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w <br />N <br />Q 0 <br />0 <br />W <br />O <br />QJ 0 <br />W <br />2 w, <br />m <br />j0w <br />ow <br />cc 5J <br />J <br />ccx <br />Z 0 <br />Q <br />5 W <br />ZIL <br />RESOLUTION 2007-136 <br />9/26/2007CLFEE2007-08 FINAL <br />07-08 I <br />FEE <br />88888 <br />asUS <br />CD <br />�CS <br />ta <br />88000 <br />gi2II <br />88 <br />o <br />�� <br />. <br />88 <br />o <br />1- <br />88888 <br />�� <br />cs to <br />� <br />88888 <br />69ER <br />VD <br />69 <br />88 <br />6�9N• <br />88888 <br />at <br />I0 <br />cn <br />CI0tCs.(U1CV <br />V,ERERfR7 <br />p <br />COI <br />OD <br />10 <br />CD <br />ERER- <br />10 <br />E) <br />C) <br />e[)N <br />69664 <br />1.11 UI <br />N•10 ) <br />p <br />p <br />CD <br />() <br />ue <br />O <br />Cn <br />OOp <br />U)Oe10 <br />p <br />000010006CCO <br />pp <br />.-e� <br />pp <br />88F) <br />p <br />88 <br />pp <br />83% - F <br />p <br />O <br />CO69-696CS <br />O <br />CS <br />p <br />O <br />ci <br />$0.00 <br />$45.65 <br />�p <br />1p <br />co <br />69 <br />$30.71 <br />$34.86 <br />010 <br />M <br />69 <br />�p <br />N <br />O <br />64 <br />CO <br />) <br />li, <br />O <br />N <br />as� <br />CA- <br />$45.65 I. <br />$49.80 <br />$45.65 <br />p <br />1a? N <br />M <br />63 <br />w <br />e <br />1- <br />{O <br />000000 <br />0690Et?OER0 <br />47 <br />69M <br />69 <br />$21.44 <br />$24.79 <br />$28.14 <br />$31.49 <br />.- <br />6N9 <br />$59.63 <br />M <br />CA <br />$36.85 i <br />$40.20 <br />$36.85 <br />$33.50 I <br />$26.80 <br />0 <br />e <br />0 <br />O <br />00000 <br />� <br />p <br />�ER <br />$16.00 <br />$18.50 <br />$21.00 <br />OO <br />06 0 if; <br />Pt0 <br />1101p <br />IE9r- <br />p <br />ppp pp <br />to 0000 <br />��� <br />M <br />M <br />0 <br />OD <br />0 <br />OD <br />0 <br />OD <br />$0.00 <br />$18.15 <br />$10.56 <br />$12.21 <br />$13.86 <br />��pp <br />10 10 <br />.-O <br />64 69 <br />C)) <br />O) <br />CV <br />$11.55 <br />IAII Lab fees will be charged in addition to office visits on a sliding fee scale. _( <br />$18.15 <br />$19.80 <br />$18.15 <br />$16.50 <br />$13.20 <br />m <br />000 <br />000 <br />000 <br />ER <br />CO- <br />ER <br />5£'6$ <br />00.0$ <br />$5.44 <br />$6.29 <br />$7.14 <br />$7.99 <br />$5.44 <br />$15.13 <br />$5.95 <br />'001.p <br />01N61f')OD <br />0)0 <br />69 d4 <br />p <br />00000 <br />00000 <br />6969696469 <br />O <br />600 <br />ER 6969 <br />a <br />e <br />e <br />O <br />00000 <br />00000 <br />69696964 <br />Q <br />E9 <br />00000 <br />00000 <br />6969E969EA) <br />p <br />00 <br />00 <br />ER 69 <br />Includes all applicable In-house laboratory services. 1 <br />I <br />1 1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />1 <br />( <br />rHMILT rL ir.iir i VI51I UtSUKIPTION <br />E/M CODES <br />m <br />Z <br />_OI <br />m <br />a <br />V <br />dN< <br />2O))e <br />a) <br />a)• <br />> <br />J. <br />e <br />I J�JLuz Level 1 WO <br />2C <br />—u. <br />a) <br />>>' <br />J <br />7» <br />A0< <br />))a)( <br />Level tour <br />ruzug <br />9201 TD Nurse Protocol <br />1 <br />' <br />. <br />1---- meaical visit - Established Patient <br />1 Level One <br />99212 Level Two <br />99213 Level Three <br />99214 Level Four <br />99211 TD Nurse Protocol <br />ei•E( <br />ramuy rlanning <br />Initial/Annual Family Planning Visit* <br />Subsequent Family Planning Visit(s) <br />1 <br />1rroceaures not included in office visit <br />�ssuu IUD insertion _ <br />58301 IUD Removal _ <br />57170 Diaphragm Fitting _ <br />57454 Colposcopy (with biopsy) <br />157452 Colposcopy (without biopsy) <br />9/26/2007CLFEE2007-08 FINAL <br />