PAC

DESCRIPTION

3

Pay the lesser of OMAP's Level 3 rate times the quanity or billed amount

4

Pay at 51% of the billed amount

5

Manually priced by OMAP; supporting documentation required

6

Documentation required; pay the lesser of OMAP's Level 3 rate or the billed amount

9

Service not covered in fee-for-service arena or is an invalid code. Verify code. Check to see if managed care is capitated for this service

A

Pay as billed (invoice unit rate times quantity billed on invoice equals the billed amount)

D

Invalid procedure code for the type of service billed

N

Procedure code is obsolete for the date of service

P

Service is not covered

T

Procedure code billed is a temporary code or a code used for tracking medical services; not covered