GOSHEN MEDICAL CENTER INCORPORATED· HAMLET, NC
ProviderClinic/Center, Federally Qualified Health Center (FQHC)Clinic/Center, Multi-Specialty
106 JEFFERSON ST, HAMLET, NC 28345
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 | $13 | $16 | $21 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $12 | $14 | $15 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $251 | $301 | $336 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $197 | $249 | $379 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $99 | $107 | $136 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $19 | $20 | $22 |
| MMR vaccine CPT 90707 • Preventive Care | $91 | $103 | $137 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $34 | $39 | $50 |
| Varicella vaccine CPT 90716 • Preventive Care | $184 | $199 | $240 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $113 | $135 | $196 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $190 | $221 | $275 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $101 | $132 | $156 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $90 | $133 | $163 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $94 | $142 | $170 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $113 | $154 | $193 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $109 | $148 | $187 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $118 | $179 | $217 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $142 | $204 | $235 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $91 | $108 | $141 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $85 | $107 | $150 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $88 | $126 | $150 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $114 | $141 | $164 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $98 | $120 | $168 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $98 | $150 | $180 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $113 | $141 | $194 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $32 | $36 | $44 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $192 | $192 | $192 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $235 | $278 | $363 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $195 | $265 | $364 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $180 | $225 | $240 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $130 | $194 | $240 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $103 | $152 | $187 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $266 | $266 | $266 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $110 | $203 | $296 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $56 | $103 | $149 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $378 | $378 | $378 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $139 | $158 | $195 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $246 | $246 | $246 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $102 | $102 | $102 |
| Spirometry CPT 94010 • Pulmonology | $7 | $31 | $44 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $14 | $40 | $55 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $31 | $31 | $31 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $36 | $38 | $42 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $97 | $97 | $97 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $7 | $19 | $44 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $17 | $17 | $18 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $11 | $34 | $46 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $14 | $29 | $37 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $46 | $48 | $51 |