GASTON FAMILY HEALTH SERVICES, INC.· BELMONT, NC
ProviderClinic/Center, Federally Qualified Health Center (FQHC)
210 SCHOOL ST, BELMONT, NC 28012
Procedures offered
947 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $10 | $10 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $253 | $253 | $253 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $258 | $264 | $271 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $92 | $92 | $92 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $25 | $25 | $25 |
| MMR vaccine CPT 90707 • Preventive Care | $47 | $74 | $102 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $38 | $38 | $38 |
| Varicella vaccine CPT 90716 • Preventive Care | $16 | $109 | $201 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $13 | $73 | $132 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $37 | $132 | $226 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $87 | $97 | $106 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $111 | $111 | $111 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $57 | $86 | $116 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $131 | $134 | $137 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $133 | $133 | $133 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $95 | $121 | $148 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $160 | $160 | $160 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $79 | $79 | $79 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $10 | $43 | $76 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $102 | $104 | $107 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $112 | $112 | $112 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $120 | $120 | $120 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $100 | $111 | $123 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $108 | $108 | $108 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $19 | $31 | $44 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $71 | $127 | $184 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $338 | $357 | $376 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $262 | $262 | $262 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $99 | $131 | $163 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $163 | $167 | $171 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $90 | $109 | $127 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $30 | $111 | $191 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $146 | $146 | $146 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $126 | $150 | $174 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $30 | $133 | $237 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $30 | $141 | $252 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $742 | $1,010 | $1,278 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $103 | $103 | $103 |
| Spirometry CPT 94010 • Pulmonology | $30 | $33 | $36 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $30 | $45 | $60 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $20 | $20 | $20 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $30 | $35 | $40 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $107 | $107 | $107 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $18 | $18 | $18 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $11 | $20 | $30 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $32 | $42 | $52 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $20 | $20 | $20 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $37 | $37 | $37 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $3 | $3 | $3 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $28 | $28 | $28 |