United Agriculture Benefit Trust Group Health Plan CHIROPRACTIC CPT 97014 2020 APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED ein 992930906 11 Professional 11.99 40.00 1265281414 ein 992930906 49 Professional 11.99 40.00 1265281414 CHIROPRACTIC CPT 97110 2020 THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES ein 204086272 11 Professional 24.78 45.00 1811053697 24.78 59, GP 45.00 1811053697 CHIROPRACTIC CPT 97140 2020 MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES ein 204086272 11 Professional 0.00 45.00 1811053697 ein 770356967 11 Professional 28.15 59, GP 40.00 1740335249 CHIROPRACTIC CPT 98940 2020 CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS ein 992930906 11 Professional 27.95 60.00 1265281414 ein 992930906 49 Professional 27.95 60.00 1265281414 CHIROPRACTIC CPT 98941 2020 CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS ein 200205735 11 Professional 33.28 93.54 1598703753 ein 204086272 11 Professional 33.28 AT 60.00 1811053697 ein 390829072 11 Professional 33.28 75.00 1932413937 ein 770356967 11 Professional 38.89 80.00 1740335249 CHIROPRACTIC CPT 98943 2020 CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION ein 204086272 11 Professional 8.95 40.00 1811053697 DIALYSIS CPT 90945 2020 DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL ein 462642183 65 Institutional 98.18 2217.97 1467847202 465.75 2217.97 1467847202 DIALYSIS CPT 90999 2020 UNLISTED DIALYSIS PROCEDURE INPATIENT/OUTPATIENT ein 831840496 65 Institutional 475.14 G4 8212.08 1356826713 HOME HEALTH CPT S9328 2020 HIT PAIN IMP PUMP DIEM ein 510269822 12 Professional 47.69 275.00 1770528994 HOSPITAL OUTPATIENT CPT H0015 2020 ALCOHOL AND/OR DRUG SERVICES ein 475173680 22 Institutional 258.00 2500.00 1659973055 HOSPITAL OUTPATIENT CPT H0018 2020 ALCOHOL AND/OR DRUG SERVICES ein 861723552 22 Institutional 1054.00 6023.70 1104568377 HOSPITAL ROOM & BOARD CPT H0018 2020 ALCOHOL AND/OR DRUG SERVICES ein 861723552 22 Institutional 1054.00 6023.70 1104568377 OFFICE VISIT CPT 90837 2020 PSYCHOTHERAPY W/PATIENT 60 MINUTES ein 830999317 11 Professional 145.00 145.00 1326484775 PED DENTAL PREVENTATIVE CPT D0230 2020 INTRAORAL-PERIAPICAL-EACH ADDITIONAL IMAGE ein 651202122 11 36.04 22.00 1053651539 1225226566 TELEMEDICINE CPT 90837 2020 PSYCHOTHERAPY W/PATIENT 60 MINUTES ein 331964295 2 Professional 175.00 175.00 1316660608 2026-04-01