>
  <concept>
    <code value="U86593"/>
    <display value="RPR TITER"/>
  </concept>
  <concept>
    <code value="208062"/>
    <display value="Narrow Band Nb-Uvb"/>
  </concept>
  <concept>
    <code value="137216"/>
    <display value="Self Assessment Scale"/>
  </concept>
  <concept>
    <code value="704134"/>
    <display value="Reduction Of Complicated Middle/Upper Face Fracture"/>
  </concept>
  <concept>
    <code value="G24130"/>
    <display value="Excision of radial head"/>
  </concept>
  <concept>
    <code value="652004"/>
    <display value="Cabg &amp; Tissue Aortic Valve Replacement"/>
  </concept>
  <concept>
    <code value="137218"/>
    <display value="Eating Disorder Scale"/>
  </concept>
  <concept>
    <code value="L90870"/>
    <display value="Electro Convulsive Therapy (ECT) Single seizure"/>
  </concept>
  <concept>
    <code value="201-39.26"/>
    <display value="Bypass, vascular, intra-abdominal"/>
  </concept>
  <concept>
    <code value="652006"/>
    <display value="Cabg &amp; Mechanical Aortic Valve"/>
  </concept>
  <concept>
    <code value="825202"/>
    <display value="Turp"/>
  </concept>
  <concept>
    <code value="518006"/>
    <display value="Progesterone"/>
  </concept>
  <concept>
    <code value="825204"/>
    <display value="Ureteroscope"/>
  </concept>
  <concept>
    <code value="U86674"/>
    <display value="Giardia Lamblia ABS."/>
  </concept>
  <concept>
    <code value="112-35.96"/>
    <display value="Valvuloplasty, percutaneous"/>
  </concept>
  <concept>
    <code value="518008"/>
    <display value="Pregnandiol"/>
  </concept>
  <concept>
    <code value="825208"/>
    <display value="Boari Flap"/>
  </concept>
  <concept>
    <code value="L90875"/>
    <display value="Bio Feedback Therapy"/>
  </concept>
  <concept>
    <code value="137222"/>
    <display value="Anorexia Nervosa Scale"/>
  </concept>
  <concept>
    <code value="H85095"/>
    <display value="Bone Marrow - Aspiration"/>
  </concept>
  <concept>
    <code value="137224"/>
    <display value="Bender Gestalat Scale"/>
  </concept>
  <concept>
    <code value="U84600"/>
    <display value="Alcohol Isopropanol"/>
  </concept>
  <concept>
    <code value="173028"/>
    <display value="Sodium Profiling"/>
  </concept>
  <concept>
    <code value="825200"/>
    <display value="Tuna"/>
  </concept>
  <concept>
    <code value="U86622"/>
    <display value="Brucella Agglutination Test"/>
  </concept>
  <concept>
    <code value="173024"/>
    <display value="Surgical Revision Of Fistula"/>
  </concept>
  <concept>
    <code value="300230"/>
    <display value="Chest Ap / Supine"/>
  </concept>
  <concept>
    <code value="173026"/>
    <display value="Bone Biopsy"/>
  </concept>
  <concept>
    <code value="173020"/>
    <display value="Creation Of A V Fistula"/>
  </concept>
  <concept>
    <code value="300234"/>
    <display value="Chest Lat. Decubitus"/>
  </concept>
  <concept>
    <code value="173022"/>
    <display
             value="Insertion Of Central Vascular Catheter(Femoral/Subclavian/Jugular)"/>
  </concept>
  <concept>
    <code value="U84490"/>
    <display value="Stool for Trypsin Activity"/>
  </concept>
  <concept>
    <code value="300232"/>
    <display value="Chest. Lat. View"/>
  </concept>
  <concept>
    <code value="I69200"/>
    <display value="Removal FB Impacted Ear"/>
  </concept>
  <concept>
    <code value="128022"/>
    <display value="Spoon Plate 6 Holes Each"/>
  </concept>
  <concept>
    <code value="300238"/>
    <display value="Ribs Ap"/>
  </concept>
  <concept>
    <code value="704030"/>
    <display value="Wiring Fractured Jaw - Simple"/>
  </concept>
  <concept>
    <code value="128024"/>
    <display value="Cancelleus Bone Screws"/>
  </concept>
  <concept>
    <code value="300236"/>
    <display value="Chest Pa / Lat. View"/>
  </concept>
  <concept>
    <code value="T76090"/>
    <display value="Mamography ( 1 Breast )"/>
  </concept>
  <concept>
    <code value="128026"/>
    <display value="Cortex Bone Screws"/>
  </concept>
  <concept>
    <code value="K56810"/>
    <display value="Perineoplasty"/>
  </concept>
  <concept>
    <code value="128028"/>
    <display value="Malleable Bone Screws"/>
  </concept>
  <concept>
    <code value="173018"/>
    <display value="Plasma Pheresis / Exchange Per Session"/>
  </concept>
  <concept>
    <code value="P-211"/>
    <display value="Stapedectomy"/>
  </concept>
  <concept>
    <code value="300240"/>
    <display value="Ribs Ap / Oblique"/>
  </concept>
  <concept>
    <code value="P-212"/>
    <display value="P-212 Adenoidectomy"/>
  </concept>
  <concept>
    <code value="173014"/>
    <display value="Haemodiafilteration 4 To 12 Hours - Per Session"/>
  </concept>
  <concept>
    <code value="T70360"/>
    <display value="NECK - Soft Tissue"/>
  </concept>
  <concept>
    <code value="U83586"/>
    <display value="17-Ketosteroids"/>
  </concept>
  <concept>
    <code value="128020"/>
    <display value="Broad Dynamic Comp Plate 14 Holes Each"/>
  </concept>
  <concept>
    <code value="173016"/>
    <display
             value="Continous Arteriovenous Haemofiltration 12 To 24 Hours Per Session"/>
  </concept>
  <concept>
    <code value="U86615"/>
    <display value="Pertussis Bordetella"/>
  </concept>
  <concept>
    <code value="300244"/>
    <display value="Shoulder Ap / Lat."/>
  </concept>
  <concept>
    <code value="173010"/>
    <display value="Permicath"/>
  </concept>
  <concept>
    <code value="300242"/>
    <display value="Shoulder Ap"/>
  </concept>
  <concept>
    <code value="173012"/>
    <display value="Subclavian Double Lumen"/>
  </concept>
  <concept>
    <code value="300204"/>
    <display value="Skeletal Survey"/>
  </concept>
  <concept>
    <code value="173050"/>
    <display value="Acid Concentrate ( Litre)"/>
  </concept>
  <concept>
    <code value="300202"/>
    <display value="Pattela - 1 View"/>
  </concept>
  <concept>
    <code value="T76080"/>
    <display value="Fistulogram/Sinogram"/>
  </concept>
  <concept>
    <code value="173052"/>
    <display value="Insertion Of Perma Cath Tunnel Line"/>
  </concept>
  <concept>
    <code value="300208"/>
    <display value="Mcu (Along With Ivp)"/>
  </concept>
  <concept>
    <code value="300206"/>
    <display value="Intra-Operative Choloangiogram (I.O.C)"/>
  </concept>
  <concept>
    <code value="212002"/>
    <display value="Operation Fine Major - Doctor Fees"/>
  </concept>
  <concept>
    <code value="300207"/>
    <display value="Mcu (Micuratug Urethrogram)"/>
  </concept>
  <concept>
    <code value="506008"/>
    <display value="T.B.Culture"/>
  </concept>
  <concept>
    <code value="K56800"/>
    <display value="Plastic Repair of Introitus"/>
  </concept>
  <concept>
    <code value="506006"/>
    <display value="Anaerobic Culture"/>
  </concept>
  <concept>
    <code value="506004"/>
    <display value="Routine Culture, Mycology"/>
  </concept>
  <concept>
    <code value="640066"/>
    <display value="Intubation"/>
  </concept>
  <concept>
    <code value="810302"/>
    <display value="Thyroidectomy"/>
  </concept>
  <concept>
    <code value="840038"/>
    <display value="Amputation Of Finger Or Toe"/>
  </concept>
  <concept>
    <code value="640140"/>
    <display value="Mitral Balloon Valuloplasty"/>
  </concept>
  <concept>
    <code value="49-25.30"/>
    <display value="Glossectomy - complete"/>
  </concept>
  <concept>
    <code value="116-37.87"/>
    <display value="Replacement any type pacemaker,dual chamber device"/>
  </concept>
  <concept>
    <code value="750112"/>
    <display value="Punch Graft - Medium Area (Skincare)"/>
  </concept>
  <concept>
    <code value="304038"/>
    <display value="Colour Doppler Sonography Neck Lesions"/>
  </concept>
  <concept>
    <code value="640142"/>
    <display value="Bronchial Artery Angiography"/>
  </concept>
  <concept>
    <code value="K57250"/>
    <display value="Posterior Colporrhaphy &amp; Repair Eectocele"/>
  </concept>
  <concept>
    <code value="750110"/>
    <display value="Punch Graft - Small Area (Skincare)"/>
  </concept>
  <concept>
    <code value="750086"/>
    <display value="Excision Of Mole - Large (Skincare)"/>
  </concept>
  <concept>
    <code value="810232"/>
    <display value="Laser Ear Surgery"/>
  </concept>
  <concept>
    <code value="110008"/>
    <display value="Wheel Chair - Rental (Per Day)"/>
  </concept>
  <concept>
    <code value="750084"/>
    <display value="Excision Of Mole - Medium (Skincare)"/>
  </concept>
  <concept>
    <code value="810234"/>
    <display value="Mastoid Abscess Drainage Under G.A."/>
  </concept>
  <concept>
    <code value="110006"/>
    <display value="Wheel Chair - Deposit"/>
  </concept>
  <concept>
    <code value="810236"/>
    <display value="Ear Foreign Body Removal Under G.A."/>
  </concept>
  <concept>
    <code value="110004"/>
    <display value="Crutches - Rental (Per Day)"/>
  </concept>
  <concept>
    <code value="750088"/>
    <display value="Comedon Extraction - Small Area (Skincare)"/>
  </concept>
  <concept>
    <code value="810238"/>
    <display value="Suction Clearance Under G.A."/>
  </concept>
  <concept>
    <code value="110002"/>
    <display value="Crutches Deposit"/>
  </concept>
  <concept>
    <code value="202007"/>
    <display value="Semi-Suite Room Per Day"/>
  </concept>
  <concept>
    <code value="750082"/>
    <display value="Excision Of Mole - Small (Skincare)"/>
  </concept>
  <concept>
    <code value="202008"/>
    <display value="Paediatric Ward"/>
  </concept>
  <concept>
    <code value="810230"/>
    <display value="Implantable Hearing Aid"/>
  </concept>
  <concept>
    <code value="202006"/>
    <display value="Semi-Private Room Per Day"/>
  </concept>
  <concept>
    <code value="202014"/>
    <display value="Special Nurse 24 Hours"/>
  </concept>
  <concept>
    <code value="202012"/>
    <display value="Nursery"/>
  </concept>
  <concept>
    <code value="202010"/>
    <display value="Infant Incubator"/>
  </concept>
  <concept>
    <code value="304042"/>
    <display value="Colour Doppler Vaginal Ultrasound With Doppler Study"/>
  </concept>
  <concept>
    <code value="304040"/>
    <display value="Colour Doppler Vaginal Ultrasound Exam W/Out Dopp.Study"/>
  </concept>
  <concept>
    <code value="810228"/>
    <display value="Second Stage Of Two Stage Tympanoplasty"/>
  </concept>
  <concept>
    <code value="110010"/>
    <display value="Walking Stick"/>
  </concept>
  <concept>
    <code value="54-20.92"/>
    <display value="Revision, Mastoidectomy"/>
  </concept>
  <concept>
    <code value="304044"/>
    <display
             value="Colour Doppler Pregnancy Umbilical Artery Placental Flow Ovarian &amp; Uterian"/>
  </concept>
  <concept>
    <code value="K57260"/>
    <display value="Combined Antero Posterior Colporraphy"/>
  </concept>
  <concept>
    <code value="304008"/>
    <display value="Colour Doppler Hip Joint (Two)"/>
  </concept>
  <concept>
    <code value="750050"/>
    <display value="Puva Per Session (Skincare)"/>
  </concept>
  <concept>
    <code value="810202"/>
    <display value="Unilateral Myringatomy (G.A.)"/>
  </concept>
  <concept>
    <code value="810204"/>
    <display value="Bilateral Myringatomy (G.A.)"/>
  </concept>
  <concept>
    <code value="750054"/>
    <display value="Eye Brow Transplant (Skincare)"/>
  </concept>
  <concept>
    <code value="D92260"/>
    <display value="Ophthalmodynametry"/>
  </concept>
  <concept>
    <code value="202018"/>
    <display value="Isolation Room"/>
  </concept>
  <concept>
    <code value="202016"/>
    <display value="Intensive Care Unit (Icu)"/>
  </concept>
  <concept>
    <code value="202026"/>
    <display value="Head Box(Neo-Natal Care)"/>
  </concept>
  <concept>
    <code value="U82725"/>
    <display value="Fatty Acids Nonesterified"/>
  </concept>
  <concept>
    <code value="202024"/>
    <display value="Observation Room Er / Or Recovery More Than 6 Hour"/>
  </concept>
  <concept>
    <code value="304010"/>
    <display value="Colour Doppler Knee Joint (One)"/>
  </concept>
  <concept>
    <code value="U82728"/>
    <display value="Ferritin"/>
  </concept>
  <concept>
    <code value="202022"/>
    <display value="Observation Room Er / Or Recovery Less Than 6 Hour"/>
  </concept>
  <concept>
    <code value="202020"/>
    <display value="Guest Board &amp; Lodging"/>
  </concept>
  <concept>
    <code value="304014"/>
    <display value="Colour Doppler Wrist J - Carpal T (One)"/>
  </concept>
  <concept>
    <code value="304012"/>
    <display value="Colour Doppler Knee Joint (Two)"/>
  </concept>
  <concept>
    <code value="304018"/>
    <display value="Colour Doppler Muscles (One Limb)"/>
  </concept>
  <concept>
    <code value="304016"/>
    <display value="Colour Doppler Wrist J - Carpal T (Two)"/>
  </concept>
  <concept>
    <code value="750064"/>
    <display value="Trichogram (Skincare)"/>
  </concept>
  <concept>
    <code value="214014"/>
    <display value="Operation Room Charges Simple"/>
  </concept>
  <concept>
    <code value="810210"/>
    <display value="Myringoplasty"/>
  </concept>
  <concept>
    <code value="750062"/>
    <display value="Skin Biopsy (Skincare)"/>
  </concept>
  <concept>
    <code value="810212"/>
    <display value="Tympanoplasty + Mastoidectomy"/>
  </concept>
  <concept>
    <code value="650478"/>
    <display
             value="Craniectomy, Brain Dissection &amp; Haematoma Evaucation"/>
  </concept>
  <concept>
    <code value="750068"/>
    <display value="Cryo Cautery - Multiple Lesion (Skincare)"/>
  </concept>
  <concept>
    <code value="214010"/>
    <display value="Operation Room Charges Medium"/>
  </concept>
  <concept>
    <code value="810214"/>
    <display value="Radical Mastoidectomy"/>
  </concept>
  <concept>
    <code value="650476"/>
    <display
             value="Microscopic Total Suprasellar Tumour Excision Through Subfrontal Approach With F"/>
  </concept>
  <concept>
    <code value="750066"/>
    <display value="Cryo Cautery - Few Lesion (Skincare)"/>
  </concept>
  <concept>
    <code value="214012"/>
    <display value="Operation Room Charges Minor"/>
  </concept>
  <concept>
    <code value="E60280"/>
    <display value="Thyro glossal cyst excision"/>
  </concept>
  <concept>
    <code value="810216"/>
    <display value="Stapedectomy"/>
  </concept>
  <concept>
    <code value="T76872"/>
    <display value="Ultra Sound Trans Rectal"/>
  </concept>
  <concept>
    <code value="T76870"/>
    <display value="Ultra Sound - Scrotum and Content"/>
  </concept>
  <concept>
    <code value="750060"/>
    <display value="Facial Cleansing Skin Care (Skincare)"/>
  </concept>
  <concept>
    <code value="202034"/>
    <display value="Companion Charges With Child Per Day"/>
  </concept>
  <concept>
    <code value="202032"/>
    <display value="Extra Lunch/Dinner Tray"/>
  </concept>
  <concept>
    <code value="304020"/>
    <display value="Colour Doppler Muscles (Two Limbs)"/>
  </concept>
  <concept>
    <code value="202030"/>
    <display value="Nursing Care Per Day"/>
  </concept>
  <concept>
    <code value="810206"/>
    <display value="Unilateral Myringatomy &amp; Grommet (G.A.)"/>
  </concept>
  <concept>
    <code value="304024"/>
    <display value="Colour Doppler Tendons (Two)"/>
  </concept>
  <concept>
    <code value="810208"/>
    <display value="Bilateral Myringatomy &amp; Grommet (G.A.)"/>
  </concept>
  <concept>
    <code value="304022"/>
    <display value="Colour Doppler Tendons (One)"/>
  </concept>
  <concept>
    <code value="49-25.40"/>
    <display value="Glossectomy - radical"/>
  </concept>
  <concept>
    <code value="304028"/>
    <display value="Colour Doppler Bones (Two Limbs)"/>
  </concept>
  <concept>
    <code value="214006"/>
    <display value="Operation Room Charges Fine Major"/>
  </concept>
  <concept>
    <code value="304026"/>
    <display value="Colour Doppler Bones (One Limb)"/>
  </concept>
  <concept>
    <code value="214008"/>
    <display value="Operation Room Charges Major"/>
  </concept>
  <concept>
    <code value="650038A"/>
    <display value="Each Additional : Coil"/>
  </concept>
  <concept>
    <code value="650038B"/>
    <display value="Microcatheter"/>
  </concept>
  <concept>
    <code value="650038C"/>
    <display value="Microguide Wire"/>
  </concept>
  <concept>
    <code value="650268"/>
    <display value="Repair Of Scalp Injury Under General Anaesthesia"/>
  </concept>
  <concept>
    <code value="650266"/>
    <display value="Excision Of Scalp Swelling Or Tumour"/>
  </concept>
  <concept>
    <code value="526308"/>
    <display value="Phenol"/>
  </concept>
  <concept>
    <code value="7-86.06"/>
    <display value="Insertion - infusion pump, totally implantable"/>
  </concept>
  <concept>
    <code value="526312"/>
    <display value="Adrenal Cortex Abs"/>
  </concept>
  <concept>
    <code value="526310"/>
    <display value="Ccp"/>
  </concept>
  <concept>
    <code value="526316"/>
    <display value="C-1 Esterase Inhibitor"/>
  </concept>
  <concept>
    <code value="526314"/>
    <display value="Anti Ccp Abs"/>
  </concept>
  <concept>
    <code value="112002"/>
    <display value="Mortuary Rent Per Day"/>
  </concept>
  <concept>
    <code value="650276"/>
    <display value="Repair Of Skull Fracture With Damaged Brain Tissue"/>
  </concept>
  <concept>
    <code value="U82980"/>
    <display value="Glutethimide"/>
  </concept>
  <concept>
    <code value="650274"/>
    <display value="Repair Of Compound Skull Fracture"/>
  </concept>
  <concept>
    <code value="650272"/>
    <display value="Repair Of Simple Skull Fracture"/>
  </concept>
  <concept>
    <code value="I30100"/>
    <display value="Nose, EUA, Biopsy"/>
  </concept>
  <concept>
    <code value="650270"/>
    <display value="Excision Of Skull Vault Tumour"/>
  </concept>
  <concept>
    <code value="650258"/>
    <display value="Craniotomy And Excision Of Clival Tumour"/>
  </concept>
  <concept>
    <code value="650256"/>
    <display value="Craniotomy And Excision Of C P Angle Tumour"/>
  </concept>
  <concept>
    <code value="526318"/>
    <display value="Aldolase"/>
  </concept>
  <concept>
    <code value="U82977"/>
    <display value="GGT (Gamma G.T.)"/>
  </concept>
  <concept>
    <code value="U82979"/>
    <display value="Glutathione Reductase"/>
  </concept>
  <concept>
    <code value="650262"/>
    <display value="Craniotomy And Evacuation Of Acute Subdural Hematoma"/>
  </concept>
  <concept>
    <code value="650036C"/>
    <display value="Microguide Wire"/>
  </concept>
  <concept>
    <code value="500014"/>
    <display value="Ammonia"/>
  </concept>
  <concept>
    <code value="303222"/>
    <display value="Ct Cardiac Angiography"/>
  </concept>
  <concept>
    <code value="H47000"/>
    <display value="Liver Biopsy"/>
  </concept>
  <concept>
    <code value="704082"/>
    <display value="Excision Of Bengin Tumour - Lesion Diameter Upto 1Cm"/>
  </concept>
  <concept>
    <code value="704080"/>
    <display value="Bone Grafting (Synthetic / Pop)"/>
  </concept>
  <concept>
    <code value="300194"/>
    <display value="T.Tube Cholanglogram"/>
  </concept>
  <concept>
    <code value="800142"/>
    <display value="Exci. Of Lid Tum=Rec. Us Flao"/>
  </concept>
  <concept>
    <code value="303226"/>
    <display value="Ct Virtual Colonography &amp; Polyp Detection"/>
  </concept>
  <concept>
    <code value="137024"/>
    <display value="Psychological Assessment- Category 2 - Personality"/>
  </concept>
  <concept>
    <code value="303224"/>
    <display value="Ct Brain Perfusion Studies"/>
  </concept>
  <concept>
    <code value="800140"/>
    <display value="Exci. Of Lid Tumour With Com. Re"/>
  </concept>
  <concept>
    <code value="300198"/>
    <display value="Heel - 1 View"/>
  </concept>
  <concept>
    <code value="1099699"/>
    <display
             value="Ang R&amp;L-H 107-88.54 Angiocardiogram- right and &amp; heart"/>
  </concept>
  <concept>
    <code value="460220"/>
    <display value="Intra Nasal Mucosal Allergy T."/>
  </concept>
  <concept>
    <code value="710022"/>
    <display value="Other Preventive Procedures: Per 15 Minutes"/>
  </concept>
  <concept>
    <code value="I92553"/>
    <display value="Speech audiometry air &amp; bone"/>
  </concept>
  <concept>
    <code value="710028"/>
    <display value="Pit &amp; Fissure Sealant - Per Tooth"/>
  </concept>
  <concept>
    <code value="208064"/>
    <display value="Removal Of Skin Tag 1 To 3"/>
  </concept>
  <concept>
    <code value="460226"/>
    <display value="Follow Up-Sinus Endoscopy (One Year )"/>
  </concept>
  <concept>
    <code value="750030"/>
    <display value="Hair Transplantation (300-400) Graft (Skincare)"/>
  </concept>
  <concept>
    <code value="460224"/>
    <display value="Follow Up Sinus Endoscopy (One Time)"/>
  </concept>
  <concept>
    <code value="N97124"/>
    <display value="N97124 Massage Therapy"/>
  </concept>
  <concept>
    <code value="T73610"/>
    <display value="Ankle - 3 Views"/>
  </concept>
  <concept>
    <code value="T71250"/>
    <display value="CT Thorax without Contrast"/>
  </concept>
  <concept>
    <code value="U82055"/>
    <display value="Alcohol, Ethyl"/>
  </concept>
  <concept>
    <code value="825194"/>
    <display value="Simple Cystectomy"/>
  </concept>
  <concept>
    <code value="825196"/>
    <display value="Simple Nephrectomy"/>
  </concept>
  <concept>
    <code value="652008"/>
    <display value="Cabg &amp; Tissue Mitral Valve"/>
  </concept>
  <concept>
    <code value="825198"/>
    <display value="Transvesical Prostatectomy"/>
  </concept>
  <concept>
    <code value="652010"/>
    <display value="Cabg &amp; Mechanical Mitral Valve"/>
  </concept>
  <concept>
    <code value="T73615"/>
    <display value="Ankle Arthrography"/>
  </concept>
  <concept>
    <code value="840160"/>
    <display value="Amputations : Upper Limbs"/>
  </concept>
  <concept>
    <code value="302008"/>
    <display value="Antenatal Scan"/>
  </concept>
  <concept>
    <code value="652012"/>
    <display value="Cabg &amp; Double Tissue Valve"/>
  </concept>
  <concept>
    <code value="652014"/>
    <display value="Cabg &amp; Double Mechanical Valve"/>
  </concept>
  <concept>
    <code value="840164"/>
    <display value="Arthroclesis, Shoulder"/>
  </concept>
  <concept>
    <code value="750226"/>
    <display value="Complete Cleft Lip (Skincare)"/>
  </concept>
  <concept>
    <code value="518002"/>
    <display value="Estrogen"/>
  </concept>
  <concept>
    <code value="640014"/>
    <display value="Ptca (Per.Tr.Coronory Angioplasty) - Dv"/>
  </concept>
  <concept>
    <code value="840162"/>
    <display
             value="Arthrodesis 1 Big Joint – Hip, Knee (Subtalar:Ankle), Foot : Triple"/>
  </concept>
  <concept>
    <code value="518004"/>
    <display value="Estradiol"/>
  </concept>
  <concept>
    <code value="750224"/>
    <display value="In-Complete Cleft Lip (Skincare)"/>
  </concept>
  <concept>
    <code value="506028"/>
    <display value="Haemoglobin H (For Alpha Thalassemia)"/>
  </concept>
  <concept>
    <code value="137220"/>
    <display value="Bulimia Nervosa Scale"/>
  </concept>
  <concept>
    <code value="506026"/>
    <display value="Food Testing For Coliforms"/>
  </concept>
  <concept>
    <code value="506024"/>
    <display value="Water Testing: Routine Bacteriological Analysis"/>
  </concept>
  <concept>
    <code value="U86664"/>
    <display value="Epstein BARR Nuclear AG."/>
  </concept>
  <concept>
    <code value="506022"/>
    <display value="Skin Scrapping Microscopy For Herpes"/>
  </concept>
  <concept>
    <code value="ICU"/>
    <display
             value="ICU Services Adult/Pediatric Incl cost Provide ICU Services, Adult/Pediatric (after 2 to 4 weeks of admission in ICU,if no active interventions patient will be converted to long term condition -definition will be applicable)
* Medication above 350 SR per day as per SFDA price list, Blood &amp; blood products, MRI, CT, ECHO, Doppler , CRRT , Surgical and endoscopic procedure are  an excluded services.
To get re-imbused for medication above the daily limit, submission must include a list of details medications as per SFDA codes and pricelist"/>
  </concept>
  <concept>
    <code value="810128"/>
    <display value="Incision &amp; Drainage Of Quinsy Under G.A."/>
  </concept>
  <concept>
    <code value="G29830"/>
    <display value="Arthroscopy (Diagnostic) Elbow"/>
  </concept>
  <concept>
    <code value="137226"/>
    <display value="A D H D Scale"/>
  </concept>
  <concept>
    <code value="137228"/>
    <display value="Brief Psychotherapy 6 Sessions"/>
  </concept>
  <concept>
    <code value="506020"/>
    <display value="Direct Fungal Wet Mount"/>
  </concept>
  <concept>
    <code value="518150"/>
    <display value="Beta Hcg"/>
  </concept>
  <concept>
    <code value="P-210"/>
    <display value="Tympanoplasty"/>
  </concept>
  <concept>
    <code value="650028A"/>
    <display value="Each Additional: Microcatheter"/>
  </concept>
  <concept>
    <code value="G29800"/>
    <display value="Arthroscopy (Diagnostic) TM joint"/>
  </concept>
  <concept>
    <code value="704038"/>
    <display value="Pericoronal Flap Removal - Complex"/>
  </concept>
  <concept>
    <code value="810120"/>
    <display value="Bronchoscopy"/>
  </concept>
  <concept>
    <code value="T74710"/>
    <display value="Pelvimetry - 2 Views"/>
  </concept>
  <concept>
    <code value="353-71.50"/>
    <display value="Vulvectomy, radical"/>
  </concept>
  <concept>
    <code value="U86644"/>
    <display value="Cytomegalo Virus Screening-IGG"/>
  </concept>
  <concept>
    <code value="156-42.84"/>
    <display value="Repair, fistula, esophageal, other"/>
  </concept>
  <concept>
    <code value="156-42.85"/>
    <display value="Repair, esophageal, stricture"/>
  </concept>
  <concept>
    <code value="173046"/>
    <display value="Dialyser"/>
  </concept>
  <concept>
    <code value="640068"/>
    <display value="Intubasion - Elective"/>
  </concept>
  <concept>
    <code value="506002"/>
    <display value="C &amp; S (Culture &amp; Sensitivity)"/>
  </concept>
  <concept>
    <code value="U86645"/>
    <display value="Cytomegalo Virus Screening-IGM"/>
  </concept>
  <concept>
    <code value="173048"/>
    <display value="Sodium Bicarbonate ( Litre)"/>
  </concept>
  <concept>
    <code value="U86648"/>
    <display value="Diptheria Antitoxin"/>
  </concept>
  <concept>
    <code value="800814"/>
    <display value="Gluocoma Cyclo Photo – Coagulation ( Cbc)"/>
  </concept>
  <concept>
    <code value="173042"/>
    <display value="Permanent Peritoneal Cathetor"/>
  </concept>
  <concept>
    <code value="173044"/>
    <display value="Acute Peritoneal Cathetor"/>
  </concept>
  <concept>
    <code value="840100"/>
    <display value="Fracture Vetebrae"/>
  </concept>
  <concept>
    <code value="800812"/>
    <display value="Conjunctival Revision (Inside Hospital)"/>
  </concept>
  <concept>
    <code value="650260"/>
    <display value="Craniotomy And Excision Of Foramen Mangum Tumour"/>
  </concept>
  <concept>
    <code value="840106"/>
    <display value="Removal K-Wires Without Incision Under G.A."/>
  </concept>
  <concept>
    <code value="K57160"/>
    <display value="Insertion of Pessary"/>
  </concept>
  <concept>
    <code value="T76070"/>
    <display value="CT Bone Density Study"/>
  </concept>
  <concept>
    <code value="173040"/>
    <display value="Central Venous Pressure Monitoring"/>
  </concept>
  <concept>
    <code value="840108"/>
    <display value="Application Of Hip Spica Muga + Uii"/>
  </concept>
  <concept>
    <code value="1099698"/>
    <display value="Ang L-H 107-88.53 Angiocardiogram- left heart"/>
  </concept>
  <concept>
    <code value="303228"/>
    <display value="Ct Virtual Bronchoscopy"/>
  </concept>
  <concept>
    <code value="1099697"/>
    <display value="Ang R-H 107-88.52 Angiocardiogram- right heart"/>
  </concept>
  <concept>
    <code value="1099696"/>
    <display
             value="Cath R&amp;L-H 107-37.23 Catheterization cardiac, combined right and left heart"/>
  </concept>
  <concept>
    <code value="650228"/>
    <display value="Endoscopy For The Management Of Hydrocephalus"/>
  </concept>
  <concept>
    <code value="U86308"/>
    <display value="Monotest (Paul Bunnel Test)"/>
  </concept>
  <concept>
    <code value="1099695"/>
    <display value="Cath L-H 107-37.22 Catheterization cardiac, left heart"/>
  </concept>
  <concept>
    <code value="830072"/>
    <display value="Cervical Polypectomy"/>
  </concept>
  <concept>
    <code value="1099694"/>
    <display value="Cath R-H 107-37.21 Catheterization cardiac, right heart"/>
  </concept>
  <concept>
    <code value="650226"/>
    <display value="Ventriculo-Peritoneal Shunt Insertion"/>
  </concept>
  <concept>
    <code value="L95881"/>
    <display value="Developmental testing"/>
  </concept>
  <concept>
    <code value="830074"/>
    <display value="Oophrectomy"/>
  </concept>
  <concept>
    <code value="650224"/>
    <display value="Brachial Plexus Repair"/>
  </concept>
  <concept>
    <code value="750354"/>
    <display value="Erbium Laser - Single Treatment (Skincare)"/>
  </concept>
  <concept>
    <code value="650222"/>
    <display value="Release Of Carpal Tunnel Syndrome"/>
  </concept>
  <concept>
    <code value="208066"/>
    <display value="Removal Of Skin Tag 4 To 10"/>
  </concept>
  <concept>
    <code value="704132"/>
    <display value="Reduction Of Simple / Middle Face Fractures + Plating"/>
  </concept>
  <concept>
    <code value="L95883"/>
    <display value="Neuro Psychological Testing Battery"/>
  </concept>
  <concept>
    <code value="750352"/>
    <display value="Laser Test (Skincare)"/>
  </concept>
  <concept>
    <code value="K57288"/>
    <display value="Sling Operation"/>
  </concept>
  <concept>
    <code value="208068"/>
    <display value="Removal Of Skin Tag More Than 10"/>
  </concept>
  <concept>
    <code value="704130"/>
    <display value="Reduction Of Fractured Zygomatic Arch"/>
  </concept>
  <concept>
    <code value="712080"/>
    <display value="Treatment Plan - C"/>
  </concept>
  <concept>
    <code value="750034"/>
    <display value="Hair Transplantation (500-600) Graft (Skincare)"/>
  </concept>
  <concept>
    <code value="140070"/>
    <display value="Ercp - With Placement Of Stent"/>
  </concept>
  <concept>
    <code value="140072"/>
    <display value="Ercp - With Nasobilliary Drainage Tube"/>
  </concept>
  <concept>
    <code value="140074"/>
    <display value="Ercp - With Mechanical Lithotripsy"/>
  </concept>
  <concept>
    <code value="N97034"/>
    <display value="Contrast bath, each 15 minutes"/>
  </concept>
  <concept>
    <code value="140066"/>
    <display
             value="Ercp - With Sphincterotomy With Or Without Removal Of Stone"/>
  </concept>
  <concept>
    <code value="N97035"/>
    <display value="Ultrasound, each 15 minutes"/>
  </concept>
  <concept>
    <code value="140068"/>
    <display value="Ercp - With Use Of Retrieval Ballon"/>
  </concept>
  <concept>
    <code value="H94760"/>
    <display value="Pulse Oximetry"/>
  </concept>
  <concept>
    <code value="712082"/>
    <display value="Treatment Plan - D"/>
  </concept>
  <concept>
    <code value="712084"/>
    <display value="Treatment Plan - E"/>
  </concept>
  <concept>
    <code value="U86588"/>
    <display value="Smart Test (Strep A)"/>
  </concept>
  <concept>
    <code value="208060"/>
    <display value="Testicular Puncture"/>
  </concept>
  <concept>
    <code value="E36450"/>
    <display value="Exchange transfusion"/>
  </concept>
  <concept>
    <code value="750360"/>
    <display value="Erbium Laser - More Than Ten Pcs (Skincare)"/>
  </concept>
  <concept>
    <code value="U85250"/>
    <display value="Factor 9"/>
  </concept>
  <concept>
    <code value="750364"/>
    <display value="Dye Laser Per Session Medium Area 5-10 Cm (Skincare)"/>
  </concept>
  <concept>
    <code value="WD9215"/>
    <display value="Local Anaesthesia"/>
  </concept>
  <concept>
    <code value="750362"/>
    <display value="Dye Laser Per Session Small Area 2-5 Cm (Skincare)"/>
  </concept>
  <concept>
    <code value="WD9210"/>
    <display value="Dental Anaesthesia w/o Surgery"/>
  </concept>
  <concept>
    <code value="WD9211"/>
    <display value="Regional Block Anaesthesia"/>
  </concept>
  <concept>
    <code value="712074"/>
    <display value="Space Retainer Removable - Follow Up"/>
  </concept>
  <concept>
    <code value="712076"/>
    <display value="Treatment Plan - A"/>
  </concept>
  <concept>
    <code value="T75710"/>
    <display value="Angiography - Extremity Unilateral"/>
  </concept>
  <concept>
    <code value="712070"/>
    <display value="Space Retainer - Fixed"/>
  </concept>
  <concept>
    <code value="712072"/>
    <display value="Space Retainer - Removable"/>
  </concept>
  <concept>
    <code value="U85246"/>
    <display value="Factor 8 Associated AG."/>
  </concept>
  <concept>
    <code value="750358"/>
    <display value="Erbium Laser - More Than Five Pcs (Skincare)"/>
  </concept>
  <concept>
    <code value="U85245"/>
    <display value="Factor 8 Ristocetin Cofactor"/>
  </concept>
  <concept>
    <code value="750356"/>
    <display value="Erbium Laser - Less Than Three Pcs (Skincare)"/>
  </concept>
  <concept>
    <code value="712078"/>
    <display value="Treatment Plan - B"/>
  </concept>
  <concept>
    <code value="T75716"/>
    <display value="Angiography - Extremity Bilateral"/>
  </concept>
  <concept>
    <code value="750332"/>
    <display value="Liposuction Upper Back (Skincare)"/>
  </concept>
  <concept>
    <code value="750330"/>
    <display value="Liposuction Lower Back (Skincare)"/>
  </concept>
  <concept>
    <code value="U85280"/>
    <display value="Factor 12"/>
  </concept>
  <concept>
    <code value="N97014"/>
    <display value="Electrical Stimulation (Unattended)"/>
  </concept>
  <concept>
    <code value="N97012"/>
    <display value="Traction, Mechanical"/>
  </concept>
  <concept>
    <code value="N97010"/>
    <display value="Application of modality to 1or more area;hot/cold pack"/>
  </concept>
  <concept>
    <code value="U88305"/>
    <display value="Gross and Micro Exam Level IV"/>
  </concept>
  <concept>
    <code value="750324"/>
    <display value="Liposuction Gynocomastia - Large (Skincare)"/>
  </concept>
  <concept>
    <code value="U88304"/>
    <display value="Gross and Micro Exam Level III"/>
  </concept>
  <concept>
    <code value="750322"/>
    <display value="Liposuction Gynocomastia - Medium (Skincare)"/>
  </concept>
  <concept>
    <code value="N97018"/>
    <display value="Paraffin Bath"/>
  </concept>
  <concept>
    <code value="750328"/>
    <display value="Liposuction Buttock (Skincare)"/>
  </concept>
  <concept>
    <code value="U88309"/>
    <display value="Gross and Micro Exam Level VI"/>
  </concept>
  <concept>
    <code value="N97016"/>
    <display value="Vasopneumatic Devices"/>
  </concept>
  <concept>
    <code value="U88307"/>
    <display value="Gross and Micro Exam Level V"/>
  </concept>
  <concept>
    <code value="750326"/>
    <display value="Liposuction Flanks (Skincare)"/>
  </concept>
  <concept>
    <code value="U85270"/>
    <display value="Factor 11"/>
  </concept>
  <concept>
    <code value="U88302"/>
    <display value="Gross and Micro Exam Level II"/>
  </concept>
  <concept>
    <code value="750342"/>
    <display value="Full Abdominoplasty - Large (Skincare)"/>
  </concept>
  <concept>
    <code value="U88300"/>
    <display value="Histopathology (Frozen Section)"/>
  </concept>
  <concept>
    <code value="750340"/>
    <display value="Full Abdominoplasty - Small (Skincare)"/>
  </concept>
  <concept>
    <code value="E39502"/>
    <display value="Paraesophageal hiatus hernia repair trans abdominal"/>
  </concept>
  <concept>
    <code value="N97026"/>
    <display value="Infra Red"/>
  </concept>
  <concept>
    <code value="N97024"/>
    <display value="Diathermy"/>
  </concept>
  <concept>
    <code value="N97022"/>
    <display value="Whirlpool"/>
  </concept>
  <concept>
    <code value="N97020"/>
    <display value="Microwave"/>
  </concept>
  <concept>
    <code value="750336"/>
    <display value="Liposuction Chin (Skincare)"/>
  </concept>
  <concept>
    <code value="750334"/>
    <display value="Liposuction Arms (Skincare)"/>
  </concept>
  <concept>
    <code value="750338"/>
    <display value="Mini Abdominoplasty (Skincare)"/>
  </concept>
  <concept>
    <code value="N97028"/>
    <display value="Ultra Violet"/>
  </concept>
  <concept>
    <code value="840238"/>
    <display value="Application Of Splints, Slabs, Pop Without Reduction"/>
  </concept>
  <concept>
    <code value="840236"/>
    <display value="Removal Of F.B. Superficial"/>
  </concept>
  <concept>
    <code value="830030"/>
    <display value="Polypectomy Fract. Curretage"/>
  </concept>
  <concept>
    <code value="750310"/>
    <display value="Liposuction Lateral Thighs (Small-Medium) (Skincare)"/>
  </concept>
  <concept>
    <code value="T74440"/>
    <display value="Vasography"/>
  </concept>
  <concept>
    <code value="T73110"/>
    <display value="Wrist - 3 Views"/>
  </concept>
  <concept>
    <code value="830036"/>
    <display value="Posterior Colpoperineorrhaphy"/>
  </concept>
  <concept>
    <code value="830038"/>
    <display value="Anterior Colpoperineorrhaphy"/>
  </concept>
  <concept>
    <code value="830032"/>
    <display value="Douglas Pouch Abscess Drainage"/>
  </concept>
  <concept>
    <code value="140030"/>
    <display value="Sclerotherapy (Oesophagus)"/>
  </concept>
  <concept>
    <code value="140020"/>
    <display value="Laryngo-Bronoscopy/Diagnostic"/>
  </concept>
  <concept>
    <code value="140022"/>
    <display value="Laryngo-Bronoscopy/Diagnostic + Biopsy"/>
  </concept>
  <concept>
    <code value="750308"/>
    <display value="Liposuction Abdomen -Large (Skincare)"/>
  </concept>
  <concept>
    <code value="140024"/>
    <display value="Laryngo-Bronoscopy/Diagnostic + Film"/>
  </concept>
  <concept>
    <code value="830028"/>
    <display
             value="Laparascopy (Not For Infertility Investigations) Diagnostic"/>
  </concept>
  <concept>
    <code value="T73100"/>
    <display value="Wrist - 2 Views"/>
  </concept>
  <concept>
    <code value="140026"/>
    <display value="Colonoscopy"/>
  </concept>
  <concept>
    <code value="140028"/>
    <display value="Endoscopy Under L.A."/>
  </concept>
  <concept>
    <code value="840242"/>
    <display value="Terminalisation"/>
  </concept>
  <concept>
    <code value="750302"/>
    <display value="Liposuction (Skincare)"/>
  </concept>
  <concept>
    <code value="840240"/>
    <display
             value="C.R. Of Fractures Or Dislocations Without Anaesthesia + Application Of Pop"/>
  </concept>
  <concept>
    <code value="840246"/>
    <display
             value="O.R. + If Of Single Bone Except Fracture Neck, Femur, Torch, Fracture And Fractu"/>
  </concept>
  <concept>
    <code value="750306"/>
    <display value="Liposuction Abdomen - Medium (Skincare)"/>
  </concept>
  <concept>
    <code value="712048"/>
    <display value="Expansion Of Lower Mandible, Crozat Appliance"/>
  </concept>
  <concept>
    <code value="840244"/>
    <display value="Wound Toilet &amp; Debridment"/>
  </concept>
  <concept>
    <code value="750304"/>
    <display value="Liposuction Abdomen - Small (Skincare)"/>
  </concept>
  <concept>
    <code value="840248"/>
    <display value="Cervical Disc Prolapse- Desectomy + Decompression"/>
  </concept>
  <concept>
    <code value="750320"/>
    <display value="Liposuction Gynocomastia - Small (Skincare)"/>
  </concept>
  <concept>
    <code value="825180"/>
    <display value="Pyeloplasty"/>
  </concept>
  <concept>
    <code value="830024"/>
    <display value="Caesarian Delivery (With Normal Baby)"/>
  </concept>
  <concept>
    <code value="T74430"/>
    <display value="Cystography"/>
  </concept>
  <concept>
    <code value="G23410"/>
    <display value="Repair of rotator cuff"/>
  </concept>
  <concept>
    <code value="830026"/>
    <display value="Shirodkar Suture"/>
  </concept>
  <concept>
    <code value="825182"/>
    <display value="Removal Of Penile Prosthesis"/>
  </concept>
  <concept>
    <code value="302007"/>
    <display value="Ultrasound Obstetric Level Iii"/>
  </concept>
  <concept>
    <code value="I69436"/>
    <display value="Gromet Sheppard vent tube, fluoroplastic"/>
  </concept>
  <concept>
    <code value="T73600"/>
    <display value="Ankle - 2 Views"/>
  </concept>
  <concept>
    <code value="640016"/>
    <display value="Ptca (Per.Tr.Coronory Angioplasty) - Tv"/>
  </concept>
  <concept>
    <code value="U82088"/>
    <display value="Aldosterone"/>
  </concept>
  <concept>
    <code value="136006"/>
    <display value="Air Mist Therapy"/>
  </concept>
  <concept>
    <code value="840168"/>
    <display value="Benign Bone Tumours : Curretage Bone Grafting"/>
  </concept>
  <concept>
    <code value="U86668"/>
    <display value="Francisella Tularensis ABS."/>
  </concept>
  <concept>
    <code value="T76938"/>
    <display value="Ultra Sound Guided Aspiration Cyst"/>
  </concept>
  <concept>
    <code value="640018"/>
    <display value="Ptca (Per.Tr.Coronory Angioplasty - Sv + Stent"/>
  </concept>
  <concept>
    <code value="840166"/>
    <display value="Arthroscopy Diagnostic + Proceed"/>
  </concept>
  <concept>
    <code value="750228"/>
    <display value="Forehead Lift (Skincare)"/>
  </concept>
  <concept>
    <code value="U86663"/>
    <display value="EB Virus(Epstein Barr Virus) IGM IFA"/>
  </concept>
  <concept>
    <code value="650020B"/>
    <display value="Microcatheter"/>
  </concept>
  <concept>
    <code value="506018"/>
    <display value="Glemsa Staining"/>
  </concept>
  <concept>
    <code value="506016"/>
    <display value="Methylene Blue Staining"/>
  </concept>
  <concept>
    <code value="506014"/>
    <display value="Acid Fast Staining"/>
  </concept>
  <concept>
    <code value="500067"/>
    <display value="Electrolytes (Na, K, C1) Urine"/>
  </concept>
  <concept>
    <code value="P-208"/>
    <display value="Septoplasty"/>
  </concept>
  <concept>
    <code value="716026"/>
    <display value="Relining Upper Or Lower Denture"/>
  </concept>
  <concept>
    <code value="P-209"/>
    <display value="Polypectomy"/>
  </concept>
  <concept>
    <code value="500066"/>
    <display value="Sodium, Serum Or Urine"/>
  </concept>
  <concept>
    <code value="128012"/>
    <display value="Broad Dynamic Comp Plate 7 Holes Each"/>
  </concept>
  <concept>
    <code value="716024"/>
    <display value="Immediate Complete Dentures (Requiring Relining)"/>
  </concept>
  <concept>
    <code value="U84481"/>
    <display value="T3 (Free T3)"/>
  </concept>
  <concept>
    <code value="500064"/>
    <display value="Total Co2"/>
  </concept>
  <concept>
    <code value="U84480"/>
    <display value="T3"/>
  </concept>
  <concept>
    <code value="128014"/>
    <display value="Broad Dynamic Comp Plate 8 Holes Each"/>
  </concept>
  <concept>
    <code value="716022"/>
    <display value="Additional Casted Clasp-Gold Or Metal"/>
  </concept>
  <concept>
    <code value="P-204"/>
    <display value="Sinus washout - Bilateral"/>
  </concept>
  <concept>
    <code value="716020"/>
    <display value="Tooth Additional (Each)"/>
  </concept>
  <concept>
    <code value="500068"/>
    <display value="Total Cholesterol"/>
  </concept>
  <concept>
    <code value="P-205"/>
    <display value="Removal of nasal foreign body"/>
  </concept>
  <concept>
    <code value="810118"/>
    <display value="Esophagoscopy"/>
  </concept>
  <concept>
    <code value="500063"/>
    <display value="Electrolytes (Na, K, C1) Serum"/>
  </concept>
  <concept>
    <code value="128016"/>
    <display value="Broad Dynamic Comp Plate 9 Holes Each"/>
  </concept>
  <concept>
    <code value="500062"/>
    <display value="Lipase"/>
  </concept>
  <concept>
    <code value="P-206"/>
    <display value="Tonsillectomy"/>
  </concept>
  <concept>
    <code value="P-207"/>
    <display value="Tonsillectomy &amp; Adenoidectomy"/>
  </concept>
  <concept>
    <code value="810304"/>
    <display value="Total Laryngectomy"/>
  </concept>
  <concept>
    <code value="U84484"/>
    <display value="CDT ( Cardiac Troponin )"/>
  </concept>
  <concept>
    <code value="128018"/>
    <display value="Broad Dynamic Comp Plate 12 Holes Each"/>
  </concept>
  <concept>
    <code value="800818"/>
    <display value="Iol Repositioning ( Inside Hospital)"/>
  </concept>
  <concept>
    <code value="P-200"/>
    <display value="Laryngoscopy + Biopsy"/>
  </concept>
  <concept>
    <code value="800816"/>
    <display value="Gluocoma Ext+ Drang Implant"/>
  </concept>
  <concept>
    <code value="P-201"/>
    <display value="Myringotomy and insertion of Gromet - Unilateral"/>
  </concept>
  <concept>
    <code value="110-37.91"/>
    <display value="Massage, cardiac, open chest"/>
  </concept>
  <concept>
    <code value="P-202"/>
    <display value="Myringotomy and insertion of Gromet - Bilateral"/>
  </concept>
  <concept>
    <code value="P-203"/>
    <display value="Sinus washout - Unilateral"/>
  </concept>
  <concept>
    <code value="650036D"/>
    <display value="Detachable Balloon"/>
  </concept>
  <concept>
    <code value="128010"/>
    <display value="Broad Dynamic Comp. Plate 6 Holes Each"/>
  </concept>
  <concept>
    <code value="N.2"/>
    <display value="NICU Second week (SR/Day) N.2 Exlusion as above"/>
  </concept>
  <concept>
    <code value="E38100"/>
    <display value="Splenectomy"/>
  </concept>
  <concept>
    <code value="830096"/>
    <display value="Removal Of Circulage / Shirodkar Suture"/>
  </concept>
  <concept>
    <code value="N.1"/>
    <display
             value="NICU First week (SR/Day) N.1
* Medication above 350 SR per day as per SFDA price list, Blood &amp; blood products, MRI, CT, ECHO, Doppler , CRRT , Surgical and endoscopic procedure are  an excluded service
To get re-imbused for medication above the daily limit, submission must include a list of details medications as per SFDA codes and pricelist"/>
  </concept>
  <concept>
    <code value="640000"/>
    <display value="Catheterization Left Heart"/>
  </concept>
  <concept>
    <code value="497-81.08"/>
    <display value="Fusion,posterior,lumbar/lumbosacral"/>
  </concept>
  <concept>
    <code value="T93882"/>
    <display value="U/S Doppler Carotid Unilateral"/>
  </concept>
  <concept>
    <code value="N.4"/>
    <display value="NICU Fourth week (SR/Day) N.4  Exlusion as above"/>
  </concept>
  <concept>
    <code value="U83505"/>
    <display value="Hydroxyproline, Total"/>
  </concept>
  <concept>
    <code value="800158"/>
    <display value="Unilateral Tarsal Strip With Graft"/>
  </concept>
  <concept>
    <code value="800156"/>
    <display value="Bilateral Tarsal Strip"/>
  </concept>
  <concept>
    <code value="800150"/>
    <display value="Unil. Levator Mus. Recession"/>
  </concept>
  <concept>
    <code value="303232"/>
    <display value="Ct Carotid &amp; Vertebral Arteries Angiography"/>
  </concept>
  <concept>
    <code value="303230"/>
    <display value="Ct Cerebral Arteries Angiography"/>
  </concept>
  <concept>
    <code value="137020"/>
    <display value="Psychological Assessment- Category 2 - Ocd"/>
  </concept>
  <concept>
    <code value="U83500"/>
    <display value="Hydroxyproline, Free"/>
  </concept>
  <concept>
    <code value="800154"/>
    <display value="Unilateral Tarsal Strip"/>
  </concept>
  <concept>
    <code value="303236"/>
    <display value="Ct Pulmonary Arteries Angiography"/>
  </concept>
  <concept>
    <code value="800152"/>
    <display value="Bil. Levator Mus. Recession"/>
  </concept>
  <concept>
    <code value="303234"/>
    <display value="Ct Aorta &amp; Mesenteric Arteries Angiography"/>
  </concept>
  <concept>
    <code value="710026"/>
    <display value="Periodontal Bone Grafting Implant/Bony Detect"/>
  </concept>
  <concept>
    <code value="T73090"/>
    <display value="ULNA Radius (Forearm) - 2 Views"/>
  </concept>
  <concept>
    <code value="830070"/>
    <display value="Abdominal Sling For Congenital Prolapse"/>
  </concept>
  <concept>
    <code value="800124"/>
    <display value="Eye Plastic Surgery"/>
  </concept>
  <concept>
    <code value="800122"/>
    <display value="Trichiasis Repair (Both Eyes)"/>
  </concept>
  <concept>
    <code value="800128"/>
    <display value="Repair Of Simple Lid+Explora"/>
  </concept>
  <concept>
    <code value="830076"/>
    <display value="Removal Of Iucd Under Ga"/>
  </concept>
  <concept>
    <code value="750032"/>
    <display value="Hair Transplantation (400-500) Graft (Skincare)"/>
  </concept>
  <concept>
    <code value="830078"/>
    <display value="Salpingectomy / Salpingostomy"/>
  </concept>
  <concept>
    <code value="U82943"/>
    <display value="Glucagon (P)"/>
  </concept>
  <concept>
    <code value="U82947"/>
    <display value="Glucose Quantitative Blood /CSF"/>
  </concept>
  <concept>
    <code value="137022"/>
    <display
             value="Psychological Assessment- Category 2 - Panic &amp; Phobia"/>
  </concept>
  <concept>
    <code value="650232"/>
    <display
             value="Spinal Stenosis : Inter Laminar Decompression / Laminectomy With Discectomy"/>
  </concept>
  <concept>
    <code value="I92562"/>
    <display value="ABLB-Alternate Binaural Loudness Balance"/>
  </concept>
  <concept>
    <code value="710008"/>
    <display value="Gingival Currettage - Per Quadrant"/>
  </concept>
  <concept>
    <code value="I92563"/>
    <display value="Tone decay test"/>
  </concept>
  <concept>
    <code value="830020"/>
    <display value="Vacuum Delivery (With Normal Baby)"/>
  </concept>
  <concept>
    <code value="825184"/>
    <display value="Repair Of Fracture Penis"/>
  </concept>
  <concept>
    <code value="830022"/>
    <display value="Breech Delivery (With Normal Baby)"/>
  </concept>
  <concept>
    <code value="U85290"/>
    <display value="Factor 13"/>
  </concept>
  <concept>
    <code value="825186"/>
    <display value="Repair Of Renal Injuries"/>
  </concept>
  <concept>
    <code value="825188"/>
    <display value="Repair Of Ruptured Urethra Or Bladder"/>
  </concept>
  <concept>
    <code value="136008"/>
    <display value="Breathing Exercise"/>
  </concept>
</CodeSystem>