means of external attachment Auditory osseointegrated L8693 device, abutment, any length, replacement Auditory only osseointegrated device, L8694 transducer/actuator, * replacement only, each Dispensing fee, V5160 $175.00 binaural V5170 Cros, in the ear Cros, BTE V5180 (behind the ear) Bicros, ITE (in V5210 the ear) Bicros, BTE V5220 (behind the ear) Dispensing fee, V5200 $106.00 cros Dispensing fee, V5240 $106.00 bicros Digital, V5254 monaural, CIC Digital, V5255 monaural, ITC Digital, V5256 monaural, ITE Digital, V5257 monaural, BTE Digital, binaural, V5258 CIC Digital, binaural, V5259 ITC Digital, binaural, V5260 ITE Digital, binaural, V5261 BTE Dispensing fee, V5241 $106.00 monaural
means of external attachment L8693 Auditory osseointegrated device, abutment, any length, replacement only L8694 Auditory osseointegrated device, transducer/actuator, replacement only, each V5160 Dispensing fee, binaural $175.00 V5170 Cros, in the ear V5180 Cros, BTE (behind the ear) V5210 Bicros, ITE (in the ear) V5220 Bicros, BTE (behind the ear) V5200 Dispensing fee, cros $106.00 V5240 Dispensing fee, bicros $106.00 V5254 Digital, monaural, CIC V5255 Digital, monaural, ITC V5256 Digital, monaural, ITE V5257 Digital, monaural, BTE V5258 Digital, binaural, CIC V5259 Digital, binaural, ITC V5260 Digital, binaural, ITE V5261 Digital, binaural, BTE V5241 Dispensing fee, monaural $106.00 *
Audiology,%20Physical%20Therapy,%20and%20EPSDT%20Provider%20Manual%206%2021%2018.docx