1 Medical care
2 Surgery
3 Consultation
4 Diagnostic radiology
5 Diagnostic laboratory
6 Therapeutic radiology
7 Anesthesia
8 Assistant at surgery
9 Other medical items or services
0 Whole blood only eff 01/96, whole blood or packed red cells before 01/96
A Used durable medical equipment (DME)
B High risk screening mammography (obsolete 1/1/98)
C Low risk screening mammography (obsolete 1/1/98)
D Ambulance (eff 04/95)
E Enteral/parenteral nutrients/supplies (eff 04/95)
F Ambulatory surgical center (facility usage for surgical services)
G Immunosuppressive drugs
H Hospice services (discontinued 01/95)
I Purchase of DME (installment basis) (discontinued 04/95)
J Diabetic shoes (eff 04/95)
K Hearing items and services (eff 04/95)
L ESRD supplies (eff 04/95) (renal supplier in the home before 04/95)
M Monthly capitation payment for dialysis
N Kidney donor
P Lump sum purchase of DME, prosthetics, orthotics
Q Vision items or services
R Rental of DME
S Surgical dressings or other medical supplies (eff 04/95)
T Psychological therapy (term. 12/31/97) outpatient mental health limitation (eff. 1/1/98)
U Occupational therapy
V Pneumococcal/flu vaccine (eff 01/96), Pneumococcal/flu/hepatitis B vaccine (eff 04/95-12/95), Pneumococcal only before 04/95
W Physical therapy
Y Second opinion on elective surgery (obsoleted 1/97)
Z Third opinion on elective surgery (obsoleted 1/97)