HCPCS SHORT LONG FULL EFFDATE EXPDATE A0021 OUTSIDE STATE AMBULANCE SERV AMBULANCE SERVICE, OUTSIDE STATE PER MILE, TRANSPORT (MEDICAID ONLY) AMBULANCE SERVICE, OUTSIDE STATE PER MILE, TRANSPORT (MEDICAID ONLY) 19850101 A0080 NONINTEREST ESCORT IN NON ER NON-EMER TRANSPORT, PER MILE - VOLUNTEER VEHICLE W NO VESTED INTEREST NON-EMERGENCY TRANSPORTATION, PER MILE - VEHICLE PROVIDED BY VOLUNTEER (INDIVIDUAL OR ORGANIZATION), WITH NO VESTED INTEREST 19820101 A0090 INTEREST ESCORT IN NON ER NON-EMER TRANSPORT, PER MILE - INDIVIDUAL VEHICLE W VESTED INTEREST, EG FAMILY NON-EMERGENCY TRANSPORTATION, PER MILE - VEHICLE PROVIDED BY INDIVIDUAL (FAMILY MEMBER, SELF, NEIGHBOR) WITH VESTED INTEREST 19820101 A0100 NONEMERGENCY TRANSPORT TAXI NON-EMERGENCY TRANSPORTATION; TAXI NON-EMERGENCY TRANSPORTATION; TAXI 19820101 A0110 NONEMERGENCY TRANSPORT BUS NON-EMERGENCY TRANSPORTATION AND BUS, INTRA OR INTER STATE CARRIER NON-EMERGENCY TRANSPORTATION AND BUS, INTRA OR INTER STATE CARRIER 19840101 ..... A4644 CONTRAST 100-199 MGS IODINE SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (100-199 MGS OF IODINE) SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (100-199 MGS OF IODINE) 19940101 20051231 A4645 CONTRAST 200-299 MGS IODINE SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (200-299 MGS OF IODINE) SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (200-299 MGS OF IODINE) 19940101 20051231 A4646 CONTRAST 300-399 MGS IODINE SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (300-399 MGS OF IODINE) SUPPLY OF LOW OSMOLAR CONTRAST MATERIAL (300-399 MGS OF IODINE) 19940101 20051231 A4647 SUPP- PARAMAGNETIC CONTR MAT SUPPLY OF PARAMAGNETIC CONTRAST MATERIAL, EG., GADOLINIUM SUPPLY OF PARAMAGNETIC CONTRAST MATERIAL, EG., GADOLINIUM 19900101 20051231 A4648 IMPLANTABLE TISSUE MARKER TISSUE MARKER, IMPLANTABLE, ANY TYPE, EA TISSUE MARKER, IMPLANTABLE, ANY TYPE, EACH 20080101 A4649 SURGICAL SUPPLIES SURGICAL SUPPLY; MISCELLANEOUS SURGICAL SUPPLY; MISCELLANEOUS 19820101 A4650 IMPLANT RADIATION DOSIMETER IMPLANTABLE RADIATION DOSIMETER, EA IMPLANTABLE RADIATION DOSIMETER, EACH 20080101 A4651 CALIBRATED MICROCAP TUBE CALIBRATED MICROCAPILLARY TUBE, EACH CALIBRATED MICROCAPILLARY TUBE, EACH 20020101 A4652 MICROCAPILLARY TUBE SEALANT MICROCAPILLARY TUBE SEALANT MICROCAPILLARY TUBE SEALANT 20020101 A4653 PD CATHETER ANCHOR BELT PERITONEAL DIALYSIS CATHETER ANCHORING DEVICE, BELT, EACH PERITONEAL DIALYSIS CATHETER ANCHORING DEVICE, BELT, EACH 20030101 A4655 ESRD SYRINGE/NEEDLE NEEDLES AND SYRINGES FOR DIALYSIS NEEDLES AND SYRINGES FOR DIALYSIS 19860101 20011231 A4656 NEEDLE ANY SIZE NEEDLE, ANY SIZE, EACH NEEDLE, ANY SIZE, EACH 20020101 20051231 A4657 SYRINGE W/WO NEEDLE SYRINGE, WITH OR WITHOUT NEEDLE, EACH SYRINGE, WITH OR WITHOUT NEEDLE, EACH 20020101 A4660 SPHYG/BP APP W CUFF AND STET SPHYGMOMANOMETER/BLOOD PRESSURE APPARATUS WITH CUFF AND STETHOSCOPE SPHYGMOMANOMETER/BLOOD PRESSURE APPARATUS WITH CUFF AND STETHOSCOPE 19860101 A4663 DIALYSIS BLOOD PRESSURE CUFF BLOOD PRESSURE CUFF ONLY BLOOD PRESSURE CUFF ONLY 19860101 A4670 AUTOMATIC BP MONITOR, DIAL AUTOMATIC BLOOD PRESSURE MONITOR AUTOMATIC BLOOD PRESSURE MONITOR 19860101 A4671 DISPOSABLE CYCLER SET DISPOSABLE CYCLER SET USED WITH CYCLER DIALYSIS MACHINE, EACH DISPOSABLE CYCLER SET USED WITH CYCLER DIALYSIS MACHINE, EACH 20040101 A4672 DRAINAGE EXT LINE, DIALYSIS DRAINAGE EXTENSION LINE, STERILE, FOR DIALYSIS, EACH DRAINAGE EXTENSION LINE, STERILE, FOR DIALYSIS, EACH 20040101 A4673 EXT LINE W EASY LOCK CONNECT EXTENSION LINE WITH EASY LOCK CONNECTORS, USED WITH DIALYSIS EXTENSION LINE WITH EASY LOCK CONNECTORS, USED WITH DIALYSIS 20040101 A4674 CHEM/ANTISEPT SOLUTION, 8OZ CHEMICALS/ANTISEPTICS SOLN USED TO CLEAN/STERILIZE DIALYSIS EQUIPMENT, PER 8 OZ CHEMICALS/ANTISEPTICS SOLUTION USED TO CLEAN/STERILIZE DIALYSIS EQUIPMENT, PER 8 OZ 20040101 A4680 ACTIVATED CARBON FILTER, EA ACTIVATED CARBON FILTER FOR HEMODIALYSIS, EACH ACTIVATED CARBON FILTER FOR HEMODIALYSIS, EACH 19860101 A4690 DIALYZER, EACH DIALYZER (ARTIFICIAL KIDNEYS), ALL TYPES, ALL SIZES, FOR HEMODIALYSIS, EACH DIALYZER (ARTIFICIAL KIDNEYS), ALL TYPES, ALL SIZES, FOR HEMODIALYSIS, EACH 19860101 A4700 STANDARD DIALYSATE SOLUTION STANDARD DIALYSATE SOLUTION, EACH STANDARD DIALYSATE SOLUTION, EACH 19860101 20011231 A4705 BICARB DIALYSATE SOLUTION BICARBONATE DIALYSATE SOLUTION, EACH BICARBONATE DIALYSATE SOLUTION, EACH 19860101 20011231 A4706 BICARBONATE CONC SOL PER GAL BICARBONATE CONCENTRATE, SOLUTION, FOR HEMODIALYSIS, PER GALLON BICARBONATE CONCENTRATE, SOLUTION, FOR HEMODIALYSIS, PER GALLON 20020101 A4707 BICARBONATE CONC POW PER PAC BICARBONATE CONCENTRATE, POWDER, FOR HEMODIALYSIS, PER PACKET BICARBONATE CONCENTRATE, POWDER, FOR HEMODIALYSIS, PER PACKET 20020101 A4708 ACETATE CONC SOL PER GALLON ACETATE CONCENTRATE SOLUTION, FOR HEMODIALYSIS, PER GALLON ACETATE CONCENTRATE SOLUTION, FOR HEMODIALYSIS, PER GALLON 20020101 A4709 ACID CONC SOL PER GALLON ACID CONCENTRATE, SOLUTION, FOR HEMODIALYSIS, PER GALLON ACID CONCENTRATE, SOLUTION, FOR HEMODIALYSIS, PER GALLON 20020101 A4712 STERILE WATER INJ PER 10 ML WATER, STERILE, FOR INJECTION, PER 10 ML WATER, STERILE, FOR INJECTION, PER 10 ML 19860101 20031231 A4714 TREATED WATER PER GALLON TREATED WATER FOR PERITONEAL DIALYSIS, PER GALLON TREATED WATER (DEIONIZED, DISTILLED, OR REVERSE OSMOSIS) FOR PERITONEAL DIALYSIS, PER GALLON 19860101 A4719 "Y SET" TUBING Y SET TUBING FOR PERITONEAL DIALYSIS "Y SET" TUBING FOR PERITONEAL DIALYSIS 20020101 A4720 DIALYSAT SOL FLD VOL > 249CC DIALYSATE SOLN, FL VOL > 249CC, BUT <= 999CC, FOR PERITONEAL DIALYSIS DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 249CC, BUT LESS THAN OR EQUAL TO 999CC, FOR PERITONEAL DIALYSIS 20020101 A4721 DIALYSAT SOL FLD VOL > 999CC DIALYSATE SOLN, FL VOL > 999CC BUT <= 1999CC, FOR PERITONEAL DIALYSIS DIALYSATE SOLUTION, ANY CONCENTRATION OF DEXTROSE, FLUID VOLUME GREATER THAN 999CC BUT LESS THAN OR EQUAL TO 1999CC, FOR PERITONEAL DIALYSIS 20020101 ......