Hospital/Clinic Information
Local Zip Code
Specific MAC Locality
Annual Patients
Average Monthly Patients
Location Payer Mix
Private Insurance*
%
Medicaid
%
Medicare
%
Uninsured / No-Pay
%
Total
%
Additional Information
Is TTE or Other Imaging Procedure Performed on the Same Day?
Yes
No
Monthly Lease Payment
$
Exam Types
Select All That Apply
(At Least One Exam Must Be Selected)
TCD Complete Study - 93886
TCD Vasoreactivity Study - 93896
TCD Emboli Monitoring Study - 93897
TCD Bubble Study - 93898
TCD Limited Study - 93888
TCD Emboli Monitoring Study - 93892
TCD Bubble Study - 93893
Estimated Financials
Average Scan Revenue
Monthly Revenue
Scans Required to Break Even
Monthly Profit
*private pay ratio set at 1.4x of Medicare rate