About Dr. Layton - Fee Schedule

1. ALLERGY TESTING/SUBLINGUAL IMMUNOTHERAPY
You determine what your costs per day of allergy testing will be since you have complete control over the number of tests you wish completed on any given testing day. We work on a payment for services rendered basis. So, if you have a limit set, please let us know.

The fee is $8.00 for each test dose received. Once testing has been completed, you will receive a one month supply of treatment containing 30 doses at a total cost of $75.00. You are required to pay for services rendered at the end of each visit.

2. LDA
Treatment of allergies and certain autoimmune medical problems can be accomplished with Low Dose Allergen (LDA. The cost for LDA injection therapy is $150.00 (see LDA section for more details).

Cash, personal checks, American Express, Discover, Master Card and Visa are all accepted. We will then give you two copies of the bill to take home. You should submit the white copy to your insurance carrier for reimbursement and keep the statement for your personal records.

Low Dose Allergen Therapy (LDA) – see LDA section for more details.

CPT CODE AND FEE SCHEDULE

PROVIDER #S913

TIN #52-1520050

Richard E. Layton, M.D.
901 Dulaney Valley Road
Dulaney Center II, Suite 101
Towson, Maryland 21204
tel. 410-337-2707 fax. 410-337-2841
email: info@allergyconnection.com
www.allergyconnection.com

The following is a list of Current Procedural Terminology (CPT) and the corresponding fees. We recommend that you consult with your health insurance company regarding coverage before visiting our office.

$400.00/per hour

CPT CODE OFFICE VISITS NEW PT

99205 NPVISIT 3/3 CH CE MDH

$600.00-800.00

CPT CODE OFFICE VISITS ESTABLISHED PT

99211 EPVISIT 2/3 MINIMAL

$100.00

99212 EPVISIT 2/3 LMTD

$200.00

99213 EPVISIT 2/3 MDRT

$300.00

99214 EPVISIT 2/3 MOD/HIGH

$400.00

99215 EPVISIT 2/3 HIGH

$600.00

CPT CODE TELEPHONE CONSULTATIONS

99371 CONSULT PHONE MINIMAL
(up to 15 minutes)

$400.00 per hour prorated

99372 CONSULT PHONE MODERATE
(15-30 minutes)

$400.00 per hour prorated

99373 CONSULT PHONE LENGTHY
(30-45 minutes)

$400.00 per hour prorated

CPT CODE ALLERGY & CLINICAL IMMUNOLOGY

95024 INTRADERMAL ALLERGY TEST

$8.00

95078 PROVOCATIVE TESTING

$8.00

95165 IMMUNOTHERAPY MULTI DOSE VIALS

(2.50/DOSE) (30 day supply)

$75.00

CPT CODE LAB TESTS IN OFFICE

36415 VENIPUNCTURE SPECIMEN(S)

$10.00

87060 THROAT CULTURE

$15.00

81000 URINALYSIS

$10.00

CPT CODE INJECTIONS

J3420 INJ VITAMIN B-12

$15.00

MISCELLANEOUS

EMLA CREAM (APPLICATION)

$5.00

INDEPENDENT LAB TESTS

Fractionated Urinary Porphyrins

$120.00

Metals - blood (11 tests, 1 calculation)

$125.00

Hair Analysis

$46.00

Organic Acid Microbiology

$145.00

Trace Minerals

$197.00

Comprehensive Stool Analysis

$275.00

Fecal metals

$99.00

IgG Immunolab Food Testing

$175.00

Metabolic Nutritional Analysis

$169.00 (except for 5 insurance companies)

(make check payable to Richard E. Layton, P.A.)