Hunters Specialties Leaf Blind Realtree Edge 56" x12'

Product Information

Adjustment code for mandated federal, state or local law/regulation that is not already covered by another code and is mandated before a new code can be created.

Workers' Compensation case settled. Patient is responsible for amount of this claim/service through WC 'Medicare set aside arrangement' or other agreement. To be used for Workers' Compensation only. (Use only with Group Code PR) This claim/service is not payable under our service area. The claim must be filed to the Payer/Plan in whose service area the specimen was collected. Alert: This is a split service and represents a portion of the units from the originally submitted service.Alert: Cost sharing was calculated based on an All-Payer Model Agreement, in accordance with the No Surprises Act.

Alert: The NDC code submitted for this service was translated to a HCPCS code for processing, but please continue to submit the NDC on future claims for this item.

Forms

The fee schedule amount allowed is calculated at 110% of the Medicare Fee Schedule for this region, specialty and type of service. This fee is calculated in compliance with Act 6.