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151 Capitol Street
Augusta, Maine |
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| Telephone: |
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(207) 287-6722 |
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| Fax:
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(207) 287-6732 |
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| Mailing Address |
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| 102 SHS |
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| Augusta, Maine |
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04333-0102 |
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Unrestricted Hospital Ambulatory Services and Non-hospital Ambulatory Services
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FACILITY
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SEX
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DATE OF SERVICE
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PRINCIPAL ICD9 DIAGNOSIS CODE
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SECONDARY ICD9 DIAGNOSIS CODE
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SECONDARY ICD9 DIAGNOSIS CODE
ICD9 Procedure codes reported by hospitals
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PRINCIPAL ICD9 DIAGNOSIS CODE
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SECONDARY ICD9 DIAGNOSIS CODE
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SECONDARY ICD9 DIAGNOSIS CODE
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DISPOSITION
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PAY SOURCE
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TOTAL CHARGES
CPT4 codes reported by surgical centers and physicians offices. All
providers are urged to report in CPT4 code.
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PRINCIPAL CPT PROCEDURE
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SECONDARY CPT PROCEDURE
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SECONDARY CPT PROCEDURE
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AGE
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COUNTY
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SERVICE AREA
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