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1 - EYE EXAMINATIONS, TREATMENT, OR SURGERY, such as -
eye examinations | eye treatments | surgery |
2 - PURCHASE OF EYE GLASSES OR CONTACT LENSES, such as -
contact lenses | insurance | ||
eye glasses | kits and equipment | ||
fittings | warranty expenses |
3 - DENTAL CARE, such as -
bridges | examinations | root canals | |||
caps or crowns | fillings | X-rays | |||
cleanings | orthodontic work | dentures | |||
any other dental services |
4 - HOSPITAL ROOM, such as -
meals | room |
5 - HOSPITAL SERVICES, including all services provided and billed by the hospital, such as —
anesthetics | injections | operating room | |||
blood transfusions | intensive care unit | oxygen | |||
drugs and medicine | laboratory tests | recovery room | |||
examinations | nursing services | therapy | |||
treatment rooms | X-rays | any other services |
6 - ALL SERVICES BY MEDICAL PROFESSIONALS OTHER THAN PHYSICIANS, such as -
acupuncturist | midwife | podiatrist | |||
chiropractor | naturopath | psychologist | |||
homeopath | nurse practitioners | substance abuse professionals | |||
marriage counselor | physical therapist |
7 - ALL SERVICES PROVIDED AND BILLED BY PHYSICIANS, such as -
dermatologist | pediatrician | general practitioner | |||
psychiatrist | gynecologist | surgeon plastic surgeon | |||
internist | urologist | osteopath | |||
any other type of physicians |
8 - LAB TESTS OR X-RAYS
blood tests | X-rays | other type of lab tests |
Do not include services received in a hospital as an inpatient or services for eye and dental care
9 - CARE IN CONVALESCENT OR NURSING HOME, such as -
nursing home | substance abuse centers |
Include all services provided and billed by a convalescent or nursing home.
10 - OTHER MEDICAL CARE, such as -
ambulance services | outpatient hospital care | blood donation | |||
rescue services | emergency room services |
If medical care is given in outpatient department or emergency room, include -
allergy shots | cancer treatment | injections | |||
baby shots | cardiogram | physicians check up | |||
blood pressure check | cardiology test | skin treatment | |||
broken/sprained bones | hearing test |
11 - PURCHASE OF HEARING AIDS
12 - PRESCRIBED MEDICINES OR PRESCRIBED DRUGS
13 - RENTAL OF SUPPORTIVE OR CONVALESCENT MEDICAL EQUIPMENT, such as -
Ace bandages | crutches | walkers | |||
braces | slings | wheelchairs | |||
canes | splints | whirlpools | |||
cervical collars |
14 - PURCHASE OF SUPPORTIVE OR CONVALESCENT MEDICAL EQUIPMENT, such as -
Ace bandages | crutches | walkers | |||
braces | slings | wheelchairs | |||
canes | splints | whirlpools | |||
cervical collars |
15 - RENTAL OF MEDICAL OR SURGICAL EQUIPMENT FOR GENERAL USE, such as -
blood pressure kits | ice bags | therapeutic heat lamps | |||
heating pads | sinus masks | vaporizers | |||
hot water bottles | sun lamps |
16 - PURCHASE OF MEDICAL OR SURGICAL EQUIPMENT FOR GENERAL USE, such as -
blood pressure kits | ice bags | therapeutic heat lamps | |||
heating pads | sinus masks | vaporizers | |||
hot water bottles | sun lamps | ||||
pollen masks | thermometers | insulin needles | |||
syringes | oxygen | ostomy supplies | |||
orthopedic appliances (supports) |
Do not include purchases of items such as Band-Aid bandages, gauze, cotton roll, and cotton balls.
Go back to Section 15, Part A »
Go back to Section 15, Part B »
Last Modified Date: January 5, 2005