Ambulance Service, Non-emergent Transport (Level 1)

Basic Life Support, Non-Emergent

Ground mileage, Per Mile

M0243 IV Infusion Casirivimab/Imdevimab Adm and Monitoring

M0243 IV Infusion Casirivimab/Imdevimab Adm and Monitoring

M0245 IV Infusion Bamlanivimab/Etesevimab Adm and Monitorin

M0247: IntravenoUltrasound infusion, sotrovimab, includes infusion a

NitroUltrasound Oxide Therapy Initiated

OXYGEN - HOUR

RECOVERY EXTENDED ABOVE 4HRS

RECOVERY EXTENDED UNDER 4HRS

TELEHEALTH FACILITY FEE

0001A

ADM Pfizer SARSCOV2 30 MCG/0.3 ML 1ST

0001A

Pfizer vaccine 1st dose: 0001A - 30mcg

0002A

ADM Pfizer SARSCOV2 30 MCG/0.3 ML 2ND

0002A

Pfizer vaccine 2nd dose: 0002A - 30mcg

0002A

Pfizer vaccine 2nd dose: 0002A - 30mcg

0003A

ADM Pfizer SARSCOV2 30MCG/0.3ML 3RD

0004A

Pfizer ADM SARSCOV2 30MCG/0.3ML Booster

0011A

ADM Moderna SARSCOV2 100 MCG/0.5 ML 1ST

0011A

Moderna Vaccine 1st Dose: 0011A - 100mcg

0012A

ADM Moderna SARSCOV2 100 MCG/0.5 ML 2ND

0012A

Moderna Vaccine 2nd dose: 0012A - 100mcg

0013A

ADM Moderna SARSCOV2 100MCG/0.5ML3RD

0013A

ADM Moderna SARSCOV2 100MCG/0.5ML3RD