G657

PDF page 430 / J16

Level 2
                                    All other monitoring devices with fewer than three skin electrodes, or that record only portions
                                    of the monitoring period or do not provide trend analysis. Minimum 12 hours monitoring.
               G654                       - technical component - 12 to 35 hours recording ................    26.45
               G655                       - technical component - 12 to 35 hours scanning.................     18.10
               G653                       - professional component - 12 to 35 hours recording ...........                    34.10
               G686                       - technical component - 36 to 59 hours recording ................    52.95
               G687                       - technical component - 36 to 59 hours scanning.................     36.25
               G656                       - professional component - 36 to 59 hours recording ...........                    51.15
               G688                       - technical component - 60 hours to 13 days recording........        79.40
               G689                       - technical component - 60 hours to 13 days scanning ........        54.40
               G657                       - professional component - 60 hours to 13 days recording ..                        68.20
               G694 - technical component – 14 or more days recording ............ 124.30
               G695 - technical component – 14 or more days scanning .............  91.45
               G696 - professional component – 14 or more days recording .......          86.80
                  Note:
                  1.Maximum one professional component, one technical recording component and one
                    technical scanning component per patient, per recording.

Master, record 2317. Record Layout PDF, page 1.

G65720250401999999990000068200000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.