Fee Schedule Lookup	Printer Friendly Page

Fee Schedule Search * Indicates Required Field *Corporate Tax ID Owner:   Select a Corporate Tax ID Owner PHYSICIAN SALLY *Physician/Provider Tax ID:   Select a Tax ID 721356674   *Physician/Provider Name:   Select a Physician/Provider Name PHYSICIAN, SALLY MD *Provider Zip Code:   *Are you the PCP/Acting PCP for this service? Yes No *Is service related to Mental Health? Yes No Member Information look-up   (Please select to locate the member to populate the fields below) *Member Zip Code:   *Date of Birth: (mm/dd/yyyy)   *Gender: Female Male *Product:   Select a Product Choice EPO Choice Plus Medicaid Open Access Options PPO   *Place of Service:   Select a Place of Service Assisted Living Facility Community Mental Health Center Inpatient Hospital *Date to Check: (mm/dd/yyyy)   Diagnosis Code:   (If a diagnosis modifier is applicable, it should be supplied) *Enter CPT (Common Procedural Terminology) or HCPC (HCFA Common Procedural Code) NOTE: The Fee Schedule shown is not a guarantee of benefits, payments or clinical coverage determination. Actual payment for services and the amount(s) to be paid are determined by your participation agreement with us and the enrollee's benefit plan at the time services are provided. Fee Schedule Look-Up is not available for non-participating providers. If you believe that your fee schedule is incorrect or have any other questions regarding your contracted rate, please contact your Network Provider Representative.

Related Links 2007/2008 UnitedHealthcare Administrative Guide  Fee Schedule Lookup Quick Reference Card  Network Contacts Reimbursement Policies