Nebraska
Nebraska*
| wdt_ID | wdt_created_by | wdt_created_at | wdt_last_edited_by | wdt_last_edited_at | CPT Code | Description | Allowable Amount | Effective Date | Additional Information |
|---|---|---|---|---|---|---|---|---|---|
| 22 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99202 | Office or other outpatient visit, new patient | 52.63 | 2024-01-01 | Non-Facility Rate |
| 23 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99202 | Office or other outpatient visit, new patient | 37.73 | 2024-01-01 | Facility Rate |
| 24 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99203 | Office or other outpatient visit, new patient | 77.56 | 2024-01-01 | Non-Facility Rate |
| 25 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99203 | Office or other outpatient visit, new patient | 57.85 | 2024-01-01 | Facility Rate |
| 26 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99203 | Office or other outpatient visit, new patient | 57.84 | 2024-01-01 | Non-Facility Rate; Restricted to certified IBCLC physician providers |
| 27 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99204 | Office or other outpatient visit, new patient | 110.80 | 2024-01-01 | Non-Facility Rate |
| 28 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99204 | Office or other outpatient visit, new patient | 94.32 | 2024-01-01 | Facility Rate |
| 29 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99204 | Office or other outpatient visit, new patient | 94.32 | 2024-01-01 | Non-Facility Rate; Restricted to certified IBCLC physician providers |
| 30 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99205 | Office or other outpatient visit, new patient | 144.04 | 2024-01-01 | |
| 31 | alex | 09/20/2024 01:26 PM | alex | 09/20/2024 01:26 PM | 99205 | Office or other outpatient visit, new patient | 122.24 | 2024-01-01 | Facility Rates |
| CPT Code | Description | Allowable Amount | Effective Date | Additional Information |
*Physician type not specified
**$0.00 amounts indicate unavailable fee information.