2013 Council Medical Codes
| Code | Coverage | Employee Amount |
Employer Amount |
Total Amount |
| RBS | ||||
| XA | E | 61.90 | 557.15 | 619.05 |
| XB | E,S | 687.13 | 557.15 | 1244.28 |
| XE | E,C | 365.23 | 557.15 | 922.38 |
| XC | E,S,C | 990.46 | 557.15 | 1547.61 |
| XD | E,S,C,C | 1244.27 | 557.15 | 1801.42 |
| GH | ||||
| XF | E | 51.97 | 467.72 | 519.69 |
| XG | E,S,C | 129.28 | 1163.49 | 1292.77 |
| WDS | ||||
| XI | E | 5.19 | 46.68 | 51.87 |
| XJ | E+1 | 9.88 | 88.89 | 98.77 |
| XK | E+2 | 17.04 | 153.32 | 170.36 |
| VSP | ||||
| XV | 2.08 | 18.67 | 20.75 | |
| EAP | 2.16 | 2.16 |