DANIEL LACKEY· WINSTON SALEM, NC

Physician group

1287 CREEKSHIRE WAY, WINSTON SALEM, NC 27103

Procedures offered

952 total

Procedure	Min	Avg	Max
Immunization admin each additional component CPT 90461 • Preventive Care	$8	$10	$12
Immunization admin injection single CPT 90471 • Preventive Care	$10	$12	$17
Immunization admin injection each additional CPT 90472 • Preventive Care	$12	$15	$19
HPV vaccine 9-valent CPT 90651 • Preventive Care	$253	$291	$329
Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care	$197	$228	$258
Rotavirus vaccine pentavalent CPT 90680 • Preventive Care	$84	$93	$102
Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care	$19	$21	$22
MMR vaccine CPT 90707 • Preventive Care	$91	$94	$97
Tdap vaccine age 7 years or older CPT 90715 • Preventive Care	$50	$50	$50
Varicella vaccine CPT 90716 • Preventive Care	$184	$188	$192
Pneumococcal vaccine adult CPT 90732 • Preventive Care	$113	$115	$117
Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care	$207	$211	$216
Preventive visit new patient infant CPT 99381 • Preventive Care	$87	$88	$90
Preventive visit new patient age 1-4 CPT 99382 • Preventive Care	$106	$118	$130
Preventive visit new patient age 5-11 CPT 99383 • Preventive Care	$94	$115	$136
Preventive visit new patient age 12-17 CPT 99384 • Preventive Care	$113	$133	$154
Preventive visit new patient age 18-39 CPT 99385 • Preventive Care	$110	$123	$149
Preventive visit new patient age 40-64 CPT 99386 • Preventive Care	$108	$127	$139
Preventive visit new patient age 65+ CPT 99387 • Preventive Care	$187	$187	$187
Preventive visit established patient infant CPT 99391 • Preventive Care	$83	$98	$112
Preventive visit established patient age 1-4 CPT 99392 • Preventive Care	$87	$96	$104
Preventive visit established patient age 5-11 CPT 99393 • Preventive Care	$88	$104	$119
Preventive visit established patient age 12-17 CPT 99394 • Preventive Care	$97	$98	$98
Preventive visit established patient age 18-39 CPT 99395 • Preventive Care	$78	$106	$134
Preventive visit established patient age 40-64 CPT 99396 • Preventive Care	$88	$118	$143
Preventive visit established patient age 65+ CPT 99397 • Preventive Care	$102	$128	$154
Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care	$32	$38	$45
Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care	$70	$70	$70
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$231	$231	$231
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$408	$408	$408
Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care	$142	$142	$142
Annual wellness visit initial HCPCS G0438 • Preventive Care	$190	$190	$190
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$121	$126	$129
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$298	$298	$298
Bronchoscopy with brushing CPT 31623 • Pulmonology	$332	$332	$332
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$310	$310	$310
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$195	$195	$195
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$450	$450	$450
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$1,354	$1,354	$1,354
Ventilation assist and management initiation CPT 94002 • Pulmonology	$104	$104	$104
Spirometry CPT 94010 • Pulmonology	$10	$16	$23
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$32	$42	$52
Bronchospasm provocation evaluation CPT 94070 • Pulmonology	$32	$32	$32
Respiratory flow volume loop CPT 94375 • Pulmonology	$27	$30	$32
Cardiopulmonary exercise test CPT 94621 • Pulmonology	$179	$179	$179
Nebulizer inhalation treatment CPT 94640 • Pulmonology	$6	$13	$20
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$15	$17	$19
Plethysmography lung volumes CPT 94726 • Pulmonology	$46	$50	$54
Gas dilution lung volumes CPT 94727 • Pulmonology	$14	$26	$37
Diffusing capacity (DLCO) CPT 94729 • Pulmonology	$46	$55	$63