Memorial Hospital
209 Northwest 8th Street
Seminole, TX 79360
Critical Access Hospitals
Overview
- CCN451358
Procedures & prices
- HC AUTOMATED PLATELET COUNT85049$14cashGross $200 payers
- Inj dexamethasone acetateJ1094$14cashGross $200 payers
- Electrocardiogram report93010$15cashGross $210 payers
- HC PRO ALLERG IMT95115$15cashGross $220 payers
- Ambulatory surgical boot eacL3260$16cashGross $230 payers
- HC DEVELOPMENTAL SCREEN W/SCORE GP96110$17cashGross $240 payers
- ONDANSETRON HCL INJECTIONJ2405$18cashGross $250 payers
- PROMETHAZINE HCL INJECTIONJ2550$18cashGross $250 payers
- HC IMMUNOTHERAPY 2+ INJECTIONS95117$18cashGross $250 payers
- SUCCINYCHOLINE CHLORIDE INJJ0330$18cashGross $250 payers
| Procedure | Code | Cash↑ | Gross | Negotiated range | Payers |
|---|---|---|---|---|---|
| HC AUTOMATED PLATELET COUNT | 85049 | $14 | $20 | — | 0 |
| Inj dexamethasone acetate | J1094 | $14 | $20 | — | 0 |
| Electrocardiogram report | 93010 | $15 | $21 | — | 0 |
| HC PRO ALLERG IMT | 95115 | $15 | $22 | — | 0 |
| Ambulatory surgical boot eac | L3260 | $16 | $23 | — | 0 |
| HC DEVELOPMENTAL SCREEN W/SCORE GP | 96110 | $17 | $24 | — | 0 |
| ONDANSETRON HCL INJECTION | J2405 | $18 | $25 | — | 0 |
| PROMETHAZINE HCL INJECTION | J2550 | $18 | $25 | — | 0 |
| HC IMMUNOTHERAPY 2+ INJECTIONS | 95117 | $18 | $25 | — | 0 |
| SUCCINYCHOLINE CHLORIDE INJ | J0330 | $18 | $25 | — | 0 |
Page 1 · 10 shown